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; 144D.03, 1.30subdivision 1; 144E.101, subdivision 6; 144E.127; 144E.35, subdivision 1; 1.31145A.17; 145C.05; 145C.07, by adding a subdivision; 148.235, by adding a 1.32subdivision; 148.6445, subdivisions 1, 2; 148B.53, subdivision 3; 149A.52, 1.33subdivision 3; 149A.97, subdivision 7; 151.37, subdivision 2; 152.11, by adding 1.34a subdivision; 153A.17; 156.001, by adding a subdivision; 156.02, subdivisions 1.351, 2; 156.04; 156.072, subdivision 2; 156.073; 156.12, subdivisions 2, 4, 6; 1.36156.15, subdivision 2; 156.16, subdivisions 3, 10; 156.18, subdivisions 1, 2; 1.37156.19; 157.16, subdivision 1; 179A.03, subdivision 7; 198.075; 245.462, 1.38subdivision 20; 245.465, by adding a subdivision; 245.4874; 245.50, subdivision 1.395; 245.98, subdivisions 2, 5; 245A.035; 245A.10, subdivision 2; 245A.16, 2.1subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04, subdivision 1; 2.2245C.05, subdivisions 1, 4, 5, 7, by adding a subdivision; 245C.08, subdivisions 2.31, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12; 2.4245C.16, subdivision 1; 245C.17, by adding a subdivision; 245C.21, by 2.5adding a subdivision; 245C.23, subdivision 2; 245C.24, subdivision 2; 246.54, 2.6subdivision 1; 252.27, subdivision 2a; 252.32, subdivision 3; 252.46, by adding 2.7a subdivision; 253B.185, subdivision 2; 254A.03, subdivision 3; 254A.16, 2.8subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06, 2.9subdivision 3; 256.01, subdivisions 2, 2b, 4, 18, by adding subdivisions; 2.10256.015, subdivision 7; 256.017, subdivisions 1, 9; 256.0471, subdivision 1; 2.11256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions 3a, 9, by adding 2.12a subdivision; 256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3, 2.134, 6; 256.9744, subdivision 1; 256.975, subdivision 7; 256.984, subdivision 1; 2.14256B.04, subdivision 14, by adding a subdivision; 256B.056, subdivisions 1a, 3, 2.155c, by adding a subdivision; 256B.057, subdivision 8; 256B.0621, subdivision 2.1611; 256B.0625, subdivisions 3f, 13c, 13d, 14, 17, 18a, 20, 23, 47, by adding 2.17subdivisions; 256B.0644; 256B.0911, subdivisions 3a, 3b, 4b, 4c, 6, 7, by 2.18adding subdivisions; 256B.0913, subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13, 14; 2.19256B.0915; 256B.0917, subdivision 8; 256B.0919, subdivision 3; 256B.0943, 2.20subdivisions 6, 9, 11, 12; 256B.0945, subdivision 4; 256B.095; 256B.0951, 2.21subdivision 1; 256B.199; 256B.431, subdivisions 1, 2e, 3f, 17e; 256B.434, 2.22subdivision 4, by adding subdivisions; 256B.437, by adding a subdivision; 2.23256B.438, subdivision 3; 256B.439, subdivision 1; 256B.441, subdivisions 1, 2, 2.245, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 256B.49, 2.25subdivision 11, by adding a subdivision; 256B.5012, by adding a subdivision; 2.26256B.69, subdivisions 5g, 5h, 23, 28; 256B.75; 256B.76; 256B.763; 256D.03, 2.27subdivision 4; 256D.44, subdivisions 2, 5; 256E.35, subdivision 2; 256I.04, 2.28subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding a subdivision; 2.29256J.02, subdivisions 1, 4; 256J.021; 256J.08, subdivision 65; 256J.21, 2.30subdivision 2; 256J.24, subdivision 10; 256J.42, subdivision 1; 256J.425, 2.31subdivisions 3, 4; 256J.46, by adding a subdivision; 256J.49, subdivision 13; 2.32256J.521, subdivisions 1, 2, by adding a subdivision; 256J.53, subdivision 2.332; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4, 5, 6; 256J.751, 2.34subdivisions 2, 5; 256J.95, subdivisions 3, 13; 256K.45, by adding a subdivision; 2.35256L.01, subdivision 4; 256L.03, subdivisions 1, 5; 256L.035; 256L.04, 2.36subdivisions 1, 12; 256L.11, subdivision 7; 256L.12, subdivision 9a; 259.20, 2.37subdivision 2; 259.24, subdivision 3; 259.29, subdivision 1; 259.41; 259.53, 2.38subdivisions 1, 2; 259.57, subdivisions 1, 2; 259.67, subdivisions 4, 7; 259.75, 2.39subdivision 8; 260.012; 260.755, subdivisions 12, 20; 260.761, subdivision 7; 2.40260.765, subdivision 5; 260.771, subdivisions 1, 2; 260B.157, subdivision 1; 2.41260C.152, subdivision 5; 260C.163, subdivision 1; 260C.201, subdivision 11; 2.42260C.209; 260C.212, subdivisions 1, 2, 4, 9; 260C.317, subdivision 3; 260C.331, 2.43subdivision 1; 270B.14, subdivision 1; 609.115, subdivision 9; 626.556, 2.44subdivisions 2, 3, 10, 10a, 10c, 10f, by adding subdivisions; Laws 2000, chapter 2.45340, section 19; Laws 2005, chapter 98, article 3, section 25; Laws 2005, First 2.46Special Session chapter 4, article 9, section 3, subdivision 2; Laws 2006, chapter 2.47282, article 20, section 37; proposing coding for new law in Minnesota Statutes, 2.48chapters 16A; 62A; 62J; 62Q; 144; 145; 148; 149A; 152; 156; 245A; 245C; 2.49254A; 256B; 256C; 256D; 256F; 256J; 260; 325E; proposing coding for new 2.50law as Minnesota Statutes, chapters 256N; 525A; repealing Minnesota Statutes 2.512006, sections 62J.052, subdivision 1; 62J.17, subdivisions 1, 5a, 6a, 8; 119B.08, 2.52subdivision 4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 2.53252.275, subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16; 254A.085; 2.54254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 2.55254A.18; 256.969, subdivision 27; 256.9743; 256B.0913, subdivisions 5b, 5c, 2.565d, 5e, 5f, 5g, 5h; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.29; 2.57256J.37, subdivisions 3a, 3b; 256J.561, subdivision 1; 256J.62, subdivision 9; 2.58256J.626, subdivisions 7, 9; 256J.65; 525.921; 525.9211; 525.9212; 525.9213; 3.1525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 3.2525.9222; 525.9223; 525.9224; Laws 1997, chapter 8, section 1; Laws 2004, 3.3chapter 288, article 6, section 27; Minnesota Rules, parts 4610.2800; 9503.0035, 3.4subpart 2; 9560.0102, subpart 2, item C; 9585.0030.3.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:3.6ARTICLE 13.7CHILDREN AND FAMILY3.8    Section 1. Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:3.9    Subd. 2. General. (a) Unless the data is summary data or a statute specifically 3.10provides a different classification, data on individuals collected, maintained, used, or 3.11disseminated by the welfare system is private data on individuals, and shall not be 3.12disclosed except:3.13    (1) according to section 
         13.05;3.14    (2) according to court order;3.15    (3) according to a statute specifically authorizing access to the private data;3.16    (4) to an agent of the welfare system, including a law enforcement person, attorney, 3.17or investigator acting for it in the investigation or prosecution of a criminal or civil 3.18proceeding relating to the administration of a program;3.19    (5) to personnel of the welfare system who require the data to verify an individual's 3.20identity; determine eligibility, amount of assistance, and the need to provide services to 3.21an individual or family across programs; evaluate the effectiveness of programs; and 3.22investigate suspected fraud;3.23    (6) to administer federal funds or programs;3.24    (7) between personnel of the welfare system working in the same program;3.25    (8) to the Department of Revenue to administer and evaluate tax refund or tax credit 3.26programs and to identify individuals who may benefit from these programs. The following 3.27information may be disclosed under this paragraph: an individual's and their dependent's 3.28names, dates of birth, Social Security numbers, income, addresses, and other data as 3.29required, upon request by the Department of Revenue. Disclosures by the commissioner 3.30of revenue to the commissioner of human services for the purposes described in this clause 3.31are governed by section 
         270B.14, subdivision 1. Tax refund or tax credit programs include, 3.32but are not limited to, the dependent care credit under section 
         290.067, the Minnesota 3.33working family credit under section 
         290.0671, the property tax refund and rental credit 3.34under section 
         290A.04, and the Minnesota education credit under section 
         290.0674;3.35    (9) between the Department of Human Services, the Department of Education, and 3.36the Department of Employment and Economic Development for the purpose of monitoring 4.1the eligibility of the data subject for unemployment benefits, for any employment or 4.2training program administered, supervised, or certified by that agency, for the purpose of 4.3administering any rehabilitation program or child care assistance program, whether alone 4.4or in conjunction with the welfare system, or to monitor and evaluate the Minnesota 4.5family investment program or the child care assistance program by exchanging data on 4.6recipients and former recipients of food support, cash assistance under chapter 256, 256D, 4.7256J, or 256K, child care assistance under chapter 119B, or medical programs under 4.8chapter 256B, 256D, or 256L;4.9    (10) to appropriate parties in connection with an emergency if knowledge of 4.10the information is necessary to protect the health or safety of the individual or other 4.11individuals or persons;4.12    (11) data maintained by residential programs as defined in section 
         245A.02 may 4.13be disclosed to the protection and advocacy system established in this state according 4.14to Part C of Public Law 98-527 to protect the legal and human rights of persons with 4.15developmental disabilities or other related conditions who live in residential facilities for 4.16these persons if the protection and advocacy system receives a complaint by or on behalf 4.17of that person and the person does not have a legal guardian or the state or a designee of 4.18the state is the legal guardian of the person;4.19    (12) to the county medical examiner or the county coroner for identifying or locating 4.20relatives or friends of a deceased person;4.21    (13) data on a child support obligor who makes payments to the public agency 4.22may be disclosed to the Minnesota Office of Higher Education to the extent necessary to 4.23determine eligibility under section 
         136A.121, subdivision 2, clause (5);4.24    (14) participant Social Security numbers and names collected by the telephone 4.25assistance program may be disclosed to the Department of Revenue to conduct an 4.26electronic data match with the property tax refund database to determine eligibility under 4.27section 
         237.70, subdivision 4a;4.28    (15) the current address of a Minnesota family investment program participant 4.29may be disclosed to law enforcement officers who provide the name of the participant 4.30and notify the agency that:4.31    (i) the participant:4.32    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 4.33conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 4.34jurisdiction from which the individual is fleeing; or4.35    (B) is violating a condition of probation or parole imposed under state or federal law;5.1    (ii) the location or apprehension of the felon is within the law enforcement officer's 5.2official duties; and5.3    (iii) the request is made in writing and in the proper exercise of those duties;5.4    (16) the current address of a recipient of general assistance or general assistance 5.5medical care may be disclosed to probation officers and corrections agents who are 5.6supervising the recipient and to law enforcement officers who are investigating the 5.7recipient in connection with a felony level offense;5.8    (17) information obtained from food support applicant or recipient households may 5.9be disclosed to local, state, or federal law enforcement officials, upon their written request, 5.10for the purpose of investigating an alleged violation of the Food Stamp Act, according 5.11to Code of Federal Regulations, title 7, section 272.1(c);5.12    (18) the address, Social Security number, and, if available, photograph of any 5.13member of a household receiving food support shall be made available, on request, to a 5.14local, state, or federal law enforcement officer if the officer furnishes the agency with the 5.15name of the member and notifies the agency that:5.16    (i) the member:5.17    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 5.18crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;5.19    (B) is violating a condition of probation or parole imposed under state or federal 5.20law; or5.21    (C) has information that is necessary for the officer to conduct an official duty related 5.22to conduct described in subitem (A) or (B);5.23    (ii) locating or apprehending the member is within the officer's official duties; and5.24    (iii) the request is made in writing and in the proper exercise of the officer's official 5.25duty;5.26    (19) the current address of a recipient of Minnesota family investment program, 5.27general assistance, general assistance medical care, or food support may be disclosed to 5.28law enforcement officers who, in writing, provide the name of the recipient and notify the 5.29agency that the recipient is a person required to register under section 
         243.166, but is not 5.30residing at the address at which the recipient is registered under section 
         243.166;5.31    (20) certain information regarding child support obligors who are in arrears may be 5.32made public according to section 
         518A.74;5.33    (21) data on child support payments made by a child support obligor and data on 5.34the distribution of those payments excluding identifying information on obligees may be 5.35disclosed to all obligees to whom the obligor owes support, and data on the enforcement 6.1actions undertaken by the public authority, the status of those actions, and data on the 6.2income of the obligor or obligee may be disclosed to the other party;6.3    (22) data in the work reporting system may be disclosed under section 
         256.998, 6.4subdivision 7
         ;6.5    (23) to the Department of Education for the purpose of matching Department of 6.6Education student data with public assistance data to determine students eligible for free 6.7and reduced price meals, meal supplements, and free milk according to United States 6.8Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and 6.9state funds that are distributed based on income of the student's family; and to verify 6.10receipt of energy assistance for the telephone assistance plan;6.11    (24) the current address and telephone number of program recipients and emergency 6.12contacts may be released to the commissioner of health or a local board of health as 6.13defined in section 
         145A.02, subdivision 2, when the commissioner or local board of health 6.14has reason to believe that a program recipient is a disease case, carrier, suspect case, or at 6.15risk of illness, and the data are necessary to locate the person;6.16    (25) to other state agencies, statewide systems, and political subdivisions of this 6.17state, including the attorney general, and agencies of other states, interstate information 6.18networks, federal agencies, and other entities as required by federal regulation or law for 6.19the administration of the child support enforcement program;6.20    (26) to personnel of public assistance programs as defined in section 
         256.741, for 6.21access to the child support system database for the purpose of administration, including 6.22monitoring and evaluation of those public assistance programs;6.23    (27) to monitor and evaluate the Minnesota family investment program by 6.24exchanging data between the Departments of Human Services and Education, on 6.25recipients and former recipients of food support, cash assistance under chapter 256, 256D, 6.26256J, or 256K, child care assistance under chapter 119B, or medical programs under 6.27chapter 256B, 256D, or 256L;6.28    (28) to evaluate child support program performance and to identify and prevent 6.29fraud in the child support program by exchanging data between the Department of Human 6.30Services, Department of Revenue under section 
         270B.14, subdivision 1, paragraphs (a) 6.31and (b), without regard to the limitation of use in paragraph (c), Department of Health, 6.32Department of Employment and Economic Development, and other state agencies as is 6.33reasonably necessary to perform these functions; or6.34    (29) counties operating child care assistance programs under chapter 119B may 6.35disseminate data on program participants, applicants, and providers to the commissioner 6.36of 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. 12.Sliding fee.Child care services to families must be made available on 9.25a sliding fee basis.9.26    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, by July 1, 2008. The commissioner shall report to the 2008 9.29legislature with the necessary statutory changes to codify this conversion to state median 9.30income. 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 12. 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 (d).50.32    (a) "Case management" means the services provided by or through the county 50.33agency or through the employment services agency to participating families, including 50.34assessment, information, referrals, and assistance in the preparation and implementation 50.35of a family stabilization plan under subdivision 5.51.1    (b) "Family stabilization plan" means a plan developed by a case manager and 51.2the participant, which identifies the participant's most appropriate path to unsubsidized 51.3employment, family stability, and barrier reduction, taking into account the family's 51.4circumstances.51.5    (c) "Family stabilization services" means programs, activities, and services in this 51.6section that provide participants and their family members with assistance regarding, 51.7but not limited to:51.8    (1) obtaining and retaining unsubsidized employment;51.9    (2) family stability;51.10    (3) economic stability; and51.11    (4) barrier reduction.51.12    The goal of the services is to achieve the greatest degree of economic self-sufficiency 51.13and family well-being possible for the family under the circumstances.51.14    (d) "Case manager" means the county-designated staff person or employment 51.15services counselor.51.16    Subd. 3.Eligibility.(a) The following MFIP or diversionary work program (DWP) 51.17participants are eligible for the services under this section:51.18    (1) a participant identified under section 256J.561, subdivision 2, paragraph (d), who 51.19has or is eligible for an employment plan developed under section 256J.521, subdivision 51.202, paragraph (c);51.21    (2) a participant identified under section 256J.95, subdivision 12, paragraph (b), as 51.22unlikely to benefit from the DWP;51.23    (3) a participant who meets the requirements for or has been granted a hardship 51.24extension under section 256J.425, subdivision 2 or 3;51.25    (4) a participant who is applying for supplemental security income or Social Security 51.26disability insurance; 51.27    (5) a participant who is a noncitizen who has been in the United States for 12 or 51.28fewer months; and51.29    (6) a new MFIP participant, for the first 30 days the participant receives assistance or 51.30when the participant's employment plan is completed, whichever is sooner.51.31    (b) Families must meet all other eligibility requirements for MFIP established in 51.32this chapter. Families are eligible for financial assistance to the same extent as if they 51.33were participating in MFIP.51.34    (c) A participant under paragraph (a), clause (5), must be provided with English as a 51.35second language opportunities and skills training for up to 12 months. After 12 months, 51.36the case manager and participant must determine whether the participant should continue 52.1with English as a second language classes or skills training, or both, or if the participant 52.2should become an MFIP participant.52.3    Subd. 4.Universal participation.All caregivers must participate in family 52.4stabilization services as defined in subdivision 2.52.5    Subd. 5.Case management; family stabilization plans; coordinated services.(a) 52.6The county agency shall provide family stabilization services to families through a case 52.7management model. A case manager shall be assigned to each participating family within 52.830 days after the family begins to receive financial assistance as a participant of the family 52.9stabilization services. The case manager, with the full involvement of the participant, shall 52.10recommend, and the county agency shall establish and modify as necessary, a family 52.11stabilization plan for each participating family. If a participant is already assigned to a 52.12county case manager or a county-designated case manager in social services, disability 52.13services, or housing services that case manager already assigned may be the case manager 52.14for purposes of these services.52.15    (b) The family stabilization plan must include:52.16    (1) each participant's plan for long-term self-sufficiency, including an employment 52.17goal where applicable;52.18    (2) an assessment of each participant's strengths and barriers, and any special 52.19circumstances of the participant's family that impact, or are likely to impact, the 52.20participant's progress towards the goals in the plan; and52.21    (3) an identification of the services, supports, education, training, and 52.22accommodations needed to reduce or overcome any barriers to enable the family to 52.23achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.52.24    (c) The case manager and the participant shall meet within 30 days of the family's 52.25referral to the case manager. The initial family stabilization plan must be completed within 52.2630 days of the first meeting with the case manager. The case manager shall establish a 52.27schedule for periodic review of the family stabilization plan that includes personal contact 52.28with the participant at least once per month. In addition, the case manager shall review 52.29and, if necessary, modify the plan under the following circumstances:52.30    (1) there is a lack of satisfactory progress in achieving the goals of the plan;52.31    (2) the participant has lost unsubsidized or subsidized employment;52.32    (3) a family member has failed or is unable to comply with a family stabilization 52.33plan requirement;52.34    (4) services, supports, or other activities required by the plan are unavailable;52.35    (5) changes to the plan are needed to promote the well-being of the children; or53.1    (6) the participant and case manager determine that the plan is no longer appropriate 53.2for any other reason.53.3    Subd. 6.Cooperation with services requirements.(a) To be eligible, a participant 53.4shall comply with paragraphs (b) to (e).53.5    (b) Participants shall engage in family stabilization plan services for the appropriate 53.6number of hours per week that the activities are scheduled and available, unless good 53.7cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate 53.8number of hours must be based on the participant's plan.53.9    (c) The case manager shall review the participant's progress toward the goals in the 53.10family stabilization plan every six months to determine whether conditions have changed, 53.11including whether revisions to the plan are needed.53.12    (d) When the participant has increased participation in work-related activities 53.13sufficient to meet the federal participation requirements of TANF, the county agency shall 53.14refer the participant to the MFIP program and assign the participant to a job counselor. 53.15The participant and the job counselor shall meet within 15 days of referral to the MFIP 53.16program to develop an employment plan under section 256J.521. No reapplication is 53.17necessary and financial assistance continues without interruption.53.18    (e) A participant's requirement to comply with any or all family stabilization plan 53.19requirements under this subdivision is excused when the case management services, 53.20training and educational services, and family support services identified in the participant's 53.21family stabilization plan are unavailable for reasons beyond the control of the participant, 53.22including when money appropriated is not sufficient to provide the services.53.23    Subd. 7.Sanctions.(a) The financial assistance grant of a participating family is 53.24reduced according to section 256J.46, if a participating adult fails without good cause to 53.25comply or continue to comply with the family stabilization plan requirements in this 53.26subdivision, unless compliance has been excused under subdivision 6, paragraph (e).53.27    (b) Given the purpose of the family stabilization services in this section and the 53.28nature of the underlying family circumstances that act as barriers to both employment and 53.29full compliance with program requirements, sanctions are appropriate only when it is clear 53.30that there is both the ability to comply and willful noncompliance by the participant, as 53.31confirmed by a behavioral health or medical professional.53.32    (c) Prior to the imposition of a sanction, the county agency shall review the 53.33participant's case to determine if the family stabilization plan is still appropriate and 53.34meet with the participant face-to-face. The participant may bring an advocate to the 53.35face-to-face meeting. 53.36    During the face-to-face meeting, the county agency must:54.1    (1) determine whether the continued noncompliance can be explained and mitigated 54.2by providing a needed family stabilization service, as defined in subdivision 2, paragraph 54.3(d);54.4    (2) determine whether the participant qualifies for a good cause exemption under 54.5section 256J.57, or if the sanction is for noncooperation with child support requirements, 54.6determine if the participant qualifies for a good cause exemption under section 256.741, 54.7subdivision 10;54.8    (3) determine whether activities in the family stabilization plan are appropriate 54.9based on the family's circumstances;54.10    (4) explain the consequences of continuing noncompliance;54.11    (5) identify other resources that may be available to the participant to meet the 54.12needs of the family; and54.13    (6) inform the participant of the right to appeal under section 256J.40.54.14    If the lack of an identified activity or service can explain the noncompliance, the 54.15county shall work with the participant to provide the identified activity.54.16    (d) If the participant fails to come to the face-to-face meeting, the case manager or a 54.17designee shall attempt at least one home visit. If a face-to-face meeting is not conducted, 54.18the county agency shall send the participant a written notice that includes the information 54.19under paragraph (c).54.20    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition 54.21of a sanction, the county agency shall provide a notice of intent to sanction under section 54.22256J.57, subdivision 2, and, when applicable, a notice of adverse action under section 54.23256J.31.54.24    (f) Section 256J.57 applies to this section except to the extent that it is modified 54.25by this subdivision.54.26    Subd. 8.Funding.(a) The commissioner of human services must treat MFIP 54.27expenditures made to or on behalf of any minor child under this section, who is part of a 54.28household that meets criteria in subdivision 3, as expenditures under a separately funded 54.29state program. These expenditures shall not count toward the state's maintenance of effort 54.30requirements under the federal TANF program.54.31    (b) A family is no longer part of a separately funded program under this section, if 54.32the caregiver no longer meets the criteria for family stabilization services in subdivision 54.333 or if it is determined at recertification that the caregiver is meeting the federal work 54.34participation rate, whichever occurs sooner.54.35    Sec. 44. Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:55.1    Subdivision 1. Consolidated fund. The consolidated fund is established to support 55.2counties and tribes in meeting their duties under this chapter. Counties and tribes must use 55.3funds from the consolidated fund to develop programs and services that are designed to 55.4improve participant outcomes as measured in section 
         256J.751, subdivision 2. Counties 55.5may use the funds for any allowable expenditures under subdivision 2, and to provide case 55.6management services to participants of the family stabilization services program. Tribes 55.7may use the funds for any allowable expenditures under subdivision 2, except those in 55.8subdivision 2, paragraph (a), clauses (1) and (6). 55.9    Sec. 45. Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:55.10    Subd. 2. Allowable expenditures. (a) The commissioner must restrict expenditures 55.11under the consolidated fund to benefits and services allowed under title IV-A of the federal 55.12Social Security Act. Allowable expenditures under the consolidated fund may include, but 55.13are not limited to:55.14    (1) short-term, nonrecurring shelter and utility needs that are excluded from the 55.15definition of assistance under Code of Federal Regulations, title 45, section 
         260.31, for 55.16families who meet the residency requirement in section 
         256J.12, subdivisions 1 and 1a. 55.17Payments under this subdivision are not considered TANF cash assistance and are not 55.18counted towards the 60-month time limit; 55.19    (2) transportation needed to obtain or retain employment or to participate in other 55.20approved work activities or activities under a family stabilization plan;55.21    (3) direct and administrative costs of staff to deliver employment services for 55.22MFIP or,  the diversionary work program, or the family stabilization services program; 55.23 to administer financial assistance,;  and to provide specialized services intended to assist 55.24hard-to-employ participants to transition to work or transition from the family stabilization 55.25services program to MFIP;55.26    (4) costs of education and training including functional work literacy and English as 55.27a second language;55.28    (5) cost of work supports including tools, clothing, boots, telephone service, and 55.29other work-related expenses;55.30    (6) county administrative expenses as defined in Code of Federal Regulations, title 55.3145, section 260(b);55.32    (7) services to parenting and pregnant teens;55.33    (8) supported work;55.34    (9) wage subsidies;56.1    (10) child care needed for MFIP or, the  diversionary work program, or the family 56.2stabilization services program  participants to participate in social services;56.3    (11) child care to ensure that families leaving MFIP or diversionary work program 56.4will continue to receive child care assistance from the time the family no longer qualifies 56.5for transition year child care until an opening occurs under the basic sliding fee child 56.6care program; and56.7    (12) services to help noncustodial parents who live in Minnesota and have minor 56.8children receiving MFIP or DWP assistance, but do not live in the same household as the 56.9child, obtain or retain employment; and56.10    (13) services to help families participating in the family stabilization services 56.11program achieve the greatest possible degree of self-sufficiency.56.12    (b) Administrative costs that are not matched with county funds as provided in 56.13subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation 56.14under this section. The commissioner shall define administrative costs for purposes of 56.15this subdivision.56.16    (c) The commissioner may waive the cap on administrative costs for a county or tribe 56.17that elects to provide an approved supported employment, unpaid work, or community 56.18work experience program for a major segment of the county's or tribe's MFIP population. 56.19The county or tribe must apply for the waiver on forms provided by the commissioner. In 56.20no case shall total administrative costs exceed the TANF limits.56.21    Sec. 46. Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:56.22    Subd. 3. Eligibility for services. Families with a minor child, a pregnant woman, 56.23or a noncustodial parent of a minor child receiving assistance, with incomes below 200 56.24percent of the federal poverty guideline for a family of the applicable size, are eligible 56.25for services funded under the consolidated fund. Counties and tribes must give priority 56.26to families currently receiving MFIP or, the  diversionary work program, or the family 56.27stabilization services program, and families at risk of receiving MFIP or diversionary 56.28work program.56.29    Sec. 47. Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:56.30    Subd. 4. County and tribal biennial service agreements. (a) Effective January 1, 56.312004, and each two-year period thereafter, each county and tribe must have in place an 56.32approved biennial service agreement related to the services and programs in this chapter. 56.33In counties with a city of the first class with a population over 300,000, the county must 56.34consider a service agreement that includes a jointly developed plan for the delivery of 57.1employment services with the city. Counties may collaborate to develop multicounty, 57.2multitribal, or regional service agreements.57.3    (b) The service agreements will be completed in a form prescribed by the 57.4commissioner. The agreement must include:57.5    (1) a statement of the needs of the service population and strengths and resources 57.6in the community;57.7    (2) numerical goals for participant outcomes measures to be accomplished during 57.8the biennial period. The commissioner may identify outcomes from section 
         256J.751, 57.9subdivision 2
         , as core outcomes for all counties and tribes; 57.10    (3) strategies the county or tribe will pursue to achieve the outcome targets. 57.11Strategies must include specification of how funds under this section will be used and may 57.12include community partnerships that will be established or strengthened; and57.13    (4) strategies the county or tribe will pursue under the family stabilization services 57.14program; and 57.15    (5) other items prescribed by the commissioner in consultation with counties and 57.16tribes.57.17    (c) The commissioner shall provide each county and tribe with information needed 57.18to complete an agreement, including: (1) information on MFIP cases in the county or 57.19tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome 57.20measures; and (4) promising program practices.57.21    (d) The service agreement must be submitted to the commissioner by October 15, 57.222003, and October 15 of each second year thereafter. The county or tribe must allow 57.23a period of not less than 30 days prior to the submission of the agreement to solicit 57.24comments from the public on the contents of the agreement.57.25    (e) The commissioner must, within 60 days of receiving each county or tribal service 57.26agreement, inform the county or tribe if the service agreement is approved. If the service 57.27agreement is not approved, the commissioner must inform the county or tribe of any 57.28revisions needed prior to approval.57.29    (f) The service agreement in this subdivision supersedes the plan requirements 57.30of section 
         116L.88. 57.31    Sec. 48. Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:57.32    Subd. 5. Innovation projects. Beginning January 1, 2005, no more than $3,000,000 57.33of the funds annually appropriated to the commissioner for use in the consolidated 57.34fund shall be available to the commissioner for projects testing innovative approaches 57.35to improving outcomes for MFIP participants, family stabilization services program 58.1participants, and persons at risk of receiving MFIP as detailed in subdivision 3, and 58.2for providing incentives to counties and tribes that exceed performance. Projects shall 58.3be targeted to geographic areas with poor outcomes as specified in section 
         256J.751, 58.4subdivision 5
         , or to subgroups within the MFIP case load who are experiencing poor 58.5outcomes. For purposes of an incentive, a county or tribe exceeds performance if the 58.6county or tribe is above the top of the county's or tribe's annualized range of expected 58.7performance on the three-year self-support index under section 256J.751, subdivision 2, 58.8clause (7), and achieves a 50 percent TANF participation rate under section 256J.751, 58.9subdivision 2, clause (7), as averaged across the four quarterly measurements for the most 58.10recent year for which the measurements are available.58.11    Sec. 49. Minnesota Statutes 2006, section 256J.626, subdivision 6, is amended to read:58.12    Subd. 6. Base allocation to counties and tribes; definitions. (a) For purposes of 58.13this section, the following terms have the meanings given.58.14    (1) "2002 historic spending base" means the commissioner's determination of 58.15the sum of the reimbursement related to fiscal year 2002 of county or tribal agency 58.16expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings 58.17related to calendar year 2002 in the base program listed in clause (6), item (v), and the 58.18amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi), 58.19issued to or on behalf of persons residing in the county or tribal service delivery area.58.20    (2) "Adjusted caseload factor" means a factor weighted:58.21    (i) 47 percent on the MFIP cases in each county at four points in time in the most 58.22recent 12-month period for which data is available multiplied by the county's caseload 58.23difficulty factor; and58.24    (ii) 53 percent on the count of adults on MFIP in each county and tribe at four points 58.25in time in the most recent 12-month period for which data is available multiplied by the 58.26county or tribe's caseload difficulty factor.58.27    (3) "Caseload difficulty factor" means a factor determined by the commissioner for 58.28each county and tribe based upon the self-support index described in section 
         256J.751, 58.29subdivision 2
         , clause (7).58.30    (4) "Initial allocation" means the amount potentially available to each county or tribe 58.31based on the formula in paragraphs (b) through (h).58.32    (5) "Final allocation" means the amount available to each county or tribe based on 58.33the formula in paragraphs (b) through (h), after adjustment by subdivision 7.58.34    (6) "Base programs" means the:59.1    (i) MFIP employment and training services under Minnesota Statutes 2002, section 59.2256J.62, subdivision 1
         , in effect June 30, 2002;59.3    (ii) bilingual employment and training services to refugees under Minnesota Statutes 59.42002, section 
         256J.62, subdivision 6, in effect June 30, 2002;59.5    (iii) work literacy language programs under Minnesota Statutes 2002, section 59.6256J.62, subdivision 7
         , in effect June 30, 2002;59.7    (iv) supported work program authorized in Laws 2001, First Special Session chapter 59.89, article 17, section 2, in effect June 30, 2002;59.9    (v) administrative aid program under section 
         256J.76 in effect December 31, 2002; 59.10and59.11    (vi) emergency assistance program under Minnesota Statutes 2002, section 
         256J.48, 59.12in effect June 30, 2002.59.13    (b) The commissioner shall:59.14    (1) beginning July 1, 2003, determine the initial allocation of funds available under 59.15this section according to clause (2);59.16    (2) allocate all of the funds available for the period beginning July 1, 2003, and 59.17ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's 59.18share of the statewide 2002 historic spending base;59.19    (3) determine for calendar year 2005 the initial allocation of funds to be made 59.20available under this section in proportion to the county or tribe's initial allocation for the 59.21period of July 1, 2003, to December 31, 2004;59.22    (4) determine for calendar year 2006 the initial allocation of funds to be made 59.23available under this section based 90 percent on the proportion of the county or tribe's 59.24share of the statewide 2002 historic spending base and ten percent on the proportion of 59.25the county or tribe's share of the adjusted caseload factor;59.26    (5) determine for calendar year 2007 the initial allocation of funds to be made 59.27available under this section based 70 percent on the proportion of the county or tribe's 59.28share of the statewide 2002 historic spending base and 30 percent on the proportion of the 59.29county or tribe's share of the adjusted caseload factor; and59.30    (6) determine for calendar year 2008 and subsequent years the initial allocation of 59.31funds to be made available under this section based 50 percent on the proportion of the 59.32county or tribe's share of the statewide 2002 historic spending base and 50 percent on the 59.33proportion of the county or tribe's share of the adjusted caseload factor.59.34    (c) With the commencement of a new or expanded tribal TANF program or an 59.35agreement under section 
         256.01, subdivision 2, paragraph (g), in which some or all of 60.1the responsibilities of particular counties under this section are transferred to a tribe, 60.2the commissioner shall:60.3    (1) in the case where all responsibilities under this section are transferred to a tribal 60.4program, determine the percentage of the county's current caseload that is transferring to a 60.5tribal program and adjust the affected county's allocation accordingly; and60.6    (2) in the case where a portion of the responsibilities under this section are 60.7transferred to a tribal program, the commissioner shall consult with the affected county or 60.8counties to determine an appropriate adjustment to the allocation.60.9    (d) Effective January 1, 2005, counties and tribes will have their final allocations 60.10adjusted based on the performance provisions of subdivision 7.60.11    Sec. 50. Minnesota Statutes 2006, section 256J.751, subdivision 2, is amended to read:60.12    Subd. 2. Quarterly comparison report. The commissioner shall report quarterly to 60.13all counties on each county's performance on the following measures:60.14    (1) percent of MFIP caseload working in paid employment;60.15    (2) percent of MFIP caseload receiving only the food portion of assistance;60.16    (3) number of MFIP cases that have left assistance;60.17    (4) median placement wage rate;60.18    (5) caseload by months of TANF assistance;60.19    (6) percent of MFIP and diversionary work program (DWP) cases off cash assistance 60.20or working 30 or more hours per week at one-year, two-year, and three-year follow-up 60.21points from a baseline quarter. This measure is called the self-support index. The 60.22commissioner shall report quarterly an expected range of performance for each county, 60.23county grouping, and tribe on the self-support index. The expected range shall be derived 60.24by a statistical methodology developed by the commissioner in consultation with the 60.25counties and tribes. The statistical methodology shall control differences across counties 60.26in economic conditions and demographics of the MFIP and DWP case load; and60.27    (7) the MFIP TANF work participation rate, defined as the participation requirements 60.28specified in title 1 of Public Law 104-193 applied to all MFIP cases except child only 60.29cases under Public Law 109-171, the Deficit Reduction Act of 2005.60.30    Sec. 51. Minnesota Statutes 2006, section 256J.751, subdivision 5, is amended to read:60.31    Subd. 5. Failure to meet federal performance standards. (a) If sanctions occur 60.32for failure to meet the performance standards specified in title 1 of Public Law 104-193 60.33of the Personal Responsibility and Work Opportunity Act of 1996, and under Public 60.34Law 109-171, the Deficit Reduction Act of 2005, the state shall pay 88 percent of the 61.1sanction. The remaining 12 percent of the sanction will be paid by the counties. The 61.2county portion of the sanction will be distributed across all counties in proportion to each 61.3county's percentage of the MFIP average monthly caseload during the period for which 61.4the sanction was applied.61.5    (b) If a county fails to meet the performance standards specified in title 1 of Public 61.6Law 104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and 61.7Public Law 109-171, the Deficit Reduction Act of 2005, for any year, the commissioner 61.8shall work with counties to organize a joint state-county technical assistance team to work 61.9with the county. The commissioner shall coordinate any technical assistance with other 61.10departments and agencies including the Departments of Employment and Economic 61.11Development and Education as necessary to achieve the purpose of this paragraph.61.12    (c) For state performance measures, a low-performing county is one that:61.13    (1) performs below the bottom of their expected range for the measure in subdivision 61.142, clause (7) (6), in an annualized measurement reported in October of each year; or61.15    (2) performs below 40 percent for the measure in subdivision 2, clause (8) (7), as 61.16averaged across the four quarterly measurements for the year, or the ten counties with the 61.17lowest rates if more than ten are below 40 percent.61.18    (d) Low-performing counties under paragraph (c) must engage in corrective action 61.19planning as defined by the commissioner. The commissioner may coordinate technical 61.20assistance as specified in paragraph (b) for low-performing counties under paragraph (c).61.21    Sec. 52. Minnesota Statutes 2006, section 256J.95, subdivision 3, is amended to read:61.22    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories 61.23of family units listed below, all family units who apply for cash benefits and who 61.24meet MFIP eligibility as required in sections 
         256J.11 to 
         256J.15 are eligible and must 61.25participate in the diversionary work program. Family units that are not eligible for the 61.26diversionary work program include:61.27    (1) child only cases;61.28    (2) a single-parent family unit that includes a child under 12 weeks of age. A parent 61.29is eligible for this exception once in a parent's lifetime and is not eligible if the parent 61.30has already used the previously allowed child under age one exemption from MFIP 61.31employment services;61.32    (3) a minor parent without a high school diploma or its equivalent;61.33    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent 61.34who chooses to have an employment plan with an education option;61.35    (5) a caregiver age 60 or over;62.1    (6) family units with a caregiver who received DWP benefits in the 12 months prior 62.2to the month the family applied for DWP, except as provided in paragraph (c);62.3    (7) family units with a caregiver who received MFIP within the 12 months prior to 62.4the month the family unit applied for DWP;62.5    (8) a family unit with a caregiver who received 60 or more months of TANF 62.6assistance; and62.7    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to 62.8fraud.; and62.9    (10) refugees as defined in Code of Federal Regulations, title 45, chapter IV, section 62.10444.43, who arrived in the United States in the 12 months prior to the date of application 62.11for family cash assistance.62.12    (b) A two-parent family must participate in DWP unless both caregivers meet the 62.13criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit 62.14includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), or (9).62.15    (c) Once DWP eligibility is determined, the four months run consecutively. If a 62.16participant leaves the program for any reason and reapplies during the four-month period, 62.17the county must redetermine eligibility for DWP.62.18EFFECTIVE DATE.This section is effective the day following final enactment.62.19    Sec. 53. Minnesota Statutes 2006, section 256J.95, subdivision 13, is amended to read:62.20    Subd. 13. Immediate referral to employment services. Within one working day of 62.21determination that the applicant is eligible for the diversionary work program, but before 62.22benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to 62.23employment services. The referral to the DWP employment services must be in writing 62.24and must contain the following information:62.25    (1) notification that, as part of the application process, applicants are required to 62.26develop an employment plan or the DWP application will be denied;62.27    (2) the employment services provider name and phone number;62.28    (3) the date, time, and location of the scheduled employment services interview;62.29    (4) (3) the immediate availability of supportive services, including, but not limited 62.30to, child care, transportation, and other work-related aid; and62.31    (5) (4) the rights, responsibilities, and obligations of participants in the program, 62.32including, but not limited to, the grounds for good cause, the consequences of refusing or 62.33failing to participate fully with program requirements, and the appeal process.63.1    Sec. 54. Minnesota Statutes 2006, section 256K.45, is amended by adding a 63.2subdivision to read:63.3    Subd. 6.Funding.Any funds appropriated for this section may be expended 63.4on programs described under subdivisions 3 to 5, technical assistance, and capacity 63.5building. In addition, up to five percent of funds appropriated may be used for program 63.6administration and up to eight percent of funds appropriated may be used for the purpose 63.7of monitoring and evaluating runaway and homeless youth programs receiving funding 63.8under this section. Funding shall be directed to meet the greatest need, with a significant 63.9share of the funding focused on homeless youth providers in greater Minnesota.63.10    Sec. 55. Minnesota Statutes 2006, section 259.24, subdivision 3, is amended to read:63.11    Subd. 3. Child. When the child to be adopted is over 14 years of age, the child's 63.12written consent to adoption by a particular person is also shall be necessary. A child 63.13of any age who is under the guardianship of the commissioner and is legally available 63.14for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to 63.15recruit, identify, and place the child in an adoptive home required under section 260C.317, 63.16subdivision 3, paragraph (b), or sign a document relieving county social services agencies 63.17of all recruitment efforts on the child's behalf.63.18    Sec. 56. Minnesota Statutes 2006, section 259.53, subdivision 1, is amended to read:63.19    Subdivision 1. Notice to commissioner; referral for postplacement assessment.63.20    (a) Upon the filing of a petition for adoption of a child who is:63.21    (1) under the guardianship of the commissioner or a licensed child-placing agency 63.22according to section 260C.201, subdivision 11, or 260C.317;63.23    (2) placed by the commissioner, commissioner's agent, or licensed child-placing 63.24agency after a consent to adopt according to section 259.24 or under an agreement 63.25conferring authority to place for adoption according to section 259.25; or63.26    (3) placed by preadoptive custody order for a direct adoptive placement ordered 63.27by the district court under section 259.47,63.28the court administrator shall immediately transmit a copy of the petition to the 63.29commissioner of human services.63.30    (b) The court shall immediately refer the petition to the agency specified below for 63.31completion of a postplacement assessment and report as required by subdivision 2.63.32    (1) If the child to be adopted has been committed to the guardianship of the 63.33commissioner or an agency under section 
         260C.317 or an agency has been given authority 63.34to place the child under section 
         259.25, the court shall refer the petition to that agency, 64.1unless another agency is supervising the placement, in which case the court shall refer the 64.2petition to the supervising agency. 64.3    (2) If the child to be adopted has been placed in the petitioner's home by a direct 64.4adoptive placement, the court shall refer the petition to the agency supervising the 64.5placement under section 
         259.47, subdivision 3, paragraph (a), clause (6). 64.6    (3) If the child is to be adopted by an individual who is related to the child as defined 64.7by section 
         245A.02, subdivision 13, and in all other instances not described in clause (1) 64.8or (2), the court shall refer the petition to the local social services agency of the county in 64.9which the prospective adoptive parent lives. 64.10    Sec. 57. Minnesota Statutes 2006, section 259.57, subdivision 1, is amended to read:64.11    Subdivision 1. Findings; orders. Upon the hearing,64.12    (a) if the court finds that it is in the best interests of the child that the petition 64.13be granted, a decree of adoption shall be made and recorded in the office of the court 64.14administrator, ordering that henceforth the child shall be the child of the petitioner. In the 64.15decree the court may change the name of the child if desired. After the decree is granted64.16for a child who is:64.17    (1) under the guardianship of the commissioner or a licensed child-placing agency 64.18according to section 260C.201, subdivision 11, or 260C.317;64.19    (2) placed by the commissioner, commissioner's agent, or licensed child-placing 64.20agency after a consent to adopt according to section 259.24 or under an agreement 64.21conferring authority to place for adoption according to section 259.25; or64.22    (3) adopted after a direct adoptive placement ordered by the district court under 64.23section 259.47,64.24the court administrator shall immediately mail a copy of the recorded decree to the 64.25commissioner of human services;64.26    (b) if the court is not satisfied that the proposed adoption is in the best interests 64.27of the child, the court shall deny the petition, and shall order the child returned to the 64.28custody of the person or agency legally vested with permanent custody or certify the 64.29case for appropriate action and disposition to the court having jurisdiction to determine 64.30the custody and guardianship of the child.64.31    Sec. 58. Minnesota Statutes 2006, section 259.67, subdivision 4, is amended to read:64.32    Subd. 4. Eligibility conditions. (a) The placing agency shall use the AFDC 64.33requirements as specified in federal law as of July 16, 1996, when determining the child's 64.34eligibility for adoption assistance under title IV-E of the Social Security Act. If the child 65.1does not qualify, the placing agency shall certify a child as eligible for state funded 65.2adoption assistance only if the following criteria are met:65.3    (1) Due to the child's characteristics or circumstances it would be difficult to provide 65.4the child an adoptive home without adoption assistance.65.5    (2)(i) A placement agency has made reasonable efforts to place the child for adoption 65.6without adoption assistance, but has been unsuccessful; or65.7    (ii) the child's licensed foster parents desire to adopt the child and it is determined by 65.8the placing agency that the adoption is in the best interest of the child.65.9    (3)(i) The child has been a ward of the commissioner, a Minnesota-licensed 65.10child-placing agency, or a tribal social service agency of Minnesota recognized by the 65.11Secretary of the Interior; or (ii) the child will be adopted according to tribal law without a 65.12termination of parental rights or relinquishment, provided that the tribe has documented 65.13the valid reason why the child cannot or should not be returned to the home of the child's 65.14parent. The placing agency shall not certify a child who remains under the jurisdiction 65.15of the sending agency pursuant to section 
         260.851, article 5, for state-funded adoption 65.16assistance when Minnesota is the receiving state.65.17    (b) For purposes of this subdivision, the characteristics or circumstances that may 65.18be considered in determining whether a child is a child with special needs under United 65.19States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of 65.20paragraph (a), clause (1), are the following:65.21    (1) The child is a member of a sibling group to be placed as one unit in which at 65.22least one sibling is older than 15 months of age or is described in clause (2) or (3).65.23    (2) The child has documented physical, mental, emotional, or behavioral disabilities.65.24    (3) The child has a high risk of developing physical, mental, emotional, or behavioral 65.25disabilities.65.26    (4) The child is adopted according to tribal law without a termination of parental 65.27rights or relinquishment, provided that the tribe has documented the valid reason why the 65.28child cannot or should not be returned to the home of the child's parent.65.29    (4) The child is five years of age or older.65.30    (c) When a child's eligibility for adoption assistance is based upon the high risk of 65.31developing physical, mental, emotional, or behavioral disabilities, payments shall not be 65.32made under the adoption assistance agreement unless and until the potential disability 65.33manifests itself as documented by an appropriate health care professional.65.34    Sec. 59. Minnesota Statutes 2006, section 259.67, subdivision 7, is amended to read:66.1    Subd. 7. Reimbursement of costs. (a) Subject to rules of the commissioner, and 66.2the provisions of this subdivision a child-placing agency licensed in Minnesota or any 66.3other state, or local or tribal social services agency shall receive a reimbursement from the 66.4commissioner equal to 100 percent of the reasonable and appropriate cost of providing 66.5adoption services for a child certified as eligible for adoption assistance under subdivision 66.64. Such assistance. Adoption services under this subdivision may include adoptive family 66.7recruitment, counseling, and special training when needed. 66.8    (b) An eligible child must have a goal of adoption, which may include an adoption 66.9in accordance with tribal law, and meet one of the following criteria: 66.10    (1) is a ward of the commissioner of human services or a ward of tribal court 66.11pursuant to section 260.755, subdivision 20, who meets one of the criteria in subdivision 66.124, paragraph (b), clause (1), (2), or (3); or 66.13    (2) is under the guardianship of a Minnesota-licensed child-placing agency who 66.14meets one of the criteria in subdivision 4, paragraph (b), clause (1) or (2).66.15    (c) A child-placing agency licensed in Minnesota or any other state shall receive 66.16reimbursement for adoption services it purchases for or directly provides to an eligible 66.17child. Tribal social services shall receive reimbursement for adoption services it purchases 66.18for or directly provides to an eligible child. A local or tribal social services agency shall 66.19receive such reimbursement only for adoption services it purchases for an eligible child.66.20    (b) A child-placing agency licensed in Minnesota or any other state or local or tribal 66.21social services agency seeking reimbursement under this subdivision shall enter into66.22Before providing adoption services for which reimbursement will be sought under this 66.23subdivision, a reimbursement agreement, on the designated format, must be entered into66.24with the commissioner before providing adoption services for which reimbursement 66.25is sought. No reimbursement under this subdivision shall be made to an agency for 66.26services provided prior to entering a reimbursement agreement. Separate reimbursement 66.27agreements shall be made for each child and separate records shall be kept on each child 66.28for whom a reimbursement agreement is made. The commissioner of human services shall 66.29agree that the reimbursement costs are reasonable and appropriate. The commissioner 66.30may spend up to $16,000 for each purchase of service agreement. Only one agreement per 66.31child is allowed, unless an exception is granted by the commissioner. Funds encumbered 66.32and obligated under such an agreement for the child remain available until the terms of 66.33the agreement are fulfilled or the agreement is terminated.66.34    (c) When a local or tribal social services agency uses a purchase of service agreement 66.35to provide services reimbursable under a reimbursement agreement, The commissioner 66.36may shall make reimbursement payments directly to the agency providing the service if 67.1direct reimbursement is specified by the purchase of service agreement, and if the request 67.2for reimbursement is submitted by the local or tribal social services agency along with a 67.3verification that the service was provided.67.4    Sec. 60. Minnesota Statutes 2006, section 259.75, subdivision 8, is amended to read:67.5    Subd. 8. Reasons for deferral. Deferral of the listing of a child with the state 67.6adoption exchange shall be only for one or more of the following reasons:67.7    (a) the child is in an adoptive placement but is not legally adopted;67.8    (b) the child's foster parents or other individuals are now considering adoption;67.9    (c) diagnostic study or testing is required to clarify the child's problem and provide 67.10an adequate description; or67.11    (d) the child is currently in a hospital and continuing need for daily professional care 67.12will not permit placement in a family setting; or.67.13    (e) the child is 14 years of age or older and will not consent to an adoption plan.67.14Approval of a request to defer listing for any of the reasons specified in paragraph (b) or 67.15(c) shall be valid for a period not to exceed 90 days, with no subsequent deferrals for 67.16those reasons.67.17    Sec. 61. Minnesota Statutes 2006, section 260.012, is amended to read:67.18260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY 67.19REUNIFICATION; REASONABLE EFFORTS.67.20    (a) Once a child alleged to be in need of protection or services is under the court's 67.21jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate 67.22services, by the social services agency are made to prevent placement or to eliminate the 67.23need for removal and to reunite the child with the child's family at the earliest possible 67.24time, and when a child cannot be reunified with the parent or guardian from whom the67.25child was removed, the court must ensure that the responsible social services agency 67.26makes reasonable efforts to finalize an alternative permanent plan for the child as provided 67.27in paragraph (e). In determining reasonable efforts to be made with respect to a child and 67.28in making those reasonable efforts, the child's best interests, health, and safety must be of 67.29paramount concern. Reasonable efforts to prevent placement and for rehabilitation and 67.30reunification are always required except upon a determination by the court that a petition 67.31has been filed stating a prima facie case that:67.32    (1) the parent has subjected a child to egregious harm as defined in section 67.33260C.007, subdivision 14
         ;68.1    (2) the parental rights of the parent to another child have been terminated 68.2involuntarily;68.3    (3) the child is an abandoned infant under section 
         260C.301, subdivision 2, 68.4paragraph (a), clause (2);68.5    (4) the parent's custodial rights to another child have been involuntarily transferred 68.6to a relative under section 
         260C.201, subdivision 11, paragraph (e), clause (1), or a similar 68.7law of another jurisdiction; or68.8    (5) the provision of services or further services for the purpose of reunification is 68.9futile and therefore unreasonable under the circumstances.68.10    (b) When the court makes one of the prima facie determinations under paragraph (a), 68.11either permanency pleadings under section 
         260C.201, subdivision 11, or a termination 68.12of parental rights petition under sections 
         260C.141 and 
         260C.301 must be filed. A 68.13permanency hearing under section 
         260C.201, subdivision 11, must be held within 30 68.14days of this determination.68.15    (c) In the case of an Indian child, in proceedings under sections 
         260B.178 or 68.16260C.178
         , 
         260C.201, and 
         260C.301 the juvenile court must make findings and conclusions 68.17consistent with the Indian Child Welfare Act of 1978, United States Code, title 25, section 68.181901 et seq., as to the provision of active efforts. In cases governed by the Indian Child 68.19Welfare Act of 1978, United States Code, title 25, section 1901, the responsible social 68.20services agency must provide active efforts as required under United States Code, title 68.2125, section 1911(d).68.22    (d) "Reasonable efforts to prevent placement" means:68.23    (1) the agency has made reasonable efforts to prevent the placement of the child in 68.24foster care; or68.25    (2) given the particular circumstances of the child and family at the time of the 68.26child's removal, there are no services or efforts available which could allow the child to 68.27safely remain in the home.68.28    (e) "Reasonable efforts to finalize a permanent plan for the child" means due 68.29diligence by the responsible social services agency to:68.30    (1) reunify the child with the parent or guardian from whom the child was removed;68.31    (2) assess a noncustodial parent's ability to provide day-to-day care for the child and, 68.32where appropriate, provide services necessary to enable the noncustodial parent to safely 68.33provide the care, as required by section 
         260C.212, subdivision 4;68.34    (3) conduct a relative search as required under section 
         260C.212, subdivision 5; and68.35    (4) when the child cannot return to the parent or guardian from whom the child was 68.36removed, to plan for and finalize a safe and legally permanent alternative home for the 69.1child, and considers permanent alternative homes for the child inside or outside of the 69.2state, preferably through adoption or transfer of permanent legal and physical custody of 69.3the child.69.4    (f) Reasonable efforts are made upon the exercise of due diligence by the responsible 69.5social services agency to use culturally appropriate and available services to meet the 69.6needs of the child and the child's family. Services may include those provided by the 69.7responsible social services agency and other culturally appropriate services available in 69.8the community. At each stage of the proceedings where the court is required to review 69.9the appropriateness of the responsible social services agency's reasonable efforts as 69.10described in paragraphs (a), (d), and (e), the social services agency has the burden of 69.11demonstrating that:69.12    (1) it has made reasonable efforts to prevent placement of the child in foster care;69.13    (2) it has made reasonable efforts to eliminate the need for removal of the child from 69.14the child's home and to reunify the child with the child's family at the earliest possible time;69.15    (3) it has made reasonable efforts to finalize an alternative permanent home for 69.16the child, and considers permanent alternative homes for the child inside or outside of 69.17the state; or69.18    (4) reasonable efforts to prevent placement and to reunify the child with the parent 69.19or guardian are not required. The agency may meet this burden by stating facts in a sworn 69.20petition filed under section 
         260C.141, by filing an affidavit summarizing the agency's 69.21reasonable efforts or facts the agency believes demonstrate there is no need for reasonable 69.22efforts to reunify the parent and child, or through testimony or a certified report required 69.23under juvenile court rules.69.24    (g) Once the court determines that reasonable efforts for reunification are not 69.25required because the court has made one of the prima facie determinations under paragraph 69.26(a), the court may only require reasonable efforts for reunification after a hearing according 69.27to section 
         260C.163, where the court finds there is not clear and convincing evidence of 69.28the facts upon which the court based its prima facie determination. In this case when there 69.29is clear and convincing evidence that the child is in need of protection or services, the 69.30court may find the child in need of protection or services and order any of the dispositions 69.31available under section 
         260C.201, subdivision 1. Reunification of a surviving child with a 69.32parent is not required if the parent has been convicted of:69.33    (1) a violation of, or an attempt or conspiracy to commit a violation of, sections 69.34609.185
          to 
         609.20; 
         609.222, subdivision 2; or 
         609.223 in regard to another child of the 69.35parent;70.1    (2) a violation of section 
         609.222, subdivision 2; or 
         609.223, in regard to the 70.2surviving child; or70.3    (3) a violation of, or an attempt or conspiracy to commit a violation of, United States 70.4Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent.70.5    (h) The juvenile court, in proceedings under sections 
         260B.178 or 
         260C.178, 70.6260C.201
         , and 
         260C.301 shall make findings and conclusions as to the provision of 70.7reasonable efforts. When determining whether reasonable efforts have been made, the 70.8court shall consider whether services to the child and family were:70.9    (1) relevant to the safety and protection of the child;70.10    (2) adequate to meet the needs of the child and family;70.11    (3) culturally appropriate;70.12    (4) available and accessible;70.13    (5) consistent and timely; and70.14    (6) realistic under the circumstances.70.15    In the alternative, the court may determine that provision of services or further 70.16services for the purpose of rehabilitation is futile and therefore unreasonable under the 70.17circumstances or that reasonable efforts are not required as provided in paragraph (a).70.18    (i) This section does not prevent out-of-home placement for treatment of a child with 70.19a mental disability when the child's diagnostic assessment or individual treatment plan 70.20indicates that appropriate and necessary treatment cannot be effectively provided outside 70.21of a residential or inpatient treatment program.70.22    (j) If continuation of reasonable efforts to prevent placement or reunify the child 70.23with the parent or guardian from whom the child was removed is determined by the court 70.24to be inconsistent with the permanent plan for the child or upon the court making one of 70.25the prima facie determinations under paragraph (a), reasonable efforts must be made to 70.26place the child in a timely manner in a safe and permanent home and to complete whatever 70.27steps are necessary to legally finalize the permanent placement of the child.70.28    (k) Reasonable efforts to place a child for adoption or in another permanent 70.29placement may be made concurrently with reasonable efforts to prevent placement or to 70.30reunify the child with the parent or guardian from whom the child was removed. When 70.31the responsible social services agency decides to concurrently make reasonable efforts for 70.32both reunification and permanent placement away from the parent under paragraph (a), the 70.33agency shall disclose its decision and both plans for concurrent reasonable efforts to all 70.34parties and the court. When the agency discloses its decision to proceed on both plans for 70.35reunification and permanent placement away from the parent, the court's review of the 70.36agency's reasonable efforts shall include the agency's efforts under both plans.71.1    Sec. 62. Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:71.2    Subd. 12. Indian tribe. "Indian tribe" means an Indian tribe, band, nation, or 71.3other organized group or community of Indians recognized as eligible for the services 71.4provided to Indians by the secretary because of their status as Indians, including any band71.5Native group under the Alaska Native Claims Settlement Act, United States Code, title 43, 71.6section 1602, and exercising tribal governmental powers.71.7    Sec. 63. Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:71.8    Subd. 20. Tribal court. "Tribal court" means a court with federally recognized71.9jurisdiction over child custody proceedings and which is either a court of Indian offenses, 71.10or a court established and operated under the code or custom of an Indian tribe, or the71.11any other administrative body of a tribe which is vested with authority over child custody 71.12proceedings. Except as provided in section 
         260.771, subdivision 5, nothing in this chapter 71.13shall be construed as conferring jurisdiction on an Indian tribe. 71.14    Sec. 64. Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:71.15    Subd. 7. Identification of extended family members. Any agency considering 71.16placement of an Indian child shall make reasonable active efforts to identify and locate 71.17extended family members.71.18    Sec. 65. Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:71.19    Subd. 5. Identification of extended family members. Any agency considering 71.20placement of an Indian child shall make reasonable active efforts to identify and locate 71.21extended family members.71.22    Sec. 66. Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:71.23    Subdivision 1. Indian tribe jurisdiction. An Indian tribe with a tribal court has 71.24exclusive jurisdiction over a child placement proceeding involving an Indian child who 71.25resides or is domiciled within the reservation of such the tribe at the commencement of 71.26the proceedings, except where jurisdiction is otherwise vested in the state by existing 71.27federal law. When an Indian child is in the legal custody of a person or agency pursuant 71.28to an order of a ward of the tribal court, the Indian tribe retains exclusive jurisdiction, 71.29notwithstanding the residence or domicile of the child.71.30    Sec. 67. Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:72.1    Subd. 2. Court determination of tribal affiliation of child. In any child placement 72.2proceeding, the court shall establish whether an Indian child is involved and the identity 72.3of the Indian child's tribe. This chapter and the federal Indian Child Welfare Act are 72.4applicable without exception in any child custody proceeding, as defined in the federal act, 72.5involving an Indian child. This chapter applies to child custody proceedings involving 72.6an Indian child whether the child is in the physical or legal custody of an Indian parent, 72.7Indian custodian, Indian extended family member, or other person at the commencement 72.8of the proceedings. A court shall not determine the applicability of this chapter or the 72.9federal Indian Child Welfare Act to a child custody proceeding based upon whether an 72.10Indian child is part of an existing Indian family or based upon the level of contact a child 72.11has with the child's Indian tribe, reservation, society, or off-reservation community.72.12    Sec. 68. [260.852] PLACEMENT PROCEDURES.72.13    Subdivision 1.Home study.The state must have procedures for the orderly and 72.14timely interstate placement of children that are implemented in accordance with an 72.15interstate compact and that, within 60 days after the state receives from another state a 72.16request to conduct a study of a home environment for purposes of assessing the safety 72.17and suitability of placing a child in the home, the state shall, directly or by contract, 72.18conduct and complete a home study and return to the other state a report on the results of 72.19the study, which shall address the extent to which placement in the home would meet the 72.20needs of the child; except in the case of a home study begun before October 1, 2008, if the 72.21state fails to comply with conducting and completing the home study within the 60-day 72.22period and this is as a result of circumstances beyond the control of the state, the state has 72.2375 days to comply if the state documents the circumstances involved and certifies that 72.24completing the home study is in the best interests of the child. 72.25    This subdivision does not require the completion within the applicable period of 72.26the parts of the home study involving the education and training of the prospective foster 72.27or adoptive parents.72.28    Subd. 2.Effect of received report.The state shall treat any report described in 72.29subdivision 1 that is received from another state, an Indian tribe, or a private agency 72.30under contract with another state or Indian tribe as meeting any requirements imposed by 72.31the state for the completion of a home study before placing a child in the home, unless, 72.32within 14 days after receipt of the report, the state determines, based on grounds that 72.33are specific to the content of the report, that making a decision in reliance on the report 72.34would be contrary to the welfare of the child.73.1    Subd. 3.Resources.The state shall make effective use of cross-jurisdictional 73.2resources, including through contract for the purchase of services, and shall eliminate 73.3legal barriers to facilitate timely adoptive or permanent placements for waiting children. 73.4The state shall not impose any restriction on the use of private agencies for the purpose of 73.5conducting a home study to meet the 60-day requirement.73.6    Subd. 4.Incentive eligibility.Minnesota is an incentive-eligible state and must:73.7    (1) have an approved plan as required by the United States Secretary of Health 73.8and Human Services;73.9    (2) be in compliance with the data requirements of the United States Department of 73.10Health and Human Services; and73.11    (3) have data that verify that a home study is completed within 30 days.73.12    Subd. 5.Data requirements.The state shall provide to the United States Secretary 73.13of Health and Human Services a written report, covering the preceding fiscal year, that 73.14specifies:73.15    (1) the total number of interstate home studies requested by the state with respect 73.16to children in foster care under the responsibility of the state, and with respect to each 73.17study, the identity of the other state involved;73.18    (2) the total number of timely interstate home studies completed by the state with 73.19respect to children in foster care under the responsibility of other states and, with respect 73.20to each study, the identity of the other state involved; and73.21    (3) other information the United States Secretary of Health and Human Services 73.22requires in order to determine whether Minnesota is a home study incentive-eligible state.73.23    Subd. 6.Definitions.(a) The definitions in this subdivision apply to this section.73.24    (b) "Home study" means an evaluation of a home environment conducted in 73.25accordance with applicable requirements of the state in which the home is located, to 73.26determine whether a proposed placement of a child would meet the individual needs of the 73.27child, including the child's safety; permanency; health; well-being; and mental, emotional, 73.28and physical development.73.29    (c) "Interstate home study" means a home study conducted by a state at the request 73.30of another state to facilitate an adoptive or foster placement in the state of a child in foster 73.31care under the responsibility of the state.73.32    (d) "Timely interstate home study" means an interstate home study completed by a 73.33state if the state provides to the state that requested the study, within 30 days after receipt 73.34of the request, a report on the results of the study, except that there is no requirement 73.35for completion within the 30-day period of the parts of the home study involving the 73.36education and training of the prospective foster or adoptive parents.74.1    Subd. 7.Background study requirements for adoption and foster care.(a) 74.2Background study requirements for an adoption home study must be completed consistent 74.3with section 259.41, subdivisions 1, 2, and 3.74.4    (b) Background study requirements for a foster care license must be completed 74.5consistent with section 245C.08.74.6    Subd. 8.Home visits.If a child has been placed in foster care outside the state in 74.7which the home of the parents of the child is located, periodically, but at least every six 74.8months, a caseworker on the staff of the agency of the state in which the home of the 74.9parents of the child is located or the state in which the child has been placed, or a private 74.10agency under contract with either state, must visit the child in the home or institution and 74.11submit a report on each visit to the agency of the state in which the home of the parents of 74.12the child is located.74.13    Sec. 69. Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:74.14    Subdivision 1. Investigation. Upon request of the court the local social services 74.15agency or probation officer shall investigate the personal and family history and 74.16environment of any minor coming within the jurisdiction of the court under section 74.17260B.101
          and shall report its findings to the court. The court may order any minor coming 74.18within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or 74.19psychologist appointed by the court. 74.20    The court shall have order a chemical use assessment conducted when a child is 74.21(1) found to be delinquent for violating a provision of chapter 152, or for committing a 74.22felony-level violation of a provision of chapter 609 if the probation officer determines 74.23that alcohol or drug use was a contributing factor in the commission of the offense, or 74.24(2) alleged to be delinquent for violating a provision of chapter 152, if the child is being 74.25held in custody under a detention order. The assessor's qualifications and the assessment 74.26criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under 74.27chapter 254B are to be used to pay for the recommended treatment, the assessment and 74.28placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to 74.299530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall 74.30reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.74.31    The court shall have order a children's mental health screening conducted when 74.32a child is found to be delinquent. The screening shall be conducted with a screening 74.33instrument approved by the commissioner of human services and shall be conducted by a 74.34mental health practitioner as defined in section 
         245.4871, subdivision 26, or a probation 74.35officer who is trained in the use of the screening instrument. If the screening indicates 75.1a need for assessment, the local social services agency, in consultation with the child's 75.2family, shall have a diagnostic assessment conducted, including a functional assessment, 75.3as defined in section 
         245.4871. 75.4    With the consent of the commissioner of corrections and agreement of the county to 75.5pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction 75.6in an institution maintained by the commissioner for the detention, diagnosis, custody and 75.7treatment of persons adjudicated to be delinquent, in order that the condition of the minor 75.8be given due consideration in the disposition of the case. Any funds received under the 75.9provisions of this subdivision shall not cancel until the end of the fiscal year immediately 75.10following the fiscal year in which the funds were received. The funds are available for 75.11use by the commissioner of corrections during that period and are hereby appropriated 75.12annually to the commissioner of corrections as reimbursement of the costs of providing 75.13these services to the juvenile courts.75.14    Sec. 70. Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:75.15    Subd. 5. Notice to foster parents and preadoptive parents and relatives. The 75.16foster parents, if any, of a child and any preadoptive parent or relative providing care 75.17for the child must be provided notice of and an opportunity a right to be heard in any 75.18review or hearing to be held with respect to the child. Any other relative may also request, 75.19and must be granted, a notice and the opportunity to be heard under this section. This 75.20subdivision does not require that a foster parent, preadoptive parent, or relative providing 75.21care for the child be made a party to a review or hearing solely on the basis of the notice 75.22and opportunity right to be heard.75.23    Sec. 71. Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:75.24    Subdivision 1. General. (a) Except for hearings arising under section 
         260C.425, 75.25hearings on any matter shall be without a jury and may be conducted in an informal 75.26manner. In all adjudicatory proceedings involving a child alleged to be in need of 75.27protection or services, the court shall admit only evidence that would be admissible in a 75.28civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of 75.29protection or services must be proved by clear and convincing evidence. 75.30    (b) Except for proceedings involving a child alleged to be in need of protection or 75.31services and petitions for the termination of parental rights, hearings may be continued or 75.32adjourned from time to time. In proceedings involving a child alleged to be in need of 75.33protection or services and petitions for the termination of parental rights, hearings may not 75.34be continued or adjourned for more than one week unless the court makes specific findings 76.1that the continuance or adjournment is in the best interests of the child. If a hearing is held 76.2on a petition involving physical or sexual abuse of a child who is alleged to be in need of 76.3protection or services or neglected and in foster care, the court shall file the decision with 76.4the court administrator as soon as possible but no later than 15 days after the matter is 76.5submitted to the court. When a continuance or adjournment is ordered in any proceeding, 76.6the court may make any interim orders as it deems in the best interests of the minor in 76.7accordance with the provisions of sections 
         260C.001 to 
         260C.421. 76.8    (c) Except as otherwise provided in this paragraph, the court shall exclude the 76.9general public from hearings under this chapter and shall admit only those persons who, in 76.10the discretion of the court, have a direct interest in the case or in the work of the court.76.11    (d) Adoption hearings shall be conducted in accordance with the provisions of 76.12laws relating to adoptions.76.13    (e) In any permanency hearing, including the transition of a child from foster care 76.14to independent living, the court shall ensure that any consult with the child is in an 76.15age-appropriate manner.76.16    Sec. 72. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to 76.17read:76.18    Subd. 11. Review of court-ordered placements; permanent placement 76.19determination. (a) This subdivision and subdivision 11a do not apply in cases where 76.20the child is in placement due solely to the child's developmental disability or emotional 76.21disturbance, where legal custody has not been transferred to the responsible social services 76.22agency, and where the court finds compelling reasons under section 
         260C.007, subdivision 76.238
         , to continue the child in foster care past the time periods specified in this subdivision. 76.24Foster care placements of children due solely to their disability are governed by section 76.25260C.141, subdivision 2a
         . In all other cases where the child is in foster care or in the care 76.26of a noncustodial parent under subdivision 1, the court shall commence proceedings 76.27to determine the permanent status of a child not later than 12 months after the child is 76.28placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing 76.29commencing such proceedings, the court shall determine whether there is a prima facie 76.30basis for finding that the agency made reasonable efforts, or in the case of an Indian 76.31child active efforts, required under section 
         260.012 and proceed according to the rules of 76.32juvenile court.76.33    For purposes of this subdivision, the date of the child's placement in foster care is 76.34the earlier of the first court-ordered placement or 60 days after the date on which the 76.35child has been voluntarily placed in foster care by the child's parent or guardian. For 77.1purposes of this subdivision, time spent by a child under the protective supervision of 77.2the responsible social services agency in the home of a noncustodial parent pursuant to 77.3an order under subdivision 1 counts towards the requirement of a permanency hearing 77.4under this subdivision or subdivision 11a. Time spent on a trial home visit does not count77.5counts towards the requirement of a permanency hearing under this subdivision orand a 77.6permanency review for a child under eight years of age under subdivision 11a.77.7    For purposes of this subdivision, 12 months is calculated as follows:77.8    (1) during the pendency of a petition alleging that a child is in need of protection 77.9or services, all time periods when a child is placed in foster care or in the home of a 77.10noncustodial parent are cumulated;77.11    (2) if a child has been placed in foster care within the previous five years under one 77.12or more previous petitions, the lengths of all prior time periods when the child was placed 77.13in foster care within the previous five years are cumulated. If a child under this clause 77.14has been in foster care for 12 months or more, the court, if it is in the best interests of the 77.15child and for compelling reasons, may extend the total time the child may continue out 77.16of the home under the current petition up to an additional six months before making a 77.17permanency determination.77.18    (b) Unless the responsible social services agency recommends return of the child 77.19to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing 77.20required under paragraph (a) and the rules of juvenile court, the responsible social services 77.21agency shall file pleadings in juvenile court to establish the basis for the juvenile court to 77.22order permanent placement of the child, including a termination of parental rights petition, 77.23according to paragraph (d). Notice of the hearing and copies of the pleadings must be 77.24provided pursuant to section 
         260C.152.77.25    (c) The permanency proceedings shall be conducted in a timely fashion including 77.26that any trial required under section 
         260C.163 shall be commenced within 60 days of the 77.27admit-deny hearing required under paragraph (a). At the conclusion of the permanency 77.28proceedings, the court shall:77.29    (1) order the child returned to the care of the parent or guardian from whom the 77.30child was removed; or77.31    (2) order a permanent placement or termination of parental rights if permanent 77.32placement or termination of parental rights is in the child's best interests. The "best 77.33interests of the child" means all relevant factors to be considered and evaluated. Transfer 77.34of permanent legal and physical custody, termination of parental rights, or guardianship 77.35and legal custody to the commissioner through a consent to adopt are preferred 77.36permanency options for a child who cannot return home.78.1    (d) If the child is not returned to the home, the court must order one of the following 78.2dispositions:78.3    (1) permanent legal and physical custody to a relative in the best interests of the 78.4child according to the following conditions:78.5    (i) an order for transfer of permanent legal and physical custody to a relative shall 78.6only be made after the court has reviewed the suitability of the prospective legal and 78.7physical custodian;78.8    (ii) in transferring permanent legal and physical custody to a relative, the juvenile 78.9court shall follow the standards applicable under this chapter and chapter 260, and the 78.10procedures set out in the juvenile court rules;78.11    (iii) an order establishing permanent legal and physical custody under this 78.12subdivision must be filed with the family court;78.13    (iv) a transfer of legal and physical custody includes responsibility for the protection, 78.14education, care, and control of the child and decision making on behalf of the child;78.15    (v) the social services agency may bring a petition or motion naming a fit and 78.16willing relative as a proposed permanent legal and physical custodian. The commissioner 78.17of human services shall annually prepare for counties information that must be given to 78.18proposed custodians about their legal rights and obligations as custodians together with 78.19information on financial and medical benefits for which the child is eligible; and78.20    (vi) the juvenile court may maintain jurisdiction over the responsible social services 78.21agency, the parents or guardian of the child, the child, and the permanent legal and 78.22physical custodian for purposes of ensuring appropriate services are delivered to the child 78.23and permanent legal custodian or for the purpose of ensuring conditions ordered by the 78.24court related to the care and custody of the child are met;78.25    (2) termination of parental rights when the requirements of sections 
         260C.301 to 78.26260C.328
          are met or according to the following conditions:78.27    (i) order the social services agency to file a petition for termination of parental 78.28rights in which case all the requirements of sections 
         260C.301 to 
         260C.328 remain 78.29applicable; and78.30    (ii) an adoption completed subsequent to a determination under this subdivision may 78.31include an agreement for communication or contact under section 
         259.58;78.32    (3) long-term foster care according to the following conditions:78.33    (i) the court may order a child into long-term foster care only if it approves the 78.34responsible social service agency's compelling reasons that neither an award of permanent 78.35legal and physical custody to a relative, nor termination of parental rights is in the child's 78.36best interests;79.1    (ii) further, the court may only order long-term foster care for the child under this 79.2section if it finds the following:79.3    (A) the child has reached age 12 and the responsible social services agency has made 79.4reasonable efforts to locate and place the child with an adoptive family or with a fit and 79.5willing relative who will agree to a transfer of permanent legal and physical custody of 79.6the child, but such efforts have not proven successful; or79.7    (B) the child is a sibling of a child described in subitem (A) and the siblings have 79.8a significant positive relationship and are ordered into the same long-term foster care 79.9home; and79.10    (iii) at least annually, the responsible social services agency reconsiders its provision 79.11of services to the child and the child's placement in long-term foster care to ensure that:79.12    (A) long-term foster care continues to be the most appropriate legal arrangement 79.13for meeting the child's need for permanency and stability, including whether there is 79.14another permanent placement option under this chapter that would better serve the child's 79.15needs and best interests;79.16    (B) whenever possible, there is an identified long-term foster care family that is 79.17committed to being the foster family for the child as long as the child is a minor or under 79.18the jurisdiction of the court;79.19    (C) the child is receiving appropriate services or assistance to maintain or build 79.20connections with the child's family and community;79.21    (D) the child's physical and mental health needs are being appropriately provided 79.22for; and79.23    (E) the child's educational needs are being met;79.24    (4) foster care for a specified period of time according to the following conditions:79.25    (i) foster care for a specified period of time may be ordered only if:79.26    (A) the sole basis for an adjudication that the child is in need of protection or 79.27services is the child's behavior;79.28    (B) the court finds that foster care for a specified period of time is in the best 79.29interests of the child; and79.30    (C) the court approves the responsible social services agency's compelling reasons 79.31that neither an award of permanent legal and physical custody to a relative, nor termination 79.32of parental rights is in the child's best interests;79.33    (ii) the order does not specify that the child continue in foster care for any period 79.34exceeding one year; or79.35    (5) guardianship and legal custody to the commissioner of human services under 79.36the following procedures and conditions:80.1    (i) there is an identified prospective adoptive home agreed to by the responsible 80.2social services agency having legal custody of the child pursuant to court order under this 80.3section that has agreed to adopt the child and the court accepts the parent's voluntary 80.4consent to adopt under section 
         259.24, except that such consent executed by a parent under 80.5this item, following proper notice that consent given under this provision is irrevocable 80.6upon acceptance by the court, shall be irrevocable unless fraud is established and an order 80.7issues permitting revocation as stated in item (vii);80.8    (ii) if the court accepts a consent to adopt in lieu of ordering one of the other 80.9enumerated permanency dispositions, the court must review the matter at least every 90 80.10days. The review will address the reasonable efforts of the agency to achieve a finalized 80.11adoption;80.12    (iii) a consent to adopt under this clause vests all legal authority regarding the child, 80.13including guardianship and legal custody of the child, with the commissioner of human 80.14services as if the child were a state ward after termination of parental rights;80.15    (iv) the court must forward a copy of the consent to adopt, together with a certified 80.16copy of the order transferring guardianship and legal custody to the commissioner, to 80.17the commissioner;80.18    (v) if an adoption is not finalized by the identified prospective adoptive parent within 80.1912 months of the execution of the consent to adopt under this clause, the commissioner of 80.20human services or the commissioner's delegate shall pursue adoptive placement in another 80.21home unless the commissioner certifies that the failure to finalize is not due to either an 80.22action or a failure to act by the prospective adoptive parent;80.23    (vi) notwithstanding item (v), the commissioner of human services or the 80.24commissioner's designee must pursue adoptive placement in another home as soon as the 80.25commissioner or commissioner's designee determines that finalization of the adoption with 80.26the identified prospective adoptive parent is not possible, that the identified prospective 80.27adoptive parent is not willing to adopt the child, that the identified prospective adoptive 80.28parent is not cooperative in completing the steps necessary to finalize the adoption, or 80.29upon the commissioner's determination to withhold consent to the adoption.80.30    (vii) unless otherwise required by the Indian Child Welfare Act, United States Code, 80.31title 25, section 1913, a consent to adopt executed under this section, following proper 80.32notice that consent given under this provision is irrevocable upon acceptance by the court, 80.33shall be irrevocable upon acceptance by the court except upon order permitting revocation 80.34issued by the same court after written findings that consent was obtained by fraud.80.35    (e) In ordering a permanent placement of a child, the court must be governed by the 80.36best interests of the child, including a review of the relationship between the child and 81.1relatives and the child and other important persons with whom the child has resided or 81.2had significant contact. When the court has determined that permanent placement of the 81.3child away from the parent is necessary, the court shall consider permanent alternative 81.4homes that are available both inside and outside the state.81.5    (f) Once a permanent placement determination has been made and permanent 81.6placement has been established, further court reviews are necessary if:81.7    (1) the placement is long-term foster care or foster care for a specified period of time;81.8    (2) the court orders further hearings because it has retained jurisdiction of a transfer 81.9of permanent legal and physical custody matter;81.10    (3) an adoption has not yet been finalized; or81.11    (4) there is a disruption of the permanent or long-term placement.81.12    (g) Court reviews of an order for long-term foster care, whether under this section 81.13or section 
         260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and 81.14must review the child's out-of-home placement plan and the reasonable efforts of the 81.15agency to finalize the permanent plan for the child including the agency's efforts to:81.16    (1) ensure that long-term foster care continues to be the most appropriate legal 81.17arrangement for meeting the child's need for permanency and stability or, if not, to identify 81.18and attempt to finalize another permanent placement option under this chapter that would 81.19better serve the child's needs and best interests;81.20    (2) identify a specific long-term foster home for the child, if one has not already 81.21been identified;81.22    (3) support continued placement of the child in the identified home, if one has been 81.23identified;81.24    (4) ensure appropriate services are provided to address the physical health, mental 81.25health, and educational needs of the child during the period of long-term foster care and 81.26also ensure appropriate services or assistance to maintain relationships with appropriate 81.27family members and the child's community; and81.28    (5) plan for the child's independence upon the child's leaving long-term foster care 81.29living as required under section 
         260C.212, subdivision 1.81.30    (h) In the event it is necessary for a child that has been ordered into foster care for a 81.31specified period of time to be in foster care longer than one year after the permanency 81.32hearing held under this section, not later than 12 months after the time the child was 81.33ordered into foster care for a specified period of time, the matter must be returned to 81.34court for a review of the appropriateness of continuing the child in foster care and of the 81.35responsible social services agency's reasonable efforts to finalize a permanent plan for 81.36the child; if it is in the child's best interests to continue the order for foster care for a 82.1specified period of time past a total of 12 months, the court shall set objectives for the 82.2child's continuation in foster care, specify any further amount of time the child may be in 82.3foster care, and review the plan for the safe return of the child to the parent.82.4    (i) An order permanently placing a child out of the home of the parent or guardian 82.5must include the following detailed findings:82.6    (1) how the child's best interests are served by the order;82.7    (2) the nature and extent of the responsible social service agency's reasonable efforts, 82.8or, in the case of an Indian child, active efforts to reunify the child with the parent or 82.9guardian where reasonable efforts are required;82.10    (3) the parent's or parents' efforts and ability to use services to correct the conditions 82.11which led to the out-of-home placement; and82.12    (4) that the conditions which led to the out-of-home placement have not been 82.13corrected so that the child can safely return home.82.14    (j) An order for permanent legal and physical custody of a child may be modified 82.15under sections 
         518.18 and 
         518.185. The social services agency is a party to the proceeding 82.16and must receive notice. A parent may only seek modification of an order for long-term 82.17foster care upon motion and a showing by the parent of a substantial change in the parent's 82.18circumstances such that the parent could provide appropriate care for the child and that 82.19removal of the child from the child's permanent placement and the return to the parent's 82.20care would be in the best interest of the child. The responsible social services agency may 82.21ask the court to vacate an order for long-term foster care upon a prima facie showing 82.22that there is a factual basis for the court to order another permanency option under this 82.23chapter and that such an option is in the child's best interests. Upon a hearing where 82.24the court determines that there is a factual basis for vacating the order for long-term 82.25foster care and that another permanent order regarding the placement of the child is in 82.26the child's best interests, the court may vacate the order for long-term foster care and 82.27enter a different order for permanent placement that is in the child's best interests. The 82.28court shall not require further reasonable efforts to reunify the child with the parent or 82.29guardian as a basis for vacating the order for long-term foster care and ordering a different 82.30permanent placement in the child's best interests. The county attorney must file pleadings 82.31and give notice as required under the rules of juvenile court in order to modify an order for 82.32long-term foster care under this paragraph.82.33    (k) The court shall issue an order required under this section within 15 days of the 82.34close of the proceedings. The court may extend issuing the order an additional 15 days 82.35when necessary in the interests of justice and the best interests of the child.83.1    (l) This paragraph applies to proceedings required under this subdivision when 83.2the child is on a trial home visit:83.3    (1) if the child is on a trial home visit 12 months after the child was placed in 83.4foster care or in the care of a noncustodial parent as calculated in this subdivision, the 83.5responsible social services agency may file a report with the court regarding the child's and 83.6parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe 83.7and permanent return to the care of the parent in lieu of filing the pleadings required under 83.8paragraph (b). The court shall make findings regarding reasonableness of the responsible 83.9social services efforts to finalize the child's return home as the permanent order in the best 83.10interests of the child. The court may continue the trial home visit to a total time not to 83.11exceed six months as provided in subdivision 1. If the court finds the responsible social 83.12services agency has not made reasonable efforts to finalize the child's return home as the 83.13permanent order in the best interests of the child, the court may order other or additional 83.14efforts to support the child remaining in the care of the parent; and83.15    (2) if a trial home visit ordered or continued at proceedings under this subdivision 83.16terminates, the court shall re-commence proceedings under this subdivision to determine 83.17the permanent status of the child not later than 30 days after the child is returned to foster 83.18care.83.19    Sec. 73. Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:83.20    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan 83.21shall be prepared within 30 days after any child is placed in a residential facility by court 83.22order or by the voluntary release of the child by the parent or parents.83.23    For purposes of this section, a residential facility means any group home, family 83.24foster home or other publicly supported out-of-home residential facility, including any 83.25out-of-home residential facility under contract with the state, county or other political 83.26subdivision, or any agency thereof, to provide those services or foster care as defined in 83.27section 
         260C.007, subdivision 18.83.28    (b) An out-of-home placement plan means a written document which is prepared by 83.29the responsible social services agency jointly with the parent or parents or guardian of the 83.30child and in consultation with the child's guardian ad litem, the child's tribe, if the child is 83.31an Indian child, the child's foster parent or representative of the residential facility, and, 83.32where appropriate, the child. For a child in placement due solely or in part to the child's 83.33emotional disturbance, preparation of the out-of-home placement plan shall additionally 83.34include the child's mental health treatment provider. As appropriate, the plan shall be:83.35    (1) submitted to the court for approval under section 
         260C.178, subdivision 7;84.1    (2) ordered by the court, either as presented or modified after hearing, under section 84.2260C.178, subdivision 7
         , or 
         260C.201, subdivision 6; and84.3    (3) signed by the parent or parents or guardian of the child, the child's guardian ad 84.4litem, a representative of the child's tribe, the responsible social services agency, and, if 84.5possible, the child.84.6    (c) The out-of-home placement plan shall be explained to all persons involved in its 84.7implementation, including the child who has signed the plan, and shall set forth:84.8    (1) a description of the residential facility including how the out-of-home placement 84.9plan is designed to achieve a safe placement for the child in the least restrictive, most 84.10family-like, setting available which is in close proximity to the home of the parent or 84.11parents or guardian of the child when the case plan goal is reunification, and how the 84.12placement is consistent with the best interests and special needs of the child according to 84.13the factors under subdivision 2, paragraph (b);84.14    (2) the specific reasons for the placement of the child in a residential facility, and 84.15when reunification is the plan, a description of the problems or conditions in the home of 84.16the parent or parents which necessitated removal of the child from home and the changes 84.17the parent or parents must make in order for the child to safely return home;84.18    (3) a description of the services offered and provided to prevent removal of the child 84.19from the home and to reunify the family including:84.20    (i) the specific actions to be taken by the parent or parents of the child to eliminate 84.21or correct the problems or conditions identified in clause (2), and the time period during 84.22which the actions are to be taken; and84.23    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made 84.24to achieve a safe and stable home for the child including social and other supportive 84.25services to be provided or offered to the parent or parents or guardian of the child, the 84.26child, and the residential facility during the period the child is in the residential facility;84.27    (4) a description of any services or resources that were requested by the child or the 84.28child's parent, guardian, foster parent, or custodian since the date of the child's placement 84.29in the residential facility, and whether those services or resources were provided and if 84.30not, the basis for the denial of the services or resources;84.31    (5) the visitation plan for the parent or parents or guardian, other relatives as defined 84.32in section 
         260C.007, subdivision 27, and siblings of the child if the siblings are not placed 84.33together in the residential facility, and whether visitation is consistent with the best interest 84.34of the child, during the period the child is in the residential facility;84.35    (6) documentation of steps to finalize the adoption or legal guardianship of the child 84.36if the court has issued an order terminating the rights of both parents of the child or of 85.1the only known, living parent of the child, and. At a minimum, the documentation must 85.2include child-specific recruitment efforts such as relative search and the use of state, 85.3regional, and national adoption exchanges to facilitate orderly and timely placements in 85.4and outside of the state. A copy of this documentation shall be provided to the court in the 85.5review required under section 
         260C.317, subdivision 3, paragraph (b);85.6    (7) to the extent available and accessible, the health and educational records of the 85.7child including the most recent information available regarding:85.8    (i) the names and addresses of the child's health and educational providers;85.9    (ii) the child's grade level performance;85.10    (iii) the child's school record;85.11    (iv) assurances that the child's placement in foster care takes into account proximity 85.12to the school in which the child is enrolled at the time of placement;85.13    (v) a record of the child's immunizations;85.14    (vi) the child's known medical problems, including any known communicable 85.15diseases, as defined in section 
         144.4172, subdivision 2;85.16    (vii) the child's medications; and85.17    (viii) any other relevant health and education information;85.18    (8) an independent living plan for a child age 16 or older who is in placement as 85.19a result of a permanency disposition. The plan should include, but not be limited to, 85.20the following objectives:85.21    (i) educational, vocational, or employment planning;85.22    (ii) health care planning and medical coverage;85.23    (iii) transportation including, where appropriate, assisting the child in obtaining a 85.24driver's license;85.25    (iv) money management;85.26    (v) planning for housing;85.27    (vi) social and recreational skills; and85.28    (vii) establishing and maintaining connections with the child's family and 85.29community; and85.30    (9) for a child in placement due solely or in part to the child's emotional disturbance, 85.31diagnostic and assessment information, specific services relating to meeting the mental 85.32health care needs of the child, and treatment outcomes.85.33    (d) The parent or parents or guardian and the child each shall have the right to legal 85.34counsel in the preparation of the case plan and shall be informed of the right at the time 85.35of placement of the child. The child shall also have the right to a guardian ad litem. 85.36If unable to employ counsel from their own resources, the court shall appoint counsel 86.1upon the request of the parent or parents or the child or the child's legal guardian. The 86.2parent or parents may also receive assistance from any person or social services agency 86.3in preparation of the case plan.86.4    After the plan has been agreed upon by the parties involved or approved or ordered 86.5by the court, the foster parents shall be fully informed of the provisions of the case plan 86.6and shall be provided a copy of the plan.86.7    Upon discharge from foster care, the parent, adoptive parent, or permanent legal and 86.8physical custodian, as appropriate, and the child, if appropriate, must be provided with 86.9a current copy of the child's health and education record.86.10    Sec. 74. Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:86.11    Subd. 4. Responsible social service agency's duties for children in placement. (a) 86.12When a child is in placement, the responsible social services agency shall make diligent 86.13efforts to identify, locate, and, where appropriate, offer services to both parents of the child.86.14    (1) The responsible social services agency shall assess whether a noncustodial or 86.15nonadjudicated parent is willing and capable of providing for the day-to-day care of the 86.16child temporarily or permanently. An assessment under this clause may include, but 86.17is not limited to, obtaining information under section 
         260C.209. If after assessment, 86.18the responsible social services agency determines that a noncustodial or nonadjudicated 86.19parent is willing and capable of providing day-to-day care of the child, the responsible 86.20social services agency may seek authority from the custodial parent or the court to have 86.21that parent assume day-to-day care of the child. If a parent is not an adjudicated parent, 86.22the responsible social services agency shall require the nonadjudicated parent to cooperate 86.23with paternity establishment procedures as part of the case plan.86.24    (2) If, after assessment, the responsible social services agency determines that the 86.25child cannot be in the day-to-day care of either parent, the agency shall:86.26    (i) prepare an out-of-home placement plan addressing the conditions that each parent 86.27must meet before the child can be in that parent's day-to-day care; and86.28    (ii) provide a parent who is the subject of a background study under section 86.29260C.209
          15 days' notice that it intends to use the study to recommend against putting the 86.30child with that parent, as well as the notice provided in section 
         260C.209, subdivision 4, 86.31and the court shall afford the parent an opportunity to be heard concerning the study.86.32    The results of a background study of a noncustodial parent shall not be used by the 86.33agency to determine that the parent is incapable of providing day-to-day care of the child 86.34unless the agency reasonably believes that placement of the child into the home of that 86.35parent would endanger the child's health, safety, or welfare.87.1    (3) If, after the provision of services following an out-of-home placement plan under 87.2this section, the child cannot return to the care of the parent from whom the child was 87.3removed or who had legal custody at the time the child was placed in foster care, the 87.4agency may petition on behalf of a noncustodial parent to establish legal custody with 87.5that parent under section 
         260C.201, subdivision 11. If paternity has not already been 87.6established, it may be established in the same proceeding in the manner provided for 87.7under chapter 257.87.8    (4) The responsible social services agency may be relieved of the requirement to 87.9locate and offer services to both parents by the juvenile court upon a finding of good cause 87.10after the filing of a petition under section 
         260C.141.87.11    (b) The responsible social services agency shall give notice to the parent or parents 87.12or guardian of each child in a residential facility, other than a child in placement due 87.13solely to that child's developmental disability or emotional disturbance, of the following 87.14information:87.15    (1) that residential care of the child may result in termination of parental rights or an 87.16order permanently placing the child out of the custody of the parent, but only after notice 87.17and a hearing as required under chapter 260C and the juvenile court rules;87.18    (2) time limits on the length of placement and of reunification services, including 87.19the date on which the child is expected to be returned to and safely maintained in the 87.20home of the parent or parents or placed for adoption or otherwise permanently removed 87.21from the care of the parent by court order;87.22    (3) the nature of the services available to the parent;87.23    (4) the consequences to the parent and the child if the parent fails or is unable to use 87.24services to correct the circumstances that led to the child's placement;87.25    (5) the first consideration for placement with relatives;87.26    (6) the benefit to the child in getting the child out of residential care as soon as 87.27possible, preferably by returning the child home, but if that is not possible, through a 87.28permanent legal placement of the child away from the parent;87.29    (7) when safe for the child, the benefits to the child and the parent of maintaining 87.30visitation with the child as soon as possible in the course of the case and, in any event, 87.31according to the visitation plan under this section; and87.32    (8) the financial responsibilities and obligations, if any, of the parent or parents for 87.33the support of the child during the period the child is in the residential facility.87.34    (c) The responsible social services agency shall inform a parent considering 87.35voluntary placement of a child who is not developmentally disabled or emotionally 87.36disturbed of the following information:88.1    (1) the parent and the child each has a right to separate legal counsel before signing a 88.2voluntary placement agreement, but not to counsel appointed at public expense;88.3    (2) the parent is not required to agree to the voluntary placement, and a parent 88.4who enters a voluntary placement agreement may at any time request that the agency 88.5return the child. If the parent so requests, the child must be returned within 24 hours of 88.6the receipt of the request;88.7    (3) evidence gathered during the time the child is voluntarily placed may be used 88.8at a later time as the basis for a petition alleging that the child is in need of protection 88.9or services or as the basis for a petition seeking termination of parental rights or other 88.10permanent placement of the child away from the parent;88.11    (4) if the responsible social services agency files a petition alleging that the child is 88.12in need of protection or services or a petition seeking the termination of parental rights 88.13or other permanent placement of the child away from the parent, the parent would have 88.14the right to appointment of separate legal counsel and the child would have a right to the 88.15appointment of counsel and a guardian ad litem as provided by law, and that counsel will 88.16be appointed at public expense if they are unable to afford counsel; and88.17    (5) the timelines and procedures for review of voluntary placements under 88.18subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a 88.19permanent placement determination hearing under section 
         260C.201, subdivision 11.88.20    (d) When an agency accepts a child for placement, the agency shall determine 88.21whether the child has had a physical examination by or under the direction of a licensed 88.22physician within the 12 months immediately preceding the date when the child came into 88.23the agency's care. If there is documentation that the child has had an examination within 88.24the last 12 months, the agency is responsible for seeing that the child has another physical 88.25examination within one year of the documented examination and annually in subsequent 88.26years. If the agency determines that the child has not had a physical examination within 88.27the 12 months immediately preceding placement, the agency shall ensure that the child 88.28has an examination within 30 days of coming into the agency's care and once a year 88.29in subsequent years.88.30    (e) If a child leaves foster care by reason of having attained the age of majority 88.31under state law, the child must be given at no cost a copy of the child's health and 88.32education report.88.33    Sec. 75. Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:88.34    Subd. 9. Review of certain child placements. (a) When a developmentally 88.35disabled child or emotionally disturbed child needs placement in a residential facility for 89.1the sole reason of accessing services or a level of skilled care that cannot be provided in 89.2the parent's home, the child must be placed pursuant to a voluntary placement agreement 89.3between the responsible social services agency and the child's parent. The voluntary 89.4placement agreement must give the responsible social services agency legal responsibility 89.5for the child's physical care, custody, and control, but must not transfer legal custody of 89.6the child to the agency. The voluntary placement agreement must be executed in a form 89.7developed and promulgated by the commissioner of human services. The responsible 89.8social services agency shall report to the commissioner the number of children who are the 89.9subject of a voluntary placement agreement under this subdivision and other information 89.10regarding these children as the commissioner may require.89.11    (b) If a developmentally disabled child or a child diagnosed as emotionally disturbed 89.12has been placed in a residential facility pursuant to a voluntary release by the child's parent 89.13or parents because of the child's disabling conditions or need for long-term residential 89.14treatment or supervision, the social services agency responsible for the placement shall 89.15report to the court and bring a petition for review of the child's foster care status as 89.16required in section 
         260C.141, subdivision 2a. 89.17    (b)(c) If a child is in placement due solely to the child's developmental disability or 89.18emotional disturbance, and the court finds compelling reasons not to proceed under section 89.19260C.201, subdivision 11
         , and custody of the child is not transferred to the responsible 89.20social services agency under section 
         260C.201, subdivision 1, paragraph (a), clause (2), 89.21and no petition is required by section 
         260C.201, subdivision 11. 89.22    (c)(d) Whenever a petition for review is brought pursuant to this subdivision, a 89.23guardian ad litem shall be appointed for the child.89.24    Sec. 76. Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:89.25    Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and 89.26the order terminating parental rights, and a summary of the court's information concerning 89.27the child shall be furnished by the court to the commissioner or the agency to which 89.28guardianship is transferred. The orders shall be on a document separate from the findings. 89.29The court shall furnish the individual to whom guardianship is transferred a copy of the 89.30order terminating parental rights.89.31    (b) The court shall retain jurisdiction in a case where adoption is the intended 89.32permanent placement disposition until the child's adoption is finalized, the child is 18 years 89.33of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The 89.34guardian ad litem and counsel for the child shall continue on the case until an adoption 89.35decree is entered. A hearing must be held every 90 days following termination of parental 90.1rights for the court to review progress toward an adoptive placement and the specific 90.2recruitment efforts the agency has taken to find an adoptive family or other placement 90.3living arrangement for the child and to finalize the adoption or other permanency plan.90.4    (c) The responsible social services agency may make a determination of compelling 90.5reasons for a child to be in long-term foster care when the agency has made exhaustive 90.6efforts to recruit, identify, and place the child in an adoptive home, and the child continues 90.7in foster care for at least 24 months after the court has issued the order terminating 90.8parental rights. A child of any age who is under the guardianship of the commissioner of 90.9the Department of Human Services and is legally available for adoption may not refuse 90.10or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the 90.11child in an adoptive home required under paragraph (b) or sign a document relieving 90.12county social services agencies of all recruitment efforts on the child's behalf. Upon 90.13approving the agency's determination of compelling reasons, the court may order the 90.14child placed in long-term foster care. At least every 12 months thereafter as long as the 90.15child continues in out-of-home placement, the court shall conduct a permanency review 90.16hearing to determine the future status of the child using the review requirements of section 90.17260C.201, subdivision 11
         , paragraph (g).90.18    (d) The court shall retain jurisdiction through the child's minority in a case where 90.19long-term foster care is the permanent disposition whether under paragraph (c) or section 90.20260C.201, subdivision 11
         .90.21    Sec. 77. Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:90.22    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights 90.23are terminated,90.24    (1) whenever legal custody of a child is transferred by the court to a responsible 90.25social services agency,90.26    (2) whenever legal custody is transferred to a person other than the responsible social 90.27services agency, but under the supervision of the responsible social services agency, or90.28    (3) whenever a child is given physical or mental examinations or treatment under 90.29order of the court, and no provision is otherwise made by law for payment for the care, 90.30examination, or treatment of the child, these costs are a charge upon the welfare funds of 90.31the county in which proceedings are held upon certification of the judge of juvenile court.90.32    (b) The court shall order, and the responsible social services agency shall require, 90.33the parents or custodian of a child, while the child is under the age of 18, to use the 90.34total income and resources attributable to the child for the period of care, examination, 90.35or treatment, except for clothing and personal needs allowance as provided in section 91.1256B.35
         , to reimburse the county for the cost of care, examination, or treatment. Income 91.2and resources attributable to the child include, but are not limited to, Social Security 91.3benefits, supplemental security income (SSI), veterans benefits, railroad retirement 91.4benefits and child support. When the child is over the age of 18, and continues to receive 91.5care, examination, or treatment, the court shall order, and the responsible social services 91.6agency shall require, reimbursement from the child for the cost of care, examination, or 91.7treatment from the income and resources attributable to the child less the clothing and 91.8personal needs allowance. Income does not include earnings from a child over the age of 91.918 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c), 91.10clause (8), to transition from foster care.91.11    (c) If the income and resources attributable to the child are not enough to reimburse 91.12the county for the full cost of the care, examination, or treatment, the court shall inquire 91.13into the ability of the parents to support the child and, after giving the parents a reasonable 91.14opportunity to be heard, the court shall order, and the responsible social services agency 91.15shall require, the parents to contribute to the cost of care, examination, or treatment of 91.16the child. When determining the amount to be contributed by the parents, the court shall 91.17use a fee schedule based upon ability to pay that is established by the responsible social 91.18services agency and approved by the commissioner of human services. The income of 91.19a stepparent who has not adopted a child shall be excluded in calculating the parental 91.20contribution under this section.91.21    (d) The court shall order the amount of reimbursement attributable to the parents 91.22or custodian, or attributable to the child, or attributable to both sources, withheld under 91.23chapter 518A from the income of the parents or the custodian of the child. A parent or 91.24custodian who fails to pay without good reason may be proceeded against for contempt, or 91.25the court may inform the county attorney, who shall proceed to collect the unpaid sums, 91.26or both procedures may be used.91.27    (e) If the court orders a physical or mental examination for a child, the examination 91.28is a medically necessary service for purposes of determining whether the service is 91.29covered by a health insurance policy, health maintenance contract, or other health 91.30coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan 91.31requirements for medical necessity. Nothing in this paragraph changes or eliminates 91.32benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions, 91.33or other requirements in the policy, contract, or plan that relate to coverage of other 91.34medically necessary services.91.35    Sec. 78. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:92.1    Subdivision 1. Disclosure to commissioner of human services. (a) On the request 92.2of the commissioner of human services, the commissioner shall disclose return information 92.3regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to 92.4the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).92.5    (b) Data that may be disclosed are limited to data relating to the identity, 92.6whereabouts, employment, income, and property of a person owing or alleged to be owing 92.7an obligation of child support.92.8    (c) The commissioner of human services may request data only for the purposes of 92.9carrying out the child support enforcement program and to assist in the location of parents 92.10who have, or appear to have, deserted their children. Data received may be used only 92.11as set forth in section 
         256.978. 92.12    (d) The commissioner shall provide the records and information necessary to 92.13administer the supplemental housing allowance to the commissioner of human services.92.14    (e) At the request of the commissioner of human services, the commissioner of 92.15revenue shall electronically match the Social Security numbers and names of participants 92.16in the telephone assistance plan operated under sections 
         237.69 to 
         237.711, with those of 92.17property tax refund filers, and determine whether each participant's household income is 92.18within the eligibility standards for the telephone assistance plan. 92.19    (f) The commissioner may provide records and information collected under sections 92.20295.50
          to 
         295.59 to the commissioner of human services for purposes of the Medicaid 92.21Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law 92.22102-234. Upon the written agreement by the United States Department of Health and 92.23Human Services to maintain the confidentiality of the data, the commissioner may provide 92.24records and information collected under sections 
         295.50 to 
         295.59 to the Centers for 92.25Medicare and Medicaid Services section of the United States Department of Health and 92.26Human Services for purposes of meeting federal reporting requirements. 92.27    (g) The commissioner may provide records and information to the commissioner of 92.28human services as necessary to administer the early refund of refundable tax credits.92.29    (h) The commissioner may disclose information to the commissioner of human 92.30services necessary to verify income for eligibility and premium payment under the 92.31MinnesotaCare program, under section 
         256L.05, subdivision 2. 92.32    (i) The commissioner may disclose information to the commissioner of human 92.33services necessary to verify whether applicants or recipients for the Minnesota family 92.34investment program, general assistance, food support, and Minnesota supplemental aid 92.35program, and child care assistance have claimed refundable tax credits under chapter 290 92.36and the property tax refund under chapter 290A, and the amounts of the credits.93.1    Sec. 79. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:93.2    Subd. 2. Definitions. As used in this section, the following terms have the meanings 93.3given them unless the specific content indicates otherwise:93.4    (a) "Family assessment" means a comprehensive assessment of child safety, risk 93.5of subsequent child maltreatment, and family strengths and needs that is applied to a 93.6child maltreatment report that does not allege substantial child endangerment. Family 93.7assessment does not include a determination as to whether child maltreatment occurred 93.8but does determine the need for services to address the safety of family members and the 93.9risk of subsequent maltreatment.93.10    (b) "Investigation" means fact gathering related to the current safety of a child 93.11and the risk of subsequent maltreatment that determines whether child maltreatment 93.12occurred and whether child protective services are needed. An investigation must be used 93.13when reports involve substantial child endangerment, and for reports of maltreatment in 93.14facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to 93.15144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 93.1613, and 124D.10; or in a nonlicensed personal care provider association as defined in 93.17sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.93.18    (c) "Substantial child endangerment" means a person responsible for a child's care, 93.19and in the case of sexual abuse includes a person who has a significant relationship to the 93.20child as defined in section 609.341, or a person in a position of authority as defined in 93.21section 609.341, who by act or omission commits or attempts to commit an act against a 93.22child under their care that constitutes any of the following:93.23    (1) egregious harm as defined in section 260C.007, subdivision 14;93.24    (2) sexual abuse as defined in paragraph (d);93.25    (3) abandonment under section 260C.301, subdivision 2;93.26    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the 93.27child's physical or mental health, including a growth delay, which may be referred to as 93.28failure to thrive, that has been diagnosed by a physician and is due to parental neglect;93.29    (5) murder in the first, second, or third degree under section 609.185, 609.19, or 93.30609.195;93.31    (6) manslaughter in the first or second degree under section 609.20 or 609.205;93.32    (7) assault in the first, second, or third degree under section 609.221, 609.222, or 93.33609.223;93.34    (8) solicitation, inducement, and promotion of prostitution under section 609.322;93.35    (9) criminal sexual conduct under sections 609.342 to 609.3451;93.36    (10) solicitation of children to engage in sexual conduct under section 609.352;94.1    (11) malicious punishment or neglect or endangerment of a child under section 94.2609.377 or 609.378;94.3    (12) use of a minor in sexual performance under section 617.246; or94.4    (13) parental behavior, status, or condition which mandates that the county attorney 94.5file a termination of parental rights petition under section 260C.301, subdivision 3, 94.6paragraph (a).94.7    (d) "Sexual abuse" means the subjection of a child by a person responsible for the 94.8child's care, by a person who has a significant relationship to the child, as defined in 94.9section 609.341, or by a person in a position of authority, as defined in section 609.341, 94.10subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual 94.11conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 94.12609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct 94.13in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual 94.14abuse also includes any act which involves a minor which constitutes a violation of 94.15prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes 94.16threatened sexual abuse.94.17    (e) "Person responsible for the child's care" means (1) an individual functioning 94.18within the family unit and having responsibilities for the care of the child such as a 94.19parent, guardian, or other person having similar care responsibilities, or (2) an individual 94.20functioning outside the family unit and having responsibilities for the care of the child 94.21such as a teacher, school administrator, other school employees or agents, or other lawful 94.22custodian of a child having either full-time or short-term care responsibilities including, 94.23but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, 94.24and coaching.94.25    (f) "Neglect" means:94.26    (1) failure by a person responsible for a child's care to supply a child with necessary 94.27food, clothing, shelter, health, medical, or other care required for the child's physical or 94.28mental health when reasonably able to do so;94.29    (2) failure to protect a child from conditions or actions that seriously endanger the 94.30child's physical or mental health when reasonably able to do so, including a growth delay, 94.31which may be referred to as a failure to thrive, that has been diagnosed by a physician and 94.32is due to parental neglect;94.33    (3) failure to provide for necessary supervision or child care arrangements 94.34appropriate for a child after considering factors as the child's age, mental ability, physical 94.35condition, length of absence, or environment, when the child is unable to care for the 94.36child's own basic needs or safety, or the basic needs or safety of another child in their care;95.1    (4) failure to ensure that the child is educated as defined in sections 120A.22 and 95.2260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 95.3child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;95.4    (5) nothing in this section shall be construed to mean that a child is neglected solely 95.5because the child's parent, guardian, or other person responsible for the child's care in 95.6good faith selects and depends upon spiritual means or prayer for treatment or care of 95.7disease or remedial care of the child in lieu of medical care; except that a parent, guardian, 95.8or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report 95.9if a lack of medical care may cause serious danger to the child's health. This section does 95.10not impose upon persons, not otherwise legally responsible for providing a child with 95.11necessary food, clothing, shelter, education, or medical care, a duty to provide that care;95.12    (6) prenatal exposure to a controlled substance, as defined in section 253B.02, 95.13subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal 95.14symptoms in the child at birth, results of a toxicology test performed on the mother at 95.15delivery or the child at birth, or medical effects or developmental delays during the child's 95.16first year of life that medically indicate prenatal exposure to a controlled substance;95.17    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);95.18    (8) chronic and severe use of alcohol or a controlled substance by a parent or 95.19person responsible for the care of the child that adversely affects the child's basic needs 95.20and safety; or95.21    (9) emotional harm from a pattern of behavior which contributes to impaired 95.22emotional functioning of the child which may be demonstrated by a substantial and 95.23observable effect in the child's behavior, emotional response, or cognition that is not 95.24within the normal range for the child's age and stage of development, with due regard to 95.25the child's culture.95.26    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury, 95.27inflicted by a person responsible for the child's care on a child other than by accidental 95.28means, or any physical or mental injury that cannot reasonably be explained by the child's 95.29history of injuries, or any aversive or deprivation procedures, or regulated interventions, 95.30that have not been authorized under section 121A.67 or 245.825. Abuse does not include 95.31reasonable and moderate physical discipline of a child administered by a parent or legal 95.32guardian which does not result in an injury. Abuse does not include the use of reasonable 95.33force by a teacher, principal, or school employee as allowed by section 121A.582. Actions 95.34which are not reasonable and moderate include, but are not limited to, any of the following 95.35that are done in anger or without regard to the safety of the child:95.36    (1) throwing, kicking, burning, biting, or cutting a child;96.1    (2) striking a child with a closed fist;96.2    (3) shaking a child under age three;96.3    (4) striking or other actions which result in any nonaccidental injury to a child 96.4under 18 months of age;96.5    (5) unreasonable interference with a child's breathing;96.6    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;96.7    (7) striking a child under age one on the face or head;96.8    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 96.9substances which were not prescribed for the child by a practitioner, in order to control or 96.10punish the child; or other substances that substantially affect the child's behavior, motor 96.11coordination, or judgment or that results in sickness or internal injury, or subjects the 96.12child to medical procedures that would be unnecessary if the child were not exposed 96.13to the substances;96.14    (9) unreasonable physical confinement or restraint not permitted under section 96.15609.379, including but not limited to tying, caging, or chaining; or96.16    (10) in a school facility or school zone, an act by a person responsible for the child's 96.17care that is a violation under section 121A.58.96.18    (h) "Report" means any report received by the local welfare agency, police 96.19department, county sheriff, or agency responsible for assessing or investigating 96.20maltreatment pursuant to this section.96.21    (i) "Facility" means: 96.22    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 96.23sanitarium, or other facility or institution required to be licensed under sections 144.50 to 96.24144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B; 96.25    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 96.26124D.10; or 96.27    (3) a nonlicensed personal care provider organization as defined in sections 256B.04, 96.28subdivision 16, and 256B.0625, subdivision 19a.96.29    (j) "Operator" means an operator or agency as defined in section 245A.02.96.30    (k) "Commissioner" means the commissioner of human services.96.31    (l) "Practice of social services," for the purposes of subdivision 3, includes but is 96.32not limited to employee assistance counseling and the provision of guardian ad litem and 96.33parenting time expeditor services.96.34    (m) "Mental injury" means an injury to the psychological capacity or emotional 96.35stability of a child as evidenced by an observable or substantial impairment in the child's 97.1ability to function within a normal range of performance and behavior with due regard to 97.2the child's culture.97.3    (n) "Threatened injury" means a statement, overt act, condition, or status that 97.4represents a substantial risk of physical or sexual abuse or mental injury. Threatened 97.5injury includes, but is not limited to, exposing a child to a person responsible for the 97.6child's care, as defined in paragraph (e), clause (1), who has:97.7    (1) subjected a child to, or failed to protect a child from, an overt act or condition 97.8that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a 97.9similar law of another jurisdiction;97.10    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause 97.11(4), or a similar law of another jurisdiction;97.12    (3) committed an act that has resulted in an involuntary termination of parental rights 97.13under section 260C.301, or a similar law of another jurisdiction; or97.14    (4) committed an act that has resulted in the involuntary transfer of permanent legal 97.15and physical custody of a child to a relative under section 260C.201, subdivision 11, 97.16paragraph (d), clause (1), or a similar law of another jurisdiction.97.17    (o) Persons who conduct assessments or investigations under this section shall take 97.18into account accepted child-rearing practices of the culture in which a child participates 97.19and accepted teacher discipline practices, which are not injurious to the child's health, 97.20welfare, and safety.97.21    Sec. 80. Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:97.22    Subd. 3. Persons mandated to report. (a) A person who knows or has reason 97.23to believe a child is being neglected or physically or sexually abused, as defined in 97.24subdivision 2, or has been neglected or physically or sexually abused within the preceding 97.25three years, shall immediately report the information to the local welfare agency, agency 97.26responsible for assessing or investigating the report, police department, or the county 97.27sheriff if the person is:97.28    (1) a professional or professional's delegate who is engaged in the practice of 97.29the healing arts, social services, hospital administration, psychological or psychiatric 97.30treatment, child care, education, correctional supervision, probation and correctional 97.31services, or law enforcement; or97.32    (2) employed as a member of the clergy and received the information while 97.33engaged in ministerial duties, provided that a member of the clergy is not required by 97.34this subdivision to report information that is otherwise privileged under section 
         595.02, 97.35subdivision 1
         , paragraph (c).98.1    The police department or the county sheriff, upon receiving a report, shall 98.2immediately notify the local welfare agency or agency responsible for assessing or 98.3investigating the report, orally and in writing. The local welfare agency, or agency 98.4responsible for assessing or investigating the report, upon receiving a report, shall 98.5immediately notify the local police department or the county sheriff orally and in writing. 98.6The county sheriff and the head of every local welfare agency, agency responsible 98.7for assessing or investigating reports, and police department shall each designate a 98.8person within their agency, department, or office who is responsible for ensuring that 98.9the notification duties of this paragraph and paragraph (b) are carried out. Nothing in 98.10this subdivision shall be construed to require more than one report from any institution, 98.11facility, school, or agency.98.12    (b) Any person may voluntarily report to the local welfare agency, agency 98.13responsible for assessing or investigating the report, police department, or the county 98.14sheriff if the person knows, has reason to believe, or suspects a child is being or has been 98.15neglected or subjected to physical or sexual abuse. The police department or the county 98.16sheriff, upon receiving a report, shall immediately notify the local welfare agency or 98.17agency responsible for assessing or investigating the report, orally and in writing. The 98.18local welfare agency or agency responsible for assessing or investigating the report, upon 98.19receiving a report, shall immediately notify the local police department or the county 98.20sheriff orally and in writing.98.21    (c) A person mandated to report physical or sexual child abuse or neglect occurring 98.22within a licensed facility shall report the information to the agency responsible for 98.23licensing the facility under sections 
         144.50 to 
         144.58; 
         241.021; 
         245A.01 to 
         245A.16; or 98.24chapter 245B; or a nonlicensed personal care provider organization as defined in sections 98.25256B.04, subdivision 16
         ; and 
         256B.0625, subdivision 19. A health or corrections agency 98.26receiving a report may request the local welfare agency to provide assistance pursuant 98.27to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work 98.28within a school facility, upon receiving a complaint of alleged maltreatment, shall provide 98.29information about the circumstances of the alleged maltreatment to the commissioner of 98.30education. Section 
         13.03, subdivision 4, applies to data received by the commissioner of 98.31education from a licensing entity.98.32    (d) Any person mandated to report shall receive a summary of the disposition of 98.33any report made by that reporter, including whether the case has been opened for child 98.34protection or other services, or if a referral has been made to a community organization, 98.35unless release would be detrimental to the best interests of the child. Any person who is 98.36not mandated to report shall, upon request to the local welfare agency, receive a concise 99.1summary of the disposition of any report made by that reporter, unless release would be 99.2detrimental to the best interests of the child.99.3    (e) For purposes of this subdivision section, "immediately" means as soon as 99.4possible but in no event longer than 24 hours.99.5    Sec. 81. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision 99.6to read:99.7    Subd. 3e.Agency responsibility for assessing or investigating reports of sexual 99.8abuse.The local welfare agency is the agency responsible for investigating allegations 99.9of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual 99.10functioning within the family unit as a person responsible for the child's care, or a person 99.11with a significant relationship to the child if that person resides in the child's household.99.12    Sec. 82. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision 99.13to read:99.14    Subd. 3f.Law enforcement agency responsibility for investigating 99.15maltreatment.The local law enforcement agency has responsibility for investigating any 99.16report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement 99.17and the responsible agency must coordinate their investigations or assessments as required 99.18under subdivision 10.99.19    Sec. 83. Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:99.20    Subd. 10. Duties of local welfare agency and local law enforcement agency upon 99.21receipt of a report. (a) Upon receipt of a report, the local welfare agency shall determine 99.22whether to conduct a family assessment or an investigation as appropriate to prevent or 99.23provide a remedy for child maltreatment. The local welfare agency:99.24    (1) shall conduct an investigation on reports involving substantial child 99.25endangerment;99.26    (2) shall begin an immediate investigation if, at any time when it is using a family 99.27assessment response, it determines that there is reason to believe that substantial child 99.28endangerment or a serious threat to the child's safety exists;99.29    (3) may conduct a family assessment for reports that do not allege substantial child 99.30endangerment. In determining that a family assessment is appropriate, the local welfare 99.31agency may consider issues of child safety, parental cooperation, and the need for an 99.32immediate response; and100.1    (4) may conduct a family assessment on a report that was initially screened and 100.2assigned for an investigation. In determining that a complete investigation is not required, 100.3the local welfare agency must document the reason for terminating the investigation and 100.4notify the local law enforcement agency if the local law enforcement agency is conducting 100.5a joint investigation.100.6    If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, 100.7or individual functioning within the family unit as a person responsible for the child's 100.8care, or sexual abuse by a person with a significant relationship to the child when that 100.9person resides in the child's household or by a sibling, the local welfare agency shall 100.10immediately conduct a family assessment or investigation as identified in clauses (1) to 100.11(4). In conducting a family assessment or investigation, the local welfare agency shall 100.12gather information on the existence of substance abuse and domestic violence and offer 100.13services for purposes of preventing future child maltreatment, safeguarding and enhancing 100.14the welfare of the abused or neglected minor, and supporting and preserving family 100.15life whenever possible. If the report alleges a violation of a criminal statute involving 100.16sexual abuse, physical abuse, or neglect or endangerment, under section 
         609.378, the 100.17local law enforcement agency and local welfare agency shall coordinate the planning and 100.18execution of their respective investigation and assessment efforts to avoid a duplication of 100.19fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of 100.20the results of its investigation. In cases of alleged child maltreatment resulting in death, 100.21the local agency may rely on the fact-finding efforts of a law enforcement investigation 100.22to make a determination of whether or not maltreatment occurred. When necessary the 100.23local welfare agency shall seek authority to remove the child from the custody of a parent, 100.24guardian, or adult with whom the child is living. In performing any of these duties, the 100.25local welfare agency shall maintain appropriate records.100.26    If the family assessment or investigation indicates there is a potential for abuse of 100.27alcohol or other drugs by the parent, guardian, or person responsible for the child's care, 100.28the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota 100.29Rules, part 9530.6615. The local welfare agency shall report the determination of the 100.30chemical use assessment, and the recommendations and referrals for alcohol and other 100.31drug treatment services to the state authority on alcohol and drug abuse.100.32    (b) When a local agency receives a report or otherwise has information indicating 100.33that a child who is a client, as defined in section 
         245.91, has been the subject of physical 100.34abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section 100.35245.91
         , it shall, in addition to its other duties under this section, immediately inform the 100.36ombudsman established under sections 
         245.91 to 
         245.97. The commissioner of education 101.1shall inform the ombudsman established under sections 
         245.91 to 
         245.97 of reports 101.2regarding a child defined as a client in section 
         245.91 that maltreatment occurred at a 101.3school as defined in sections 
         120A.05, subdivisions 9, 11, and 13, and 
         124D.10.101.4    (c) Authority of the local welfare agency responsible for assessing or investigating 101.5the child abuse or neglect report, the agency responsible for assessing or investigating 101.6the report, and of the local law enforcement agency for investigating the alleged abuse or 101.7neglect includes, but is not limited to, authority to interview, without parental consent, 101.8the alleged victim and any other minors who currently reside with or who have resided 101.9with the alleged offender. The interview may take place at school or at any facility or 101.10other place where the alleged victim or other minors might be found or the child may be 101.11transported to, and the interview conducted at, a place appropriate for the interview of a 101.12child designated by the local welfare agency or law enforcement agency. The interview 101.13may take place outside the presence of the alleged offender or parent, legal custodian, 101.14guardian, or school official. For family assessments, it is the preferred practice to request 101.15a parent or guardian's permission to interview the child prior to conducting the child 101.16interview, unless doing so would compromise the safety assessment. Except as provided in 101.17this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible 101.18local welfare or law enforcement agency no later than the conclusion of the investigation 101.19or assessment that this interview has occurred. Notwithstanding rule 
         49.02 32 of the 101.20Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on 101.21an ex parte motion by the local welfare agency, order that, where reasonable cause exists, 101.22the agency withhold notification of this interview from the parent, legal custodian, or 101.23guardian. If the interview took place or is to take place on school property, the order shall 101.24specify that school officials may not disclose to the parent, legal custodian, or guardian the 101.25contents of the notification of intent to interview the child on school property, as provided 101.26under this paragraph, and any other related information regarding the interview that may 101.27be a part of the child's school record. A copy of the order shall be sent by the local welfare 101.28or law enforcement agency to the appropriate school official.101.29    (d) When the local welfare, local law enforcement agency, or the agency responsible 101.30for assessing or investigating a report of maltreatment determines that an interview should 101.31take place on school property, written notification of intent to interview the child on school 101.32property must be received by school officials prior to the interview. The notification 101.33shall include the name of the child to be interviewed, the purpose of the interview, and 101.34a reference to the statutory authority to conduct an interview on school property. For 101.35interviews conducted by the local welfare agency, the notification shall be signed by the 101.36chair of the local social services agency or the chair's designee. The notification shall be 102.1private data on individuals subject to the provisions of this paragraph. School officials 102.2may not disclose to the parent, legal custodian, or guardian the contents of the notification 102.3or any other related information regarding the interview until notified in writing by the 102.4local welfare or law enforcement agency that the investigation or assessment has been 102.5concluded, unless a school employee or agent is alleged to have maltreated the child. 102.6Until that time, the local welfare or law enforcement agency or the agency responsible 102.7for assessing or investigating a report of maltreatment shall be solely responsible for any 102.8disclosures regarding the nature of the assessment or investigation.102.9    Except where the alleged offender is believed to be a school official or employee, 102.10the time and place, and manner of the interview on school premises shall be within the 102.11discretion of school officials, but the local welfare or law enforcement agency shall have 102.12the exclusive authority to determine who may attend the interview. The conditions as to 102.13time, place, and manner of the interview set by the school officials shall be reasonable and 102.14the interview shall be conducted not more than 24 hours after the receipt of the notification 102.15unless another time is considered necessary by agreement between the school officials and 102.16the local welfare or law enforcement agency. Where the school fails to comply with the 102.17provisions of this paragraph, the juvenile court may order the school to comply. Every 102.18effort must be made to reduce the disruption of the educational program of the child, other 102.19students, or school staff when an interview is conducted on school premises.102.20    (e) Where the alleged offender or a person responsible for the care of the alleged 102.21victim or other minor prevents access to the victim or other minor by the local welfare 102.22agency, the juvenile court may order the parents, legal custodian, or guardian to produce 102.23the alleged victim or other minor for questioning by the local welfare agency or the local 102.24law enforcement agency outside the presence of the alleged offender or any person 102.25responsible for the child's care at reasonable places and times as specified by court order.102.26    (f) Before making an order under paragraph (e), the court shall issue an order to 102.27show cause, either upon its own motion or upon a verified petition, specifying the basis for 102.28the requested interviews and fixing the time and place of the hearing. The order to show 102.29cause shall be served personally and shall be heard in the same manner as provided in 102.30other cases in the juvenile court. The court shall consider the need for appointment of a 102.31guardian ad litem to protect the best interests of the child. If appointed, the guardian ad 102.32litem shall be present at the hearing on the order to show cause.102.33    (g) The commissioner of human services, the ombudsman for mental health and 102.34developmental disabilities, the local welfare agencies responsible for investigating reports, 102.35the commissioner of education, and the local law enforcement agencies have the right to 102.36enter facilities as defined in subdivision 2 and to inspect and copy the facility's records, 103.1including medical records, as part of the investigation. Notwithstanding the provisions of 103.2chapter 13, they also have the right to inform the facility under investigation that they are 103.3conducting an investigation, to disclose to the facility the names of the individuals under 103.4investigation for abusing or neglecting a child, and to provide the facility with a copy of 103.5the report and the investigative findings.103.6    (h) The local welfare agency responsible for conducting a family assessment or 103.7investigation shall collect available and relevant information to determine child safety, 103.8risk of subsequent child maltreatment, and family strengths and needs and share not public 103.9information with an Indian's tribal social services agency without violating any law of the 103.10state that may otherwise impose duties of confidentiality on the local welfare agency in 103.11order to implement the tribal state agreement. The local welfare agency or the agency 103.12responsible for investigating the report shall collect available and relevant information 103.13to ascertain whether maltreatment occurred and whether protective services are needed. 103.14Information collected includes, when relevant, information with regard to the person 103.15reporting the alleged maltreatment, including the nature of the reporter's relationship to the 103.16child and to the alleged offender, and the basis of the reporter's knowledge for the report; 103.17the child allegedly being maltreated; the alleged offender; the child's caretaker; and other 103.18collateral sources having relevant information related to the alleged maltreatment. The 103.19local welfare agency or the agency responsible for assessing or investigating the report 103.20may make a determination of no maltreatment early in an assessment, and close the case 103.21and retain immunity, if the collected information shows no basis for a full assessment or 103.22investigation.103.23    Information relevant to the assessment or investigation must be asked for, and 103.24may include:103.25    (1) the child's sex and age, prior reports of maltreatment, information relating 103.26to developmental functioning, credibility of the child's statement, and whether the 103.27information provided under this clause is consistent with other information collected 103.28during the course of the assessment or investigation;103.29    (2) the alleged offender's age, a record check for prior reports of maltreatment, and 103.30criminal charges and convictions. The local welfare agency or the agency responsible for 103.31assessing or investigating the report must provide the alleged offender with an opportunity 103.32to make a statement. The alleged offender may submit supporting documentation relevant 103.33to the assessment or investigation;103.34    (3) collateral source information regarding the alleged maltreatment and care of the 103.35child. Collateral information includes, when relevant: (i) a medical examination of the 103.36child; (ii) prior medical records relating to the alleged maltreatment or the care of the 104.1child maintained by any facility, clinic, or health care professional and an interview with 104.2the treating professionals; and (iii) interviews with the child's caretakers, including the 104.3child's parent, guardian, foster parent, child care provider, teachers, counselors, family 104.4members, relatives, and other persons who may have knowledge regarding the alleged 104.5maltreatment and the care of the child; and104.6    (4) information on the existence of domestic abuse and violence in the home of 104.7the child, and substance abuse.104.8    Nothing in this paragraph precludes the local welfare agency, the local law 104.9enforcement agency, or the agency responsible for assessing or investigating the report 104.10from collecting other relevant information necessary to conduct the assessment or 104.11investigation. Notwithstanding section 
         13.384 or 
         144.335, the local welfare agency has 104.12access to medical data and records for purposes of clause (3). Notwithstanding the data's 104.13classification in the possession of any other agency, data acquired by the local welfare 104.14agency or the agency responsible for assessing or investigating the report during the course 104.15of the assessment or investigation are private data on individuals and must be maintained 104.16in accordance with subdivision 11. Data of the commissioner of education collected 104.17or maintained during and for the purpose of an investigation of alleged maltreatment 104.18in a school are governed by this section, notwithstanding the data's classification as 104.19educational, licensing, or personnel data under chapter 13.104.20    In conducting an assessment or investigation involving a school facility as defined 104.21in subdivision 2, paragraph (i), the commissioner of education shall collect investigative 104.22reports and data that are relevant to a report of maltreatment and are from local law 104.23enforcement and the school facility.104.24    (i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face 104.25contact with the child reported to be maltreated and with the child's primary caregiver 104.26sufficient to complete a safety assessment and ensure the immediate safety of the child. 104.27The face-to-face contact with the child and primary caregiver shall occur immediately 104.28if substantial child endangerment is alleged and within five calendar days for all other 104.29reports. If the alleged offender was not already interviewed as the primary caregiver, the 104.30local welfare agency shall also conduct a face-to-face interview with the alleged offender 104.31in the early stages of the assessment or investigation. At the initial contact, the local child 104.32welfare agency or the agency responsible for assessing or investigating the report must 104.33inform the alleged offender of the complaints or allegations made against the individual in 104.34a manner consistent with laws protecting the rights of the person who made the report. 104.35The interview with the alleged offender may be postponed if it would jeopardize an active 104.36law enforcement investigation.105.1    (j) When conducting an investigation, the local welfare agency shall use a question 105.2and answer interviewing format with questioning as nondirective as possible to elicit 105.3spontaneous responses. For investigations only, the following interviewing methods and 105.4procedures must be used whenever possible when collecting information:105.5    (1) audio recordings of all interviews with witnesses and collateral sources; and105.6    (2) in cases of alleged sexual abuse, audio-video recordings of each interview with 105.7the alleged victim and child witnesses.105.8    (k) In conducting an assessment or investigation involving a school facility as 105.9defined in subdivision 2, paragraph (i), the commissioner of education shall collect 105.10available and relevant information and use the procedures in paragraphs (i), (k), and 105.11subdivision 3d, except that the requirement for face-to-face observation of the child 105.12and face-to-face interview of the alleged offender is to occur in the initial stages of the 105.13assessment or investigation provided that the commissioner may also base the assessment 105.14or investigation on investigative reports and data received from the school facility and 105.15local law enforcement, to the extent those investigations satisfy the requirements of 105.16paragraphs (i) and (k), and subdivision 3d.105.17    Sec. 84. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to 105.18read:105.19    Subd. 10a. Abuse outside family unit Law enforcement agency responsibility 105.20for investigation; welfare agency reliance on law enforcement fact-finding; welfare 105.21agency offer of services.(a) If the report alleges neglect, physical abuse, or sexual abuse 105.22by a person who is not a parent, guardian, sibling, person responsible for the child's care 105.23functioning outside within the family unit, or a person who lives in the child's household 105.24and who has a significant relationship to the child, in a setting other than a facility as 105.25defined in subdivision 2, the local welfare agency shall immediately notify the appropriate 105.26law enforcement agency, which shall conduct an investigation of the alleged abuse or 105.27neglect if a violation of a criminal statute is alleged. 105.28    (b) The local agency may rely on the fact-finding efforts of the law enforcement 105.29investigation conducted under this subdivision to make a determination whether or not 105.30threatened harm or other maltreatment has occurred under subdivision 2 if an alleged 105.31offender has minor children or lives with minors.105.32    (c) The local welfare agency shall offer appropriate social services for the purpose of 105.33safeguarding and enhancing the welfare of the abused or neglected minor.106.1    Sec. 85. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to 106.2read:106.3    Subd. 10c. Duties of local social service agency upon receipt of a report of 106.4medical neglect. If the report alleges medical neglect as defined in section 
         260C.007, 106.5subdivision 4 6, clause (5), the local welfare agency shall, in addition to its other duties 106.6under this section, immediately consult with designated hospital staff and with the parents 106.7of the infant to verify that appropriate nutrition, hydration, and medication are being 106.8provided; and shall immediately secure an independent medical review of the infant's 106.9medical charts and records and, if necessary, seek a court order for an independent medical 106.10examination of the infant. If the review or examination leads to a conclusion of medical 106.11neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings 106.12under section 
         260C.141 and by filing an expedited motion to prevent the withholding 106.13of medically indicated treatment. 106.14    Sec. 86. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:106.15    Subd. 10f. Notice of determinations. Within ten working days of the conclusion 106.16of a family assessment, the local welfare agency shall notify the parent or guardian of 106.17the child of the need for services to address child safety concerns or significant risk of 106.18subsequent child maltreatment. The local welfare agency and the family may also jointly 106.19agree that family support and family preservation services are needed. Within ten working 106.20days of the conclusion of an investigation, the local welfare agency or agency responsible 106.21for assessing or investigating the report shall notify the parent or guardian of the child, the 106.22person determined to be maltreating the child, and if applicable, the director of the facility, 106.23of the determination and a summary of the specific reasons for the determination. The 106.24notice must also include a certification that the information collection procedures under 106.25subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a 106.26data subject to obtain access to other private data on the subject collected, created, or 106.27maintained under this section. In addition, the notice shall include the length of time that 106.28the records will be kept under subdivision 11c. The investigating agency shall notify the 106.29parent or guardian of the child who is the subject of the report, and any person or facility 106.30determined to have maltreated a child, of their appeal or review rights under this section 106.31or section 
         256.022. The notice must also state that a finding of maltreatment may result 106.32in denial of a license application or background study disqualification under chapter 106.33245C related to employment or services that are licensed by the Department of Human 106.34Services under chapter 245A, the Department of Health under chapter 144 or 144A, the 107.1Department of Corrections under section 241.021, and from providing services related to 107.2an unlicensed personal care provider organization under chapter 256B.107.3    Sec. 87. KINSHIP NAVIGATOR PROGRAM; DEMONSTRATION GRANT.107.4    (a) The commissioner of human services shall fund a two-year demonstration grant 107.5to be transferred to a nonprofit organization experienced in kinship advocacy and policy 107.6that has:107.7    (1) experience working with grandparents and relatives who are raising kinship 107.8children;107.9    (2) an established statewide outreach network;107.10    (3) established kinship support groups;107.11    (4) an intergenerational approach to programming; and107.12    (5) a board of directors consisting of 50 percent grandparents and relatives raising 107.13kinship children.107.14    (b) The purpose of the grant is to provide support to grandparents or relatives raising 107.15kinship children. One site must be in the metropolitan area, and the other in the Bemidji 107.16region. One-stop services may include, but are not limited to, legal services, education, 107.17information, family activities, support groups, mental health access, advocacy, mentors, 107.18and information related to foster care licensing. Funds may also be used for a media 107.19campaign to inform kinship families about available information and services, support 107.20sites, and other program development.107.21    Sec. 88. MFIP PILOT PROGRAM; WORKFORCE U.107.22    Subdivision 1.Establishment.A pilot program is established in Stearns and 107.23Benton Counties to expand the Workforce U program administered by the Stearns-Benton 107.24Employment and Training Council.107.25    Subd. 2.Evaluation.The Workforce U pilot program must be evaluated by a 107.26research and evaluation organization with experience evaluating welfare programs. The 107.27evaluation must include information on the total number of persons served, percentage 107.28of participants exiting the program, percentage of former participants reentering the 107.29program, average wages of program participants, and recommendations to the legislature 107.30for possible statewide implementation of the program. The evaluation must be presented 107.31to the legislature by February 15, 2011.107.32    Subd. 3.Expiration.The Workforce U pilot program expires on June 30, 2011.107.33    Sec. 89. LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.108.1    (a) The commissioner of human services shall provide a planning grant to address 108.2the unmet need for local, effective, culturally relevant alcohol and drug treatment for 108.3American Indian youth, and develop a plan for a family-based youth treatment center in 108.4the Leech Lake area. The planning grant must be provided to a volunteer board consisting 108.5of at least four members appointed by the commissioner, to include at least the following:108.6    (1) two members of the Leech Lake Tribal Council or their designees;108.7    (2) one member appointed by the Cass County Social Services administrator; and108.8    (3) one member appointed by the Cass Lake-Bena Public School superintendent.108.9    (b) The plan must include:108.10    (1) an interest, feasibility, and suitability of location study;108.11    (2) defining scope of programs and services to be offered;108.12    (3) defining site use limitations and restrictions, including physical and capacity;108.13    (4) defining facilities required for programs and services offered;108.14    (5) identifying partners, partnership roles, and partner resources;108.15    (6) developing proposed operating and maintenance budgets;108.16    (7) identifying funding sources;108.17    (8) developing a long-term funding plan; and108.18    (9) developing a formal steering committee, structure, and bylaws.108.19    (c) The plan is due to the legislative committees having jurisdiction over chemical 108.20health issues no later than September 2008 in order to provide the 12 months necessary to 108.21complete the plan.108.22    Sec. 90. MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED 108.23APPLICATION.108.24    The Department of Human Services shall create a simplified application for the 108.25Minnesota food support program for persons over the age of 60 and persons with 108.26disabilities. The application must be no longer than three pages in length.108.27EFFECTIVE DATE.This section is effective January 1, 2008.108.28    Sec. 91. INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.108.29    The commissioner of human services, in consultation with the commissioners of 108.30health and education and the counties, shall develop and present recommendations to 108.31the legislature in January 2008 in order for each legally unlicensed child care provider 108.32receiving child care assistance funds to receive a onetime home visit to receive information 108.33on health and safety, and school readiness.109.1    Sec. 92. COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY 109.2CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT 109.3TRAINING.109.4    Subdivision 1.Development and implementation of an early childhood and 109.5school-age professional development system.(a) The commissioner of human services, 109.6in cooperation with the commissioners of education and health, shall develop and phase-in 109.7the implementation of a professional development system for practitioners serving 109.8children in early childhood and school-age programs. The system shall provide training 109.9options and supports for practitioners to voluntarily choose, as they complete or exceed 109.10existing licensing requirements.109.11    The system must, at a minimum, include the following features:109.12    (1) a continuum of training content based on the early childhood and school-age 109.13care practitioner core competencies that translates knowledge into improved practice to 109.14support children's school success;109.15    (2) training strategies that provide direct feedback about practice to practitioners 109.16through ongoing consultation, mentoring, or coaching with special emphasis on early 109.17literacy and early mathematics;109.18    (3) an approval process for trainers;109.19    (4) a professional development registry for early childhood and school-age care 109.20practitioners that will provide tracking and recognition of practitioner training/career 109.21development progress;109.22    (5) a career lattice that includes a range of professional development and educational 109.23opportunities that provide appropriate coursework and degree pathways;109.24    (6) development of a plan with public higher education institutions for an articulated 109.25system of education, training, and professional development that includes credit for prior 109.26learning and development of equivalences to two- and four-year degrees;109.27    (7) incentives and supports for early childhood and school-age care practitioners 109.28to seek additional training and education, including TEACH, other scholarships, and 109.29career guidance; and109.30    (8) coordinated and accessible delivery of training to early childhood and school-age 109.31care practitioners.109.32    (b) By January 1, 2008, the commissioner, in consultation with the organizations 109.33named in subdivision 2 shall develop additional opportunities in order to qualify more 109.34licensed family child care providers under section 119B.13, subdivision 3a.109.35    (c) The commissioner of human services must evaluate the professional development 109.36system and make continuous improvements.110.1    (d) Beginning July 1, 2007, as appropriations permit, the commissioner shall 110.2phase-in the professional development system.110.3    Subd. 2.Two-hour early childhood training.By January 15, 2008, the 110.4commissioner of human services, with input from the Minnesota Licensed Family Child 110.5Care Association and the Minnesota Professional Development Council, shall identify 110.6trainings that qualify for the two-hour early childhood development training requirement 110.7for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision 110.89a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also 110.9seek the input of labor unions that serve licensed family child care providers, if the union 110.10has been recognized by a county to serve licensed family child care providers.110.11    Sec. 93. SCHOOL READINESS SERVICE AGREEMENTS.110.12    Subdivision 1.Overview.(a) Effective July 1, 2007, funds must be made available 110.13to allow the commissioner to pay higher rates to up to 50 child care providers who are 110.14deemed by the commissioner to meet the requirements of a school readiness service 110.15agreement (SRSA) provider and perform services that support school readiness for 110.16children and economic stability for parents.110.17    (b) A provider may be paid a rate above that currently allowed under Minnesota 110.18Statutes, section 119B.13, if:110.19    (1) the provider has entered into an SRSA with the commissioner; 110.20    (2) a family using that provider receives child care assistance under any provision in 110.21Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035; 110.22    (3) the family using that provider meets the criteria in this section; and 110.23    (4) funding is available under this section.110.24    Subd. 2.Provider eligibility.(a) To be considered for an SRSA, a provider shall 110.25apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:110.26    (1) be eligible for child care assistance payments under Minnesota Statutes, chapter 110.27119B;110.28    (2) have at least 25 percent of the children enrolled with the provider subsidized 110.29through the child care assistance program;110.30    (3) provide full-time, full-year child care services; and 110.31    (4) serve at least one child who is subsidized through the child care assistance 110.32program and who is expected to enter kindergarten within the following 30 months.110.33    (b) The commissioner may waive the 25 percent requirement in paragraph (a), clause 110.34(2), if necessary to achieve geographic distribution of SRSA providers and diversity of 110.35types of care provided by SRSA providers.111.1    (c) An eligible provider who would like to enter into an SRSA with the commissioner 111.2shall submit an SRSA application. To determine whether to enter into an SRSA with a 111.3provider, the commissioner shall evaluate the following factors:111.4    (1) the qualifications of the provider and the provider's staff;111.5    (2) the provider's staff-child ratios;111.6    (3) the provider's curriculum;111.7    (4) the provider's current or planned parent education activities;111.8    (5) the provider's current or planned social service and employment linkages;111.9    (6) the provider's child development assessment plan;111.10    (7) the geographic distribution needed for SRSA providers;111.11    (8) the inclusion of a variety of child care delivery models; and 111.12    (9) other related factors determined by the commissioner.111.13    Subd. 3.Family and child eligibility.(a) A family eligible to choose an SRSA 111.14provider for their children shall:111.15    (1) be eligible to receive child care assistance under any provision in Minnesota 111.16Statutes, chapter 119B, except Minnesota Statutes, section 119B.035; 111.17    (2) be in an authorized activity for an average of at least 35 hours per week when 111.18initial eligibility is determined; and 111.19    (3) include a child who has not yet entered kindergarten.111.20    (b) A family who is determined to be eligible to choose an SRSA provider remains 111.21eligible to be paid at a higher rate through the SRSA provider when the following 111.22conditions exist:111.23    (1) the child attends child care with the SRSA provider a minimum of 25 hours per 111.24week, on average;111.25    (2) the family has a child who has not yet entered kindergarten; and 111.26    (3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except 111.27Minnesota Statutes, section 119B.035.111.28    (c) For the 12 months after initial eligibility has been determined, a decrease in 111.29the family's authorized activities to an average of less than 35 hours per week does not 111.30result in ineligibility for the SRSA rate.111.31    (d) A family that moves between counties but continues to use the same SRSA 111.32provider shall continue to receive SRSA funding for the increased payments.111.33    Subd. 4.Requirements of providers.An SRSA must include assessment, 111.34evaluation, and reporting requirements that promote the goals of improved school 111.35readiness and movement toward appropriate child development milestones. A provider 112.1who enters into an SRSA shall comply with the assessment, evaluation, and reporting 112.2requirements in the SRSA.112.3    Subd. 5.Relationship to current law.(a) The following provisions in Minnesota 112.4Statutes, chapter 119B, must be waived or modified for families receiving services under 112.5this section.112.6    (b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a, 112.7maximum weekly rates under this section are 125 percent of the existing maximum 112.8weekly rate for like-care. Providers eligible for a differential rate under Minnesota 112.9Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the 112.10rate identified in this section. Only care for children who have not yet entered kindergarten 112.11may be paid at the maximum rate under this section. The provider's charge for service 112.12provided through an SRSA may not exceed the rate that the provider charges a private-pay 112.13family for like-care arrangements.112.14    (c) A family or child care provider may not be assessed an overpayment for care 112.15provided through an SRSA unless: 112.16    (1) there was an error in the amount of care authorized for the family; or 112.17    (2) the family or provider did not timely report a change as required under the law.112.18    (d) Care provided through an SRSA is authorized on a weekly basis.112.19    (e) Funds appropriated under this section to serve families eligible under Minnesota 112.20Statutes, section 119B.03, are not allocated through the basic sliding fee formula under 112.21Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to 112.22offset increased costs when payments are made under SRSA's.112.23    (f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the 112.24maximum amount of child care assistance that may be authorized for a child receiving 112.25care through an SRSA in a two-week period is 160 hours per child.112.26    Subd. 6.Establishment of service agreements.(a) The commissioner shall 112.27approve SRSA's for up to 50 providers that represent diverse parts of the state and a 112.28variety of child care delivery models. Entering into a service agreement does not guarantee 112.29that a provider will receive payment at a higher rate for families receiving child care 112.30assistance. A family eligible under this section shall choose a provider participating in an 112.31SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by 112.32the availability of SRSA funds.112.33    (b) Nothing in this section shall be construed to limit parent choice as defined in 112.34Minnesota Statutes, section 119B.09, subdivision 5.113.1    (c) The commissioner may allow for startup time for some providers if failing to 113.2do so would limit geographic diversity of SRSA providers or a variety of child care 113.3delivery models.113.4    Sec. 94. FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.113.5    Subdivision 1.Establishment.A family, friend, and neighbor (FFN) grant program 113.6is established to promote children's early literacy, healthy development, and school 113.7readiness, and to foster community partnerships to promote children's school readiness. 113.8The commissioner shall attempt to ensure that grants are made in all areas of the state. The 113.9commissioner of human services shall make grants available to fund: community-based 113.10organizations, nonprofit organizations, and Indian tribes working with FFN caregivers 113.11under subdivision 2, paragraph (a); and community-based partnerships to implement early 113.12literacy programs under subdivision 2, paragraph (b).113.13    Subd. 2.Program components.(a)(1) Grants that the commissioner awards under 113.14this section must be used by community-based organizations, nonprofit organizations, and 113.15Indian tribes working with FFN caregivers in local communities, cultural communities, 113.16and Indian tribes to:113.17    (i) provide training, support, and resources to FFN caregivers in order to improve 113.18and promote children's health, safety, nutrition, and school readiness;113.19    (ii) connect FFN caregivers and children's families with appropriate community 113.20resources that support the families' health, mental health, economic, and developmental 113.21needs;113.22    (iii) connect FFN caregivers and children's families to early childhood screening 113.23programs and facilitate referrals where appropriate;113.24    (iv) provide FFN caregivers and children's families with information about early 113.25learning guidelines from the Departments of Human Services and Education;113.26    (v) provide FFN caregivers and children's families with information about becoming 113.27a licensed family child care provider; and113.28    (vi) provide FFN caregivers and children's families with information about early 113.29learning allowances and enrollment opportunities in high quality community-based 113.30child-care and preschool programs.113.31    (2) Grants that the commissioner awards under this paragraph also may be used for:113.32    (i) health and safety and early learning kits for FFN caregivers;113.33    (ii) play-and-learn groups with FFN caregivers;113.34    (iii) culturally appropriate early childhood training for FFN caregivers;114.1    (iv) transportation for FFN caregivers and children's families to school readiness and 114.2other early childhood training activities;114.3    (v) other activities that promote school readiness;114.4    (vi) data collection and evaluation;114.5    (vii) staff outreach and outreach activities;114.6    (viii) translation needs; or114.7    (ix) administrative costs that equal up to 12 percent of the recipient's grant award.114.8    (b) Grants that the commissioner awards under this section also must be used to fund 114.9partnerships among Minnesota public and regional library systems, community-based 114.10organizations, nonprofit organizations, and Indian tribes to implement early literacy 114.11programs in low-income communities, including tribal communities, to:114.12    (1) purchase and equip early childhood read-mobiles that provide FFN caregivers 114.13and children's families with books, training, and early literacy activities;114.14    (2) provide FFN caregivers and children's families with translations of early 114.15childhood books, training, and early literacy activities in native languages; or114.16    (3) provide FFN caregivers and children's families with early literacy activities in 114.17local libraries.114.18    Subd. 3.Grant awards.Interested entities eligible to receive a grant under 114.19this section may apply to the commissioner in the form and manner the commissioner 114.20determines. The commissioner shall awards grants to eligible entities consistent with 114.21the requirements of this section.114.22    Subd. 4.Evaluation.The commissioner, in consultation with early childhood 114.23care and education experts at the University of Minnesota, must evaluate the impact of 114.24the grants under subdivision 2 on children's school readiness and submit a written report 114.25to the human services and education finance and policy committees of the legislature by 114.26February 15, 2010.114.27EFFECTIVE DATE.This section is effective the day following final enactment.114.28    Sec. 95. CHILD CARE PROVIDER STUDY.114.29    The commissioner of human services is directed to study the implications of 114.30restricting the use of state subsidies in center-based child care to centers meeting state 114.31quality standards under Minnesota Statutes, section 124D.175, paragraph (c), and to 114.32publish the results no later than January 1, 2010. The study must include:114.33    (1) the likelihood of there being sufficient child care providers meeting the standards;114.34    (2) the cost to bring providers up to the standards and how this cost would be funded;115.1    (3) how the standards and the ratings would be communicated to both parents and 115.2the general public; and115.3    (4) a determination whether a similar system could be implemented for 115.4non-center-based care.115.5    Sec. 96. DIRECTION TO COMMISSIONER.115.6    (a) The commissioner of human services shall offer a request for proposals to 115.7identify a research and evaluation firm with experience working with:115.8    (1) homeless youth providers;115.9    (2) data; and115.10    (3) the topics of housing, homelessness, and a continuum of care for youth.115.11    (b) The research and evaluation firm identified under paragraph (a) shall monitor and 115.12evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.115.13    Sec. 97. REVISOR'S INSTRUCTION.115.14    (a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d, 115.15as Minnesota Statutes, section 626.556, subdivision 3g.115.16    (b) The revisor shall change references to Minnesota Statutes, section 260.851, 115.17to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to 115.18section 260.853, article 4, wherever those references appear in Minnesota Statutes and 115.19Minnesota Rules.115.20    Sec. 98.  REPEALER.115.21(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.29; 256J.37, 115.22subdivisions 3a and 3b; and 256J.626, subdivisions 7 and 9, are repealed.115.23(b) Laws 1997, chapter 8, section 1, is repealed.115.24(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed.115.25ARTICLE 2115.26LICENSING115.27    Section 1. Minnesota Statutes 2006, section 245A.035, is amended to read:115.28245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY 115.29LICENSE RELATIVE PLACEMENT.115.30    Subdivision 1. Grant of Emergency license placement. Notwithstanding section 115.31245A.03, subdivision 2a
         , or 
         245C.13, subdivision 2, a county agency may place a child 115.32for foster care with a relative who is not licensed to provide foster care, provided the 116.1requirements of subdivision 2 this section are met. As used in this section, the term 116.2"relative" has the meaning given it under section 
         260C.007, subdivision 27.116.3    Subd. 2. Cooperation with emergency licensing placement process. (a) A county 116.4agency that places a child with a relative who is not licensed to provide foster care must 116.5begin the process of securing an emergency license for the relative as soon as possible 116.6and must conduct the initial inspection required by subdivision 3, clause (1), whenever 116.7possible, prior to placing the child in the relative's home, but no later than three working 116.8days after placing the child in the home. A child placed in the home of a relative who is 116.9not licensed to provide foster care must be removed from that home if the relative fails 116.10to cooperate with the county agency in securing an emergency foster care license. The 116.11commissioner may issue an emergency foster care license to a relative with whom the 116.12county agency wishes to place or has placed a child for foster care, or to a relative with 116.13whom a child has been placed by court order.116.14    (b) If a child is to be placed in the home of a relative not licensed to provide foster 116.15care, either the placing agency or the county agency in the county in which the relative 116.16lives shall conduct the emergency licensing placement process as required in this section.116.17    Subd. 3. Requirements for emergency license placement. Before an emergency 116.18license placement may be issued made, the following requirements must be met:116.19    (1) the county agency must conduct an initial inspection of the premises where 116.20the foster care placement is to be provided made to ensure the health and safety of any 116.21child placed in the home. The county agency shall conduct the inspection using a form 116.22developed by the commissioner;116.23    (2) at the time of the inspection or placement, whichever is earlier, the county 116.24agency must provide the relative being considered for an emergency license shall receive116.25placement an application form for a child foster care license;116.26    (3) whenever possible, prior to placing the child in the relative's home, the relative 116.27being considered for an emergency license placement shall provide the information 116.28required by section 
         245C.05; and 116.29    (4) if the county determines, prior to the issuance of an emergency license116.30placement, that anyone requiring a background study may be prior to licensure of the 116.31home is disqualified under section 245C.14 and chapter 245C, and the disqualification 116.32is one which the commissioner cannot set aside, an emergency license shall placement 116.33must not be issued made.116.34    Subd. 4. Applicant study. When the county agency has received the information 116.35required by section 
         245C.05, the county agency shall begin an applicant study according to 116.36the procedures in chapter 245C. The commissioner may issue an emergency license upon 117.1recommendation of the county agency once the initial inspection has been successfully 117.2completed and the information necessary to begin the applicant background study has been 117.3provided. If the county agency does not recommend that the emergency license be granted, 117.4the agency shall notify the relative in writing that the agency is recommending denial to the 117.5commissioner; shall remove any child who has been placed in the home prior to licensure; 117.6and shall inform the relative in writing of the procedure to request review pursuant to 117.7subdivision 6. An emergency license shall be effective until a child foster care license is 117.8granted or denied, but shall in no case remain in effect more than 120 days from the date 117.9of placement submit the information to the commissioner according to section 245C.05.117.10    Subd. 5. Child foster care license application. (a) The relatives with whom the117.11emergency license holder placement has been made shall complete the child foster care 117.12license application and necessary paperwork within ten days of the placement. The county 117.13agency shall assist the emergency license holder applicant to complete the application. 117.14The granting of a child foster care license to a relative shall be under the procedures in this 117.15chapter and according to the standards set forth by foster care rule in Minnesota Rules, 117.16chapter 2960. In licensing a relative, the commissioner shall consider the importance of 117.17maintaining the child's relationship with relatives as an additional significant factor in 117.18determining whether to a background study disqualification should be set aside a licensing 117.19disqualifier under section 
         245C.22, or to grant a variance of licensing requirements should 117.20be granted under sections 245C.21 to 245C.27 section 245C.30.117.21    (b) When the county or private child-placing agency is processing an application 117.22for child foster care licensure of a relative as defined in section 
         260B.007, subdivision 117.2312
         , or 
         260C.007, subdivision 27, the county agency or child-placing agency must explain 117.24the licensing process to the prospective licensee, including the background study process 117.25and the procedure for reconsideration of an initial disqualification for licensure. The 117.26county or private child-placing agency must also provide the prospective relative licensee 117.27with information regarding appropriate options for legal representation in the pertinent 117.28geographic area. If a relative is initially disqualified under section 
         245C.14, the county 117.29or child-placing agency commissioner must provide written notice of the reasons for the 117.30disqualification and the right to request a reconsideration by the commissioner as required 117.31under section 
         245C.17.117.32    (c) The commissioner shall maintain licensing data so that activities related to 117.33applications and licensing actions for relative foster care providers may be distinguished 117.34from other child foster care settings.117.35    Subd. 6.Denial of emergency license.If the commissioner denies an application 117.36for an emergency foster care license under this section, that denial must be in writing and 118.1must include reasons for the denial. Denial of an emergency license is not subject to 118.2appeal under chapter 14. The relative may request a review of the denial by submitting 118.3to the commissioner a written statement of the reasons an emergency license should be 118.4granted. The commissioner shall evaluate the request for review and determine whether 118.5to grant the emergency license. The commissioner's review shall be based on a review 118.6of the records submitted by the county agency and the relative. Within 15 working 118.7days of the receipt of the request for review, the commissioner shall notify the relative 118.8requesting review in written form whether the emergency license will be granted. The 118.9commissioner's review shall be based on a review of the records submitted by the county 118.10agency and the relative. A child shall not be placed or remain placed in the relative's home 118.11while the request for review is pending. Denial of an emergency license shall not preclude 118.12an individual from reapplying for an emergency license or from applying for a child foster 118.13care license. The decision of the commissioner is the final administrative agency action.118.14    Sec. 2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:118.15    Subd. 2. County fees for background studies and licensing inspections. (a) For 118.16purposes of family and group family child care licensing under this chapter, a county 118.17agency may charge a fee to an applicant or license holder to recover the actual cost of 118.18background studies, but in any case not to exceed $100 annually. A county agency may 118.19also charge alicense fee to an applicant or license holder to recover the actual cost of 118.20licensing inspections, but in any case not to exceed $150 annually$50 for a one-year 118.21license or $100 for a two-year license.118.22    (b) A county agency may charge a fee to a legal nonlicensed child care provider or 118.23applicant for authorization to recover the actual cost of background studies completed 118.24under section  
         119B.125, but in any case not to exceed $100 annually. 118.25    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):118.26    (1) in cases of financial hardship;118.27    (2)  if the county has a shortage of providers in the county's area;118.28    (3) for new providers; or118.29    (4) for providers who have attained at least 16 hours of training before seeking 118.30initial licensure.118.31    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on 118.32an installment basis for up to one year. If the provider is receiving child care assistance 118.33payments from the state, the provider may have the fees under paragraph (a) or (b) 118.34deducted from the child care assistance payments for up to one year and the state shall 118.35reimburse the county for the county fees collected in this manner.119.1EFFECTIVE DATE.This section is effective the day following final enactment.119.2    Sec. 3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:119.3    Subdivision 1. Delegation of authority to agencies. (a) County agencies and 119.4private agencies that have been designated or licensed by the commissioner to perform 119.5licensing functions and activities under section 
         245A.04andbackground studies for adult 119.6foster care, family adult day services, and until December 31, 2007, family child care, 119.7under chapter 245C,; to recommend denial of applicants under section 
         245A.05,; to issue 119.8correction orders, to issue variances, and recommend a conditional license under section 119.9245A.06
         , or to recommend suspending or revoking a license or issuing a fine under section 119.10245A.07
         , shall comply with rules and directives of the commissioner governing those 119.11functions and with this section. The following variances are excluded from the delegation 119.12of variance authority and may be issued only by the commissioner:119.13    (1) dual licensure of family child care and child foster care, dual licensure of child 119.14and adult foster care, and adult foster care and family child care;119.15    (2) adult foster care maximum capacity;119.16    (3) adult foster care minimum age requirement;119.17    (4) child foster care maximum age requirement;119.18    (5) variances regarding disqualified individuals except that county agencies may 119.19issue variances under section 
         245C.30 regarding disqualified individuals when the county 119.20is responsible for conducting a consolidated reconsideration according to sections 
         245C.25119.21and 
         245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 119.22and a disqualification based on serious or recurring maltreatment; and119.23    (6) the required presence of a caregiver in the adult foster care residence during 119.24normal sleeping hours.119.25    (b) County agencies must report:119.26    (1) information about disqualification reconsiderations under sections 
         245C.25 and 119.27245C.27, subdivision 2
         , clauses paragraphs (a) and (b), and variances granted under 119.28paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by 119.29the commissioner; and.119.30    (2) for relative child foster care applicants and license holders, the number of 119.31relatives, as defined in section 260C.007, subdivision 27, and household members of 119.32relatives who are disqualified under section 245C.14; the disqualifying characteristics 119.33under section 245C.15; the number of these individuals who requested reconsideration 119.34under section 245C.21; the number of set-asides under section 245C.22; and variances 120.1under section 245C.30 issued. This information shall be reported to the commissioner 120.2annually by January 15 of each year in a format prescribed by the commissioner.120.3    (c) For family day care programs, the commissioner may authorize licensing reviews 120.4every two years after a licensee has had at least one annual review.120.5    (d) For family adult day services programs, the commissioner may authorize 120.6licensing reviews every two years after a licensee has had at least one annual review.120.7    (e) A license issued under this section may be issued for up to two years.120.8    Sec. 4. Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:120.9    Subd. 3. Recommendations to the commissioner. The county or private agency 120.10shall not make recommendations to the commissioner regarding licensure without 120.11first conducting an inspection, and for adult foster care, family adult day services, and 120.12until December 31, 2007, family child care, a background study of the applicant, and 120.13evaluation pursuant to under chapter 245C. The county or private agency must forward its 120.14recommendation to the commissioner regarding the appropriate licensing action within 20 120.15working days of receipt of a completed application.120.16EFFECTIVE DATE.This section is effective January 1, 2008.120.17    Sec. 5. Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision 120.18to read:120.19    Subd. 14a.Private agency."Private agency" has the meaning given in section 120.20245A.02, subdivision 12.120.21    Sec. 6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:120.22    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a 120.23background study of an individual required to be studied under section 
         245C.03, 120.24subdivision 1
         , at least upon application for initial license for all license types. 120.25    (b) The commissioner shall conduct a background study of an individual required 120.26to be studied under section 
         245C.03, subdivision 1, at reapplication for a license for 120.27family child care, child foster care, and adult foster care, family adult day services, and 120.28until January 1, 2008, family child care. 120.29    (c) The commissioner is not required to conduct a study of an individual at the time 120.30of reapplication for a license if the individual's background study was completed by the 120.31commissioner of human services for an adult foster care license holder that is also:120.32    (1) registered under chapter 144D; or121.1    (2) licensed to provide home and community-based services to people with 121.2disabilities at the foster care location and the license holder does not reside in the foster 121.3care residence; and121.4    (3) the following conditions are met:121.5    (i) a study of the individual was conducted either at the time of initial licensure or 121.6when the individual became affiliated with the license holder;121.7    (ii) the individual has been continuously affiliated with the license holder since 121.8the last study was conducted; and121.9    (iii) the last study of the individual was conducted on or after October 1, 1995.121.10    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services 121.11shall conduct a study of an individual required to be studied under section 245C.03, at 121.12the time of reapplication for a child foster care license. The county or private agency 121.13shall collect and forward to the commissioner the information required under section 121.14245C.05, subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The 121.15background study conducted by the commissioner of human services under this paragraph 121.16must include a review of the information required under section 245C.08, subdivisions 121.171, paragraph (a), clauses (1) to (4), and 3.121.18    (e) From January 1, 2008, to December 31, 2009, the commissioner shall conduct 121.19a study of an individual required to be studied under section 245C.03, at the time of 121.20reapplication for a family child care license. The county shall collect and forward to the 121.21commissioner the information required under section 245C.05, subdivisions 1 and 5. The 121.22background study conducted by the commissioner under this paragraph must include a 121.23review of the information required under section 245C.08, subdivisions 1, paragraph 121.24(a), and 3.121.25    (f) The commissioner of human services shall conduct a background study of an 121.26individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) 121.27to (6), who is newly affiliated with a child foster care license holder. The county or 121.28private agency shall collect and forward to the commissioner the information required 121.29under section 245C.05, subdivisions 1 and 5. The background study conducted by the 121.30commissioner of human services under this paragraph must include a review of the 121.31information required under section 245C.08, subdivisions 1, paragraph (a), and 3.121.32    (g) Applicants for licensure, license holders, and other entities as provided in this 121.33chapter must submit completed background study forms to the commissioner before 121.34individuals specified in section 
         245C.03, subdivision 1, begin positions allowing direct 121.35contact in any licensed program. 122.1    (e) (h) For purposes of this section, a physician licensed under chapter 147 is 122.2considered to be continuously affiliated upon the license holder's receipt from the 122.3commissioner of health or human services of the physician's background study results.122.4    Sec. 7. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:122.5    Subdivision 1. Individual studied. (a) The individual who is the subject of the 122.6background study must provide the applicant, license holder, or other entity under section 122.7245C.04
          with sufficient information to ensure an accurate study, including: 122.8    (1) the individual's first, middle, and last name and all other names by which the 122.9individual has been known;122.10    (2) home address, city, and state of residence;122.11    (3) zip code;122.12    (4) sex;122.13    (5) date of birth; and122.14    (6) Minnesota driver's license number or state identification number.122.15    (b) Every subject of a background study conducted or initiated by counties or private 122.16agencies under this chapter must also provide the home address, city, county, and state of 122.17residence for the past five years.122.18    (c) Every subject of a background study related to child foster care licensed through 122.19a private agency shall also provide the commissioner a signed consent for the release of 122.20any information received from national crime information databases to the private agency 122.21that initiated the background study.122.22    (d) The subject of a background study shall provide fingerprints as required in 122.23subdivision 5, paragraph (c).122.24    Sec. 8. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision 122.25to read:122.26    Subd. 2a.County or private agency.For background studies related to child 122.27foster care, and beginning January 1, 2008, for studies related to family child care, county 122.28and private agencies must collect the information under subdivision 1 and forward it to 122.29the commissioner.122.30    Sec. 9. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:122.31    Subd. 4. Electronic transmission. For background studies conducted by the 122.32Department of Human Services, the commissioner shall implement a system for the 122.33electronic transmission of:123.1    (1) background study information to the commissioner; and123.2    (2) background study results to the license holder; and123.3    (3) background study results to county and private agencies for background studies 123.4conducted by the commissioner for child foster care, and beginning January 1, 2008, 123.5also for family child care.123.6EFFECTIVE DATE.This section is effective January 1, 2008.123.7    Sec. 10. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:123.8    Subd. 5. Fingerprints. (a) Except as provided in paragraph (c), for any background 123.9study completed under this chapter, when the commissioner has reasonable cause to 123.10believe that further pertinent information may exist on the subject of the background 123.11study, the subject shall provide the commissioner with a set of classifiable fingerprints 123.12obtained from an authorized law enforcement agency.123.13    (b) For purposes of requiring fingerprints, the commissioner has reasonable cause 123.14when, but not limited to, the:123.15    (1) information from the Bureau of Criminal Apprehension indicates that the subject 123.16is a multistate offender;123.17    (2) information from the Bureau of Criminal Apprehension indicates that multistate 123.18offender status is undetermined; or123.19    (3) commissioner has received a report from the subject or a third party indicating 123.20that the subject has a criminal history in a jurisdiction other than Minnesota.123.21    (c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for 123.22background studies conducted by the commissioner for child foster care, the subject of the 123.23background study shall provide the commissioner with a set of classifiable fingerprints 123.24obtained from an authorized agency.123.25    Sec. 11. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:123.26    Subd. 7. Probation officer and corrections agent. (a) A probation officer or 123.27corrections agent shall notify the commissioner of an individual's conviction if the 123.28individual is:123.29    (1) affiliated with a program or facility regulated by the Department of Human 123.30Services or Department of Health, a facility serving children or youth licensed by the 123.31Department of Corrections, or any type of home care agency or provider of personal care 123.32assistance services; and123.33    (2) convicted of a crime constituting a disqualification under section 
         245C.14. 124.1    (b) For the purpose of this subdivision, "conviction" has the meaning given it 124.2in section 
         609.02, subdivision 5. 124.3    (c) The commissioner, in consultation with the commissioner of corrections, shall 124.4develop forms and information necessary to implement this subdivision and shall provide 124.5the forms and information to the commissioner of corrections for distribution to local 124.6probation officers and corrections agents.124.7    (d) The commissioner shall inform individuals subject to a background study that 124.8criminal convictions for disqualifying crimes will be reported to the commissioner by the 124.9corrections system.124.10    (e) A probation officer, corrections agent, or corrections agency is not civilly or 124.11criminally liable for disclosing or failing to disclose the information required by this 124.12subdivision.124.13    (f) Upon receipt of disqualifying information, the commissioner shall provide the 124.14notice required under section 
         245C.17, as appropriate, to agencies on record as having 124.15initiated a background study or making a request for documentation of the background 124.16study status of the individual. 124.17    (g) This subdivision does not apply to family child care and child foster care124.18programs until January 1, 2008.124.19    Sec. 12. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:124.20    Subdivision 1. Background studies conducted by commissioner of human 124.21services. (a) For a background study conducted by the commissioner, the commissioner 124.22shall review:124.23    (1) information related to names of substantiated perpetrators of maltreatment of 124.24vulnerable adults that has been received by the commissioner as required under section 124.25626.557, subdivision 9c
         , paragraph (i);124.26    (2) the commissioner's records relating to the maltreatment of minors in licensed 124.27programs, and from county agency findings of maltreatment of minors as indicated 124.28through the social service information system;124.29    (3) information from juvenile courts as required in subdivision 4 for individuals 124.30listed in section 
         245C.03, subdivision 1, clauses (2), (5), and (6); and124.31    (4) information from the Bureau of Criminal Apprehension.; 124.32    (5) except as provided in clause (6), information from the national crime information 124.33system when the commissioner has reasonable cause as defined under section 245C.05, 124.34subdivision 5; and125.1    (6) for a background study related to a child foster care application for licensure, the 125.2commissioner shall also review:125.3    (i) information from the child abuse and neglect registry for any state in which the 125.4background study subject has resided in for the past five years; and125.5    (ii) information from national crime information databases.125.6    (b) Notwithstanding expungement by a court, the commissioner may consider 125.7information obtained under paragraph (a), clauses (3) and (4), unless the commissioner 125.8received notice of the petition for expungement and the court order for expungement is 125.9directed specifically to the commissioner.125.10    Sec. 13. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:125.11    Subd. 2. Background studies conducted by a county or private agency. (a) For 125.12a background study conducted by a county or private agency for child foster care, adult 125.13foster care, family adult day services, and until January 1, 2008, family child care homes125.14services, the commissioner shall review:125.15    (1) information from the county agency's record of substantiated maltreatment 125.16of adults and the maltreatment of minors;125.17    (2) information from juvenile courts as required in subdivision 4 for individuals 125.18listed in section 
         245C.03, subdivision 1, clauses (2), (5), and (6);125.19    (3) information from the Bureau of Criminal Apprehension; and125.20    (4) arrest and investigative records maintained by the Bureau of Criminal 125.21Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the 125.22National Criminal Records Repository, and criminal records from other states.125.23    (b) If the individual has resided in the county for less than five years, the study shall 125.24include the records specified under paragraph (a) for the previous county or counties of 125.25residence for the past five years.125.26    (c) Notwithstanding expungement by a court, the county or private agency may 125.27consider information obtained under paragraph (a), clauses (3) and (4), unless the 125.28commissioner received notice of the petition for expungement and the court order for 125.29expungement is directed specifically to the commissioner.125.30    Sec. 14. Minnesota Statutes 2006, section 245C.10, is amended by adding a 125.31subdivision to read:125.32    Subd. 4.Temporary personnel agencies, educational programs, and professional 125.33services agencies.The commissioner shall recover the cost of the background studies 125.34initiated by temporary personnel agencies, educational programs, and professional 126.1services agencies that initiate background studies under section 245C.03, subdivision 4, 126.2through a fee of no more than $20 per study charged to the agency. In fiscal years 2008 126.3and 2009, the fees collected under this subdivision are appropriated to the commissioner 126.4for the purpose of conducting background studies.126.5    Sec. 15. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:126.6    Subdivision 1. Adult foster care; criminal conviction data. For individuals who 126.7are required to have background studies under section 
         245C.03, subdivisions 1 and 2, and 126.8who have been continuously affiliated with a an adult foster care provider that is licensed 126.9in more than one county, criminal conviction data may be shared among those counties in 126.10which the adult foster care programs are licensed. A county agency's receipt of criminal 126.11conviction data from another county agency shall meet the criminal data background 126.12study requirements of this chapter. 126.13    Sec. 16. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:126.14    Subd. 2. Jointly licensed programs. A county agency may accept a background 126.15study completed by the commissioner under this chapter in place of the background study 126.16required under section 
         245A.16, subdivision 3, in programs with joint licensure as home 126.17and community-based services and adult foster care for people with developmental 126.18disabilities when the license holder does not reside in the adult foster care residence and 126.19the subject of the study has been continuously affiliated with the license holder since the 126.20date of the commissioner's study. 126.21    Sec. 17. Minnesota Statutes 2006, section 245C.12, is amended to read:126.22245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.126.23    (a) For the purposes of background studies completed by tribal organizations 126.24performing licensing activities otherwise required of the commissioner under this chapter, 126.25after obtaining consent from the background study subject, tribal licensing agencies shall 126.26have access to criminal history data in the same manner as county licensing agencies and 126.27private licensing agencies under this chapter.126.28    (b) Tribal organizations may contract with the commissioner to obtain background 126.29study data on individuals under tribal jurisdiction related to adoptions according to 126.30section 245C.34. Tribal organizations may also contract with the commissioner to obtain 126.31background study data on individuals under tribal jurisdiction related to child foster care 126.32according to section 245C.34.127.1    Sec. 18. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:127.2    Subdivision 1. Determining immediate risk of harm. (a) If the commissioner 127.3determines that the individual studied has a disqualifying characteristic, the commissioner 127.4shall review the information immediately available and make a determination as to the 127.5subject's immediate risk of harm to persons served by the program where the individual 127.6studied will have direct contact.127.7    (b) The commissioner shall consider all relevant information available, including the 127.8following factors in determining the immediate risk of harm:127.9    (1) the recency of the disqualifying characteristic;127.10    (2) the recency of discharge from probation for the crimes;127.11    (3) the number of disqualifying characteristics;127.12    (4) the intrusiveness or violence of the disqualifying characteristic;127.13    (5) the vulnerability of the victim involved in the disqualifying characteristic;127.14    (6) the similarity of the victim to the persons served by the program where the 127.15individual studied will have direct contact; and127.16    (7) whether the individual has a disqualification from a previous background study 127.17that has not been set aside.127.18    (c) This section does not apply when the subject of a background study is regulated 127.19by a health-related licensing board as defined in chapter 214, and the subject is determined 127.20to be responsible for substantiated maltreatment under section 
         626.556 or 
         626.557. 127.21    (d) This section does not apply to a background study related to an initial application 127.22for a child foster care license.127.23    (e) If the commissioner has reason to believe, based on arrest information or an 127.24active maltreatment investigation, that an individual poses an imminent risk of harm to 127.25persons receiving services, the commissioner may order that the person be continuously 127.26supervised or immediately removed pending the conclusion of the maltreatment 127.27investigation or criminal proceedings.127.28    Sec. 19. Minnesota Statutes 2006, section 245C.17, is amended by adding a 127.29subdivision to read:127.30    Subd. 5.Notice to county or private agency.For studies on individuals related 127.31to a license to provide child foster care, and beginning January 1, 2008, for family child 127.32care, the commissioner shall also provide a notice of the background study results to the 127.33county or private agency that initiated the background study.128.1    Sec. 20. Minnesota Statutes 2006, section 245C.21, is amended by adding a 128.2subdivision to read:128.3    Subd. 1a.Submission of reconsideration request to county or private agency.128.4    (a) For disqualifications related to studies conducted by county agencies, and for 128.5disqualifications related to studies conducted by the commissioner for child foster care, and 128.6beginning January 1, 2008, for family child care, the individual shall submit the request 128.7for reconsideration to the county or private agency that initiated the background study.128.8    (b) A reconsideration request shall be submitted within the time frames specified in 128.9subdivision 2.128.10    (c) The county or private agency shall forward the individual's request for 128.11reconsideration and provide the commissioner with a recommendation whether to set aside 128.12the individual's disqualification.128.13    Sec. 21. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:128.14    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The 128.15commissioner shall notify the license holder of the disqualification and order the license 128.16holder to immediately remove the individual from any position allowing direct contact 128.17with persons receiving services from the license holder if:128.18    (1) the individual studied does not submit a timely request for reconsideration 128.19under section 
         245C.21;128.20    (2) the individual submits a timely request for reconsideration, but the commissioner 128.21does not set aside the disqualification for that license holder under section 
         245C.22;128.22    (3) an individual who has a right to request a hearing under sections 
         245C.27 and 128.23256.045
         , or 
         245C.28 and chapter 14 for a disqualification that has not been set aside, does 128.24not request a hearing within the specified time; or128.25    (4) an individual submitted a timely request for a hearing under sections 
         245C.27128.26and 
         256.045, or 
         245C.28 and chapter 14, but the commissioner does not set aside the 128.27disqualification under section 
         245A.08, subdivision 5, or 
         256.045.128.28    (b) If the commissioner does not set aside the disqualification under section 
         245C.22, 128.29and the license holder was previously ordered under section 
         245C.17 to immediately 128.30remove the disqualified individual from direct contact with persons receiving services or 128.31to ensure that the individual is under continuous, direct supervision when providing direct 128.32contact services, the order remains in effect pending the outcome of a hearing under 128.33sections 
         245C.27 and 
         256.045, or 
         245C.28 and chapter 14.129.1    (c) For background studies related to child foster care, and beginning January 129.21, 2008, for family child care, the commissioner shall also notify the county or private 129.3agency that initiated the study of the results of the reconsideration.129.4    Sec. 22. Minnesota Statutes 2006, section 245C.24, subdivision 2, is amended to read:129.5    Subd. 2. Permanent bar to set aside a disqualification. (a) Except as provided in 129.6paragraph (b), the commissioner may not set aside the disqualification of any individual 129.7disqualified pursuant to this chapter, in connection with a license to provide family child 129.8care for children, foster care for children in the provider's home, or foster care or day care 129.9services for adults in the provider's home regardless of how much time has passed, if the 129.10individual was disqualified for a crime or conduct listed in section 
         245C.15, subdivision 1.129.11    (b) For an individual in the chemical dependency field who was disqualified for a 129.12crime or conduct listed under section 
         245C.15, subdivision 1, and whose disqualification 129.13was set aside prior to July 1, 2005, the commissioner must consider granting a variance 129.14pursuant to section 
         245C.30 for the license holder for a program dealing primarily with 129.15adults. A request for reconsideration evaluated under this paragraph must include a 129.16letter of recommendation from the license holder that was subject to the prior set-aside 129.17decision addressing the individual's quality of care to children or vulnerable adults and the 129.18circumstances of the individual's departure from that service.129.19    Sec. 23. [245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.129.20    Subdivision 1.Background studies conducted by commissioner.Before 129.21placement of a child for purposes of adoption, the commissioner shall conduct a 129.22background study on individuals listed in section 259.41, subdivision 3, for county 129.23agencies and private agencies licensed to place children for adoption.129.24    Subd. 2.Information and data provided to county or private agency.The 129.25subject of the background study shall provide the following information to the county 129.26or private agency:129.27    (1) the information specified in section 245C.05;129.28    (2) a set of classifiable fingerprints obtained from an authorized agency; and129.29    (3) for studies initiated by a private agency, a signed consent for the release of 129.30information received from national crime information databases to the private agency.129.31    Subd. 3.Information and data provided to commissioner.The county or private 129.32agency shall forward the data collected under subdivision 2 to the commissioner.129.33    Subd. 4.Information commissioner reviews.(a) The commissioner shall review 129.34the following information regarding the background study subject:130.1    (1) the information under section 245C.08, subdivisions 1, 3, and 4;130.2    (2) information from the child abuse and neglect registry for any state in which the 130.3subject has resided for the past five years; and130.4    (3) information from national crime information databases.130.5    (b) The commissioner shall provide any information collected under this subdivision 130.6to the county or private agency that initiated the background study. The commissioner 130.7shall indicate if the information collected shows that the subject of the background study 130.8has a conviction listed in United States Code, title 42, section 671(a)(20)(A).130.9    Sec. 24. [245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND 130.10STUDIES; TRIBAL ORGANIZATIONS.130.11    Subdivision 1.Background studies may be conducted by commissioner.(a) 130.12Tribal organizations may contract with the commissioner under section 245C.12 to obtain 130.13background study data on individuals under tribal jurisdiction related to adoptions.130.14    (b) Tribal organizations may contract with the commissioner under section 245C.12 130.15to obtain background study data on individuals under tribal jurisdiction related to child 130.16foster care.130.17    (c) Background studies initiated by tribal organizations under paragraphs (a) and (b) 130.18must be conducted as provided in subdivisions 2 and 3.130.19    Subd. 2.Information and data provided to tribal organization.The background 130.20study subject must provide the following information to the tribal organization:130.21    (1) for background studies related to adoptions, the information under section 130.22245C.05;130.23    (2) for background studies related to child foster care, the information under section 130.24245C.05;130.25    (3) a set of classifiable fingerprints obtained from an authorized agency; and130.26    (4) a signed consent for the release of information received from national crime 130.27information databases to the tribal organization.130.28    Subd. 3.Information and data provided to commissioner.The tribal organization 130.29shall forward the data collected under subdivision 2 to the commissioner.130.30    Subd. 4.Information commissioner reviews.(a) The commissioner shall review 130.31the following information regarding the background study subject:130.32    (1) the information under section 245C.08, subdivisions 1, 3, and 4;130.33    (2) information from the child abuse and neglect registry for any state in which the 130.34subject has resided for the past five years; and130.35    (3) information from national crime information databases.131.1    (b) The commissioner shall provide any information collected under this subdivision 131.2to the tribal organization that initiated the background study. The commissioner shall 131.3indicate if the information collected shows that the subject of the background study has a 131.4conviction listed in United States Code, title 42, section 671(a)(20)(A).131.5    Sec. 25. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:131.6    Subd. 2. Other applicable law.(a) Portions of chapters 245A, 245C, 257, 260, and 131.7317A may also affect the adoption of a particular child. 131.8    (b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter 131.921, sections 1901-1923, may also apply in the adoption of an Indian child, and may 131.10preempt specific provisions of this chapter.131.11    (c) Consistent with section 245C.33 and Public Law 109-248, a completed 131.12background study is required before the approval of any foster or adoptive placement in 131.13a related or an unrelated home.131.14    Sec. 26. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:131.15    Subdivision 1. Best interests of the child. (a) The policy of the state of Minnesota 131.16is to ensure that the best interests of the child are met by requiring individualized 131.17determination of the needs of the child and of how the adoptive placement will serve the 131.18needs of the child.131.19    (b) Among the factors the agency shall consider in determining the needs of the child 131.20are those specified under section 
         260C.193, subdivision 3, paragraph (b).131.21    (c) Except for emergency placements provided for in section 245A.035, a completed 131.22background study is required under section 245C.33 before the approval of an adoptive 131.23placement in a home.131.24    Sec. 27. Minnesota Statutes 2006, section 259.41, is amended to read:131.25259.41 ADOPTION STUDY.131.26    Subdivision 1. Study required before placement; certain relatives excepted. (a) 131.27An approved adoption study; completed background study, as required under section 131.28245C.33; and written report must be completed before the child is placed in a prospective 131.29adoptive home under this chapter, except as allowed by section 
         259.47, subdivision 6. 131.30In an agency placement, the report must be filed with the court at the time the adoption 131.31petition is filed. In a direct adoptive placement, the report must be filed with the court in 131.32support of a motion for temporary preadoptive custody under section 
         259.47, subdivision 131.333
         , or, if the study and report are complete, in support of an emergency order under section 132.1259.47, subdivision 6
         . The study and report shall be completed by a licensed child-placing 132.2agency and must be thorough and comprehensive. The study and report shall be paid for 132.3by the prospective adoptive parent, except as otherwise required under section 
         259.67132.4or 
         259.73. 132.5    (b) A placement for adoption with an individual who is related to the child, as 132.6defined by section 
         245A.02, subdivision 13, is not subject to this section except as required 132.7by section sections 245C.33 and259.53, subdivision 2, paragraph (c). 132.8    (c) In the case of a licensed foster parent seeking to adopt a child who is in the foster 132.9parent's care, any portions of the foster care licensing process that duplicate requirements 132.10of the home study may be submitted in satisfaction of the relevant requirements of this 132.11section.132.12    Subd. 2. Form of study. (a) The adoption study must include at least one in-home 132.13visit with the prospective adoptive parent. At a minimum, the study must include132.14document the following information about the prospective adoptive parent:132.15    (1) a background check study as required by subdivision 3 and section 245C.33, 132.16and including:132.17    (i) an evaluation assessment of the data and information provided by section 132.18245C.33, subdivision 4, to determine if the prospective adoptive parent and any other 132.19person over the age of 13 living in the home has a felony conviction consistent with 132.20subdivision 3 and section 471(a)(2) of the Social Security Act; and132.21    (ii) an assessment of the effect of a any conviction or finding of substantiated 132.22maltreatment on the ability to capacity of the prospective adoptive parent to safely care 132.23for and parent a child;132.24    (2) a medical and social history and assessment of current health;132.25    (3) an assessment of potential parenting skills;132.26    (4) an assessment of ability to provide adequate financial support for a child; and132.27    (5) an assessment of the level of knowledge and awareness of adoption issues 132.28including, where appropriate, matters relating to interracial, cross-cultural, and special 132.29needs adoptions.132.30    (b) The adoption study is the basis for completion of a written report. The report 132.31must be in a format specified by the commissioner and must contain recommendations 132.32regarding the suitability of the subject of the study to be an adoptive parent.132.33    Subd. 3. Background check; affidavit of history study. (a) At the time an adoption 132.34study is commenced, each prospective adoptive parent must:132.35    (1) authorize access by the agency to any private data needed to complete the study;133.1    (2) provide all addresses at which the prospective adoptive parent and anyone in the 133.2household over the age of 13 has resided in the previous five years; and133.3    (3) disclose any names used previously other than the name used at the time of 133.4the study.133.5    (b) When the requirements of paragraph (a) have been met, the agency shall 133.6immediately begin initiate a background check, study under section 245C.33 to be 133.7completed by the commissioner on each person over the age of 13 living in the home, 133.8consisting, at a minimum, of the following:. As required under section 245C.33 and Public 133.9Law 109-248, a completed background study is required before the approval of any foster 133.10or adoptive placement in a related or an unrelated home. The required background study 133.11must be completed as part of the home study.133.12    (1) a check of criminal conviction data with the Bureau of Criminal Apprehension 133.13and local law enforcement authorities;133.14    (2) a check for data on substantiated maltreatment of a child or vulnerable adult 133.15and domestic violence data with local law enforcement and social services agencies and 133.16district courts; and133.17    (3) for those persons under the age of 25, a check of juvenile court records.133.18    Notwithstanding the provisions of section 260B.171 or 260C.171, the Bureau of 133.19Criminal Apprehension, local law enforcement and social services agencies, district courts, 133.20and juvenile courts shall release the requested information to the agency completing 133.21the adoption study.133.22    (c) When paragraph (b) requires checking the data or records of local law 133.23enforcement and social services agencies and district and juvenile courts, the agency 133.24shall check with the law enforcement and social services agencies and courts whose 133.25jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the 133.26agency is unable to complete any of the record checks required by paragraph (b), the 133.27agency shall document the fact and the agency's efforts to obtain the information.133.28    (d) For a study completed under this section, when the agency has reasonable 133.29cause to believe that further information may exist on the prospective adoptive parent or 133.30household member over the age of 13 that may relate to the health, safety, or welfare of 133.31the child, the prospective adoptive parent or household member over the age of 13 shall 133.32provide the agency with a set of classifiable fingerprints obtained from an authorized law 133.33enforcement agency and the agency may obtain criminal history data from the National 133.34Criminal Records Repository by submitting fingerprints to the Bureau of Criminal 133.35Apprehension. The agency has reasonable cause when, but not limited to, the:134.1    (1) information from the Bureau of Criminal Apprehension indicates that the 134.2prospective adoptive parent or household member over the age of 13 is a multistate 134.3offender;134.4    (2) information from the Bureau of Criminal Apprehension indicates that multistate 134.5offender status is undetermined;134.6    (3) the agency has received a report from the prospective adoptive parent or 134.7household member over the age of 13 or a third party indicating that the prospective 134.8adoptive parent or household member over the age of 13 has a criminal history in a 134.9jurisdiction other than Minnesota; or134.10    (4) the prospective adoptive parent or household member over the age of 13 is or has 134.11been a resident of a state other than Minnesota in the prior five years.134.12    (e) At any time prior to completion of the background check required under 134.13paragraph (b), a prospective adoptive parent may submit to the agency conducting the 134.14study a sworn affidavit stating whether they or any person residing in the household have 134.15been convicted of a crime. The affidavit shall also state whether the adoptive parent or any 134.16other person residing in the household is the subject of an open investigation of, or have 134.17been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment 134.18within the past ten years. A complete description of the crime, open investigation, or 134.19substantiated abuse, and a complete description of any sentence, treatment, or disposition 134.20must be included. The affidavit must contain an acknowledgment that if, at any time 134.21before the adoption is final, a court receives evidence leading to a conclusion that a 134.22prospective adoptive parent knowingly gave false information in the affidavit, it shall be 134.23determined that the adoption of the child by the prospective adoptive parent is not in the 134.24best interests of the child.134.25    (f) For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an 134.26adoption study is complete for placement, even though the background checks required by 134.27paragraph (b) have not been completed, if each prospective adoptive parent has completed 134.28the affidavit allowed by paragraph (e) and the other requirements of this section have been 134.29met. The background checks required by paragraph (b) must be completed before an 134.30adoption petition is filed. If an adoption study has been submitted to the court under section 134.31259.47, subdivision 3 or 6, before the background checks required by paragraph (b) were 134.32complete, an updated adoption study report which includes the results of the background 134.33check must be filed with the adoption petition. In the event that an agency is unable to 134.34complete any of the records checks required by paragraph (b), the agency shall submit with 134.35the petition to adopt an affidavit documenting the agency's efforts to complete the checks.135.1    (c) A home study under paragraph (b) used to consider placement of any child 135.2on whose behalf Title IV-E adoption assistance payments are to be made must not be 135.3approved if a background study reveals a felony conviction at any time for:135.4    (1) child abuse or neglect;135.5    (2) spousal abuse;135.6    (3) a crime against children, including child pornography; or135.7    (4) a crime involving violence, including rape, sexual assault, or homicide, but not 135.8including other physical assault or battery.135.9    (d) A home study under paragraph (b) used to consider placement of any child 135.10on whose behalf Title IV-E adoption assistance payments are to be made must not be 135.11approved if a background study reveals a felony conviction within the past five years for:135.12    (1) physical assault or battery; or135.13    (2) a drug-related offense.135.14    Subd. 4. Updates to adoption study; period of validity. An agency may update 135.15an adoption study and report as needed, regardless of when the original study and report 135.16or most recent update was completed. An update must be in a format specified by the 135.17commissioner and must verify the continuing accuracy of the elements of the original 135.18report and document any changes to elements of the original report. An update to a study 135.19and report not originally completed under this section must ensure that the study and 135.20report, as updated, meet the requirements of this section. An adoption study is valid if the 135.21report has been completed or updated within the previous 12 months.135.22    Sec. 28. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:135.23    Subd. 2. Adoption agencies; postplacement assessment and report. (a) The 135.24agency to which the petition has been referred under subdivision 1 shall conduct a 135.25postplacement assessment and file a report with the court within 90 days of receipt 135.26of a copy of the adoption petition. The agency shall send a copy of the report to the 135.27commissioner at the time it files the report with the court. The assessment and report 135.28must evaluate the environment and antecedents of the child to be adopted, the home of 135.29the petitioners, whether placement with the petitioners meets the needs of the child as 135.30described in section 
         259.57, subdivision 2. The report must include a recommendation to 135.31the court as to whether the petition should or should not be granted. 135.32    In making evaluations and recommendations, the postplacement assessment and 135.33report must, at a minimum, address the following:135.34    (1) the level of adaptation by the prospective adoptive parents to parenting the child;135.35    (2) the health and well-being of the child in the prospective adoptive parents' home;136.1    (3) the level of incorporation by the child into the prospective adoptive parents' 136.2home, extended family, and community; and136.3    (4) the level of inclusion of the child's previous history into the prospective adoptive 136.4home, such as cultural or ethnic practices, or contact with former foster parents or 136.5biological relatives.136.6    (b) A postplacement adoption report is valid for 12 months following its date 136.7of completion.136.8    (c) If the petitioner is an individual who is related to the child, as defined by section 136.9245A.02, subdivision 13, the agency, as part of its postplacement assessment and report 136.10under paragraph (a), shall conduct a background check meeting the requirements of 136.11section 259.41, subdivision 3, paragraph (b). The prospective adoptive parent shall 136.12cooperate in the completion of the background check by supplying the information and 136.13authorizations described in section 259.41, subdivision 3, paragraph (a).136.14    (d) (c) If the report recommends that the court not grant the petition to adopt the 136.15child, the provisions of this paragraph apply. Unless the assessment and report were 136.16completed by the local social services agency, the agency completing the report, at the 136.17time it files the report with the court under paragraph (a), must provide a copy of the report 136.18to the local social services agency in the county where the prospective adoptive parent 136.19lives. The agency or local social services agency may recommend that the court dismiss 136.20the petition. If the local social services agency determines that continued placement in the 136.21home endangers the child's physical or emotional health, the agency shall seek a court 136.22order to remove the child from the home.136.23    (e) (d) If, through no fault of the petitioner, the agency to whom the petition was 136.24referred under subdivision 1, paragraph (b), fails to complete the assessment and file the 136.25report within 90 days of the date it received a copy of the adoption petition, the court may 136.26hear the petition upon giving the agency and the local social services agency, if different, 136.27five days' notice by mail of the time and place of the hearing.136.28    Sec. 29. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:136.29    Subd. 2. Protection of child's best interests. (a) The policy of the state of 136.30Minnesota is to ensure that the best interests of children are met by requiring an 136.31individualized determination of the needs of the child and how the adoptive placement 136.32will serve the needs of the child.136.33    (b) Among the factors the court shall consider in determining the needs of the child 136.34are those specified under section 
         260C.193, subdivision 3, paragraph (b). Consistent with 137.1section 245C.33 and Public Law 109-248, a complete background study is required before 137.2the approval of an adoptive placement in a home. 137.3    (c) In reviewing adoptive placement and in determining appropriate adoption, 137.4the court shall consider placement, consistent with the child's best interests and in the 137.5following order, with (1) a relative or relatives of the child, or (2) an important friend with 137.6whom the child has resided or had significant contact. Placement of a child cannot be 137.7delayed or denied based on race, color, or national origin of the adoptive parent or the 137.8child. Whenever possible, siblings should be placed together unless it is determined 137.9not to be in the best interests of a sibling.137.10    (d) If the child's birth parent or parents explicitly request that relatives and important 137.11friends not be considered, the court shall honor that request consistent with the best 137.12interests of the child.137.13    If the child's birth parent or parents express a preference for placing the child in an 137.14adoptive home of the same or a similar religious background to that of the birth parent 137.15or parents, the court shall place the child with a family that also meets the birth parent's 137.16religious preference. Only if no family is available as described in clause (a) or (b) 137.17may the court give preference to a family described in clause (c) that meets the parent's 137.18religious preference.137.19    (e) This subdivision does not affect the Indian Child Welfare Act, United States 137.20Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation 137.21Act, sections 
         260.751 to 
         260.835.137.22    Sec. 30. Minnesota Statutes 2006, section 260C.209, is amended to read:137.23260C.209 BACKGROUND CHECKS.137.24    Subdivision 1. Subjects. The responsible social services agency must conduct137.25initiate a background check study to be completed by the commissioner under this section 137.26of chapter 245C on the following individuals:137.27    (1) a noncustodial parent or nonadjudicated parent who is being assessed for 137.28purposes of providing day-to-day care of a child temporarily or permanently under section 137.29260C.212, subdivision 4
         , and any member of the parent's household who is over the age of 137.3013 when there is a reasonable cause to believe that the parent or household member over 137.31age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult 137.32which would endanger the child's health, safety, or welfare;137.33    (2) an individual whose suitability for relative placement under section 
         260C.212, 137.34subdivision 5
         , is being determined and any member of the relative's household who is 137.35over the age of 13 when:138.1    (i) the relative must be licensed for foster care; or138.2    (ii) the agency must conduct a background study is required under section 
         259.53, 138.3subdivision 2
         ; or138.4    (iii) the agency or the commissioner has reasonable cause to believe the relative 138.5or household member over the age of 13 has a criminal history which would not make 138.6transfer of permanent legal and physical custody to the relative under section 
         260C.201, 138.7subdivision 11
         , in the child's best interest; and138.8    (3) a parent, following an out-of-home placement, when the responsible social 138.9services agency has reasonable cause to believe that the parent has been convicted of a 138.10crime directly related to the parent's capacity to maintain the child's health, safety, or 138.11welfare or the parent is the subject of an open investigation of, or has been the subject 138.12of a substantiated allegation of, child or vulnerable-adult maltreatment within the past 138.13ten years.138.14"Reasonable cause" means that the agency has received information or a report from the 138.15subject or a third person that creates an articulable suspicion that the individual has a 138.16history that may pose a risk to the health, safety, or welfare of the child. The information 138.17or report must be specific to the potential subject of the background check and shall not 138.18be based on the race, religion, ethnic background, age, class, or lifestyle of the potential 138.19subject.138.20    Subd. 2. General procedures. (a) When conducting initiating a background check 138.21under subdivision 1, the agency may shall require the individual being assessed to provide 138.22sufficient information to ensure an accurate assessment under this section, including:138.23    (1) the individual's first, middle, and last name and all other names by which the 138.24individual has been known;138.25    (2) home address, zip code, city, county, and state of residence for the past ten five138.26years;138.27    (3) sex;138.28    (4) date of birth; and138.29    (5) driver's license number or state identification number.138.30    (b) When notified by the commissioner or the responsible social services agency that 138.31it is conducting an assessment under this section, the Bureau of Criminal Apprehension, 138.32commissioners of health and human services, law enforcement, and county agencies must 138.33provide the commissioner or the responsible social services agency or county attorney 138.34with the following information on the individual being assessed: criminal history data, 138.35reports about the maltreatment of adults substantiated under section 
         626.557, and reports 138.36of maltreatment of minors substantiated under section 
         626.556.139.1    Subd. 3. Multistate information.(a) For any assessment every background study139.2completed under this section, if the responsible social services agency has reasonable 139.3cause to believe that the individual is a multistate offender, the individual must the subject 139.4of the background study shall provide the responsible social services agency or the 139.5county attorney with a set of classifiable fingerprints obtained from an authorized law 139.6enforcement agency. The responsible social services agency or county attorney may shall 139.7provide the fingerprints to the commissioner, and the commissioner shall obtain criminal 139.8history data from the National Criminal Records Repository by submitting the fingerprints 139.9to the Bureau of Criminal Apprehension.139.10    (b) For purposes of this subdivision, the responsible social services agency has 139.11reasonable cause when, but not limited to:139.12    (1) information from the Bureau of Criminal Apprehension indicates that the 139.13individual is a multistate offender;139.14    (2) information from the Bureau of Criminal Apprehension indicates that multistate 139.15offender status is undetermined;139.16    (3) the social services agency has received a report from the individual or a third 139.17party indicating that the individual has a criminal history in a jurisdiction other than 139.18Minnesota; or139.19    (4) the individual is or has been a resident of a state other than Minnesota at any 139.20time during the prior ten years.139.21    Subd. 4. Notice upon receipt. The responsible social services agency commissioner139.22must provide the subject of the background study with the results of the study as required139.23under this section within 15 business days of receipt or at least 15 days prior to the hearing 139.24at which the results will be presented, whichever comes first. The subject may provide 139.25written information to the agency that the results are incorrect and may provide additional 139.26or clarifying information to the agency and to the court through a party to the proceeding. 139.27This provision does not apply to any background study conducted under chapters 245A 139.28and chapter 245C.139.29    Sec. 31. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:139.30    Subd. 2. Placement decisions based on best interest of the child. (a) The policy 139.31of the state of Minnesota is to ensure that the child's best interests are met by requiring an 139.32individualized determination of the needs of the child and of how the selected placement 139.33will serve the needs of the child being placed. The authorized child-placing agency shall 139.34place a child, released by court order or by voluntary release by the parent or parents, in 140.1a family foster home selected by considering placement with relatives and important 140.2friends in the following order:140.3    (1) with an individual who is related to the child by blood, marriage, or adoption; or140.4    (2) with an individual who is an important friend with whom the child has resided or 140.5had significant contact.140.6    (b) Among the factors the agency shall consider in determining the needs of the 140.7child are the following:140.8    (1) the child's current functioning and behaviors;140.9    (2) the medical, educational, and developmental needs of the child;140.10    (3) the child's history and past experience;140.11    (4) the child's religious and cultural needs;140.12    (5) the child's connection with a community, school, and church;140.13    (6) the child's interests and talents;140.14    (7) the child's relationship to current caretakers, parents, siblings, and relatives; and140.15    (8) the reasonable preference of the child, if the court, or the child-placing agency 140.16in the case of a voluntary placement, deems the child to be of sufficient age to express 140.17preferences.140.18    (c) Placement of a child cannot be delayed or denied based on race, color, or national 140.19origin of the foster parent or the child.140.20    (d) Siblings should be placed together for foster care and adoption at the earliest 140.21possible time unless it is determined not to be in the best interests of a sibling or unless it 140.22is not possible after appropriate efforts by the responsible social services agency.140.23    (e) Except for emergency placement as provided for in section 245A.035, a 140.24completed background study is required under section 245C.08 before the approval of a 140.25foster placement in a related or unrelated home.140.26    Sec. 32. EFFECTIVE DATE.140.27Changes made to sections in this article related to family child care are effective 140.28January 1, 2008.140.29ARTICLE 3140.30HEALTH CARE140.31    Section 1. Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to 140.32read:140.33    Subd. 2. Transfers. (a) Notwithstanding section 
         295.581, to the extent available 140.34resources in the health care access fund exceed expenditures in that fund, effective with 141.1the biennium beginning July 1, 2007,the commissioner shall transfer funds from the 141.2health care access fund to the general fund to offset the costs of MinnesotaCare enrollees 141.3shifting to medical assistance due to the implementation of an automated eligibility 141.4determination system. The medical assistance costs shall be identified and updated in the 141.5November and February forecasts.141.6    (b) In addition to the amounts in paragraph (a), the commissioner of finance shall 141.7transfer the excess funds from the health care access fund to the general fund on June 141.830 of each year, provided that the amount transferred in any fiscal biennium shall not 141.9exceed $96,000,000. For the biennium ending June 30, 2011, the transfer shall not exceed 141.10$48,000,000.141.11    (b)(c) For fiscal years 2006 to 2009, MinnesotaCare shall be a forecasted program, 141.12and, if necessary, the commissioner shall reduce these transfers from the health care access 141.13fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, 141.14transfer sufficient funds from the general fund to the health care access fund to meet 141.15annual MinnesotaCare expenditures.141.16    Sec. 2. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to read:141.17    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 141.18assistance program must not be submitted until the recipient is discharged. However, 141.19the commissioner shall establish monthly interim payments for inpatient hospitals that 141.20have individual patient lengths of stay over 30 days regardless of diagnostic category. 141.21Except as provided in section 
         256.9693, medical assistance reimbursement for treatment 141.22of mental illness shall be reimbursed based on diagnostic classifications. Individual 141.23hospital payments established under this section and sections 
         256.9685, 
         256.9686, and 141.24256.9695
         , in addition to third party and recipient liability, for discharges occurring during 141.25the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 141.26inpatient services paid for the same period of time to the hospital. This payment limitation 141.27shall be calculated separately for medical assistance and general assistance medical 141.28care services. The limitation on general assistance medical care shall be effective for 141.29admissions occurring on or after July 1, 1991. Services that have rates established under 141.30subdivision 11 or 12, must be limited separately from other services. After consulting with 141.31the affected hospitals, the commissioner may consider related hospitals one entity and 141.32may merge the payment rates while maintaining separate provider numbers. The operating 141.33and property base rates per admission or per day shall be derived from the best Medicare 141.34and claims data available when rates are established. The commissioner shall determine 141.35the best Medicare and claims data, taking into consideration variables of recency of the 142.1data, audit disposition, settlement status, and the ability to set rates in a timely manner. 142.2The commissioner shall notify hospitals of payment rates by December 1 of the year 142.3preceding the rate year. The rate setting data must reflect the admissions data used to 142.4establish relative values. Base year changes from 1981 to the base year established for the 142.5rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 142.6to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 142.71. The commissioner may adjust base year cost, relative value, and case mix index data 142.8to exclude the costs of services that have been discontinued by the October 1 of the year 142.9preceding the rate year or that are paid separately from inpatient services. Inpatient stays 142.10that encompass portions of two or more rate years shall have payments established based 142.11on payment rates in effect at the time of admission unless the date of admission preceded 142.12the rate year in effect by six months or more. In this case, operating payment rates for 142.13services rendered during the rate year in effect and established based on the date of 142.14admission shall be adjusted to the rate year in effect by the hospital cost index.142.15    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 142.16payment, before third-party liability and spenddown, made to hospitals for inpatient 142.17services is reduced by .5 percent from the current statutory rates.142.18    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 142.19admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 142.20before third-party liability and spenddown, is reduced five percent from the current 142.21statutory rates. Mental health services within diagnosis related groups 424 to 432, and142.22facilities defined under subdivision 16, and, effective for admissions occurring on or after 142.23July 1, 2007, a long-term hospital as designated by the Medicare program that is located in 142.24a city of the first class as defined in section 410.01, are excluded from this paragraph.142.25    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 142.26fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 142.27inpatient services before third-party liability and spenddown, is reduced 6.0 percent from 142.28the current statutory rates. Mental health services within diagnosis related groups 424 to 142.29432 and, facilities defined under subdivision 16, and, effective for admissions occurring 142.30on or after July 1, 2007, a long-term hospital as designated by the Medicare program 142.31that is located in a city of the first class as defined in section 410.01, are excluded from 142.32this paragraph. Notwithstanding section 
         256.9686, subdivision 7, for purposes of this 142.33paragraph, medical assistance does not include general assistance medical care. Payments 142.34made to managed care plans shall be reduced for services provided on or after January 142.351, 2006, to reflect this reduction.143.1    Sec. 3. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:143.2    Subd. 9. Disproportionate numbers of low-income patients served. (a) For 143.3admissions occurring on or after October 1, 1992, through December 31, 1992, the 143.4medical assistance disproportionate population adjustment shall comply with federal law 143.5and shall be paid to a hospital, excluding regional treatment centers and facilities of the 143.6federal Indian Health Service, with a medical assistance inpatient utilization rate in excess 143.7of the arithmetic mean. The adjustment must be determined as follows:143.8    (1) for a hospital with a medical assistance inpatient utilization rate above the 143.9arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 143.10federal Indian Health Service but less than or equal to one standard deviation above the 143.11mean, the adjustment must be determined by multiplying the total of the operating and 143.12property payment rates by the difference between the hospital's actual medical assistance 143.13inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 143.14treatment centers and facilities of the federal Indian Health Service; and143.15    (2) for a hospital with a medical assistance inpatient utilization rate above one 143.16standard deviation above the mean, the adjustment must be determined by multiplying 143.17the adjustment that would be determined under clause (1) for that hospital by 1.1. If 143.18federal matching funds are not available for all adjustments under this subdivision, the 143.19commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for 143.20federal match. The commissioner may establish a separate disproportionate population 143.21operating payment rate adjustment under the general assistance medical care program. 143.22For purposes of this subdivision medical assistance does not include general assistance 143.23medical care. The commissioner shall report annually on the number of hospitals likely to 143.24receive the adjustment authorized by this paragraph. The commissioner shall specifically 143.25report on the adjustments received by public hospitals and public hospital corporations 143.26located in cities of the first class.143.27    (b) For admissions occurring on or after July 1, 1993, the medical assistance 143.28disproportionate population adjustment shall comply with federal law and shall be paid to 143.29a hospital, excluding regional treatment centers and facilities of the federal Indian Health 143.30Service, with a medical assistance inpatient utilization rate in excess of the arithmetic 143.31mean. The adjustment must be determined as follows:143.32    (1) for a hospital with a medical assistance inpatient utilization rate above the 143.33arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 143.34federal Indian Health Service but less than or equal to one standard deviation above the 143.35mean, the adjustment must be determined by multiplying the total of the operating and 143.36property payment rates by the difference between the hospital's actual medical assistance 144.1inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 144.2treatment centers and facilities of the federal Indian Health Service;144.3    (2) for a hospital with a medical assistance inpatient utilization rate above one 144.4standard deviation above the mean, the adjustment must be determined by multiplying 144.5the adjustment that would be determined under clause (1) for that hospital by 1.1. The 144.6commissioner may establish a separate disproportionate population operating payment 144.7rate adjustment under the general assistance medical care program. For purposes of this 144.8subdivision, medical assistance does not include general assistance medical care. The 144.9commissioner shall report annually on the number of hospitals likely to receive the 144.10adjustment authorized by this paragraph. The commissioner shall specifically report on 144.11the adjustments received by public hospitals and public hospital corporations located 144.12in cities of the first class;144.13    (3) for a hospital that had medical assistance fee-for-service payment volume during 144.14calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service 144.15payment volume, a medical assistance disproportionate population adjustment shall be 144.16paid in addition to any other disproportionate payment due under this subdivision as 144.17follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. 144.18For a hospital that had medical assistance fee-for-service payment volume during calendar 144.19year 1991 in excess of eight percent of total medical assistance fee-for-service payment 144.20volume and was the primary hospital affiliated with the University of Minnesota, a 144.21medical assistance disproportionate population adjustment shall be paid in addition to any 144.22other disproportionate payment due under this subdivision as follows: $505,000 due on 144.23the 15th of each month after noon, beginning July 15, 1995; and144.24    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be 144.25reduced to zero.144.26    (c) The commissioner shall adjust rates paid to a health maintenance organization 144.27under contract with the commissioner to reflect rate increases provided in paragraph (b), 144.28clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those 144.29rates to reflect payments provided in clause (3).144.30    (d) If federal matching funds are not available for all adjustments under paragraph 144.31(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a 144.32pro rata basis so that all adjustments under paragraph (b) qualify for federal match.144.33    (e) For purposes of this subdivision, medical assistance does not include general 144.34assistance medical care.144.35    (f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, general 144.36assistance medical care expenditures for fee-for-service inpatient and outpatient hospital 145.1services made by the department and by prepaid health plans participating in general 145.2assistance medical careeffective July 1, 2007, payments under section 256B.199 shall be 145.3considered Medicaid disproportionate share hospital payments, except as limited below:145.4by clauses (1) to (5);145.5    (1) only the portion of Minnesota's disproportionate share hospital allotment under 145.6section 1923(f) of the Social Security Act that is not spent on the disproportionate 145.7population adjustments in paragraph (b), clauses (1) and (2), may be used for general 145.8assistance medical care expenditures;145.9    (2) only those general assistance medical care expenditures made to hospitals that 145.10qualify for disproportionate share payments under section 1923 of the Social Security Act 145.11and the Medicaid state plan may be considered disproportionate share hospital payments;145.12    (3) only those general assistance medical care expenditures made to an individual 145.13hospital that would not cause the hospital to exceed its individual hospital limits under 145.14section 1923 of the Social Security Act may be considered; and145.15    (4) general assistance medical care expenditures may be considered only to the 145.16extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.145.17All hospitals and prepaid health plans participating in general assistance medical care 145.18must provide any necessary expenditure, cost, and revenue information required by 145.19the commissioner as necessary for purposes of obtaining federal Medicaid matching 145.20funds for general assistance medical care expenditures. Medicaid disproportionate share 145.21payments; and145.22    (5) expenditures under general assistance medical care shall be used to the fullest 145.23extent before payments under section 256B.199.145.24    (g) Upon federal approval of the related state plan amendment, paragraph (f) is 145.25effective retroactively from July 1, 2005, or the earliest effective date approved by the 145.26Centers for Medicare and Medicaid Services.145.27    Sec. 4. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision 145.28to read:145.29    Subd. 28.Long-term hospital payment adjustment.For admissions occurring on 145.30or after July 1, 2009, the commissioner shall increase the medical assistance payments 145.31to a long-term hospital with a medical assistance inpatient utilization rate of 17.95 145.32percent of total patient days as of the base year in effect on July 1, 2005, by an amount 145.33equal to 13 percent of the total of the operating and property payment rates. Payments 145.34made to managed care plans shall not reflect this payment increase. For purposes of 145.35this subdivision, medical assistance does not include general assistance medical care. 146.1Payments to a hospital under this subdivision shall be reduced by the amount of any 146.2payments made under subdivision 27.146.3    Sec. 5. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:146.4    Subd. 14. Competitive bidding. (a) When determined to be effective, economical, 146.5and feasible, the commissioner may utilize volume purchase through competitive bidding 146.6and negotiation under the provisions of chapter 16C, to provide items under the medical 146.7assistance program including but not limited to the following:146.8    (1) eyeglasses;146.9    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency 146.10situation on a short-term basis, until the vendor can obtain the necessary supply from 146.11the contract dealer;146.12    (3) hearing aids and supplies; and146.13    (4) durable medical equipment, including but not limited to:146.14    (i) hospital beds;146.15    (ii) commodes;146.16    (iii) glide-about chairs;146.17    (iv) patient lift apparatus;146.18    (v) wheelchairs and accessories;146.19    (vi) oxygen administration equipment;146.20    (vii) respiratory therapy equipment;146.21    (viii) electronic diagnostic, therapeutic and life support systems;146.22    (5) specialnonemergency transportation services level of need determinations, 146.23disbursement of public transportation passes and tokens, and volunteer and recipient 146.24mileage and parking reimbursements; and146.25    (6) drugs.146.26    (b) Rate changes under this chapter and chapters 256D and 256L do not affect 146.27contract payments under this subdivision unless specifically identified.146.28    Sec. 6. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision 146.29to read:146.30    Subd. 14a.Level of need determination.Nonemergency medical transportation 146.31level of need determinations must be performed by a physician, a registered nurse working 146.32under direct supervision of a physician, a physician's assistant, a nurse practitioner, a 146.33licensed practical nurse, or a discharge planner. Nonemergency medical transportation 146.34level of need determinations must not be performed more than semiannually on any 147.1individual, unless the individual's circumstances have sufficiently changed so as to 147.2require a new level of need determination. Individuals residing in licensed nursing 147.3facilities and individuals requiring stretcher transportation are exempt from a level of need 147.4determination and are eligible for special transportation services until the individual no 147.5longer resides in a licensed nursing facility or no longer requires stretcher transportation.147.6    Sec. 7. Minnesota Statutes 2006, section 256B.056, is amended by adding a 147.7subdivision to read:147.8    Subd. 1d.Treatment of certain monetary gifts.The commissioner shall disregard 147.9as income any portion of a monetary gift received by an applicant or enrollee that is 147.10designated to purchase a prosthetic device not covered by insurance, other third-party 147.11payers, or medical assistance.147.12    Sec. 8. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to 147.13read:147.14    Subd. 3f. Circumcision for newborns.Newborn Circumcision is not covered, 147.15unless the procedure is medically necessary or required because of a well-established 147.16religious practice.147.17    Sec. 9. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 147.18subdivision to read:147.19    Subd. 8d.Chiropractic services.Medical assistance covers the following 147.20medically necessary chiropractic services: one initial or progress exam per year, manual 147.21manipulation of the spine, and x-rays.147.22EFFECTIVE DATE.This section is effective July 1, 2007.147.23    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to 147.24read:147.25    Subd. 13c. Formulary committee. The commissioner, after receiving 147.26recommendations from professional medical associations and professional pharmacy 147.27associations, and consumer groups shall designate a Formulary Committee to carry 147.28out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be 147.29comprised of four licensed physicians actively engaged in the practice of medicine in 147.30Minnesota one of whom must be actively engaged in the treatment of persons with mental 147.31illness; at least three licensed pharmacists actively engaged in the practice of pharmacy 147.32in Minnesota; and one consumer representative; the remainder to be made up of health 148.1care professionals who are licensed in their field and have recognized knowledge in the 148.2clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs. 148.3Members of the Formulary Committee shall not be employed by the Department of 148.4Human Services, but the committee shall be staffed by an employee of the department 148.5who shall serve as an ex officio, nonvoting member of the board committee. The 148.6department's medical director shall also serve as an ex officio, nonvoting member for the 148.7committee. Committee members shall serve three-year terms and may be reappointed 148.8by the commissioner. The Formulary Committee shall meet at least quarterly. The 148.9commissioner may require more frequent Formulary Committee meetings as needed. An 148.10honorarium of $100 per meeting and reimbursement for mileage shall be paid to each 148.11committee member in attendance.148.12    Sec. 11. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to 148.13read:148.14    Subd. 13d. Drug formulary.(a) The commissioner shall establish a drug 148.15formulary. Its establishment and publication shall not be subject to the requirements of the 148.16Administrative Procedure Act, but the Formulary Committee shall review and comment 148.17on the formulary contents.148.18    (b) The formulary shall not include:148.19    (1) drugs or products for which there is no federal funding;148.20    (2) over-the-counter drugs, except as provided in subdivision 13;148.21    (3) drugs used for weight loss, except that medically necessary lipase inhibitors may 148.22be covered for a recipient with type II diabetes;148.23    (4) drugs when used for the treatment of impotence or erectile dysfunction;148.24    (5) drugs for which medical value has not been established; and148.25    (6) drugs from manufacturers who have not signed a rebate agreement with the 148.26Department of Health and Human Services pursuant to section 1927 of title XIX of the 148.27Social Security Act.148.28    (c) If a single-source drug used by at least two percent of the fee-for-service 148.29medical assistance recipients is removed from the formulary due to the failure of the 148.30manufacturer to sign a rebate agreement with the Department of Health and Human 148.31Services, the commissioner shall notify prescribing practitioners within 30 days of 148.32receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a 148.33rebate agreement was not signed.148.34EFFECTIVE DATE.This section is effective the day following final enactment.149.1    Sec. 12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 149.2subdivision to read:149.3    Subd. 13i.Medicare Part D.Notwithstanding subdivision 13, paragraph (d), for 149.4recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare 149.5Advantage special needs plan, medical assistance covers co-payments which the recipient 149.6is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage 149.7special needs plan, once the recipient has paid $12 per month in prescription drug 149.8co-payments, and according to the requirements of the plan.149.9    Sec. 13. Minnesota Statutes 2006, section 256B.0625, subdivision 17, is amended to 149.10read:149.11    Subd. 17. Transportation costs. (a) Medical assistance covers transportation costs 149.12incurred solely for obtaining emergency medical care or transportation costs incurred 149.13by eligible persons in obtaining emergency or nonemergency medical care when paid 149.14directly to an ambulance company, common carrier, or other recognized providers of 149.15transportation services.149.16    (b) Medical assistance covers special transportation, as defined in Minnesota Rules, 149.17part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 149.18would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 149.19transportation, or private automobile.149.20The commissioner may use an order by the recipient's attending physician to certify that 149.21the recipient requires special transportation services. Special transportation includes 149.22driver-assisted service to eligible individuals. Driver-assisted service includes passenger 149.23pickup at and return to the individual's residence or place of business, assistance with 149.24admittance of the individual to the medical facility, and assistance in passenger securement 149.25or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers 149.26must obtain written documentation from the health care service provider who is serving 149.27the recipient being transported, identifying the time that the recipient arrived. Special 149.28transportation providers may not bill for separate base rates for the continuation of a trip 149.29beyond the original destination. Special transportation providers must take recipients 149.30to the nearest appropriate health care provider, using the most direct quickest route 149.31available as determined by a commercially available mileage software program approved 149.32by the commissioner. The maximum medical assistance reimbursement rates for special 149.33transportation services are:149.34    (1) $17 for the base rate and $1.35 $1.43 per mile for services to eligible persons 149.35who need a wheelchair-accessible van;150.1    (2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who 150.2do not need a wheelchair-accessible van; and150.3    (3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 150.4services to eligible persons who need a stretcher-accessible vehicle.150.5    Sec. 14. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 150.6read:150.7    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 150.8meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 150.9$6.50 for lunch, or $8 for dinner.150.10    (b) Medical assistance reimbursement for lodging for persons traveling to receive 150.11medical care may not exceed $50 per day unless prior authorized by the local agency.150.12    (c) Medical assistance direct mileage reimbursement to thean eligible person or the150.13an eligible person's driver may not exceed 20 cents per mile friend, neighbor, or relative 150.14that is providing direct transportation to a covered service shall be at 15 cents below the 150.15current Internal Revenue Service mileage reimbursement for business purposes.150.16    (d) Medical assistance covers oral language interpreter services when provided by 150.17an enrolled health care provider during the course of providing a direct, person-to-person 150.18covered health care service to an enrolled recipient with limited English proficiency.150.19    Sec. 15. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 150.20subdivision to read:150.21    Subd. 49.Community health worker.(a) Medical assistance covers the care 150.22coordination and patient education services provided by a community health worker if 150.23the community health worker has: 150.24    (1) received a certificate from the Minnesota State Colleges and Universities System 150.25approved community health worker curriculum; or150.26    (2) at least five years of supervised experience with an enrolled physician or 150.27advanced practice registered nurse.150.28Community health workers eligible for payment under clause (2) must complete the 150.29certification program by January 1, 2010, to continue to be eligible for payment.150.30    (b) Community health workers must work under the supervision of a medical 150.31assistance enrolled physician or advanced practice registered nurse.151.1    Sec. 16. Minnesota Statutes 2006, section 256B.0644, is amended to read:151.2256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 151.3PROGRAMS.151.4    (a) A vendor of medical care, as defined in section 
         256B.02, subdivision 7, and a 151.5health maintenance organization, as defined in chapter 62D, must participate as a provider 151.6or contractor in the medical assistance program, general assistance medical care program, 151.7and MinnesotaCare as a condition of participating as a provider in health insurance plans 151.8and programs or contractor for state employees established under section 
         43A.18, the 151.9public employees insurance program under section 
         43A.316, for health insurance plans 151.10offered to local statutory or home rule charter city, county, and school district employees, 151.11the workers' compensation system under section 
         176.135, and insurance plans provided 151.12through the Minnesota Comprehensive Health Association under sections 
         62E.01 to 151.1362E.19
         . The limitations on insurance plans offered to local government employees shall 151.14not be applicable in geographic areas where provider participation is limited by managed 151.15care contracts with the Department of Human Services. 151.16    (b) For providers other than health maintenance organizations, participation in the 151.17medical assistance program means that:151.18     (1) the provider accepts new medical assistance, general assistance medical care, 151.19and MinnesotaCare patients or;151.20    (2) for providers other than dental service providers, at least 20 percent of the 151.21provider's patients are covered by medical assistance, general assistance medical care, and 151.22MinnesotaCare as their primary source of coverage, or; or151.23    (3) for dental service providers, at least ten percent of the provider's patients are 151.24covered by medical assistance, general assistance medical care, and MinnesotaCare as 151.25their primary source of coverage, or the provider accepts new medical assistance and 151.26MinnesotaCare patients who are children with special health care needs. For purposes 151.27of this section, "children with special health care needs" means children up to age 18 151.28who: (i) require health and related services beyond that required by children generally; 151.29and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 151.30condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 151.31cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 151.32neurological diseases; visual impairment or deafness; Down syndrome and other genetic 151.33disorders; autism; fetal alcohol syndrome; and other conditions designated by the 151.34commissioner after consultation with representatives of pediatric dental providers and 151.35consumers. 152.1    (c) Patients seen on a volunteer basis by the provider at a location other than the 152.2provider's usual place of practice may be considered in meeting this the participation 152.3requirement in this section. The commissioner shall establish participation requirements 152.4for health maintenance organizations. The commissioner shall provide lists of 152.5participating medical assistance providers on a quarterly basis to the commissioner of 152.6employee relations, the commissioner of labor and industry, and the commissioner of 152.7commerce. Each of the commissioners shall develop and implement procedures to exclude 152.8as participating providers in the program or programs under their jurisdiction those 152.9providers who do not participate in the medical assistance program. The commissioner 152.10of employee relations shall implement this section through contracts with participating 152.11health and dental carriers. 152.12    Sec. 17. [256B.0751] CARE COORDINATION FOR CHILDREN WITH 152.13HIGH-COST MEDICAL CONDITIONS.152.14    Subdivision 1.Care coordination required.(a) The commissioner of human 152.15services shall contract with the U special kids program to provide care coordination, 152.16beginning October 1, 2007, for medical assistance enrollees who are children with 152.17high-cost medical conditions, and to perform the other duties specified in this section.152.18    (b) For purposes of this section, "care coordination" means collaboration with 152.19primary care physicians and specialists to manage care, development of medical 152.20management plans for recurrent acute illnesses, oversight and coordination of all aspects 152.21of care in partnership with families, organization of medical information into a summary 152.22of critical information, coordination and appropriate sequencing of tests and multiple 152.23appointments, information and assistance with accessing resources, and telephone triage 152.24for acute illnesses or problems.152.25    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer 152.26children to the U special kids program for care coordination. Beginning October 1, 2007, 152.27and subject to the limits on total program enrollment specified in subdivision 3, the 152.28commissioner shall refer to the U special kids program children who:152.29    (1) incur medical expenses that exceed the qualifying level specified in subdivision 3;152.30    (2) have medical conditions that involve four or more major systems; require 152.31multiple specialists; require use of technology such as G-tube, trach, central line, or 152.32oxygen; and require multiple medications;152.33    (3) do not have a medical case manager for cancer, organ transplantation, epilepsy, 152.34or bone marrow replacement; and152.35    (4) voluntarily agree to participate in the program.153.1    Subd. 3.Qualifying level of medical expenses.(a) For the period October 1, 2007, 153.2through September 30, 2008, the commissioner shall refer children for care coordination 153.3under this section if they incurred medical expenses of $500,000 or more during the 153.4fiscal year ending June 30, 2007.153.5    (b) For the period October 1, 2008, through September 30, 2009, the commissioner 153.6shall refer children for care coordination under this section if they incurred medical 153.7expenses of $400,000 or more during the fiscal year ending June 30, 2008.153.8    (c) For the period October 1, 2009, through September 30, 2010, the commissioner 153.9shall refer children for care coordination under this section if they incurred medical 153.10expenses of $300,000 or more during the fiscal year ending June 30, 2009.153.11    (d) Beginning October 1, 2010, the commissioner shall refer children for care 153.12coordination under this section if they incurred medical expenses of $250,000 or more 153.13during the previous fiscal year.153.14    (e) The commissioner shall limit referrals to the extent necessary to ensure that 153.15total enrollment in the U special kids program does not exceed 100 children for the 153.16period October 1, 2007, through September 30, 2008, and does not exceed 150 children 153.17beginning October 1, 2008.153.18    Subd. 4.Case management.Beginning October 1, 2007, the U special kids 153.19program shall coordinate all nonmedical case management services provided to children 153.20who are required to receive care coordination under this section. The program may 153.21require all nonmedical case managers, including, but not limited to, county case managers 153.22and case managers for children served under a home and community-based waiver, 153.23to submit care plans for approval, and to document client compliance with the care 153.24plans. The U special kids program, beginning October 1, 2008, may employ or contract 153.25with nonmedical case managers to provide all nonmedical case management services to 153.26children required to receive care coordination under this section. The commissioner shall 153.27reimburse the U special kids program for case management services through the medical 153.28assistance program.153.29    Subd. 5.Statewide availability of care coordination.The U special kids program 153.30may contract with other entities to provide care coordination services as defined in 153.31subdivision 1, in order to ensure the availability of these services in all regions of the state.153.32    Subd. 6.Advance practice nurse telephone triage system.The U special kids 153.33program shall establish and operate an advance practice nurse telephone triage system that 153.34is available statewide, 24 hours a day, seven days per week. The system must provide 153.35advance practice nurses with access to a Web-based information system to appropriately 153.36triage medical problems, manage care, and reduce unnecessary hospitalizations.154.1    Subd. 7.Monitoring and evaluation.The commissioner shall monitor program 154.2outcomes and evaluate the extent to which referrals to the U special kids program have 154.3improved the quality and coordination of care and provided financial savings to the 154.4medical assistance program. The U special kids program shall submit to the commissioner, 154.5in the form and manner specified by the commissioner, all data and information necessary 154.6to monitor program outcomes and evaluate the program. The commissioner shall present a 154.7preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 154.8legislature by January 15, 2010.154.9EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 154.10approval, whichever is later.154.11    Sec. 18. [256B.0752] CARE COORDINATION FOR CHILDREN WITH 154.12HIGH-COST MENTAL HEALTH CONDITIONS.154.13    Subdivision 1.Care coordination required.(a) The commissioner of human 154.14services shall contract with the U special kids program to provide care coordination, 154.15beginning October 1, 2007, for medical assistance enrollees who are children with 154.16high-cost mental health conditions and behavioral problems, and to perform the other 154.17duties specified in this section.154.18    (b) For purposes of this section, "care coordination" means: collaboration with 154.19primary care physicians and specialists to manage care; development of mental health 154.20management plans for recurrent mental health issues; oversight and coordination of all 154.21aspects of care in partnership with families; organization of medical, treatment, and 154.22therapy information into a summary of critical information; coordination and appropriate 154.23sequencing of evaluations and multiple appointments; information and assistance with 154.24accessing resources; and telephone triage for behavior or other problems.154.25    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer children 154.26to the program for care coordination. Beginning October 1, 2007, and subject to the limits 154.27on total program enrollment specified in subdivision 3, the commissioner shall refer to 154.28the U special kids program children who:154.29    (1) incur mental health expenses that exceed the qualifying level specified in 154.30subdivision 3;154.31    (2) are currently receiving or at risk of needing inpatient mental health treatment, 154.32foster home care, or both; and154.33    (3) voluntarily agree to participate in the program.155.1    Subd. 3.Qualifying level of medical expenses.(a) Beginning October 1, 2007, the 155.2commissioner shall refer children for care coordination under this section if they incurred 155.3medical and mental health expenses of $250,000 or more in the previous fiscal year.155.4    (b) The commissioner shall limit referrals to the extent necessary to ensure that total 155.5enrollment in the U special kids program does not exceed 25 children for the period 155.6October 1, 2007, through September 30, 2008; does not exceed 75 children for the 155.7period October 1, 2008, through September 30, 2009; and does not exceed 125 children 155.8beginning October 1, 2009.155.9    Subd. 4.Case management.The U special kids program, beginning October 1, 155.102007, shall coordinate all nonmedical case management services provided to children who 155.11are required to receive care coordination under this section. The program may require all 155.12nonmedical case managers, including but not limited to county case managers and case 155.13managers for children served under a home and community-based waiver, to submit care 155.14plans for approval, and to document client compliance with the care plans. The U special 155.15kids program, beginning October 1, 2008, may employ or contract with nonmedical case 155.16managers to provide all nonmedical case management services to children required to 155.17receive care coordination under this section. The commissioner shall reimburse the 155.18U special kids program for case management services through the medical assistance 155.19program.155.20    Subd. 5.Statewide availability of care coordination.The program may contract 155.21with other entities to provide care coordination services as defined in subdivision 1, in 155.22order to ensure the availability of these services in all regions of the state.155.23    Subd. 6.Monitoring and evaluation.The commissioner shall monitor program 155.24outcomes and shall evaluate the extent to which referrals to the U special kids program 155.25have improved the quality and coordination of care and provided financial savings to the 155.26medical assistance program. The U special kids program shall submit to the commissioner, 155.27in the form and manner specified by the commissioner, all data and information necessary 155.28to monitor program outcomes and evaluate the program. The commissioner shall present a 155.29preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 155.30legislature by January 15, 2010.155.31EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 155.32approval, whichever is later. The commissioner shall notify the Office of the Revisor of 155.33Statutes when federal approval is obtained.155.34    Sec. 19. [256B.194] FEDERAL PAYMENTS.156.1    Subdivision 1.Payments at actual cost.If the Centers for Medicare & Medicaid 156.2Services (CMS) promulgates a final rule consistent with its stated intent in the proposed 156.3rule published at 72 Federal Register, No. 11, January 18, 2007, regarding limiting 156.4payments to units of government, and notwithstanding Minnesota Statutes or Minnesota 156.5Rules to the contrary, for providers that are units of government, the commissioner may 156.6limit medical assistance and MinnesotaCare payments to a provider's actual cost of 156.7providing services, in accordance with the CMS final rule. If a final rule is promulgated, 156.8the commissioner may also require medical assistance and MinnesotaCare providers to 156.9provide any information necessary to determine Medicaid-related costs, and require the 156.10cooperation of providers in any audit or review necessary to ensure payments are limited 156.11to cost. This section does not apply to providers who are exempt from the provisions of 156.12the CMS final rule.156.13    Subd. 2.Loss of federal financial participation.For all transfers, certified 156.14expenditures, and medical assistance payments listed below, if the commissioner 156.15determines that federal financial participation is no longer available for the medical 156.16assistance payments listed, then related obligations for the nonfederal share of payments 156.17and the medical assistance payments shall terminate. The commissioner shall notify all 156.18affected parties of the loss of federal financial participation, and the resulting payments 156.19and obligations that are terminated. If the commissioner determines that federal financial 156.20participation is no longer available for any medical assistance payments or contributions 156.21to the nonfederal share of medical assistance payments that have already been made, the 156.22commissioner may collect the medical assistance payments from providers and return 156.23contributions of the nonfederal share to its source. The transfers, certified expenditures, 156.24and medical assistance payments subject to this section are those specified in: sections 156.2562J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d; 156.26256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses 156.27(2), (3), and (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws 156.282005, First Special Session chapter 4, article 9, section 2, subdivision 1.156.29    Sec. 20. Minnesota Statutes 2006, section 256B.199, is amended to read:156.30256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.156.31    (a) Hennepin County,and Hennepin County Medical Center, Ramsey County, 156.32Regions Hospital, the University of Minnesota, and Fairview-University Medical Center156.33shall report quarterly to the commissioner beginning June 1, 2007, payments made during 156.34the second previous quarter that may qualify for reimbursement under federal law.157.1    (b) Based on these reports, the commissioner shall apply for federal matching funds. 157.2These funds are appropriated to the commissioner for the payments under section 256.969, 157.3subdivision 27 to Hennepin County Medical Center.157.4    (c) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform 157.5the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 157.6hospital payment money expected to be available in the current federal fiscal year.157.7    (d) This section sunsets on June 30, 2009. The commissioner shall report to 157.8the legislature by December 15, 2008, with recommendations for maximizing federal 157.9disproportionate share hospital payments after June 30, 2009.157.10    Sec. 21. Minnesota Statutes 2006, section 256B.75, is amended to read:157.11256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.157.12    (a) For outpatient hospital facility fee payments for services rendered on or after 157.13October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted 157.14charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those 157.15services for which there is a federal maximum allowable payment. Effective for services 157.16rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital 157.17facility fees and emergency room facility fees shall be increased by eight percent over the 157.18rates in effect on December 31, 1999, except for those services for which there is a federal 157.19maximum allowable payment. Services for which there is a federal maximum allowable 157.20payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum 157.21allowable payment. Total aggregate payment for outpatient hospital facility fee services 157.22shall not exceed the Medicare upper limit. If it is determined that a provision of this 157.23section conflicts with existing or future requirements of the United States government with 157.24respect to federal financial participation in medical assistance, the federal requirements 157.25prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to 157.26avoid reduced federal financial participation resulting from rates that are in excess of 157.27the Medicare upper limitations.157.28    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and 157.29ambulatory surgery hospital facility fee services for critical access hospitals designated 157.30under section 
         144.1483, clause (10), shall be paid on a cost-based payment system that 157.31is based on the cost-finding methods and allowable costs of the Medicare program. All 157.32hospital outpatient services provided by any hospital exclusively devoted to the care of 157.33pediatric patients under age 21 that is located in a Minnesota metropolitan statistical area 157.34must be paid for using the methodology established for critical access hospitals at a rate 157.35equal to fee-for-service rates plus 46 percent, as limited by allowable costs.158.1    (c) Effective for services provided on or after July 1, 2003, rates that are based 158.2on the Medicare outpatient prospective payment system shall be replaced by a budget 158.3neutral prospective payment system that is derived using medical assistance data. The 158.4commissioner shall provide a proposal to the 2003 legislature to define and implement 158.5this provision.158.6    (d) For fee-for-service services provided on or after July 1, 2002, the total payment, 158.7before third-party liability and spenddown, made to hospitals for outpatient hospital 158.8facility services is reduced by .5 percent from the current statutory rate.158.9    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 158.10services provided on or after July 1, 2003, made to hospitals for outpatient hospital 158.11facility services before third-party liability and spenddown, is reduced five percent from 158.12the current statutory rates. Facilities defined under section 
         256.969, subdivision 16, are 158.13excluded from this paragraph.158.14EFFECTIVE DATE.This section is effective July 1, 2007, and applies to services 158.15provided on or after that date.158.16    Sec. 22. Minnesota Statutes 2006, section 256B.76, is amended to read:158.17256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.158.18    (a) Effective for services rendered on or after October 1, 1992, the commissioner 158.19shall make payments for physician services as follows:158.20    (1) payment for level one Centers for Medicare and Medicaid Services' common 158.21procedural coding system codes titled "office and other outpatient services," "preventive 158.22medicine new and established patient," "delivery, antepartum, and postpartum care," 158.23"critical care," cesarean delivery and pharmacologic management provided to psychiatric 158.24patients, and level three codes for enhanced services for prenatal high risk, shall be paid 158.25at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 158.2630, 1992. If the rate on any procedure code within these categories is different than the 158.27rate that would have been paid under the methodology in section 
         256B.74, subdivision 2, 158.28then the larger rate shall be paid; 158.29    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 158.30or (ii) 15.4 percent above the rate in effect on June 30, 1992;158.31    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 158.32percentile of 1989, less the percent in aggregate necessary to equal the above increases 158.33except that payment rates for home health agency services shall be the rates in effect 158.34on September 30, 1992;159.1    (4) effective for services rendered on or after January 1, 2000, payment rates for 159.2physician and professional services shall be increased by three percent over the rates in 159.3effect on December 31, 1999, except for home health agency and family planning agency 159.4services; and159.5    (5) the increases in clause (4) shall be implemented January 1, 2000, for managed 159.6care.159.7    (b) Effective for services rendered on or after October 1, 1992, the commissioner 159.8shall make payments for dental services as follows:159.9    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 159.10percent above the rate in effect on June 30, 1992;159.11    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 159.12percentile of 1989, less the percent in aggregate necessary to equal the above increases;159.13    (3) effective for services rendered on or after January 1, 2000, payment rates for 159.14dental services shall be increased by three percent over the rates in effect on December 159.1531, 1999;159.16    (4) the commissioner shall award grants to community clinics or other nonprofit 159.17community organizations, political subdivisions, professional associations, or other 159.18organizations that demonstrate the ability to provide dental services effectively to public 159.19program recipients. Grants may be used to fund the costs related to coordinating access for 159.20recipients, developing and implementing patient care criteria, upgrading or establishing 159.21new facilities, acquiring furnishings or equipment, recruiting new providers, or other 159.22development costs that will improve access to dental care in a region. In awarding grants, 159.23the commissioner shall give priority to applicants that plan to serve areas of the state in 159.24which the number of dental providers is not currently sufficient to meet the needs of 159.25recipients of public programs or uninsured individuals. The commissioner shall consider 159.26the following in awarding the grants:159.27    (i) potential to successfully increase access to an underserved population;159.28    (ii) the ability to raise matching funds;159.29    (iii) the long-term viability of the project to improve access beyond the period 159.30of initial funding;159.31    (iv) the efficiency in the use of the funding; and159.32    (v) the experience of the proposers in providing services to the target population.159.33    The commissioner shall monitor the grants and may terminate a grant if the grantee 159.34does not increase dental access for public program recipients. The commissioner shall 159.35consider grants for the following:160.1    (i) implementation of new programs or continued expansion of current access 160.2programs that have demonstrated success in providing dental services in underserved 160.3areas;160.4    (ii) a pilot program for utilizing hygienists outside of a traditional dental office to 160.5provide dental hygiene services; and160.6    (iii) a program that organizes a network of volunteer dentists, establishes a system to 160.7refer eligible individuals to volunteer dentists, and through that network provides donated 160.8dental care services to public program recipients or uninsured individuals;160.9    (5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 160.10shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;160.11    (6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, 160.12for managed care; and160.13    (7) effective for services provided on or after January 1, 2002, payment for 160.14diagnostic examinations and dental x-rays provided to children under age 21 shall be the 160.15lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.160.16    (c) Effective for dental services rendered on or after January 1, 2002, the 160.17commissioner may, within the limits of available appropriation, increase reimbursements 160.18to dentists and dental clinics deemed by the commissioner to be critical access dental 160.19providers. Reimbursement to a critical access dental provider may be increased by not 160.20more than 50 percent above the reimbursement rate that would otherwise be paid to the 160.21provider. Payments toFor dental services rendered after June 30, 2007, the commissioner 160.22shall increase reimbursement by 33 percent above the reimbursement rate that would 160.23otherwise be paid to the provider. The commissioner shall pay the health plan companies 160.24shall be adjustedin amounts sufficient to reflect increased reimbursements to critical 160.25access dental providers as approved by the commissioner. In determining which dentists 160.26and dental clinics shall be deemed critical access dental providers, the commissioner 160.27shall review:160.28    (1) the utilization rate in the service area in which the dentist or dental clinic operates 160.29for dental services to patients covered by medical assistance, general assistance medical 160.30care, or MinnesotaCare as their primary source of coverage;160.31    (2) the level of services provided by the dentist or dental clinic to patients covered 160.32by medical assistance, general assistance medical care, or MinnesotaCare as their primary 160.33source of coverage; and160.34    (3) whether the level of services provided by the dentist or dental clinic is critical to 160.35maintaining adequate levels of patient access within the service area.161.1In the absence of a critical access dental provider in a service area, the commissioner may 161.2designate a dentist or dental clinic as a critical access dental provider if the dentist or 161.3dental clinic is willing to provide care to patients covered by medical assistance, general 161.4assistance medical care, or MinnesotaCare at a level which significantly increases access 161.5to dental care in the service area.161.6    The commissioner shall annually establish a reimbursement schedule for critical 161.7access dental providers and provider-specific limits on total reimbursement received 161.8under the reimbursement schedule, and shall notify each critical access dental provider 161.9of the schedule and limit.161.10    (d) An entity that operates both a Medicare certified comprehensive outpatient 161.11rehabilitation facility and a facility which was certified prior to January 1, 1993, that is 161.12licensed under Minnesota Rules, parts 
         9570.2000 to 
         9570.3600, and for whom at least 33 161.13percent of the clients receiving rehabilitation services in the most recent calendar year are 161.14medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation 161.15services at rates that are 38 percent greater than the maximum reimbursement rate 161.16allowed under paragraph (a), clause (2), when those services are (1) provided within the 161.17comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing 161.18facilities owned by the entity.161.19    (e) Effective for services rendered on or after January 1, 2007, the commissioner 161.20shall make payments for physician and professional services based on the Medicare 161.21relative value units (RVU's). This change shall be budget neutral and the cost of 161.22implementing RVU's will be incorporated in the established conversion factor.161.23    Sec. 23. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:161.24    Subd. 4. General assistance medical care; services. (a)(i) For a person who is 161.25eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 161.26care covers, except as provided in paragraph (c):161.27    (1) inpatient hospital services;161.28    (2) outpatient hospital services;161.29    (3) services provided by Medicare certified rehabilitation agencies;161.30    (4) prescription drugs and other products recommended through the process 161.31established in section 
         256B.0625, subdivision 13;161.32    (5) equipment necessary to administer insulin and diagnostic supplies and equipment 161.33for diabetics to monitor blood sugar level;161.34    (6) eyeglasses and eye examinations provided by a physician or optometrist;161.35    (7) hearing aids;162.1    (8) prosthetic devices;162.2    (9) laboratory and X-ray services;162.3    (10) physician's services;162.4    (11) medical transportation except special transportation;162.5    (12) chiropractic services as covered under the medical assistance program;162.6    (13) podiatric services;162.7    (14) dental services as covered under the medical assistance program;162.8    (15) outpatient services provided by a mental health center or clinic that is under 162.9contract with the county board and is established under section 
         245.62;162.10    (16) day treatment services for mental illness provided under contract with the 162.11county board;162.12    (17) prescribed medications for persons who have been diagnosed as mentally ill as 162.13necessary to prevent more restrictive institutionalization;162.14    (18) psychological services, medical supplies and equipment, and Medicare 162.15premiums, coinsurance and deductible payments;162.16    (19) medical equipment not specifically listed in this paragraph when the use of 162.17the equipment will prevent the need for costlier services that are reimbursable under 162.18this subdivision;162.19    (20) services performed by a certified pediatric nurse practitioner, a certified family 162.20nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 162.21nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 162.22practitioner in independent practice, if (1) the service is otherwise covered under this 162.23chapter as a physician service, (2) the service provided on an inpatient basis is not included 162.24as part of the cost for inpatient services included in the operating payment rate, and (3) the 162.25service is within the scope of practice of the nurse practitioner's license as a registered 162.26nurse, as defined in section 
         148.171;162.27    (21) services of a certified public health nurse or a registered nurse practicing in 162.28a public health nursing clinic that is a department of, or that operates under the direct 162.29authority of, a unit of government, if the service is within the scope of practice of the 162.30public health nurse's license as a registered nurse, as defined in section 
         148.171;162.31    (22) telemedicine consultations, to the extent they are covered under section 162.32256B.0625, subdivision 3b
         ; and162.33    (23) mental health telemedicine and psychiatric consultation as covered under 162.34section 
         256B.0625, subdivisions 46 and 48.;162.35    (24) care coordination and patient education services provided by a community 162.36health worker according to section 256B.0625, subdivision 49; and163.1    (25) regardless of the number of employees that an enrolled health care provider 163.2may have, sign language interpreter services when provided by an enrolled health care 163.3provider during the course of providing a direct, person-to-person covered health care 163.4service to an enrolled recipient who has a hearing loss and uses interpreting services.163.5    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 163.6paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 163.7to inpatient hospital services, including physician services provided during the inpatient 163.8hospital stay. A $1,000 deductible is required for each inpatient hospitalization.163.9    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this 163.10subdivision.163.11    (c) In order to contain costs, the commissioner of human services shall select 163.12vendors of medical care who can provide the most economical care consistent with high 163.13medical standards and shall where possible contract with organizations on a prepaid 163.14capitation basis to provide these services. The commissioner shall consider proposals by 163.15counties and vendors for prepaid health plans, competitive bidding programs, block grants, 163.16or other vendor payment mechanisms designed to provide services in an economical 163.17manner or to control utilization, with safeguards to ensure that necessary services are 163.18provided. Before implementing prepaid programs in counties with a county operated or 163.19affiliated public teaching hospital or a hospital or clinic operated by the University of 163.20Minnesota, the commissioner shall consider the risks the prepaid program creates for the 163.21hospital and allow the county or hospital the opportunity to participate in the program in a 163.22manner that reflects the risk of adverse selection and the nature of the patients served by 163.23the hospital, provided the terms of participation in the program are competitive with the 163.24terms of other participants considering the nature of the population served. Payment for 163.25services provided pursuant to this subdivision shall be as provided to medical assistance 163.26vendors of these services under sections 
         256B.02, subdivision 8, and 
         256B.0625. For 163.27payments made during fiscal year 1990 and later years, the commissioner shall consult 163.28with an independent actuary in establishing prepayment rates, but shall retain final control 163.29over the rate methodology.163.30    (d) Effective January 1, 2008, drug coverage under general assistance medical care 163.31is limited to prescription drugs that:163.32    (i) are covered under the medical assistance program as described in section 163.33256B.0625, subdivisions 13 and 13d; and163.34    (ii) are provided by manufacturers that have fully executed general assistance 163.35medical care rebate agreements with the commissioner and comply with the agreements. 163.36Prescription drug coverage under general assistance medical care must conform to 164.1coverage under the medical assistance program according to section 256B.0625, 164.2subdivisions 13 to 13g.164.3    (d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 164.4co-payments for services provided on or after October 1, 2003:164.5    (1) $25 for eyeglasses;164.6    (2) $25 for nonemergency visits to a hospital-based emergency room;164.7    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, 164.8subject to a $12 per month maximum for prescription drug co-payments. No co-payments 164.9shall apply to antipsychotic drugs when used for the treatment of mental illness; and164.10    (4) 50 percent coinsurance on restorative dental services.164.11    (e) (f) Co-payments shall be limited to one per day per provider for nonpreventive 164.12visits, eyeglasses, and nonemergency visits to a hospital-based emergency room. 164.13Recipients of general assistance medical care are responsible for all co-payments in this 164.14subdivision. The general assistance medical care reimbursement to the provider shall be 164.15reduced by the amount of the co-payment, except that reimbursement for prescription 164.16drugs shall not be reduced once a recipient has reached the $12 per month maximum for 164.17prescription drug co-payments. The provider collects the co-payment from the recipient. 164.18Providers may not deny services to recipients who are unable to pay the co-payment, 164.19except as provided in paragraph (f).164.20    (f) (g) If it is the routine business practice of a provider to refuse service to an 164.21individual with uncollected debt, the provider may include uncollected co-payments 164.22under this section. A provider must give advance notice to a recipient with uncollected 164.23debt before services can be denied.164.24    (g) (h) Any county may, from its own resources, provide medical payments for 164.25which state payments are not made.164.26    (h) (i) Chemical dependency services that are reimbursed under chapter 254B must 164.27not be reimbursed under general assistance medical care.164.28    (i) (j) The maximum payment for new vendors enrolled in the general assistance 164.29medical care program after the base year shall be determined from the average usual and 164.30customary charge of the same vendor type enrolled in the base year.164.31    (j) (k) The conditions of payment for services under this subdivision are the same 164.32as the conditions specified in rules adopted under chapter 256B governing the medical 164.33assistance program, unless otherwise provided by statute or rule.164.34    (k) (l) Inpatient and outpatient payments shall be reduced by five percent, effective 164.35July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 164.362003, and incorporated by reference in paragraph (i).165.1    (l) (m) Payments for all other health services except inpatient, outpatient, and 165.2pharmacy services shall be reduced by five percent, effective July 1, 2003.165.3    (m) (n) Payments to managed care plans shall be reduced by five percent for services 165.4provided on or after October 1, 2003.165.5    (n) (o) A hospital receiving a reduced payment as a result of this section may apply 165.6the unpaid balance toward satisfaction of the hospital's bad debts.165.7    (o) (p) Fee-for-service payments for nonpreventive visits shall be reduced by $3 165.8for services provided on or after January 1, 2006. For purposes of this subdivision, a 165.9visit means an episode of service which is required because of a recipient's symptoms, 165.10diagnosis, or established illness, and which is delivered in an ambulatory setting by 165.11a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 165.12audiologist, optician, or optometrist.165.13    (p) (q) Payments to managed care plans shall not be increased as a result of the 165.14removal of the $3 nonpreventive visit co-payment effective January 1, 2006.165.15    Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:165.16    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 165.17and (c), the MinnesotaCare benefit plan shall include the following co-payments and 165.18coinsurance requirements for all enrollees:165.19    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 165.20subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 165.21$3,000 per family;165.22    (2) $3 per prescription for adult enrollees;165.23    (3) $25 for eyeglasses for adult enrollees;165.24    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 165.25episode of service which is required because of a recipient's symptoms, diagnosis, or 165.26established illness, and which is delivered in an ambulatory setting by a physician or 165.27physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 165.28audiologist, optician, or optometrist; and165.29    (5) $6 for nonemergency visits to a hospital-based emergency room.165.30    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 165.31children under the age of 21 in households with family income equal to or less than 175 165.32percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 165.33parents and relative caretakers of children under the age of 21 in households with family 165.34income greater than 175 percent of the federal poverty guidelines for inpatient hospital 165.35admissions occurring on or after January 1, 2001.166.1    (c) Paragraph (a), clauses (1) to (4), dodoes not apply to pregnant women and 166.2children under the age of 21.166.3    (d) Adult enrollees with family gross income that exceeds 175 percent of the 166.4federal poverty guidelines and who are not pregnant shall be financially responsible for 166.5the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 166.6hospital benefit limit.166.7    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 166.8or changes from one prepaid health plan to another during a calendar year, any charges 166.9submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 166.10expenses incurred by the enrollee for inpatient services, that were submitted or incurred 166.11prior to enrollment, or prior to the change in health plans, shall be disregarded.166.12    Sec. 25. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:166.13    Subdivision 1. Families with children. (a) Families with children with family 166.14income equal to or less than 275 percent of the federal poverty guidelines for the 166.15applicable family size shall be eligible for MinnesotaCare according to this section. All 166.16other provisions of sections 
         256L.01 to 
         256L.18, including the insurance-related barriers 166.17to enrollment under section 
         256L.07, shall apply unless otherwise specified. 166.18    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, 166.19if the children are eligible. Children may be enrolled separately without enrollment by 166.20parents. However, if one parent in the household enrolls, both parents must enroll, unless 166.21other insurance is available. If one child from a family is enrolled, all children must 166.22be enrolled, unless other insurance is available. If one spouse in a household enrolls, 166.23the other spouse in the household must also enroll, unless other insurance is available. 166.24Families cannot choose to enroll only certain uninsured members.166.25    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies 166.26to the MinnesotaCare program. These persons are no longer counted in the parental 166.27household and may apply as a separate household.166.28    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents 166.29are not eligible for MinnesotaCare if their gross income exceeds $50,000 $25,000 for the 166.30six-month period of eligibility.166.31    Sec. 26. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:166.32    Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing 166.33in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee 167.1residing in a correctional or detention facility is not eligible at renewal of eligibility under 167.2section 
         256L.05, subdivision 3b 3a.167.3    Sec. 27. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:167.4    Subd. 7. Critical access dental providers. Effective for dental services provided 167.5to MinnesotaCare enrollees on or afterbetween January 1, 2007, and June 30, 2007, the 167.6commissioner shall increase payment rates to dentists and dental clinics deemed by the 167.7commissioner to be critical access providers under section 
         256B.76, paragraph (c), by 50 167.8percent above the payment rate that would otherwise be paid to the provider. Effective 167.9for dental services provided to MinnesotaCare enrollees on or after July 1, 2007, the 167.10commissioner shall increase payment rates to dentists and dental clinics deemed by the 167.11commissioner to be critical access providers under section 256B.76, paragraph (c), by 167.1233 percent above the payment rate that would otherwise be paid to the provider. The 167.13commissioner shall adjust the rates paid on or after January 1, 2007, topay the prepaid 167.14health plans under contract with the commissioner amounts sufficient to reflect this rate 167.15increase. The prepaid health plan must pass this rate increase to providers who have 167.16been identified by the commissioner as critical access dental providers under section 167.17256B.76
         , paragraph (c).167.18    Sec. 28. HENNEPIN COUNTY PILOT PROJECT.167.19    The commissioner of human services shall support a pilot project in Hennepin 167.20County to demonstrate the effectiveness of alternative strategies to redetermine eligibility 167.21for certain recipient populations in the medical assistance program. The target populations 167.22for the demonstration are persons who are eligible based upon disability or age, who have 167.23chronic medical conditions, and who are expected to experience minimal change in income 167.24or assets from month to month. The commissioner and the county shall analyze the issues 167.25and strategies employed and the outcomes to determine reasonable efforts to streamline 167.26eligibility statewide. The duration of the pilot project shall be no more than two years. 167.27The commissioner shall apply for any federal waivers needed to implement this section.167.28    Sec. 29. COUNTY-BASED PURCHASING STUDY.167.29    The commissioner of health shall study county-based purchasing initiatives 167.30established under Minnesota Statutes, section 256B.692, and compare these initiatives 167.31to managed care plans serving medical assistance, general assistance medical care, and 167.32MinnesotaCare enrollees. The study must:168.1    (1) provide a history and description of county-based purchasing initiatives, 168.2including state and federal requirements and any federal waivers Minnesota counties have 168.3applied for or received;168.4    (2) provide a history and description of managed care plan participation in the 168.5prepaid medical assistance, prepaid general assistance medical care, and prepaid 168.6Minnesota programs, and the provision by managed care plans of third-party administrator 168.7services for county-based purchasing initiatives;168.8    (3) provide relevant data, including limitations on data, data that was requested but 168.9not received, and explanations for why requested data was not received;168.10    (4) provide recommendations for further data collection and research;168.11    (5) summarize successes and challenges of the two service delivery methods;168.12    (6) provide recommendations for possible expansion of county-based purchasing 168.13in rural and urban settings; and168.14    (7) identify and describe features of county-based purchasing and managed care 168.15plans serving medical assistance, general assistance medical care, and MinnesotaCare 168.16enrollees, to provide a comparison of cost, quality, access, and community health 168.17improvement that includes, but is not limited to:168.18    (i) descriptions of how health care and social services are integrated and coordinated 168.19for persons with complex care needs, including persons with high-risk pregnancies, 168.20adolescents, persons who are disabled, persons who are elderly, and persons with chronic 168.21health care and social needs;168.22    (ii) use of monetary grants and surpluses to:168.23    (A) increase provider reimbursement, including dental care reimbursement, in order 168.24to improve health care access; and168.25    (B) improve community health beyond the requirements of the public health care 168.26programs, such as the funding of public education, research, and community initiatives to 168.27enhance utilization of preventive services, social services, or mental health care;168.28    (iii) administrative costs, including billing and collection of unpaid fees, co-pays or 168.29other charges, and top five management salaries;168.30    (iv) reporting requirements of contracts with the Department of Human Services;168.31    (v) public access to all information about management and administration, including 168.32but not limited to provider contracts and reimbursement, models of care management and 168.33coordination, utilization review, contracts with consultants and other vendors, handling of 168.34monetary grants and surpluses, and health outcomes data;168.35    (vi) provider reimbursement by clinical practice area;169.1    (vii) populations served, described by age, disability, income, race, language, 169.2occupation, and other demographic characteristics;169.3    (viii) utilization of community-based prevention interventions, including but not 169.4limited to public health nursing visits to new parents, use of nurse-managed interventions 169.5to reduce cardiac hospitalizations, and the use of medical homes for chronic disease 169.6management;169.7    (ix) utilization of cancer screening;169.8    (x) utilization of interpreter services;169.9    (xi) immunization rates for children age five and under;169.10    (xii) hospitalization rates for conditions related to diabetes, asthma, or cardiac 169.11illnesses;169.12    (xiii) rates of rehospitalization within a month of hospital discharge;169.13    (xiv) coordination with county agencies to increase enrollment;169.14    (xv) number of new program enrollees and the rate of enrollment, including the 169.15percentage of eligible persons who become enrollees;169.16    (xvi) enrollee satisfaction with their care; and169.17    (xvii) number of enrollees who do not receive care.169.18    Managed care plans, county-based purchasing initiatives, health care providers, 169.19counties, and the commissioner of human services shall, upon request, provide data to 169.20the commissioner of health that is necessary to complete the study. The commissioner of 169.21health shall submit the study to the legislature by December 31, 2007.169.22    Sec. 30. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.169.23    The commissioner of human services shall award a grant to the Neighborhood 169.24Health Care Network to pay the costs of maintaining and staffing a toll-free telephone 169.25number to provide callers with information on health coverage options, eligibility for 169.26MinnesotaCare and other health care programs, and health care providers that offer free or 169.27reduced-cost health care services.169.28    Sec. 31. IMPLEMENTATION OF PHARMACY DISPENSING FEE INCREASE.169.29    The commissioner, after consulting with the Pharmacy Payment Reform Advisory 169.30Committee established under Laws 2006, chapter 282, article 16, section 15, may 169.31proportionally increase or decrease the dispensing fee for multiple-source generic drugs 169.32under Minnesota Statutes, section 256B.0625, subdivision 13e, paragraph (a), to reflect 169.33the actual amount of reductions in program cost for ingredient reimbursement savings 169.34obtained.170.1EFFECTIVE DATE.This section is effective upon implementation of changes to 170.2the federal upper reimbursement limit under title VI, chapter IV of the federal Deficit 170.3Reduction Act of 2005, United States Code, title 42, section 1396r-8(e)(5).170.4    Sec. 32. REPEALER.170.5Minnesota Statutes 2006, section 256.969, subdivision 27, is repealed effective 170.6July 1, 2007.170.7ARTICLE 4170.8CONTINUING CARE170.9    Section 1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to 170.10read:170.11    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The 170.12commissioner of health, in coordination with the commissioner of human services, may 170.13approve the renovation, replacement, upgrading, or relocation of a nursing home or 170.14boarding care home, under the following conditions:170.15    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be 170.16constructed on the site of a new city-owned hospital to replace an existing 85-bed facility 170.17attached to a hospital that is also being replaced. The threshold allowed for this project 170.18under section 
         144A.073 shall be the maximum amount available to pay the additional 170.19medical assistance costs of the new facility; 170.20    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St. 170.21Louis County, provided that the 29 beds must be transferred from active or layaway status 170.22at an existing facility in St. Louis County that had 235 beds on April 1, 2003.170.23The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment 170.24rate at that facility shall not be adjusted as a result of this transfer. The operating payment 170.25rate of the facility adding beds after completion of this project shall be the same as it was 170.26on the day prior to the day the beds are licensed and certified. This project shall not 170.27proceed unless it is approved and financed under the provisions of section 
         144A.073;  170.28    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of 170.29the new beds are transferred from a 45-bed facility in Austin under common ownership 170.30that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea 170.31under common ownership; (ii) the commissioner of human services is authorized by the 170.322004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) 170.33money is available from planned closures of facilities under common ownership to make 170.34implementation of this clause budget-neutral to the state. The bed capacity of the Albert 171.1Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the 171.2new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's 171.3disease or related dementias; and171.4    (4) to license and certify up to 80 beds transferred from an existing state-owned 171.5nursing facility in Cass County to a new facility located on the grounds of the 171.6Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be 171.7determined based on the interim and settle-up payment provisions of Minnesota Rules, 171.8part 
         9549.0057, and the reimbursement provisions of section 
         256B.431. The property 171.9payment rate for the first three years of operation shall be $35 per day. For subsequent 171.10years, the property payment rate of $35 per day shall be adjusted for inflation as provided 171.11in section 
         256B.434, subdivision 4, paragraph (c), as long as the facility has a contract 171.12under section 
         256B.434.; and171.13    (5) to license and certify 180 beds transferred from an existing facility in 171.14Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred from a 171.15219-bed facility under common ownership that shall be closed following the transfer. The 171.16operating payment rate of the new facility after completion of this project shall be adjusted 171.17upward by $35 per day and the property payment rate shall be $34.049 per day.171.18    (b) Projects approved under this subdivision shall be treated in a manner equivalent 171.19to projects approved under subdivision 4a.171.20EFFECTIVE DATE.This section is effective the day following final enactment.171.21    Sec. 2. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:171.22    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 171.23child, including a child determined eligible for medical assistance without consideration of 171.24parental income, must contribute to the cost of services used by making monthly payments 171.25on a sliding scale based on income, unless the child is married or has been married, 171.26parental rights have been terminated, or the child's adoption is subsidized according to 171.27section 
         259.67 or through title IV-E of the Social Security Act. The parental contribution 171.28is a partial or full payment for medical services provided for diagnostic, therapeutic, 171.29curing, treating, mitigating, rehabilitation, and maintenance and personal care services as 171.30defined in United States Code, title 26, section 213, needed by the child with a chronic 171.31illness or disability.171.32    (b) For households with adjusted gross income equal to or greater than 100 percent 171.33of federal poverty guidelines, the parental contribution shall be computed by applying the 171.34following schedule of rates to the adjusted gross income of the natural or adoptive parents:172.1    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 172.2poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 172.3contribution is $4 per month;172.4    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 172.5poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 172.6the parental contribution shall be determined using a sliding fee scale established by the 172.7commissioner of human services which begins at one percent of adjusted gross income 172.8at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 172.9gross income for those with adjusted gross income up to 545 percent of federal poverty 172.10guidelines;172.11    (3) if the adjusted gross income is greater than 545 percent of federal poverty 172.12guidelines and less than 675 percent of federal poverty guidelines, the parental 172.13contribution shall be 7.5 percent of adjusted gross income;172.14    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 172.15poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 172.16contribution shall be determined using a sliding fee scale established by the commissioner 172.17of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 172.18federal poverty guidelines and increases to ten percent of adjusted gross income for those 172.19with adjusted gross income up to 975 percent of federal poverty guidelines; and172.20    (5) if the adjusted gross income is equal to or greater than 975 percent of federal 172.21poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 172.22income.172.23    If the child lives with the parent, the annual adjusted gross income parental 172.24contribution is reduced by $2,400 prior to calculating the parental contribution$100 172.25per month. If the child resides in an institution specified in section 
         256B.35, the parent 172.26is responsible for the personal needs allowance specified under that section in addition 172.27to the parental contribution determined under this section. The parental contribution is 172.28reduced by any amount required to be paid directly to the child pursuant to a court order, 172.29but only if actually paid.172.30    (c) The household size to be used in determining the amount of contribution under 172.31paragraph (b) includes natural and adoptive parents and their dependents, including the 172.32child receiving services. Adjustments in the contribution amount due to annual changes 172.33in the federal poverty guidelines shall be implemented on the first day of July following 172.34publication of the changes.172.35    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 172.36natural or adoptive parents determined according to the previous year's federal tax form, 173.1except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 173.2have been used to purchase a home shall not be counted as income.173.3    (e) The contribution shall be explained in writing to the parents at the time eligibility 173.4for services is being determined. The contribution shall be made on a monthly basis 173.5effective with the first month in which the child receives services. Annually upon 173.6redetermination or at termination of eligibility, if the contribution exceeded the cost of 173.7services provided, the local agency or the state shall reimburse that excess amount to 173.8the parents, either by direct reimbursement if the parent is no longer required to pay 173.9a contribution, or by a reduction in or waiver of parental fees until the excess amount 173.10is exhausted.173.11    (f) The monthly contribution amount must be reviewed at least every 12 months; 173.12when there is a change in household size; and when there is a loss of or gain in income 173.13from one month to another in excess of ten percent. The local agency shall mail a written 173.14notice 30 days in advance of the effective date of a change in the contribution amount. 173.15A decrease in the contribution amount is effective in the month that the parent verifies a 173.16reduction in income or change in household size.173.17    (g) Parents of a minor child who do not live with each other shall each pay the 173.18contribution required under paragraph (a). An amount equal to the annual court-ordered 173.19child support payment actually paid on behalf of the child receiving services shall be 173.20deducted from the adjusted gross income of the parent making the payment prior to 173.21calculating the parental contribution under paragraph (b).173.22    (h) The contribution under paragraph (b) shall be increased by an additional five 173.23percent if the local agency determines that insurance coverage is available but not 173.24obtained for the child. For purposes of this section, "available" means the insurance is a 173.25benefit of employment for a family member at an annual cost of no more than five percent 173.26of the family's annual income. For purposes of this section, "insurance" means health 173.27and accident insurance coverage, enrollment in a nonprofit health service plan, health 173.28maintenance organization, self-insured plan, or preferred provider organization.173.29    Parents who have more than one child receiving services shall not be required 173.30to pay more than the amount for the child with the highest expenditures. There shall 173.31be no resource contribution from the parents. The parent shall not be required to pay 173.32a contribution in excess of the cost of the services provided to the child, not counting 173.33payments made to school districts for education-related services. Notice of an increase in 173.34fee payment must be given at least 30 days before the increased fee is due.173.35    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 173.36in the 12 months prior to July 1:174.1    (1) the parent applied for insurance for the child;174.2    (2) the insurer denied insurance;174.3    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 174.4a complaint or appeal, in writing, to the commissioner of health or the commissioner of 174.5commerce, or litigated the complaint or appeal; and174.6    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.174.7    For purposes of this section, "insurance" has the meaning given in paragraph (h).174.8    A parent who has requested a reduction in the contribution amount under this 174.9paragraph shall submit proof in the form and manner prescribed by the commissioner or 174.10county agency, including, but not limited to, the insurer's denial of insurance, the written 174.11letter or complaint of the parents, court documents, and the written response of the insurer 174.12approving insurance. The determinations of the commissioner or county agency under this 174.13paragraph are not rules subject to chapter 14.174.14    Sec. 3. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:174.15    Subd. 3. Amount of support grant; use. Support grant amounts shall be 174.16determined by the county social service agency. Services and items purchased with a 174.17support grant must:174.18    (1) be over and above the normal costs of caring for the dependent if the dependent 174.19did not have a disability;174.20    (2) be directly attributable to the dependent's disabling condition; and174.21    (3) enable the family to delay or prevent the out-of-home placement of the dependent.174.22    The design and delivery of services and items purchased under this section must 174.23suit the dependent's chronological age and be provided in the least restrictive environment 174.24possible, consistent with the needs identified in the individual service plan.174.25    Items and services purchased with support grants must be those for which there 174.26are no other public or private funds available to the family. Fees assessed to parents 174.27for health or human services that are funded by federal, state, or county dollars are not 174.28reimbursable through this program.174.29    In approving or denying applications, the county shall consider the following factors:174.30    (1) the extent and areas of the functional limitations of the disabled child;174.31    (2) the degree of need in the home environment for additional support; and174.32    (3) the potential effectiveness of the grant to maintain and support the person in 174.33the family environment.174.34    The maximum monthly grant amount shall be $250 per eligible dependent, or 174.35$3,000 per eligible dependent per state fiscal year, within the limits of available funds and 175.1as adjusted by any legislatively authorized cost of living adjustment. The county social 175.2service agency may consider the dependent's supplemental security income in determining 175.3the amount of the support grant.175.4    Any adjustments to their monthly grant amount must be based on the needs of the 175.5family and funding availability.175.6    Sec. 4. Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision 175.7to read:175.8    Subd. 22.Provider rate increase; St. Louis County.A day training and 175.9habilitation provider in St. Louis County licensed to provide services to up to 80 175.10individuals shall receive a per diem rate increase that does not exceed 95 percent of the 175.11greater of 125 percent of the current statewide median or 125 percent of the regional 175.12average per diem rate, whichever is higher.175.13    Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 175.14to read:175.15    Subd. 24.Disability linkage line.The commissioner shall establish the disability 175.16linkage line, a statewide consumer information, referral, and assistance system for people 175.17with disabilities and chronic illnesses that: 175.18    (1) provides information about state and federal eligibility requirements, benefits, 175.19and service options; 175.20    (2) makes referrals to appropriate support entities; 175.21    (3) delivers information and assistance based on national and state standards; 175.22    (4) assists people to make well-informed decisions; and 175.23    (5) supports the timely resolution of service access and benefit issues.175.24    Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:175.25    Subdivision 1. Purpose and goals. The commissioner of human services shall 175.26establish a consumer support grant program for individuals with functional limitations and 175.27their families who wish to purchase and secure their own supports. The commissioner and 175.28local agencies shall jointly develop an implementation plan which must include a way to 175.29resolve the issues related to county liability. The program shall:175.30    (1) make support grants available to individuals or families as an effective alternative 175.31to the developmental disability family support program, personal care attendant services, 175.32home health aide services, and private duty nursing services;176.1    (2) provide consumers more control, flexibility, and responsibility over their services 176.2and supports;176.3    (3) promote local program management and decision making; and176.4    (4) encourage the use of informal and typical community supports.176.5    Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:176.6    Subd. 2. Definitions. For purposes of this section, the following terms have the 176.7meanings given them:176.8    (a) "County board" means the county board of commissioners for the county of 176.9financial responsibility as defined in section 
         256G.02, subdivision 4, or its designated 176.10representative. When a human services board has been established under sections 
         402.01176.11to 
         402.10, it shall be considered the county board for the purposes of this section. 176.12    (b) "Family" means the person's birth parents, adoptive parents or stepparents, 176.13siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece, 176.14nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is 176.15at least 18 years of age.176.16    (c) "Functional limitations" means the long-term inability to perform an activity or 176.17task in one or more areas of major life activity, including self-care, understanding and use 176.18of language, learning, mobility, self-direction, and capacity for independent living. For the 176.19purpose of this section, the inability to perform an activity or task results from a mental, 176.20emotional, psychological, sensory, or physical disability, condition, or illness.176.21    (d) "Informed choice" means a voluntary decision made by the person or,176.22the person's legal representative, or other authorized representative after becoming 176.23familiarized with the alternatives to:176.24    (1) select a preferred alternative from a number of feasible alternatives;176.25    (2) select an alternative which may be developed in the future; and176.26    (3) refuse any or all alternatives.176.27    (e) "Local agency" means the local agency authorized by the county board or, 176.28for counties not participating in the consumer grant program by July 1, 2002, the 176.29commissioner, to carry out the provisions of this section.176.30    (f) "Person" or "persons" means a person or persons meeting the eligibility criteria in 176.31subdivision 3.176.32    (g) "Authorized representative" means an individual designated by the person or 176.33their legal representative to act on their behalf. This individual may be a family member, 176.34guardian, representative payee, or other individual designated by the person or their legal 177.1representative, if any, to assist in purchasing and arranging for supports. For the purposes 177.2of this section, an authorized representative is at least 18 years of age.177.3    (h) "Screening" means the screening of a person's service needs under sections 177.4256B.0911
          and 
         256B.092. 177.5    (i) "Supports" means services, care, aids, environmental modifications, or assistance 177.6purchased by the person or the person's family, the person's legal representative, or other 177.7authorized representative. Examples of supports include respite care, assistance with daily 177.8living, and assistive technology. For the purpose of this section, notwithstanding the 177.9provisions of section 
         144A.43, supports purchased under the consumer support program 177.10are not considered home care services. 177.11    (j) "Program of origination" means the program the individual transferred from 177.12when approved for the consumer support grant program.177.13    Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:177.14    Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a 177.15consumer support grant if the person meets all of the following criteria:177.16    (1) the person is eligible for and has been approved to receive services under 177.17medical assistance as determined under sections 
         256B.055 and 
         256B.056 or the person 177.18has been approved to receive a grant under the developmental disability family support 177.19program under section 
         252.32; 177.20    (2) the person is able to direct and purchase the person's own care and supports, or 177.21the person has a family member, legal representative, or other authorized representative 177.22who can purchase and arrange supports on the person's behalf;177.23    (3) the person has functional limitations, requires ongoing supports to live in the 177.24community, and is at risk of or would continue institutionalization without such supports; 177.25and177.26    (4) the person will live in a home. For the purpose of this section, "home" means the 177.27person's own home or home of a person's family member. These homes are natural home 177.28settings and are not licensed by the Department of Health or Human Services.177.29    (b) Persons may not concurrently receive a consumer support grant if they are:177.30    (1) receiving personal care attendant and home health aide services, or private duty 177.31nursing under section 
         256B.0625; a developmental disability family support grant; or 177.32alternative care services under section 
         256B.0913; or 177.33    (2) residing in an institutional or congregate care setting.177.34    (c) A person or person's family receiving a consumer support grant shall not be 177.35charged a fee or premium by a local agency for participating in the program.178.1    (d) Individuals receiving home and community-based waivers under United States 178.2Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except 178.3for individuals receiving consumer support grants before July 1, 2003, as long as other 178.4eligibility criteria are met.178.5    (e) The commissioner shall establish a budgeted appropriation each fiscal year 178.6for the consumer support grant program. The number of individuals participating in 178.7the program will be adjusted so the total amount allocated to counties does not exceed 178.8the amount of the budgeted appropriation. The budgeted appropriation will be adjusted 178.9annually to accommodate changes in demand for the consumer support grants.178.10    Sec. 9. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:178.11    Subd. 4. Support grants; criteria and limitations. (a) A county board may 178.12choose to participate in the consumer support grant program. If a county has not chosen 178.13to participate by July 1, 2002, the commissioner shall contract with another county or 178.14other entity to provide access to residents of the nonparticipating county who choose 178.15the consumer support grant option. The commissioner shall notify the county board 178.16in a county that has declined to participate of the commissioner's intent to enter into 178.17a contract with another county or other entity at least 30 days in advance of entering 178.18into the contract. The local agency shall establish written procedures and criteria to 178.19determine the amount and use of support grants. These procedures must include, at least, 178.20the availability of respite care, assistance with daily living, and adaptive aids. The local 178.21agency may establish monthly or annual maximum amounts for grants and procedures 178.22where exceptional resources may be required to meet the health and safety needs of the 178.23person on a time-limited basis, however, the total amount awarded to each individual may 178.24not exceed the limits established in subdivision 11.178.25    (b) Support grants to a person or a person's family, a person's legal representative, 178.26or other authorized representative will be provided through a monthly subsidy payment 178.27and be in the form of cash, voucher, or direct county payment to vendor. Support grant 178.28amounts must be determined by the local agency. Each service and item purchased with a 178.29support grant must meet all of the following criteria:178.30    (1) it must be over and above the normal cost of caring for the person if the person 178.31did not have functional limitations;178.32    (2) it must be directly attributable to the person's functional limitations;178.33    (3) it must enable the person or the person's family, a person's legal representative, 178.34or other authorized representative to delay or prevent out-of-home placement of the 178.35person; and179.1    (4) it must be consistent with the needs identified in the service agreement, when 179.2applicable.179.3    (c) Items and services purchased with support grants must be those for which there 179.4are no other public or private funds available to the person or the person's family, a person's 179.5legal representative, or other authorized representative. Fees assessed to the person or the 179.6person's family for health and human services are not reimbursable through the grant.179.7    (d) In approving or denying applications, the local agency shall consider the 179.8following factors:179.9    (1) the extent and areas of the person's functional limitations;179.10    (2) the degree of need in the home environment for additional support; and179.11    (3) the potential effectiveness of the grant to maintain and support the person in the 179.12family environment or the person's own home.179.13    (e) At the time of application to the program or screening for other services, 179.14the person or the person's family, a person's legal representative, or other authorized 179.15representative shall be provided sufficient information to ensure an informed choice 179.16of alternatives by the person, the person's legal representative, or other authorized 179.17representative, if any, or the person's family. The application shall be made to the local 179.18agency and shall specify the needs of the person and family, the form and amount of 179.19grant requested, the items and services to be reimbursed, and evidence of eligibility for 179.20medical assistance.179.21    (f) Upon approval of an application by the local agency and agreement on a support 179.22plan for the person or person's family, the local agency shall make grants to the person or 179.23the person's family. The grant shall be in an amount for the direct costs of the services or 179.24supports outlined in the service agreement.179.25    (g) Reimbursable costs shall not include costs for resources already available, such as 179.26special education classes, day training and habilitation, case management, other services to 179.27which the person is entitled, medical costs covered by insurance or other health programs, 179.28or other resources usually available at no cost to the person or the person's family.179.29    (h) The state of Minnesota, the county boards participating in the consumer 179.30support grant program, or the agencies acting on behalf of the county boards in the 179.31implementation and administration of the consumer support grant program shall not be 179.32liable for damages, injuries, or liabilities sustained through the purchase of support by 179.33the individual, the individual's family, or the authorized representative under this section 179.34with funds received through the consumer support grant program. Liabilities include but 179.35are not limited to: workers' compensation liability, the Federal Insurance Contributions 179.36Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, 180.1participating county boards and agencies acting on behalf of county boards are exempt 180.2from the provisions of section 
         268.04.180.3    Sec. 10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:180.4    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of 180.5transferring persons to the consumer support grant program from the developmental 180.6disability family support program and personal care assistant services, home health 180.7aide services, or private duty nursing services, the amount of funds transferred by the 180.8commissioner between the developmental disability family support program account, the 180.9medical assistance account, or the consumer support grant account shall be based on each 180.10county's participation in transferring persons to the consumer support grant program 180.11from those programs and services.180.12    (b) At the beginning of each fiscal year, county allocations for consumer support 180.13grants shall be based on:180.14    (1) the number of persons to whom the county board expects to provide consumer 180.15supports grants;180.16    (2) their eligibility for current program and services;180.17    (3) the amount of nonfederal dollars allowed under subdivision 11; and180.18    (4) projected dates when persons will start receiving grants. County allocations shall 180.19be adjusted periodically by the commissioner based on the actual transfer of persons or 180.20service openings, and the nonfederal dollars associated with those persons or service 180.21openings, to the consumer support grant program.180.22    (c) The amount of funds transferred by the commissioner from the medical 180.23assistance account for an individual may be changed if it is determined by the county or its 180.24agent that the individual's need for support has changed.180.25    (d) The authority to utilize funds transferred to the consumer support grant account 180.26for the purposes of implementing and administering the consumer support grant program 180.27will not be limited or constrained by the spending authority provided to the program 180.28of origination.180.29    (e) The commissioner may use up to five percent of each county's allocation, as 180.30adjusted, for payments for administrative expenses, to be paid as a proportionate addition 180.31to reported direct service expenditures.180.32    (f) The county allocation for each individual or individual's family cannot exceed 180.33the amount allowed under subdivision 11.180.34    (g) The commissioner may recover, suspend, or withhold payments if the county 180.35board, local agency, or grantee does not comply with the requirements of this section.181.1    (h) Grant funds unexpended by consumers shall return to the state once a year. The 181.2annual return of unexpended grant funds shall occur in the quarter following the end of 181.3the state fiscal year.181.4    Sec. 11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:181.5    Subd. 10. Consumer responsibilities. Persons receiving grants under this section 181.6shall:181.7    (1) spend the grant money in a manner consistent with their agreement with the 181.8local agency;181.9    (2) notify the local agency of any necessary changes in the grant or the items on 181.10which it is spent;181.11    (3) notify the local agency of any decision made by the person, the a person's legal 181.12representative, or the person's family or other authorized representative that would change 181.13their eligibility for consumer support grants;181.14    (4) arrange and pay for supports; and181.15    (5) inform the local agency of areas where they have experienced difficulty securing 181.16or maintaining supports.181.17    Sec. 12. Minnesota Statutes 2006, section 256.974, is amended to read:181.18256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS181.19LONG-TERM CARE; LOCAL PROGRAMS.181.20    The ombudsman for older Minnesotans long-term care serves in the classified service 181.21under section 
         256.01, subdivision 7, in an office within the Minnesota Board on Aging that 181.22incorporates the long-term care ombudsman program required by the Older Americans 181.23Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12)181.24(9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota 181.25Board on Aging may make grants to and designate local programs for the provision of 181.26ombudsman services to clients in county or multicounty areas. The local program may not 181.27be an agency engaged in the provision of nursing home care, hospital care, or home care 181.28services either directly or by contract, or have the responsibility for planning, coordinating, 181.29funding, or administering nursing home care, hospital care, or home care services.181.30    Sec. 13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:181.31    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing 181.32home licensed under sections 
         144A.02 to 
         144A.10or; a boarding care home licensed 182.1under sections 
         144.50 to 
         144.56; or a licensed or registered residential setting which 182.2provides or arranges for the provision of home care services. 182.3    Sec. 14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:182.4    Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a 182.5request is made for, ombudsman services and is (a) a resident of a long-term care facility 182.6or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or 182.7denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or 182.8requesting a home care service.182.9    Sec. 15. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:182.10    Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a 182.11conspicuous place the address and telephone number of the office. A home care service 182.12provider shall provide all recipients, including those in elderly housing with services 182.13under chapter 144D, with the address and telephone number of the office. Counties shall 182.14provide clients receiving a consumer support grant or a service allowancelong-term care 182.15consultation services under section 256B.0911 or home and community-based services 182.16through a state or federally funded program with the name, address, and telephone number 182.17of the office. The posting or notice is subject to approval by the ombudsman.182.18    Sec. 16. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:182.19    Subd. 4. Access to long-term care and acute care facilities and clients. The 182.20ombudsman or designee may:182.21    (1) enter any long-term care facility without notice at any time;182.22    (2) enter any acute care facility without notice during normal business hours;182.23    (3) enter any acute care facility without notice at any time to interview a patient or 182.24observe services being provided to the patient as part of an investigation of a matter that is 182.25within the scope of the ombudsman's authority, but only if the ombudsman's or designee's 182.26presence does not intrude upon the privacy of another patient or interfere with routine 182.27hospital services provided to any patient in the facility;182.28    (4) communicate privately and without restriction with any client in accordance 182.29with section 144.651, as long as the ombudsman has the client's consent for such 182.30communication; 182.31    (5) inspect records of a long-term care facility, home care service provider, or acute 182.32care facility that pertain to the care of the client according to sectionssection 144.335and 182.33144.651; and 183.1    (6) with the consent of a client or client's legal guardian, the ombudsman or 183.2designated staff shall have access to review records pertaining to the care of the client 183.3according to sectionssection 144.335and 144.651. If a client cannot consent and has no 183.4legal guardian, access to the records is authorized by this section. 183.5    A person who denies access to the ombudsman or designee in violation of this 183.6subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a 183.7misdemeanor.183.8    Sec. 17. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:183.9    Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take 183.10discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a 183.11patient, resident, or guardian or family member of a patient, resident, or guardian for filing 183.12in good faith a complaint with or providing information to the ombudsman or designee 183.13including volunteers. A person who violates this subdivision or who aids, abets, invites, 183.14compels, or coerces another to do so is guilty of a misdemeanor.183.15    (b) There shall be a rebuttable presumption that any adverse action, as defined below, 183.16within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose 183.17of this clause, the term "adverse action" refers to action taken by the entity involved in a 183.18report against the person making the report or the person with respect to whom the report 183.19was made because of the report, and includes, but is not limited to:183.20    (1) discharge or transfer from a facility;183.21    (2) termination of service;183.22    (3) restriction or prohibition of access to the facility or its residents;183.23    (4) discharge from or termination of employment;183.24    (5) demotion or reduction in remuneration for services; and183.25    (6) any restriction of rights set forth in section 
         144.651or,144A.44, or 144A.751. 183.26    Sec. 18. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:183.27    Subdivision 1. Classification. Except as provided in this section, data maintained 183.28by the office under sections 
         256.974 to 
         256.9744 are private data on individuals or 183.29nonpublic data as defined in section 
         13.02, subdivision 9 or 12, and must be maintained 183.30in accordance with the requirements of Public Law 100-75 the Older Americans Act, as 183.31amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).183.32    Sec. 19. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:184.1    Subd. 7. Consumer information and assistance; senior linkage. (a) The 184.2Minnesota Board on Aging shall operate a statewide information and assistance service 184.3to aid older Minnesotans and their families in making informed choices about long-term 184.4care options and health care benefits. Language services to persons with limited English 184.5language skills may be made available. The service, known as Senior LinkAge Line, must 184.6be available during business hours through a statewide toll-free number and must also 184.7be available through the Internet.184.8    (b) The service must assist older adults, caregivers, and providers in accessing 184.9information about choices in long-term care services that are purchased through private 184.10providers or available through public options. The service must:184.11    (1) develop a comprehensive database that includes detailed listings in both 184.12consumer- and provider-oriented formats;184.13    (2) make the database accessible on the Internet and through other telecommunication 184.14and media-related tools;184.15    (3) link callers to interactive long-term care screening tools and make these tools 184.16available through the Internet by integrating the tools with the database;184.17    (4) develop community education materials with a focus on planning for long-term 184.18care and evaluating independent living, housing, and service options;184.19    (5) conduct an outreach campaign to assist older adults and their caregivers in 184.20finding information on the Internet and through other means of communication;184.21    (6) implement a messaging system for overflow callers and respond to these callers 184.22by the next business day;184.23    (7) link callers with county human services and other providers to receive more 184.24in-depth assistance and consultation related to long-term care options; and184.25    (8) link callers with quality profiles for nursing facilities and other providers 184.26developed by the commissioner of health.; and184.27    (9) incorporate information about housing with services and consumer rights 184.28within the MinnesotaHelp.info network long-term care database to facilitate consumer 184.29comparison of services and costs among housing with services establishments and with 184.30other in-home services and to support financial self-sufficiency as long as possible. 184.31Housing with services establishments and their arranged home care providers shall provide 184.32information to the commissioner of human services that is consistent with information 184.33required by the commissioner of health under section 144G.06, the Uniform Consumer 184.34Information Guide. The commissioner of human services shall provide the data to the 184.35Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term 184.36care database.185.1    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 185.2of the statewide information and assistance, and submit this evaluation to the legislature 185.3by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 185.4in service delivery, continuity in information between the service and identified linkages, 185.5and potential use of private funding to enhance the service.185.6EFFECTIVE DATE.This section is effective the day following final enactment.185.7    Sec. 20. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to 185.8read:185.9    Subd. 1a. Income and assets generally. Unless specifically required by state law or 185.10rule or federal law or regulation, the methodologies used in counting income and assets 185.11to determine eligibility for medical assistance for persons whose eligibility category is 185.12based on blindness, disability, or age of 65 or more years, the methodologies for the 185.13supplemental security income program shall be used, except as provided under subdivision 185.143, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be 185.15counted as income for purposes of this subdivision until July 1 of each year. Effective 185.16upon federal approval, for children eligible under section 
         256B.055, subdivision 12, or 185.17for home and community-based waiver services whose eligibility for medical assistance 185.18is determined without regard to parental income, child support payments, including any 185.19payments made by an obligor in satisfaction of or in addition to a temporary or permanent 185.20order for child support, and Social Security payments are not counted as income. For 185.21families and children, which includes all other eligibility categories, the methodologies 185.22under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal 185.23Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public 185.24Law 104-193, shall be used, except that effective October 1, 2003, the earned income 185.25disregards and deductions are limited to those in subdivision 1c. For these purposes, a 185.26"methodology" does not include an asset or income standard, or accounting method, 185.27or method of determining effective dates.185.28    Sec. 21. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:185.29    Subd. 3. Asset limitations for aged, blind, or disabled individuals and families.185.30    To be eligible for medical assistance, a person whose eligibility is based on blindness, 185.31disability, or age of 65 or more years must not individually own more than $3,000 $6,000185.32in assets, or if a member of a household with two family members, husband and wife, or 185.33parent and child, the household must not own more than $6,000 $12,000 in assets, plus 185.34$200 $400 for each additional legal dependent. In addition to these maximum amounts, 186.1an eligible individual or family may accrue interest on these amounts, but they must be 186.2reduced to the maximum at the time of an eligibility redetermination. The accumulation 186.3of the clothing and personal needs allowance according to section 
         256B.35 must also be 186.4reduced to the maximum at the time of the eligibility redetermination. The value of assets 186.5that are not considered in determining eligibility for medical assistance is the value of 186.6those assets excluded under the supplemental security income program for aged, blind, 186.7and disabled persons, with the following exceptions: 186.8    (a) Household goods and personal effects are not considered.186.9    (b) Capital and operating assets of a trade or business that the local agency 186.10determines are necessary to the person's ability to earn an income are not considered.186.11    (c) Motor vehicles are excluded to the same extent excluded by the supplemental 186.12security income program.186.13    (d) Assets designated as burial expenses are excluded to the same extent excluded by 186.14the supplemental security income program. Burial expenses funded by annuity contracts 186.15or life insurance policies must irrevocably designate the individual's estate as contingent 186.16beneficiary to the extent proceeds are not used for payment of selected burial expenses.186.17    (e) Effective upon federal approval, for a person who no longer qualifies as an 186.18employed person with a disability due to loss of earnings, assets allowed while eligible 186.19for medical assistance under section 
         256B.057, subdivision 9, are not considered for 12 186.20months, beginning with the first month of ineligibility as an employed person with a 186.21disability, to the extent that the person's total assets remain within the allowed limits of 186.22section 
         256B.057, subdivision 9, paragraph (b). 186.23    (f) When a person enrolled in medical assistance under section 256B.057, 186.24subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive 186.25months before the person's 65th birthday, the assets owned by the person and the person's 186.26spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph 186.27(b), when determining eligibility for medical assistance under section 256B.055, 186.28subdivision 7. The income of a spouse of a person enrolled in medical assistance under 186.29section 256B.057, subdivision 9, during each of the 24 consecutive months before the 186.30person's 65th birthday must be disregarded when determining eligibility for medical 186.31assistance under section 256B.055, subdivision 7, when the person reaches age 65. This 186.32paragraph does not apply at the time the person or the person's spouse requests medical 186.33assistance payment for long-term care services.186.34EFFECTIVE DATE.This section is effective July 1, 2007, except that the increase 186.35in the asset standard for persons whose eligibility for medical assistance is based on 186.36blindness, disability, or age of 65 or more years is effective July 1, 2008.187.1    Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 5c, is amended to 187.2read:187.3    Subd. 5c. Excess income standard. (a) The excess income standard for families 187.4with children is the standard specified in subdivision 4.187.5    (b) The excess income standard for a person whose eligibility is based on blindness, 187.6disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the 187.7family size. Effective July 1, 2002, the excess income standard for this paragraph shall 187.8equal 75 percent of the federal poverty guidelines. Effective July 1, 2007, the excess 187.9income standard for this paragraph shall equal 85 percent of the federal poverty guidelines. 187.10The excess income standard for this paragraph shall be increased by five percentage points 187.11on July 1 of each of the next three years, so that the excess income standard shall equal 187.12100 percent of the federal poverty guidelines effective July 1, 2010.187.13EFFECTIVE DATE.This section is effective July 1, 2007.187.14    Sec. 23. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to 187.15read:187.16    Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner 187.17shall execute a data use agreement with the Centers for Medicare and Medicaid Services 187.18to obtain the long-term care minimum data set data to assist residents of nursing facilities 187.19who have establish a process with the Centers for Independent Living that allows a person 187.20residing in a Minnesota nursing facility to receive needed information, consultation, and 187.21assistance from one of the centers about the available community support options that may 187.22enable the person to relocate to the community, if the person: (1) is under the age of 65, 187.23(2) has indicated a desire to live in the community. The commissioner shall in turn enter 187.24into agreements with the Centers for Independent Living to provide information about 187.25assistance for persons who want to move to the community. The commissioner shall work 187.26with the Centers for Independent Living on both the content of the information to be 187.27provided and privacy protections for the individual residents, and (3) has signed a release 187.28of information authorized by the person or the person's appointed legal representative. 187.29The process established under this subdivision shall be coordinated with the long-term 187.30care consultation service activities established in section 256B.0911.187.31    Sec. 24. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 187.32read:188.1    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 188.2meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 188.3$6.50 for lunch, or $8 for dinner.188.4    (b) Medical assistance reimbursement for lodging for persons traveling to receive 188.5medical care may not exceed $50 per day unless prior authorized by the local agency.188.6    (c) Medical assistance direct mileage reimbursement to the eligible person or the 188.7eligible person's driver may not exceed 20 cents per mile.188.8    (d) Regardless of the number of employees that an enrolled health care provider 188.9may have, medical assistance covers sign and oral language interpreter services when 188.10provided by an enrolled health care provider during the course of providing a direct, 188.11person-to-person covered health care service to an enrolled recipient with limited English 188.12proficiency or who has a hearing loss and uses interpreting services.188.13    Sec. 25. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 188.14subdivision to read:188.15    Subd. 49.Self-directed supports option.Upon federal approval, medical 188.16assistance covers the self-directed supports option as defined under section 256B.0657 and 188.17section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.188.18EFFECTIVE DATE.This section is effective upon federal approval of the state 188.19Medicaid plan amendment. The commissioner of human services shall inform the Office 188.20of the Revisor of Statutes when approval is obtained.188.21    Sec. 26. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.188.22    Subdivision 1.Definition."Self-directed supports option" means personal 188.23assistance, supports, items, and related services purchased under an approved budget 188.24plan and budget by a recipient.188.25    Subd. 2.Eligibility.(a) The self-directed supports option is available to a person 188.26who:188.27    (1) is a recipient of medical assistance as determined under sections 256B.055, 188.28256B.056, and 256B.057, subdivision 9;188.29    (2) is eligible for personal care assistant services under section 256B.0655;188.30    (3) lives in the person's own apartment or home, which is not owned, operated, or 188.31controlled by a provider of services not related by blood or marriage;188.32    (4) has the ability to hire, fire, supervise, establish staff compensation for, and 188.33manage the individuals providing services, and to choose and obtain items, related 188.34services, and supports as described in the participant's plan. If the recipient is not able to 189.1carry out these functions but has a legal guardian or parent to carry them out, the guardian 189.2or parent may fulfill these functions on behalf of the recipient; and189.3    (5) has not been excluded or disenrolled by the commissioner.189.4    (b) The commissioner may disenroll or exclude recipients, including guardians and 189.5parents, under the following circumstances:189.6    (1) recipients who have been restricted by the Primary Care Utilization Review 189.7Committee may be excluded for a specified time period; and 189.8    (2) recipients who exit the self-directed supports option during the recipient's 189.9service plan year shall not access the self-directed supports option for the remainder 189.10of that service plan year.189.11    Subd. 3.Eligibility for other services.Selection of the self-directed supports 189.12option by a recipient shall not restrict access to other medically necessary care and 189.13services furnished under the state plan medical assistance benefit, including home care 189.14targeted case management, except that a person receiving home and community-based 189.15waiver services, a family support grant or a consumer support grant is not eligible for 189.16funding under the self-directed supports option.189.17    Subd. 4.Assessment requirements.(a) The self-directed supports option 189.18assessment must meet the following requirements:189.19    (1) it shall be conducted by the county public health nurse or a certified public 189.20health nurse under contract with the county;189.21    (2) it shall be conducted face-to-face in the recipient's home initially, and at least 189.22annually thereafter; when there is a significant change in the recipient's condition; and 189.23when there is a change in the need for personal care assistant services. A recipient who is 189.24residing in a facility may be assessed for the self-directed support option for the purpose 189.25of returning to the community using this option; and 189.26    (3) it shall be completed using the format established by the commissioner.189.27    (b) The results of the assessment and recommendations shall be communicated to 189.28the commissioner and the recipient by the county public health nurse or certified public 189.29health nurse under contract with the county.189.30    Subd. 5.Self-directed supports option plan requirements.(a) The plan for the 189.31self-directed supports option must meet the following requirements:189.32    (1) the plan must be completed using a person-centered process that:189.33    (i) builds upon the recipient's capacity to engage in activities that promote 189.34community life;189.35    (ii) respects the recipient's preferences, choices, and abilities;190.1    (iii) involves families, friends, and professionals in the planning or delivery of 190.2services or supports as desired or required by the recipient; and 190.3    (iv) addresses the need for personal care assistant services identified in the recipient's 190.4self-directed supports option assessment;190.5    (2) the plan shall be developed by the recipient or by the guardian of an adult 190.6recipient or by a parent or guardian of a minor child, with the assistance of an enrolled 190.7medical assistance home care targeted case manager provider who meets the requirements 190.8established for using a person-centered planning process and shall be reviewed at least 190.9annually upon reassessment or when there is a significant change in the recipient's 190.10condition; and 190.11    (3) the plan must include the total budget amount available divided into monthly 190.12amounts that cover the number of months of personal care assistant services authorization 190.13included in the budget. The amount used each month may vary, but additional funds shall 190.14not be provided above the annual personal care assistant services authorized amount 190.15unless a change in condition is documented.190.16    (b) The commissioner shall:190.17    (1) establish the format and criteria for the plan as well as the requirements for 190.18providers who assist with plan development;190.19    (2) review the assessment and plan and, within 30 days after receiving the 190.20assessment and plan, make a decision on approval of the plan;190.21    (3) notify the recipient, parent, or guardian of approval or denial of the plan and 190.22provide notice of the right to appeal under section 256.045; and 190.23    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.190.24    Subd. 6.Services covered.(a) Services covered under the self-directed supports 190.25option include:190.26    (1) personal care assistant services under section 256B.0655; and 190.27    (2) items, related services, and supports, including assistive technology, that increase 190.28independence or substitute for human assistance to the extent expenditures would 190.29otherwise be used for human assistance.190.30    (b) Items, supports, and related services purchased under this option shall not be 190.31considered home care services for the purposes of section 144A.43.190.32    Subd. 7.Noncovered services.Services or supports that are not eligible for 190.33payment under the self-directed supports option include:190.34    (1) services, goods, or supports that do not benefit the recipient;190.35    (2) any fees incurred by the recipient, such as Minnesota health care program fees 190.36and co-pays, legal fees, or costs related to advocate agencies;191.1    (3) insurance, except for insurance costs related to employee coverage or fiscal 191.2support entity payments;191.3    (4) room and board and personal items that are not related to the disability, except 191.4that medically prescribed specialized diet items may be covered if they reduce the need for 191.5human assistance;191.6    (5) home modifications that add square footage;191.7    (6) home modifications for a residence other than the primary residence of the 191.8recipient, or in the event of a minor with parents not living together, the primary residences 191.9of the parents;191.10    (7) expenses for travel, lodging, or meals related to training the recipient, the parent 191.11or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or 191.12unpaid caregivers that exceed $500 in a 12-month period;191.13    (8) experimental treatment;191.14    (9) any service or item covered by other medical assistance state plan services, 191.15including prescription and over-the-counter medications, compounds, and solutions and 191.16related fees, including premiums and co-payments;191.17    (10) membership dues or costs, except when the service is necessary and appropriate 191.18to treat a physical condition or to improve or maintain the recipient's physical condition. 191.19The condition must be identified in the recipient's plan of care and monitored by a 191.20Minnesota health care program enrolled physician;191.21    (11) vacation expenses other than the cost of direct services;191.22    (12) vehicle maintenance or modifications not related to the disability;191.23    (13) tickets and related costs to attend sporting or other recreational events; and191.24    (14) costs related to Internet access, except when necessary for operation of assistive 191.25technology, to increase independence, or to substitute for human assistance.191.26    Subd. 8.Self-directed budget requirements.The budget for the provision of the 191.27self-directed service option shall be equal to the greater of either:191.28    (1) the annual amount of personal care assistant services under section 256B.0655 191.29that the recipient has used in the most recent 12-month period; or 191.30    (2) the amount determined using the consumer support grant methodology under 191.31section 256.476, subdivision 11, except that the budget amount shall include the federal 191.32and nonfederal share of the average service costs.191.33    Subd. 9.Quality assurance and risk management.(a) The commissioner 191.34shall establish quality assurance and risk management measures for use in developing 191.35and implementing self-directed plans and budgets that (1) recognize the roles and 191.36responsibilities involved in obtaining services in a self-directed manner, and (2) assure 192.1the appropriateness of such plans and budgets based upon a recipient's resources and 192.2capabilities. These measures must include (i) background studies, and (ii) backup and 192.3emergency plans, including disaster planning.192.4    (b) The commissioner shall provide ongoing technical assistance and resource and 192.5educational materials for families and recipients selecting the self-directed option.192.6    (c) Performance assessments measures, such as of a recipient's satisfaction with the 192.7services and supports, and ongoing monitoring of health and well-being shall be identified 192.8in consultation with the stakeholder group.192.9    Subd. 10.Fiscal support entity.(a) Each recipient shall choose a fiscal support 192.10entity provider certified by the commissioner to make payments for services, items, 192.11supports, and administrative costs related to managing a self-directed service plan 192.12authorized for payment in the approved plan and budget. Recipients shall also choose 192.13the payroll, agency with choice, or the fiscal conduit model of financial and service 192.14management.192.15    (b) The fiscal support entity:192.16    (1) may not limit or restrict the recipient's choice of service or support providers, 192.17including use of the payroll, agency with choice, or fiscal conduit model of financial 192.18and service management; 192.19    (2) must have a written agreement with the recipient or the recipient's representative 192.20that identifies the duties and responsibilities to be performed and the specific related 192.21charges; 192.22    (3) must provide the recipient and the home care targeted case manager with a 192.23monthly written summary of the self-directed supports option services that were billed, 192.24including charges from the fiscal support entity;192.25    (4) must be knowledgeable of and comply with Internal Revenue Service 192.26requirements necessary to process employer and employee deductions, provide appropriate 192.27and timely submission of employer tax liabilities, and maintain documentation to support 192.28medical assistance claims; 192.29    (5) must have current and adequate liability insurance and bonding and sufficient 192.30cash flow and have on staff or under contract a certified public accountant or an individual 192.31with a baccalaureate degree in accounting; and 192.32    (6) must maintain records to track all self-directed supports option services 192.33expenditures, including time records of persons paid to provide supports and receipts for 192.34any goods purchased. The records must be maintained for a minimum of five years from 192.35the claim date and be available for audit or review upon request. Claims submitted by 193.1the fiscal support entity must correspond with services, amounts, and time periods as 193.2authorized in the recipient's self-directed supports option plan.193.3    (c) The commissioner shall have authority to:193.4    (1) set or negotiate rates with fiscal support entities;193.5    (2) limit the number of fiscal support entities;193.6    (3) identify a process to certify and recertify fiscal support entities and assure fiscal 193.7support entities are available to recipients throughout the state; and 193.8    (4) establish a uniform format and protocol to be used by eligible fiscal support 193.9entities.193.10    Subd. 11.Stakeholder consultation.The commissioner shall consult with a 193.11statewide consumer-directed services stakeholder group, including representatives of 193.12all types of consumer-directed service users, advocacy organizations, counties, and 193.13consumer-directed service providers. The commissioner shall seek recommendations 193.14from this stakeholder group in developing:193.15    (1) the self-directed plan format;193.16    (2) requirements and guidelines for the person-centered plan assessment and 193.17planning process;193.18    (3) implementation of the option and the quality assurance and risk management 193.19techniques; and 193.20    (4) standards and requirements, including rates for the personal support plan 193.21development provider and the fiscal support entity; policies; training; and implementation. 193.22The stakeholder group shall provide recommendations on the repeal of the personal care 193.23assistant choice option, transition issues, and whether the consumer support grant program 193.24under section 256.476 should be modified. The stakeholder group shall meet at least 193.25three times each year to provide advice on policy, implementation, and other aspects of 193.26consumer and self-directed services.193.27EFFECTIVE DATE.Subdivisions 1 to 10 are effective upon federal approval of 193.28the state Medicaid plan amendment. The commissioner of human services shall inform 193.29the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11 193.30is effective July 1, 2007.193.31    Sec. 27. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to 193.32read:193.33    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 193.34services planning, or other assistance intended to support community-based living, 193.35including persons who need assessment in order to determine waiver or alternative care 194.1program eligibility, must be visited by a long-term care consultation team within ten 194.2working days after the date on which an assessment was requested or recommended. 194.3Assessments must be conducted according to paragraphs (b) to (g) (i).194.4    (b) The county may utilize a team of either the social worker or public health nurse, 194.5or both, to conduct the assessment in a face-to-face interview. The consultation team 194.6members must confer regarding the most appropriate care for each individual screened or 194.7assessed.194.8    (c) The long-term care consultation team must assess the health and social needs of 194.9the person, using an assessment form provided by the commissioner.194.10    (d) The team must conduct the assessment in a face-to-face interview with the 194.11person being assessed and the person's legal representative, if applicable.194.12    (e) The team must provide the person, or the person's legal representative, with 194.13written recommendations for facility- or community-based services. The team must 194.14document that the most cost-effective alternatives available were offered to the individual. 194.15For purposes of this requirement, "cost-effective alternatives" means community services 194.16and living arrangements that cost the same as or less than nursing facility care.194.17    (f) If the person chooses to use community-based services, the team must provide 194.18the person or the person's legal representative with a written community support plan, 194.19regardless of whether the individual is eligible for Minnesota health care programs. 194.20The person may request assistance in developing a community support plan without 194.21participating in a complete assessment.194.22    (g) The person has the right to make the final decision between nursing facility 194.23placement and community placement after the screening team's recommendation, except 194.24as provided in subdivision 4a, paragraph (c).194.25    (h) The team must give the person receiving assessment or support planning, or 194.26the person's legal representative, materials, and forms supplied by the commissioner 194.27containing the following information:194.28    (1) the need for and purpose of preadmission screening and assessment if the person 194.29selects nursing facility placement;194.30    (2) the role of the long-term care consultation assessment and support planning in 194.31waiver and alternative care program eligibility determination;194.32    (2) (3) information about Minnesota health care programs;194.33    (3) (4) the person's freedom to accept or reject the recommendations of the team;194.34    (4) (5) the person's right to confidentiality under the Minnesota Government Data 194.35Practices Act, chapter 13; and195.1    (6) the long-term care consultant's decision regarding the person's need for nursing 195.2facility level of care;195.3    (5) (7) the person's right to appeal the decision regarding the need for nursing facility 195.4level of care or the county's final decisions regarding public programs eligibility according 195.5to section 
         256.045, subdivision 3. 195.6    (i) Face-to-face assessment completed as part of eligibility determination for 195.7the alternative care, elderly waiver, community alternatives for disabled individuals, 195.8community alternative care, and traumatic brain injury waiver programs under sections 195.9256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 195.10than 60 calendar days after the date of assessment. The effective eligibility start date 195.11for these programs can never be prior to the date of assessment. If an assessment was 195.12completed more than 60 days before the effective waiver or alternative care program 195.13eligibility start date, assessment and support plan information must be updated in a 195.14face-to-face visit and documented in the department's Medicaid Management Information 195.15System (MMIS). The effective date of program eligibility in this case cannot be prior to 195.16the date the updated assessment is completed.195.17    Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to 195.18read:195.19    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall 195.20provide assistance to persons residing in a nursing facility, hospital, regional treatment 195.21center, or intermediate care facility for persons with developmental disabilities who 195.22request or are referred for assistance. Transition assistance must include assessment, 195.23community support plan development, referrals to Minnesota health care programs, 195.24and referrals to programs that provide assistance with housing. Transition assistance 195.25must also include information about the Centers for Independent Living and about other 195.26organizations that can provide assistance with relocation efforts, and information about 195.27contacting these organizations to obtain their assistance and support. 195.28    (b) The county shall develop transition processes with institutional social workers 195.29and discharge planners to ensure that:195.30    (1) persons admitted to facilities receive information about transition assistance 195.31that is available;195.32    (2) the assessment is completed for persons within ten working days of the date of 195.33request or recommendation for assessment; and195.34    (3) there is a plan for transition and follow-up for the individual's return to the 195.35community. The plan must require notification of other local agencies when a person 196.1who may require assistance is screened by one county for admission to a facility located 196.2in another county.196.3    (c) If a person who is eligible for a Minnesota health care program is admitted to a 196.4nursing facility, the nursing facility must include a consultation team member or the case 196.5manager in the discharge planning process.196.6    Sec. 29. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 196.7subdivision to read:196.8    Subd. 3c.Transition to housing with services.(a) Transitional consultation shall 196.9be offered to all prospective residents 65 years of age or older regardless of income, assets, 196.10or funding sources before housing with services establishments offering or providing 196.11assisted living execute a lease or contract with the prospective resident. The purpose of 196.12transitional long-term care consultation is to support persons with current or anticipated 196.13long-term care needs in making informed choices among options that include the most 196.14cost-effective and least restrictive settings, and to delay spenddown to eligibility for 196.15publicly funded programs by connecting people to alternative services in their homes 196.16before transition to housing with services.196.17    (b) Transitional consultation services are provided as determined by the 196.18commissioner of human services in partnership with county long-term care consultation 196.19units, and the Area Agencies on Aging, and are a combination of telephone-based 196.20and in-person assistance provided under models developed by the commissioner. The 196.21consultation is to be performed in a manner which provides objective and complete 196.22information. Transitional consultation must be provided within five working days of the 196.23request of the prospective resident as follows:196.24    (1) the consultation must be provided by a qualified professional as determined by 196.25the commissioner;196.26    (2) the consultation must include a review of the prospective resident's reasons for 196.27considering assisted living, the prospective resident's personal goals, a discussion of the 196.28prospective resident's immediate and projected long-term care needs, and alternative 196.29community services or assisted living settings that may meet the prospective resident's 196.30needs; and196.31    (3) the prospective resident will be informed of the availability of long-term care 196.32consultation services described in subdivision 3a that are available at no charge to the 196.33prospective resident to assist the prospective resident in assessment and planning to 196.34meet the prospective resident's long-term care needs. Regardless of the consultation, 197.1prospective residents maintain the right to choose housing with services or assisted living, 197.2if that is their choice.197.3EFFECTIVE DATE.This section is effective October 1, 2008.197.4    Sec. 30. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to 197.5read:197.6    Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the 197.7federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are 197.8limited to:197.9    (1) a person who, having entered an acute care facility from a certified nursing 197.10facility, is returning to a certified nursing facility;197.11    (2) a person transferring from one certified nursing facility in Minnesota to another 197.12certified nursing facility in Minnesota; and197.13    (3) a person, 21 years of age or older, who satisfies the following criteria, as specified 197.14in Code of Federal Regulations, title 42, section 483.106(b)(2):197.15    (i) the person is admitted to a nursing facility directly from a hospital after receiving 197.16acute inpatient care at the hospital;197.17    (ii) the person requires nursing facility services for the same condition for which 197.18care was provided in the hospital; and197.19    (iii) the attending physician has certified before the nursing facility admission that 197.20the person is likely to receive less than 30 days of nursing facility services.197.21    (b) Persons who are exempt from preadmission screening for purposes of level of 197.22care determination include:197.23    (1) persons described in paragraph (a);197.24    (2) an individual who has a contractual right to have nursing facility care paid for 197.25indefinitely by the veterans' administration;197.26    (3) an individual enrolled in a demonstration project under section 
         256B.69, 197.27subdivision 8
         , at the time of application to a nursing facility; and197.28    (4) an individual currently being served under the alternative care program or under 197.29a home and community-based services waiver authorized under section 1915(c) of the 197.30federal Social Security Act; and.197.31    (5) individuals admitted to a certified nursing facility for a short-term stay, which 197.32is expected to be 14 days or less in duration based upon a physician's certification, and 197.33who have been assessed and approved for nursing facility admission within the previous 197.34six months. This exemption applies only if the consultation team member determines at 197.35the time of the initial assessment of the six-month period that it is appropriate to use the 198.1nursing facility for short-term stays and that there is an adequate plan of care for return to 198.2the home or community-based setting. If a stay exceeds 14 days, the individual must be 198.3referred no later than the first county working day following the 14th resident day for a 198.4screening, which must be completed within five working days of the referral. The payment 198.5limitations in subdivision 7 apply to an individual found at screening to not meet the level 198.6of care criteria for admission to a certified nursing facility.198.7    (c) Persons admitted to a Medicaid-certified nursing facility from the community 198.8on an emergency basis as described in paragraph (d) or from an acute care facility on a 198.9nonworking day must be screened the first working day after admission.198.10    (d) Emergency admission to a nursing facility prior to screening is permitted when 198.11all of the following conditions are met:198.12    (1) a person is admitted from the community to a certified nursing or certified 198.13boarding care facility during county nonworking hours;198.14    (2) a physician has determined that delaying admission until preadmission screening 198.15is completed would adversely affect the person's health and safety;198.16    (3) there is a recent precipitating event that precludes the client from living safely in 198.17the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's 198.18inability to continue to provide care;198.19    (4) the attending physician has authorized the emergency placement and has 198.20documented the reason that the emergency placement is recommended; and198.21    (5) the county is contacted on the first working day following the emergency 198.22admission.198.23Transfer of a patient from an acute care hospital to a nursing facility is not considered 198.24an emergency except for a person who has received hospital services in the following 198.25situations: hospital admission for observation, care in an emergency room without hospital 198.26admission, or following hospital 24-hour bed care.198.27    (e) A nursing facility must provide a written notice to persons who satisfy the criteria 198.28in paragraph (a), clause (3),information to all persons admitted regarding the person's 198.29right to request and receive long-term care consultation services as defined in subdivision 198.301a. The noticeinformation must be provided prior to the person's discharge from the 198.31facility and in a format specified by the commissioner.198.32    Sec. 31. Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to 198.33read:199.1    Subd. 4c. Screening requirements. (a) A person may be screened for nursing 199.2facility admission by telephone or in a face-to-face screening interview. Consultation team 199.3members shall identify each individual's needs using the following categories:199.4    (1) the person needs no face-to-face screening interview to determine the need 199.5for nursing facility level of care based on information obtained from other health care 199.6professionals;199.7    (2) the person needs an immediate face-to-face screening interview to determine the 199.8need for nursing facility level of care and complete activities required under subdivision 199.94a; or199.10    (3) the person may be exempt from screening requirements as outlined in subdivision 199.114b, but will need transitional assistance after admission or in-person follow-along after 199.12a return home.199.13    (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing 199.14facility must be screened prior to admission.199.15    (c) The long-term care consultation team shall recommend a case mix classification 199.16for persons admitted to a certified nursing facility when sufficient information is received 199.17to make that classification. The nursing facility is authorized to conduct all case mix 199.18assessments for persons who have been screened prior to admission for whom the county 199.19did not recommend a case mix classification. The nursing facility is authorized to conduct 199.20all case mix assessments for persons admitted to the facility prior to a preadmission 199.21screening. The county retains the responsibility of distributing appropriate case mix 199.22forms to the nursing facility.199.23    (d) (c) The county screening or intake activity must include processes to identify 199.24persons who may require transition assistance as described in subdivision 3b.199.25    Sec. 32. Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to 199.26read:199.27    Subd. 6. Payment for long-term care consultation services. (a) The total payment 199.28for each county must be paid monthly by certified nursing facilities in the county. The 199.29monthly amount to be paid by each nursing facility for each fiscal year must be determined 199.30by dividing the county's annual allocation for long-term care consultation services by 12 199.31to determine the monthly payment and allocating the monthly payment to each nursing 199.32facility based on the number of licensed beds in the nursing facility. Payments to counties 199.33in which there is no certified nursing facility must be made by increasing the payment 199.34rate of the two facilities located nearest to the county seat.200.1    (b) The commissioner shall include the total annual payment determined under 200.2paragraph (a) for each nursing facility reimbursed under section 
         256B.431 or 
         256B.434200.3according to section 
         256B.431, subdivision 2b, paragraph (g), or 256B.435.200.4    (c) In the event of the layaway, delicensure and decertification, or removal from 200.5layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 200.6the per diem payment amount in paragraph (b) and may adjust the monthly payment 200.7amount in paragraph (a). The effective date of an adjustment made under this paragraph 200.8shall be on or after the first day of the month following the effective date of the layaway, 200.9delicensure and decertification, or removal from layaway.200.10    (d) Payments for long-term care consultation services are available to the county 200.11or counties to cover staff salaries and expenses to provide the services described in 200.12subdivision 1a. The county shall employ, or contract with other agencies to employ, within 200.13the limits of available funding, sufficient personnel to provide long-term care consultation 200.14services while meeting the state's long-term care outcomes and objectives as defined in 200.15section 
         256B.0917, subdivision 1. The county shall be accountable for meeting local 200.16objectives as approved by the commissioner in the biennial home and community-based 200.17services quality assurance plan on a form provided by the commissioner.200.18    (e) Notwithstanding section 
         256B.0641, overpayments attributable to payment of the 200.19screening costs under the medical assistance program may not be recovered from a facility.200.20    (f) The commissioner of human services shall amend the Minnesota medical 200.21assistance plan to include reimbursement for the local consultation teams.200.22    (g) The county may bill, as case management services, assessments, support 200.23planning, and follow-along provided to persons determined to be eligible for case 200.24management under Minnesota health care programs. No individual or family member 200.25shall be charged for an initial assessment or initial support plan development provided 200.26under subdivision 3a or 3b.200.27    Sec. 33. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 200.28subdivision to read:200.29    Subd. 6a.Withholding.If any provider obligated to pay the long-term care 200.30consultation amount as described in subdivision 6 is more than two months delinquent in 200.31the timely payment of the monthly installment, the commissioner may withhold payments, 200.32penalties, and interest in accordance with the methods outlined in section 256.9657, 200.33subdivision 7a. Any amount withheld under this provision must be returned to the county 200.34to whom the delinquent payments were due.201.1    Sec. 34. Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to 201.2read:201.3    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance 201.4reimbursement for nursing facilities shall be authorized for a medical assistance recipient 201.5only if a preadmission screening has been conducted prior to admission or the county has 201.6authorized an exemption. Medical assistance reimbursement for nursing facilities shall 201.7not be provided for any recipient who the local screener has determined does not meet the 201.8level of care criteria for nursing facility placement or, if indicated, has not had a level II 201.9OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 201.101987 completed unless an admission for a recipient with mental illness is approved by the 201.11local mental health authority or an admission for a recipient with developmental disability 201.12is approved by the state developmental disability authority.201.13    (b) The nursing facility must not bill a person who is not a medical assistance 201.14recipient for resident days that preceded the date of completion of screening activities as 201.15required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 201.16resident days in the nursing facility resident day totals reported to the commissioner.201.17    (c) The commissioner shall make a request to the Centers for Medicare and Medicaid 201.18Services for a waiver allowing team approval of Medicaid payments for certified nursing 201.19facility care. An individual has a choice and makes the final decision between nursing 201.20facility placement and community placement after the screening team's recommendation, 201.21except as provided in subdivision 4a, paragraph (c).201.22    Sec. 35. Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to 201.23read:201.24    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.201.25    (a) Funding for services under the alternative care program is available to persons who 201.26meet the following criteria:201.27    (1) the person has been determined by a community assessment under section 201.28256B.0911
          to be a person who would require the level of care provided in a nursing 201.29facility, but for the provision of services under the alternative care program;201.30    (2) the person is age 65 or older;201.31    (3) the person would be eligible for medical assistance within 135 days of admission 201.32to a nursing facility;201.33    (4) the person is not ineligible for the payment of long-term care services by the201.34medical assistance program due to an asset transfer penalty under section 256B.0595 or 201.35equity interest in the home exceeding $500,000 as stated in section 256B.056;202.1    (5) the person needs long-term care services that are not funded through other state 202.2or federal funding;202.3    (6) the monthly cost of the alternative care services funded by the program for 202.4this person does not exceed 75 percent of the monthly limit described under section 202.5256B.0915, subdivision 3a
         . This monthly limit does not prohibit the alternative care client 202.6from payment for additional services, but in no case may the cost of additional services 202.7purchased under this section exceed the difference between the client's monthly service 202.8limit defined under section 
         256B.0915, subdivision 3, and the alternative care program 202.9monthly service limit defined in this paragraph. If medical care-related supplies and 202.10equipment or environmental modifications and adaptations are or will be purchased for 202.11an alternative care services recipient, the costs may be prorated on a monthly basis for 202.12up to 12 consecutive months beginning with the month of purchase. If the monthly cost 202.13of a recipient's other alternative care services exceeds the monthly limit established in 202.14this paragraph, the annual cost of the alternative care services shall be determined. In this 202.15event, the annual cost of alternative care services shall not exceed 12 times the monthly 202.16limit described in this paragraph; and202.17    (7) the person is making timely payments of the assessed monthly fee.202.18A person is ineligible if payment of the fee is over 60 days past due, unless the person 202.19agrees to:202.20    (i) the appointment of a representative payee;202.21    (ii) automatic payment from a financial account;202.22    (iii) the establishment of greater family involvement in the financial management of 202.23payments; or202.24    (iv) another method acceptable to the county lead agency to ensure prompt fee 202.25payments.202.26    The county shall lead agency may extend the client's eligibility as necessary while 202.27making arrangements to facilitate payment of past-due amounts and future premium 202.28payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall 202.29not be reinstated for a period of 30 days.202.30    (b) Alternative care funding under this subdivision is not available for a person 202.31who is a medical assistance recipient or who would be eligible for medical assistance 202.32without a spenddown or waiver obligation. A person whose initial application for medical 202.33assistance and the elderly waiver program is being processed may be served under the 202.34alternative care program for a period up to 60 days. If the individual is found to be eligible 202.35for medical assistance, medical assistance must be billed for services payable under the 202.36federally approved elderly waiver plan and delivered from the date the individual was 203.1found eligible for the federally approved elderly waiver plan. Notwithstanding this 203.2provision, alternative care funds may not be used to pay for any service the cost of which: 203.3(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 203.4or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 203.5to participate in the federally approved elderly waiver program under the special income 203.6standard provision.203.7    (c) Alternative care funding is not available for a person who resides in a licensed 203.8nursing home, certified boarding care home, hospital, or intermediate care facility, except 203.9for case management services which are provided in support of the discharge planning 203.10process for a nursing home resident or certified boarding care home resident to assist with 203.11a relocation process to a community-based setting.203.12    (d) Alternative care funding is not available for a person whose income is greater 203.13than the maintenance needs allowance under section 
         256B.0915, subdivision 1d, but equal 203.14to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal203.15year for which alternative care eligibility is determined, who would be eligible for the 203.16elderly waiver with a waiver obligation.203.17    Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to 203.18read:203.19    Subd. 5. Services covered under alternative care. Alternative care funding may 203.20be used for payment of costs of:203.21    (1) adult day care;203.22    (2) home health aide;203.23    (3) homemaker services;203.24    (4) personal care;203.25    (5) case management;203.26    (6) respite care;203.27    (7) care-related supplies and equipment;203.28    (8) meals delivered to the home;203.29    (9) nonmedical transportation;203.30    (10) nursing services;203.31    (11) chore services;203.32    (12) companion services;203.33    (13) nutrition services;203.34    (14) training for direct informal caregivers;204.1    (15) telehome care to provide services in their own homes in conjunction with 204.2in-home visits;204.3    (16) discretionary services, for which counties may make payment from their 204.4alternative care program allocation or services not otherwise defined in this section 204.5or section 256B.0625, following approval by the commissioner consumer-directed 204.6community services under the alternative care programs which are available statewide and 204.7limited to the average monthly expenditures representative of all alternative care program 204.8participants for the same case mix resident class assigned in the most recent fiscal year for 204.9which complete expenditure data is available;204.10    (17) environmental modifications and adaptations; and204.11    (18) direct cash payments for which counties may make payment from their 204.12alternative care program allocation to clients for the purpose of purchasing services, 204.13following approval by the commissioner, and subject to the provisions of subdivision 5h, 204.14until approval and implementation of consumer-directed services through the federally 204.15approved elderly waiver plan. Upon implementation, consumer-directed services under 204.16the alternative care program are available statewide and limited to the average monthly 204.17expenditures representative of all alternative care program participants for the same case 204.18mix resident class assigned in the most recent fiscal year for which complete expenditure 204.19data is available discretionary services, for which lead agencies may make payment from 204.20their alternative care program allocation for services not otherwise defined in this section 204.21or section 256B.0625, following approval by the commissioner.204.22    Total annual payments for discretionary services and direct cash payments, until 204.23the federally approved consumer-directed service option is implemented statewide, for 204.24all clients within a county may served by a lead agency must not exceed 25 percent of 204.25that county's lead agency's annual alternative care program base allocation. Thereafter, 204.26discretionary services are limited to 25 percent of the county's annual alternative care 204.27program base allocation.204.28    Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to 204.29read:204.30    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in 204.31statute, the services, service definitions, and standards for alternative care services shall 204.32be the same as the services, service definitions, and standards specified in the federally 204.33approved elderly waiver plan, except foralternative care does not cover transitional 204.34support services, assisted living services, adult foster care services, and residential care 205.1services and benefits defined under section 256B.0625 that meet primary and acute 205.2health care needs.205.3    (b) The county lead agency must ensure that the funds are not used to supplant 205.4or supplement services available through other public assistance or services programs., 205.5including supplementation of client co-pays, deductibles, premiums, or other cost-sharing 205.6arrangements for health-related benefits and services or entitlement programs and services 205.7that are available to the person, but in which they have elected not to enroll. For a provider 205.8of supplies and equipment when the monthly cost of the supplies and equipment is less 205.9than $250, persons or agencies must be employed by or under a contract with the county205.10lead agency or the public health nursing agency of the local board of health in order to 205.11receive funding under the alternative care program. Supplies and equipment may be 205.12purchased from a vendor not certified to participate in the Medicaid program if the cost for 205.13the item is less than that of a Medicaid vendor.205.14    (c) Personal care services must meet the service standards defined in the federally 205.15approved elderly waiver plan, except that a county lead agency may contract with a 205.16client's relative who meets the relative hardship waiver requirements or a relative who 205.17meets the criteria and is also the responsible party under an individual service plan that 205.18ensures the client's health and safety and supervision of the personal care services by a 205.19qualified professional as defined in section 
         256B.0625, subdivision 19c. Relative hardship 205.20is established by the county lead agency when the client's care causes a relative caregiver 205.21to do any of the following: resign from a paying job, reduce work hours resulting in lost 205.22wages, obtain a leave of absence resulting in lost wages, incur substantial client-related 205.23expenses, provide services to address authorized, unstaffed direct care time, or meet 205.24special needs of the client unmet in the formal service plan.205.25    Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to 205.26read:205.27    Subd. 8. Requirements for individual care plan. (a) The case manager shall 205.28implement the plan of care for each alternative care client and ensure that a client's 205.29service needs and eligibility are reassessed at least every 12 months. The plan shall 205.30include any services prescribed by the individual's attending physician as necessary to 205.31allow the individual to remain in a community setting. In developing the individual's care 205.32plan, the case manager should include the use of volunteers from families and neighbors, 205.33religious organizations, social clubs, and civic and service organizations to support the 205.34formal home care services. The county lead agency shall be held harmless for damages or 205.35injuries sustained through the use of volunteers under this subdivision including workers' 206.1compensation liability. The county of service case manager shall provide documentation 206.2in each individual's plan of care and, if requested, to the commissioner that the most 206.3cost-effective alternatives available have been offered to the individual and that the 206.4individual was free to choose among available qualified providers, both public and private, 206.5including qualified case management or service coordination providers other than those 206.6employed by any county; however, the county or tribe maintains responsibility for prior 206.7authorizing services in accordance with statutory and administrative requirements. The 206.8case manager must give the individual a ten-day written notice of any denial, termination, 206.9or reduction of alternative care services.206.10    (b) The county of service or tribe must provide access to and arrange for case 206.11management services, including assuring implementation of the plan. "County of service" 206.12has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The county of 206.13service must notify the county of financial responsibility of the approved care plan and 206.14the amount of encumbered funds.206.15    Sec. 39. Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to 206.16read:206.17    Subd. 9. Contracting provisions for providers. Alternative care funds paid to 206.18service providers are subject to audit by the commissioner for fiscal and utilization control.206.19    The lead agency must select providers for contracts or agreements using the 206.20following criteria and other criteria established by the county lead agency:206.21    (1) the need for the particular services offered by the provider;206.22    (2) the population to be served, including the number of clients, the length of time 206.23services will be provided, and the medical condition of clients;206.24    (3) the geographic area to be served;206.25    (4) quality assurance methods, including appropriate licensure, certification, or 206.26standards, and supervision of employees when needed;206.27    (5) rates for each service and unit of service exclusive of county lead agency206.28administrative costs;206.29    (6) evaluation of services previously delivered by the provider; and206.30    (7) contract or agreement conditions, including billing requirements, cancellation, 206.31and indemnification.206.32    The county lead agency must evaluate its own agency services under the criteria 206.33established for other providers.207.1    Sec. 40. Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to 207.2read:207.3    Subd. 10. Allocation formula. (a) The alternative care appropriation for fiscal 207.4years 1992 and beyond shall cover only alternative care eligible clients. By July 1 15 of 207.5each year, the commissioner shall allocate to county agencies the state funds available for 207.6alternative care for persons eligible under subdivision 2.207.7    (b) The adjusted base for each county lead agency is the county's lead agency's207.8current fiscal year base allocation plus any targeted funds approved during the current 207.9fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each 207.10county lead agency, the determination of alternative care program expenditures shall be 207.11based on payments for services rendered from April 1 through March 31 in the base year, 207.12to the extent that claims have been submitted and paid by June 1 of that year.207.13    (c) If the alternative care program expenditures as defined in paragraph (b) are 95 207.14percent or more of the county's lead agency's adjusted base allocation, the allocation for 207.15the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that 207.16inflation is included in the state budget.207.17    (d) If the alternative care program expenditures as defined in paragraph (b) are less 207.18than 95 percent of the county's lead agency's adjusted base allocation, the allocation 207.19for the next fiscal year is the adjusted base allocation less the amount of unspent funds 207.20below the 95 percent level.207.21    (e) If the annual legislative appropriation for the alternative care program is 207.22inadequate to fund the combined county lead agency allocations for a biennium, the 207.23commissioner shall distribute to each county lead agency the entire annual appropriation 207.24as that county's lead agency's percentage of the computed base as calculated in paragraphs 207.25(c) and (d).207.26    (f) On agreement between the commissioner and the lead agency, the commissioner 207.27may have discretion to reallocate alternative care base allocations distributed to lead 207.28agencies in which the base amount exceeds program expenditures.207.29    Sec. 41. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to 207.30read:207.31    Subd. 11. Targeted funding. (a) The purpose of targeted funding is to make 207.32additional money available to counties lead agencies with the greatest need. Targeted 207.33funds are not intended to be distributed equitably among all counties lead agencies, but 207.34rather, allocated to those with long-term care strategies that meet state goals.208.1    (b) The funds available for targeted funding shall be the total appropriation for each 208.2fiscal year minus county lead agency allocations determined under subdivision 10 as 208.3adjusted for any inflation increases provided in appropriations for the biennium.208.4    (c) The commissioner shall allocate targeted funds to counties lead agencies that 208.5demonstrate to the satisfaction of the commissioner that they have developed feasible 208.6plans to increase alternative care spending. In making targeted funding allocations, the 208.7commissioner shall use the following priorities:208.8    (1) counties lead agencies that received a lower allocation in fiscal year 1991 than in 208.9fiscal year 1990. Counties remain in this priority until they have been restored to their 208.10fiscal year 1990 level plus inflation;208.11    (2) counties lead agencies that sustain a base allocation reduction for failure to spend 208.1295 percent of the allocation if they demonstrate that the base reduction should be restored;208.13    (3) counties lead agencies that propose projects to divert community residents from 208.14nursing home placement or convert nursing home residents to community living; and208.15    (4) counties lead agencies that can otherwise justify program growth by 208.16demonstrating the existence of waiting lists, demographically justified needs, or other 208.17unmet needs.208.18    (d) Counties Lead agencies that would receive targeted funds according to 208.19paragraph (c) must demonstrate to the commissioner's satisfaction that the funds 208.20would be appropriately spent by showing how the funds would be used to further the 208.21state's alternative care goals as described in subdivision 1, and that the county has the 208.22administrative and service delivery capability to use them.208.23    (e) The commissioner shall request applications make applications available for 208.24targeted funds by November 1 of each year. The counties lead agencies selected for 208.25targeted funds shall be notified of the amount of their additional funding. Targeted funds 208.26allocated to a county lead agency in one year shall be treated as part of the county's lead 208.27agency's base allocation for that year in determining allocations for subsequent years. No 208.28reallocations between counties lead agencies shall be made.208.29    Sec. 42. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to 208.30read:208.31    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients 208.32to help pay for the cost of participating in the program. The amount of the fee for the 208.33alternative care client shall be determined as follows:208.34    (1) when the alternative care client's income less recurring and predictable medical 208.35expenses is less than 100 percent of the federal poverty guideline effective on July 1 of 209.1the state fiscal year in which the fee is being computed, and total assets are less than 209.2$10,000, the fee is zero;209.3    (2) when the alternative care client's income less recurring and predictable medical 209.4expenses is equal to or greater than 100 percent but less than 150 percent of the federal 209.5poverty guideline effective on July 1 of the state fiscal year in which the fee is being 209.6computed, and total assets are less than $10,000, the fee is five percent of the cost of 209.7alternative care services;209.8    (3) when the alternative care client's income less recurring and predictable medical 209.9expenses is equal to or greater than 150 percent but less than 200 percent of the federal 209.10poverty guidelines effective on July 1 of the state fiscal year in which the fee is being 209.11computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative 209.12care services;209.13    (4) when the alternative care client's income less recurring and predictable medical 209.14expenses is equal to or greater than 200 percent of the federal poverty guidelines effective 209.15on July 1 of the state fiscal year in which the fee is being computed and assets are less than 209.16$10,000, the fee is 30 percent of the cost of alternative care services; and209.17    (5) when the alternative care client's assets are equal to or greater than $10,000, the 209.18fee is 30 percent of the cost of alternative care services.209.19    For married persons, total assets are defined as the total marital assets less the 209.20estimated community spouse asset allowance, under section 
         256B.059, if applicable. For 209.21married persons, total income is defined as the client's income less the monthly spousal 209.22allotment, under section 
         256B.058. 209.23    All alternative care services shall be included in the estimated costs for the purpose 209.24of determining the fee.209.25    Fees are due and payable each month alternative care services are received unless the 209.26actual cost of the services is less than the fee, in which case the fee is the lesser amount.209.27    (b) The fee shall be waived by the commissioner when:209.28    (1) a person who is residing in a nursing facility is receiving case management only;209.29    (2) a married couple is requesting an asset assessment under the spousal 209.30impoverishment provisions;209.31    (3) a person is found eligible for alternative care, but is not yet receiving alternative 209.32care services including case management services; or209.33    (4) a person has chosen to participate in a consumer-directed service plan for which 209.34the cost is no greater than the total cost of the person's alternative care service plan less 209.35the monthly fee amount that would otherwise be assessed.210.1    (c) The county agency must record in the state's receivable system the client's 210.2assessed fee amount or the reason the fee has been waived. The commissioner will bill 210.3and collect the fee from the client. Money collected must be deposited in the general fund 210.4and is appropriated to the commissioner for the alternative care program. The client must 210.5supply the county lead agency with the client's Social Security number at the time of 210.6application. The county lead agency shall supply the commissioner with the client's Social 210.7Security number and other information the commissioner requires to collect the fee from 210.8the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in 210.9chapter 270A and other methods available to the commissioner. The commissioner may 210.10require counties lead agencies to inform clients of the collection procedures that may be 210.11used by the state if a fee is not paid. This paragraph does not apply to alternative care 210.12pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 210.13133, if a county operating under the pilot project reports the following dollar amounts 210.14to the commissioner quarterly:210.15    (1) total fees billed to clients;210.16    (2) total collections of fees billed; and210.17    (3) balance of fees owed by clients.210.18If a county lead agency does not adhere to these reporting requirements, the commissioner 210.19may terminate the billing, collecting, and remitting portions of the pilot project and require 210.20the county lead agency involved to operate under the procedures set forth in this paragraph.210.21    Sec. 43. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to 210.22read:210.23    Subd. 13. County Lead agency biennial plan. The county lead agency biennial 210.24plan for long-term care consultation services under section 
         256B.0911, the alternative 210.25care program under this section, and waivers for the elderly under section 
         256B.0915, 210.26shall be submitted by the lead agency as the home and community-based services quality 210.27assurance plan on a form provided by the commissioner.210.28    Sec. 44. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to 210.29read:210.30    Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless 210.31otherwise specified in statute, providers must be enrolled as Minnesota health care 210.32program providers and abide by the requirements for provider participation according to 210.33Minnesota Rules, part 9505.0195.211.1    (b) Payment for provided alternative care services as approved by the client's 211.2case manager shall occur through the invoice processing procedures of the department's 211.3Medicaid Management Information System (MMIS). To receive payment, the county lead 211.4agency or vendor must submit invoices within 12 months following the date of service. 211.5The county lead agency and its vendors under contract shall not be reimbursed for services 211.6which exceed the county allocation.211.7    (c) The county lead agency shall negotiate individual rates with vendors and may 211.8authorize service payment for actual costs up to the county's current approved rate. 211.9Notwithstanding any other rule or statutory provision to the contrary, the commissioner 211.10shall not be authorized to increase rates by an annual inflation factor, unless so authorized 211.11by the legislature. To improve access to community services and eliminate payment 211.12disparities between the alternative care program and the elderly waiver program, the 211.13commissioner shall establish statewide maximum service rate limits and eliminate 211.14county-specific service rate limits.211.15    (1) Effective July 1, 2001, for service rate limits, except those in subdivision 5, 211.16paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative 211.17care statewide maximum rate or the elderly waiver statewide maximum rate.211.18    (2) Counties Lead agencies may negotiate individual service rates with vendors for 211.19actual costs up to the statewide maximum service rate limit.211.20    Sec. 45. Minnesota Statutes 2006, section 256B.0915, is amended to read:211.21256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.211.22    Subdivision 1. Authority. The commissioner is authorized to apply for a home 211.23and community-based services waiver for the elderly, authorized under section 1915(c) 211.24of the Social Security Act, in order to obtain federal financial participation to expand 211.25the availability of services for persons who are eligible for medical assistance. The 211.26commissioner may apply for additional waivers or pursue other federal financial 211.27participation which is advantageous to the state for funding home care services for the 211.28frail elderly who are eligible for medical assistance. The provision of waivered services 211.29to elderly and disabled medical assistance recipients must comply with the criteria for 211.30service definitions and provider standards approved in the waiver.211.31    Subd. 1a. Elderly waiver case management services. (a) Elderly case management 211.32services under the home and community-based services waiver for elderly individuals are 211.33available from providers meeting qualification requirements and the standards specified 211.34in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case 211.35management services.212.1    Case management services assist individuals who receive waiver services in gaining 212.2access to needed waiver and other state plan services, as well as needed medical, social, 212.3educational, and other services regardless of the funding source for the services to which 212.4access is gained.212.5    A case aide shall provide assistance to the case manager in carrying out 212.6administrative activities of the case management function. The case aide may not assume 212.7responsibilities that require professional judgment including assessments, reassessments, 212.8and care plan development. The case manager is responsible for providing oversight of 212.9the case aide.212.10    Case managers shall be responsible for ongoing monitoring of the provision of 212.11services included in the individual's plan of care. Case managers shall initiate and oversee 212.12the process of assessment and reassessment of the individual's care and review plan of 212.13care at intervals specified in the federally approved waiver plan.212.14    (b) The county of service or tribe must provide access to and arrange for case 212.15management services. County of service has the meaning given it in Minnesota Rules, 212.16part 9505.0015, subpart 11.212.17    Subd. 1b. Provider qualifications and standards. The commissioner must 212.18enroll qualified providers of elderly case management services under the home 212.19and community-based waiver for the elderly under section 1915(c) of the Social 212.20Security Act. The enrollment process shall ensure the provider's ability to meet the 212.21qualification requirements and standards in this subdivision and other federal and state 212.22requirements of this service. An elderly case management provider is an enrolled medical 212.23assistance provider who is determined by the commissioner to have all of the following 212.24characteristics:212.25    (1) the demonstrated capacity and experience to provide the components of 212.26case management to coordinate and link community resources needed by the eligible 212.27population;212.28    (2) administrative capacity and experience in serving the target population for 212.29whom it will provide services and in ensuring quality of services under state and federal 212.30requirements;212.31    (3) a financial management system that provides accurate documentation of services 212.32and costs under state and federal requirements;212.33    (4) the capacity to document and maintain individual case records under state and 212.34federal requirements; and212.35    (5) the countylead agency may allow a case manager employed by the countylead 212.36agency to delegate certain aspects of the case management activity to another individual 213.1employed by the countylead agency provided there is oversight of the individual by 213.2the case manager. The case manager may not delegate those aspects which require 213.3professional judgment including assessments, reassessments, and care plan development.213.4Lead agencies include counties, health plans, and federally recognized tribes who 213.5authorize services under this section.213.6    Subd. 1c.Case management activities under the state plan.The commissioner 213.7shall seek an amendment to the home and community-based services waiver for the 213.8elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner 213.9is unable to secure the approval of the secretary of health and human services for the 213.10requested waiver amendment by December 31, 1993, the commissioner shall amend 213.11the medical assistance state plan to provide that case management provided under the 213.12home and community-based services waiver for the elderly is performed by counties 213.13as an administrative function for the proper and effective administration of the state 213.14medical assistance plan. The state shall reimburse counties for the nonfederal share of 213.15costs for case management performed as an administrative function under the home and 213.16community-based services waiver for the elderly.213.17    Subd. 1d. Posteligibility treatment of income and resources for elderly waiver.213.18    Notwithstanding the provisions of section 
         256B.056, the commissioner shall make the 213.19following amendment to the medical assistance elderly waiver program effective July 1, 213.201999, or upon federal approval, whichever is later. 213.21    A recipient's maintenance needs will be an amount equal to the Minnesota 213.22supplemental aid equivalent rate as defined in section 
         256I.03, subdivision 5, plus the 213.23medical assistance personal needs allowance as defined in section 
         256B.35, subdivision 213.241
         , paragraph (a), when applying posteligibility treatment of income rules to the gross 213.25income of elderly waiver recipients, except for individuals whose income is in excess of 213.26the special income standard according to Code of Federal Regulations, title 42, section 213.27435.236
         . Recipient maintenance needs shall be adjusted under this provision each July 1. 213.28    Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend 213.29the federal waiver and the medical assistance state plan to allowapply:213.30    (1) the spousal impoverishment criteria as authorized under United States Code, title 213.3142, section 1396r-5, and as implemented in sections 
         256B.0575, 
         256B.058, and 
         256B.059, 213.32except that the amendment shall seek to add to;213.33    (2)  the personal needs allowance permitted in section 
         256B.0575,; and213.34    (3) an amount equivalent to the group residential housing rate as set by section 213.35256I.03, subdivision 5
         , and according to the approved federal waiver and medical 213.36assistance state plan. 214.1    Subd. 3. Limits of cases. The number of medical assistance waiver recipients that 214.2a countylead agency may serve must be allocated according to the number of medical 214.3assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be 214.4served with the approval of the commissioner.214.5    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered 214.6services to an individual elderly waiver client shall be the weighted average monthly 214.7nursing facility rate of the case mix resident class to which the elderly waiver client would 214.8be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's 214.9maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first 214.10day of the state fiscal year in which the resident assessment system as described in section 214.11256B.437
          for nursing home rate determination is implemented. Effective on the first day 214.12of the state fiscal year in which the resident assessment system as described in section 214.13256B.437
          for nursing home rate determination is implemented and the first day of each 214.14subsequent state fiscal year, the monthly limit for the cost of waivered services to an 214.15individual elderly waiver client shall be the rate of the case mix resident class to which the 214.16waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 214.17in effect on the last day of the previous state fiscal year, adjusted by the greater of any 214.18legislatively adopted home and community-based services percentage rate increase or the 214.19average statewide percentage increase in nursing facility payment rates. 214.20    (b) If extended medical supplies and equipment or environmental modifications are 214.21or will be purchased for an elderly waiver client, the costs may be prorated for up to 214.2212 consecutive months beginning with the month of purchase. If the monthly cost of a 214.23recipient's waivered services exceeds the monthly limit established in paragraph (a), the 214.24annual cost of all waivered services shall be determined. In this event, the annual cost of 214.25all waivered services shall not exceed 12 times the monthly limit of waivered services as 214.26described in paragraph (a).214.27    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing 214.28facility. (a) For a person who is a nursing facility resident at the time of requesting a 214.29determination of eligibility for elderly waivered services, a monthly conversion limit for 214.30the cost of elderly waivered services may be requested. The monthly conversion limit for 214.31the cost of elderly waiver services shall be the resident class assigned under Minnesota 214.32Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where 214.33the resident currently resides until July 1 of the state fiscal year in which the resident 214.34assessment system as described in section 
         256B.437 for nursing home rate determination 214.35is implemented. Effective on July 1 of the state fiscal year in which the resident 214.36assessment system as described in section 
         256B.437 for nursing home rate determination 215.1is implemented, the monthly conversion limit for the cost of elderly waiver services 215.2shall be the per diem nursing facility rate as determined by the resident assessment 215.3system as described in section 
         256B.437 for that resident in the nursing facility where 215.4the resident currently resides multiplied by 365 and divided by 12, less the recipient's 215.5maintenance needs allowance as described in subdivision 1d. The initially approved 215.6conversion rate may be adjusted by the greater of any subsequent legislatively adopted 215.7home and community-based services percentage rate increase or the average statewide 215.8percentage increase in nursing facility payment rates. The limit under this subdivision 215.9only applies to persons discharged from a nursing facility after a minimum 30-day stay 215.10and found eligible for waivered services on or after July 1, 1997. For conversions from the 215.11nursing home to the elderly waiver with consumer directed community support services, 215.12the conversion rate limit is equal to the nursing facility rate reduced by a percentage equal 215.13to the percentage difference between the consumer directed services budget limit that 215.14would be assigned according to the federally approved waiver plan and the corresponding 215.15community case mix cap, but not to exceed 50 percent.215.16    (b) The following costs must be included in determining the total monthly costs 215.17for the waiver client:215.18    (1) cost of all waivered services, including extended medical supplies and equipment 215.19and environmental modifications and adaptations; and215.20    (2) cost of skilled nursing, home health aide, and personal care services reimbursable 215.21by medical assistance.215.22    Subd. 3c. Service approval and contracting provisions. (a) Medical assistance 215.23funding for skilled nursing services, private duty nursing, home health aide, and personal 215.24care services for waiver recipients must be approved by the case manager and included in 215.25the individual care plan.215.26    (b) A countylead agency is not required to contract with a provider of supplies and 215.27equipment if the monthly cost of the supplies and equipment is less than $250.215.28    Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered 215.29a difficulty of care payment and shall not include room and board. The adult foster 215.30care service rate shall be negotiated between the countylead agency and the foster care 215.31provider. The elderly waiver payment for the foster care service in combination with 215.32the payment for all other elderly waiver services, including case management, must not 215.33exceed the limit specified in subdivision 3a, paragraph (a).215.34    Subd. 3e. Assisted livingCustomized living service rate. (a) Payment for assisted 215.35living servicecustomize living services shall be a monthly rate negotiated and authorized 215.36by the county agency based on an individualized service plan for each resident and may 216.1not cover direct rent or food costs. lead agency within the parameters established by 216.2the commissioner. The payment agreement must delineate the services that have been 216.3customized for each recipient and specify the amount of each service to be provided. The 216.4lead agency shall ensure that there is a documented need for all services authorized. 216.5Customized living services must not include rent or raw food costs. The negotiated 216.6payment rate must be based on services to be provided. Negotiated rates must not exceed 216.7payment rates for comparable elderly waiver or medical assistance services and must 216.8reflect economies of scale.216.9    (b) The individualized monthly negotiated payment for assisted livingcustomized 216.10living services as described in section 256B.0913, subdivisions 5d to 5f, and residential 216.11care services as described in section 256B.0913, subdivision 5c, shall not exceed the 216.12nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit 216.13is being calculated, of the greater of either the statewide or any of the geographic 216.14groups' weighted average monthly nursing facility rate of the case mix resident class 216.15to which the elderly waiver eligible client would be assigned under Minnesota Rules, 216.16parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in 216.17subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident 216.18assessment system as described in section 
         256B.437 for nursing home rate determination 216.19is implemented. Effective on July 1 of the state fiscal year in which the resident 216.20assessment system as described in section 
         256B.437 for nursing home rate determination 216.21is implemented and July 1 of each subsequent state fiscal year, the individualized monthly 216.22negotiated payment for the services described in this clause shall not exceed the limit 216.23described in this clause which was in effect on June 30 of the previous state fiscal year 216.24and which has been adjusted by the greater of any legislatively adopted home and 216.25community-based services cost-of-living percentage increase or any legislatively adopted 216.26statewide percent rate increase for nursing facilities. 216.27    (c) The individualized monthly negotiated payment for assisted Customized living 216.28services described in section 144A.4605 and are delivered by a provider licensed by the 216.29Department of Health as a class A or class F home care provider or an assisted living 216.30home care provider and provided in a building that is registered as a housing with services 216.31establishment under chapter 144D and that provides 24-hour supervision in combination 216.32with the payment for other elderly waiver services, including case management, must not 216.33exceed the limit specified in subdivision 3a. 216.34    Subd. 3f. Individual service rates; expenditure forecasts. (a) The countylead 216.35agency shall negotiate individual service rates with vendors and may authorize payment 216.36for actual costs up to the county'slead agency's current approved rate. Persons or agencies 217.1must be employed by or under a contract with the countylead agency or the public health 217.2nursing agency of the local board of health in order to receive funding under the elderly 217.3waiver program, except as a provider of supplies and equipment when the monthly cost of 217.4the supplies and equipment is less than $250.217.5    (b) Reimbursement for the medical assistance recipients under the approved waiver 217.6shall be made from the medical assistance account through the invoice processing 217.7procedures of the department's Medicaid Management Information System (MMIS), 217.8only with the approval of the client's case manager. The budget for the state share of the 217.9Medicaid expenditures shall be forecasted with the medical assistance budget, and shall 217.10be consistent with the approved waiver.217.11    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access 217.12to community services and eliminate payment disparities between the alternative care 217.13program and the elderly waiver, the commissioner shall establish statewide maximum 217.14service rate limits and eliminate county-specificlead agency-specific service rate limits.217.15    (b) Effective July 1, 2001, for service rate limits, except those described or defined in 217.16subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative 217.17care statewide maximum rate or the elderly waiver statewide maximum rate.217.18    (c) CountiesLead agencies may negotiate individual service rates with vendors for 217.19actual costs up to the statewide maximum service rate limit.217.20    Subd. 3h.Service rate limits; 24-hour customized living services.The payment 217.21rates for 24-hour customized living services is a monthly rate negotiated and authorized by 217.22the lead agency within the parameters established by the commissioner of human services. 217.23The payment agreement must delineate the services that have been customized for each 217.24recipient and specify the amount of each service to be provided. The lead agency shall 217.25ensure that there is a documented need for all services authorized. The lead agency shall 217.26not authorize 24-hour customized living services unless there is a documented need for 217.2724-hour supervision. For purposes of this section, "24-hour supervision" means that the 217.28recipient requires assistance due to needs related to one or more of the following:217.29    (1) intermittent assistance with toileting or transferring;217.30    (2) cognitive or behavioral issues;217.31    (3) a medical condition that requires clinical monitoring; or217.32    (4) other conditions or needs as defined by the commissioner of human services. 217.33The lead agency shall ensure that the frequency and mode of supervision of the recipient 217.34and the qualifications of staff providing supervision are described and meet the needs 217.35of the recipient. Customized living services must not include rent or raw food costs. 217.36The negotiated payment rate for 24-hour customized living services must be based on 218.1services to be provided. Negotiated rates must not exceed payment rates for comparable 218.2elderly waiver or medical assistance services and must reflect economies of scale. The 218.3individually negotiated 24-hour customized living payments, in combination with the 218.4payment for other elderly waiver services, including case management, must not exceed 218.5the recipient's community budget cap specified in subdivision 3a.218.6    Subd. 4. Termination notice. The case manager must give the individual a ten-day 218.7written notice of any denial, reduction, or termination of waivered services.218.8    Subd. 5. Assessments and reassessments for waiver clients. Each client shall 218.9receive an initial assessment of strengths, informal supports, and need for services in 218.10accordance with section 
         256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 218.11client served under the elderly waiver must be conducted at least every 12 months and 218.12at other times when the case manager determines that there has been significant change 218.13in the client's functioning. This may include instances where the client is discharged 218.14from the hospital. 218.15    Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided 218.16a copy of a written care plan that meets the requirements outlined in section 
         256B.0913, 218.17subdivision 8
         . The care plan must be implemented by the county administering waivered 218.18servicesof service when it is different than the county of financial responsibility. The 218.19county of service administering waivered services must notify the county of financial 218.20responsibility of the approved care plan.218.21    Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health 218.22plan is liable for nursing home services or elderly waiver services according to section 218.23256B.69, subdivision 6a
         , is not eligible to also receive county-administered elderly waiver 218.24services under this section. 218.25    Subd. 8. Services and supports. (a) Services and supports shall meet the 218.26requirements set out in United States Code, title 42, section 1396n.218.27    (b) Services and supports shall promote consumer choice and be arranged and 218.28provided consistent with individualized, written care plans.218.29    (c) The state of Minnesota, county, managed care organization, or tribal government 218.30under contract to administer the elderly waiver shall not be liable for damages, injuries, 218.31or liabilities sustained through the purchase of direct supports or goods by the person, 218.32the person's family, or the authorized representatives with funds received through 218.33consumer-directed community support services under the federally approved waiver plan. 218.34Liabilities include, but are not limited to, workers' compensation liability, the Federal 218.35Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).219.1    Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary 219.2provisions of this section, or those in other state laws or rules, the commissioner may 219.3develop a model for tribal management of the elderly waiver program and implement this 219.4model through a contract between the state and any of the state's federally recognized tribal 219.5governments. The model shall include the provision of tribal waiver case management, 219.6assessment for personal care assistance, and administrative requirements otherwise carried 219.7out by countieslead agencies but shall not include tribal financial eligibility determination 219.8for medical assistance.219.9EFFECTIVE DATE.Subdivision 3h is effective the day following final enactment.219.10    Sec. 46. Minnesota Statutes 2006, section 256B.0917, subdivision 8, is amended to 219.11read:219.12    Subd. 8. Living-at-home/block nurse program grant. (a) The organization 219.13awarded the contract under subdivision 7, shall develop and administer a grant program 219.14to establish or expand up to 3351 community-based organizations that will implement 219.15living-at-home/block nurse programs that are designed to enable senior citizens to live as 219.16independently as possible in their homes and in their communities. At least one-half of 219.17the programs must be in counties outside the seven-county metropolitan area. Nonprofit 219.18organizations and units of local government are eligible to apply for grants to establish 219.19the community organizations that will implement living-at-home/block nurse programs. 219.20In awarding grants, the organization awarded the contract under subdivision 7 shall give 219.21preference to nonprofit organizations and units of local government from communities 219.22that:219.23    (1) have high nursing home occupancy rates;219.24    (2) have a shortage of health care professionals;219.25    (3) are located in counties adjacent to, or are located in, counties with existing 219.26living-at-home/block nurse programs; and219.27    (4) meet other criteria established by LAH/BN, Inc., in consultation with the 219.28commissioner.219.29    (b) Grant applicants must also meet the following criteria:219.30    (1) the local community demonstrates a readiness to establish a community model 219.31of care, including the formation of a board of directors, advisory committee, or similar 219.32group, of which at least two-thirds is comprised of community citizens interested in 219.33community-based care for older persons;219.34    (2) the program has sponsorship by a credible, representative organization within 219.35the community;220.1    (3) the program has defined specific geographic boundaries and defined its 220.2organization, staffing and coordination/delivery of services;220.3    (4) the program demonstrates a team approach to coordination and care, ensuring 220.4that the older adult participants, their families, the formal and informal providers are all 220.5part of the effort to plan and provide services; and220.6    (5) the program provides assurances that all community resources and funding will 220.7be coordinated and that other funding sources will be maximized, including a person's 220.8own resources.220.9    (c) Grant applicants must provide a minimum of five percent of total estimated 220.10development costs from local community funding. Grants shall be awarded for four-year 220.11periods, and the base amount shall not exceed $80,000 $100,000 per applicant for the grant 220.12period. The organization under contract may increase the grant amount for applicants from 220.13communities that have socioeconomic characteristics that indicate a higher level of need 220.14for assistance. Subject to the availability of funding, grants and grant renewals awarded or 220.15entered into on or after July 1, 1997, shall be renewed by LAH/BN, Inc. every four years, 220.16unless LAH/BN, Inc. determines that the grant recipient has not satisfactorily operated the 220.17living-at-home/block nurse program in compliance with the requirements of paragraphs 220.18(b) and (d). Grants provided to living-at-home/block nurse programs under this paragraph 220.19may be used for both program development and the delivery of services.220.20    (d) Each living-at-home/block nurse program shall be designed by representatives of 220.21the communities being served to ensure that the program addresses the specific needs of 220.22the community residents. The programs must be designed to:220.23    (1) incorporate the basic community, organizational, and service delivery principles 220.24of the living-at-home/block nurse program model;220.25    (2) provide senior citizens with registered nurse directed assessment, provision and 220.26coordination of health and personal care services on a sliding fee basis as an alternative 220.27to expensive nursing home care;220.28    (3) provide information, support services, homemaking services, counseling, and 220.29training for the client and family caregivers;220.30    (4) encourage the development and use of respite care, caregiver support, and 220.31in-home support programs, such as adult foster care and in-home adult day care;220.32    (5) encourage neighborhood residents and local organizations to collaborate in 220.33meeting the needs of senior citizens in their communities;220.34    (6) recruit, train, and direct the use of volunteers to provide informal services and 220.35other appropriate support to senior citizens and their caregivers; and221.1    (7) provide coordination and management of formal and informal services to senior 221.2citizens and their families using less expensive alternatives.221.3    Sec. 47. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to 221.4read:221.5    Subd. 3. County certification of persons providing adult foster care to related 221.6persons. A person exempt from licensure under section 
         245A.03, subdivision 2, who 221.7provides adult foster care to a related individual age 65 and older, and who meets the 221.8requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the 221.9county to provide adult foster care. A person certified by the county to provide adult foster 221.10care may be reimbursed for services provided and eligible for funding under sections 221.11256B.0913 and section256B.0915, if the relative would suffer a financial hardship as 221.12a result of providing care. For purposes of this subdivision, financial hardship refers 221.13to a situation in which a relative incurs a substantial reduction in income as a result of 221.14resigning from a full-time job or taking a leave of absence without pay from a full-time 221.15job to care for the client. 221.16    Sec. 48. Minnesota Statutes 2006, section 256B.095, is amended to read:221.17256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.221.18    (a) Effective July 1, 1998, a quality assurance system for persons with developmental 221.19disabilities, which includes an alternative quality assurance licensing system for programs, 221.20is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, 221.21Steele, Wabasha, and Winona Counties for the purpose of improving the quality of 221.22services provided to persons with developmental disabilities. A county, at its option, may 221.23choose to have all programs for persons with developmental disabilities located within 221.24the county licensed under chapter 245A using standards determined under the alternative 221.25quality assurance licensing system or may continue regulation of these programs under 221.26the licensing system operated by the commissioner. The project expires on June 30, 221.2720092014.221.28    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to 221.29participate in the quality assurance system established under paragraph (a). The 221.30commission established under section 
         256B.0951 may, at its option, allow additional 221.31counties to participate in the system.221.32    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) 221.33may establish a quality assurance system under this section. A new system established 221.34under this section shall have the same rights and duties as the system established 222.1under paragraph (a). A new system shall be governed by a commission under section 222.2256B.0951
         . The commissioner shall appoint the initial commission members based 222.3on recommendations from advocates, families, service providers, and counties in the 222.4geographic area included in the new system. Counties that choose to participate in a 222.5new system shall have the duties assigned under section 
         256B.0952. The new system 222.6shall establish a quality assurance process under section 
         256B.0953. The provisions of 222.7section 
         256B.0954 shall apply to a new system established under this paragraph. The 222.8commissioner shall delegate authority to a new system established under this paragraph 222.9according to section 
         256B.0955.222.10    (d) Effective July 1, 2007, the quality assurance system may be expanded to include 222.11programs for persons with disabilities and older adults.222.12    Sec. 49. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to 222.13read:222.14    Subdivision 1. Membership. The Quality Assurance Commission is established. 222.15The commission consists of at least 14 but not more than 21 members as follows: at 222.16least three but not more than five members representing advocacy organizations; at 222.17least three but not more than five members representing consumers, families, and their 222.18legal representatives; at least three but not more than five members representing service 222.19providers; at least three but not more than five members representing counties; and the 222.20commissioner of human services or the commissioner's designee. The first commission 222.21shall establish membership guidelines for the transition and recruitment of membership for 222.22the commission's ongoing existence. Members of the commission who do not receive a 222.23salary or wages from an employer for time spent on commission duties may receive a per 222.24diem payment when performing commission duties and functions. All members may be 222.25reimbursed for expenses related to commission activities. Notwithstanding the provisions 222.26of section 
         15.059, subdivision 5, the commission expires on June 30, 20092014.222.27    Sec. 50. [256B.096] QUALITY MANAGEMENT; ASSURANCE; AND 222.28IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY 222.29SERVICES.222.30    Subdivision 1.Scope.In order to improve the quality of services provided to 222.31Minnesotans with disabilities and to meet the requirements of the federally approved home 222.32and community-based waivers under section 1915c of the Social Security Act, a statewide 222.33quality assurance and improvement system for Minnesotans receiving disability services 222.34shall be developed. The disability services included are the home and community-based 223.1services waiver programs for persons with developmental disabilities under section 223.2256B.092, subdivision 4, and persons with disabilities under section 256B.49.223.3    Subd. 2.Stakeholder advisory group.The commissioner shall consult with a 223.4stakeholder advisory group on the development and implementation of the state quality 223.5management, assurance, and improvement system, including representatives from: 223.6disability service recipients, disability service providers, disability advocacy groups, 223.7county human service agencies, and state agency staff from the Departments of Human 223.8Services and Health and ombudsman for mental health and developmental disabilities on 223.9the development of a statewide quality assurance and improvement system.223.10    Subd. 3.Annual survey of service recipients.The commissioner, in consultation 223.11with the stakeholder advisory group, shall develop and conduct an annual independent 223.12random statewide survey of between five and ten percent of service recipients to determine 223.13the effectiveness and quality of disability services. The survey shall be consistent with 223.14the system performance expectations of the Centers for Medicare and Medicaid Services 223.15quality management requirements and framework. The survey shall analyze whether 223.16desired outcomes have been achieved for persons with different demographic, diagnostic, 223.17health, and functional needs and receiving different types of services, in different settings, 223.18with different costs. The survey shall be field tested during 2008 and implemented by 223.19February 1, 2009. Annual statewide and regional reports of the results shall be published 223.20for use by regions, counties, and providers to plan and measure the impact of quality 223.21improvement activities.223.22    Subd. 4.Improvements for incident reporting, investigation, analysis, and 223.23follow-up.In consultation with the stakeholder advisory group, the commissioner shall 223.24identify the information, data sources, and technology needed to improve the system 223.25of incident reporting, including:223.26    (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and223.27    (2) investigation, analysis, and follow-up for disability services.223.28    The commissioner must ensure that the federal home and community-based waiver 223.29requirements are met and that incidents that may have jeopardized safety; health; or 223.30violated service-related assurances, civil and human rights, and other protections designed 223.31to prevent abuse, neglect, and exploitation are reviewed, investigated, and acted upon 223.32in a timely manner.223.33    Subd. 5.Biennial report.The commissioner shall provide a biennial report to the 223.34chairs of the legislative committees with jurisdiction over health and human services 223.35policy and funding beginning January 15, 2009, on the development and activities of the 223.36quality management, assurance, and improvement system designed to meet the federal 224.1requirements under the home and community-based services waiver programs for persons 224.2with disabilities. By January 15, 2008, the commissioner shall provide a preliminary 224.3report on the priorities for meeting the federal requirements, progress on the annual 224.4survey, recommendations for improvements in the incident reporting system, and a plan 224.5for incorporating the quality assurance efforts under section 256B.095 and other regional 224.6efforts into the statewide system.224.7    Sec. 51. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:224.8    Subdivision 1. In general. The commissioner shall determine prospective 224.9payment rates for resident care costs. For rates established on or after July 1, 1985, the 224.10commissioner shall develop procedures for determining operating cost payment rates that 224.11take into account the mix of resident needs, geographic location, and other factors as 224.12determined by the commissioner. The commissioner shall consider whether the fact that a 224.13facility is attached to a hospital or has an average length of stay of 180 days or less should 224.14be taken into account in determining rates. The commissioner shall consider the use of the 224.15standard metropolitan statistical areas when developing groups by geographic location. 224.16The commissioner shall provide notice to each nursing facility on or before May 1 August 224.1715 of the rates effective for the following rate year except that if legislation is pending on 224.18May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the 224.19rates after the legislation is enacted and provide notice to each facility as soon as possible.224.20    Compensation for top management personnel shall continue to be categorized as a 224.21general and administrative cost and is subject to any limits imposed on that cost category.224.22    Sec. 52. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to 224.23read:224.24    Subd. 2e. Contracts for services for ventilator-dependent persons.(a) 224.25The commissioner may negotiate with a nursing facility eligible to receive medical 224.26assistance payments to provide services to a ventilator-dependent person identified by the 224.27commissioner according to criteria developed by the commissioner, including:224.28    (1) nursing facility care has been recommended for the person by a preadmission 224.29screening team;224.30    (2) the person has been hospitalized and no longer requires inpatient acute care 224.31hospital services; and224.32    (3) the commissioner has determined that necessary services for the person cannot 224.33be provided under existing nursing facility rates.225.1    The commissioner may negotiate an adjustment to the operating cost payment 225.2rate for a nursing facility with a resident who is ventilator-dependent, for that resident. 225.3The negotiated adjustment must reflect only the actual additional cost of meeting the 225.4specialized care needs of a ventilator-dependent person identified by the commissioner 225.5for whom necessary services cannot be provided under existing nursing facility rates and 225.6which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or 225.79505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before 225.8July 1, 2001, and have their payment rate under this subdivision negotiated after July 1, 225.92001, the negotiated payment rate must not exceed 200 percent of the highest multiple 225.10bedroom payment rate for the facility, as initially established by the commissioner for the 225.11rate year for case mix classification K; or, upon implementation of the RUG's-based case 225.12mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a 225.13nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300 225.14percent of the facility's multiple bedroom payment rate for case mix classification K; or, 225.15upon implementation of the RUG's-based case mix system, 300 percent of the highest 225.16RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private 225.17paying residents under the provisions of section   
         256B.48, subdivision 1. 225.18    (b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to 225.19care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever 225.20is later, the operating payment rates for residents determined eligible under paragraph (a) 225.21of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds 225.22and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300 225.23percent of the facility's highest RUG rate.225.24    Sec. 53. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to 225.25read:225.26    Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the 225.27rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571 225.28per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom. 225.29For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a 225.30single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060, 225.31subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per 225.32bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060, 225.33subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per 225.34bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060, 225.35subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the 226.1Census: Composite fixed-weighted price index as published in the C30 Report, Value 226.2of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed 226.3Investments in Structures; Special Care. 226.4    (b)  Rental factor. For the rate year beginning July 1, 1988, the commissioner shall 226.5increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8, 226.6item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing 226.7nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation 226.8services used by the state's contracted appraisers. For rate years beginning on or after July 226.91, 1989, the rental factor is the amount determined under this paragraph for the rate year 226.10beginning July 1, 1988. 226.11    (c)  Occupancy factor. For rate years beginning on or after July 1, 1988, in order 226.12to determine property-related payment rates under Minnesota Rules, part 9549.0060, 226.13for all nursing facilities except those whose average length of stay in a skilled level of 226.14care within a nursing facility is 180 days or less, the commissioner shall use 95 percent 226.15of capacity days. For a nursing facility whose average length of stay in a skilled level of 226.16care within a nursing facility is 180 days or less, the commissioner shall use the greater of 226.17resident days or 80 percent of capacity days but in no event shall the divisor exceed 95 226.18percent of capacity days. 226.19    (d)  Equipment allowance. For rate years beginning on July 1, 1988, and July 1, 226.201989, the commissioner shall add ten cents per resident per day to each nursing facility's 226.21property-related payment rate. The ten-cent property-related payment rate increase is not 226.22cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the 226.23commissioner shall increase each nursing facility's equipment allowance as established 226.24in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For 226.25rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be 226.26adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E. 226.27For the rate period beginning October 1, 1992, the equipment allowance for each nursing 226.28facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the 226.29allowance must be adjusted annually for inflation. 226.30    (e)  Post chapter 199 related-organization debts and interest expense. For rate 226.31years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item 226.32E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983, 226.33provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010 226.34to 9510.0480, the debt is subject to repayment through annual principal payments, and 226.35the nursing facility demonstrates to the commissioner's satisfaction that the interest rate 226.36on the debt was less than market interest rates for similar arm's-length transactions at 227.1the time the debt was incurred. If the debt was incurred due to a sale between family 227.2members, the nursing facility must also demonstrate that the seller no longer participates 227.3in the management or operation of the nursing facility. Debts meeting the conditions of 227.4this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010 227.5to 9549.0080. 227.6    (f)  Building capital allowance for nursing facilities with operating leases. For 227.7rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs 227.8incurred for the nursing facility's buildings shall receive its building capital allowance 227.9computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating 227.10lease provides that the lessee's rent is adjusted to recognize improvements made by the 227.11lessor and related debt, the costs for capital improvements and related debt shall be allowed 227.12in the computation of the lessee's building capital allowance, provided that reimbursement 227.13for these costs under an operating lease shall not exceed the rate otherwise paid. 227.14    Sec. 54. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to 227.15read:227.16    Subd. 17e. Replacement-costs-new per bed limit effective July 1, 2001.227.17    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), 227.18for a total replacement, as defined in paragraph (f) subdivision 17d, authorized under 227.19section   
         144A.071 or   
         144A.073 after July 1, 1999, or any building project that is a 227.20relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, the 227.21replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed 227.22rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating 227.23the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 227.249549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be 227.25adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000. 227.26    Sec. 55. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:227.27    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which 227.28have their payment rates determined under this section rather than section 
         256B.431, the 227.29commissioner shall establish a rate under this subdivision. The nursing facility must enter 227.30into a written contract with the commissioner.227.31    (b) A nursing facility's case mix payment rate for the first rate year of a facility's 227.32contract under this section is the payment rate the facility would have received under 227.33section 
         256B.431.228.1    (c) A nursing facility's case mix payment rates for the second and subsequent years 228.2of a facility's contract under this section are the previous rate year's contract payment 228.3rates plus an inflation adjustment and, for facilities reimbursed under this section or 228.4section 
         256B.431, an adjustment to include the cost of any increase in Health Department 228.5licensing fees for the facility taking effect on or after July 1, 2001. The index for the 228.6inflation adjustment must be based on the change in the Consumer Price Index-all items 228.7(United States City average) (CPI-U) forecasted by the commissioner of finance's national 228.8economic consultant, as forecasted in the fourth quarter of the calendar year preceding 228.9the rate year. The inflation adjustment must be based on the 12-month period from the 228.10midpoint of the previous rate year to the midpoint of the rate year for which the rate 228.11is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 228.121, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 228.132007, and July 1, 2008, July 1, 2009, and July 1, 2010, this paragraph shall apply only 228.14to the property-related payment rate, except that adjustments to include the cost of any 228.15increase in Health Department licensing fees taking effect on or after July 1, 2001, shall 228.16be provided. Beginning in 2005, adjustment to the property payment rate under this 228.17section and section 
         256B.431 shall be effective on October 1. In determining the amount 228.18of the property-related payment rate adjustment under this paragraph, the commissioner 228.19shall determine the proportion of the facility's rates that are property-related based on the 228.20facility's most recent cost report. 228.21    (d) The commissioner shall develop additional incentive-based payments of up to 228.22five percent above a facility's operating payment rate for achieving outcomes specified 228.23in a contract. The commissioner may solicit contract amendments and implement those 228.24which, on a competitive basis, best meet the state's policy objectives. The commissioner 228.25shall limit the amount of any incentive payment and the number of contract amendments 228.26under this paragraph to operate the incentive payments within funds appropriated for this 228.27purpose. The contract amendments may specify various levels of payment for various 228.28levels of performance. Incentive payments to facilities under this paragraph may be in the 228.29form of time-limited rate adjustments or onetime supplemental payments. In establishing 228.30the specified outcomes and related criteria, the commissioner shall consider the following 228.31state policy objectives:228.32    (1) successful diversion or discharge of residents to the residents' prior home or other 228.33community-based alternatives;228.34    (2) adoption of new technology to improve quality or efficiency; 228.35    (3) improved quality as measured in the Nursing Home Report Card; 228.36    (4) reduced acute care costs; and229.1    (5) any additional outcomes proposed by a nursing facility that the commissioner 229.2finds desirable.229.3    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 229.4take action to come into compliance with existing or pending requirements of the life 229.5safety code provisions or other federal regulations governing sprinkler systems shall 229.6receive reimbursement for the costs associated with compliance if all of the following 229.7conditions are met:229.8    (1) the expenses associated with compliance occurred on or after January 1, 2005, 229.9and before December 31, 2008;229.10    (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073, 229.11or 256B.434, subdivision 4f; and229.12    (3) the total allowable costs reported under this paragraph are less than the minimum 229.13threshold established under section 256B.431, subdivisions 15, paragraph (e), and 16.229.14The commissioner shall use funds appropriated for this purpose to provide to qualifying 229.15nursing facilities a rate adjustment beginning October 1, 2007, and ending September 229.1630, 2008. Nursing facilities that have expended funds or anticipate the need to expend 229.17funds to satisfy the most recent life safety code requirements by (1) installing a sprinkler 229.18system or (2) replacing all or portions of an existing sprinkler system may submit to the 229.19commissioner by June 30, 2007, on a form provided by the commissioner the actual 229.20costs of a completed project or the estimated costs, based on a project bid, of a planned 229.21project. The commissioner shall calculate a rate adjustment equal to the allowable 229.22costs of the project divided by the resident days reported for the report year ending 229.23September 30, 2006. If the costs from all projects exceed the appropriation for this 229.24purpose, the commissioner shall allocate the funds appropriated on a pro rata basis to the 229.25qualifying facilities by reducing the rate adjustment determined for each facility by an 229.26equal percentage. If the rate adjustments under this subdivision are reduced to fit the 229.27appropriation, facilities may include the portion of the costs that are not reimbursed by 229.28the rate adjustment as part of a project that meets the requirements of subdivision 4f. 229.29If the commissioner determines that there are any unexpended funds for the purposes 229.30of this paragraph, the commissioner may allocate the remainder of the funds to the 229.31qualifying facilities on a pro rata basis for other physical plant changes required by the 229.32nursing facility in order to meet the most recent life safety code compliance standards. 229.33Facilities that used estimated costs when requesting the rate adjustment shall report to 229.34the commissioner by January 31, 2009, on the use of these funds on a form provided by 229.35the commissioner. If the nursing facility fails to provide the report, the commissioner 229.36shall recoup the funds appropriated to the facility for this purpose. If the facility reports 230.1expenditures allowable under this subdivision that are less than the amount received in the 230.2facility's annualized rate adjustment, the commissioner shall recoup the difference.230.3    Sec. 56. Minnesota Statutes 2006, section 256B.434, is amended by adding a 230.4subdivision to read:230.5    Subd. 4i.Nursing facility rate increase effective October 1, 2007; Hennepin 230.6County.For the rate year beginning October 1, 2007, the commissioner shall provide to 230.7a nursing facility in Hennepin County licensed for 268 beds as of February 1, 2007, an 230.8increase in the property payment rate of $6.52 per resident per day. The increase under 230.9this subdivision must be added following the determination under this chapter of the 230.10payment rate for the rate year beginning October 1, 2007, and must be included in the 230.11facility's total payment rate for purposes of determining future rates under this section or 230.12any other section.230.13    Sec. 57. Minnesota Statutes 2006, section 256B.434, is amended by adding a 230.14subdivision to read:230.15    Subd. 4j.Rate increase for facilities in Chisago County.Effective October 230.161, 2007, operating payment rates of all nursing facilities in Chisago County that are 230.17reimbursed under this section or section 256B.441 shall be increased to be equal, for 230.18a RUG's rate with a weight of 1.00, to the geographic group III median rate for the 230.19same RUG's weight. The percentage of the operating payment rate for each facility to 230.20be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that 230.21facility's September 30, 2007, operating payment rate. This subdivision applies only if it 230.22results in a rate increase. Increases provided by this subdivision shall be added to the rate 230.23determined under any new reimbursement system established under section 256B.441.230.24    Sec. 58. Minnesota Statutes 2006, section 256B.434, is amended by adding a 230.25subdivision to read:230.26    Subd. 4k.Nursing facility rate increase effective January 1, 2008; Hennepin 230.27County.Effective January 1, 2008, a nursing facility in Hennepin County licensed for 230.28137 beds as of February 1, 2007, shall receive an increase of $2.81 in each case mix 230.29payment rate to offset property tax payments due as a result of the facility's conversion 230.30from nonprofit to for-profit status. The increase under this subdivision must be added 230.31following the determination under this chapter of the payment rate for the rate year 230.32beginning October 1, 2007, and must be included in the facility's total payment rate for the 230.33purposes of determining future rates under this section or any other section.231.1    Sec. 59. Minnesota Statutes 2006, section 256B.434, is amended by adding a 231.2subdivision to read:231.3    Subd. 4l.Property rate adjustment; Kanabec County.The commissioner 231.4shall allow a property rate adjustment for a facility located in Kanabec County that 231.5was approved for a moratorium exception project in 2001, but experienced a delay and 231.6additional costs associated with the project, and completed the project in 2005. The 231.7property payment rate for the rate years beginning October 1, 2007, and ending September 231.830, 2009, must be $22.73 per resident day. For subsequent years, the property rate of 231.9$22.73 per resident day shall be adjusted as provided in subdivision 4, paragraph (c), as 231.10long as the facility has a contract under this section.231.11    Sec. 60. Minnesota Statutes 2006, section 256B.434, is amended by adding a 231.12subdivision to read:231.13    Subd. 4m.Rate increase for facilities in Rice County.Effective July 1, 2007, 231.14operating payment rates of nursing facilities in Rice County located within two miles 231.15of Scott County or Dakota County that are reimbursed under this section or section 231.16256B.441 must be increased to be equal, for a RUG's rate with a weight of 1.00, to the 231.17geographic group III median rate for the same RUG's weight. The percentage of the 231.18operating payment rate for each facility to be case-mix adjusted must be equal to the 231.19percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment 231.20rate. This subdivision applies only if it results in a rate increase.231.21    Sec. 61. Minnesota Statutes 2006, section 256B.434, is amended by adding a 231.22subdivision to read:231.23    Subd. 4n.Facility rate increase.For the rate year beginning October 1, 2007, a 231.24nursing facility in Faribault County licensed for 50 beds as of April 19, 2006, shall receive 231.25a rate increase of $2.64 in each case mix payment rate to offset property tax payments 231.26due as a result of the facility's conversion from nonprofit to for-profit status. The increase 231.27under this subdivision shall be added to the payment rates in effect for the facility on 231.28September 30, 2007, and shall be included in the facility's total payment rates for the 231.29purposes of determining future rates under this section or any other section.231.30    Sec. 62. Minnesota Statutes 2006, section 256B.434, is amended by adding a 231.31subdivision to read:231.32    Subd. 19.Nursing facility rate increases beginning October 1, 2007, and 231.33October 1, 2008.(a) For the rate year beginning October 1, 2007, the commissioner 232.1shall make available to each nursing facility reimbursed under this section operating 232.2payment rate adjustments equal to three percent of the operating payment rates in effect 232.3on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner 232.4shall make available to each nursing facility reimbursed under this section operating 232.5payment rate adjustments equal to three percent of the operating payment rates in effect 232.6on September 30, 2008.232.7    (b) Seventy-five percent of the money resulting from the rate adjustments under 232.8paragraph (a) must be used for increases in compensation-related costs of eligible 232.9employees. 232.10    (c) For purposes of this subdivision, eligible employees includes all persons directly 232.11employed by the nursing facility on or after the effective date of the rate adjustments, 232.12except:232.13    (1) persons employed in the central office of a corporation that has an ownership 232.14interest in the nursing facility or exercises control over the nursing facility; and 232.15    (2) persons paid by the nursing facility under a management contract.232.16    (d) The commissioner shall allow as compensation-related costs all costs for:232.17    (1) wages and salaries;232.18    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 232.19compensation;232.20    (3) the employer's share of health and dental insurance, life insurance, disability 232.21insurance, long-term care insurance, uniform allowance, and pensions; and232.22    (4) other benefits provided, subject to the approval of the commissioner.232.23    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the 232.24requirements in paragraph (b) shall be provided to nursing facilities effective October 232.251 of each year.232.26    (f) Nursing facilities may apply for the portion of the rate adjustments under 232.27paragraph (a) that is subject to the requirements in paragraph (b). The application 232.28must be submitted to the commissioner within six months of the effective date of the 232.29rate adjustments, and the nursing facility must provide additional information required 232.30by the commissioner within nine months of the effective date of the rate adjustments. 232.31The commissioner must respond to all applications within three weeks of receipt. 232.32The commissioner may waive the deadlines in this paragraph under extraordinary 232.33circumstances, to be determined at the sole discretion of the commissioner. The 232.34application must contain:232.35    (1) an estimate of the amounts of money that must be used as specified in paragraph 232.36(b);233.1    (2) a detailed distribution plan specifying the allowable compensation-related 233.2increases the nursing facility will implement to use the funds available in clause (1);233.3    (3) a description of how the nursing facility will notify eligible employees of 233.4the contents of the approved application, which must provide for giving each eligible 233.5employee a copy of the approved application, excluding the information required in clause 233.6(1), or posting a copy of the approved application, excluding the information required in 233.7clause (1), for a period of at least six weeks in an area of the nursing facility to which all 233.8eligible employees have access; and233.9    (4) instructions for employees who believe they have not received the 233.10compensation-related increases specified in clause (2), as approved by the commissioner, 233.11and which must include a mailing address, e-mail address, and the telephone number 233.12that may be used by the employee to contact the commissioner or the commissioner's 233.13representative.233.14    (g) The commissioner shall ensure that cost increases in distribution plans under 233.15paragraph (f), clause (2), that may be included in approved applications, comply with 233.16requirements in clauses (1) to (4):233.17    (1) costs to be incurred during the applicable rate year resulting from wage and 233.18salary increases implemented prior to the first day of the nursing facility's payroll period 233.19that includes October 1 of each year shall be allowed if they were not used in a prior 233.20year's application;233.21    (2) a portion of the costs resulting from tenure-related wage or salary increases may 233.22be considered to be allowable compensation-related increases, in accordance with existing 233.23formulas that the commissioner shall provide;233.24    (3) the annualized amount of increases in costs for the employer's share of health 233.25and dental insurance, life insurance, disability insurance, and workers' compensation shall 233.26be allowable compensation-related increases if they are effective on or after April 1 of 233.27the year in which the rate adjustments are effective and prior to April 1 of the following 233.28year; and 233.29    (4) for nursing facilities in which employees are represented by an exclusive 233.30bargaining representative, an agreement negotiated and agreed to by the employer and 233.31the exclusive bargaining representative constitutes the plan. The commissioner shall not 233.32review and shall not require changes to the portions of the plan covered by collective 233.33bargaining agreements. A negotiated agreement may constitute the plan only if the 233.34agreement is finalized after the date of enactment of all increases for the rate year and 233.35signed by both parties prior to submission to the commissioner.234.1    (h) The commissioner shall review applications received under paragraph (f) and 234.2shall provide the portion of the rate adjustments under paragraph (b) if the requirements of 234.3this subdivision have been met. The rate adjustments shall be effective October 1 of each 234.4year. Notwithstanding paragraph (a), if the approved application distributes less money 234.5than is available, the amount of the rate adjustment shall be reduced so that the amount of 234.6money made available is equal to the amount to be distributed.234.7    Sec. 63. Minnesota Statutes 2006, section 256B.434, is amended by adding a 234.8subdivision to read:234.9    Subd. 20.Payment of Public Employees Retirement Association costs.Nursing 234.10facilities that participate in the Public Employees Retirement Association (PERA) shall 234.11have the component of their payment rate associated with the costs of PERA determined 234.12for each rate year. Effective for rate years beginning on and after October 1, 2007, the 234.13commissioner shall determine the portion of the payment rate in effect on September 30 234.14each year and shall subtract that amount from the payment rate to be effective on the 234.15following October 1. The portion that shall be deemed to be included in the September 30, 234.162007, rate that is associated with PERA costs shall be the allowed costs in the facility's 234.17base for determining rates under this section, divided by the resident days reported for that 234.18year. The commissioner shall add to the payment rate to be effective on October 1 each 234.19year an amount equal to the reported costs associated with PERA, for the year ended on 234.20the most recent September 30 for which data is available, divided by total resident days 234.21for that year, as reported by the facility and audited under section 256B.441.234.22    Sec. 64. Minnesota Statutes 2006, section 256B.437, is amended by adding a 234.23subdivision to read:234.24    Subd. 11.Big Stone County rate adjustment. Notwithstanding the time period 234.25specified in subdivision 3, the commissioner shall approve a planned closure rate 234.26adjustment in Big Stone County for an eight-bed facility in Clinton for reassignment to a 234.2750-bed facility in Graceville. The adjustment shall be calculated according to subdivisions 234.283 and 6.234.29    Sec. 65. Minnesota Statutes 2006, section 256B.438, subdivision 3, is amended to read:234.30    Subd. 3. Case mix indices. (a) The commissioner of human services shall assign a 234.31case mix index to each resident class based on the Centers for Medicare and Medicaid 234.32Services staff time measurement study and adjusted for Minnesota-specific wage indices. 234.33The case mix indices assigned to each resident class shall be published in the Minnesota 235.1State Register at least 120 days prior to the implementation of the 34 group, RUG-III 235.2resident classification system.235.3    (b) An index maximization approach shall be used to classify residents.235.4    (c) After implementation of the revised case mix system, the commissioner of 235.5human services may annually rebase case mix indices and base rates using more current 235.6data on average wage rates and staff time measurement studies. This rebasing shall be 235.7calculated under subdivision 7, paragraph (b). The commissioner shall publish in the 235.8Minnesota State Register adjusted case mix indices at least 45 days prior to the effective 235.9date of the adjusted case mix indices.235.10    Sec. 66. Minnesota Statutes 2006, section 256B.439, subdivision 1, is amended to read:235.11    Subdivision 1. Development and implementation of quality profiles. (a) The 235.12commissioner of human services, in cooperation with the commissioner of health, shall 235.13develop and implement a quality profile system for nursing facilities and, beginning not 235.14later than July 1, 2004, other providers of long-term care services, except when the quality 235.15profile system would duplicate requirements under section 
         256B.5011, 
         256B.5012, or 235.16256B.5013
         . Beginning July 1, 2008, the commissioners shall include quality profiles of 235.17nursing homes that are not medical assistance certified in the Minnesota Nursing Home 235.18Report Card. The nonmedical assistance certified nursing homes may provide to the 235.19commissioners information necessary to conduct consumer satisfaction surveys and to 235.20determine other quality measures. The system must be developed and implemented to the 235.21extent possible without the collection of significant amounts of new data. To the extent 235.22possible, the system must incorporate or be coordinated with information on quality 235.23maintained by area agencies on aging, long-term care trade associations, and other entities. 235.24The system must be designed to provide information on quality to: 235.25    (1) consumers and their families to facilitate informed choices of service providers;235.26    (2) providers to enable them to measure the results of their quality improvement 235.27efforts and compare quality achievements with other service providers; and235.28    (3) public and private purchasers of long-term care services to enable them to 235.29purchase high-quality care.235.30    (b) The system must be developed in consultation with the long-term care task force, 235.31area agencies on aging, and representatives of consumers, providers, and labor unions. 235.32Within the limits of available appropriations, the commissioners may employ consultants 235.33to assist with this project.235.34    Sec. 67. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:236.1    Subdivision 1. Rate determination Rebasing of nursing facility operating cost 236.2payment rates. (a) The commissioner shall establish a value-based nursing facility 236.3reimbursement system which will provide facility-specific, prospective rates for nursing 236.4facilities participating in the medical assistance program. The rates shall be determined 236.5using an annual statistical and cost report filed by each nursing facility. The total payment 236.6rate shall be composed of four rate components: direct care services, support services, 236.7external fixed, and property-related rate components. The payment rate shall be derived 236.8from statistical measures of actual costs incurred in facility operation of nursing facilities. 236.9From this cost basis, the components of the total payment rate shall be adjusted for quality 236.10of services provided, recognition of staffing levels, geographic variation in labor costs, and 236.11resident acuity. The commissioner shall rebase nursing facility operating cost payment 236.12rates to align payments to facilities with the cost of providing care. The rebased operating 236.13cost payment rates shall be calculated using the statistical and cost report filed by each 236.14nursing facility for the report period ending one year prior to the rate year.236.15    (b) Rates shall be rebased annually. The new operating cost payment rates based on 236.16this section shall take effect beginning with the rate year beginning October 1, 2009, and 236.17shall be phased in over three rate years through October 1, 2011.236.18    (c) Operating cost payment rates shall be rebased on October 1, 2012, and every 236.19two years after that date.236.20    (d) Operating cost payment rates for rate years in which rebasing does not occur 236.21shall be increased by the Global Insight SNF Market Basket inflation factor from the 236.22midpoint of the previous rate year to the midpoint of the next rate year.236.23    (e) Each cost reporting year shall begin on October 1 and end on the following 236.24September 30. Beginning in 2006, a statistical and cost report shall be filed by each 236.25nursing facility by January 15. Notice of rates shall be distributed by August 15 and the 236.26rates shall go into effect on October 1 for one year.236.27    (c) The commissioner shall begin to phase in the new reimbursement system 236.28beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.236.29    Sec. 68. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:236.30    Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to 236.3142 42a  have the meanings given unless otherwise provided for in this section.236.32    Sec. 69. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:236.33    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for 236.34administering the overall activities of the nursing home. These costs include salaries and 237.1wages of the administrator, assistant administrator, business office employees, security 237.2guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases 237.3related to business office functions, licenses, and permits except as provided in the 237.4external fixed costs category, employee recognition, travel including meals and lodging, 237.5training, voice and data communication or transmission, office supplies, liability insurance 237.6and other forms of insurance not designated to other areas, personnel recruitment, legal 237.7services, accounting services, management or business consultants, data processing, 237.8information technology, Web site, central or home office costs, business meetings and 237.9seminars, postage, fees for professional organizations, subscriptions, security services, 237.10advertising, board of director's fees, working capital interest expense, and bad debts and 237.11bad debt collection fees.237.12    Sec. 70. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:237.13    Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the facility 237.14which are necessary for the operation of the facility and the care of residents and which 237.15are reviewed by the department for accuracy, reasonableness, and compliance with this 237.16section and generally accepted accounting principles. All references to costs in this section 237.17shall be assumed to refer to allowed costs.237.18    Sec. 71. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to 237.19read:237.20    Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages 237.21of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees 237.22assigned to the kitchen and dining room, and associated fringe benefits and payroll 237.23taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs 237.24of raw food (both normal and special diet food), dietary supplies, and food preparation 237.25and serving. Also included are special dietary supplements used for tube feeding or oral 237.26feeding, such as elemental high nitrogen diet, even if written as a prescription item by a 237.27physician.237.28    Sec. 72. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to 237.29read:237.30    Subd. 11. Direct care costs category."Direct care costs category" "Direct care 237.31costs" means costs for nursing services, activities, and social services the wages of nursing 237.32administration, staff education, direct care registered nurses, licensed practical nurses, 237.33certified nursing assistants, trained medication aides, and associated fringe benefits and 238.1payroll taxes; services from a supplemental nursing services agency; supplies that are 238.2stocked at nursing stations or on the floor and distributed or used individually, including, 238.3but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice 238.4bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas, 238.5enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products, 238.6thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic 238.7agents, drugs that are not paid for on a separate fee schedule by the medical assistance 238.8program or any other payer, and technology related to the provision of nursing care to 238.9residents, such as electronic charting systems.238.10    Sec. 73. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to 238.11read:238.12    Subd. 13. External fixed costs category."External fixed costs category" "External 238.13fixed costs"  means costs related to the nursing home surcharge under section 
         256.9657, 238.14subdivision 1
         ; licensure fees under section 
         144.122; long-term care consultation fees 238.15under section 
         256B.0911, subdivision 6; family advisory council fee under section 238.16 144A.33
         ; scholarships under section 
         256B.431, subdivision 36; planned closure rate 238.17adjustments under section 256B.436 or256B.437; or single bed room incentives under 238.18section 256B.431, subdivision 42; property taxes and property insurance; and PERA.238.19    Sec. 74. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to 238.20read:238.21    Subd. 14. Facility average case mix index. "Facility average case mix index" or 238.22"CMI" means a numerical value score that describes the relative resource use for all 238.23residents within the groups under the resource utilization group (RUG-III) classification 238.24system prescribed by the commissioner based on an assessment of each resident. The 238.25facility average CMI shall be computed as the standardized days divided by total days for 238.26all residents in the facility. The RUG's weights used in this section shall be as follows 238.27for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB 238.281.109; RAA 0.957; SSC 1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2 238.291.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676; 238.30BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023; 238.31PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1 238.320.651; and DDF 1.000239.1    Sec. 75. Minnesota Statutes 2006, section 256B.441, is amended by adding a 239.2subdivision to read:239.3    Subd. 14a.Facility type groups.Facilities shall be classified into two groups, 239.4called "facility type groups," which shall consist of:239.5    (1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota 239.6Rules, parts 9570.2000 to 9570.3400; and 239.7    (2) freestanding: all other facilities.239.8    Sec. 76. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to 239.9read:239.10    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group 239.11life, health, dental, workers' compensation, and other employee insurances and pension, 239.12profit-sharing, and retirement plans for which the employer pays all or a portion of the 239.13costs and that are available to at least all employees who work at least 20 hours per week.239.14    Sec. 77. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to 239.15read:239.16    Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the 239.17salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning 239.18employees and associated fringe benefits and payroll taxes. It also includes the cost of 239.19housekeeping supplies, including, but not limited to,  cleaning and lavatory supplies and 239.20contract services.239.21    Sec. 78. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to 239.22read:239.23    Subd. 24. Maintenance and plant operations costs. "Maintenance and plant 239.24operations costs" means the costs for the salaries and wages of the maintenance supervisor, 239.25engineers, heating-plant employees, and other maintenance employees and associated 239.26fringe benefits and payroll taxes. It also includes direct costs for maintenance and 239.27operation of the building and grounds, including, but not limited to,  fuel, electricity, 239.28medical waste and garbage removal, water, sewer, supplies, tools, and repairs.239.29    Sec. 79. Minnesota Statutes 2006, section 256B.441, is amended by adding a 239.30subdivision to read:239.31    Subd. 28a.Other direct care costs."Other direct care costs" means the costs 239.32for the salaries and wages and associated fringe benefits and payroll taxes of mental 240.1health workers, religious personnel, and other direct care employees not specified in 240.2the definition of direct care costs. 240.3    Sec. 80. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to 240.4read:240.5    Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer 240.6groups," which by county. The groups  shall consist of:240.7    (1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed 240.8per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000 240.9to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota, 240.10Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott, 240.11Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;240.12    (2) boarding care homes - facilities that have more than 50 percent of their beds 240.13licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth, 240.14Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, 240.15Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, 240.16Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, 240.17Watonwan, or Wilkin County; and240.18    (3) standard - all other facilities group three: facilities in all other counties.240.19    Sec. 81. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to 240.20read:240.21    Subd. 31. Prior rate-setting method system operating cost payment rate."Prior 240.22rate-setting method" "Prior system operating cost payment rate"  means the operating cost 240.23payment rate determination process in effect prior to October 1, 2006 on September 30, 240.242009, under Minnesota Rules and Minnesota Statutes, not including planned closure rate 240.25adjustments under section 256B.436 or 256B.437, or single bed room incentives under 240.26section 256B.431, subdivision 42.240.27    Sec. 82. Minnesota Statutes 2006, section 256B.441, is amended by adding a 240.28subdivision to read:240.29    Subd. 33a.Raw food costs."Raw food costs" means the cost of food provided to 240.30nursing facility residents. Also included are special dietary supplements used for tube 240.31feeding or oral feeding, such as elemental high nitrogen diet.241.1    Sec. 83. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to 241.2read:241.3    Subd. 34. Related organization. "Related organization" means a person that 241.4furnishes goods or services to a nursing facility and that is a close relative of a nursing 241.5facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility, 241.6or an affiliate of a close relative of an affiliate of a nursing facility. As used in this 241.7subdivision, paragraphs (a) to (d) apply:241.8    (a) "Affiliate" means a person that directly, or indirectly through one or more 241.9intermediaries, controls or is controlled by, or is under common control with another 241.10person.241.11    (b) "Person" means an individual, a corporation, a partnership, an association, a 241.12trust, an unincorporated organization, or a government or political subdivision.241.13    (c) "Close relative of an affiliate of a nursing facility" means an individual whose 241.14relationship by blood, marriage, or adoption to an individual who is an affiliate of a 241.15nursing facility is no more remote than first cousin.241.16    (d) "Control" including the terms "controlling," "controlled by," and "under common 241.17control with" means the possession, direct or indirect, of the power to direct or cause the 241.18direction of the management, operations, or policies of a person, whether through the 241.19ownership of voting securities, by contract, or otherwise, or to influence in any manner 241.20other than through an arms length, legal transaction.241.21    Sec. 84. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to 241.22read:241.23    Subd. 38. Social services costs. "Social services costs" means the costs for the 241.24salaries and wages of the supervisor and other social work employees, associated fringe 241.25benefits and payroll taxes, supplies, services, and consultants. This category includes the 241.26cost of those employees who manage and process admission to the nursing facility.241.27    Sec. 85. Minnesota Statutes 2006, section 256B.441, is amended by adding a 241.28subdivision to read:241.29    Subd. 42a.Therapy costs."Therapy costs" means any costs related to medical 241.30assistance therapy services provided to residents that are not billed separately from the 241.31daily operating rate.241.32    Sec. 86. Minnesota Statutes 2006, section 256B.441, is amended by adding a 241.33subdivision to read:242.1    Subd. 48.Calculation of operating per diems.The direct care per diem for 242.2each facility shall be the facility's direct care costs divided by its standardized days. 242.3The other care-related per diem shall be the sum of the facility's activities costs, other 242.4direct care costs, raw food costs, therapy costs, and social services costs, divided by the 242.5facility's resident days. The other operating per diem shall be the sum of the facility's 242.6administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance 242.7and plant operations costs divided by the facility's resident days.242.8    Sec. 87. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.9subdivision to read:242.10    Subd. 49.Determination of total care-related per diem.The total care-related 242.11per diem for each facility shall be the sum of the direct care per diem and the other 242.12care-related per diem.242.13    Sec. 88. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.14subdivision to read:242.15    Subd. 50.Determination of total care-related limit.The limit on the total 242.16care-related per diem shall be determined for each peer group and facility type group 242.17combination. A facility's total care-related per diems shall be limited to 120 percent of the 242.18median for the facility's peer and facility type group. The facility-specific direct care costs 242.19used in making this comparison and in the calculation of the median shall be based on a 242.20RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per 242.21diem reduced to the limit. If a reduction of the total care-related per diem is necessary 242.22because of this limit, the reduction shall be made proportionally to both the direct care per 242.23diem and the other care-related per diem.242.24    Sec. 89. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.25subdivision to read:242.26    Subd. 51.Determination of other operating limit.The limit on the other operating 242.27per diem shall be determined for each peer group. A facility's other operating per diem 242.28shall be limited to 105 percent of the median for its peer group. A facility that is above 242.29that limit shall have its other operating per diem reduced to the limit.242.30    Sec. 90. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.31subdivision to read:243.1    Subd. 52.Determination of efficiency incentive.Each facility shall be eligible 243.2for an efficiency incentive based on its other operating per diem. A facility with an other 243.3operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency 243.4incentive. All other facilities shall receive an incentive calculated as 50 percent times the 243.5difference between the facility's other operating per diem and its other operating per diem 243.6limit, up to a maximum incentive of $3.243.7    Sec. 91. Minnesota Statutes 2006, section 256B.441, is amended by adding a 243.8subdivision to read:243.9    Subd. 53.Calculation of payment rate for external fixed costs.The commissioner 243.10shall calculate a payment rate for external fixed costs.243.11    (a) For a facility licensed as a nursing home, the portion related to section 256.9657 243.12shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care 243.13home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the 243.14result of its number of nursing home beds divided by its total number of licensed beds.243.15    (b) The portion related to the licensure fee under section 144.122, paragraph (d), 243.16shall be the amount of the fee divided by actual resident days.243.17    (c) The portion related to scholarships shall be determined under section 256B.431, 243.18subdivision 36.243.19    (d) The portion related to long-term care consultation shall be determined according 243.20to section 256B.0911, subdivision 6.243.21    (e) The portion related to development and education of resident and family advisory 243.22councils under section 144A.33 shall be $5 divided by 365.243.23    (f) The portion related to planned closure rate adjustments shall be as determined 243.24under sections 256B.436 and 256B.437, subdivision 6.243.25    (g) The portions related to property insurance, real estate taxes, special assessments, 243.26and payments made in lieu of real estate taxes directly identified or allocated to the nursing 243.27facility shall be the actual amounts divided by actual resident days.243.28    (h) The portion related to the Public Employees Retirement Association shall be 243.29actual costs divided by resident days.243.30    (i) The single bed room incentives shall be as determined under section 256B.431, 243.31subdivision 42.243.32    (j) The payment rate for external fixed costs shall be the sum of the amounts in 243.33paragraphs (a) to (i).244.1    Sec. 92. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.2subdivision to read:244.3    Subd. 54.Adjustment of per diem for inflation.The total care-related per diem 244.4and other operating per diem calculated under this section shall be adjusted for inflation to 244.5adjust for the delay between the reporting year and the rate year. The total care-related 244.6payment rate and other operating payment rate shall be calculated as the per diem 244.7increased by the Global Insight Consumer Price Index urban inflation factor for the period 244.8from the midpoint of the reporting year to the midpoint of the rate year. 244.9    Sec. 93. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.10subdivision to read:244.11    Subd. 55.Determination of total payment rates.In rate years when rates are 244.12rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total 244.13care-related payment rate, other operating payment rate, efficiency incentive, external 244.14fixed cost rate, and the property rate determined under section 256B.434. To determine 244.15a total payment rate for each RUG's level, the total care-related payment rate shall be 244.16divided into the direct care payment rate and the other care-related payment rate, and the 244.17direct care payment rate multiplied by the RUG's weight for each RUG's level using the 244.18weights in subdivision 14.244.19    Sec. 94. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.20subdivision to read:244.21    Subd. 56.Phase-in of rebased operating cost payment rates.For the rate years 244.22beginning October 1, 2009, October 1, 2010, and October 1, 2011, the operating cost 244.23payment rate calculated under this section shall be phased in by blending it with the 244.24operating cost payment rate determined under section 256B.434. For the rate year 244.25beginning October 1, 2009, the operating cost payment rate for each facility shall be 244.2625 percent of the operating cost payment rate from this section, and 75 percent of the 244.27operating cost payment rate from section 256B.434. For the rate year beginning October 1, 244.282010, the operating cost payment rate for each facility shall be 35 percent of the operating 244.29cost payment rate from this section, and 65 percent of the operating cost payment rate 244.30from section 256B.434. For the rate year beginning October 1, 2011, the operating cost 244.31payment rate for each facility shall be the operating cost payment rate determined under 244.32this section. The blending of operating cost payment rates under this section shall be 244.33performed separately for each RUG's class.245.1    Sec. 95. Minnesota Statutes 2006, section 256B.441, is amended by adding a 245.2subdivision to read:245.3    Subd. 57.Adjustment for inflation during phase-in of rebased operating cost 245.4payment rates.During the phase-in of operating cost payment rates under subdivision 245.556, both the operating costs per diem under this section and the operating cost payment 245.6rate under section 256B.434 shall be adjusted for inflation. The adjustment for each year 245.7for the operating cost per diems shall be the Global Insight Consumer Price Index urban 245.8inflation factor from the midpoint of the reporting year to the midpoint of the current rate 245.9year. The adjustment for each year for the operating cost payment rate under section 245.10256B.434 shall be the Global Insight Consumer Price Index urban inflation factor from the 245.11midpoint of the October 1, 2007, rate year to the midpoint of the current rate year.245.12    Sec. 96. Minnesota Statutes 2006, section 256B.441, is amended by adding a 245.13subdivision to read:245.14    Subd. 58.Hold harmless.For the rate years beginning October 1, 2009, October 1, 245.152010, and October 1, 2011, no nursing facility shall receive an operating cost payment 245.16rate less than its operating cost payment rate under section 256B.434. The comparison 245.17of operating cost payment rates under this section shall be made for each of the RUG's 245.18classes separately, and the operating cost payment rates under section 256B.434 used 245.19under this section shall not include the inflation increases described in subdivision 57.245.20    Sec. 97. Minnesota Statutes 2006, section 256B.441, is amended by adding a 245.21subdivision to read:245.22    Subd. 59.Appeals.Nursing facilities may appeal, as defined under section 256B.50, 245.23the determination of a payment rate established under this chapter.245.24    Sec. 98. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:245.25    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and 245.26community-based service waivers, as authorized under section 1915(c) of the Social 245.27Security Act to serve persons under the age of 65 who are determined to require the level 245.28of care provided in a nursing home and persons who require the level of care provided in a 245.29hospital. The commissioner shall apply for the home and community-based waivers in 245.30order to:245.31    (i) promote the support of persons with disabilities in the most integrated settings;245.32    (ii) expand the availability of services for persons who are eligible for medical 245.33assistance;246.1    (iii) promote cost-effective options to institutional care; and246.2    (iv) obtain federal financial participation.246.3    (b) The provision of waivered services to medical assistance recipients with 246.4disabilities shall comply with the requirements outlined in the federally approved 246.5applications for home and community-based services and subsequent amendments, 246.6including provision of services according to a service plan designed to meet the needs of 246.7the individual. For purposes of this section, the approved home and community-based 246.8application is considered the necessary federal requirement.246.9    (c) The commissioner shall provide interested persons serving on agency advisory 246.10committees and, task forces, the Centers for Independent Living, and others upon who246.11request, with to be on a list to receive, notice of, and an opportunity to comment on, 246.12at least 30 days before any effective dates, (1) any substantive changes to the state's 246.13disability services program manual, or (2) changes or amendments to the federally 246.14approved applications for home and community-based waivers, prior to their submission 246.15to the federal Centers for Medicare and Medicaid Services.246.16    (d) The commissioner shall seek approval, as authorized under section 1915(c) of 246.17the Social Security Act, to allow medical assistance eligibility under this section for 246.18children under age 21 without deeming of parental income or assets.246.19    (e) The commissioner shall seek approval, as authorized under section 1915(c) of 246.20the Social Act, to allow medical assistance eligibility under this section for individuals 246.21under age 65 without deeming the spouse's income or assets.246.22    Sec. 99. Minnesota Statutes 2006, section 256B.49, is amended by adding a 246.23subdivision to read:246.24    Subd. 16a.Medical assistance reimbursement.(a) The commissioner shall 246.25seek federal approval for medical assistance reimbursement of independent living skills 246.26services, foster care waiver service, supported employment, prevocational service, 246.27structured day service, and adult day care under the home and community-based waiver 246.28for persons with a traumatic brain injury, the community alternatives for disabled 246.29individuals waivers, and the community alternative care waivers.246.30    (b) Medical reimbursement shall be made only when the provider demonstrates 246.31evidence of its capacity to meet basic health, safety, and protection standards through 246.32one of the methods in paragraphs (c) to (e).246.33    (c) The provider is licensed to provide services under chapter 245B and agrees to 246.34apply these standards to services funded through the traumatic brain injury, community 247.1alternatives for disabled, or community alternative care home and community-based 247.2waivers.247.3    (d) The local agency contracting for the services certifies on a form provided by the 247.4commissioner that the provider has the capacity to meet the individual needs as identified 247.5in each person's individual service plan. When certifying that the service provider meets 247.6the necessary provider qualifications, the local agency shall verify that the provider has 247.7policies and procedures governing the following:247.8    (1) protection of the consumer's rights and privacy;247.9    (2) risk assessment and planning;247.10    (3) record keeping and reporting of incidents and emergencies with documentation 247.11of corrective action if needed;247.12    (4) service outcomes, regular reviews of progress, and periodic reports;247.13    (5) complaint and grievance procedures;247.14    (6) service termination or suspension;247.15    (7) necessary training and supervision of direct care staff that includes:247.16    (i) documentation in personnel files of 20 hours of orientation training in providing 247.17training related to service provision;247.18    (ii) training in recognizing the symptoms and effects of certain disabilities, health 247.19conditions, and positive behavioral supports and interventions; and 247.20    (iii) a minimum of five hours of related training annually; and 247.21    (8) when applicable, the local agency shall verify that the provider has policies and 247.22procedures in place governing the following:247.23    (i) safe medication administration;247.24    (ii) proper handling of consumer funds; and 247.25    (iii) behavioral interventions that are in compliance with prohibitions and standards 247.26developed by the commissioner to meet federal requirements regarding the use of 247.27restraints and restrictive interventions.247.28    (e) For foster care waiver services or independent living skills services, the local 247.29agency contracting for the services certifies on a form provided by the commissioner that 247.30the provider meets the following:247.31    (1) the provider of foster care waiver services is licensed to provide adult foster 247.32care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under 247.33Minnesota Rules, parts 2960.3000 to 2960.3230;247.34    (2) the provider of independent living skills services also provides licensed foster 247.35care services and agrees to apply the foster care standards under Minnesota Rules, parts 247.369555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225, subpart 248.18; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts 10 248.2and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of those 248.3services; and248.4    (3) the provider has policies and procedures applying to the provision of foster 248.5care waiver services or independent living skills services that govern (i) behavioral 248.6interventions that are in compliance with prohibitions and standards developed by the 248.7commissioner to meet federal requirements regarding the use of restraints and restrictive 248.8interventions and (ii) documentation of service needs and outcomes, regular reviews 248.9of progress, and periodic reports.248.10    (f) The local agency shall review each provider's continued compliance with 248.11the basic health, safety, and protection standards on a regular basis. For the review 248.12of paragraph (e), the local agency shall coordinate the review with the county review 248.13of foster care licensure.248.14EFFECTIVE DATE.This section is effective the day following final enactment.248.15    Sec. 100. Minnesota Statutes 2006, section 256B.5012, is amended by adding a 248.16subdivision to read:248.17    Subd. 7.ICF/MR rate increases October 1, 2007, and October 1, 2008.(a) For 248.18the rate periods beginning October 1, 2007, and October 1, 2008, the commissioner shall 248.19make available to each facility reimbursed under this section an adjustment to the total 248.20operating payment rate of three percent.248.21    (b) Seventy-five percent of the money resulting from the rate adjustment under 248.22paragraph (a) must be used to increase wages and benefits and pay associated costs for 248.23employees, except for administrative and central office employees. Seventy-five percent 248.24of the money received by a facility as a result of the rate adjustment provided in paragraph 248.25(a) must be used only for wage, benefit, and staff increases implemented on or after 248.26the effective date of the rate increase each year, and must not be used for increases 248.27implemented prior to that date. The wage adjustment eligible employees may receive may 248.28vary based on merit, seniority, or other factors determined by the provider.248.29    (c) For each facility, the commissioner shall make available an adjustment, based 248.30on occupied beds, using the percentage specified in paragraph (a) multiplied by the total 248.31payment rate, including variable rate but excluding the property-related payment rate, in 248.32effect on the preceding day. The total payment rate must include the adjustment provided 248.33in section 256B.501, subdivision 12.249.1    (d) A facility whose payment rates are governed by closure agreements, receivership 249.2agreements, or Minnesota Rules, part 9553.0075, is not eligible for an adjustment 249.3otherwise granted under this subdivision.249.4    (e) A facility may apply for the portion of the payment rate adjustment provided 249.5under paragraph (a) for employee wages and benefits and associated costs. The application 249.6must be made to the commissioner and contain a plan by which the facility will distribute 249.7the funds according to paragraph (b). For facilities in which the employees are represented 249.8by an exclusive bargaining representative, an agreement negotiated and agreed to by 249.9the employer and the exclusive bargaining representative constitutes the plan. The 249.10commissioner shall not review, and shall not require changes, to the portion or portions 249.11of the plan covered by collective bargaining agreements. A negotiated agreement may 249.12constitute the plan only if the agreement is finalized after the date of enactment of all rate 249.13increases for the rate year. The commissioner shall review the plan to ensure that the 249.14payment rate adjustment per diem is used as provided in this subdivision. To be eligible, a 249.15facility must submit its plan by March 31, 2008, and December 31, 2008, respectively. 249.16If a facility's plan is effective for its employees after the first day of the applicable rate 249.17period that the funds are available, the payment rate adjustment per diem is effective 249.18the same date as its plan.249.19    (f) A copy of the approved distribution plan must be made available to all employees 249.20by giving each employee a copy or by posting it in an area of the facility to which all 249.21employees have access. If an employee does not receive the wage and benefit adjustment 249.22described in the facility's approved plan and is unable to resolve the problem with the 249.23facility's management or through the employee's union representative, the employee 249.24may contact the commissioner at an address or telephone number provided by the 249.25commissioner and included in the approved plan.249.26    Sec. 101. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to 249.27read:249.28    Subd. 23. Alternative services; elderly and disabled persons. (a) The 249.29commissioner may implement demonstration projects to create alternative integrated 249.30delivery systems for acute and long-term care services to elderly persons and persons 249.31with disabilities as defined in section 
         256B.77, subdivision 7a, that provide increased 249.32coordination, improve access to quality services, and mitigate future cost increases. 249.33The commissioner may seek federal authority to combine Medicare and Medicaid 249.34capitation payments for the purpose of such demonstrations and may contract with 249.35Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 250.1services shall be administered according to the terms and conditions of the federal contract 250.2and demonstration provisions. For the purpose of administering medical assistance funds, 250.3demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 250.4of Minnesota Rules, parts 
         9500.1450 to 
         9500.1464, apply to these demonstrations, 250.5with the exceptions of parts 
         9500.1452, subpart 2, item B; and 
         9500.1457, subpart 1, 250.6items B and C, which do not apply to persons enrolling in demonstrations under this 250.7section. An initial open enrollment period may be provided. Persons who disenroll from 250.8demonstrations under this subdivision remain subject to Minnesota Rules, parts 
         9500.1450250.9to 
         9500.1464. When a person is enrolled in a health plan under these demonstrations and 250.10the health plan's participation is subsequently terminated for any reason, the person shall 250.11be provided an opportunity to select a new health plan and shall have the right to change 250.12health plans within the first 60 days of enrollment in the second health plan. Persons 250.13required to participate in health plans under this section who fail to make a choice of 250.14health plan shall not be randomly assigned to health plans under these demonstrations. 250.15Notwithstanding section 
         256L.12, subdivision 5, and Minnesota Rules, part 
         9505.5220, 250.16subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 250.17the commissioner may contract with managed care organizations, including counties, to 250.18serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 250.19disabled persons only. For persons with a primary diagnosis of developmental disability, 250.20serious and persistent mental illness, or serious emotional disturbance, the commissioner 250.21must ensure that the county authority has approved the demonstration and contracting 250.22design. Enrollment in these projects for persons with disabilities shall be voluntary. The 250.23commissioner shall not implement any demonstration project under this subdivision for 250.24persons with a primary diagnosis of developmental disabilities, serious and persistent 250.25mental illness, or serious emotional disturbance, without approval of the county board of 250.26the county in which the demonstration is being implemented.250.27    (b) Notwithstanding chapter 245B, sections 
         252.40 to 
         252.46, 
         256B.092, 
         256B.501250.28to 
         256B.5015, and Minnesota Rules, parts 
         9525.0004 to 
         9525.0036, 
         9525.1200 to 250.299525.1330
         , 
         9525.1580, and 
         9525.1800 to 
         9525.1930, the commissioner may implement 250.30under this section projects for persons with developmental disabilities. The commissioner 250.31may capitate payments for ICF/MR services, waivered services for developmental 250.32disabilities, including case management services, day training and habilitation and 250.33alternative active treatment services, and other services as approved by the state and by 250.34the federal government. Case management and active treatment must be individualized 250.35and developed in accordance with a person-centered plan. Costs under these projects may 250.36not exceed costs that would have been incurred under fee-for-service. Beginning July 1, 251.12003, and until twofour years after the pilot project implementation date, subcontractor 251.2participation in the long-term care developmental disability pilot is limited to a nonprofit 251.3long-term care system providing ICF/MR services, home and community-based waiver 251.4services, and in-home services to no more than 120 consumers with developmental 251.5disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the 251.6legislature prior to expansion of the developmental disability pilot project. This paragraph 251.7expires twofour years after the implementation date of the pilot project.251.8    (c) Before implementation of a demonstration project for disabled persons, the 251.9commissioner must provide information to appropriate committees of the house of 251.10representatives and senate and must involve representatives of affected disability groups 251.11in the design of the demonstration projects.251.12    (d) A nursing facility reimbursed under the alternative reimbursement methodology 251.13in section 
         256B.434 may, in collaboration with a hospital, clinic, or other health care entity 251.14provide services under paragraph (a). The commissioner shall amend the state plan and 251.15seek any federal waivers necessary to implement this paragraph.251.16    (e) The commissioner, in consultation with the commissioners of commerce and 251.17health, may approve and implement programs for all-inclusive care for the elderly (PACE) 251.18according to federal laws and regulations governing that program and state laws or rules 251.19applicable to participating providers. The process for approval of these programs shall 251.20begin only after the commissioner receives grant money in an amount sufficient to cover 251.21the state share of the administrative and actuarial costs to implement the programs during 251.22state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 251.23account in the special revenue fund and are appropriated to the commissioner to be used 251.24solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 251.25not required to be licensed or certified as a health plan company as defined in section 251.2662Q.01, subdivision 4
         . Persons age 55 and older who have been screened by the county 251.27and found to be eligible for services under the elderly waiver or community alternatives 251.28for disabled individuals or who are already eligible for Medicaid but meet level of 251.29care criteria for receipt of waiver services may choose to enroll in the PACE program. 251.30Medicare and Medicaid services will be provided according to this subdivision and 251.31federal Medicare and Medicaid requirements governing PACE providers and programs. 251.32PACE enrollees will receive Medicaid home and community-based services through the 251.33PACE provider as an alternative to services for which they would otherwise be eligible 251.34through home and community-based waiver programs and Medicaid State Plan Services. 251.35The commissioner shall establish Medicaid rates for PACE providers that do not exceed 252.1costs that would have been incurred under fee-for-service or other relevant managed care 252.2programs operated by the state.252.3    (f) The commissioner shall seek federal approval to expand the Minnesota disability 252.4health options (MnDHO) program established under this subdivision in stages, first to 252.5regional population centers outside the seven-county metro area and then to all areas 252.6of the state. Until January 1, 2008July 1, 2009, expansion for MnDHO projects that 252.7include home and community-based services is limited to the two projects and service 252.8areas in effect on March 1, 2006.  Enrollment in integrated MnDHO programs that 252.9include home and community-based services shall remain voluntary. Costs for home 252.10and community-based services included under MnDHO must not exceed costs that 252.11would have been incurred under the fee-for-service program. In developing program 252.12specifications for expansion of integrated programs, the commissioner shall involve and 252.13consult the state-level stakeholder group established in subdivision 28, paragraph (d), 252.14including consultation on whether and how to include home and community-based waiver 252.15programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 252.16of the house and senate committees with jurisdiction over health and human services 252.17policy and finance by February 1, 2007.252.18    (g) Notwithstanding section 
         256B.0261, health plans providing services under this 252.19section are responsible for home care targeted case management and relocation targeted 252.20case management. Services must be provided according to the terms of the waivers and 252.21contracts approved by the federal government.252.22    Sec. 102. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to 252.23read:252.24    Subd. 28. Medicare special needs plans; medical assistance basic health care.252.25    (a) The commissioner may contract with qualified Medicare-approved special needs 252.26plans to provide medical assistance basic health care services to persons with disabilities, 252.27including those with developmental disabilities. Basic health care services include:252.28    (1) those services covered by the medical assistance state plan except for ICF/MR 252.29services, home and community-based waiver services, case management for persons with 252.30developmental disabilities under section 
         256B.0625, subdivision 20a, and personal care 252.31and certain home care services defined by the commissioner in consultation with the 252.32stakeholder group established under paragraph (d); and252.33    (2) basic health care services may also include risk for up to 100 days of nursing 252.34facility services for persons who reside in a noninstitutional setting and home health 253.1services related to rehabilitation as defined by the commissioner after consultation with 253.2the stakeholder group.253.3    The commissioner may exclude other medical assistance services from the basic 253.4health care benefit set. Enrollees in these plans can access any excluded services on the 253.5same basis as other medical assistance recipients who have not enrolled.253.6    Unless a person is otherwise required to enroll in managed care, enrollment in these 253.7plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 253.8enrollment with an option to opt out is not voluntary enrollment. 253.9    (b) Beginning January 1, 2007, the commissioner may contract with qualified 253.10Medicare special needs plans to provide basic health care services under medical 253.11assistance to persons who are dually eligible for both Medicare and Medicaid and those 253.12Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 253.13The commissioner shall consult with the stakeholder group under paragraph (d) (e) in 253.14developing program specifications for these services. The commissioner shall report to 253.15the chairs of the house and senate committees with jurisdiction over health and human 253.16services policy and finance by February 1, 2007, on implementation of these programs and 253.17the need for increased funding for the ombudsman for managed care and other consumer 253.18assistance and protections needed due to enrollment in managed care of persons with 253.19disabilities. Payment for Medicaid services provided under this subdivision for the months 253.20of May and June will be made no earlier than July 1 of the same calendar year.253.21    (c) Beginning January 1, 2008, the commissioner may expand contracting under this 253.22subdivision to all persons with disabilities not otherwise required to enroll in managed 253.23care.253.24    (d) By February 1, 2009, the commissioner shall report to the chairs of the house and 253.25senate committees with jurisdiction over health and human services policy and finance on 253.26the initial results of implementation of contracts with qualified Medicare special needs 253.27plans to provide basic health care services under medical assistance to persons who are 253.28dually eligible for both Medicare and Medicaid. This report shall include an overall 253.29assessment of the impact on quality of care including actual costs and benefits.253.30    (e) The commissioner shall establish a state-level stakeholder group to provide 253.31advice on managed care programs for persons with disabilities, including both MnDHO 253.32and contracts with special needs plans that provide basic health care services as described 253.33in paragraphs (a) and (b). The stakeholder group shall include representatives of the 253.34counties and labor organizations representing county social service workers, members, 253.35consumer advocates, and providers, and provide advice on program expansions under this 253.36subdivision and subdivision 23, including:254.1    (1) implementation efforts; 254.2    (2) consumer protections; and254.3    (3) program specifications such as quality assurance measures, data collection and 254.4reporting, and evaluation of costs, quality, and results.; and254.5    (4) county safety net protections for persons with disabilities.254.6    (e) (f) Each plan under contract to provide medical assistance basic health care 254.7services shall establish a local or regional stakeholder group, including representatives 254.8of the counties covered by the plan and labor organizations representing county social 254.9service workers, members, consumer advocates, and current providers, for advice on 254.10issues that arise in the local or regional area.254.11    Sec. 103. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.254.12     (a) The commissioner of human services shall combine the existing biennial base 254.13level funding for deaf-blind services into a single grant program. At least 35 percent 254.14of the total funding is awarded for services and other supports to deaf-blind children 254.15and their families and at least 25 percent is awarded for services and other supports to 254.16deaf-blind adults.254.17    The commissioner shall award grants for the purposes of: 254.18    (1) providing services and supports to individuals who are deaf-blind; and 254.19    (2) developing and providing training to counties and the network of senior citizen 254.20service providers. The purpose of the training grants is to teach counties how to use 254.21existing programs that capture federal financial participation to meet the needs of eligible 254.22deaf-blind persons and to build capacity of senior service programs to meet the needs of 254.23seniors with a dual sensory hearing and vision loss.254.24    (b) The commissioner may make grants:254.25    (1) for services and training provided by organizations; and254.26    (2) to develop and administer consumer-directed services.254.27    (c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant 254.28under paragraph (a).254.29    (d) Deaf-blind service providers are not required to, but may, provide intervenor 254.30services as part of the service package provided with grant funds under this section.254.31    Sec. 104. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:254.32    Subd. 2. Standard of assistance for persons eligible for medical assistance 254.33waivers or at risk of placement in a group residential housing facility. The state 254.34standard of assistance for a person (1) who is eligible for a medical assistance home 255.1and community-based services waiver or a person, (2) who has been determined by the 255.2local agency to meet the plan requirements for placement in a group residential housing 255.3facility under section 
         256I.04, subdivision 1a, or (3) who is eligible for a shelter needy 255.4payment under subdivision 5, paragraph (f), is the standard established in subdivision 3, 255.5paragraph (a) or (b).255.6    Sec. 105. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:255.7    Subd. 5. Special needs. In addition to the state standards of assistance established in 255.8subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 255.9Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 255.10center, or a group residential housing facility.255.11    (a) The county agency shall pay a monthly allowance for medically prescribed 255.12diets if the cost of those additional dietary needs cannot be met through some other 255.13maintenance benefit. The need for special diets or dietary items must be prescribed by 255.14a licensed physician. Costs for special diets shall be determined as percentages of the 255.15allotment for a one-person household under the thrifty food plan as defined by the United 255.16States Department of Agriculture. The types of diets and the percentages of the thrifty 255.17food plan that are covered are as follows:255.18    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;255.19    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 255.20of thrifty food plan;255.21    (3) controlled protein diet, less than 40 grams and requires special products, 125 255.22percent of thrifty food plan;255.23    (4) low cholesterol diet, 25 percent of thrifty food plan;255.24    (5) high residue diet, 20 percent of thrifty food plan;255.25    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;255.26    (7) gluten-free diet, 25 percent of thrifty food plan;255.27    (8) lactose-free diet, 25 percent of thrifty food plan;255.28    (9) antidumping diet, 15 percent of thrifty food plan;255.29    (10) hypoglycemic diet, 15 percent of thrifty food plan; or255.30    (11) ketogenic diet, 25 percent of thrifty food plan.255.31    (b) Payment for nonrecurring special needs must be allowed for necessary home 255.32repairs or necessary repairs or replacement of household furniture and appliances using 255.33the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 255.34as long as other funding sources are not available.256.1    (c) A fee for guardian or conservator service is allowed at a reasonable rate 256.2negotiated by the county or approved by the court. This rate shall not exceed five percent 256.3of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 256.4guardian or conservator is a member of the county agency staff, no fee is allowed.256.5    (d) The county agency shall continue to pay a monthly allowance of $68 for 256.6restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 256.71990, and who eats two or more meals in a restaurant daily. The allowance must continue 256.8until the person has not received Minnesota supplemental aid for one full calendar month 256.9or until the person's living arrangement changes and the person no longer meets the criteria 256.10for the restaurant meal allowance, whichever occurs first.256.11    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 256.12is allowed for representative payee services provided by an agency that meets the 256.13requirements under SSI regulations to charge a fee for representative payee services. This 256.14special need is available to all recipients of Minnesota supplemental aid regardless of 256.15their living arrangement.256.16    (f) Notwithstanding the language in this subdivision, an amount equal to the 256.17maximum allotment authorized by the federal Food Stamp Program for a single individual 256.18which is in effect on the first day of January July of the previous each year will be added to 256.19the standards of assistance established in subdivisions 1 to 4 for individuals adults under 256.20the age of 65 who qualify as shelter needy and are: (1) relocating from an institution, or 256.21an adult mental health residential treatment program under section 
         256B.0622, and who 256.22are shelter needy; (2) self-directed supports option participants defined under section 256.23256B.0657 if enacted in the 2007 legislative session; or (3) home and community-based 256.24waiver recipients living in their own rented, leased, or owned apartment or home not 256.25owned, operated, or controlled by a provider of service not related by blood or marriage. 256.26Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy 256.27benefit under subdivision 5, paragraph (f), is considered a household of one. An eligible 256.28individual who receives this benefit prior to age 65 may continue to receive the benefit 256.29after the age of 65.256.30    (g)(1) Persons eligible for shelter needy funding under paragraph (f), who are not 256.31receiving medial assistance home and community-based waiver services, are eligible for 256.32a state-funded transitional supports allowance under section 256B.49, subdivision 16, 256.33paragraph (e), to establish their own residence not owned, operated, or controlled by a 256.34provider of service not related by blood or marriage.256.35    (2) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 256.36exceed 40 percent of the assistance unit's gross income before the application of this 257.1special needs standard. "Gross income" for the purposes of this section is the applicant's or 257.2recipient's income as defined in section 
         256D.35, subdivision 10, or the standard specified 257.3in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 257.4state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 257.5considered shelter needy for purposes of this paragraph.257.6    Sec. 106. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:257.7    Subd. 3. Moratorium on the development of group residential housing beds. (a) 257.8County agencies shall not enter into agreements for new group residential housing beds 257.9with total rates in excess of the MSA equivalent rate except: (1) for group residential 257.10housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 257.11provided the facility is needed to meet the census reduction targets for persons with 257.12developmental disabilities at regional treatment centers; (2) to ensure compliance with 257.13the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements 257.14for inappropriately placed persons with developmental disabilities or mental illness; 257.15(3) up to 80 beds in a single, specialized facility located in Hennepin County that will 257.16provide housing for chronic inebriates who are repetitive users of detoxification centers 257.17and are refused placement in emergency shelters because of their state of intoxication, 257.18and planning for the specialized facility must have been initiated before July 1, 1991, in 257.19anticipation of receiving a grant from the Housing Finance Agency under section 
         462A.05, 257.20subdivision 20a
         , paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for 257.21up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County 257.22for homeless adults with a mental illness, a history of substance abuse, or human 257.23immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this 257.24section, "homeless adult" means a person who is living on the street or in a shelter or 257.25discharged from a regional treatment center, community hospital, or residential treatment 257.26program and has no appropriate housing available and lacks the resources and support 257.27necessary to access appropriate housing. At least 70 percent of the supportive housing 257.28units must serve homeless adults with mental illness, substance abuse problems, or human 257.29immunodeficiency virus or acquired immunodeficiency syndrome who are about to be 257.30or, within the previous six months, has been discharged from a regional treatment center, 257.31or a state-contracted psychiatric bed in a community hospital, or a residential mental 257.32health or chemical dependency treatment program. If a person meets the requirements of 257.33subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group 257.34residential housing rate for that person is limited to the supplementary rate under section 257.35256I.05, subdivision 1a
         , and is determined by subtracting the amount of the person's 258.1countable income that exceeds the MSA equivalent rate from the group residential housing 258.2supplementary rate. A resident in a demonstration project site who no longer participates 258.3in the demonstration program shall retain eligibility for a group residential housing 258.4payment in an amount determined under section 
         256I.06, subdivision 8, using the MSA 258.5equivalent rate. Service funding under section 
         256I.05, subdivision 1a, will end June 30, 258.61997, if federal matching funds are available and the services can be provided through a 258.7managed care entity. If federal matching funds are not available, then service funding will 258.8continue under section 
         256I.05, subdivision 1a; or (6) (5) for group residential housing 258.9beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which 258.10are used exclusively for recipients receiving home and community-based waiver services 258.11under sections 
         256B.0915, 
         256B.092, subdivision 5, 
         256B.093, and 
         256B.49, and who 258.12resided in a nursing facility for the six months immediately prior to the month of entry 258.13into the group residential housing setting. The group residential housing rate for these 258.14beds must be set so that the monthly group residential housing payment for an individual 258.15occupying the bed when combined with the nonfederal share of services delivered under 258.16the waiver for that person does not exceed the nonfederal share of the monthly medical 258.17assistance payment made for the person to the nursing facility in which the person resided 258.18prior to entry into the group residential housing establishment. The rate may not exceed 258.19the MSA equivalent rate plus $426.37 for any case.; or (6) for an additional two beds, 258.20resulting in a total of 32 beds, for a facility located in Hennepin County providing services 258.21for recovering and chemically dependent men that has had a group residential housing 258.22contract with the county and has been licensed as a board and lodge facility with special 258.23services since 1980; (7) for a group residential housing provider located in Stearns County 258.24that operates a 40-bed facility, that received financing through the Minnesota Housing 258.25Finance Agency Ending Long-Term Homelessness Initiative and serves chemically 258.26dependent clientele, providing 24-hour-a-day supervision; (8) for a group residential 258.27housing provider located in Crow Wing County that serves a chemically dependent 258.28clientele, providing 24-hour-a-day supervision and limiting a resident's maximum length 258.29of stay to 13 months out of a consecutive 24-month period; (9) for a 60-bed facility in 258.30St. Louis County which opened in January 2006 that will serve chemically dependent 258.31persons operated by a group residential housing provider that currently operates a 304-bed 258.32facility in Minneapolis; and (10) for a group residential housing provider that operates two 258.33ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 258.34which provide community support and serve the mental health needs of individuals who 258.35have chronically lived unsheltered, providing 24-hour-a-day supervision.259.1    (b) A county agency may enter into a group residential housing agreement for beds 259.2with rates in excess of the MSA equivalent rate in addition to those currently covered 259.3under a group residential housing agreement if the additional beds are only a replacement 259.4of beds with rates in excess of the MSA equivalent rate which have been made available 259.5due to closure of a setting, a change of licensure or certification which removes the beds 259.6from group residential housing payment, or as a result of the downsizing of a group 259.7residential housing setting. The transfer of available beds from one county to another can 259.8only occur by the agreement of both counties.259.9    Sec. 107. Minnesota Statutes 2006, section 256I.05, is amended by adding a 259.10subdivision to read:259.11    Subd. 1h.Supplementary rate for certain facilities serving chemically 259.12dependent males.Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a 259.13county agency shall negotiate a supplementary rate in addition to the rate specified in 259.14subdivision 1, not to exceed $737.87 per month, including any legislatively authorized 259.15inflationary adjustments, for a group residential housing provider that:259.16    (1) is located in Ramsey County and has had a group residential housing contract 259.17with the county since 1982 and has been licensed as a board and lodge facility with special 259.18services since 1979; and259.19    (2) serves recovering and chemically dependent males, providing 24-hour-a-day 259.20supervision.259.21    Sec. 108. Minnesota Statutes 2006, section 256I.05, is amended by adding a 259.22subdivision to read:259.23    Subd. 1i.Supplementary rate for certain facilities; Hennepin County.259.24    Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate 259.25a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 259.26per month, including any legislatively authorized inflationary adjustments, for a facility 259.27located in Hennepin County with a capacity of up to 48 beds that has been licensed since 259.281978 as a board and lodging facility and that until August 1, 2007, operated as a licensed 259.29chemical dependency treatment program.259.30EFFECTIVE DATE.This section is effective the day following final enactment.259.31    Sec. 109. Minnesota Statutes 2006, section 256I.05, is amended by adding a 259.32subdivision to read:260.1    Subd. 1j.Supplementary rate for certain facilities; St. Louis County.(a) 260.2Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 260.3county agency shall negotiate a supplementary rate in addition to the rate specified in 260.4subdivision 1, not to exceed $700 per month, including any legislatively authorized 260.5inflationary adjustments, for a 60-bed facility in St. Louis County which opened in 260.6January 2006 that will serve chemically dependent persons operated by a group residential 260.7housing provider that currently operates a 304-bed facility in Minneapolis.260.8    (b) The supplementary rate in paragraph (a) applies to the 48 beds which do not 260.9already receive a supplementary rate.260.10    Sec. 110. Minnesota Statutes 2006, section 256I.05, is amended by adding a 260.11subdivision to read:260.12    Subd. 1k.Supplementary rate for certain facilities; Crow Wing County.260.13    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 260.14county agency shall negotiate a supplementary rate in addition to the rate specified in 260.15subdivision 1, not to exceed $700 per month, including any legislatively authorized 260.16inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve 260.17chemically dependent persons operated by a group residential housing provider that 260.18currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which 260.19opened in January of 2006.260.20    Sec. 111. Minnesota Statutes 2006, section 256I.05, is amended by adding a 260.21subdivision to read:260.22    Subd. 1l.Supplementary rate for certain facilities; Stearns County.260.23    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 260.24shall negotiate a supplementary service rate in addition to the rate specified in subdivision 260.251, not to exceed $700 per month, including any legislatively authorized inflationary 260.26adjustments, for a group residential housing provider located in Stearns County that 260.27operates a 40-bed facility, that received financing through the Minnesota Housing Finance 260.28Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 260.29clientele, providing 24-hour-a-day supervision.260.30    Sec. 112. Minnesota Statutes 2006, section 256I.05, is amended by adding a 260.31subdivision to read:260.32    Subd. 1m.Supplementary rate for certain facilities; St. Louis County.260.33    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 261.1shall negotiate a supplementary service rate in addition to the rate specified in subdivision 261.21, not to exceed $700 per month, including any legislatively authorized inflationary 261.3adjustments, for a group residential housing provider located in St. Louis County that 261.4operates a 30-bed facility, that received financing through the Minnesota Housing Finance 261.5Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 261.6clientele, providing 24-hour-a-day supervision. 261.7    Sec. 113. Minnesota Statutes 2006, section 256I.05, is amended by adding a 261.8subdivision to read:261.9    Subd. 1n.Supplemental rate for certain facilities; Hennepin and Ramsey 261.10Counties.Notwithstanding the provisions of this section, beginning July 1, 2007, a county 261.11agency shall negotiate a supplemental service rate in addition to the rate specified in 261.12subdivision 1, not to exceed $715.78 per month, including any legislatively authorized 261.13inflationary adjustments, for a group residential housing provider that operates two 261.14ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 261.15which provide community support and serve the mental health needs of individuals who 261.16have chronically lived unsheltered, providing 24-hour-a-day supervision.261.17    Sec. 114. Laws 2000, chapter 340, section 19, is amended to read:261.18    Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.261.19    (a) Expenditures for housing with services and adult foster care shall be excluded 261.20when determining average monthly expenditures per client for alternative care pilot 261.21projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.261.22    (b) Alternative care pilot projects shall not expire on June 30, 2001, but shall 261.23continue until June 30, 2005 2007.261.24EFFECTIVE DATE.This section is effective retroactively from June 29, 2005, for 261.25activities related to discontinuing pilot projects under this section.261.26    Sec. 115. Laws 2006, chapter 282, article 20, section 37, is amended to read:261.27    Sec. 37. REPAYMENT DELAY.261.28    A county that overspent its allowed amounts in calendar year 2004 or 2005 under 261.29the waivered services program for persons with developmental disabilities shall not be 261.30required to pay back the amount of overspending until May 31, 2007.261.31EFFECTIVE DATE.This section is effective the day following final enactment.262.1    Sec. 116. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.262.2    (a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the 262.3recommendation of a county agency, the commissioner of human services shall grant a 262.4license with any necessary variances to a nonresidential program for youth which provides 262.5services to youth with disabilities under age 21 during nonschool hours established 262.6to ensure health and safety, prevent out-of-home placement, and increase community 262.7inclusion of youth with disabilities. The nonresidential youth program is subject to the 262.8conditions of any variances granted and with consumer rights under Minnesota Statutes, 262.9section 245B.04, consumer protection standards under Minnesota Statutes, section 262.10245B.05, service standards under Minnesota Statutes, section 245B.06, management 262.11standards under Minnesota Statutes, section 245B.07, and fire marshal inspections under 262.12Minnesota Statutes, section 245A.151, until the commissioner develops other licensure 262.13requirements for this type of program.262.14    (b) By February 1, 2008, the commissioner shall recommend amendments to 262.15licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of 262.16appropriate services for school-age youth with disabilities under age 21 who need 262.17supervision and services to develop skills necessary to maintain personal safety and 262.18increase their independence, productivity, and participation in their communities during 262.19nonschool hours. As part of developing the recommendations, the commissioner shall 262.20survey county agencies to determine how the needs of youth with disabilities under age 21 262.21who require supervision and support services are being met and the funding sources used. 262.22The recommendations must be provided to the house and senate chairs of the committees 262.23with jurisdiction over licensing of programs for youth with disabilities.262.24    Sec. 117. INDEPENDENT LIVING.262.25    An individual who has lived in one of the facilities under Minnesota Statutes, 262.26section 256I.05, subdivision 1n, who is being transitioned to independent living as 262.27part of the program plan continues to be eligible for group residential housing and the 262.28supplemental service rate negotiated with the county under Minnesota Statutes, section 262.29256I.05, subdivision 1n.262.30    Sec. 118. ASSISTIVE TECHNOLOGY RECOMMENDATIONS.262.31    Subdivision 1.Review.(a) During the biennium ending June 30, 2009, the Council 262.32on Disability shall facilitate a statewide review of the assistive technology needs of people 262.33with disabling conditions, and seniors. The council shall identify community-based 263.1service providers, state agencies, and other entities involved in providing assistive 263.2technology supports.263.3    (b) The council shall provide oversight and direction to the Minnesota Regions 263.4Assistive Technology Collaborative during the biennium ending June 30, 2009.263.5    Subd. 2.Recommendations.The council shall present to the chairs of the house 263.6and senate committees having jurisdiction over human services, by January 1, 2009, 263.7recommendations, including proposed legislation creating a statewide comprehensive plan 263.8to meet the assistive technology needs of people with disabling conditions and seniors. 263.9The statewide plan must include steps to coordinate and streamline assistive technology 263.10services.263.11    Sec. 119. COMMUNITY SERVICES PROVIDER RATE INCREASES.263.12    (a) The commissioner of human services shall increase allocations, reimbursement 263.13rates, or rate limits, as applicable, by three percent for the rate period beginning October 1, 263.142007, and the rate period beginning October 1, 2008, effective for services rendered on 263.15or after those dates.263.16    (b) The three percent annual rate increase described in this section must be provided 263.17to:263.18    (1) home and community-based waivered services for persons with developmental 263.19disabilities or related conditions under Minnesota Statutes, section 256B.501;263.20    (2) home and community-based waivered services for the elderly under Minnesota 263.21Statutes, section 256B.0915;263.22    (3) waivered services under community alternatives for disabled individuals under 263.23Minnesota Statutes, section 256B.49;263.24    (4) community alternative care waivered services under Minnesota Statutes, section 263.25256B.49;263.26    (5) traumatic brain injury waivered services under Minnesota Statutes, section 263.27256B.49;263.28    (6) nursing services and home health services under Minnesota Statutes, section 263.29256B.0625, subdivision 6a;263.30    (7) personal care services and nursing supervision of personal care services under 263.31Minnesota Statutes, section 256B.0625, subdivision 19a;263.32    (8) private duty nursing services under Minnesota Statutes, section 256B.0625, 263.33subdivision 7;263.34    (9) day training and habilitation services for adults with developmental disabilities 263.35or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 264.1additional cost of rate adjustments on day training and habilitation service, provided as a 264.2social service under Minnesota Statutes, section 256M.60;264.3    (10) alternative care services under Minnesota Statutes, section 256B.0913;264.4    (11) adult residential program grants under Minnesota Statutes, section 245.73;264.5    (12) adult and children's mental health grants under Minnesota Rules, parts 264.69535.1700 to 9535.1760;264.7    (13) the group residential housing supplementary service rate under Minnesota 264.8Statutes, section 256I.05, subdivision 1a;264.9    (14) adult mental health integrated fund grants under Minnesota Statutes, section 264.10245.4661;264.11    (15) semi-independent living services (SILS) under Minnesota Statutes, section 264.12252.275, including SILS funding under county social services grants formerly funded 264.13under Minnesota Statutes, chapter 256I;264.14    (16) community support services for deaf and hard-of-hearing adults with mental 264.15illness who use or wish to use sign language as their primary means of communication 264.16under Minnesota Statutes, section 256.01, subdivision 2;264.17    (17) living skills training programs for persons with intractable epilepsy who need 264.18assistance in the transition to independent living under Laws 1988, chapter 689;264.19    (18) physical therapy services under Minnesota Statutes, sections 256B.0625, 264.20subdivision 8, and 256D.03, subdivision 4;264.21    (19) occupational therapy services under Minnesota Statutes, sections 256B.0625, 264.22subdivision 8a, and 256D.03, subdivision 4;264.23    (20) speech-language therapy services under Minnesota Statutes, section 256D.03, 264.24subdivision 4, and Minnesota Rules, part 9505.0390; 264.25    (21) respiratory therapy services under Minnesota Statutes, section 256D.03, 264.26subdivision 4, and Minnesota Rules, part 9505.0295;264.27    (22) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, 264.28and 256B.0928;264.29    (23) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233; 264.30256C.25; Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter 264.315, section 20;264.32    (24) children's therapeutic services and supports under Minnesota Statutes, section 264.33256B.0943;264.34    (25) tier I chemical health services under Minnesota Statutes, chapter 254B;264.35    (26) consumer support grants under Minnesota Statutes, section 256.476;264.36    (27) family support grants under Minnesota Statutes, section 252.32;265.1    (28) case management services to persons with HIV or AIDS under Minnesota 265.2Statutes, section 256.01, subdivision 19; and265.3    (29) adult rehabilitative mental health services under Minnesota Statutes, section 265.4256B.0623.265.5    (c) Providers that receive a rate increase under this section shall use 75 percent of 265.6the additional revenue to increase wages and benefits and pay associated costs for all 265.7employees, except for management fees, the administrator, and central office staff.265.8    (d) For public employees, the increase for wages and benefits for certain staff is 265.9available and pay rates must be increased only to the extent that they comply with laws 265.10governing public employees' collective bargaining. Money received by a provider for pay 265.11increases under this section may be used only for increases implemented on or after the 265.12first day of the rate period in which the increase is available and must not be used for 265.13increases implemented prior to that date.265.14    (e) A copy of the provider's plan for complying with paragraph (c) must be made 265.15available to all employees by giving each employee a copy or by posting a copy in an area 265.16of the provider's operation to which all employees have access. If an employee does not 265.17receive the adjustment, if any, described in the plan and is unable to resolve the problem 265.18with the provider, the employee may contact the employee's union representative. If the 265.19employee is not covered by a collective bargaining agreement, the employee may contact 265.20the commissioner at a telephone number provided by the commissioner and included in 265.21the provider's plan. 265.22    (f) The commissioner and each county agency shall take steps necessary to 265.23implement the increases required by this section on the dates specified, and the increases 265.24must be effective on the dates specified, regardless of the client's service authorization date 265.25and notwithstanding the terms of any provider contract, service agreement, or schedule 265.26that limits when a county may increase payment rates.265.27    Sec. 120. DENTAL ACCESS FOR PERSONS WITH DISABILITIES.265.28    The commissioner of human services shall study access to dental services for 265.29persons with disabilities, and shall present recommendations for improving access to 265.30dental services to the legislature by January 15, 2008. The study must examine physical 265.31and geographic access, the willingness of dentists to serve persons with disabilities 265.32enrolled in state health care programs, reimbursement rates for dental service providers, 265.33and other factors identified by the commissioner.265.34    Sec. 121. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.266.1    By October 1, 2007, the commissioner shall seek federal approval to allow persons 266.2who have been eligible for medical assistance for employed persons with disabilities 266.3(MA-EPD) under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24 266.4consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility 266.5rules as long as they qualify.266.6    Sec. 122. MINNESOTA RULES.266.7    The Department of Administration shall publish adopted rules in the State Register 266.8making the terminology changes specified in section 92 in Minnesota Rules. Upon 266.9publication in the State Register, the terminology changes for Minnesota Rules are 266.10adopted without further administrative action.266.11    Sec. 123. REVISOR'S INSTRUCTION.266.12    The revisor of statutes shall change the terms in column A to the terms in column B 266.13wherever they appear in Minnesota Statutes:

266.14Column AColumn B266.15266.16266.17266.18266.19"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans""Office of Ombudsman for Long-Term Care"266.20266.21"ombudsman for older Minnesotans""ombudsman for long-term care"

266.22    Sec. 124. REPEALER.266.23Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 266.24252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h; 266.25and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.266.26ARTICLE 5266.27MENTAL HEALTH266.28    Section 1. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to 266.29read:266.30    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the 266.31brain or a clinically significant disorder of thought, mood, perception, orientation, 266.32memory, or behavior that is listed in the clinical manual of the International Classification 266.33of Diseases (ICD-9-CM), current edition, code range 290.0 to 
         302.99 or 306.0 to 316.0 266.34or the corresponding code in the American Psychiatric Association's Diagnostic and 267.1Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and 267.2that seriously limits a person's capacity to function in primary aspects of daily living such 267.3as personal relations, living arrangements, work, and recreation. 267.4    (b) An "adult with acute mental illness" means an adult who has a mental illness that 267.5is serious enough to require prompt intervention.267.6    (c) For purposes of case management and community support services, a "person 267.7with serious and persistent mental illness" means an adult who has a mental illness and 267.8meets at least one of the following criteria:267.9    (1) the adult has undergone two or more episodes of inpatient care for a mental 267.10illness within the preceding 24 months;267.11    (2) the adult has experienced a continuous psychiatric hospitalization or residential 267.12treatment exceeding six months' duration within the preceding 12 months;267.13    (3) the adult has been treated by a crisis team two or more times within the preceding 267.1424 months;267.15    (4) the adult:267.16    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline 267.17personality disorder;267.18    (ii) indicates a significant impairment in functioning; and267.19    (iii) has a written opinion from a mental health professional, in the last three years, 267.20stating that the adult is reasonably likely to have future episodes requiring inpatient or 267.21residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 267.22management or community support services are provided;267.23    (4) (5) the adult has, in the last three years, been committed by a court as a person 267.24who is mentally ill under chapter 253B, or the adult's commitment has been stayed or 267.25continued; or267.26    (5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time 267.27period has expired or the adult was eligible as a child under section 
         245.4871, subdivision 267.286
         ; and (ii) has a written opinion from a mental health professional, in the last three years, 267.29stating that the adult is reasonably likely to have future episodes requiring inpatient or 267.30residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 267.31management or community support services are provided. 267.32    Sec. 2. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision 267.33to read:268.1    Subd. 3.Responsibility not duplicated.For individuals who have health care 268.2coverage, the county board is not responsible for providing mental health services which 268.3are within the limits of the individual's health care coverage.268.4    Sec. 3. Minnesota Statutes 2006, section 245.4874, is amended to read:268.5245.4874 DUTIES OF COUNTY BOARD.268.6    Subdivision 1.Duties of the county board. (a) The county board must:268.7    (1) develop a system of affordable and locally available children's mental health 268.8services according to sections 
         245.487 to 
         245.4887;268.9    (2) establish a mechanism providing for interagency coordination as specified in 268.10section 
         245.4875, subdivision 6;268.11    (3) consider the assessment of unmet needs in the county as reported by the local 268.12children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 268.13(b), clause (3). The county shall provide, upon request of the local children's mental health 268.14advisory council, readily available data to assist in the determination of unmet needs;268.15    (4) assure that parents and providers in the county receive information about how to 268.16gain access to services provided according to sections 
         245.487 to 
         245.4887;268.17    (5) coordinate the delivery of children's mental health services with services 268.18provided by social services, education, corrections, health, and vocational agencies to 268.19improve the availability of mental health services to children and the cost-effectiveness of 268.20their delivery;268.21    (6) assure that mental health services delivered according to sections 
         245.487268.22to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 268.23assessment and individual treatment plan;268.24    (7) provide the community with information about predictors and symptoms of 268.25emotional disturbances and how to access children's mental health services according to 268.26sections 
         245.4877 and 
         245.4878;268.27    (8) provide for case management services to each child with severe emotional 268.28disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 268.29subdivisions 1, 3, and 5
         ;268.30    (9) provide for screening of each child under section 
         245.4885 upon admission 268.31to a residential treatment facility, acute care hospital inpatient treatment, or informal 268.32admission to a regional treatment center;268.33    (10) prudently administer grants and purchase-of-service contracts that the county 268.34board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 268.35245.4887
         ;269.1    (11) assure that mental health professionals, mental health practitioners, and case 269.2managers employed by or under contract to the county to provide mental health services 269.3are qualified under section 
         245.4871;269.4    (12) assure that children's mental health services are coordinated with adult mental 269.5health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 269.6health services is available to serve persons with mental illness, regardless of the person's 269.7age;269.8    (13) assure that culturally informed mental health consultants are used as necessary 269.9to assist the county board in assessing and providing appropriate treatment for children of 269.10cultural or racial minority heritage; and269.11    (14) consistent with section 
         245.486, arrange for or provide a children's mental 269.12health screening to a child receiving child protective services or a child in out-of-home 269.13placement, a child for whom parental rights have been terminated, a child found to be 269.14delinquent, and a child found to have committed a juvenile petty offense for the third or 269.15subsequent time, unless a screening has been performed within the previous 180 days, or 269.16the child is currently under the care of a mental health professional. The court or county 269.17agency must notify a parent or guardian whose parental rights have not been terminated of 269.18the potential mental health screening and the option to prevent the screening by notifying 269.19the court or county agency in writing. The screening shall be conducted with a screening 269.20instrument approved by the commissioner of human services according to criteria that 269.21are updated and issued annually to ensure that approved screening instruments are valid 269.22and useful for child welfare and juvenile justice populations, and shall be conducted 269.23by a mental health practitioner as defined in section 
         245.4871, subdivision 26, or a 269.24probation officer or local social services agency staff person who is trained in the use of 269.25the screening instrument. Training in the use of the instrument shall include training in the 269.26administration of the instrument, the interpretation of its validity given the child's current 269.27circumstances, the state and federal data practices laws and confidentiality standards, the 269.28parental consent requirement, and providing respect for families and cultural values. 269.29If the screen indicates a need for assessment, the child's family, or if the family lacks 269.30mental health insurance, the local social services agency, in consultation with the child's 269.31family, shall have conducted a diagnostic assessment, including a functional assessment, 269.32as defined in section 
         245.4871. The administration of the screening shall safeguard the 269.33privacy of children receiving the screening and their families and shall comply with the 269.34Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance 269.35Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be 269.36considered private data and the commissioner shall not collect individual screening results.270.1    (b) When the county board refers clients to providers of children's therapeutic 270.2services and supports under section 
         256B.0943, the county board must clearly identify 270.3the desired services components not covered under section 
         256B.0943 and identify the 270.4reimbursement source for those requested services, the method of payment, and the 270.5payment rate to the provider.270.6    Subd. 2.Responsibility not duplicated.For individuals who have health care 270.7coverage, the county board is not responsible for providing mental health services which 270.8are within the limits of the individual's health care coverage.270.9    Sec. 4. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:270.10    Subd. 5. Special contracts; bordering states. (a) An individual who is detained, 270.11committed, or placed on an involuntary basis under chapter 253B may be confined or 270.12treated in a bordering state pursuant to a contract under this section. An individual who is 270.13detained, committed, or placed on an involuntary basis under the civil law of a bordering 270.14state may be confined or treated in Minnesota pursuant to a contract under this section. A 270.15peace or health officer who is acting under the authority of the sending state may transport 270.16an individual to a receiving agency that provides services pursuant to a contract under 270.17this section and may transport the individual back to the sending state under the laws 270.18of the sending state. Court orders valid under the law of the sending state are granted 270.19recognition and reciprocity in the receiving state for individuals covered by a contract 270.20under this section to the extent that the court orders relate to confinement for treatment 270.21or care of mental illness or chemical dependency. Such treatment or care may address 270.22other conditions that may be co-occurring with the mental illness or chemical dependency. 270.23These court orders are not subject to legal challenge in the courts of the receiving state. 270.24Individuals who are detained, committed, or placed under the law of a sending state and 270.25who are transferred to a receiving state under this section continue to be in the legal 270.26custody of the authority responsible for them under the law of the sending state. Except 270.27in emergencies, those individuals may not be transferred, removed, or furloughed from 270.28a receiving agency without the specific approval of the authority responsible for them 270.29under the law of the sending state.270.30    (b) While in the receiving state pursuant to a contract under this section, an 270.31individual shall be subject to the sending state's laws and rules relating to length of 270.32confinement, reexaminations, and extensions of confinement. No individual may be sent 270.33to another state pursuant to a contract under this section until the receiving state has 270.34enacted a law recognizing the validity and applicability of this section.271.1    (c) If an individual receiving services pursuant to a contract under this section leaves 271.2the receiving agency without permission and the individual is subject to involuntary 271.3confinement under the law of the sending state, the receiving agency shall use all 271.4reasonable means to return the individual to the receiving agency. The receiving agency 271.5shall immediately report the absence to the sending agency. The receiving state has the 271.6primary responsibility for, and the authority to direct, the return of these individuals 271.7within its borders and is liable for the cost of the action to the extent that it would be 271.8liable for costs of its own resident.271.9    (d) Responsibility for payment for the cost of care remains with the sending agency.271.10    (e) This subdivision also applies to county contracts under subdivision 2 which 271.11include emergency care and treatment provided to a county resident in a bordering state.271.12    (f) If a Minnesota resident is admitted to a facility in a bordering state under this 271.13chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or 271.14an advance practice registered nurse certified in mental health, who is licensed in the 271.15bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092, 271.16253B.12, and 253B.17 subject to the same requirements and limitations in section 271.17253B.02, subdivision 7.271.18    Sec. 5. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:271.19    Subd. 2. Program. The commissioner of human services shall establish a program 271.20for the treatment of compulsive gamblers. The commissioner may contract with an 271.21entity with expertise regarding the treatment of compulsive gambling to operate the 271.22program. The program may include the establishment of a statewide toll-free number, 271.23resource library, public education programs; regional in-service training programs and 271.24conferences for health care professionals, educators, treatment providers, employee 271.25assistance programs, and criminal justice representatives; and the establishment of 271.26certification standards for programs and service providers. The commissioner may enter 271.27into agreements with other entities and may employ or contract with consultants to 271.28facilitate the provision of these services or the training of individuals to qualify them to 271.29provide these services. The program may also include inpatient and outpatient treatment 271.30and rehabilitation services and for residents in a temporary or permanent residential 271.31setting for mental health or chemical dependency, and individuals in jails or correctional 271.32facilities. The program may also include research studies. The research studies must 271.33include baseline and prevalence studies for adolescents and adults to identify those at the 271.34highest risk. The program must be approved by the commissioner before it is established.272.1    Sec. 6. Minnesota Statutes 2006, section 245.98, subdivision 5, is amended to read:272.2    Subd. 5. Standards. The commissioner shall create standards for treatment and 272.3provider qualifications for the treatment component of the compulsive gambling program.272.4The commissioner, in coordination with the commissioner of corrections, shall create 272.5standards for the assessment and treatment of compulsive gamblers in programs operated 272.6by the commissioner of corrections.272.7    Sec. 7. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.272.8    Prior to placement of a child in a foster care home, the child foster care provider, if 272.9required to be licensed, must complete two hours of training that addresses the causes, 272.10symptoms, and key warning signs of mental health disorders; cultural considerations; and 272.11effective approaches for dealing with a child's behaviors. At least one hour of the annual 272.1212-hour training requirement for foster parents must be on children's mental health issues 272.13and treatment. Training curriculum shall be approved by the commissioner of human 272.14services.272.15    Sec. 8. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:272.16    Subdivision 1. County portion for cost of care. Except for chemical dependency 272.17services provided under sections 
         254B.01 to 
         254B.09, the client's county shall pay to the 272.18state of Minnesota a portion of the cost of care provided in a regional treatment center 272.19or a state nursing facility to a client legally settled in that county. A county's payment 272.20shall be made from the county's own sources of revenue and payments shall be paid as 272.21follows: payments to the state from the county shall equal 20 percent a percentage of the 272.22cost of care, as determined by the commissioner, for each day, or the portion thereof, that 272.23the client spends at a regional treatment center or a state nursing facility. according to 272.24the following schedule for each admission:272.25    (1) for the first 30 days: 20 percent until January 1, 2008, ten percent from January 272.261, 2008, to June 30, 2009, and zero percent thereafter;272.27    (2) 20 percent for days 31 to 60; and272.28    (3) for any days over 60: 20 percent until January 1, 2008, 30 percent from January 272.291, 2008, to June 30, 2009, 40 percent from July 1, 2009, to June 30, 2010, and 50 percent 272.30thereafter.272.31 If payments received by the state under sections 
         246.50 to 
         246.53 exceed 80 percent the 272.32noncounty portion of the cost of care, the county shall be responsible for paying the state 272.33only the remaining amount. The county shall not be entitled to reimbursement from 272.34the client, the client's estate, or from the client's relatives, except as provided in section 273.1246.53
         . No such payments shall be made for any client who was last committed prior to 273.2July 1, 1947.273.3    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to 273.4read:273.5    Subd. 20. Mental health case management. (a) To the extent authorized by rule 273.6of the state agency, medical assistance covers case management services to persons with 273.7serious and persistent mental illness and children with severe emotional disturbance. 273.8Services provided under this section must meet the relevant standards in sections 
         245.461273.9to 
         245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota 273.10Rules, parts 
         9520.0900 to 
         9520.0926, and 
         9505.0322, excluding subpart 10. 273.11    (b) Entities meeting program standards set out in rules governing family community 273.12support services as defined in section 
         245.4871, subdivision 17, are eligible for medical 273.13assistance reimbursement for case management services for children with severe 273.14emotional disturbance when these services meet the program standards in Minnesota 273.15Rules, parts 
         9520.0900 to 
         9520.0926 and 
         9505.0322, excluding subparts 6 and 10. 273.16    (c) Medical assistance and MinnesotaCare payment for mental health case 273.17management shall be made on a monthly basis. In order to receive payment for an eligible 273.18child, the provider must document at least a face-to-face contact with the child, the child's 273.19parents, or the child's legal representative. To receive payment for an eligible adult, the 273.20provider must document:273.21    (1) at least a face-to-face contact with the adult or the adult's legal representative; or273.22    (2) at least a telephone contact with the adult or the adult's legal representative and 273.23document a face-to-face contact with the adult or the adult's legal representative within 273.24the preceding two months.273.25    (d) Payment for mental health case management provided by county or state staff 273.26shall be based on the monthly rate methodology under section 
         256B.094, subdivision 6, 273.27paragraph (b), with separate rates calculated for child welfare and mental health, and 273.28within mental health, separate rates for children and adults. 273.29    (e) Payment for mental health case management provided by Indian health services 273.30or by agencies operated by Indian tribes may be made according to this section or other 273.31relevant federally approved rate setting methodology.273.32    (f) Payment for mental health case management provided by vendors who contract 273.33with a county or Indian tribe shall be based on a monthly rate negotiated by the host county 273.34or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 273.35service to other payers. If the service is provided by a team of contracted vendors, the 274.1county or tribe may negotiate a team rate with a vendor who is a member of the team. The 274.2team shall determine how to distribute the rate among its members. No reimbursement 274.3received by contracted vendors shall be returned to the county or tribe, except to reimburse 274.4the county or tribe for advance funding provided by the county or tribe to the vendor.274.5    (g) If the service is provided by a team which includes contracted vendors, tribal 274.6staff, and county or state staff, the costs for county or state staff participation in the team 274.7shall be included in the rate for county-provided services. In this case, the contracted 274.8vendor, the tribal agency, and the county may each receive separate payment for services 274.9provided by each entity in the same month. In order to prevent duplication of services, 274.10each entity must document, in the recipient's file, the need for team case management and 274.11a description of the roles of the team members.274.12    (h) The commissioner shall calculate the nonfederal share of actual medical 274.13assistance and general assistance medical care payments for each county, based on the 274.14higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999, 274.15and transfer one-half of the result from medical assistance and general assistance medical 274.16care to each county's mental health grants under section 
         256E.12 for calendar year 1999. 274.17The annualized minimum amount added to each county's mental health grant shall be 274.18$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce 274.19the statewide growth factor in order to fund these minimums. The annualized total amount 274.20transferred shall become part of the base for future mental health grants for each county. 274.21    (i) Notwithstanding section 
         256B.19, subdivision 1, the nonfederal share of costs 274.22for mental health case management shall be provided by the recipient's county of 274.23responsibility, as defined in sections 
         256G.01 to 
         256G.12, from sources other than federal 274.24funds or funds used to match other federal funds. If the service is provided by a tribal 274.25agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this 274.26service is paid by the state without a federal share through fee-for-service, 50 percent of 274.27the cost shall be provided by the recipient's county of responsibility.274.28    (j) Notwithstanding any administrative rule to the contrary, prepaid medical 274.29assistance, general assistance medical care, and MinnesotaCare include mental health case 274.30management. When the service is provided through prepaid capitation, the nonfederal 274.31share is paid by the state and the county pays no share.274.32    (j)(k) The commissioner may suspend, reduce, or terminate the reimbursement to a 274.33provider that does not meet the reporting or other requirements of this section. The county 274.34of responsibility, as defined in sections 
         256G.01 to 
         256G.12, or, if applicable, the tribal 274.35agency, is responsible for any federal disallowances. The county or tribe may share this 274.36responsibility with its contracted vendors. 275.1    (k)(l) The commissioner shall set aside a portion of the federal funds earned for 275.2county expenditures under this section to repay the special revenue maximization account 275.3under section 
         256.01, subdivision 2, clause (15). The repayment is limited to: 275.4    (1) the costs of developing and implementing this section; and275.5    (2) programming the information systems.275.6    (l)(m) Payments to counties and tribal agencies for case management expenditures 275.7under this section shall only be made from federal earnings from services provided 275.8under this section. When this service is paid by the state without a federal share through 275.9fee-for-service, 50 percent of the cost shall be provided by the state. Payments to 275.10county-contracted vendors shall include both the federal earnings, the state share, and the 275.11county share.275.12    (m)(n) Notwithstanding section 
         256B.041, county payments for the cost of mental 275.13health case management services provided by county or state staff shall not be made 275.14to the commissioner of finance. For the purposes of mental health case management 275.15services provided by county or state staff under this section, the centralized disbursement 275.16of payments to counties under section 
         256B.041 consists only of federal earnings from 275.17services provided under this section. 275.18    (n)(o) Case management services under this subdivision do not include therapy, 275.19treatment, legal, or outreach services.275.20    (o)(p) If the recipient is a resident of a nursing facility, intermediate care facility, 275.21or hospital, and the recipient's institutional care is paid by medical assistance, payment 275.22for case management services under this subdivision is limited to the last 180 days of 275.23the recipient's residency in that facility and may not exceed more than six months in a 275.24calendar year.275.25    (p)(q) Payment for case management services under this subdivision shall not 275.26duplicate payments made under other program authorities for the same purpose.275.27    (q)(r) By July 1, 2000, the commissioner shall evaluate the effectiveness of the 275.28changes required by this section, including changes in number of persons receiving 275.29mental health case management, changes in hours of service per person, and changes in 275.30caseload size.275.31    (r)(s) For each calendar year beginning with the calendar year 2001, the annualized 275.32amount of state funds for each county determined under paragraph (h) shall be adjusted by 275.33the county's percentage change in the average number of clients per month who received 275.34case management under this section during the fiscal year that ended six months prior to 275.35the calendar year in question, in comparison to the prior fiscal year.276.1    (s)(t) For counties receiving the minimum allocation of $3,000 or $5,000 described 276.2in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county 276.3receives the higher of the following amounts:276.4    (1) a continuation of the minimum allocation in paragraph (h); or276.5    (2) an amount based on that county's average number of clients per month who 276.6received case management under this section during the fiscal year that ended six months 276.7prior to the calendar year in question, times the average statewide grant per person per 276.8month for counties not receiving the minimum allocation.276.9    (t)(u) The adjustments in paragraphs (s) and (t) shall be calculated separately for 276.10children and adults.276.11EFFECTIVE DATE.This section is effective January 1, 2009, except the 276.12amendment to paragraph (i) is effective January 1, 2008.276.13    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to 276.14read:276.15    Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject 276.16to federal approval, medical assistance covers treatment foster care services according to 276.17section 
         256B.0946.276.18    Sec. 11. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to 276.19read:276.20    Subd. 4. Payment rates. (a) Notwithstanding sections 
         256B.19 and 
         256B.041, 276.21payments to counties for residential services provided by a residential facility shall only 276.22be made of federal earnings for services provided under this section, and the nonfederal 276.23share of costs for services provided under this section shall be paid by the county from 276.24sources other than federal funds or funds used to match other federal funds. Payment to 276.25counties for services provided according to this section shall be a proportion of the per 276.26day contract rate that relates to rehabilitative mental health services and shall not include 276.27payment for costs or services that are billed to the IV-E program as room and board. 276.28    (b) Per diem rates paid to providers under this section by prepaid plans shall be the 276.29proportion of the per-day contract rate that relates to rehabilitative mental health services 276.30and shall not include payment for group foster care costs or services that are billed to the 276.31county of financial responsibility.276.32    (c) The commissioner shall set aside a portion not to exceed five percent of the 276.33federal funds earned for county expenditures under this section to cover the state costs of 277.1administering this section. Any unexpended funds from the set-aside shall be distributed 277.2to the counties in proportion to their earnings under this section.277.3EFFECTIVE DATE.This section is effective January 1, 2009.277.4    Sec. 12. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:277.5    Subd. 5g. Payment for covered services. For services rendered on or after January 277.61, 2003, the total payment made to managed care plans for providing covered services 277.7under the medical assistance and general assistance medical care programs is reduced by 277.8.5 percent from their current statutory rates. This provision excludes payments for nursing 277.9home services, home and community-based waivers, and payments to demonstration 277.10projects for persons with disabilities, and mental health services added as covered benefits 277.11after December 31, 2007.277.12    Sec. 13. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:277.13    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g, 277.14the total payment made to managed care plans under the medical assistance program is 277.15reduced 1.0 percent for services provided on or after October 1, 2003, and an additional 277.161.0 percent for services provided on or after January 1, 2004. This provision excludes 277.17payments for nursing home services, home and community-based waivers, and payments 277.18to demonstration projects for persons with disabilities, and mental health services added as 277.19covered benefits after December 1, 2007.277.20    Sec. 14. Minnesota Statutes 2006, section 256B.763, is amended to read:277.21256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.277.22    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007, 277.23payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 277.242006, for:277.25    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;277.26    (2) community mental health centers under section 
         256B.0625, subdivision 5; and277.27    (3) mental health clinics and centers certified under Minnesota Rules, parts 277.289520.0750
          to 
         9520.0870, or hospital outpatient psychiatric departments that are designated 277.29as essential community providers under section 
         62Q.19.277.30    (b) This increase applies to group skills training when provided as a component of 277.31children's therapeutic services and support, psychotherapy, medication management, 277.32evaluation and management, diagnostic assessment, explanation of findings, psychological 278.1testing, neuropsychological services, direction of behavioral aides, and inpatient 278.2consultation.278.3    (c) This increase does not apply to rates that are governed by section 
         256B.0625, 278.4subdivision 30, or 
         256B.761, paragraph (b), other cost-based rates, rates that are 278.5negotiated with the county, rates that are established by the federal government, or rates 278.6that increased between January 1, 2004, and January 1, 2005.278.7    (d) The commissioner shall adjust rates paid to prepaid health plans under contract 278.8with the commissioner to reflect the rate increases provided in paragraph (a). The prepaid 278.9health plan must pass this rate increase to the providers identified in paragraph (a)278.10paragraphs (a), (e), and (f). The prepaid plan must pass this rate increase to the providers 278.11identified in paragraphs (a), (e), and (f).278.12    (e) For MinnesotaCare only, payment rates shall be increased by 23.7 percent over 278.13the rates in effect on December 31, 2007, for:278.14    (1) medication education services provided on or after January 1, 2008, by adult 278.15rehabilitative mental health services providers certified under section 256B.0623; and278.16    (2) mental health behavioral aide services provided on or after January 1, 2008, by 278.17children's therapeutic services and support providers certified under section 256B.0943.278.18    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by 278.19children's therapeutic services and support providers certified under section 256B.0943 278.20and not already included in paragraph (a), payment rates for MinnesotaCare shall be 278.21increased by 23.7 percent over the rates in effect on December 31, 2007.278.22    Sec. 15. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:278.23    Subdivision 1. Covered health services. For individuals under section 
         256L.04, 278.24subdivision 7
         , with income no greater than 75 percent of the federal poverty guidelines 278.25or for families with children under section 
         256L.04, subdivision 1, all subdivisions of 278.26this section apply. "Covered health services" means the health services reimbursed 278.27under chapter 256B, with the exception of inpatient hospital services, special education 278.28services, private duty nursing services, adult dental care services other than services 278.29covered under section 
         256B.0625, subdivision 9, orthodontic services, nonemergency 278.30medical transportation services, personal care assistant and case management services, 278.31nursing home or intermediate care facilities services, inpatient mental health services, 278.32and chemical dependency services. Outpatient mental health services covered under the 278.33MinnesotaCare program are limited to diagnostic assessments, psychological testing, 278.34explanation of findings, mental health telemedicine, psychiatric consultation, medication 279.1management by a physician, day treatment, partial hospitalization, and individual, family, 279.2and group psychotherapy.279.3    "Covered health services" also includes intensive mental health outpatient treatment 279.4for dialectical behavioral therapy for adults.279.5    No public funds shall be used for coverage of abortion under MinnesotaCare 279.6except where the life of the female would be endangered or substantial and irreversible 279.7impairment of a major bodily function would result if the fetus were carried to term; or 279.8where the pregnancy is the result of rape or incest.279.9    Covered health services shall be expanded as provided in this section.279.10EFFECTIVE DATE.This section is effective January 1, 2008, except coverage for 279.11mental health case management is effective January 1, 2009.279.12    Sec. 16. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:279.13    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 279.14and (c), the MinnesotaCare benefit plan shall include the following co-payments and 279.15coinsurance requirements for all enrollees:279.16    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 279.17subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 279.18$3,000 per family;279.19    (2) $3 per prescription for adult enrollees;279.20    (3) $25 for eyeglasses for adult enrollees;279.21    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 279.22episode of service which is required because of a recipient's symptoms, diagnosis, or 279.23established illness, and which is delivered in an ambulatory setting by a physician or 279.24physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 279.25audiologist, optician, or optometrist; and279.26    (5) $6 for nonemergency visits to a hospital-based emergency room.279.27    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 279.28children under the age of 21 in households with family income equal to or less than 175 279.29percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 279.30parents and relative caretakers of children under the age of 21 in households with family 279.31income greater than 175 percent of the federal poverty guidelines for inpatient hospital 279.32admissions occurring on or after January 1, 2001.279.33    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children 279.34under the age of 21.279.35    (d) Paragraph (a), clause (4), does not apply to mental health services.280.1    (e) Adult enrollees with family gross income that exceeds 175 percent of the 280.2federal poverty guidelines and who are not pregnant shall be financially responsible for 280.3the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 280.4hospital benefit limit.280.5    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 280.6or changes from one prepaid health plan to another during a calendar year, any charges 280.7submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 280.8expenses incurred by the enrollee for inpatient services, that were submitted or incurred 280.9prior to enrollment, or prior to the change in health plans, shall be disregarded.280.10    Sec. 17. Minnesota Statutes 2006, section 256L.035, is amended to read:280.11256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE 280.12ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.280.13    (a) "Covered health services" for individuals under section 
         256L.04, subdivision 280.147
         , with income above 75 percent, but not exceeding 175 percent, of the federal poverty 280.15guideline means:280.16    (1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and 280.17subject to an annual limitation of $10,000;280.18    (2) physician services provided during an inpatient stay; and280.19    (3) physician services not provided during an inpatient stay; outpatient hospital 280.20services; freestanding ambulatory surgical center services; chiropractic services; lab and 280.21diagnostic services; diabetic supplies and equipment; mental health services as covered 280.22under chapter 256B; and prescription drugs; subject to the following co-payments:280.23    (i) $50 co-pay per emergency room visit;280.24    (ii) $3 co-pay per prescription drug; and280.25    (iii) $5 co-pay per nonpreventive visit; except this co-pay does not apply to mental 280.26health services or community mental health services.280.27The services covered under this section may be provided by a physician, physician 280.28ancillary, chiropractor, psychologist, or licensed independent clinical social worker, or 280.29other mental health providers covered under chapter 256B if the services are within the 280.30scope of practice of that health care professional.280.31    For purposes of this section, "a visit" means an episode of service which is required 280.32because of a recipient's symptoms, diagnosis, or established illness, and which is delivered 280.33in an ambulatory setting by any health care provider identified in this paragraph.280.34    Enrollees are responsible for all co-payments in this section.281.1    (b) Reimbursement to the providers shall be reduced by the amount of the 281.2co-payment, except that reimbursement for prescription drugs shall not be reduced once a 281.3recipient has reached the $20 per month maximum for prescription drug co-payments. 281.4The provider collects the co-payment from the recipient. Providers may not deny services 281.5to recipients who are unable to pay the co-payment, except as provided in paragraph (c).281.6    (c) If it is the routine business practice of a provider to refuse service to an individual 281.7with uncollected debt, the provider may include uncollected co-payments under this 281.8section. A provider must give advance notice to a recipient with uncollected debt before 281.9services can be denied.281.10EFFECTIVE DATE.This section is effective January 1, 2008, except coverage 281.11for mental health case management under paragraph (a), clause (3), is effective January 281.121, 2009.281.13    Sec. 18. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:281.14    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after 281.15October 1, 2003, the total payment made to managed care plans under the MinnesotaCare 281.16program is reduced 1.0 percent. This provision excludes payments for mental health 281.17services added as covered benefits after December 31, 2007.281.18    Sec. 19. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:281.19    Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted 281.20of theft under section 
         609.52, embezzlement of public funds under section 
         609.54, or 281.21forgery under section 
         609.625, 
         609.63, or 
         609.631, the probation officer shall determine in 281.22the report prepared under subdivision 1 whether or not compulsive gambling contributed 281.23to the commission of the offense. If so, the report shall contain the results of a compulsive 281.24gambling assessment conducted in accordance with this subdivision. The probation officer 281.25shall make an appointment for the offender to undergo the assessment if so indicated. 281.26    (b) The compulsive gambling assessment report must include a recommended level 281.27of treatment for the offender if the assessor concludes that the offender is in need of 281.28compulsive gambling treatment. The assessment must be conducted by an assessor 281.29qualified under section 
         245.98, subdivision 2a, to perform these assessments or to 281.30provide compulsive gambling treatment. An assessor providing a compulsive gambling 281.31assessment may not have any direct or shared financial interest or referral relationship 281.32resulting in shared financial gain with a treatment provider. If an independent assessor is 281.33not available, the probation officer may use the services of an assessor with a financial 282.1interest or referral relationship as authorized under rules adopted by the commissioner 282.2of human services under section 
         245.98, subdivision 2a. 282.3    (c) The commissioner of human services shall reimburse the assessor for the 282.4costs associated with a compulsive gambling assessment at a rate established by the 282.5commissioner up to a maximum of $100 for each assessment. To the extent practicable, the 282.6commissioner shall standardize reimbursement rates for assessments. The commissioner 282.7shall reimburse these costs after receiving written verification from the probation officer 282.8that the assessment was performed and found acceptable.282.9    (d) The commissioner shall make a report to the legislature by January 15, 2008, 282.10regarding the transfer of funds to counties for state registered nurses employed in 282.11community mental health pilot projects as part of the assertive community treatment 282.12teams under section 245.4661. The report shall address the impact of the nursing shortage 282.13on replacing these positions, continuity of patient care if these positions cannot be filled, 282.14and ways to maintain state registered nurses in these positions until the nurse retires or 282.15leaves employment. No funds for state registered nurse positions may be transferred 282.16before the report date.282.17    Sec. 20. CASE MANAGEMENT; BEST PRACTICES.282.18    The commissioner of human services, in consultation with consumers, families, 282.19counties, and other interested stakeholders, will develop recommendations for changes in 282.20the adult mental health act related to case management, consistent with evidence-based 282.21and best practices.282.22    Sec. 21. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.282.23    Subdivision 1.Pilot project authorized; purpose.A two-year Regional Children's 282.24Mental Health Initiative pilot project is established to improve children's mental health 282.25service coordination, communication, and processes in Blue Earth, Brown, Faribault, 282.26Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The 282.27purpose of the Regional Children's Mental Health Initiative will be to plan and develop 282.28new programs and services related to children's mental health in south central Minnesota.282.29    Subd. 2.Goals.To accomplish its purpose, the Regional Children's Mental Health 282.30Initiative shall have the following goals:282.31    (1) work to streamline delivery and regional access to services;282.32    (2) share strategies and resources for the management of out-of-home placements;282.33    (3) establish standard protocols and operating procedures for functions that are 282.34performed across all counties;283.1    (4) share information to improve resource allocation and service delivery across 283.2counties;283.3    (5) evaluate outcomes of various treatment alternatives;283.4    (6) create a network for and provide support to service delivery groups;283.5    (7) establish a regional process to match children in need of out-of-home placement 283.6with foster homes that can meet their needs; and283.7    (8) recruit and retain foster homes.283.8    Subd. 3.Director's Council.The Director's Council shall govern the operations of 283.9the Regional Children's Mental Health Initiative. Members of the Director's Council shall 283.10represent each of the 11 counties participating in the pilot project.283.11    Subd. 4.Regional Children's Mental Health Initiative Team.The members 283.12of the Regional Children's Mental Health Initiative Team shall conduct planning and 283.13development of new and modified children's mental health programs and services in the 283.14region. Members of the team shall reflect the cultural, demographic, and geographic 283.15diversity of the region and shall be composed of representatives from each of the 283.16following:283.17    (1) the medical community;283.18    (2) human services;283.19    (3) corrections;283.20    (4) education;283.21    (5) mental health providers and vendors;283.22    (6) advocacy organizations;283.23    (7) parents; and283.24    (8) children and youth.283.25    Subd. 5.Authority.The regional children's mental health initiative shall have the 283.26authority to develop and implement the following programs:283.27    (1) Flexible funding payments. This program will make funds available to respond to 283.28the unique and unpredictable needs of children with mental health issues such as the need 283.29for prescription drugs, transportation, clothing, and assessments not otherwise available.283.30    (2) Transition to self-sufficiency. This program will help youths between the ages of 283.3114 and 21 establish professional relationships, find jobs, build financial foundations, and 283.32learn to fulfill their roles as productive citizens.283.33    (3) Crisis response. This program will establish public and private partnerships 283.34to offer a range of options to meet the needs of children in crisis. Methods to meet 283.35these needs may include accessible local services, holistic assessments, urgent care and 283.36stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.284.1    (4) Integrated services for complex conditions. This program will design, develop, 284.2and implement packages of integrated services to meet the needs of children with specific, 284.3complex conditions.284.4    Subd. 6.Evaluation and report.The regional children's mental health initiative 284.5shall develop a method for evaluating the effectiveness of this pilot project focusing on 284.6identifiable goals and outcomes. An interim report on the pilot project's effectiveness 284.7shall be submitted to the house and senate finance committees having jurisdiction over 284.8mental health, the commissioner of human services, and the Minnesota Association of 284.9County Social Service Administrators no later than December 31, 2008. A final report 284.10is due no later than December 31, 2009.284.11    Sec. 22. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES TO 284.12CHILDREN.284.13    Organizations that are certified to provide children's therapeutic services and 284.14supports under Minnesota Statutes, section 256B.0943, are eligible to apply for a grant. 284.15Grants are to be used to provide trauma-focused evidence-based practices to children 284.16who are living in a battered women's shelter, homeless shelter, transitional housing, or 284.17supported housing. Children served must have been exposed to or witnessed domestic 284.18violence, have been exposed to or witnessed community violence, or be a refugee. Priority 284.19shall be given to organizations that demonstrate collaboration with battered women's 284.20shelters, homeless shelters, or providers of transitional housing or supported housing. The 284.21commissioner shall specify which constitutes evidence-based practice. Organizations shall 284.22use all available funding streams.284.23    Sec. 23. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.284.24    (a) The commissioner of human services shall fund demonstration projects for high 284.25risk adults with serious mental illness and co-occurring substance abuse problems. The 284.26projects must include, but not be limited to, the following:284.27    (1) housing services, including rent or housing subsidies, housing with clinical 284.28staff, or housing support;284.29    (2) assertive outreach services; and284.30    (3) intensive direct therapeutic, rehabilitative, and care management services 284.31oriented to harm reduction.284.32    (b) The commissioner shall work with providers to ensure proper licensure or 284.33certification to meet medical assistance or third-party payor reimbursement requirements.285.1    Sec. 24. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S 285.2MENTAL HEALTH PILOT PROJECT.285.3    Subdivision 1.Pilot project authorized.The commissioner of human services 285.4shall fund a three-year pilot project to measure the effect of children's identified mental 285.5health needs, including social and emotional needs, on Minnesota family investment 285.6program (MFIP) participants' ability to obtain and retain employment. The project shall 285.7also measure the effect on work activity of MFIP participants' needs to address their 285.8children's identified mental health needs.285.9    Subd. 2.Provider and agency proposals.(a) Interested MFIP providers and 285.10agencies shall: 285.11    (1) submit proposals defining how they will identify participants whose children 285.12have mental health needs that hinder the employment process; 285.13    (2) connect families with appropriate developmental, social, and emotional 285.14screenings and services; and 285.15    (3) incorporate those services into the participant's employment plan.285.16Each proposal under this paragraph must include an evaluation component.285.17    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP 285.18participants of the following: 285.19    (1) the availability of developmental, social, and emotional screening tools for 285.20children and youth; 285.21    (2) the purpose of the screenings; 285.22    (3) how the information will be used to assist the participants in identifying and 285.23addressing potential barriers to employment; and 285.24    (4) that their employment plan may be modified based on the screening results.285.25    Subd. 3.Program components.(a) MFIP providers shall obtain the participant's 285.26written consent for participation in the pilot project, including consent for developmental, 285.27social, and emotional screening.285.28    (b) MFIP providers shall coordinate with county social service agencies and health 285.29plans to assist recipients in arranging referrals indicated by the screening results.285.30    (c) Tools used for developmental, social, and emotional screenings shall be approved 285.31by the commissioner of human services.285.32    Subd. 4.Program evaluation.The commissioner of human services shall conduct 285.33an evaluation of the pilot project to determine:285.34    (1) the number of participants who took part in the screening;285.35    (2) the number of children who were screened and what screening tools were used;286.1    (3) the number of children who were identified in the screening who needed referral 286.2or follow-up services;286.3    (4) the number of children who received services, what agency provided the services, 286.4and what type of services were provided;286.5    (5) the number of employment plans that were adjusted to include the activities 286.6recommended in the screenings;286.7    (6) the changes in work participation rates;286.8    (7) the changes in earned income;286.9    (8) the changes in sanction rates; and286.10    (9) the participants' report of program effectiveness.286.11    Subd. 5.Work activity.Participant involvement in screenings and subsequent 286.12referral and follow-up services shall count as work activity under Minnesota Statutes, 286.13section 256J.49, subdivision 13.286.14    Sec. 25. SOCIAL AND ECONOMIC COSTS OF GAMBLING.286.15    Subdivision 1.Report.The commissioner of human services, in consultation with 286.16the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed 286.17vendors, shall prepare a report that provides a process and funding mechanism to study the 286.18issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate 286.19of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall 286.20include in the report potential financial commitments made by stakeholders and others in 286.21order to fund the study. The report is due to the legislative committees having jurisdiction 286.22over compulsive gambling issues by December 1, 2007. 286.23    Subd. 2.Issues to be addressed.The study must address:286.24    (1) state, local, and tribal government policies and practices in Minnesota to legalize 286.25or prohibit gambling;286.26    (2) the relationship between gambling and crime in Minnesota, including: (i) the 286.27relationship between gambling and overall crime rates; (ii) the relationship between 286.28gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child 286.29neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement 286.30and regulation practices that are intended to address the relationship between gambling 286.31and levels of crime;286.32    (3) the relationship between expanded gambling and increased rates of problem 286.33gambling in Minnesota, including the impact of pathological or problem gambling on 286.34individuals, families, businesses, social institutions, and the economy;287.1    (4) the social impact of gambling on individuals, families, businesses, and social 287.2institutions in Minnesota, including an analysis of the relationship between gambling and 287.3depression, abuse, divorce, homelessness, suicide, and bankruptcy;287.4    (5) the economic impact of gambling on state, local, and tribal economies in 287.5Minnesota; and287.6    (6) any other issues deemed necessary in assessing the social and economic impact 287.7of gambling in Minnesota.287.8    Subd. 3.Quantification of social and economic impact.The study shall quantify 287.9the social and economic impact on both (1) state, local, and tribal governments in 287.10Minnesota, and (2) Minnesota's communities and social institutions, including individuals, 287.11families, and businesses within those communities and institutions.287.12    Sec. 26.  REPEALER.287.13Minnesota Rules, part 9585.0030, is repealed.287.14ARTICLE 6287.15DEPARTMENT OF HEALTH287.16    Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:287.17    Subd. 2. Definitions. For purposes of this section, the terms defined in this 287.18subdivision have the meanings given.287.19    (a) "Access" means the financial, temporal, and geographic availability of health 287.20care to individuals who need it.287.21    (b)(a) "Capital expenditure" means an expenditure which, under generally accepted 287.22accounting principles, is not properly chargeable as an expense of operation and 287.23maintenance.287.24    (c) "Cost" means the amount paid by consumers or third party payers for health 287.25care services or products.287.26    (d) "Date of the major spending commitment" means the date the provider formally 287.27obligated itself to the major spending commitment. The obligation may be incurred 287.28by entering into a contract, making a down payment, issuing bonds or entering a loan 287.29agreement to provide financing for the major spending commitment, or taking some other 287.30formal, tangible action evidencing the provider's intention to make the major spending 287.31commitment.287.32    (e)(b) "Health care service" means:288.1    (1) a service or item that would be covered by the medical assistance program 288.2under chapter 256B if provided in accordance with medical assistance requirements to an 288.3eligible medical assistance recipient; and288.4    (2) a service or item that would be covered by medical assistance except that it is 288.5characterized as experimental, cosmetic, or voluntary.288.6    "Health care service" does not include retail, over-the-counter sales of 288.7nonprescription drugs and other retail sales of health-related products that are not generally 288.8paid for by medical assistance and other third-party coverage.288.9    (f)(c) "Major spending commitment" means an expenditure in excess of $1,000,000 288.10for:288.11    (1) acquisition of a unit of medical equipment;288.12    (2) a capital expenditure for a single project for the purposes of providing health 288.13care services, other than for the acquisition of medical equipment;288.14    (3) offering a new specialized service not offered before;288.15    (4) planning for an activity that would qualify as a major spending commitment 288.16under this paragraph; or288.17    (5) a project involving a combination of two or more of the activities in clauses 288.18(1) to (4).288.19    The cost of acquisition of medical equipment, and the amount of a capital 288.20expenditure, is the total cost to the provider regardless of whether the cost is distributed 288.21over time through a lease arrangement or other financing or payment mechanism.288.22    (g)(d) "Medical equipment" means fixed and movable equipment that is used by 288.23a provider in the provision of a health care service. "Medical equipment" includes, but 288.24is not limited to, the following:288.25    (1) an extracorporeal shock wave lithotripter;288.26    (2) a computerized axial tomography (CAT) scanner;288.27    (3) a magnetic resonance imaging (MRI) unit;288.28    (4) a positron emission tomography (PET) scanner; and288.29    (5) emergency and nonemergency medical transportation equipment and vehicles.288.30    (h)(e) "New specialized service" means a specialized health care procedure or 288.31treatment regimen offered by a provider that was not previously offered by the provider, 288.32including, but not limited to:288.33    (1) cardiac catheterization services involving high-risk patients as defined in the 288.34Guidelines for Coronary Angiography established by the American Heart Association 288.35and the American College of Cardiology;289.1    (2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or 289.2any other service for transplantation of any other organ;289.3    (3) megavoltage radiation therapy;289.4    (4) open heart surgery;289.5    (5) neonatal intensive care services; and289.6    (6) any new medical technology for which premarket approval has been granted by 289.7the United States Food and Drug Administration, excluding implantable and wearable 289.8devices.289.9    (f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic, 289.10obstetrics, mental health, chemical dependency, and emergency services.289.11    Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:289.12    Subd. 4a. Expenditure reporting.(a) A provider making a major spending 289.13commitment after April 1, 1992, shall submit notification of the expenditure to the 289.14commissioner and provide the commissioner with any relevant background information.289.15    (b) Notification must include a report, submitted within 60 days after the date of the 289.16major spending commitment, using terms conforming to the definitions in section 62J.03289.17and this section. Each report is subject to retrospective review and must contain: 289.18    (1) a detailed description of the major spending commitment, including the specific 289.19dollar amount of each expenditure, and its purpose;289.20    (2) the date of the major spending commitment;289.21    (3) a statement of the expected impact that the major spending commitment will 289.22have on charges by the provider to patients and third party payers;289.23    (4) a statement of the expected impact on the clinical effectiveness or quality of care 289.24received by the patients that the provider expects to serve;289.25    (5) a statement of the extent to which equivalent services or technology are already 289.26available to the provider's actual and potential patient population;289.27    (6) a statement of the distance from which the nearest equivalent services or 289.28technology are already available to the provider's actual and potential population;289.29    (7) a statement describing the pursuit of any lawful collaborative arrangements; and289.30    (8) a statement of assurance that the provider will not use, purchase, or perform 289.31health care technologies and procedures that are not clinically effective and cost-effective, 289.32unless the technology is used for experimental or research purposes to determine whether 289.33a technology or procedure is clinically effective and cost-effective.289.34    The provider may submit any additional information that it deems relevant.290.1    (c) The commissioner may request additional information from a provider for the 290.2purpose of review of a report submitted by that provider, and may consider relevant 290.3information from other sources. A provider shall provide any information requested by 290.4the commissioner within the time period stated in the request, or within 30 days after the 290.5date of the request if the request does not state a time.290.6    (d) If the provider fails to submit a complete and timely expenditure report, including 290.7any additional information requested by the commissioner, the commissioner may make 290.8the provider's subsequent major spending commitments subject to the procedures of 290.9prospective review and approval under subdivision 6a.290.10    Each hospital, outpatient surgical center, diagnostic imaging center, and physician 290.11clinic shall report annually to the commissioner on all major spending commitments, 290.12in the form and manner specified by the commissioner. The report shall include the 290.13following information:290.14    (a) a description of major spending commitments made during the previous year, 290.15including the total dollar amount of major spending commitments and purpose of the 290.16expenditures;290.17    (b) the cost of land acquisition, construction of new facilities, and renovation of 290.18existing facilities;290.19    (c) the cost of purchased or leased medical equipment, by type of equipment;290.20    (d) expenditures by type for specialty care and new specialized services;290.21    (e) information on the amount and types of added capacity for diagnostic imaging 290.22services, outpatient surgical services, and new specialized services; and290.23    (f) information on investments in electronic medical records systems.290.24For hospitals and outpatient surgical centers, this information shall be included in reports 290.25to the commissioner that are required under section 144.698. For diagnostic imaging 290.26centers, this information shall be included in reports to the commissioner that are required 290.27under section 144.565. For physician clinics, this information shall be included in reports 290.28to the commissioner that are required under section 62J.41. For all other health care 290.29providers that are subject to this reporting requirement, reports must be submitted to the 290.30commissioner by March 1 each year for the preceding calendar year.290.31    Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:290.32    Subd. 7. Exceptions. (a) The retrospective review process as described in 290.33subdivision 5a and the prospective review and approval process as described in subdivision 290.346a reporting requirement in subdivision 4adodoes not apply to:291.1    (1) a major spending commitment to replace existing equipment with comparable 291.2equipment used for direct patient care, upgrades of equipment beyond the current model, 291.3or comparable model must be reported;291.4    (2) (1) a major spending commitment made by a research and teaching institution 291.5for purposes of conducting medical education, medical research supported or sponsored 291.6by a medical school, or by a federal or foundation grant or clinical trials;291.7    (3) a major spending commitment to repair, remodel, or replace existing buildings or 291.8fixtures if, in the judgment of the commissioner, the project does not involve a substantial 291.9expansion of service capacity or a substantial change in the nature of health care services 291.10provided;291.11    (4) (2) a major spending commitment for building maintenance including heating, 291.12water, electricity, and other maintenance-related expenditures; and291.13    (5) (3) a major spending commitment for activities, not directly related to the 291.14delivery of patient care services, including food service, laundry, housekeeping, and 291.15other service-related activities; and.291.16    (6) a major spending commitment for computer equipment or data systems not 291.17directly related to the delivery of patient care services, including computer equipment or 291.18data systems related to medical record automation.291.19    (b) In addition to the exceptions listed in paragraph (a), the prospective review and 291.20approval process described in subdivision 6a reporting requirement in subdivision 4a does 291.21not apply to mergers, acquisitions, and other changes in ownership or control that, in the 291.22judgment of the commissioner, do not involve a substantial expansion of service capacity 291.23or a substantial change in the nature of health care services provided.291.24    Sec. 4. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:291.25    Subdivision 1. Cost containment data to be collected from providers. The 291.26commissioner shall require health care providers to collect and provide both patient 291.27specific information and descriptive and financial aggregate data on:291.28    (1) the total number of patients served;291.29    (2) the total number of patients served by state of residence and Minnesota county;291.30    (3) the site or sites where the health care provider provides services;291.31    (4) the number of individuals employed, by type of employee, by the health care 291.32provider;291.33    (5) the services and their costs for which no payment was received;291.34    (6) total revenue by type of payer or by groups of payers, including but not limited 291.35to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service 292.1plan corporations, commercial insurers, health maintenance organizations, and individual 292.2patients;292.3    (7) revenue from research activities;292.4    (8) revenue from educational activities;292.5    (9) revenue from out-of-pocket payments by patients;292.6    (10) revenue from donations; and292.7    (11) a report on health care capital expenditures during the previous year, as required 292.8by section 62J.17; and292.9    (11) (12) any other data required by the commissioner, including data in 292.10unaggregated form, for the purposes of developing spending estimates, setting spending 292.11limits, monitoring actual spending, and monitoring costs.292.12The commissioner may, by rule, modify the data submission categories listed above if the 292.13commissioner determines that this will reduce the reporting burden on providers without 292.14having a significant negative effect on necessary data collection efforts.292.15    Sec. 5. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:292.16    Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1, 292.171996, all institutional inpatient hospital services, ancillary services, institutionally owned 292.18or operated outpatient services rendered by providers in Minnesota, and institutional 292.19or noninstitutional home health services that are not being billed using an equivalent 292.20electronic billing format, must be billed using the uniform billing form CMS 1450, except 292.21as provided in subdivision 5.292.22    (b) The instructions and definitions for the use of the uniform billing form CMS 292.231450 shall be in accordance with the uniform billing form manual specified by the 292.24commissioner. In promulgating these instructions, the commissioner may utilize the 292.25manual developed by the National Uniform Billing Committee, as adopted and finalized 292.26by the Minnesota Uniform Billing Committee.292.27    (c) Services to be billed using the uniform billing form CMS 1450 include: 292.28institutional inpatient hospital services and distinct units in the hospital such as psychiatric 292.29unit services, physical therapy unit services, swing bed (SNF) services, inpatient state 292.30psychiatric hospital services, inpatient skilled nursing facility services, home health 292.31services (Medicare part A), and hospice services; ancillary services, where benefits are 292.32exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals, 292.33skilled nursing facilities, and home health (Medicare part B); institutional owned or 292.34operated outpatient services such as waivered services, hospital outpatient services, 292.35including ambulatory surgical center services, hospital referred laboratory services, 293.1hospital-based ambulance services, and other hospital outpatient services, skilled nursing 293.2facilities, home health, freestanding renal dialysis centers, comprehensive outpatient 293.3rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health 293.4clinics, and community mental health centers; home health services such as home health 293.5intravenous therapy providers, waivered services, personal care attendants, and hospice; 293.6and any other health care provider certified by the Medicare program to use this form.293.7    (d) On and after January 1, 1996, a mother and newborn child must be billed 293.8separately, and must not be combined on one claim form.293.9    (e) Services provided by Medicare Critical Access Hospitals electing Method 293.10II billing will be allowed an exception to this provision to allow the inclusion of the 293.11professional fees on the CMS 1450.293.12    Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:293.13    Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all 293.14noninstitutional health care services rendered by providers in Minnesota except dental 293.15or pharmacy providers, that are not currently being billed using an equivalent electronic 293.16billing format, must be billed using the health insurance claim form CMS 1500, except as 293.17provided in subdivision 5.293.18    (b) The instructions and definitions for the use of the uniform billing form CMS 293.191500 shall be in accordance with the manual developed by the Administrative Uniformity 293.20Committee entitled standards for the use of the CMS 1500 form, dated February 1994, 293.21as further defined by the commissioner.293.22    (c) Services to be billed using the uniform billing form CMS 1500 include physician 293.23services and supplies, durable medical equipment, noninstitutional ambulance services, 293.24independent ancillary services including occupational therapy, physical therapy, speech 293.25therapy and audiology, home infusion therapy, podiatry services, optometry services, 293.26mental health licensed professional services, substance abuse licensed professional 293.27services, nursing practitioner professional services, certified registered nurse anesthetists, 293.28chiropractors, physician assistants, laboratories, medical suppliers, and other health care 293.29providers such as day activity centers and freestanding ambulatory surgical centers.293.30    (d) Services provided by Medicare Critical Access Hospitals electing Method 293.31II billing will be allowed an exception to this provision to allow the inclusion of the 293.32professional fees on the CMS 1450.293.33    Sec. 7. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:294.1    Subd. 2. General characteristics. (a) The Minnesota uniform health care 294.2identification card must be a preprinted card constructed of plastic, paper, or any other 294.3medium that conforms with ANSI and ISO 7810 physical characteristics standards. The 294.4card dimensions must also conform to ANSI and ISO 7810 physical characteristics 294.5standard. The use of a signature panel is optional. The uniform prescription drug 294.6information contained on the card must conform with the format adopted by the NCPDP 294.7and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of 294.8the fields required to submit a claim in conformance with the most recent pharmacy 294.9identification card implementation guide produced by the NCPDP. All information 294.10required to submit a prescription drug claim, exclusive of information provided on a 294.11prescription that is required by law, must be included on the card in a clear, readable, and 294.12understandable manner. If a health benefit plan requires a conditional or situational field, 294.13as defined by the NCPDP, the conditional or situational field must conform to the most 294.14recent pharmacy information card implementation guide produced by the NCPDP.294.15    (b) The Minnesota uniform health care identification card must have an essential 294.16information window on the front side with the following data elements: card issuer name, 294.17electronic transaction routing information, card issuer identification number, cardholder 294.18(insured) identification number, and cardholder (insured) identification name. No optional 294.19data may be interspersed between these data elements. 294.20    (c) Standardized labels are required next to human readable data elements and 294.21must come before the human data elements.294.22    Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:294.23    Subd. 3. Human readable data elements. (a) The following are the minimum 294.24human readable data elements that must be present on the front side of the Minnesota 294.25uniform health care identification card:294.26    (1) card issuer name or logo, which is the name or logo that identifies the card issuer. 294.27The card issuer name or logo may be located at the top of the card. No standard label 294.28is required for this data element;294.29    (2) complete electronic transaction routing information including, at a minimum, 294.30the international identification number. The standardized label of this data element 294.31is "RxBIN." Processor control numbers and group numbers are required if needed to 294.32electronically process a prescription drug claim. The standardized label for the process 294.33control numbers data element is "RxPCN" and the standardized label for the group 294.34numbers data element is "RxGrp," except that if the group number data element is a 294.35universal element to be used by all health care providers, the standardized label may be 295.1"Grp." To conserve vertical space on the card, the international identification number and 295.2the processor control number may be printed on the same line;295.3     (3) cardholder (insured) identification number, which is the unique identification 295.4number of the individual card holder established and defined under this section. The 295.5standardized label for the data element is "ID";295.6    (4) cardholder (insured) identification name, which is the name of the individual 295.7card holder. The identification name must be formatted as follows: first name, space, 295.8optional middle initial, space, last name, optional space and name suffix. The standardized 295.9label for this data element is "Name";295.10    (5) care type, which is the description of the group purchaser's plan product under 295.11which the beneficiary is covered. The description shall include the health plan company 295.12name and the plan or product name. The standardized label for this data element is 295.13"Care Type";295.14    (6) service type, which is the description of coverage provided such as hospital, 295.15dental, vision, prescription, or mental health. The standard label for this data element 295.16is "Svc Type"; and295.17    (7) provider/clinic name, which is the name of the primary care clinic the card 295.18holder is assigned to by the health plan company. The standard label for this field is 295.19"PCP." This information is mandatory only if the health plan company assigns a specific 295.20primary care provider to the card holder.295.21    (b) The following human readable data elements shall be present on the back side 295.22of the Minnesota uniform health care identification card. These elements must be left 295.23justified, and no optional data elements may be interspersed between them:295.24    (1) claims submission names and addresses, which are the names and addresses of 295.25the entity or entities to which claims should be submitted. If different destinations are 295.26required for different types of claims, this must be labeled;295.27    (2) telephone numbers and names that pharmacies and other health care providers 295.28may call for assistance. These telephone numbers and names are required on the back 295.29side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies 295.30or other providers with assistance or with the telephone numbers and names of contacts 295.31for assistance; and295.32    (3) telephone numbers and names; which are the telephone numbers and names of the 295.33following contacts with a standardized label describing the service function as applicable:295.34    (i) eligibility and benefit information;295.35    (ii) utilization review;295.36    (iii) precertification; or296.1    (iv) customer services.296.2    (c) The following human readable data elements are mandatory on the back 296.3side of the Minnesota uniform health care identification card for health maintenance 296.4organizations:296.5    (1) emergency care authorization telephone number or instruction on how to receive 296.6authorization for emergency care. There is no standard label required for this information; 296.7and296.8    (2) one of the following:296.9    (i) telephone number to call to appeal to or file a complaint with the commissioner of 296.10health; or296.11    (ii) for persons enrolled under section 
         256B.69, 
         256D.03, or 
         256L.12, the telephone 296.12number to call to file a complaint with the ombudsperson designated by the commissioner 296.13of human services under section 
         256B.69 and the address to appeal to the commissioner of 296.14human services. There is no standard label required for this information. 296.15    (d) All human readable data elements not required under paragraphs (a) to (c) are 296.16optional and may be used at the issuer's discretion.296.17    Sec. 9. Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision 296.18to read:296.19    Subd. 1a.Demonstration project.The commissioner of health shall award a 296.20demonstration project grant to a community-based health care initiative to develop and 296.21operate a community-based health care coverage program to operate within Carlton, 296.22Cook, Lake, and St. Louis Counties. The demonstration project shall extend for five years 296.23and must comply with all the requirements of this section.296.24    Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:296.25    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 296.26coverage program, a community-based health initiative shall submit to the commissioner 296.27of health for approval the community-based health care coverage program developed by 296.28the initiative. The commissioner shall only approve a program that has been awarded 296.29a community access program grant from the United States Department of Health and 296.30Human Services. The commissioner shall ensure that the program meets the federal grant 296.31requirements and any requirements described in this section and is actuarially sound based 296.32on a review of appropriate records and methods utilized by the community-based health 296.33initiative in establishing premium rates for the community-based health care coverage 296.34program. 297.1    (b) Prior to approval, the commissioner shall also ensure that:297.2    (1) the benefits offered comply with subdivision 8 and that there are adequate 297.3numbers of health care providers participating in the community-based health network to 297.4deliver the benefits offered under the program;297.5    (2) the activities of the program are limited to activities that are exempt under this 297.6section or otherwise from regulation by the commissioner of commerce;297.7    (3) the complaint resolution process meets the requirements of subdivision 10; and 297.8    (4) the data privacy policies and procedures comply with state and federal law.297.9    Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:297.10    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 297.11by the commissioner of health a community-based health care coverage program. The 297.12operational structure established by the initiative shall include, but is not limited to: 297.13    (1) establishing a process for enrolling eligible individuals and their dependents; 297.14    (2) collecting and coordinating premiums from enrollees and employers of enrollees;297.15    (3) providing payment to participating providers; 297.16    (4) establishing a benefit set according to subdivision 8 and establishing premium 297.17rates and cost-sharing requirements; 297.18    (5) creating incentives to encourage primary care and wellness services; and 297.19    (6) initiating disease management services, as appropriate. 297.20    (b) The payments collected under paragraph (a), clause (2), may be used to capture 297.21available federal funds.297.22    Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:297.23    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 297.24commissioner of health on January 15, April 15, July 15, and October 15 of each year, 297.25with the first report due January 15, 2007 2008. The status report shall include:297.26    (1) the financial status of the program, including the premium rates, cost per member 297.27per month, claims paid out, premiums received, and administrative expenses; 297.28    (2) a description of the health care benefits offered and the services utilized; 297.29    (3) the number of employers participating, the number of employees and dependents 297.30covered under the program, and the number of health care providers participating; 297.31    (4) a description of the health outcomes to be achieved by the program and a status 297.32report on the performance measurements to be used and collected; and 297.33    (5) any other information requested by the commissioner of health or commerce or 297.34the legislature. 298.1    (b) The initiative shall contract with an independent entity to conduct an evaluation 298.2of the program to be submitted to the commissioners of health and commerce and the 298.3legislature by January 15, 2009 2010. The evaluation shall include:298.4    (1) an analysis of the health outcomes established by the initiative and the 298.5performance measurements to determine whether the outcomes are being achieved;298.6    (2) an analysis of the financial status of the program, including the claims to 298.7premiums loss ratio and utilization and cost experience; 298.8    (3) the demographics of the enrollees, including their age, gender, family income, 298.9and the number of dependents; 298.10    (4) the number of employers and employees who have been denied access to the 298.11program and the basis for the denial; 298.12    (5) specific analysis on enrollees who have aggregate medical claims totaling over 298.13$5,000 per year, including data on the enrollee's main diagnosis and whether all the 298.14medical claims were covered by the program; 298.15    (6) number of enrollees referred to state public assistance programs; 298.16    (7) a comparison of employer-subsidized health coverage provided in a comparable 298.17geographic area to the designated community-based geographic area served by the 298.18program, including, to the extent available: 298.19    (i) the difference in the number of employers with 50 or fewer employees offering 298.20employer-subsidized health coverage; 298.21    (ii) the difference in uncompensated care being provided in each area; and298.22    (iii) a comparison of health care outcomes and measurements established by the 298.23initiative; and 298.24    (8) any other information requested by the commissioner of health or commerce.298.25    Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:298.26    Subd. 14. Sunset. This section expires December 31, 2011 2012.298.27    Sec. 14. [144.291] MINNESOTA HEALTH RECORDS ACT.298.28    Subdivision 1.Short title.Sections 144.291 to 144.298 may be cited as the 298.29Minnesota Health Records Act.298.30    Subd. 2.Definitions.For the purposes of sections 144.291 to 144.298, the following 298.31terms have the meanings given.298.32    (a) Affiliate. "Affiliate" has the meaning given in section 144.6521, subdivision 3, 298.33paragraph (b).299.1    (b) Group purchaser. "Group purchaser" has the meaning given in section 62J.03, 299.2subdivision 6.299.3    (c) Health record. "Health record" means any information, whether oral or recorded 299.4in any form or medium, that relates to the past, present, or future physical or mental health 299.5or condition of a patient; the provision of health care to a patient; or the past, present, or 299.6future payment for the provision of health care to a patient.299.7    (d) Identifying information. "Identifying information" means the patient's name, 299.8address, date of birth, gender, parent's or guardian's name regardless of the age of the 299.9patient, and other nonclinical data which can be used to uniquely identify a patient.299.10    (e) Individually identifiable form. "Individually identifiable form" means a form in 299.11which the patient is or can be identified as the subject of the health records.299.12    (f) Medical emergency. "Medical emergency" means medically necessary care 299.13which is immediately needed to preserve life, prevent serious impairment to bodily 299.14functions, organs, or parts, or prevent placing the physical or mental health of the patient 299.15in serious jeopardy.299.16    (g) Patient. "Patient" means a natural person who has received health care services 299.17from a provider for treatment or examination of a medical, psychiatric, or mental 299.18condition, the surviving spouse and parents of a deceased patient, or a person the patient 299.19appoints in writing as a representative, including a health care agent acting according to 299.20chapter 145C, unless the authority of the agent has been limited by the principal in the 299.21principal's health care directive. Except for minors who have received health care services 299.22under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or 299.23guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.299.24    (h) Provider. "Provider" means: 299.25    (1) any person who furnishes health care services and is regulated to furnish the 299.26services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 299.27151, 153, or 153A; 299.28    (2) a home care provider licensed under section 144A.46; 299.29    (3) a health care facility licensed under this chapter or chapter 144A; 299.30    (4) a physician assistant registered under chapter 147A; and 299.31    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to 299.32148B.71.299.33    (i) Record locator service. "Record locator service" means an electronic index of 299.34patient identifying information that directs providers in a health information exchange to 299.35the location of patient health records held by providers and group purchasers.300.1    (j) Related health care entity. "Related health care entity" means an affiliate of 300.2the provider releasing the health records.300.3    Sec. 15. [144.292] PATIENT RIGHTS.300.4    Subdivision 1.Scope.Patients have the rights specified in this section regarding the 300.5treatment the patient receives and the patient's health record.300.6    Subd. 2.Patient access.Upon request, a provider shall supply to a patient complete 300.7and current information possessed by that provider concerning any diagnosis, treatment, 300.8and prognosis of the patient in terms and language the patient can reasonably be expected 300.9to understand.300.10    Subd. 3.Additional patient rights.A patient's right specified in this section and 300.11sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and 300.12144.652 and any other provision of law relating to the access of a patient to the patient's 300.13health records.300.14    Subd. 4.Notice of rights; information on release.A provider shall provide to 300.15patients, in a clear and conspicuous manner, a written notice concerning practices and 300.16rights with respect to access to health records. The notice must include an explanation of:300.17    (1) disclosures of health records that may be made without the written consent of the 300.18patient, including the type of records and to whom the records may be disclosed; and300.19    (2) the right of the patient to have access to and obtain copies of the patient's health 300.20records and other information about the patient that is maintained by the provider.300.21    The notice requirements of this subdivision are satisfied if the notice is included with 300.22the notice and copy of the patient and resident bill of rights under section 144.652 or if it 300.23is displayed prominently in the provider's place of business. The commissioner of health 300.24shall develop the notice required in this subdivision and publish it in the State Register.300.25    Subd. 5.Copies of health records to patients.Except as provided in section 300.26144.296, upon a patient's written request, a provider, at a reasonable cost to the patient, 300.27shall promptly furnish to the patient:300.28    (1) copies of the patient's health record, including but not limited to laboratory 300.29reports, x-rays, prescriptions, and other technical information used in assessing the 300.30patient's health conditions; or300.31    (2) the pertinent portion of the record relating to a condition specified by the patient.300.32    With the consent of the patient, the provider may instead furnish only a summary 300.33of the record. The provider may exclude from the health record written speculations 300.34about the patient's health condition, except that all information necessary for the patient's 300.35informed consent must be provided.301.1    Subd. 6.Cost.(a) When a patient requests a copy of the patient's record for 301.2purposes of reviewing current medical care, the provider must not charge a fee.301.3    (b) When a provider or its representative makes copies of patient records upon a 301.4patient's request under this section, the provider or its representative may charge the 301.5patient or the patient's representative no more than 75 cents per page, plus $10 for time 301.6spent retrieving and copying the records, unless other law or a rule or contract provide for 301.7a lower maximum charge. This limitation does not apply to x-rays. The provider may 301.8charge a patient no more than the actual cost of reproducing x-rays, plus no more than 301.9$10 for the time spent retrieving and copying the x-rays.301.10    (c) The respective maximum charges of 75 cents per page and $10 for time provided 301.11in this subdivision are in effect for calendar year 1992 and may be adjusted annually each 301.12calendar year as provided in this subdivision. The permissible maximum charges shall 301.13change each year by an amount that reflects the change, as compared to the previous year, 301.14in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 301.15published by the Department of Labor.301.16    (d) A provider or its representative must not charge a fee to provide copies of records 301.17requested by a patient or the patient's authorized representative if the request for copies 301.18of records is for purposes of appealing a denial of Social Security disability income or 301.19Social Security disability benefits under title II or title XVI of the Social Security Act. For 301.20the purpose of further appeals, a patient may receive no more than two medical record 301.21updates without charge, but only for medical record information previously not provided. 301.22For purposes of this paragraph, a patient's authorized representative does not include units 301.23of state government engaged in the adjudication of Social Security disability claims.301.24    Subd. 7.Withholding health records from patient.(a) If a provider reasonably 301.25determines that the information is detrimental to the physical or mental health of the 301.26patient, or is likely to cause the patient to inflict self harm, or to harm another, the provider 301.27may withhold the information from the patient and may supply the information to an 301.28appropriate third party or to another provider. The other provider or third party may 301.29release the information to the patient.301.30    (b) A provider shall release information upon written request unless, prior to the 301.31request, a provider has designated and described a specific basis for withholding the 301.32information as authorized by paragraph (a).301.33    Sec. 16. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.301.34    Subdivision 1.Release or disclosure of health records.Health records can be 301.35released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.302.1    Subd. 2.Patient consent to release of records.A provider, or a person who 302.2receives health records from a provider, may not release a patient's health records to a 302.3person without:302.4    (1) a signed and dated consent from the patient or the patient's legally authorized 302.5representative authorizing the release;302.6    (2) specific authorization in law; or302.7    (3) a representation from a provider that the provider holds a consent from the 302.8patient.302.9    Subd. 3.Release from one provider to another.A patient's health record, 302.10including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical 302.11information used in assessing the patient's condition, or the pertinent portion of the record 302.12relating to a specific condition, or a summary of the record, shall promptly be furnished to 302.13another provider upon the written request of the patient. The written request shall specify 302.14the name of the provider to whom the health record is to be furnished. The provider who 302.15furnishes the health record or summary may retain a copy of the materials furnished. The 302.16patient shall be responsible for the reasonable costs of furnishing the information.302.17    Subd. 4.Duration of consent.Except as provided in this section, a consent is 302.18valid for one year or for a lesser period specified in the consent or for a different period 302.19provided by law.302.20    Subd. 5.Exceptions to consent requirement.This section does not prohibit the 302.21release of health records:302.22    (1) for a medical emergency when the provider is unable to obtain the patient's 302.23consent due to the patient's condition or the nature of the medical emergency;302.24    (2) to other providers within related health care entities when necessary for the 302.25current treatment of the patient; or302.26    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same 302.27types of health care facilities licensed by this chapter and chapter 144A that are licensed 302.28in another state when a patient:302.29    (i) is returning to the health care facility and unable to provide consent; or302.30    (ii) who resides in the health care facility, has services provided by an outside 302.31resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable 302.32to provide consent.302.33    Subd. 6.Consent does not expire.Notwithstanding subdivision 4, if a patient 302.34explicitly gives informed consent to the release of health records for the purposes and 302.35restrictions in clauses (1) and (2), the consent does not expire after one year for:303.1    (1) the release of health records to a provider who is being advised or consulted with 303.2in connection with the releasing provider's current treatment of the patient;303.3    (2) the release of health records to an accident and health insurer, health service plan 303.4corporation, health maintenance organization, or third-party administrator for purposes of 303.5payment of claims, fraud investigation, or quality of care review and studies, provided that:303.6    (i) the use or release of the records complies with sections 72A.49 to 72A.505;303.7    (ii) further use or release of the records in individually identifiable form to a person 303.8other than the patient without the patient's consent is prohibited; and303.9    (iii) the recipient establishes adequate safeguards to protect the records from 303.10unauthorized disclosure, including a procedure for removal or destruction of information 303.11that identifies the patient.303.12    Subd. 7.Exception to consent.Subdivision 2 does not apply to the release of health 303.13records to the commissioner of health or the Health Data Institute under chapter 62J, 303.14provided that the commissioner encrypts the patient identifier upon receipt of the data.303.15    Subd. 8.Record locator service.(a) A provider or group purchaser may send 303.16patient identifying information and information about the location of the patient's health 303.17records to a record locator service without consent from the patient. Except in the case of 303.18a medical emergency, a provider participating in a health information exchange using a 303.19record locator service cannot access patient identifying information and information 303.20about the location of the patient's health records until the patient has provided consent. 303.21The Minnesota Department of Health may not access the record locator service or receive 303.22data from the record locator service. Only a provider may access patient identifying 303.23information in a record locator service. The consent does not expire and may be revoked 303.24by the patient at any time by providing written notice of the revocation to the provider.303.25    (b) A health information exchange maintaining a record locator service or an entity 303.26maintaining a record locator service for a health information exchange must maintain an 303.27audit log of providers accessing information in a record locator service that minimally 303.28contains information on: 303.29    (1) the identity of the provider accessing the information; 303.30    (2) the identity of the patient whose information was accessed by the provider; and 303.31    (3) the date the information was accessed. 303.32    (c) No group purchaser may in any way require a provider to participate in any 303.33record locator service as a condition of payment or participation.303.34    (d) A record locator service must provide a mechanism for patients to opt out of 303.35including their identifying information and information about the location of their health 303.36records in a record locator service. At a minimum, any consent form that permits a 304.1provider to access a record locator service must include a check-box option that allows a 304.2patient to completely opt out of the record locator service which shall be clearly displayed 304.3to the patient. A provider participating in a health information exchange with a record 304.4locator service who receives a patient's request to completely opt out of the record locator 304.5service or to not have a specific provider contact in the record locator service shall be 304.6responsible for removing the patient's information from the record locator service.304.7    Subd. 9.Documentation of release.(a) In cases where a provider releases health 304.8records without patient consent as authorized by law, the release must be documented in 304.9the patient's health record. In the case of a release under section 144.294, subdivision 2, the 304.10documentation must include the date and circumstances under which the release was made, 304.11the person or agency to whom the release was made, and the records that were released.304.12    (b) When a health record is released using a representation from a provider that 304.13holds a consent from the patient, the releasing provider shall document: 304.14    (1) the provider requesting the health records; 304.15    (2) the identity of the patient;304.16    (3) the health records requested; and 304.17    (4) the date the health records were requested.304.18    Sec. 17. [144.294] RECORDS RELATING TO MENTAL HEALTH.304.19    Subdivision 1.Provider inquiry.Upon the written request of a spouse, parent, 304.20child, or sibling of a patient being evaluated for or diagnosed with mental illness, a 304.21provider shall inquire of a patient whether the patient wishes to authorize a specific 304.22individual to receive information regarding the patient's current and proposed course of 304.23treatment. If the patient so authorizes, the provider shall communicate to the designated 304.24individual the patient's current and proposed course of treatment. Section 144.293, 304.25subdivisions 2 and 4, apply to consents given under this subdivision.304.26    Subd. 2.Disclosure to law enforcement agency.Notwithstanding section 144.293, 304.27subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental 304.28health to a law enforcement agency if the law enforcement agency provides the name 304.29of the patient and communicates that the:304.30    (1) patient is currently involved in an emergency interaction with the law 304.31enforcement agency; and304.32    (2) disclosure of the records is necessary to protect the health or safety of the patient 304.33or of another person. 304.34    The scope of disclosure under this subdivision is limited to the minimum necessary 304.35for law enforcement to respond to the emergency. A law enforcement agency that obtains 305.1health records under this subdivision shall maintain a record of the requestor, the provider 305.2of the information, and the patient's name. Health records obtained by a law enforcement 305.3agency under this subdivision are private data on individuals as defined in section 13.02, 305.4subdivision 12, and must not be used by law enforcement for any other purpose.305.5    Subd. 3.Records release for family and caretaker; mental health care.(a) 305.6Notwithstanding section 144.293, a provider providing mental health care and treatment 305.7may disclose health record information described in paragraph (b) about a patient to a 305.8family member of the patient or other person who requests the information if:305.9    (1) the request for information is in writing;305.10    (2) the family member or other person lives with, provides care for, or is directly 305.11involved in monitoring the treatment of the patient;305.12    (3) the involvement under clause (2) is verified by the patient's mental health care 305.13provider, the patient's attending physician, or a person other than the person requesting the 305.14information, and is documented in the patient's medical record;305.15    (4) before the disclosure, the patient is informed in writing of the request, the name 305.16of the person requesting the information, the reason for the request, and the specific 305.17information being requested;305.18    (5) the patient agrees to the disclosure, does not object to the disclosure, or is 305.19unable to consent or object, and the patient's decision or inability to make a decision is 305.20documented in the patient's medical record; and305.21    (6) the disclosure is necessary to assist in the provision of care or monitoring of the 305.22patient's treatment. 305.23    (b) The information disclosed under this paragraph is limited to diagnosis, admission 305.24to or discharge from treatment, the name and dosage of the medications prescribed, side 305.25effects of the medication, consequences of failure of the patient to take the prescribed 305.26medication, and a summary of the discharge plan. 305.27    (c) If a provider reasonably determines that providing information under this 305.28subdivision would be detrimental to the physical or mental health of the patient or is 305.29likely to cause the patient to inflict self harm or to harm another, the provider must not 305.30disclose the information. 305.31    (d) This subdivision does not apply to disclosures for a medical emergency or 305.32to family members as authorized or required under subdivision 1 or section 144.293, 305.33subdivision 5, clause (1).305.34    Sec. 18. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL 305.35RESEARCH.306.1    Subdivision 1.Methods of release.(a) Notwithstanding section 144.293, 306.2subdivisions 2 and 4, health records may be released to an external researcher solely for 306.3purposes of medical or scientific research only as follows:306.4    (1) health records generated before January 1, 1997, may be released if the patient 306.5has not objected or does not elect to object after that date;306.6    (2) for health records generated on or after January 1, 1997, the provider must:306.7    (i) disclose in writing to patients currently being treated by the provider that health 306.8records, regardless of when generated, may be released and that the patient may object, in 306.9which case the records will not be released; and306.10    (ii) use reasonable efforts to obtain the patient's written general authorization that 306.11describes the release of records in item (i), which does not expire but may be revoked or 306.12limited in writing at any time by the patient or the patient's authorized representative; 306.13    (3) the provider must advise the patient of the rights specified in clause (4); and306.14    (4) the provider must, at the request of the patient, provide information on how the 306.15patient may contact an external researcher to whom the health record was released and 306.16the date it was released.306.17    (b) Authorization may be established if an authorization is mailed at least two 306.18times to the patient's last known address with a postage prepaid return envelope and a 306.19conspicuous notice that the patient's medical records may be released if the patient does 306.20not object, and at least 60 days have expired since the second notice was sent.306.21    Subd. 2.Duties of researcher.In making a release for research purposes, the 306.22provider shall make a reasonable effort to determine that:306.23    (1) the use or disclosure does not violate any limitations under which the record 306.24was collected;306.25    (2) the use or disclosure in individually identifiable form is necessary to accomplish 306.26the research or statistical purpose for which the use or disclosure is to be made;306.27    (3) the recipient has established and maintains adequate safeguards to protect the 306.28records from unauthorized disclosure, including a procedure for removal or destruction of 306.29information that identifies the patient; and306.30    (4) further use or release of the records in individually identifiable form to a person 306.31other than the patient without the patient's consent is prohibited.306.32    Sec. 19. [144.296] COPIES OF VIDEOTAPES.306.33    A provider may not release a copy of a videotape of a child victim or alleged victim 306.34of physical or sexual abuse without a court order under section 13.03, subdivision 6, or 307.1as provided in section 611A.90. This section does not limit the right of a patient to view 307.2the videotape.307.3    Sec. 20. [144.297] INDEPENDENT MEDICAL EXAMINATION.307.4    This section applies to the subject and provider of an independent medical 307.5examination requested by or paid for by a third party. Notwithstanding section 144.293, a 307.6provider may release health records created as part of an independent medical examination 307.7to the third party who requested or paid for the examination.307.8    Sec. 21. [144.298] PENALTIES.307.9    Subdivision 1.Licensing action.A violation of sections 144.291 to 144.298 may 307.10be grounds for disciplinary action against a provider by the appropriate licensing board 307.11or agency.307.12    Subd. 2.Allocation of liability.In adjudicating a dispute involving the disclosure 307.13of patient health records, a court shall use the criteria in this subdivision in determining 307.14how liability will be allocated.307.15    (a) When requesting health records using consent, a person warrants that the consent:307.16    (1) contains no information known to the person to be false; and307.17    (2) accurately states the patient's desire to have health records disclosed or that there 307.18is specific authorization in law.307.19    (b) When requesting health records using consent or the representation authorized in 307.20section 144.293, subdivision 2, a provider warrants that the request:307.21    (1) contains no information known to the provider to be false;307.22    (2) accurately states the patient's desire to have health records disclosed or that 307.23there is specific authorization in law; and307.24    (3) does not exceed any limits imposed by the patient in the consent.307.25    (c) When disclosing health records, a person releasing health records warrants that 307.26the person:307.27    (1) has complied with the requirements of this section regarding disclosure of 307.28health records;307.29    (2) knows of no information related to the request that is false; and307.30    (3) has complied with the limits set by the patient in the consent or as described 307.31in the representation of consent.307.32    (d) A court of this state presumes that:307.33    (1) a request made by a person that complies with the provisions of this section is 307.34valid and represents the wishes of the patient;308.1    (2) the information listed in a consent or representation of consent is accurate;308.2    (3) the recipient of a consent or representation of consent has no knowledge or 308.3notice that the person making the request breached a duty to the patient or does not 308.4rightfully have a consent;308.5    (4) the signature on the consent or representation of consent is not forged;308.6    (5) the consent or representation of consent was not obtained under false pretenses; 308.7and308.8    (6) the consent or representation of consent was not altered without the patient's 308.9permission.308.10    (e) No person or provider may disclaim or contractually limit the application of this 308.11section, or obtain indemnity for its effects, if the disclaimer, limitation, or indemnity 308.12restricts liability for misrepresentation against persons reasonably relying on the consent, 308.13representation of consent, or disclosure.308.14    (f) A court of this state shall give effect to liability allocations between the parties 308.15provided by contract that does not allocate liability to the detriment of the patient and the 308.16allocation is consistent with the requirements of sections 144.291 to 144.298.308.17    (g) A patient is eligible to receive compensatory damages plus costs and reasonable 308.18attorney fees if there is a negligent or intentional violation of sections 144.293 to 144.295.308.19    Subd. 3.Liability for a record locator service.A patient is eligible to receive 308.20compensatory damages plus costs and reasonable attorney fees if a health information 308.21exchange maintaining a record locator service, or an entity maintaining a record locator 308.22service for a health information exchange, negligently or intentionally violates the 308.23provisions of section 144.293, subdivision 8.308.24    Sec. 22. Minnesota Statutes 2006, section 144.3345, is amended to read:308.25144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD 308.26GRANTS.308.27    Subdivision 1. Definitions. The following definitions are used for the purposes 308.28of this section.308.29    (a) "Eligible community e-health collaborative" means an existing or newly 308.30established collaborative to support the adoption and use of interoperable electronic 308.31health records. A collaborative must consist of at least three two or more eligible health 308.32care entities in at least two of the categories listed in paragraph (b) and have a focus on 308.33interconnecting the members of the collaborative for secure and interoperable exchange of 308.34health care information.308.35    (b) "Eligible health care entity" means one of the following:309.1    (1) community clinics, as defined under section 
         145.9268; 309.2    (2) hospitals eligible for rural hospital capital improvement grants, as defined 309.3in section 
         144.148;309.4    (3) physician clinics located in a community with a population of less than 50,000 309.5according to United States Census Bureau statistics and outside the seven-county 309.6metropolitan area; 309.7    (4) nursing facilities licensed under sections 
         144A.01 to 
         144A.27; 309.8    (5) community health boards or boards of health as established under chapter 145A; 309.9    (6) nonprofit entities with a purpose to provide health information exchange 309.10coordination governed by a representative, multi-stakeholder board of directors; and309.11    (7) other providers of health or health care services approved by the commissioner 309.12for which interoperable electronic health record capability would improve quality of 309.13care, patient safety, or community health.309.14    Subd. 2. Grants authorized. The commissioner of health shall award grants to:309.15    (a) eligible community e-health collaborative projects to improve the implementation 309.16and use of interoperable electronic health records including but not limited to the 309.17following projects:309.18    (1) collaborative efforts to host and support fully functional interoperable electronic 309.19health records in multiple care settings; 309.20    (2) electronic medication history and electronic patient registration medical history309.21information; 309.22    (3) electronic personal health records for persons with chronic diseases and for 309.23prevention services; 309.24    (4) rural and underserved community models for electronic prescribing; and309.25    (5) enabling modernize local public health information systems to rapidly and 309.26electronically exchange information needed to participate in community e-health 309.27collaboratives or for public health emergency preparedness and response.; and309.28    (6) implement regional or community-based health information exchange 309.29organizations;309.30    (b) community clinics, as defined under section 145.9268, to implement and use 309.31interoperable electronic health records, including but not limited to the following projects:309.32    (1) efforts to plan for and implement fully functional, standards-based interoperable 309.33electronic health records; and309.34    (2) purchases and implementation of computer hardware, software, and technology 309.35to fully implement interoperable electronic health records;310.1    (c) regional or community-based health information exchange organizations to 310.2connect and facilitate the exchange of health information between eligible health care 310.3entities, including but not limited to the development, testing, and implementation of:310.4    (1) data exchange standards, including data, vocabulary, and messaging standards, 310.5for the exchange of health information, provided that such standards are consistent with 310.6state and national standards;310.7    (2) security standards necessary to ensure the confidentiality and integrity of health 310.8records;310.9    (3) computer interfaces and mechanisms for standardizing health information 310.10exchanged between eligible health care entities;310.11    (4) a record locator service for identifying the location of patient health records; or310.12    (5) interfaces and mechanisms for implementing patient consent requirements; and310.13    (d) community health boards and boards of health as established under chapter 310.14145A to modernize local public health information systems to be standards-based and 310.15interoperable with other electronic health records and information systems, or for 310.16enhanced public health emergency preparedness and response.310.17    Grant funds may not be used for construction of health care or other buildings or 310.18facilities.310.19    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible 310.20community e-health collaborative, community clinic, regional or community-based health 310.21information exchange, or community health boards and boards of health must submit an 310.22application to the commissioner of health by the deadline established by the commissioner. 310.23A grant may be awarded upon the signing of a grant contract. In awarding grants, the 310.24commissioner shall give preference to projects benefiting providers located in rural and 310.25underserved areas of Minnesota which the commissioner has determined have an unmet 310.26need for the development and funding of electronic health records. Applicants may apply 310.27for and the commissioner may award grants for one-year, two-year, or three-year periods.310.28    (b) An application must be on a form and contain information as specified by the 310.29commissioner but at a minimum must contain:310.30    (1) a description of the purpose or project for which grant funds will be used; 310.31    (2) a description of the problem or problems the grant funds will be used to address, 310.32including an assessment of the likelihood of the project occurring absent grant funding; 310.33    (3) a description of achievable objectives, a workplan, budget, budget narrative, a 310.34project communications plan, a timeline for implementation and completion of processes 310.35or projects enabled by the grant, and an assessment of privacy and security issues and a 310.36proposed approach to address these issues;311.1    (4) a description of the health care entities and other groups participating in the 311.2project, including identification of the lead entity responsible for applying for and 311.3receiving grant funds; 311.4    (5) a plan for how patients and consumers will be involved in development of 311.5policies and procedures related to the access to and interchange of information; 311.6    (6) evidence of consensus and commitment among the health care entities and others 311.7who developed the proposal and are responsible for its implementation; and311.8    (7) a plan for documenting and evaluating results of the grant. ; and311.9    (8) a plan for use of data exchange standards, including data and vocabulary.311.10    (c) The commissioner shall review each application to determine whether the 311.11application is complete and whether the applicant and the project are eligible for a 311.12grant. In evaluating applications, the commissioner shall take into consideration factors, 311.13including but not limited to, the following:311.14    (1) the degree to which the proposal interconnects the various providers of care with 311.15other health care entities in the applicant's geographic community; 311.16    (2) the degree to which the project provides for the interoperability of electronic 311.17health records or related health information technology between the members of the 311.18collaborative, and presence and scope of a description of how the project intends to 311.19interconnect with other providers not part of the project into the future;311.20    (3) the degree to which the project addresses current unmet needs pertaining 311.21to interoperable electronic health records in a geographic area of Minnesota and the 311.22likelihood that the needs would not be met absent grant funds; 311.23    (4) the applicant's thoroughness and clarity in describing the project, how the project 311.24will improve patient safety, quality of care, and consumer empowerment, and the role of 311.25the various collaborative members;311.26    (5) the recommendations of the Health Information and Technology Infrastructure 311.27Advisory Committee; and311.28    (6) other factors that the commissioner deems relevant.311.29    (d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall 311.30be required to provide $1 in the form of cash or in-kind staff or services for each $3 311.31provided under the grant program.311.32    (e) Grants shall not exceed $900,000 per grant. The commissioner has discretion 311.33over the size and number of grants awarded.311.34    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the 311.35overall effectiveness of the grant program. The commissioner shall collect progress 312.1and expenditure reports to evaluate the grant program from the eligible community 312.2collaboratives receiving grants.312.3    Sec. 23. Minnesota Statutes 2006, section 144.565, is amended to read:312.4144.565 DIAGNOSTIC IMAGING FACILITIES.312.5    Subdivision 1. Utilization and services data; economic and financial interests.312.6    The commissioner shall require diagnostic imaging facilities and providers of diagnostic 312.7imaging services in Minnesota to annually report by March 1 each year for the preceding 312.8fiscal year to the commissioner, in the form and manner specified by the commissioner:312.9    (1) utilization data for each health plan company and each public program, 312.10including workers' compensation, as follows: of diagnostic imaging services as defined 312.11in subdivision 4, paragraph (b);312.12    (i) the number of computerized tomography (CT) procedures performed;312.13    (ii) the number of magnetic resonance imaging (MRI) procedures performed; and312.14    (iii) the number of positron emission tomography (PET) procedures performed; and312.15    (2) the names of all physicians with any financial or economic interest and all other 312.16individuals with a ten percent or greater financial or economic interest in the facility.;312.17    (3) the location where procedures were performed;312.18    (4) the number of units of each type of fixed, portable, and mobile scanner used at 312.19each location;312.20    (5) the average number of hours per month each mobile scanner was operated at 312.21each location;312.22    (6) the number of hours per month each scanner was leased, if applicable;312.23    (7) the total number of diagnostic imaging procedures billed for by the provider at 312.24each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph 312.25(b); and312.26    (8) a report on major health care capital expenditures during the previous year, as 312.27required by section 62J.17.312.28    Subd. 2. Commissioner's right to inspect records. If the report is not filed or 312.29the commissioner of health has reason to believe the report is incomplete or false, the 312.30commissioner shall have the right to inspect diagnostic imaging facility books, audits, 312.31and records.312.32    Subd. 3. Separate reports.For a diagnostic imaging facility that is not attached 312.33or not contiguous to a hospital or a hospital affiliate, the commissioner shall require 312.34the information in subdivision 1 be reported separately for each detached diagnostic 312.35imaging facility as part of the report required under section 144.702. If any entity owns 313.1more than one diagnostic imaging facility, that entity must report by individual facility. 313.2Reports must include only services that were billed by the provider of diagnostic imaging 313.3services submitting the report. If a diagnostic imaging facility leases capacity, technical 313.4services, or professional services to one or more other providers of diagnostic imaging 313.5services, each provider must submit a separate annual report to the commissioner for all 313.6diagnostic imaging services that it provided and billed. The owner of the leased capacity 313.7must provide a report listing the names and addresses of providers to whom the diagnostic 313.8imaging services and equipment were leased.313.9    Subd. 4. Definitions. For purposes of this section, the following terms have the 313.10meanings given:313.11    (a) "Diagnostic imaging facility" means a health care facility that providesis not 313.12a hospital or location licensed as a hospital which offers diagnostic imaging services 313.13through the use of ionizing radiation or other imaging technique including, but not limited 313.14to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a 313.15freestanding or mobile basis in Minnesota, regardless of whether the equipment used 313.16to provide the service is owned or leased. For the purposes of this section, diagnostic 313.17imaging facility includes, but is not limited to, facilities such as a physician's office, clinic, 313.18mobile transport vehicle, outpatient imaging center, or surgical center.313.19    (b) "Diagnostic imaging service" means the use of ionizing radiation or other 313.20imaging technique on a human patient including, but not limited to, magnetic resonance 313.21imaging (MRI) or computerized tomography (CT), positron emission tomography (PET), 313.22or single photon emission computerized tomography (SPECT) scans using fixed, portable, 313.23or mobile equipment.313.24    (b)(c) "Financial or economic interest" means a direct or indirect:313.25    (1) equity or debt security issued by an entity, including, but not limited to, shares of 313.26stock in a corporation, membership in a limited liability company, beneficial interest in 313.27a trust, units or other interests in a partnership, bonds, debentures, notes or other equity 313.28interests or debt instruments, or any contractual arrangements;313.29    (2) membership, proprietary interest, or co-ownership with an individual, group, or 313.30organization to which patients, clients, or customers are referred to; or313.31    (3) employer-employee or independent contractor relationship, including, but not 313.32limited to, those that may occur in a limited partnership, profit-sharing arrangement, or 313.33other similar arrangement with any facility to which patients are referred, including any 313.34compensation between a facility and a health care provider, the group practice of which 313.35the provider is a member or employee or a related party with respect to any of them.314.1    (c)(d) "Freestanding Fixed equipment" means a stationary diagnostic imaging 314.2facility that is not located within a: machine installed in a permanent location.314.3    (1) hospital;314.4    (2) location licensed as a hospital; or314.5    (3) physician's office or clinic where the professional practice of medicine by 314.6licensed physicians is the primary purpose and not the provision of ancillary services 314.7such as diagnostic imaging.314.8    (d)(e) "Mobile equipment" means a diagnostic imaging facility that is transported to 314.9various sites not including movement within a hospital or a physician's office or clinic314.10machine in a self-contained transport vehicle designed to be brought to a temporary offsite 314.11location to perform diagnostic imaging services.314.12    (f) "Portable equipment" means a diagnostic imaging machine designed to be 314.13temporarily transported within a permanent location to perform diagnostic imaging 314.14services.314.15    (g) "Provider of diagnostic imaging services" means a diagnostic imaging facility 314.16or an entity that offers and bills for diagnostic imaging services at a facility owned or 314.17leased by the entity.314.18    Subd. 5.Reports open to public inspection.All reports filed pursuant to this 314.19section shall be open to public inspection.314.20    Sec. 24. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS 314.21CONTROL PROGRAMS.314.22    In order to improve the prevention of hospital-associated bloodstream infections due 314.23to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall establish 314.24an MRSA control program that meets Minnesota Department of Health best practices 314.25standards as published January 15, 2008, including considerations of: 314.26    (1) identification of all MRSA-colonized patients in all intensive care units, and 314.27other at-risk patients identified by the hospital, through active surveillance testing; 314.28    (2) isolation of identified MRSA-colonized or MRSA-infected patients in an 314.29appropriate manner; 314.30    (3) monitoring and strict enforcement of hand hygiene requirements; and 314.31    (4) maintenance of records.314.32    Sec. 25. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:314.33    Subd. 26. Right to associate.(a) Residents may meet with and receive visitors 314.34and participate in activities of commercial, religious, political, as defined in section 315.1203B.11
          and community groups without interference at their discretion if the activities 315.2do not infringe on the right to privacy of other residents or are not programmatically 315.3contraindicated. This includes:315.4    (1) the right to join with other individuals within and outside the facility to work for 315.5improvements in long-term care;315.6    (2) the right to visitation by an individual the patient has appointed as the patient's 315.7health care agent under chapter 145C;315.8    (3) the right to visitation and health care decision making by an individual designated 315.9by the patient under paragraph (c).315.10    (b) Upon admission to a facility where federal law prohibits unauthorized disclosure 315.11of patient or resident identifying information to callers and visitors, the patient or 315.12resident, or the legal guardian or conservator of the patient or resident, shall be given the 315.13opportunity to authorize disclosure of the patient's or resident's presence in the facility 315.14to callers and visitors who may seek to communicate with the patient or resident. To the 315.15extent possible, the legal guardian or conservator of a patient or resident shall consider the 315.16opinions of the patient or resident regarding the disclosure of the patient's or resident's 315.17presence in the facility. 315.18    (c) Upon admission to a facility, the patient or resident, or the legal guardian 315.19or conservator of the patient or resident, must be given the opportunity to designate 315.20a person who is not related who will have the status of the patient's next of kin with 315.21respect to visitation and making a health care decision. A designation must be included 315.22in the patient's health record. With respect to making a health care decision, a health 315.23care directive or appointment of a health care agent under chapter 145C prevails over a 315.24designation made under this paragraph. The unrelated person may also be identified as 315.25such by the patient or by the patient's family.315.26    Sec. 26. Minnesota Statutes 2006, section 144D.03, subdivision 1, is amended to read:315.27    Subdivision 1. Registration procedures. The commissioner shall establish forms 315.28and procedures for annual registration of housing with services establishments. The 315.29commissioner shall charge an annual registration fee of $35 $155. No fee shall be 315.30refunded. A registered establishment shall notify the commissioner within 30 days of the 315.31date it is no longer required to be registered under this chapter or of any change in the 315.32business name or address of the establishment, the name or mailing address of the owner 315.33or owners, or the name or mailing address of the managing agent. There shall be no 315.34fee for submission of the notice.316.1    Sec. 27. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.316.2    Subdivision 1.Definitions.For purposes of this section, "federally qualified health 316.3center" means an entity that is receiving a grant under United States Code, title 42, 316.4section 254b, or, based on the recommendation of the Health Resources and Services 316.5Administration within the Public Health Service, is determined by the secretary to meet 316.6the requirements for receiving such a grant.316.7    Subd. 2.Allocation of subsidies.The commissioner of health shall distribute 316.8subsidies to federally qualified health centers operating in Minnesota to continue, expand, 316.9and improve federally qualified health center services to low-income populations. The 316.10commissioner shall distribute the funds appropriated under this section to federally 316.11qualified health centers operating in Minnesota as of January 1, 2007. The amount of 316.12each subsidy shall be in proportion to each federally qualified health center's amount of 316.13discounts granted to patients during calendar year 2006 as reported on the federal Uniform 316.14Data System report in conformance with the Bureau of Primary Health Care Program 316.15Expectations Policy Information Notice 98-23, except that each eligible federally qualified 316.16health center shall receive at least two percent but no more than 30 percent of the total 316.17amount of money available under this section.316.18    Sec. 28. Minnesota Statutes 2006, section 145C.05, is amended to read:316.19145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.316.20    Subdivision 1. Content. A health care directive executed pursuant to this chapter 316.21may, but need not, be in the form contained in section 
         145C.16. 316.22    Subd. 2. Provisions that may be included. (a) A health care directive may include 316.23provisions consistent with this chapter, including, but not limited to:316.24    (1) the designation of one or more alternate health care agents to act if the named 316.25health care agent is not reasonably available to serve;316.26    (2) directions to joint health care agents regarding the process or standards by which 316.27the health care agents are to reach a health care decision for the principal, and a statement 316.28whether joint health care agents may act independently of one another;316.29    (3) limitations, if any, on the right of the health care agent or any alternate health 316.30care agents to receive, review, obtain copies of, and consent to the disclosure of the 316.31principal's medical records or to visit the principal when the principal is a patient in a 316.32health care facility;316.33    (4) limitations, if any, on the nomination of the health care agent as guardian for 316.34purposes of sections 
         524.5-202, 
         524.5-211, 
         524.5-302, and 
         524.5-303; 317.1    (5) a document of gift for the purpose of making an anatomical gift, as set forth in 317.2sections 
         525.921 to 
         525.9224, or an amendment to, revocation of, or refusal to make 317.3an anatomical gift; 317.4    (6) a declaration regarding intrusive mental health treatment under section 
         253B.03, 317.5subdivision 6d
         , or a statement that the health care agent is authorized to give consent for 317.6the principal under section 
         253B.04, subdivision 1a; 317.7    (7) a funeral directive as provided in section 
         149A.80, subdivision 2; 317.8    (8) limitations, if any, to the effect of dissolution or annulment of marriage or 317.9termination of domestic partnership on the appointment of a health care agent under 317.10section 
         145C.09, subdivision 2; 317.11    (9) specific reasons why a principal wants a health care provider or an employee 317.12of a health care provider attending the principal to be eligible to act as the principal's 317.13health care agent;317.14    (10) health care instructions by a woman of child bearing age regarding how she 317.15would like her pregnancy, if any, to affect health care decisions made on her behalf; and317.16    (11) health care instructions regarding artificially administered nutrition or hydration.317.17    (b) A health care directive may include a statement of the circumstances under 317.18which the directive becomes effective other than upon the judgment of the principal's 317.19attending physician in the following situations:317.20    (1) a principal who in good faith generally selects and depends upon spiritual means 317.21or prayer for the treatment or care of disease or remedial care and does not have an 317.22attending physician, may include a statement appointing an individual who may determine 317.23the principal's decision-making capacity; and317.24    (2) a principal who in good faith does not generally select a physician or a health 317.25care facility for the principal's health care needs may include a statement appointing an 317.26individual who may determine the principal's decision-making capacity, provided that if 317.27the need to determine the principal's capacity arises when the principal is receiving care 317.28under the direction of an attending physician in a health care facility, the determination 317.29must be made by an attending physician after consultation with the appointed individual.317.30    If a person appointed under clause (1) or (2) is not reasonably available and the 317.31principal is receiving care under the direction of an attending physician in a health care 317.32facility, an attending physician shall determine the principal's decision-making capacity.317.33    (c) A health care directive may authorize a health care agent to make health care 317.34decisions for a principal even though the principal retains decision-making capacity.318.1    Sec. 29. Minnesota Statutes 2006, section 145C.07, is amended by adding a 318.2subdivision to read:318.3    Subd. 5.Visitation.A health care agent may visit the principal when the 318.4principal is a patient in a health care facility regardless of whether the principal retains 318.5decision-making capacity, unless:318.6    (1) the principal has otherwise specified in the health care directive;318.7    (2) a principal who retains decision-making capacity indicates otherwise; or318.8    (3) a health care provider reasonably determines that the principal must be isolated 318.9from all visitors or that the presence of the health care agent would endanger the health or 318.10safety of the principal, other patients, or the facility in which the care is being provided.318.11    Sec. 30. Minnesota Statutes 2006, section 148.6445, subdivision 1, is amended to read:318.12    Subdivision 1. Initial licensure fee. The initial licensure fee for occupational 318.13therapists is $180 $145. The initial licensure fee for occupational therapy assistants is 318.14$100 $80. The commissioner shall prorate fees based on the number of quarters remaining 318.15in the biennial licensure period.318.16    Sec. 31. Minnesota Statutes 2006, section 148.6445, subdivision 2, is amended to read:318.17    Subd. 2. Licensure renewal fee. The biennial licensure renewal fee for 318.18occupational therapists is $180 $145. The biennial licensure renewal fee for occupational 318.19therapy assistants is $100 $80.318.20    Sec. 32. [148.785] FEES.318.21    The fees charged by the board are fixed at the following rates:318.22    (1) application fee for physical therapists and physical therapist assistants, $100;318.23    (2) annual licensure for physical therapists and physical therapist assistants, $60;318.24    (3) licensure renewal late fee, $20;318.25    (4) temporary permit, $25;318.26    (5) duplicate license or registration, $20;318.27    (6) certification letter, $25;318.28    (7) education or training program approval, $100;318.29    (8) report creation and generation, $60 per hour billed in quarter-hour increments 318.30with a quarter-hour minimum; and318.31    (9) examination administration:318.32    (i) half day, $50; and318.33    (ii) full day, $80.319.1    Sec. 33. Minnesota Statutes 2006, section 148B.53, subdivision 3, is amended to read:319.2    Subd. 3. Fee. Nonrefundable fees are as follows:319.3    (1) initial license application fee for licensed professional counseling (LPC) - $250319.4$150;319.5    (2) initial license fee for LPC - $250;319.6    (3) annual active license renewal fee for LPC - $200 $250 or equivalent;319.7    (3) (4) annual inactive license renewal fee for LPC - $100 $125;319.8    (5) initial license application fee for licensed professional clinical counseling 319.9(LPCC) - $150;319.10    (6) initial license fee for LPCC - $250;319.11    (7) annual active license renewal fee for LPCC - $250 or equivalent;319.12    (8) annual inactive license renewal fee for LPCC - $125;319.13    (4) (9) license renewal late fee - $100 per month or portion thereof;319.14    (5) (10) copy of board order or stipulation - $10;319.15    (6) (11) certificate of good standing or license verification - $10 $25;319.16    (7) (12) duplicate certificate fee - $10 $25;319.17    (8) (13) professional firm renewal fee - $25;319.18    (9) (14) sponsor application for approval of a continuing education course - $60;319.19    (15) initial registration fee - $50; and319.20    (10) (16) annual registration renewal fee - $25; and319.21    (17) approved supervisor application processing fee - $30.319.22    Sec. 34. Minnesota Statutes 2006, section 149A.52, subdivision 3, is amended to read:319.23    Subd. 3. Application procedure; documentation; initial inspection. An applicant 319.24for a license to operate a crematory shall submit to the commissioner a completed 319.25application. A completed application includes:319.26    (1) a completed application form, as provided by the commissioner;319.27    (2) proof of business form and ownership; and319.28    (3) proof of liability insurance coverage or other financial documentation, as 319.29determined by the commissioner, that demonstrates the applicant's ability to respond in 319.30damages for liability arising from the ownership, maintenance, management, or operation 319.31of a crematory.319.32    Upon receipt of the application and appropriate fee, the commissioner shall review 319.33and verify all information. Upon completion of the verification process and resolution 319.34of any deficiencies in the application information, the commissioner shall conduct an 319.35initial inspection of the premises to be licensed. After the inspection and resolution of 320.1any deficiencies found and any reinspections as may be necessary, the commissioner shall 320.2make a determination, based on all the information available, to grant or deny licensure. If 320.3the commissioner's determination is to grant the license, the applicant shall be notified and 320.4the license shall issue and remain valid for a period prescribed on the license, but not to 320.5exceed one calendar year from the date of issuance of the license. If the commissioner's 320.6determination is to deny the license, the commissioner must notify the applicant, in 320.7writing, of the denial and provide the specific reason for denial.320.8    Sec. 35. [149A.65] FEES.320.9    Subdivision 1.Generally.This section establishes the fees for registrations, 320.10examinations, initial and renewal licenses, and late fees authorized under the provisions 320.11of this chapter.320.12    Subd. 2.Mortuary science fees.Fees for mortuary science are:320.13    (1) $50 for the initial and renewal registration of a mortuary science intern;320.14    (2) $100 for the mortuary science examination;320.15    (3) $125 for issuance of initial and renewal mortuary science licenses;320.16    (4) $25 late fee charge for a license renewal; and320.17    (5) $200 for issuing a mortuary science license by endorsement.320.18    Subd. 3.Funeral directors.The license renewal fee for funeral directors is $125. 320.19The late fee charge for a license renewal is $25.320.20    Subd. 4.Funeral establishments.The initial and renewal fee for funeral 320.21establishments is $300. The late fee charge for a license renewal is $25.320.22    Subd. 5.Crematories.The initial and renewal fee for a crematory is $300. The 320.23late fee charge for a license renewal is $25.320.24    Sec. 36. Minnesota Statutes 2006, section 149A.97, subdivision 7, is amended to read:320.25    Subd. 7. Reports to commissioner. Every funeral provider lawfully doing business 320.26in Minnesota that accepts funds under subdivision 2 must make a complete annual report 320.27to the commissioner. The reports may be on forms provided by the commissioner or 320.28substantially similar forms containing, at least, identification and the state of each trust 320.29account, including all transactions involving principal and accrued interest, and must be 320.30filed by March 31 of the calendar year following the reporting year along with a filing 320.31fee of $15 $25 for each report. Fees shall be paid to the commissioner of finance, state of 320.32Minnesota, for deposit in the state government special revenue fund in the state treasury. 320.33Reports must be signed by an authorized representative of the funeral provider and 320.34notarized under oath. All reports to the commissioner shall be reviewed for account 321.1inaccuracies or possible violations of this section. If the commissioner has a reasonable 321.2belief to suspect that there are account irregularities or possible violations of this section, 321.3the commissioner shall report that belief, in a timely manner, to the state auditor. The 321.4commissioner shall also file an annual letter with the state auditor disclosing whether or 321.5not any irregularities or possible violations were detected in review of the annual trust 321.6fund reports filed by the funeral providers. This letter shall be filed with the state auditor 321.7by May 31 of the calendar year following the reporting year.321.8    Sec. 37. Minnesota Statutes 2006, section 153A.17, is amended to read:321.9153A.17 EXPENSES; FEES.321.10    The expenses for administering the certification requirements including the 321.11complaint handling system for hearing aid dispensers in sections 
         153A.14 and 
         153A.15321.12and the Consumer Information Center under section 
         153A.18 must be paid from initial 321.13application and examination fees, renewal fees, penalties, and fines. All fees are 321.14nonrefundable. The initial and annual renewal certificate application fee is $350 $1,000, 321.15the examination fee is $250 $700 for the written portion and $250 $700 for the practical 321.16portion each time one or the other is taken, and the trainee application fee is $200. 321.17Effective July 1, 2007, a surcharge of $200 shall be paid at the time of certification 321.18application or renewal until June 30, 2011, to recover the commissioner's accumulated 321.19direct expenditures for administering the requirements of this chapter. The penalty fee for 321.20late submission of a renewal application is $200. The fee for verification of certification 321.21to other jurisdictions or entities is $25. All fees, penalties, and fines received must be 321.22deposited in the state government special revenue fund. The commissioner may prorate 321.23the certification fee for new applicants based on the number of quarters remaining in 321.24the annual certification period.321.25    Sec. 38. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:321.26    Subdivision 1. License required annually. A license is required annually for every 321.27person, firm, or corporation engaged in the business of conducting a food and beverage 321.28service establishment, hotel, motel, lodging establishment, or resort. Any person wishing 321.29to operate a place of business licensed in this section shall first make application, pay the 321.30required fee specified in this section, and receive approval for operation, including plan 321.31review approval. Seasonal and temporary food stands and special event food stands are 321.32not required to submit plans. Nonprofit organizations operating a special event food 321.33stand with multiple locations at an annual one-day event shall be issued only one license. 321.34Application shall be made on forms provided by the commissioner and shall require 322.1the applicant to state the full name and address of the owner of the building, structure, 322.2or enclosure, the lessee and manager of the food and beverage service establishment, 322.3hotel, motel, lodging establishment, or resort; the name under which the business is to 322.4be conducted; and any other information as may be required by the commissioner to 322.5complete the application for license.322.6    Sec. 39. HEALTH PROMOTION PROGRAM.322.7    The State Community Health Services Advisory Committee established in 322.8Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to fund and 322.9implement an ongoing comprehensive health promotion program that can effect change 322.10more effectively and at lower cost at a community level rather than through individual 322.11counseling and change promotion. The program shall use proven public health strategies 322.12to promote healthy lifestyles and behaviors in order to establish a sustainable, long-term 322.13approach to reducing preventable disability, chronic health conditions, and disease. The 322.14focus shall be on community based initiatives that address childhood and adult obesity, 322.15tobacco and substance abuse, improved activity levels among senior citizens, and other 322.16lifestyle issues that impact health and healthcare costs. Because of its population health 322.17focus, funding shall be related to the size of the population to be served. The plan shall be 322.18completed by September 15, 2007, and shared with the Legislative Health Care Access 322.19Commission.322.20    Sec. 40. INJUNCTIVE RELIEF REPORT.322.21    The commissioner of health shall present to the 2008 legislature, by December 15, 322.222007, recommendations to fund the cost of bringing actions for injunctive relief under 322.23Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).322.24    Sec. 41. DIAGNOSTIC IMAGING SERVICES ADVISORY COMMITTEE; 322.25ESTABLISHMENT.322.26    (a) The commissioner of health shall establish a Diagnostic Imaging Services 322.27Advisory Committee to perform the following duties:322.28    (1) gather and analyze data to understand the factors driving utilization of diagnostic 322.29imaging services, including computed tomography (CT), magnetic resonance imaging 322.30(MRI), positron emission tomography (PET), magnetic resonance angiography (MRA), 322.31and nuclear cardiology, in the state relative to evidence-based guidelines; and322.32    (2) develop recommendations, based on the data collected, on how to improve 322.33the delivery of evidence-based diagnostic imaging services. In developing these 323.1recommendations, the advisory committee shall consider the impacts on patient care, 323.2premium costs, and administrative simplicity.323.3    (b) The members of the Diagnostic Imaging Services Advisory Committee shall 323.4include the commissioners of health and human services or the commissioners' designees 323.5and the following:323.6    (1) three physicians representing speciality and geographic diversity, appointed by 323.7the Minnesota Medical Association;323.8    (2) two hospital representatives, one from a metropolitan hospital and one from a 323.9rural hospital, appointed by the Minnesota Hospital Association;323.10    (3) three health plan company representatives appointed by the Minnesota Council 323.11of Health Plans;323.12    (4) two representatives appointed by the Institute for Clinical System Improvement; 323.13and323.14    (5) one clinic manager appointed by the Minnesota Medical Group Management 323.15Association.323.16    (c) The Diagnostic Imaging Services Advisory Committee shall convene no later 323.17than September 1, 2007. The commissioner shall report back to the legislature no later 323.18than January 15, 2008. The advisory committee is governed under Minnesota Statutes, 323.19section 15.059, except that members shall not receive a per diem and may only be 323.20reimbursed for expenses.323.21    (d) A strategy to improve the delivery of evidence-based diagnostic imaging services 323.22may be developed by health plans. The commissioner of health shall report the agreement 323.23to the chairs of the senate and house health care committees immediately.323.24EFFECTIVE DATE.This section is effective July 1, 2007.323.25    Sec. 42. HEARING AID DISPENSER FEES.323.26    Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section 323.27153A.17, may not be increased until after the Department of Health provides a report to 323.28the legislature regarding the need and reasons for fee increases.323.29    Sec. 43. REVISOR'S INSTRUCTION.323.30    In Minnesota Statutes and Minnesota Rules, the revisor shall change the references 323.31in column A with the references in column B.

323.32Column AColumn B323.33section 144.335sections 144.291 to 144.298323.34section 144.335, subdivision 1section 144.291, subdivision 2324.1324.2section 144.335, subdivision 1, paragraph (b)section 144.291, subdivision 2, paragraph (h)324.3324.4section 144.335, subdivision 2, paragraphs (a) and (b)section 144.292, subdivisions 2 and 5324.5section 144.335, subdivision 2section 144.292324.6section 144.335, subdivision 3asection 144.294, subdivision 2324.7324.8section 144.335, subdivision 3a, paragraph (d)section 144.295324.9324.10section 144.335, subdivision 3a, paragraph (f)section 144.294324.11section 144.335, subdivision 3bsection 144.293, subdivision 7

324.12    Sec. 44.  REPEALER.324.13(a) Minnesota Statutes 2006, section 144.335, is repealed.324.14(b) Minnesota Statutes 2006, section 62J.17, subdivisions 1, 5a, 6a, and 8, are 324.15repealed.324.16(c) Minnesota Rules, part 4610.2800, is repealed.324.17ARTICLE 7324.18MISCELLANEOUS324.19    Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a 324.20subdivision to read:324.21    Subd. 2a.Base budget detail.Within one week of the release of the budget forecasts 324.22required in section 16A.102 in November of an even-numbered year and February of an 324.23odd-numbered year, the commissioner, after consulting with the commissioners of human 324.24services and health, must provide to the legislature information at the program, budget 324.25activity and management activity level for the base level budget of the Department of 324.26Human Services and the Department of Health for the next biennium. The information 324.27must be organized in a manner that explains how base level budget appropriations are 324.28projected to be spent. Within one week of the release of the budget forecasts required in 324.29section 16A.102 in November of an even-numbered year, the commissioner must also 324.30provide the legislature with the information submitted by the commissioners of human 324.31services and health under subdivision 2, clauses (3) and (4).324.32    Sec. 2. Minnesota Statutes 2006, section 43A.316, is amended to read:324.3343A.316 PUBLIC EMPLOYEES INSURANCE PROGRAM.324.34    Subdivision 1. Intent. The legislature finds that the creation of a statewide program 324.35to provide public employees and other eligible persons with life insurance and hospital, 325.1medical, and dental benefit coverage through provider organizations would result in a 325.2greater utilization more efficient use of government resources and would advance the 325.3health and welfare of the citizens of the state.325.4    Subd. 2. Definitions. For the purpose of this section, the terms defined in this 325.5subdivision have the meaning given them.325.6    (a)  Commissioner. "Commissioner" means the commissioner of employee relations. 325.7    (b)  Employee. "Employee" means: 325.8    (1) a person who is a public employee within the definition of section 
         179A.03, 325.9subdivision 14
         , who is insurance eligible and is employed by an eligible employer; 325.10    (2) an elected public official of an eligible employer who is insurance eligible;325.11    (3) a person employed by a labor organization or employee association certified as 325.12an exclusive representative of employees of an eligible employer or by another public 325.13employer approved by the commissioner, so long as the plan meets the requirements of a 325.14governmental plan under United States Code, title 29, section 1002(32); or325.15    (4) a person employed by a county or municipal hospital.325.16    (c)  Eligible employer. "Eligible employer" means: 325.17    (1) a public employer within the definition of section 
         179A.03, subdivision 15, that 325.18is a town, county, city, school district as defined in section 
         120A.05, service cooperative 325.19as defined in section 
         123A.21, intermediate district as defined in section 
         136D.01, 325.20Cooperative Center for Vocational Education as defined in section 
         123A.22, regional 325.21management information center as defined in section 
         123A.23, or an education unit 325.22organized under the joint powers action, section 
         471.59; or 325.23    (2) an exclusive representative of employees, as defined in paragraph (b);325.24    (3) a county or municipal hospital; or325.25    (4) another public employer approved by the commissioner; or325.26    (5) a nursing home as defined in section 144A.01, subdivision 5, located in this state.325.27    (d)  Exclusive representative. "Exclusive representative" means an exclusive 325.28representative as defined in section 
         179A.03, subdivision 8. 325.29    (e)  Labor-Management Committee. "Labor-Management Committee" means the 325.30committee established by subdivision 4. 325.31    (f)  Program. "Program" means the statewide public employees insurance program 325.32created by subdivision 3. 325.33    Subd. 3. Public employee insurance program. The commissioner shall be the 325.34administrator of the public employee insurance program and may determine its funding 325.35arrangements. The commissioner may contract with a qualified entity to perform the 325.36administrative functions. The commissioner shall model the program after the plan 326.1established in section 
         43A.18, subdivision 2, but may modify adopt variations from that 326.2plan, in consultation with the Labor-Management Committee. The variations may include 326.3different deductibles, coinsurance, co-pays, or other enrollee cost-sharing provisions.326.4    Subd. 4. Labor-Management Committee.(a) The Labor-Management Committee 326.5consists of ten members appointed by the commissioner. The Labor-Management 326.6Committee must comprise five members who represent employees, including at least 326.7one retired employee, and five members who represent eligible employers. Committee 326.8members are eligible for expense reimbursement in the same manner and amount as 326.9authorized by the commissioner's plan adopted under section 
         43A.18, subdivision 2. The 326.10commissioner shall consult with the labor-management committee in major decisions 326.11that affect the program. The committee shall study issues and make recommendations 326.12relating to the insurance program including, but not limited to, flexible benefits, utilization 326.13review, quality assessment, and cost efficiency. The committee continues to exist while 326.14the program remains in operation. 326.15    (b) The five members of the Labor-Management Committee who represent 326.16employees must be chosen by the commissioner from among persons nominated as 326.17provided in this paragraph. Exclusive representatives of employees of counties, cities, 326.18school districts, and nursing homes are entitled to nominate two candidates for the 326.19Labor-Management Committee from each of those four categories, and the commissioner 326.20shall appoint one of those two nominees from each category. The commissioner shall 326.21choose the fifth employee to represent retired employees.326.22    (c) The five members of the Labor-Management Committee who represent employers 326.23must be chosen by the commissioner from among persons nominated as provided in 326.24this paragraph. The Association of Minnesota Counties, Minnesota League of Cities, 326.25Minnesota School Boards Association, and the Minnesota Association of Nursing Homes 326.26are each entitled to nominate two candidates for the committee, and the commissioner 326.27shall appoint one of those from each group. The commissioner shall select the fifth 326.28employer member from an employer participating in the program and not represented 326.29by the other four employer members, if any, or if that is not reasonably possible, the 326.30commissioner may appoint any other person as the fifth employer representative.326.31    Subd. 5. Public employee participation. (a) Participation in the program is subject 326.32to the conditions in this subdivision.326.33    (b) Each exclusive representative for an eligible employer determines whether the 326.34employees it represents will participate in the program. The exclusive representative shall 326.35give the employer notice of intent to participate at least 30 60 days before the expiration 326.36date of the collective bargaining agreement preceding the collective bargaining agreement 327.1that covers the date of entry into the program. Either all or none of the employees 327.2represented by an exclusive representative must participate. The exclusive representative 327.3and the eligible employer shall give notice to the commissioner of the determination to 327.4participate in the program at least 30 60 days before entry into the program. Entry into the 327.5program is governed by a schedule established by the commissioner.327.6    (c) Employees not represented by exclusive representatives may become members 327.7of the program upon a determination of an eligible employer to include these employees 327.8in the program. Either all or none of the employer's unrepresented employees must 327.9participate. The eligible employer shall give at least 30 60 days' notice to the commissioner 327.10before entering the program. Entry into the program is governed by a schedule established 327.11by the commissioner.327.12    (d) Participation in the program is for a two-year three-year term. Participation is 327.13automatically renewed for an additional two-year three-year term unless the exclusive 327.14representative, or the employer for unrepresented employees, gives the commissioner 327.15notice of withdrawal at least 30 60 days before expiration of the participation period. A 327.16group that withdraws must wait two years before rejoining, except with the approval of 327.17the commissioner. An exclusive representative, or employer for unrepresented employees, 327.18may also withdraw if premiums increase 50 percent by more than 20 percent in excess of 327.19the Consumer Price Index for all urban consumers or more from one insurance year to 327.20the next.327.21    (e) The exclusive representative shall give the employer notice of intent to withdraw 327.22to the commissioner at least 30 60 days before the expiration date of a collective 327.23bargaining agreement that includes the date on which the term of participation expires.327.24    (f) Each participating eligible employer shall notify the commissioner of the names 327.25of individuals who will be participating within two weeks of after the commissioner 327.26receiving receives notice of the parties' intent to participate. The employer shall also 327.27submit other information as required by the commissioner for administration of the 327.28program.327.29    (g) An employer that withdraws from the program under circumstances that do not 327.30permit withdrawal under this subdivision is liable to the board for premiums payable by 327.31the employer until the time that the employer is eligible to withdraw, and the employer 327.32shall pay those premiums voluntarily and no later than their due date. If the premiums are 327.33not paid voluntarily, the board has authority to and shall collect these premiums under any 327.34method permitted by law for a governmental or nongovernmental creditor of the employer.327.35    Subd. 6. Coverage. (a) By January 1, 1989, The commissioner shall announce the 327.36benefits of the program. The program shall include employee hospital, medical, dental, 328.1and life insurance for employees and hospital and medical benefits for dependents. Health 328.2maintenance organization options and other delivery system options may be provided if 328.3they are available, cost-effective, and capable of servicing the number of people covered 328.4in the program. Participation in optional coverages may be provided by collective 328.5bargaining agreements. For employees not represented by an exclusive representative, the 328.6employer may offer the optional coverages to eligible employees and their dependents 328.7provided in the program. Health coverage must include at least the benefits required of a 328.8health plan company regulated under chapter 62A, 62C, or 62D.328.9    (b) The commissioner, with the assistance of the Labor-Management Committee, 328.10shall periodically assess whether it is financially feasible for the program to offer or to 328.11continue an individual retiree program that has competitive premium rates and benefits. 328.12If the commissioner determines it to be feasible to offer an individual retiree program, 328.13the commissioner shall announce the applicable benefits, premium rates, and terms of 328.14participation. Eligibility to participate in the individual retiree program is governed by 328.15subdivision 8, but applies to retirees of eligible employers that do not participate in the 328.16program and to those retirees' dependents and surviving spouses.328.17    Subd. 6a. Chiropractic services Choice of type of provider. All benefits provided 328.18by the program or a successor program relating to expenses incurred for medical treatment 328.19or services of a physician health care provider must also include chiropractic treatment 328.20and services of a chiropractor any other type of licensed, certified, or registered health care 328.21provider to the extent that the chiropractic services and treatment are within the scope of 328.22chiropractic licensure the provider's licensure, certification, or registration.328.23    This subdivision is intended to provide equal access to benefits for program members 328.24who choose to obtain treatment for illness or injury from a doctor of chiropractic, as long 328.25as the treatment falls within the chiropractor's scope of practice. This subdivision is not 328.26intended to change or add to the benefits provided for in the program.328.27    Subd. 7. Premiums.(a) The proportion of premium paid by the employer and 328.28employee is subject to collective bargaining or personnel policies. If, at the beginning of 328.29the coverage period, no collective bargaining agreement has been finalized, the increased 328.30dollar costs, if any, from the previous year is the sole responsibility of the individual 328.31participant until a collective bargaining agreement states otherwise. Premiums, including 328.32an administration fee, shall be established by the commissioner. The commissioner may 328.33decide to rate specific employers separately for premium purposes, if the commissioner 328.34determines that doing so is in the best interests of the program. Each employer shall pay 328.35monthly the amounts due for employee benefits including the amounts under subdivision 328.368 to the commissioner no later than the dates established by the commissioner. If an 329.1employer fails to make the payments as required, the commissioner may shall cancel 329.2program benefits and pursue other civil remedies, as provided in subdivision 5, paragraph 329.3(d).329.4    (b) The premium charged for an employer's first month in the program must be 329.5three times the regular monthly premium charged to that employer, to help establish 329.6and maintain the program's financial resources. The extra two months premium must 329.7be refunded to the employer if the employer leaves the program, if the refund would 329.8not reduce the program's reserves below the level determined to be appropriate by the 329.9commissioner.329.10    Subd. 8. Continuation of coverage. (a) A former employee of an employer 329.11participating in the program who is receiving a public pension disability benefit or an 329.12annuity or has met the age and service requirements necessary to receive an annuity under 329.13chapter 353, 353C, 354, 354A, 356, 422A, 423, 423A, or 424, and the former employee's 329.14dependents, are eligible to participate in the program. This participation is at the person's 329.15expense unless a collective bargaining agreement or personnel policy provides otherwise. 329.16Premiums for these participants must be established by the commissioner.329.17    The commissioner may provide policy exclusions for preexisting conditions 329.18only when there is a break in coverage between a participant's coverage under the 329.19employment-based group insurance program and the participant's coverage under this 329.20section. An employer shall notify an employee of the option to participate under this 329.21paragraph no later than the effective date of retirement. The retired employee or the 329.22employer of a participating group on behalf of a current or retired employee shall notify 329.23the commissioner within 30 days of the effective date of retirement of intent to participate 329.24in the program according to the rules established by the commissioner.329.25    (b) The spouse of a deceased employee or former employee may purchase the 329.26benefits provided at premiums established by the commissioner if the spouse was a 329.27dependent under the employee's or former employee's coverage under this section at the 329.28time of the death. The spouse remains eligible to participate in the program as long as 329.29the group that included the deceased employee or former employee participates in the 329.30program. Coverage under this clause must be coordinated with relevant insurance benefits 329.31provided through the federally sponsored Medicare program.329.32    (c) The program benefits must continue in the event of strike permitted by section 329.33179A.18
         , if the exclusive representative chooses to have coverage continue and the 329.34employee pays the total monthly premiums when due. 329.35    (d) A participant who discontinues coverage may not reenroll.330.1    (d) Persons participating under these paragraphs this subdivision shall make 330.2appropriate premium payments in the time and manner established by the commissioner.330.3They are not subject to the payment of the extra payments required under subdivision 7, 330.4paragraph (b).330.5    Subd. 9. Insurance trust fund. The insurance trust fund in the state treasury 330.6consists of deposits of the premiums received from employers participating in the 330.7program and transfers before July 1, 1994, from the excess contributions holding account 330.8established by section 
         353.65, subdivision 7. All money in the fund is appropriated to 330.9the commissioner to pay insurance premiums, approved claims, refunds, administrative 330.10costs, and other related service costs. Premiums paid by employers to the fund are exempt 330.11from the taxes imposed by chapter 297I. The commissioner shall reserve an amount of 330.12money to cover the estimated costs of claims incurred but unpaid. The State Board of 330.13Investment shall invest the money according to section 
         11A.24. Investment income and 330.14losses attributable to the fund must be credited to the fund. 330.15    Subd. 10. Exemption. The public employee insurance program and, where 330.16applicable, the employers participating in it are exempt from chapters 60A, 62A, 62C, 330.1762D, 62E, and 62H, section 
         471.617, subdivisions 2 and 3, and the bidding requirements 330.18of section 
         471.6161, except as otherwise provided in subdivision 6, paragraph (a). 330.19    Subd. 11.Reinsurance.The commissioner may, on behalf of the program, 330.20participate in an insured or self-insured reinsurance pool.330.21    Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:330.2262H.02 REQUIRED PROVISIONS.330.23    (a) A joint self-insurance plan must include aggregate excess stop-loss coverage and 330.24individual excess stop-loss coverage provided by an insurance company licensed by the 330.25state of Minnesota. 330.26    (b) Aggregate excess stop-loss coverage must include provisions to cover incurred, 330.27unpaid claim liability in the event of plan termination. In addition,330.28    (c) The plan of self-insurance must have participating employers fund an amount at 330.29least equal to the point at which the excess or stop-loss insurer has contracted to assume 330.30100 percent of additional liability. 330.31    (d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance 330.32contract to the commissioner of commerce at least 30 days prior to the proposed plan's 330.33effective date and at least 30 days subsequent to any renewal date. The commissioner shall 330.34review the contract to determine if they meet the standards established by sections 
         62H.01330.35to 
         62H.08 and respond within a 30-day period. 331.1    (e) Any excess or stop-loss insurance plan must contain a provision that the excess 331.2or stop-loss insurer will give the plan and the commissioner of commerce a minimum of 331.3180 days' notice of termination or nonrenewal. If the plan fails to secure replacement 331.4coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the 331.5commissioner shall issue an order providing for the orderly termination of the plan. 331.6    (f) The commissioner may waive the requirements of this section and of any rule 331.7relating to the requirements of this section, if the commissioner determines that a joint 331.8self-insurance plan has established alternative arrangements that fully fund the plan's 331.9liability or incurred but unpaid claims. The commissioner may not waive the requirement 331.10that a joint self-insurance plan have excess stop-loss coverage. 331.11EFFECTIVE DATE.This section is effective the day following final enactment.331.12    Sec. 4. [62Q.40] LANGUAGE INTERPRETER SERVICES.331.13    (a) A health plan must cover sign language interpreter services provided to deaf and 331.14hard-of-hearing enrollees and language interpreter services provided to enrollees with 331.15limited English proficiency in order to facilitate the provision of health care services by a 331.16provider. For purposes of this section, "provider" has the meaning given in section 62J.03, 331.17subdivision 8, and includes a health care provider facility; and "health plan" includes 331.18coverage excluded under section 62A.011, subdivision 3, clauses (6), (7), (9), and (10). 331.19Interpreter services may be provided in person, by telephone, facsimile, video or audio 331.20streaming, or by video conference. In accordance with paragraphs (b) and (c), a health 331.21plan company shall reimburse either the party providing interpreter services directly 331.22for the costs of language interpreter services provided to the enrollee or the provider 331.23arranging for the provision of interpreter services. Providers that employ or contract 331.24with interpreters may bill and shall be reimbursed directly by health plan companies for 331.25such services in accordance with paragraph (b). A health plan company shall provide to 331.26enrollees, upon request, the policies and procedures for addressing the needs of deaf and 331.27hard-of-hearing enrollees and enrollees with limited English proficiency. All parties 331.28providing interpreter services must disclose their methods for ensuring competency upon 331.29request of any health plan company, provider, or consumer.331.30    (b) A health plan company shall pay for interpreter services as required in paragraph 331.31(a) by establishing a network of interpreter service providers and requiring use of its own 331.32network of interpreter services providers. The health plan company shall consider, as part 331.33of its interpreter service provider network, entering into an agreement with a provider for 331.34use of an interpreter service provider employed by or under contract with the provider if:332.1    (1) the provider accepts as reimbursement for services rendered by the provider's 332.2employed or contracted interpreter service provider the lesser of either the health plan 332.3company's reimbursement rate for its in-network interpreter service providers or the 332.4provider's fee for services rendered by the provider's interpreter service provider; and332.5    (2) the interpreter service provider meets the published quality standards of the 332.6health plan company.332.7    (c) If a health plan company's or a provider's employed or contracted interpreter 332.8service provider is unavailable to provide interpreter services, the health plan company 332.9shall reimburse the interpreter service provider at the lesser of the health plan company's 332.10median reimbursement rate for its in-network interpreter service providers or the 332.11interpreter service provider's fee. An interpreter service provider not employed or under 332.12contract with a health plan company or provider who fails to meet the quality standards 332.13of a health plan company or as required by law, shall be ineligible for reimbursement 332.14under this section.332.15    (d) If the health plan company pays the interpreter service provider directly, it has no 332.16obligation to pay the provider under this section.332.17    (e) Nothing in this section requires a health plan company to establish a network 332.18of interpreter service providers.332.19EFFECTIVE DATE.This section is effective July 1, 2008, and applies to plans 332.20issued or renewed to provide coverage to Minnesota residents on or after that date unless 332.21the legislature enacts alternative funding sources based on the recommendations of the 332.22commissioner.332.23    Sec. 5. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision 332.24to read:332.25    Subd. 5.Base budget detail.The commissioner shall provide the commissioner 332.26of finance with the information necessary to provide base budget detail to the legislature 332.27under section 16A.10, subdivision 2a.332.28    Sec. 6. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision 332.29to read:332.30    Subd. 11.Dispensing by protocol.A registered nurse in a family planning agency 332.31as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives 332.32prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant 332.33to a dispensing protocol established by the agency's medical director or under the direction 333.1of a physician. The dispensing protocol must address the requirements of sections 151.01, 333.2subdivision 30, and 151.212, subdivision 1.333.3    Sec. 7. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:333.4    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of 333.5professional practice only, may prescribe, administer, and dispense a legend drug, and may 333.6cause the same to be administered by a nurse, a physician assistant, or medical student or 333.7resident under the practitioner's direction and supervision, and may cause a person who 333.8is an appropriately certified, registered, or licensed health care professional to prescribe, 333.9dispense, and administer the same within the expressed legal scope of the person's practice 333.10as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, 333.11without reference to a specific patient, by directing a nurse, pursuant to section 
         148.235, 333.12subdivisions 8 and 9
         , physician assistant, or medical student or resident to adhere to 333.13a particular practice guideline or protocol when treating patients whose condition falls 333.14within such guideline or protocol, and when such guideline or protocol specifies the 333.15circumstances under which the legend drug is to be prescribed and administered. An 333.16individual who verbally, electronically, or otherwise transmits a written, oral, or electronic 333.17order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. 333.18This paragraph applies to a physician assistant only if the physician assistant meets the 333.19requirements of section 
         147A.18. 333.20    (b) A licensed practitioner that dispenses for profit a legend drug that is to be 333.21administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must 333.22file with the practitioner's licensing board a statement indicating that the practitioner 333.23dispenses legend drugs for profit, the general circumstances under which the practitioner 333.24dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to 333.25dispense legend drugs for profit after July 31, 1990, unless the statement has been filed 333.26with the appropriate licensing board. For purposes of this paragraph, "profit" means (1) 333.27any amount received by the practitioner in excess of the acquisition cost of a legend drug 333.28for legend drugs that are purchased in prepackaged form, or (2) any amount received 333.29by the practitioner in excess of the acquisition cost of a legend drug plus the cost of 333.30making the drug available if the legend drug requires compounding, packaging, or other 333.31treatment. The statement filed under this paragraph is public data under section 
         13.03. 333.32This paragraph does not apply to a licensed doctor of veterinary medicine or a registered 333.33pharmacist. Any person other than a licensed practitioner with the authority to prescribe, 333.34dispense, and administer a legend drug under paragraph (a) shall not dispense for profit. 334.1To dispense for profit does not include dispensing by a community health clinic when the 334.2profit from dispensing is used to meet operating expenses. 334.3    (c) A prescription or drug order for a legend drug is not valid unless it is issued 334.4for a legitimate medical purpose arising from a prescriber-patient relationship that 334.5includes a documented patient evaluation adequate to establish diagnoses and identify 334.6underlying conditions and contraindications to the treatment. Treatment, including issuing 334.7a prescription or drug order, based solely on an online questionnaire does not constitute a 334.8legitimate medical purpose.334.9    Sec. 8. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to 334.10read:334.11    Subd. 2d.Identification requirement for schedule II or III controlled substance.334.12    No person may dispense a controlled substance included in schedule II or III without 334.13requiring the person purchasing the controlled substance, who need not be the person for 334.14whom the controlled substance prescription is written, to present valid photographic 334.15identification, unless the person purchasing the controlled substance, or if applicable the 334.16person for whom the controlled substance prescription is written, is known to the dispenser.334.17    Sec. 9. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES 334.18PRESCRIPTION ELECTRONIC REPORTING SYSTEM.334.19    Subdivision 1.Definitions.For purposes of this section, the terms defined in this 334.20subdivision have the meanings given.334.21    (a) "Board" means the Minnesota State Board of Pharmacy established under 334.22chapter 151.334.23    (b) "Controlled substances" means those substances listed in section 152.02, 334.24subdivisions 3 and 4, and those substances defined by the board pursuant to section 334.25152.02, subdivisions 8 and 12.334.26    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 334.2730. Dispensing does not include the direct administering of a controlled substance to a 334.28patient by a licensed health care professional.334.29    (d) "Dispenser" means a person authorized by law to dispense a controlled substance, 334.30pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy 334.31that distributes controlled substances for inpatient hospital care.334.32    (e) "Prescriber" means a licensed health care professional who is authorized to 334.33prescribe a controlled substance under section 152.12, subdivision 1.334.34    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.335.1    Subd. 2.Prescription electronic reporting system.(a) By January 1, 2009, 335.2or upon enactment of legislation that implements the recommendations of the Board 335.3of Pharmacy under subdivision 3, paragraph (c), whichever is later, the board shall 335.4establish an electronic system for reporting the information required under subdivision 335.54 for all controlled substances dispensed within the state. Data for controlled substance 335.6prescriptions that are dispensed in a quantity small enough to provide treatment to a 335.7patient for a period of 48 hours or less need not be reported.335.8    (b) The board may contract with a vendor for the purpose of obtaining technical 335.9assistance in the design, implementation, and maintenance of the electronic reporting 335.10system. The vendor's role shall be limited to providing technical support to the board 335.11concerning the software, databases, and computer systems required to interface with the 335.12existing systems currently used by pharmacies to dispense prescriptions and transmit 335.13prescription data to other third parties.335.14    (c) The board may issue a waiver to a dispenser that is unable to submit dispensing 335.15information by electronic means. The waiver may permit the dispenser to submit 335.16dispensing information by paper form or other means, provided all information required 335.17by subdivision 4 is submitted in this alternative format.335.18    Subd. 3.Prescription Electronic Reporting Advisory Committee.(a) The 335.19board shall convene an advisory committee. The committee must include at least one 335.20representative of:335.21    (1) the Department of Health;335.22    (2) the Department of Human Services;335.23    (3) each health-related licensing board that licenses prescribers;335.24    (4) a professional medical association, which may include an association of pain 335.25management and chemical dependency specialists;335.26    (5) a professional pharmacy association; 335.27    (6) a consumer privacy or security advocate; and 335.28    (7) a consumer or patient rights organization.335.29    (b) The advisory committee shall advise the board on the development and operation 335.30of the electronic reporting system, including, but not limited to:335.31    (1) technical standards for electronic prescription drug reporting;335.32    (2) proper analysis and interpretation of prescription monitoring data; and335.33    (3) an evaluation process for the program.335.34    (c) The Board of Pharmacy, after consultation with the advisory committee, shall 335.35present recommendations and draft legislation on the issues addressed by the advisory 335.36committee under paragraph (b), to the legislature by December 15, 2007.336.1    Subd. 4.Reporting requirements and notice.(a) Each dispenser must submit the 336.2following data to the board or its designated vendor, subject to the notice required under 336.3paragraph (d):336.4    (1) prescriber DEA number;336.5    (2) dispenser DEA number;336.6    (3) name of the patient for whom the prescription was written;336.7    (4) date of birth of the patient for whom the prescription was written;336.8    (5) date the prescription was written;336.9    (6) date the prescription was filled;336.10    (7) NDC code for drug dispensed; and336.11    (8) quantity of controlled substance dispensed.336.12    (b) The dispenser must submit the required information according to the format and 336.13protocols specified in the "ASAP Telecommunications Format for Controlled Substances," 336.14May 1995 edition, published by the American Society for Automation in Pharmacy, which 336.15is hereby adopted by reference, by a procedure established by the board.336.16    (c) A dispenser is not required to submit this data for those controlled substance 336.17prescriptions dispensed for:336.18    (1) individuals residing in licensed skilled nursing or intermediate care facilities;336.19    (2) individuals receiving assisted living services under chapter 144G or through a 336.20medical assistance home and community-based waiver;336.21    (3) individuals receiving medication intravenously;336.22    (4) individuals receiving hospice and other palliative or end-of-life care; and336.23    (5) individuals receiving services from a home care provider regulated under chapter 336.24144A.336.25    (d) A dispenser must not submit data under this subdivision unless a conspicuous 336.26notice of the reporting requirements of this section is given to the patient for whom the 336.27prescription was written.336.28    Subd. 5.Use of data by board.(a) The board shall develop and maintain a database 336.29of the data reported under subdivision 4. The board shall maintain data that could identify 336.30an individual prescriber or dispenser in encrypted form. The database may be used by 336.31permissible users identified under subdivision 6 for the identification of:336.32    (1) individuals receiving prescriptions for controlled substances from prescribers 336.33who subsequently obtain controlled substances from dispensers in quantities or with a 336.34frequency inconsistent with generally recognized standards of dosage for those controlled 336.35substances; and 337.1    (2) individuals presenting forged or otherwise false or altered prescriptions for 337.2controlled substances to dispensers. 337.3    (b) No permissible user identified under subdivision 6 may access the database 337.4for the sole purpose of identifying prescribers of controlled substances for unusual or 337.5excessive prescribing patterns without a valid search warrant or court order.337.6    (c) No personnel of a state or federal occupational licensing board or agency may 337.7access the database for the purpose of obtaining information to be used to initiate or 337.8substantiate a disciplinary action against a prescriber.337.9    (d) Data reported under subdivision 4 shall be retained by the board in the database 337.10for a six-month period, and shall be removed from the database six months from the 337.11date the data was received.337.12    Subd. 6.Access to reporting system data.(a) Except as indicated in this 337.13subdivision, the data submitted to the board under subdivision 4 is private data on 337.14individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.337.15    (b) Except as specified in subdivision 5, the following persons shall be considered 337.16permissible users and may access the data submitted under subdivision 4 in the same or 337.17similar manner, and for the same or similar purposes, as those persons who are authorized 337.18to access similar private data on individuals under federal and state law:337.19    (1) a prescriber, to the extent the information relates specifically to a current patient 337.20of the prescriber, to whom the practitioner is prescribing or considering prescribing any 337.21controlled substance;337.22    (2) a dispenser to the extent the information relates specifically to a current patient to 337.23whom that dispenser is dispensing or considering dispensing any controlled substance;337.24    (3) an individual who is the recipient of a controlled substance prescription for 337.25which data was submitted under subdivision 4;337.26    (4) personnel of the board specifically assigned to conduct a bona fide investigation 337.27of a specific board licensee;337.28    (5) personnel of the board engaged in the collection of controlled substance 337.29prescription information as part of the assigned duties and responsibilities under this 337.30section;337.31    (6) authorized personnel of a vendor under contract with the board who are engaged 337.32in the design, implementation, and maintenance of the electronic reporting system as part 337.33of the assigned duties and responsibilities of their employment, provided that access to data 337.34is limited to the minimum amount necessary to test and maintain the system databases;337.35    (7) federal, state, and local law enforcement authorities engaged in a bona fide 337.36investigation of a specific person; and338.1    (8) personnel of the medical assistance program assigned to use the data collected 338.2under this section to identify recipients whose usage of controlled substances may warrant 338.3restriction to a single primary care physician, a single outpatient pharmacy, or a single 338.4hospital.338.5    (c) Any permissible user identified in paragraph (b), who directly accesses 338.6the data electronically, shall implement and maintain a comprehensive information 338.7security program that contains administrative, technical, and physical safeguards that 338.8are appropriate to the user's size and complexity, and the sensitivity of the personal 338.9information obtained. The permissible user shall identify reasonably foreseeable internal 338.10and external risks to the security, confidentiality, and integrity of personal information 338.11that could result in the unauthorized disclosure, misuse, or other compromise of the 338.12information and assess the sufficiency of any safeguards in place to control the risks.338.13    (d) The board shall not release data submitted under this section unless it is provided 338.14with evidence, satisfactory to the board, that the person requesting the information is 338.15entitled to receive the data. Access to the data by law enforcement authorities must be 338.16accompanied by a valid search warrant.338.17    (e) The board shall not release the name of a prescriber without the written consent 338.18of the prescriber or a valid search warrant or court order. The board shall provide a 338.19mechanism for a prescriber to submit to the board a signed consent authorizing the release 338.20of the prescriber's name when data containing the prescriber's name is requested.338.21    (f) The board shall maintain a log of all persons who access the data and shall ensure 338.22that any permissible user complies with paragraph (c) prior to attaining direct access to 338.23the data.338.24    Subd. 7.Disciplinary action.(a) A dispenser who knowingly fails to submit data to 338.25the board as required under this section is subject to disciplinary action by the appropriate 338.26health-related licensing board.338.27    (b) A prescriber or dispenser authorized to access the data who knowingly discloses 338.28the data in violation of state or federal laws relating to the privacy of health care data 338.29shall be subject to disciplinary action by the appropriate health-related licensing board, 338.30and appropriate civil penalties.338.31    Subd. 8.Evaluation and reporting.(a) The board shall evaluate the prescription 338.32electronic reporting system to determine if the system is cost-effective and whether it is 338.33negatively impacting appropriate prescribing practices of controlled substances. The 338.34board may contract with a vendor to design and conduct the evaluation.338.35    (b) The board shall submit the evaluation of the system to the legislature by January 338.3615, 2010.339.1    Subd. 9.Immunity from liability; no requirement to obtain information.(a) A 339.2pharmacist, prescriber, or other dispenser making a report to the program in good faith 339.3under this section is immune from any civil, criminal, or administrative liability, which 339.4might otherwise be incurred or imposed as a result of the report, or on the basis that the 339.5pharmacist or prescriber did or did not seek or obtain or use information from the program.339.6    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser 339.7to obtain information about a patient from the program, and the pharmacist, prescriber, 339.8or other dispenser, if acting in good faith, is immune from any civil, criminal, or 339.9administrative liability that might otherwise be incurred or imposed for requesting, 339.10receiving, or using information from the program.339.11EFFECTIVE DATE.This section is effective July 1, 2007, or upon receiving 339.12sufficient nonstate funds to implement the prescription electronic reporting program, 339.13whichever is later. In the event that nonstate funds are not secured by the Board of 339.14Pharmacy to adequately fund the implementation of the prescription electronic reporting 339.15program, the board is not required to implement this section without a subsequent 339.16appropriation from the legislature.339.17    Sec. 10. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:339.18    Subd. 7. Essential employee. "Essential employee" means firefighters, peace 339.19officers subject to licensure under sections 
         626.84 to 
         626.863, 911 system and police and 339.20fire department public safety dispatchers, guards at correctional facilities, confidential 339.21employees, supervisory employees, assistant county attorneys, assistant city attorneys, 339.22principals, and assistant principals. However, for state employees, "essential employee" 339.23means all employees, except for nonprofessional employees employed by the Department 339.24of Human Services in mental health facilities for the treatment of psychopathic 339.25personalities, sexual predators, and the criminally insane, in law enforcement, public 339.26safety radio communications operators, health care professionals, correctional guards, 339.27professional engineering, and supervisory collective bargaining units, irrespective of 339.28severance, and no other employees. For University of Minnesota employees, "essential 339.29employee" means all employees in law enforcement, nursing professional and supervisory 339.30units, irrespective of severance, and no other employees. "Firefighters" means salaried 339.31employees of a fire department whose duties include, directly or indirectly, controlling, 339.32extinguishing, preventing, detecting, or investigating fires. Employees for whom the state 339.33court administrator is the negotiating employer are not essential employees. For Hennepin 339.34Healthcare System, Inc. employees, "essential employees" means all employees.340.1EFFECTIVE DATE.This section is effective the day following final enactment.340.2    Sec. 11. Minnesota Statutes 2006, section 245.4874, is amended to read:340.3245.4874 DUTIES OF COUNTY BOARD.340.4    (a) The county board must:340.5    (1) develop a system of affordable and locally available children's mental health 340.6services according to sections 
         245.487 to 
         245.4887;340.7    (2) establish a mechanism providing for interagency coordination as specified in 340.8section 
         245.4875, subdivision 6;340.9    (3) consider the assessment of unmet needs in the county as reported by the local 340.10children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 340.11(b), clause (3). The county shall provide, upon request of the local children's mental health 340.12advisory council, readily available data to assist in the determination of unmet needs;340.13    (4) assure that parents and providers in the county receive information about how to 340.14gain access to services provided according to sections 
         245.487 to 
         245.4887;340.15    (5) coordinate the delivery of children's mental health services with services 340.16provided by social services, education, corrections, health, and vocational agencies to 340.17improve the availability of mental health services to children and the cost-effectiveness of 340.18their delivery;340.19    (6) assure that mental health services delivered according to sections 
         245.487340.20to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 340.21assessment and individual treatment plan;340.22    (7) provide the community with information about predictors and symptoms of 340.23emotional disturbances and how to access children's mental health services according to 340.24sections 
         245.4877 and 
         245.4878;340.25    (8) provide for case management services to each child with severe emotional 340.26disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 340.27subdivisions 1, 3, and 5
         ;340.28    (9) provide for screening of each child under section 
         245.4885 upon admission 340.29to a residential treatment facility, acute care hospital inpatient treatment, or informal 340.30admission to a regional treatment center;340.31    (10) prudently administer grants and purchase-of-service contracts that the county 340.32board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 340.33245.4887
         ;341.1    (11) assure that mental health professionals, mental health practitioners, and case 341.2managers employed by or under contract to the county to provide mental health services 341.3are qualified under section 
         245.4871;341.4    (12) assure that children's mental health services are coordinated with adult mental 341.5health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 341.6health services is available to serve persons with mental illness, regardless of the person's 341.7age;341.8    (13) assure that culturally informed mental health consultants are used as necessary 341.9to assist the county board in assessing and providing appropriate treatment for children of 341.10cultural or racial minority heritage; and341.11    (14) consistent with section 
         245.486, arrange for or provide a children's mental 341.12health screening to a child receiving child protective services or a child in out-of-home 341.13placement, a child for whom parental rights have been terminated, a child found to be 341.14delinquent, and a child found to have committed a juvenile petty offense for the third 341.15or subsequent time, unless a screening or diagnostic assessment has been performed 341.16within the previous 180 days, or the child is currently under the care of a mental health 341.17professional. The court or county agency must notify a parent or guardian whose 341.18parental rights have not been terminated of the potential mental health screening and the 341.19option to prevent the screening by notifying the court or county agency in writing. The 341.20screening shall be conducted with a screening instrument approved by the commissioner 341.21of human services according to criteria that are updated and issued annually to ensure 341.22that approved screening instruments are valid and useful for child welfare and juvenile 341.23justice populations, and shall be conducted by a mental health practitioner as defined in 341.24section 
         245.4871, subdivision 26, or a probation officer or local social services agency 341.25staff person who is trained in the use of the screening instrument. Training in the use of the 341.26instrument shall include training in the administration of the instrument, the interpretation 341.27of its validity given the child's current circumstances, the state and federal data practices 341.28laws and confidentiality standards, the parental consent requirement, and providing respect 341.29for families and cultural values. If the screen indicates a need for assessment, the child's 341.30family, or if the family lacks mental health insurance, the local social services agency, 341.31in consultation with the child's family, shall have conducted a diagnostic assessment, 341.32including a functional assessment, as defined in section 
         245.4871. The administration of 341.33the screening shall safeguard the privacy of children receiving the screening and their 341.34families and shall comply with the Minnesota Government Data Practices Act, chapter 341.3513, and the federal Health Insurance Portability and Accountability Act of 1996, Public 342.1Law 104-191. Screening results shall be considered private data and the commissioner 342.2shall not collect individual screening results.342.3    (b) When the county board refers clients to providers of children's therapeutic 342.4services and supports under section 
         256B.0943, the county board must clearly identify 342.5the desired services components not covered under section 
         256B.0943 and identify the 342.6reimbursement source for those requested services, the method of payment, and the 342.7payment rate to the provider.342.8    Sec. 12. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:342.9    Subd. 2. Transfer to correctional facility. (a) If a person has been committed 342.10under this section and later is committed to the custody of the commissioner of corrections 342.11for any reason, including but not limited to, being sentenced for a crime or revocation of 342.12the person's supervised release or conditional release under section 
         244.05, 609.108, 342.13subdivision 6, or 
         609.109, subdivision 7, the person shall be transferred to a facility 342.14designated by the commissioner of corrections without regard to the procedures provided 342.15in section 
         253B.18. 342.16    (b) If a person is committed under this section after a commitment to the 342.17commissioner of corrections, the person shall first serve the sentence in a facility 342.18designated by the commissioner of corrections. After the person has served the sentence, 342.19the person shall be transferred to a treatment program designated by the commissioner 342.20of human services.342.21    Sec. 13. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:342.22    Subd. 3. Rules for chemical dependency care. The commissioner of human 342.23services shall establish by rule criteria to be used in determining the appropriate level 342.24of chemical dependency care, whether outpatient, inpatient or short-term treatment 342.25programs, for each recipient of public assistance seeking treatment for alcohol or other 342.26drug dependency and abuse problems. The criteria shall address, at least, the family 342.27relationship, past treatment history, medical or physical problems, arrest record, and 342.28employment situation.342.29    Sec. 14. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:342.30    Subd. 2. Program and service guidelines. (a) The commissioner shall provide 342.31program and service guidelines and technical assistance to the county boards in carrying 342.32out services authorized under sections section254A.08, 254A.12, 254A.14, and their 342.33responsibilities under chapter 256E. 343.1    (b) The commissioner shall recommend to the governor means of improving 343.2the efficiency and effectiveness of comprehensive program services in the state and 343.3maximizing the use of nongovernmental funds for providing comprehensive programs.343.4    Sec. 15. [254A.20] CHEMICAL USE ASSESSMENTS; FINANCIAL CONFLICT 343.5OF INTEREST.343.6    (a) Except as provided in paragraph (b), an assessor conducting a chemical use 343.7assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any 343.8direct or shared financial interest or referral relationship resulting in shared financial 343.9interest or referral relationship resulting in shared financial gain with a treatment provider. 343.10    (b) A county may contract with an assessor having a conflict described in paragraph 343.11(a) if the county documents that: 343.12    (1) the assessor is employed by a culturally specific service provider or a service 343.13provider with a program designed to treat individuals of a specific age, sex, or sexual 343.14preference; 343.15    (2) the county does not employ a sufficient number of qualified assessors and the 343.16only qualified assessors available in the county have a direct or shared financial interest or 343.17a referral relationship resulting in shared financial gain with a treatment provider; or 343.18    (3) the county social service agency has an existing relationship with an assessor 343.19or service provider and elects to enter into a contract with that assessor to provide both 343.20assessment and treatment under circumstances specified in the county's contract, provided 343.21the county retains responsibility for making placement decisions.343.22EFFECTIVE DATE.This section is effective the day following final enactment.343.23    Sec. 16. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:343.24    Subdivision 1. Chemical dependency treatment allocation. The chemical 343.25dependency funds appropriated for allocation shall be placed in a special revenue account. 343.26The commissioner shall annually transfer funds from the chemical dependency fund to pay 343.27for operation of the drug and alcohol abuse normative evaluation system and to pay for all 343.28costs incurred by adding two positions for licensing of chemical dependency treatment 343.29and rehabilitation programs located in hospitals for which funds are not otherwise 343.30appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall 343.31allocate funds to the American Indian chemical dependency tribal account for treatment 343.32of American Indians by eligible vendors under section 254B.05, equal to the amount 343.33allocated in fiscal year 1997. Six percent of the remaining money must be reserved for 343.34tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall 344.1annually divide the money available in the chemical dependency fund that is not held 344.2in reserve by counties from a previous allocation, or allocated to the American Indian 344.3chemical dependency tribal account. Six percent of the remaining money must be 344.4reserved for the nonreservation American Indian chemical dependency allocation for 344.5treatment of American Indians by eligible vendors under section 
         254B.05, subdivision 344.61
         . The remainder of the money must be allocated among the counties according to the 344.7following formula, using state demographer data and other data sources determined by 344.8the commissioner: 344.9    (a) For purposes of this formula, American Indians and children under age 14 are 344.10subtracted from the population of each county to determine the restricted population.344.11    (b) The amount of chemical dependency fund expenditures for entitled persons for 344.12services not covered by prepaid plans governed by section 
         256B.69 in the previous year is 344.13divided by the amount of chemical dependency fund expenditures for entitled persons for 344.14all services to determine the proportion of exempt service expenditures for each county. 344.15    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 344.16service expenditures to determine the adjusted prepaid plan months of eligibility for 344.17each county.344.18    (d) The adjusted prepaid plan months of eligibility is added to the number of 344.19restricted population fee for service months of eligibility for the Minnesota family 344.20investment program, general assistance, and medical assistance and divided by the county 344.21restricted population to determine county per capita months of covered service eligibility.344.22    (e) The number of adjusted prepaid plan months of eligibility for the state is added 344.23to the number of fee for service months of eligibility for the Minnesota family investment 344.24program, general assistance, and medical assistance for the state restricted population and 344.25divided by the state restricted population to determine state per capita months of covered 344.26service eligibility.344.27    (f) The county per capita months of covered service eligibility is divided by the 344.28state per capita months of covered service eligibility to determine the county welfare 344.29caseload factor.344.30    (g) The median married couple income for the most recent three-year period 344.31available for the state is divided by the median married couple income for the same period 344.32for each county to determine the income factor for each county.344.33    (h) The county restricted population is multiplied by the sum of the county welfare 344.34caseload factor and the county income factor to determine the adjusted population.344.35    (i) $15,000 shall be allocated to each county.345.1    (j) The remaining funds shall be allocated proportional to the county adjusted 345.2population.345.3    Sec. 17. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:345.4    Subd. 5. Administrative adjustment. The commissioner may make payments to 345.5local agencies from money allocated under this section to support administrative activities 345.6under sections 
         254B.03 and 
         254B.04. The administrative payment must not exceed 345.7five percent of the first $50,000, four percent of the next $50,000, and three percent of 345.8the remaining payments for services from the allocation. Twenty-five percent of the 345.9administrative allowance shall be advanced at the beginning of each quarter, based on 345.10the payments for services made in the most recent quarter for which data is available. 345.11Adjustment of any overestimate or underestimate based on actual expenditures shall be 345.12made by the state agency by adjusting the administrative allowance for any succeeding 345.13quarter.345.14    Sec. 18. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:345.15    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical 345.16dependency services to persons residing within its jurisdiction who meet criteria 345.17established by the commissioner for placement in a chemical dependency residential or 345.18nonresidential treatment service. Chemical dependency money must be administered 345.19by the local agencies according to law and rules adopted by the commissioner under 345.20sections 
         14.001 to 
         14.69. 345.21    (b) In order to contain costs, the county board shall, with the approval of the 345.22commissioner of human services, select eligible vendors of chemical dependency services 345.23who can provide economical and appropriate treatment. Unless the local agency is a social 345.24services department directly administered by a county or human services board, the local 345.25agency shall not be an eligible vendor under section 
         254B.05. The commissioner may 345.26approve proposals from county boards to provide services in an economical manner or to 345.27control utilization, with safeguards to ensure that necessary services are provided. If a 345.28county implements a demonstration or experimental medical services funding plan, the 345.29commissioner shall transfer the money as appropriate. If a county selects a vendor located 345.30in another state, the county shall ensure that the vendor is in compliance with the rules 345.31governing licensure of programs located in the state. 345.32    (c) The calendar year 2002 rate for vendors may not increase more than three 345.33percent above the rate approved in effect on January 1, 2001. The calendar year 2003 345.34rate for vendors may not increase more than three percent above the rate in effect on 346.1January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in 346.2effect on January 1, 2003.346.3    (d) (c) A culturally specific vendor that provides assessments under a variance under 346.4Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 346.5persons not covered by the variance.346.6    Sec. 19. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:346.7    Subd. 3. Local agencies to pay state for county share.Local agencies shall submit 346.8invoices to the state on forms supplied by the commissioner and according to procedures 346.9established by the commissioner. Local agencies shall pay the state for the county share 346.10of the invoiced services authorized by the local agency. Payments shall be made at the 346.11beginning of each month for services provided in the previous month. The commissioner 346.12shall bill the county monthly for services, based on the most recent month for which 346.13expenditure information is available. Adjustment of any overestimate or underestimate 346.14based on actual expenditures shall be made by the state agency by adjusting the estimate 346.15for any succeeding month.346.16    Sec. 20. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:346.17    Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for 346.18placements made by local agencies under section 
         254B.03, subdivision 1, and placements 346.19by tribal designated agencies according to section 
         254B.09. The commissioner may 346.20reduce or deny payment of the state share when services are not provided according to the 346.21placement criteria established by the commissioner. The commissioner may pay for all or 346.22a portion of improper county chemical dependency placements and bill the county for the 346.23entire payment made when the placement did not comply with criteria established by the 346.24commissioner. The commissioner may make payments to vendors and charge the county 346.25100 percent of the payments if documentation of a county approved placement is received 346.26more than 30 working days, exclusive of weekends and holidays, after the date services 346.27began; or if the county approved invoice is received by the commissioner more than 120 346.28days after the last date of service provided. The commissioner shall not pay vendors until 346.29private insurance company claims have been settled. 346.30    Sec. 21. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 346.31to read:347.1    Subd. 25.Base budget detail.The commissioner shall provide the commissioner 347.2of finance with the information necessary to provide base budget detail to the legislature 347.3under section 16A.10, subdivision 2a.347.4    Sec. 22. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to 347.5read:347.6    Subd. 23. Day treatment services. Medical assistance covers day treatment 347.7services as specified in sections 
         245.462, subdivision 8, and 
         245.4871, subdivision 10, that 347.8are provided under contract with the county board. Notwithstanding Minnesota Rules, 347.9part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day 347.10treatment for adults according to section 
         256B.0625, subdivision 25. Notwithstanding 347.11Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance 347.12covers day treatment services for children as specified under section 
         256B.0943. 347.13    Sec. 23. [256B.0636] PRESCRIBING OF CONTROLLED SUBSTANCES; 347.14ABUSE PREVENTION.347.15    The commissioner shall develop and implement a plan to:347.16    (1) monitor the prescribing of controlled substances listed in section 152.02, 347.17subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 347.18section 152.02, subdivisions 8 and 12, by enrolled providers and providers under contract 347.19with participating managed care plans;347.20    (2) require enrolled providers and providers under contract with participating 347.21managed care plans to report information related to potential patient abuse of the 347.22controlled substances to the commissioner, and the Board of Pharmacy; and347.23    (3) provide education to Minnesota health care program enrollees on the proper use 347.24of controlled substances.347.25    Sec. 24. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to 347.26read:347.27    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be 347.28an eligible provider entity under this section, a provider entity must have a clinical 347.29infrastructure that utilizes diagnostic assessment, an individualized treatment plan, 347.30service delivery, and individual treatment plan review that are culturally competent, 347.31child-centered, and family-driven to achieve maximum benefit for the client. The provider 347.32entity must review and update the clinical policies and procedures every three years and 348.1must distribute the policies and procedures to staff initially and upon each subsequent 348.2update.348.3    (b) The clinical infrastructure written policies and procedures must include policies 348.4and procedures for:348.5    (1) providing or obtaining a client's diagnostic assessment that identifies acute and 348.6chronic clinical disorders, co-occurring medical conditions, sources of psychological and 348.7environmental problems, and a functional assessment. The functional assessment must 348.8clearly summarize the client's individual strengths and needs;348.9    (2) developing an individual treatment plan that is:348.10    (i) based on the information in the client's diagnostic assessment;348.11    (ii) developed no later than the end of the first psychotherapy session after the 348.12completion of the client's diagnostic assessment by the mental health professional who 348.13provides the client's psychotherapy;348.14    (iii) developed through a child-centered, family-driven planning process that 348.15identifies service needs and individualized, planned, and culturally appropriate 348.16interventions that contain specific treatment goals and objectives for the client and the 348.17client's family or foster family;348.18    (iv) reviewed at least once every 90 days and revised, if necessary; and348.19    (v) signed by the client or, if appropriate, by the client's parent or other person 348.20authorized by statute to consent to mental health services for the client;348.21    (3) developing an individual behavior plan that documents services to be provided 348.22by the mental health behavioral aide. The individual behavior plan must include:348.23    (i) detailed instructions on the service to be provided;348.24    (ii) time allocated to each service;348.25    (iii) methods of documenting the child's behavior;348.26    (iv) methods of monitoring the child's progress in reaching objectives; and348.27    (v) goals to increase or decrease targeted behavior as identified in the individual 348.28treatment plan;348.29    (4) clinical supervision of the mental health practitioner and mental health behavioral 348.30aide. A mental health professional must document the clinical supervision the professional 348.31provides by cosigning individual treatment plans and making entries in the client's record 348.32on supervisory activities. Clinical supervision does not include the authority to make or 348.33terminate court-ordered placements of the child. A clinical supervisor must be available 348.34for urgent consultation as required by the individual client's needs or the situation. Clinical 348.35supervision may occur individually or in a small group to discuss treatment and review 348.36progress toward goals. The focus of clinical supervision must be the client's treatment 349.1needs and progress and the mental health practitioner's or behavioral aide's ability to 349.2provide services;349.3    (4a) CTSS certified provider entities providing day treatment programs must meet 349.4the conditions in items (i) to (iii):349.5    (i) the provider supervisor must be present and available on the premises more 349.6than 50 percent of the time in a five-working-day period during which the supervisee is 349.7providing a mental health service;349.8    (ii) the diagnosis and the client's individual treatment plan or a change in the 349.9diagnosis or individual treatment plan must be made by or reviewed, approved, and signed 349.10by the provider supervisor; and349.11    (iii) every 30 days, the supervisor must review and sign the record of the client's care 349.12for all activities in the preceding 30-day period;349.13    (4b) for all other services provided under CTSS, clinical supervision standards 349.14provided in items (i) to (iii) must be used:349.15    (i) medical assistance shall reimburse a mental health practitioner who maintains a 349.16consulting relationship with a mental health professional who accepts full professional 349.17responsibility and is present on site for at least one observation during the first 12 hours 349.18in which the mental health practitioner provides the individual, family, or group skills 349.19training to the child or the child's family;349.20    (ii) thereafter, the mental health professional is required to be present on site for 349.21observation as clinically appropriate when the mental health practitioner is providing 349.22individual, family, or group skills training to the child or the child's family; and349.23    (iii) the observation must be a minimum of one clinical unit. The on-site presence of 349.24the mental health professional must be documented in the child's record and signed by the 349.25mental health professional who accepts full professional responsibility;349.26    (5) providing direction to a mental health behavioral aide. For entities that employ 349.27mental health behavioral aides, the clinical supervisor must be employed by the provider 349.28entity or other certified children's therapeutic supports and services provider entity to 349.29ensure necessary and appropriate oversight for the client's treatment and continuity 349.30of care. The mental health professional or mental health practitioner giving direction 349.31must begin with the goals on the individualized treatment plan, and instruct the mental 349.32health behavioral aide on how to construct therapeutic activities and interventions that 349.33will lead to goal attainment. The professional or practitioner giving direction must also 349.34instruct the mental health behavioral aide about the client's diagnosis, functional status, 349.35and other characteristics that are likely to affect service delivery. Direction must also 349.36include determining that the mental health behavioral aide has the skills to interact with 350.1the client and the client's family in ways that convey personal and cultural respect and 350.2that the aide actively solicits information relevant to treatment from the family. The aide 350.3must be able to clearly explain the activities the aide is doing with the client and the 350.4activities' relationship to treatment goals. Direction is more didactic than is supervision 350.5and requires the professional or practitioner providing it to continuously evaluate the 350.6mental health behavioral aide's ability to carry out the activities of the individualized 350.7treatment plan and the individualized behavior plan. When providing direction, the 350.8professional or practitioner must:350.9    (i) review progress notes prepared by the mental health behavioral aide for accuracy 350.10and consistency with diagnostic assessment, treatment plan, and behavior goals and the 350.11professional or practitioner must approve and sign the progress notes;350.12    (ii) identify changes in treatment strategies, revise the individual behavior plan, 350.13and communicate treatment instructions and methodologies as appropriate to ensure 350.14that treatment is implemented correctly;350.15    (iii) demonstrate family-friendly behaviors that support healthy collaboration among 350.16the child, the child's family, and providers as treatment is planned and implemented;350.17    (iv) ensure that the mental health behavioral aide is able to effectively communicate 350.18with the child, the child's family, and the provider; and350.19    (v) record the results of any evaluation and corrective actions taken to modify the 350.20work of the mental health behavioral aide;350.21    (6) providing service delivery that implements the individual treatment plan and 350.22meets the requirements under subdivision 9; and350.23    (7) individual treatment plan review. The review must determine the extent to which 350.24the services have met the goals and objectives in the previous treatment plan. The review 350.25must assess the client's progress and ensure that services and treatment goals continue to 350.26be necessary and appropriate to the client and the client's family or foster family. Revision 350.27of the individual treatment plan does not require a new diagnostic assessment unless the 350.28client's mental health status has changed markedly. The updated treatment plan must be 350.29signed by the client, if appropriate, and by the client's parent or other person authorized by 350.30statute to give consent to the mental health services for the child.350.31    Sec. 25. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to 350.32read:350.33    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a 350.34certified provider entity must ensure that:351.1    (1) each individual provider's caseload size permits the provider to deliver services 351.2to both clients with severe, complex needs and clients with less intensive needs. The 351.3provider's caseload size should reasonably enable the provider to play an active role in 351.4service planning, monitoring, and delivering services to meet the client's and client's 351.5family's needs, as specified in each client's individual treatment plan;351.6    (2) site-based programs, including day treatment and preschool programs, provide 351.7staffing and facilities to ensure the client's health, safety, and protection of rights, and that 351.8the programs are able to implement each client's individual treatment plan;351.9    (3) a day treatment program is provided to a group of clients by a multidisciplinary 351.10team under the clinical supervision of a mental health professional. The day treatment 351.11program must be provided in and by: (i) an outpatient hospital accredited by the Joint 351.12Commission on Accreditation of Health Organizations and licensed under sections 351.13144.50
          to 
         144.55; (ii) a community mental health center under section 
         245.62; and (iii) 351.14an entity that is under contract with the county board to operate a program that meets 351.15the requirements of sections 
         245.4712, subdivision 2, and 
         245.4884, subdivision 2, 351.16and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must 351.17stabilize the client's mental health status while developing and improving the client's 351.18independent living and socialization skills. The goal of the day treatment program must be 351.19to reduce or relieve the effects of mental illness and provide training to enable the client 351.20to live in the community. The program must be available at least one day a week for a 351.21minimum three-hour time block. The three-hour time block must include at least one 351.22hour, but no more than two hours, of individual or group psychotherapy. The remainder 351.23of the three-hour time block may include recreation therapy, socialization therapy, or 351.24independent living skills therapy, but only if the therapies are included in the client's 351.25individual treatment plan. Day treatment programs are not part of inpatient or residential 351.26treatment services; and 351.27    (4) a preschool program is a structured treatment program offered to a child who 351.28is at least 33 months old, but who has not yet reached the first day of kindergarten, by a 351.29preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts 351.309503.0005 to 9503.0175. The program must be available at least one day a week for a 351.31minimum two-hour time block. The structured treatment program may include individual 351.32or group psychotherapy and recreation therapy, socialization therapy, or independent 351.33living skills therapy, if included in the client's individual treatment plan.351.34    (b) A provider entity must deliver the service components of children's therapeutic 351.35services and supports in compliance with the following requirements:352.1    (1) individual, family, and group psychotherapy must be delivered as specified in 352.2Minnesota Rules, part 9505.0323;352.3    (2) individual, family, or group skills training must be provided by a mental health 352.4professional or a mental health practitioner who has a consulting relationship with a 352.5mental health professional who accepts full professional responsibility for the training;352.6    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis 352.7through arrangements for direct intervention and support services to the child and the 352.8child's family. Crisis assistance must utilize resources designed to address abrupt or 352.9substantial changes in the functioning of the child or the child's family as evidenced by 352.10a sudden change in behavior with negative consequences for well being, a loss of usual 352.11coping mechanisms, or the presentation of danger to self or others;352.12    (4) medically necessary services that are provided by a mental health behavioral 352.13aide must be designed to improve the functioning of the child and support the family in 352.14activities of daily and community living. A mental health behavioral aide must document 352.15the delivery of services in written progress notes. The mental health behavioral aide 352.16must implement goals in the treatment plan for the child's emotional disturbance that 352.17allow the child to acquire developmentally and therapeutically appropriate daily living 352.18skills, social skills, and leisure and recreational skills through targeted activities. These 352.19activities may include:352.20    (i) assisting a child as needed with skills development in dressing, eating, and 352.21toileting;352.22    (ii) assisting, monitoring, and guiding the child to complete tasks, including 352.23facilitating the child's participation in medical appointments;352.24    (iii) observing the child and intervening to redirect the child's inappropriate behavior;352.25    (iv) assisting the child in using age-appropriate self-management skills as related 352.26to the child's emotional disorder or mental illness, including problem solving, decision 352.27making, communication, conflict resolution, anger management, social skills, and 352.28recreational skills;352.29    (v) implementing deescalation techniques as recommended by the mental health 352.30professional;352.31    (vi) implementing any other mental health service that the mental health professional 352.32has approved as being within the scope of the behavioral aide's duties; or352.33    (vii) assisting the parents to develop and use parenting skills that help the child 352.34achieve the goals outlined in the child's individual treatment plan or individual behavioral 352.35plan. Parenting skills must be directed exclusively to the child's treatment; and352.36    (5) direction of a mental health behavioral aide must include the following:353.1    (i) a total of one hour of on-site observation by a mental health professional during 353.2the first 12 hours of service provided to a child;353.3    (ii) ongoing on-site observation by a mental health professional or mental health 353.4practitioner for at least a total of one hour during every 40 hours of service provided 353.5to a child; and353.6    (iii) immediate accessibility of the mental health professional or mental health 353.7practitioner to the mental health behavioral aide during service provision.353.8    Sec. 26. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to 353.9read:353.10    Subd. 11. Documentation and billing. (a) A provider entity must document the 353.11services it provides under this section. The provider entity must ensure that the entity's 353.12documentation standards meet the requirements of federal and state laws. Services billed 353.13under this section that are not documented according to this subdivision shall be subject to 353.14monetary recovery by the commissioner. The provider entity may not bill for anything 353.15other than direct service time.353.16    (b) An individual mental health provider must promptly document the following 353.17in a client's record after providing services to the client:353.18    (1) each occurrence of the client's mental health service, including the date, type, 353.19length, and scope of the service;353.20    (2) the name of the person who gave the service;353.21    (3) contact made with other persons interested in the client, including representatives 353.22of the courts, corrections systems, or schools. The provider must document the name 353.23and date of each contact;353.24    (4) any contact made with the client's other mental health providers, case manager, 353.25family members, primary caregiver, legal representative, or the reason the provider did 353.26not contact the client's family members, primary caregiver, or legal representative, if 353.27applicable; and353.28    (5) required clinical supervision, as appropriate.353.29    Sec. 27. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to 353.30read:353.31    Subd. 12. Excluded services. The following services are not eligible for medical 353.32assistance payment as children's therapeutic services and supports:354.1    (1) service components of children's therapeutic services and supports 354.2simultaneously provided by more than one provider entity unless prior authorization is 354.3obtained;354.4    (2) children's therapeutic services and supports provided in violation of medical 354.5assistance policy in Minnesota Rules, part 9505.0220;354.6    (3) mental health behavioral aide services provided by a personal care assistant who 354.7is not qualified as a mental health behavioral aide and employed by a certified children's 354.8therapeutic services and supports provider entity;354.9    (4) service components of CTSS that are the responsibility of a residential or 354.10program license holder, including foster care providers under the terms of a service 354.11agreement or administrative rules governing licensure; and354.12    (5) adjunctive activities that may be offered by a provider entity but are not 354.13otherwise covered by medical assistance, including:354.14    (i) a service that is primarily recreation oriented or that is provided in a setting that 354.15is not medically supervised. This includes sports activities, exercise groups, activities 354.16such as craft hours, leisure time, social hours, meal or snack time, trips to community 354.17activities, and tours;354.18    (ii) a social or educational service that does not have or cannot reasonably be 354.19expected to have a therapeutic outcome related to the client's emotional disturbance;354.20    (iii) consultation with other providers or service agency staff about the care or 354.21progress of a client;354.22    (iv) prevention or education programs provided to the community; and354.23    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and354.24    (6) activities that are not direct service time.354.25    Sec. 28. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.354.26    Effective for services rendered on or after July 1, 2007, payment rates for family 354.27planning services shall be increased by 25 percent over the rates in effect July 30, 2007, 354.28when these services are provided by a community clinic as defined in section 145.9268, 354.29subdivision 1.354.30    Sec. 29. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:354.31    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.354.32    (b) "Family asset account" means a savings account opened by a household 354.33participating in the Minnesota family assets for independence initiative.354.34    (c) "Fiduciary organization" means:355.1    (1) a community action agency that has obtained recognition under section 
         268.53355.2256E.31;355.3    (2) a federal community development credit union serving the seven-county 355.4metropolitan area; or355.5    (3) a women-oriented economic development agency serving the seven-county 355.6metropolitan area.355.7    (d) "Financial institution" means a bank, bank and trust, savings bank, savings 355.8association, or credit union, the deposits of which are insured by the Federal Deposit 355.9Insurance Corporation or the National Credit Union Administration.355.10    (e) "Permissible use" means:355.11    (1) postsecondary educational expenses at an accredited public postsecondary 355.12institution including books, supplies, and equipment required for courses of instruction;355.13    (2) acquisition costs of acquiring, constructing, or reconstructing a residence, 355.14including any usual or reasonable settlement, financing, or other closing costs;355.15    (3) business capitalization expenses for expenditures on capital, plant, equipment, 355.16working capital, and inventory expenses of a legitimate business pursuant to a business 355.17plan approved by the fiduciary organization; and355.18    (4) acquisition costs of a principal residence within the meaning of section 1034 of 355.19the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area 355.20purchase price applicable to the residence determined according to section 143(e)(2) and 355.21(3) of the Internal Revenue Code of 1986.355.22    (f) "Household" means all individuals who share use of a dwelling unit as primary 355.23quarters for living and eating separate from other individuals.355.24    Sec. 30. [525A.01] SHORT TITLE.355.25    This chapter may be cited as the "Darlene Luther Revised Uniform Anatomical 355.26Gift Act."355.27    Sec. 31. [525A.02] DEFINITIONS.355.28    Subdivision 1.Scope.The definitions in this section apply to this chapter.355.29    Subd. 2.Adult."Adult" means an individual who is at least 18 years of age.355.30    Subd. 3.Agent."Agent" means an individual who is:355.31    (1) authorized to make health care decisions on the principal's behalf by a power of 355.32attorney for health care; or355.33    (2) expressly authorized to make an anatomical gift on the principal's behalf by 355.34any other record signed by the principal.356.1    Subd. 4.Anatomical gift."Anatomical gift" means a donation of all or part of 356.2a human body to take effect after the donor's death for the purpose of transplantation, 356.3therapy, research, or education.356.4    Subd. 5.Decedent."Decedent" means a deceased individual and includes a stillborn 356.5infant or an embryo or fetus that has died of natural causes in utero.356.6    Subd. 6.Disinterested witness."Disinterested witness" means a witness other than 356.7the spouse, child, parent, sibling, grandchild, grandparent, or guardian of the individual 356.8who makes, amends, revokes, or refuses to make an anatomical gift, or another adult who 356.9exhibited special care and concern for the individual. The term does not include a person 356.10to which an anatomical gift could pass under section 525A.11.356.11    Subd. 7.Document of gift."Document of gift" means a donor card or other record 356.12used to make an anatomical gift. The term includes a statement or symbol on a driver's 356.13license, identification card, or donor registry.356.14    Subd. 8.Donor."Donor" means an individual whose body or part is the subject of 356.15an anatomical gift.356.16    Subd. 9.Donor registry."Donor registry" means a database that contains records 356.17of anatomical gifts and amendments to or revocations of anatomical gifts.356.18    Subd. 10.Driver's license."Driver's license" means a license or permit issued 356.19under chapter 171 to operate a vehicle, whether or not conditions are attached to the 356.20license or permit.356.21    Subd. 11.Eye bank."Eye bank" means a person that is licensed, accredited, 356.22or regulated under federal or state law to engage in the recovery, screening, testing, 356.23processing, storage, or distribution of human eyes or portions of human eyes.356.24    Subd. 12.Guardian."Guardian" means a person appointed by a court to make 356.25decisions regarding the support, care, education, health, or welfare of an individual. The 356.26term does not include a guardian ad litem.356.27    Subd. 13.Hospital."Hospital" means a facility licensed as a hospital under the 356.28law of any state or a facility operated as a hospital by the United States, a state, or a 356.29subdivision of a state.356.30    Subd. 14.Identification card."Identification card" means a Minnesota 356.31identification card issued under chapter 171.356.32    Subd. 15.Know."Know" means to have actual knowledge.356.33    Subd. 16.Medical examiner."Medical examiner" includes coroner.356.34    Subd. 17.Minor."Minor" means an individual who is under 18 years of age.357.1    Subd. 18.Organ procurement organization."Organ procurement organization" 357.2means a person designated by the secretary of the United States Department of Health and 357.3Human Services as an organ procurement organization.357.4    Subd. 19.Parent."Parent" means a parent whose parental rights have not been 357.5terminated.357.6    Subd. 20.Part."Part" means an organ, an eye, or tissue of a human being. The term 357.7does not include the whole body.357.8    Subd. 21.Person."Person" means an individual, corporation, business trust, estate, 357.9trust, partnership, limited liability company, association, joint venture, public corporation, 357.10government or governmental subdivision, agency, or instrumentality, or any other legal or 357.11commercial entity.357.12    Subd. 22.Physician."Physician" means an individual authorized to practice 357.13medicine or osteopathy under the law of any state.357.14    Subd. 23.Procurement organization."Procurement organization" means an eye 357.15bank, organ procurement organization, or tissue bank.357.16    Subd. 24.Prospective donor."Prospective donor" means an individual who is dead 357.17or near death and has been determined by a procurement organization to have a part that 357.18could be medically suitable for transplantation, therapy, research, or education. The term 357.19does not include an individual who has made a refusal.357.20    Subd. 25.Reasonably available."Reasonably available" means able to be 357.21contacted by a procurement organization without undue effort and willing and able to act 357.22in a timely manner consistent with existing medical criteria necessary for the making of 357.23an anatomical gift.357.24    Subd. 26.Recipient."Recipient" means an individual into whose body a decedent's 357.25part has been or is intended to be transplanted.357.26    Subd. 27.Record."Record" means information that is inscribed on a tangible 357.27medium or that is stored in an electronic or other medium and is retrievable in perceivable 357.28form.357.29    Subd. 28.Refusal."Refusal" means a record created under section 525A.07 that 357.30expressly states an intent to bar other persons from making an anatomical gift of an 357.31individual's body or part.357.32    Subd. 29.Sign."Sign" means, with the present intent to authenticate or adopt 357.33a record:357.34    (1) to execute or adopt a tangible symbol; or357.35    (2) to attach to or logically associate with the record an electronic symbol, sound, 357.36or process.358.1    Subd. 30.State."State" means a state of the United States, the District of Columbia, 358.2Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject 358.3to the jurisdiction of the United States.358.4    Subd. 31.Technician."Technician" means an individual determined to be qualified 358.5to remove or process parts by an appropriate organization that is licensed, accredited, or 358.6regulated under federal or state law. The term includes an enucleator.358.7    Subd. 32.Tissue."Tissue" means a portion of the human body other than an organ 358.8or an eye. The term does not include blood unless the blood is donated for the purpose 358.9of research or education.358.10    Subd. 33.Tissue bank."Tissue bank" means a person that is licensed, accredited, 358.11or regulated under federal or state law to engage in the recovery, screening, testing, 358.12processing, storage, or distribution of tissue.358.13    Subd. 34.Transplant hospital."Transplant hospital" means a hospital that 358.14furnishes organ transplants and other medical and surgical specialty services required 358.15for the care of transplant patients.358.16    Sec. 32. [525A.03] APPLICABILITY.358.17    This chapter applies to an anatomical gift or amendment to, revocation of, or refusal 358.18to make an anatomical gift, whenever made.358.19    Sec. 33. [525A.04] WHO MAY MAKE ANATOMICAL GIFT BEFORE 358.20DONOR'S DEATH.358.21    Subject to section 525A.08, an anatomical gift of a donor's body or part may be 358.22made during the life of the donor for the purpose of transplantation, therapy, research, or 358.23education in the manner provided in section 525A.05 by:358.24    (1) the donor, if the donor is an adult or if the donor is a minor and is:358.25    (i) emancipated; or358.26    (ii) authorized under state law to apply for a driver's license because the donor is 358.27at least 16 years of age;358.28    (2) an agent of the donor, unless the power of attorney for health care or other record 358.29prohibits the agent from making an anatomical gift;358.30    (3) a parent of the donor, if the donor is an unemancipated minor; or358.31    (4) the donor's guardian.358.32    Sec. 34. [525A.05] MANNER OF MAKING ANATOMICAL GIFT BEFORE 358.33DONOR'S DEATH.359.1    (a) A donor may make an anatomical gift:359.2    (1) by authorizing a statement or symbol indicating that the donor has made an 359.3anatomical gift to be imprinted on the donor's driver's license or identification card;359.4    (2) in a will;359.5    (3) during a terminal illness or injury of the donor, by any form of communication 359.6addressed to at least two adults, at least one of whom is a disinterested witness; or359.7    (4) as provided in paragraph (b).359.8    (b) A donor or other person authorized to make an anatomical gift under section 359.9525A.04 may make a gift by a donor card or other record signed by the donor or other 359.10person making the gift or by authorizing that a statement or symbol indicating that the 359.11donor has made an anatomical gift be included on a donor registry. If the donor or 359.12other person is physically unable to sign a record, the record may be signed by another 359.13individual at the direction of the donor or other person and must:359.14    (1) be witnessed by at least two adults, at least one of whom is a disinterested 359.15witness, who have signed at the request of the donor or the other person; and359.16    (2) state that it has been signed and witnessed as provided in clause (1).359.17    (c) Revocation, suspension, expiration, or cancellation of a driver's license or 359.18identification card upon which an anatomical gift is indicated does not invalidate the gift.359.19    (d) An anatomical gift made by will takes effect upon the donor's death whether or 359.20not the will is probated. Invalidation of the will after the donor's death does not invalidate 359.21the gift.359.22    (e) The making of an anatomical gift shall not itself authorize or direct the denial 359.23of health care.359.24    Sec. 35. [525A.06] AMENDING OR REVOKING ANATOMICAL GIFT 359.25BEFORE DONOR'S DEATH.359.26    (a) Subject to section 525A.08, a donor or other person authorized to make an 359.27anatomical gift under section 525A.04 may amend or revoke an anatomical gift by:359.28    (1) a record signed by:359.29    (i) the donor;359.30    (ii) the other person; or359.31    (iii) subject to paragraph (b), another individual acting at the direction of the donor 359.32or the other person if the donor or other person is physically unable to sign; or359.33    (2) a later-executed document of gift that amends or revokes a previous anatomical 359.34gift or portion of an anatomical gift, either expressly or by inconsistency.359.35    (b) A record signed pursuant to paragraph (a), clause (1), item (iii), must:360.1    (1) be witnessed by at least two adults, at least one of whom is a disinterested 360.2witness, who have signed at the request of the donor or the other person; and360.3    (2) state that it has been signed and witnessed as provided in clause (1).360.4    (c) Subject to section 525A.08, a donor or other person authorized to make an 360.5anatomical gift under section 525A.04 may revoke an anatomical gift by the destruction or 360.6cancellation of the document of gift, or the portion of the document of gift used to make 360.7the gift, with the intent to revoke the gift.360.8    (d) A donor may amend or revoke an anatomical gift that was not made in a will 360.9by any form of communication during a terminal illness or injury addressed to at least 360.10two adults, at least one of whom is a disinterested witness.360.11    (e) A donor who makes an anatomical gift in a will may amend or revoke the gift in 360.12the manner provided for amendment or revocation of wills or as provided in paragraph (a).360.13    Sec. 36. [525A.07] REFUSAL TO MAKE ANATOMICAL GIFT; EFFECT OF 360.14REFUSAL.360.15    (a) An individual may refuse to make an anatomical gift of the individual's body 360.16or part by:360.17    (1) a record signed by:360.18    (i) the individual; or360.19    (ii) subject to paragraph (b), another individual acting at the direction of the 360.20individual if the individual is physically unable to sign;360.21    (2) the individual's will, whether or not the will is admitted to probate or invalidated 360.22after the individual's death; or360.23    (3) any form of communication made by the individual during the individual's 360.24terminal illness or injury addressed to at least two adults, at least one of whom is a 360.25disinterested witness.360.26    (b) A record signed pursuant to paragraph (a), clause (1), item (ii), must:360.27    (1) be witnessed by at least two adults, at least one of whom is a disinterested 360.28witness, who have signed at the request of the individual; and360.29    (2) state that it has been signed and witnessed as provided in clause (1).360.30    (c) An individual who has made a refusal may amend or revoke the refusal:360.31    (1) in the manner provided in paragraph (a) for making a refusal;360.32    (2) by subsequently making an anatomical gift pursuant to section 525A.05 that is 360.33inconsistent with the refusal; or360.34    (3) by destroying or canceling the record evidencing the refusal, or the portion of the 360.35record used to make the refusal, with the intent to revoke the refusal.361.1    (d) Except as otherwise provided in section 525A.08, paragraph (h), in the absence 361.2of an express, contrary indication by the individual set forth in the refusal, an individual's 361.3unrevoked refusal to make an anatomical gift of the individual's body or part bars all other 361.4persons from making an anatomical gift of the individual's body or part.361.5    Sec. 37. [525A.08] PRECLUSIVE EFFECT OF ANATOMICAL GIFT, 361.6AMENDMENT, OR REVOCATION.361.7    (a) Except as otherwise provided in paragraph (g) and subject to paragraph (f), in the 361.8absence of an express, contrary indication by the donor, a person other than the donor is 361.9barred from making, amending, or revoking an anatomical gift of a donor's body or part if 361.10the donor made an anatomical gift of the donor's body or part under section 525A.05 or an 361.11amendment to an anatomical gift of the donor's body or part under section 525A.06. An 361.12anatomical gift made in a will, a designation on a driver's license or identification card, or 361.13a health care directive under chapter 145C, and not revoked, establishes the intent of the 361.14person making the designation and may not be overridden by any other person.361.15    (b) A donor's revocation of an anatomical gift of the donor's body or part under 361.16section 525A.06 is not a refusal and does not bar another person specified in section 361.17525A.04 or 525A.09 from making an anatomical gift of the donor's body or part under 361.18section 525A.05 or 525A.10.361.19    (c) If a person other than the donor makes an unrevoked anatomical gift of the 361.20donor's body or part under section 525A.05 or an amendment to an anatomical gift of the 361.21donor's body or part under section 525A.06, another person may not make, amend, or 361.22revoke the gift of the donor's body or part under section 525A.10.361.23    (d) A revocation of an anatomical gift of a donor's body or part under section 361.24525A.06 by a person other than the donor does not bar another person from making an 361.25anatomical gift of the body or part under section 525A.05 or 525A.10.361.26    (e) In the absence of an express, contrary indication by the donor or other person 361.27authorized to make an anatomical gift under section 525A.04, an anatomical gift of a part 361.28is neither a refusal to give another part nor a limitation on the making of an anatomical gift 361.29of another part at a later time by the donor or another person.361.30    (f) In the absence of an express, contrary indication by the donor or other person 361.31authorized to make an anatomical gift under section 525A.04, an anatomical gift of a 361.32part for one or  more of the purposes set forth in section 525A.04 is not a limitation on 361.33the making of an anatomical gift of the part for any of the other purposes by the donor 361.34or any other person under section 525A.05 or 525A.10.362.1    (g) If a donor who is an unemancipated minor dies, a parent of the donor who is 362.2reasonably available may revoke or amend an anatomical gift of the donor's body or part.362.3    (h) If an unemancipated minor who signed a refusal dies, a parent of the minor who 362.4is reasonably available may revoke the minor's refusal.362.5    Sec. 38. [525A.09] WHO MAY MAKE ANATOMICAL GIFT OF DECEDENT'S 362.6BODY OR PART.362.7    (a) Subject to paragraphs (b) and (c) and unless barred by section 525A.07 or 362.8525A.08, an anatomical gift of a decedent's body or part for the purpose of transplantation, 362.9therapy, research, or education may be made by any member of the following classes of 362.10persons who is reasonably available, in the order of priority listed:362.11    (1) an agent of the decedent at the time of death who could have made an anatomical 362.12gift under section 525A.04, clause (2), immediately before the decedent's death;362.13    (2) the spouse of the decedent;362.14    (3) adult children of the decedent;362.15    (4) parents of the decedent;362.16    (5) adult siblings of the decedent;362.17    (6) adult grandchildren of the decedent;362.18    (7) grandparents of the decedent;362.19    (8) an adult who exhibited special care and concern for the decedent;362.20    (9) the persons who were acting as the guardians of the person of the decedent 362.21at the time of death; and 362.22    (10) any other person having the authority to dispose of the decedent's body.362.23    (b) If there is more than one member of a class listed in paragraph (a), clause (1), 362.24(3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an anatomical gift may 362.25be made by a member of the class unless that member or a person to which the gift may 362.26pass under section 525A.11 knows of an objection by another member of the class. If 362.27an objection is known, the gift may be made only by a majority of the members of the 362.28class who are reasonably available.362.29    (c) A person may not make an anatomical gift if, at the time of the decedent's death, 362.30a person in a prior class under paragraph (a) is reasonably available to make or to object to 362.31the making of an anatomical gift.362.32    Sec. 39. [525A.10] MANNER OF MAKING, AMENDING, OR REVOKING 362.33ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.363.1    (a) A person authorized to make an anatomical gift under section 525A.09 may 363.2make an anatomical gift by a document of gift signed by the person making the gift or by 363.3that person's oral communication that is electronically recorded or is contemporaneously 363.4reduced to a record and signed by the individual receiving the oral communication.363.5    (b) Subject to paragraph (c), an anatomical gift by a person authorized under section 363.6525A.09 may be amended or revoked orally or in a record by any member of a prior class 363.7who is reasonably available. If more than one member of the prior class is reasonably 363.8available, the gift made by a person authorized under section 525A.09 may be:363.9    (1) amended only if a majority of the reasonably available members agree to the 363.10amending of the gift; or363.11    (2) revoked only if a majority of the reasonably available members agree to the 363.12revoking of the gift or if they are equally divided as to whether to revoke the gift.363.13    (c) A revocation under paragraph (b) is effective only if, before an incision has been 363.14made to remove a part from the donor's body or before invasive procedures have begun to 363.15prepare the recipient, the procurement organization, transplant hospital, or physician or 363.16technician knows of the revocation.363.17    Sec. 40. [525A.11] PERSONS THAT MAY RECEIVE ANATOMICAL GIFT; 363.18PURPOSE OF ANATOMICAL GIFT.363.19    (a) An anatomical gift may be made to the following persons named in the document 363.20of gift:363.21    (1) a hospital; accredited medical school, dental school, college, or university; organ 363.22procurement organization; or nonprofit organization in medical education or research, 363.23for research or education;363.24    (2) subject to paragraph (b), an individual designated by the person making the 363.25anatomical gift if the individual is the recipient of the part; and 363.26    (3) an eye bank or tissue bank.363.27    (b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be 363.28transplanted into the individual, the part passes in accordance with paragraph (g) in the 363.29absence of an express, contrary indication by the person making the anatomical gift.363.30    (c) If an anatomical gift of one or more specific parts or of all parts is made in a 363.31document of gift that does not name a person described in paragraph (a) but identifies the 363.32purpose for which an anatomical gift may be used, the following rules apply:363.33    (1) if the part is an eye and the gift is for the purpose of transplantation or therapy, 363.34the gift passes to the appropriate eye bank;364.1    (2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the 364.2gift passes to the appropriate tissue bank;364.3    (3) if the part is an organ and the gift is for the purpose of transplantation or therapy, 364.4the gift passes to the appropriate organ procurement organization as custodian of the 364.5organ; and364.6    (4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research 364.7or education, the gift passes to the appropriate procurement organization.364.8    (d) For the purpose of paragraph (c), if there is more than one purpose of an 364.9anatomical gift set forth in the document of gift but the purposes are not set forth in any 364.10priority, the gift must be used for transplantation or therapy, if suitable. If the gift cannot 364.11be used for transplantation or therapy, the gift may be used for research or education. 364.12    (e) If an anatomical gift of one or more specific parts is made in a document of gift 364.13that does not name a person described in paragraph (a) and does not identify the purpose 364.14of the gift, the gift may be used only for transplantation or therapy, and the gift passes in 364.15accordance with paragraph (g).364.16    (f) If a document of gift specifies only a general intent to make an anatomical gift 364.17by words such as "donor," "organ donor," or "body donor," or by a symbol or statement 364.18of similar import, the gift may be used only for transplantation or therapy, and the gift 364.19passes in accordance with paragraph (g).364.20    (g) For purposes of paragraphs (b), (e), and (f), the following rules apply:364.21    (1) if the part is an eye, the gift passes to the appropriate eye bank;364.22    (2) if the part is tissue, the gift passes to the appropriate tissue bank; and364.23    (3) if the part is an organ, the gift passes to the appropriate organ procurement 364.24organization as custodian of the organ.364.25    (h) An anatomical gift of an organ for transplantation or therapy, other than 364.26an anatomical gift under paragraph (a), clause (2), passes to the organ procurement 364.27organization as custodian of the organ.364.28    (i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the 364.29decedent's body or part is not used for transplantation, therapy, research, or education, 364.30custody of the body or part passes to the person under obligation to dispose of the body or 364.31part.364.32    (j) A person may not accept an anatomical gift if the person knows that the gift was 364.33not effectively made under section 525A.05 or 525A.10 or if the person knows that the 364.34decedent made a refusal under section 525A.07 that was not revoked. For purposes of 364.35this paragraph, if a person knows that an anatomical gift was made on a document of gift, 365.1the person is deemed to know of any amendment or revocation of the gift or any refusal 365.2to make an anatomical gift on the same document of gift.365.3    (k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter 365.4affects the allocation of organs for transplantation or therapy.365.5    Sec. 41. [525A.12] SEARCH AND NOTIFICATION.365.6    (a) The following persons shall make a reasonable search of an individual who 365.7the person reasonably believes is dead or near death for a document of gift or other 365.8information identifying the individual as a donor or as an individual who made a refusal:365.9    (1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer 365.10finding the individual; and365.11    (2) if no other source of the information is immediately available, a hospital, as soon 365.12as practical after the individual's arrival at the hospital.365.13    (b) If a document of gift or a refusal to make an anatomical gift is located by the 365.14search required by paragraph (a), clause (1), and the individual or deceased individual to 365.15whom it relates is taken to a hospital, the person responsible for conducting the search 365.16shall send the document of gift or refusal to the hospital. If a body is transferred to 365.17the custody of the medical examiner, the person who discovered the body must notify 365.18the person's dispatcher. A dispatcher notified under this section must notify the state's 365.19federally designated organ procurement organization and inform the organization of the 365.20deceased's name, donor status, and location.365.21    (c) A person is not subject to criminal or civil liability for failing to discharge the 365.22duties imposed by this section but may be subject to administrative sanctions.365.23    Sec. 42. [525A.13] DELIVERY OF DOCUMENT OF GIFT NOT REQUIRED; 365.24RIGHT TO EXAMINE.365.25    (a) A document of gift need not be delivered during the donor's lifetime to be 365.26effective.365.27    (b) Upon or after an individual's death, a person in possession of a document of 365.28gift or a refusal to make an anatomical gift with respect to the individual shall allow 365.29examination and copying of the document of gift or refusal by a person authorized to 365.30make or object to the making of an anatomical gift with respect to the individual or by a 365.31person to which the gift could pass under section 525A.11.365.32    Sec. 43. [525A.14] RIGHTS AND DUTIES OF PROCUREMENT 365.33ORGANIZATION AND OTHERS.366.1    (a) When a hospital refers an individual at or near death to a procurement 366.2organization, the organization shall make a reasonable search of the records of the 366.3Department of Public Safety and any donor registry that it knows exists for the 366.4geographical area in which the individual resides to ascertain whether the individual has 366.5made an anatomical gift.366.6    (b) A procurement organization must be allowed reasonable access to information 366.7in the records of the Department of Public Safety to ascertain whether an individual at 366.8or near death is a donor.366.9    (c) When a hospital refers an individual at or near death to a procurement 366.10organization, the organization may conduct any reasonable examination necessary to 366.11ensure the medical suitability of a part that is or could be the subject of an anatomical gift 366.12for transplantation, therapy, research, or education from a donor or a prospective donor. 366.13During the examination period, measures necessary to ensure the medical suitability of the 366.14part may not be withdrawn unless the hospital or procurement organization knows that 366.15the individual expressed a contrary intent.366.16    (d) Unless prohibited by law other than this chapter, at any time after a donor's death, 366.17the person to which a part passes under section 525A.11 may conduct any reasonable 366.18examination necessary to ensure the medical suitability of the body or part for its intended 366.19purpose.366.20    (e) Unless prohibited by law other than this chapter, an examination under paragraph 366.21(c) or (d) may include an examination of all medical and dental records of the donor or 366.22prospective donor.366.23    (f) Upon the death of a minor who was a donor or had signed a refusal, unless a 366.24procurement organization knows the minor is emancipated, the procurement organization 366.25shall conduct a reasonable search for the parents of the minor and provide the parents with 366.26an opportunity to revoke or amend the anatomical gift or revoke the refusal.366.27    (g) Upon referral by a hospital under paragraph (a), a procurement organization shall 366.28make a reasonable search for any person listed in section 525A.09 having priority to make 366.29an anatomical gift on behalf of a prospective donor. If a procurement organization receives 366.30information that an anatomical gift to any other person was made, amended, or revoked, it 366.31shall promptly advise the other person of all relevant information.366.32    (h) Subject to sections 525A.11, paragraph (i), and 525A.23, the rights of the person 366.33to which a part passes under section 525A.11 are superior to the rights of all others with 366.34respect to the part. The person may accept or reject an anatomical gift in whole or in part. 366.35Subject to the terms of the document of gift and this chapter, a person that accepts an 366.36anatomical gift of an entire body may allow embalming, burial, or cremation, and use of 367.1remains in a funeral service. If the gift is of a part, the person to which the part passes 367.2under section 525A.11, upon the death of the donor and before embalming, burial, or 367.3cremation, shall cause the part to be removed without unnecessary mutilation.367.4    (i) Neither the physician who attends the decedent at death nor the physician who 367.5determines the time of the decedent's death may participate in the procedures for removing 367.6or transplanting a part from the decedent.367.7    (j) A physician or technician may remove a donated part from the body of a donor 367.8that the physician or technician is qualified to remove.367.9    Sec. 44. [525A.15] COORDINATION OF PROCUREMENT AND USE.367.10    Each hospital in this state shall enter into agreements or affiliations with procurement 367.11organizations for coordination of procurement and use of anatomical gifts.367.12    Sec. 45. [525A.16] SALE OR PURCHASE OF PARTS PROHIBITED; FELONY.367.13    (a) Except as otherwise provided in paragraph (b), a person that, for valuable 367.14consideration, knowingly purchases or sells a part for transplantation or therapy if removal 367.15of a part from an individual is intended to occur after the individual's death, commits a 367.16felony and upon conviction is subject to a fine not exceeding $10,000 or imprisonment 367.17not exceeding five years, or both.367.18    (b) A person may charge a reasonable amount for the removal, processing, 367.19preservation, quality control, storage, transportation, implantation, or disposal of a part.367.20    Sec. 46. [525A.17] PROHIBITED ACTS; FELONY.367.21    A person that, in order to obtain a financial gain, intentionally falsifies, forges, 367.22conceals, defaces, or obliterates a document of gift, an amendment or revocation of a 367.23document of gift, or a refusal commits a felony and upon conviction is subject to a fine not 367.24exceeding $10,000 or imprisonment not exceeding five years, or both.367.25    Sec. 47. [525A.18] IMMUNITY.367.26    (a) A person that acts in accordance with this chapter or with the applicable 367.27anatomical gift law of another state, or attempts in good faith to do so, is not liable for the 367.28act in a civil action, criminal prosecution, or administrative proceeding.367.29    (b) Neither the person making an anatomical gift nor the donor's estate is liable for 367.30any injury or damage that results from the making or use of the gift.367.31    (c) In determining whether an anatomical gift has been made, amended, or revoked 367.32under this chapter, a person may rely upon representations of an individual listed in 368.1section 525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating to the 368.2individual's relationship to the donor or prospective donor unless the person knows that 368.3the representation is untrue.368.4    (d) An anatomical gift under this chapter is not a sale of goods as that term is defined 368.5in section 336.2-105, paragraph (1), or the sale of a product.368.6    Sec. 48. [525A.19] LAW GOVERNING VALIDITY; CHOICE OF LAW AS TO 368.7EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.368.8    (a) A document of gift is valid if executed in accordance with:368.9    (1) this chapter;368.10    (2) the laws of the state or country where it was executed; or368.11    (3) the laws of the state or country where the person making the anatomical gift 368.12was domiciled, has a place of residence, or was a national at the time the document of 368.13gift was executed.368.14    (b) If a document of gift is valid under this section, the law of this state governs 368.15the interpretation of the document of gift.368.16    (c) A person may presume that a document of gift or amendment of an anatomical 368.17gift is valid unless that person knows that it was not validly executed or was revoked.368.18    Sec. 49. [525A.20] DONOR REGISTRY.368.19    (a) The Department of Health may establish or contract for the establishment of a 368.20donor registry.368.21    (b) The Department of Public Safety shall cooperate with a person that administers 368.22any donor registry that this state establishes, contracts for, or recognizes for the purpose 368.23of transferring to the donor registry all relevant information regarding a donor's making, 368.24amendment to, or revocation of an anatomical gift.368.25    (c) A donor registry must:368.26    (1) allow a donor or other person authorized under section 525A.04 to include on 368.27the donor registry a statement or symbol that the donor has made, amended, or revoked 368.28an anatomical gift;368.29    (2) be accessible to a procurement organization to allow it to obtain relevant 368.30information on the donor registry to determine, at or near death of the donor or a 368.31prospective donor, whether the donor or prospective donor has made, amended, or revoked 368.32an anatomical gift; and368.33    (3) be accessible, for purposes of clauses (1) and (2), seven days a week on a 368.3424-hour basis.369.1    (d) Personally identifiable information on a donor registry about a donor or 369.2prospective donor may not be used or disclosed without the express consent of the donor, 369.3prospective donor, or person that made the anatomical gift for any purpose other than 369.4to determine, at or near death of the donor or prospective donor, whether the donor or 369.5prospective donor has made, amended, or revoked an anatomical gift.369.6    (e) This section does not prohibit any person from creating or maintaining a donor 369.7registry that is not established by or under contract with the state. Any such registry 369.8must comply with paragraphs (c) and (d).369.9    Sec. 50. [525A.21] EFFECT OF ANATOMICAL GIFT ON ADVANCE HEALTH 369.10CARE DIRECTIVE.369.11    (a) In this section:369.12    (1) "advance health care directive" means a power of attorney for health care 369.13or a record signed by a prospective donor containing the prospective donor's direction 369.14concerning a health care decision for the prospective donor;369.15    (2) "declaration" means a record signed by a prospective donor specifying the 369.16circumstances under which a life support system may be withheld or withdrawn from 369.17the prospective donor; and369.18    (3) "health care decision" means any decision made regarding the health care of the 369.19prospective donor.369.20    (b) If a prospective donor has a declaration or advance health care directive, 369.21measures necessary to ensure the medical suitability of an organ for transplantation 369.22or therapy may not be withheld or withdrawn from the prospective donor, unless the 369.23declaration expressly provides to the contrary.369.24    Sec. 51. [525A.22] COOPERATION BETWEEN MEDICAL EXAMINER AND 369.25PROCUREMENT ORGANIZATION.369.26    (a) A medical examiner shall cooperate with procurement organizations to maximize 369.27the opportunity to recover anatomical gifts for the purpose of transplantation, therapy, 369.28research, or education.369.29    (b) If a medical examiner receives notice from a procurement organization that an 369.30anatomical gift might be available or was made with respect to a decedent whose body is 369.31under the jurisdiction of the medical examiner and a postmortem examination is going to 369.32be performed, unless the medical examiner denies recovery in accordance with section 369.33525A.23, the medical examiner or designee shall conduct a postmortem examination of 370.1the body or the part in a manner and within a period compatible with its preservation for 370.2the purposes of the gift.370.3    (c) A part may not be removed from the body of a decedent under the jurisdiction 370.4of a medical examiner for transplantation, therapy, research, or education unless the part 370.5is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the 370.6medical examiner may not be delivered to a person for research or education unless the 370.7body is the subject of an anatomical gift. This paragraph does not preclude a medical 370.8examiner from performing the medicolegal investigation upon the body or parts of a 370.9decedent under the jurisdiction of the medical examiner.370.10    Sec. 52. [525A.23] FACILITATION OF ANATOMICAL GIFT FROM 370.11DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL 370.12EXAMINER.370.13    (a) Upon request of a procurement organization, a medical examiner shall release to 370.14the procurement organization the name, contact information, and available medical and 370.15social history of a decedent whose body is under the jurisdiction of the medical examiner. 370.16If the decedent's body or part is medically suitable for transplantation, therapy, research, 370.17or education, the medical examiner shall release postmortem examination results to 370.18the procurement organization. The procurement organization may make a subsequent 370.19disclosure of the postmortem examination results or other information received from the 370.20medical examiner only if relevant to transplantation or therapy.370.21    (b) The medical examiner may conduct a medicolegal examination by reviewing 370.22all medical records, laboratory test results, x-rays, other diagnostic results, and other 370.23information that any person possesses about a donor or prospective donor whose body is 370.24under the jurisdiction of the medical examiner which the medical examiner determines 370.25may be relevant to the investigation.370.26    (c) A person that has any information requested by a medical examiner pursuant 370.27to paragraph (b) shall provide that information as expeditiously as possible to allow the 370.28medical examiner to conduct the medicolegal investigation within a period compatible 370.29with the preservation of parts for the purpose of transplantation, therapy, research, or 370.30education.370.31    (d) If an anatomical gift has been or might be made of a part of a decedent whose 370.32body is under the jurisdiction of the medical examiner and a postmortem examination 370.33is not required, or the medical examiner determines that a postmortem examination is 370.34required but that the recovery of the part that is the subject of an anatomical gift will 370.35not interfere with the examination, the medical examiner and procurement organization 371.1shall cooperate in the timely removal of the part from the decedent for the purpose of 371.2transplantation, therapy, research, or education.371.3    (e) If an anatomical gift of a part from the decedent under the jurisdiction of 371.4the medical examiner has been or might be made, but the medical examiner initially 371.5believes that the recovery of the part could interfere with the postmortem investigation 371.6into the decedent's cause or manner of death, the medical examiner shall consult with 371.7the procurement organization or physician or technician designated by the procurement 371.8organization about the proposed recovery. After consultation, the medical examiner may 371.9allow the recovery.371.10    (f) Following the consultation under paragraph (e), in the absence of mutually 371.11agreed-upon protocols to resolve conflict between the medical examiner and the 371.12procurement organization, if the medical examiner intends to deny recovery of an organ 371.13for transplantation, the medical examiner or designee, at the request of the procurement 371.14organization, shall attend the removal procedure for the part before making a final 371.15determination not to allow the procurement organization to recover the part. During 371.16the removal procedure, the medical examiner or designee may allow recovery by the 371.17procurement organization to proceed, or, if the medical examiner or designee reasonably 371.18believes that the part may be involved in determining the decedent's cause or manner of 371.19death, deny recovery by the procurement organization.371.20    (g) If the medical examiner or designee denies recovery under paragraph (f), the 371.21medical examiner or designee shall:371.22    (1) explain in a record the specific reasons for not allowing recovery of the part;371.23    (2) include the specific reasons in the records of the medical examiner; and371.24    (3) provide a record with the specific reasons to the procurement organization.371.25    (h) If the medical examiner or designee allows recovery of a part under paragraph 371.26(d), (e), or (f), the procurement organization, upon request, shall cause the physician 371.27or technician who removes the part to provide the medical examiner with a record 371.28describing the condition of the part, a biopsy, a photograph, and any other information and 371.29observations that would assist in the postmortem examination.371.30    (i) If a medical examiner or designee is required to be present at a removal procedure 371.31under paragraph (f), upon request the procurement organization requesting the recovery 371.32of the part shall reimburse the medical examiner or designee for the additional costs 371.33incurred in complying with paragraph (f).371.34    Sec. 53. [525A.24] RELATION TO ELECTRONIC SIGNATURES IN GLOBAL 371.35AND NATIONAL COMMERCE ACT.372.1    This chapter modifies, limits, and supersedes the Electronic Signatures in Global and 372.2National Commerce Act, United States Code, title 15, section 7001 et seq., but does not 372.3modify, limit, or supersede section 101(a) of that act, United States Code, title 15, section 372.47001, or authorize electronic delivery of any of the notices described in section 103(b) 372.5of that act, United States Code, title 15, section 7003(b).372.6    Sec. 54. Laws 2005, chapter 98, article 3, section 25, is amended to read:372.7    Sec. 25. REPEALER.372.8    Minnesota Statutes 2004, sections 
         245.713, subdivisions 2 and subdivision 4; 372.9245.716
         ; and 
         626.5551, subdivision 4, are repealed.372.10EFFECTIVE DATE.This section is effective retroactively from August 1, 2005.372.11    Sec. 55. SOBER HOUSES.372.12    Subdivision 1.Sober house defined.For purposes of this section, a "sober house" 372.13means a cooperative living residence that:372.14    (1) provides temporary housing to persons with alcohol or other drug dependency 372.15and abuse problems in exchange for compensation;372.16    (2) stipulates residents must abstain from using alcohol or drugs and meet other 372.17requirements as a condition of living in the residence; and372.18    (3) does not provide counseling or treatment services to those residents within the 372.19meaning of Minnesota Statutes, chapter 148C or 254A.372.20    Subd. 2.Work group creation; membership.The commissioner of human services 372.21shall convene a sober house work group which is comprised of the following members:372.22    (1) sober house landlords;372.23    (2) sober house residents;372.24    (3) community members with knowledge of sober housing;372.25    (4) representatives of cities and counties;372.26    (5) a representative from the Department of Human Services, Chemical Health 372.27Division;372.28    (6) a representative from the Department of Human Services, Licensing Division;372.29    (7) a representative of chemical dependency treatment providers; and372.30    (8) a representative from the Department of Health.372.31    Subd. 3.Report.The work group created in subdivision 2 is directed to study the 372.32issue of sober houses in the state and determine whether state licensing or other regulation 372.33of sober houses is appropriate. Based on findings of the work group, the commissioner of 373.1human services shall submit a report of recommendations to the legislature by January 373.21, 2008.373.3    Sec. 56. INTERPRETER SERVICES WORK GROUP.373.4    (a) The commissioner of health shall, in consultation with the commissioners of 373.5commerce, human services, and employee relations, convene a work group to study the 373.6provision of interpreter services to patients in medical and dental care settings. The work 373.7group shall include one representative from each of the following groups:373.8    (1) consumers;373.9    (2) interpreters;373.10    (3) interpreter service providers or agencies;373.11    (4) health plan companies;373.12    (5) self-insured purchasers;373.13    (6) hospitals;373.14    (7) health care providers;373.15    (8) dental providers;373.16    (9) clinic administrators;373.17    (10) state agency staff from the Departments of Health, Human Services, and 373.18Employee Relations;373.19    (11) Minnesota Registry of Interpreters for the Deaf;373.20    (12) local county social services agencies;373.21    (13) local public health agencies;373.22    (14) interpreting stakeholders group;373.23    (15) one interpreter trainer; and373.24    (16) one interpreter certification examiner.373.25    (b) The work group shall develop findings and recommendations on the following: 373.26    (1) assuring access to interpreter services;373.27    (2) compliance with requirements of federal law and guidance;373.28    (3) developing a quality assurance program to ensure the quality of health care 373.29interpreting services, including requirements for training and establishing a certification 373.30process; and 373.31    (4) identifying broad-based funding mechanisms for interpreter services.373.32    (c) Based on the discussions of the work group, the commissioner shall make 373.33recommendations to the chairs of the health policy and finance committees in the house 373.34and senate by January 15, 2008, on how to ensure high quality interpreter services for 374.1patients in medical and dental settings, and for a broad-based funding mechanism for 374.2delivering these services.374.3EFFECTIVE DATE.This section is effective the day following final enactment.374.4    Sec. 57. FEDERAL GRANTS.374.5    The Board of Pharmacy shall apply for any applicable federal grants or other nonstate 374.6funds to establish and fully implement the prescription electronic reporting system.374.7EFFECTIVE DATE.This section is effective the day following final enactment.374.8    Sec. 58. BOARD OF PHARMACY.374.9    The Board of Pharmacy shall not increase the license fees of pharmacists or 374.10pharmacies in order to adequately fund the prescription electronic reporting system under 374.11Minnesota Statutes, section 152.126, without specific authority from the legislature.374.12EFFECTIVE DATE.This section is effective the day following final enactment.374.13    Sec. 59. BOARD OF MEDICAL PRACTICE.374.14    The Board of Medical Practice shall convene a work group to discuss the appropriate 374.15prescribing of controlled substances listed in Minnesota Statutes, section 152.02, 374.16subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 374.17Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and 374.18shall report to the legislature by December 15, 2007.374.19    Sec. 60. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.374.20    Subdivision 1.Pilot project requirements.The commissioner of commerce shall 374.21authorize a joint self-insurance pilot project administered by a trust sponsored by one 374.22or more agricultural cooperatives organized under Minnesota Statutes, chapter 308A, 374.23or under a federal charter for the purpose of offering health coverage to members of 374.24the cooperatives and their families, provided the project satisfies the requirements of 374.25Minnesota Statutes, chapter 62H, except as follows:374.26    (1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;374.27    (2) the notice period required under Minnesota Statutes, section 62H.02, paragraph 374.28(e), is 90 days;374.29    (3) the commissioner shall grant necessary waivers and approve an alternative 374.30arrangement that fully funds the plan's liability or incurred but unpaid claims under 374.31Minnesota Statutes, section 62H.02, paragraph (f), unless the commissioner provides 375.1evidence demonstrating that the insolvency protection proposed is substantially less than 375.2that typically provided by self-insured group plans of a similar size in Minnesota;375.3    (4) notwithstanding Minnesota Statutes, section 62H.04, paragraph (a), the joint 375.4self-insurance plan shall be considered a large group and not subject to the small group 375.5insurance requirements in Minnesota Statutes, chapter 62L, even if some employer 375.6groups enrolled in the plan would be defined as small employers, except that the joint 375.7self-insurance plan may elect to treat the sale of a health plan to or for an employer that 375.8has only one eligible employee who has not waived coverage as the sale of an individual 375.9health plan as allowed under Minnesota Statutes, section 62L.02, subdivision 26;375.10    (5) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), does not 375.11apply; and 375.12    (6) the trust must pay the assessment for the Minnesota comprehensive health 375.13association as provided under Minnesota Statutes, section 62E.11.375.14    Subd. 2.Evaluation and renewal.The pilot project authorized under this section 375.15is for a period of four years from the date of initial enrollment. The commissioner shall 375.16grant an extension of four additional years if the trust provides evidence that it remains in 375.17compliance with the requirements of this section and other applicable laws and rules. If the 375.18commissioner determines that the operation of the trust has not improved access, expanded 375.19health plan choices, or improved affordability of health coverage for farm families, or 375.20that it has significantly damaged access, choice, or affordability for other consumers not 375.21enrolled in the trust, the commissioner shall provide at least 180 days' advance written 375.22notice to the trust and to the chairs of the senate and house finance and policy committees 375.23with jurisdiction over health and insurance matters of the commissioner's intention not to 375.24renew the pilot project at the expiration of a four-year period.375.25EFFECTIVE DATE.This section is effective the day following final enactment.375.26    Sec. 61. HEALTH PLAN PURCHASING POOL STUDY GROUP.375.27    Subdivision 1.Creation; membership.A health care purchasing pool study group 375.28is created to study and make recommendations regarding the creation of a voluntary, 375.29statewide health care purchasing pool that would contract directly with providers to 375.30provide affordable health coverage to eligible Minnesota residents. The study group is 375.31composed of:375.32    (1) the chief house and senate authors of this act;375.33    (2) the chairs of the senate Committee on Health, Housing, and Family Security and 375.34the Health and Human Services Budget Division;376.1    (3) the chairs of the house Health Care and Human Services Committee and the 376.2Health Care and Human Services Division;376.3    (4) the attorney general or the attorney general's designated representative; 376.4    (5) three representatives of health care providers appointed as follows:376.5    (i) one member appointed by the governor;376.6    (ii) one member appointed by the speaker of the house; and376.7    (iii) one member appointed by the Subcommittee on Committees of the senate 376.8Committee on Rules and Administration; and376.9    (6) two consumers of health care appointed by the governor.376.10    All appointments to be made under this subdivision must be made within 30 days 376.11of the effective date of this act.376.12    Subd. 2.Study; report.The study group shall study and make recommendations 376.13on the following issues related to the creation, maintenance, and funding of a voluntary, 376.14statewide health plan purchasing pool to provide comprehensive, cost-effective, and 376.15medically appropriate health coverage to all public and private employees in Minnesota 376.16and all Minnesota residents:376.17    (1) the creation of an independent public entity to administer the pool; 376.18    (2) eligibility and participation requirements for existing public and private health 376.19care purchasing pools, public and private employers, and residents of this state; 376.20    (3) how to contract directly with providers to provide comprehensive coverage for 376.21preventive, mental health, dental and other medical services, and comprehensive drug 376.22benefits to enrollees and maximize the cost savings and other efficiencies that a large 376.23purchasing pool would be expected to generate without the need for a public subsidy; 376.24    (4) provisions that allow the pool to contract directly with health care providers 376.25to provide coverage to enrollees;376.26    (5) incentives designed to attract and retain the maximum number of enrollees; 376.27    (6) recommendations for the administration of the pool and the plans that will be 376.28available to enrollees including, but not limited to, recommendations to keep the pool 376.29solvent and profitable so that public subsidies are not necessary; and 376.30    (7) other elements the study group concludes are necessary or desirable for the 376.31pool to possess. 376.32    The study group shall submit its report and the draft legislation necessary to 376.33implement its recommendations to the chairs of the legislative committees and divisions 376.34with jurisdiction over health care policy and finance, the Health Care Access Commission, 376.35and the governor by February 1, 2008. 377.1    Subd. 3.Staffing.State agencies shall assist the study group with any requests for 377.2information the study group considers necessary to complete the study and report under 377.3subdivision 2.377.4    Subd. 4.Removal; vacancies; expenses.Removal of members, vacancies, and 377.5expenses for members shall be as provided in Minnesota Statutes, section 15.059.377.6    Subd. 5.Expiration.This section expires after the submission of the report as 377.7required in subdivision 2.377.8EFFECTIVE DATE.This section is effective the day following final enactment.377.9    Sec. 62.  REPEALER.377.10(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16; 377.11254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 377.12254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.377.13(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.377.14(c) Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213; 377.15525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222; 377.16525.9223; and 525.9224, are repealed.377.17ARTICLE 8377.18CHILDREN'S HEALTH SECURITY PROGRAM377.19    Section 1. [16A.726] CHILDREN'S HEALTH SECURITY ACCOUNT.377.20    A children's health security account is created in a special revenue fund in the 377.21state treasury. The commissioner shall deposit to the credit of the account money made 377.22available to the account. Notwithstanding section 11A.20, any investment income 377.23attributable to the investment of the children's health security account not currently needed 377.24shall be credited to the children's health security account.377.25    Sec. 2. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended to read:377.26    Subd. 8. Children under age two. Medical assistance may be paid for a child under 377.27two years of age whose countable family income is above 275 300 percent of the federal 377.28poverty guidelines for the same size family but less than or equal to 280 305 percent of the 377.29federal poverty guidelines for the same size family.377.30EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal 377.31approval, whichever is later.378.1    Sec. 3. [256N.01] CITATION.378.2    This chapter may be cited as the "Children's Health Security Act."378.3    Sec. 4. [256N.02] DEFINITIONS.378.4    Subdivision 1.Applicability.The terms used in this chapter have the following 378.5meanings unless otherwise provided for by text.378.6    Subd. 2.Child."Child" means an individual under age 21.378.7    Subd. 3.Commissioner."Commissioner" means the commissioner of human 378.8services.378.9    Subd. 4.Dependent child."Dependent child" means an unmarried child under 378.10age 25 who is claimed as a dependent for federal income tax purposes by a parent, 378.11grandparent, foster parent, relative caretaker, or legal guardian.378.12    Sec. 5. [256N.03] ESTABLISHMENT.378.13    The commissioner shall establish the children's health security program. The 378.14commissioner shall begin implementation of the program on October 1, 2008, or upon 378.15federal approval, whichever is later. The children's health security program must comply 378.16with title XIX of the federal Social Security Act, and waivers granted under title XIX.378.17    Sec. 6. [256N.05] ELIGIBILITY.378.18    Subdivision 1.General requirements.Children meeting the eligibility 378.19requirements of this section are eligible for the children's health security program.378.20    Subd. 2.Income limit.(a) Effective October 1, 2008, children in families with 378.21gross household incomes equal to or less than 225 percent of the federal poverty 378.22guidelines are eligible for the children's health security program. In determining gross 378.23income, the commissioner shall use the income methodology applied to children under the 378.24MinnesotaCare program.378.25    (b) Effective October 1, 2008, a dependent child who meets the program income 378.26limits under paragraph (a) and all other program eligibility requirements is eligible for 378.27state-funded benefits under this section. 378.28    (c) Effective January 1, 2011, or upon federal approval, whichever is later, children 378.29in families with household incomes equal to or less than 300 percent of the federal poverty 378.30guidelines must be included in the children's health security program.378.31    (d) The Legislative Task Force On Children's Health Care Coverage established 378.32under section 19 shall develop recommendations on options for extending health insurance 379.1coverage to children in families with household incomes in excess of 300 percent of the 379.2federal poverty guidelines.379.3    Subd. 3.Residency.Program participants must meet the residency requirements of 379.4section 256B.056, subdivision 1.379.5    Subd. 4.Enrollment voluntary.Enrollment in the children's health security 379.6program is voluntary. Parents or guardians may retain private sector or Medicare coverage 379.7for a child as the sole source of coverage. Parents or guardians who have private sector or 379.8Medicare coverage for children may also enroll children in the children's health security 379.9program. If private sector or Medicare coverage is available, coverage under the children's 379.10health security program is secondary to the private sector or Medicare coverage.379.11    Subd. 5.Emergency services.Payment must be made for care and services that 379.12are furnished to noncitizens, regardless of immigration status, who otherwise meet the 379.13eligibility requirements of this chapter, if the care and services are necessary for the 379.14treatment of an emergency medical condition, except for organ transplants and related 379.15care and services and routine prenatal care. For purposes of this subdivision, "emergency 379.16medical condition" means a medical condition that meets the requirements of United 379.17States Code, title 42, section 1396b(v).379.18    Subd. 6.Medical assistance standards and procedures.(a) Unless otherwise 379.19specified in this chapter, the commissioner shall use medical assistance procedures and 379.20methodology when determining initial eligibility and redetermining eligibility for the 379.21children's health security program.379.22    (b) The procedures and income standard specified in section 256B.056, subdivisions 379.235 and 5c, paragraph (a), apply to children who would be eligible for the children's health 379.24security program, except for excess income.379.25    (c) Retroactive coverage for the children's health security program must be provided 379.26as specified in section 256B.056, subdivision 7.379.27    Sec. 7. [256N.07] COVERED SERVICES.379.28    Covered services under the children's health security program must consist of all 379.29covered services under chapter 256B.379.30    Sec. 8. [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.379.31    In order to ensure broad access to coverage, the children's health security program 379.32has no enrollee premium or cost-sharing requirements.380.1    Sec. 9. [256N.11] APPLICATION PROCEDURES; ELIGIBILITY 380.2DETERMINATION.380.3    Subdivision 1.Application procedure.The application form for the program 380.4must be easily understandable and must not exceed two pages in length. Applications for 380.5the program must be made available to provider offices, local human services agencies, 380.6school districts, schools, community health offices, and other sites willing to cooperate in 380.7program outreach. These sites may accept applications and forward applications to the 380.8commissioner, and counties where applicable. Applications may also be made directly to 380.9the commissioner and to counties that determine eligibility.380.10    Subd. 2.Eligibility determination.Counties that determine eligibility for 380.11MinnesotaCare as of March 1, 2007, shall determine eligibility for the children's health 380.12security program. The commissioner, and counties where applicable, shall determine an 380.13applicant's eligibility for the program within 30 days of the date the application is received, 380.14according to the procedures in Code of Federal Regulations, title 42, section 435.911.380.15    Subd. 3.Presumptive eligibility.Coverage under the program is available during a 380.16presumptive eligibility period for children under age 19 whose family income does not 380.17exceed the applicable income standard. The presumptive eligibility period begins on the 380.18date on which a health care provider enrolled in the program, or other entity designated by 380.19the commissioner, determines, based on preliminary information, that the child's family 380.20income does not exceed the applicable income standard. The presumptive eligibility period 380.21ends the earlier of the day on which a determination is made of eligibility under this section 380.22or the last day of the month following the month presumptive eligibility was determined. 380.23    Subd. 4.Renewal of eligibility.The commissioner shall require enrollees to renew 380.24eligibility every 12 months.380.25    Subd. 5.Continuous eligibility.Children under the age of 19 who are eligible 380.26under this section shall be continuously eligible until the earlier of the next renewal period, 380.27or the time that a child exceeds age 19.380.28    Sec. 10. [256N.12] COUNTY ROLE.380.29    Counties not required to determine eligibility under section 256N.11, subdivision 380.302, may choose to determine eligibility under that section. Counties may also choose 380.31to provide assistance to applicants under section 256N.17, subdivision 1, and provide 380.32ombudsperson services under section 256N.17, subdivision 2. This must not limit the 380.33ability of the commissioner to establish reasonable staffing standards that relate to the 380.34number of persons served, and that provide a county option to hire part-time staff or pursue 380.35multicounty implementation models. If a county chooses not to deliver these services, they 381.1must be delivered by the commissioner. State and federal funding to support these services 381.2must be the same, whether delivered by the state or by a county or group of counties.381.3    Sec. 11. [256N.13] SERVICE DELIVERY.381.4    Subdivision 1.Contracts for service delivery.The commissioner, within each 381.5county, may contract with managed care organizations, including health maintenance 381.6organizations licensed under chapter 62D, community integrated service networks licensed 381.7under chapter 62N, accountable provider networks licensed under chapter 62T, and 381.8county-based purchasing plans established under section 256B.692, to provide covered 381.9health care services to program enrollees under a managed care system, and may contract 381.10with health care and social service providers to provide services on a fee-for-service basis. 381.11Section 256B.69, subdivision 26, applies to contracts with managed care organizations. In 381.12determining the method for service delivery, the commissioner shall consider the cost and 381.13quality of health care services; the breadth of services offered, including medical, dental 381.14and mental health services; the breadth of choice of medical providers for enrollees; the 381.15ease of access to quality medical care for enrollees; the efficiency and cost-effectiveness of 381.16service delivery; and the integration of best medical practice standards into the children's 381.17health security program.381.18    Subd. 2.Managed care organization requirements.(a) Managed care 381.19organizations under contract are responsible for coordinating covered health care services 381.20provided to eligible individuals. Managed care organizations under contract:381.21    (1) shall authorize and arrange for the provision of all needed covered health 381.22services under chapter 256B, with the exception of services available only under a medical 381.23assistance home and community-based waiver, in order to ensure appropriate health care 381.24is delivered to enrollees;381.25    (2) shall comply with the requirements of section 256B.69, subdivision 26;381.26    (3) shall accept the prospective, per capita payment from the commissioner in return 381.27for the provision of comprehensive and coordinated health care services for enrollees;381.28    (4) may contract with health care and social service providers to provide covered 381.29services to enrollees; and381.30    (5) shall institute enrollee grievance procedures according to the method established 381.31by the commissioner, utilizing applicable requirements of chapter 62D and Code of 381.32Federal Regulations, title 42, section 438, subpart F. Disputes may also be appealed to 381.33the commissioner using the procedures in section 256.045.381.34    (b) Upon implementation of the children's health security program, the commissioner 381.35shall withhold five percent of managed care organization payments pending completion 382.1of performance targets, including lead screening, well child services, immunizations, 382.2vision screening, and customer service performance targets. Effective January 1, 2011, 382.3the commissioner shall add treatment of asthma and screening for mental health as new 382.4performance targets. Each performance target must apply uniformly to all managed care 382.5organizations, and be qualitative, objective, measurable, and reasonably attainable, except 382.6in the case of a performance target based on federal or state law or rule. Criteria for 382.7assessment of each performance target must be outlined in writing prior to the contract 382.8effective date. The withhold funds must be returned no sooner than July of the following 382.9year if performance targets in the contract are achieved. The success of each managed care 382.10organization in reaching performance targets must be reported to the legislature annually.382.11    Subd. 3.Fee-for-service delivery.Disputes related to services provided under 382.12the fee-for-service system may be appealed to the commissioner using the procedures 382.13in section 256.045.382.14    Subd. 4.Contracts for waiver services.The commissioner, when services 382.15are delivered through managed care, may contract with health care and social service 382.16providers on a fee-for-service basis to provide program enrollees with covered services 382.17available only under a medical assistance home and community-based waiver. The 382.18commissioner shall determine eligibility for home and community-based waiver services 382.19using the criteria and procedures in chapter 256B. Disputes related to services provided 382.20on a fee-for-service basis may be appealed to the commissioner using the procedures 382.21in section 256.045.382.22    Subd. 5.Service delivery for Minnesota disabilities health option recipient.382.23    Individuals who voluntarily enroll in the Minnesota Disability Health Option (MnDHO), 382.24established under section 256B.69, subdivision 23, shall continue to receive their home 382.25and community-based waiver services through MnDHO.382.26    Subd. 6.Disabled or blind children.Children eligible for medical assistance due 382.27to blindness or disability as determined by the Social Security Administration or the state 382.28medical review team are exempt from enrolling in a managed care organization and shall 382.29be provided health benefits on a fee-for-service basis.382.30    Sec. 12. [256N.15] PAYMENT RATES.382.31    Subdivision 1.Establishment.The commissioner, in consultation with a health 382.32care actuary, shall establish the method and amount of payments for services. The 382.33commissioner shall annually contract with eligible entities to provide services to program 382.34enrollees. The commissioner, in consultation with the Risk Adjustment Association 383.1established under section 62Q.03, subdivision 6, shall develop and implement a risk 383.2adjustment system for the program.383.3    Subd. 2.Provider rates.In establishing the payment amount under subdivision 383.41, the commissioner shall ensure that fee-for-service payment rates for preventative 383.5care services provided on or after October 1, 2008, are at least five percent above the 383.6medical assistance rates for preventative services in effect on September 30, 2008, and 383.7shall ensure that fee-for-service payment rates for all other services provided on or after 383.8October 1, 2008, are at least three percent above the medical assistance rates for those 383.9services in effect on September 30, 2008. The commissioner shall adjust managed care 383.10capitation rates to reflect these increases, and shall require managed care organizations, as 383.11a condition of contract, to pass these increases on to providers under contract.383.12    Sec. 13. [256N.17] CONSUMER ASSISTANCE.383.13    Subdivision 1.Assistance to applicants.The commissioner shall assist applicants 383.14in choosing a managed care organization or fee-for-service provider by:383.15    (1) establishing a Web site to provide information about managed care organizations 383.16and fee-for-service providers and to allow online enrollment;383.17    (2) make information on managed care organizations and fee-for-service providers 383.18available at the sites specified in section 256N.11, subdivision 1;383.19    (3) make applications and information on managed care organizations and 383.20fee-for-service providers available to applicants and enrollees according to Title VI of the 383.21Civil Rights Act and federal regulations adopted under that law or any guidance from the 383.22United States Department of Health and Human Services; and383.23    (4) make benefit educators available to assist applicants in choosing a managed care 383.24organization or fee-for-service provider.383.25    Subd. 2.Ombudsperson.The commissioner shall designate an ombudsperson 383.26to advocate for children enrolled in the children's health security program. The 383.27ombudsperson shall assist enrollees in understanding and making use of complaint and 383.28appeal procedures and ensure that necessary medical services are provided to enrollees. At 383.29the time of enrollment, the commissioner shall inform enrollees about the ombudsperson 383.30program, the right to a resolution of the enrollee's complaint by the managed care 383.31organization if the enrollee experiences a problem with the managed care organization 383.32or its providers, and appeal rights under section 256.045.383.33    Sec. 14. [256N.19] MONITORING AND EVALUATION OF QUALITY AND 383.34COSTS.384.1    (a) The commissioner, as a condition of contract, shall require each participating 384.2managed care organization and participating provider to submit, in the form and manner 384.3specified by the commissioner, data required for assessing enrollee satisfaction, quality 384.4of care, cost, and utilization of services. The commissioner shall evaluate this data, in 384.5order to:384.6    (1) make summary information on the quality of care across managed care 384.7organizations, medical clinics, and providers available to consumers;384.8    (2) require managed care organizations and providers, as a condition of contract, to 384.9implement quality improvement plans; and384.10    (3) compare the cost and quality of services under the program to the cost and 384.11quality of services provided to private sector enrollees.384.12    (b) The commissioner shall implement this section to the extent allowed by federal 384.13and state laws on data privacy.384.14    Sec. 15. [256N.21] FEDERAL APPROVAL.384.15    The commissioner shall seek all federal waivers and approvals necessary to 384.16implement this chapter including, but not limited to, waivers and approvals necessary to:384.17    (1) coordinate medical assistance and MinnesotaCare coverage for children with the 384.18children's health security program;384.19    (2) use federal medical assistance and MinnesotaCare dollars to pay for health care 384.20services under the children's health security program;384.21    (3) maximize receipt of the federal medical assistance match for covered children, 384.22by increasing income standards through the use of more liberal income methodologies as 384.23provided under United States Code, title 42, sections 1396a and 1396u-1;384.24    (4) extend presumptive eligibility and continuous eligibility to children under age 384.2521; and384.26    (5) use federal medical assistance and MinnesotaCare dollars to provide benefits to 384.27dependent children.384.28    Sec. 16. [256N.23] RULEMAKING.384.29    The commissioner shall adopt rules to implement this chapter.384.30    Sec. 17. [256N.25] CHILDREN'S HEALTH SECURITY PROGRAM 384.31OUTREACH.384.32    Subdivision 1.Grant awards.The commissioner shall award grants to public or 384.33private organizations to:385.1    (1) provide information, in areas of the state with high uninsured populations, on the 385.2importance of maintaining insurance coverage and on how to obtain coverage through 385.3the children's health security program; and385.4    (2) monitor and provide ongoing support to ensure enrolled children remain covered.385.5    Subd. 2.Criteria.In awarding the grants, the commissioner shall consider the 385.6following:385.7    (1) geographic areas and populations with high uninsured rates;385.8    (2) the ability to raise matching funds;385.9    (3) the ability to contact, effectively communicate with, or serve eligible populations; 385.10and385.11    (4) the applicant's plan to monitor and provide support to ensure enrolled children 385.12remain covered.385.13    Subd. 3.Monitoring and termination.The commissioner shall monitor the grants 385.14and may terminate a grant if the outreach effort does not increase enrollment in the 385.15children's health security program.385.16    Sec. 18. IMPLEMENTATION PLAN.385.17    The commissioner of human services shall develop an implementation plan for the 385.18children's health security program, which includes a health delivery plan based on the 385.19criteria specified in Minnesota Statutes, section 256N.13, subdivision 1. The commissioner 385.20shall present this plan, any necessary draft legislation, and a draft of proposed rules 385.21to the legislature by December 15, 2007. The plan must include recommendations 385.22for any additional legislative changes necessary to coordinate medical assistance and 385.23MinnesotaCare coverage for children with the children's health security program. The 385.24commissioner shall evaluate the provision of services under the program to children with 385.25disabilities and shall present recommendations to the legislature by December 15, 2009, 385.26for any program changes necessary to ensure the quality and continuity of care.385.27    Sec. 19. LEGISLATIVE TASK FORCE ON CHILDREN'S HEALTH CARE 385.28COVERAGE.385.29    Subdivision 1.Establishment; membership.(a) The Legislative Task Force on 385.30Children's Health Care Coverage is established. The task force is made up of 12 voting 385.31members and six nonvoting members.385.32    (b) The voting members are:385.33    (1) six members of the house of representatives appointed by the speaker, three from 385.34the majority party and three from the minority party; and386.1    (2) six members of the senate appointed by the Subcommittee on Committees of the 386.2senate Committee on Rules and Administration, three from the majority party and three 386.3from the minority party.386.4    (c) The nonvoting members are one representative selected by each of the following 386.5organizations:386.6    (1) the American Academy of Pediatrics, Minnesota chapter;386.7    (2) the Minnesota Nurses Association;386.8    (3) the Minnesota Council of Health Plans;386.9    (4) the Minnesota Children's Platform Coalition;386.10    (5) the Minnesota Universal Health Care Coalition; and386.11    (6) the Minnesota Business Partnership.386.12    (d) The task force members must be appointed by September 1, 2007. The majority 386.13leader of the senate and the speaker of the house of representatives must each designate 386.14a chair from their appointments. The chair appointed by the speaker of the house of 386.15representatives shall convene and chair the first meeting of the task force. The chair 386.16appointed by the majority leader of the senate shall chair the next meeting of the task 386.17force. The chairs shall then alternate for the duration of the task force.386.18    Subd. 2.Study; staff support.(a) The task force shall study viable options to extend 386.19coverage to all children as provided in Minnesota Statutes, section 256N.05, subdivision 386.202, paragraph (d), and provide recommendations to the legislature. The study must:386.21    (1) evaluate methods to achieve universal coverage for children, including, but not 386.22limited to, changes to the employer-based coverage system and an expansion of eligibility 386.23for the children's health security program established under Minnesota Statutes, chapter 386.24256N;386.25    (2) examine health care reform and cost containment methods that will contain costs 386.26and increase access and improve health outcomes;386.27    (3) examine how to increase access to preventive care and health care services; and386.28    (4) examine how to reduce health disparities among minority populations. 386.29    (b) The task force, through the Legislative Coordinating Commission, may hire staff 386.30or contract for staff support for the study.386.31    (c) The task force, in developing recommendations, shall hold meetings to hear 386.32public testimony at locations throughout the state, including locations outside of the 386.33seven-county metropolitan area.386.34    Subd. 3.Recommendations.The task force shall report its recommendations to 386.35the legislature by December 15, 2009. Recommendations must be consistent with the 386.36following criteria:387.1    (1) health care coverage must include preventive care and all other medically 387.2necessary services;387.3    (2) health care coverage must be affordable for families, with the family share of 387.4premium costs and cost-sharing in total not exceeding five percent of family income;387.5    (3) the system of coverage must give priority to ensuring access to and the quality 387.6and continuity of care; and387.7    (4) enrollment must be simple and seamless for families.387.8    Subd. 4.Expiration.This section expires December 16, 2009.387.9ARTICLE 9387.10HEALTH CARE REFORM387.11    Section 1. Minnesota Statutes 2006, section 62A.65, subdivision 3, is amended to read:387.12    Subd. 3. Premium rate restrictions. No individual health plan may be offered, 387.13sold, issued, or renewed to a Minnesota resident unless the premium rate charged is 387.14determined in accordance with the following requirements:387.15    (a) Premium rates must be no more than 25 percent above and no more than 25 387.16percent below the index rate charged to individuals for the same or similar coverage, 387.17adjusted pro rata for rating periods of less than one year. The premium variations 387.18permitted by this paragraph must be based only upon health status, claims experience, 387.19and occupation. For purposes of this paragraph, health status includes refraining from 387.20tobacco use or other actuarially valid lifestyle factors associated with good health, 387.21provided that the lifestyle factor and its effect upon premium rates have been determined 387.22by the commissioner to be actuarially valid and have been approved by the commissioner. 387.23Variations permitted under this paragraph must not be based upon age or applied 387.24differently at different ages. This paragraph does not prohibit use of a constant percentage 387.25adjustment for factors permitted to be used under this paragraph.387.26    (b) Premium rates may vary based upon the ages of covered persons only as 387.27provided in this paragraph. In addition to the variation permitted under paragraph (a), 387.28each health carrier may use an additional premium variation based upon age for adults 387.29aged 19 and above of up to plus or minus 50 percent of the index rate. Premium rates for 387.30children under the age of 19 may not vary based on age, regardless of whether the child is 387.31covered as a dependent or as a primary insured.387.32    (c) A health carrier may request approval by the commissioner to establish separate 387.33geographic regions determined by the health carrier and to establish separate index rates 387.34for each such region. The commissioner shall grant approval if the following conditions 387.35are met: 388.1    (1) the geographic regions must be applied uniformly by the health carrier;388.2    (2) each geographic region must be composed of no fewer than seven counties that 388.3create a contiguous region; and388.4    (3) the health carrier provides actuarial justification acceptable to the commissioner 388.5for the proposed geographic variations in index rates, establishing that the variations are 388.6based upon differences in the cost to the health carrier of providing coverage.388.7    (d) Health carriers may use rate cells and must file with the commissioner the rate 388.8cells they use. Rate cells must be based upon the number of adults or children covered 388.9under the policy and may reflect the availability of Medicare coverage. The rates for 388.10different rate cells must not in any way reflect generalized differences in expected costs 388.11between principal insureds and their spouses.388.12    (e) In developing its index rates and premiums for a health plan, a health carrier shall 388.13take into account only the following factors:388.14    (1) actuarially valid differences in rating factors permitted under paragraphs (a) 388.15and (b); and388.16    (2) actuarially valid geographic variations if approved by the commissioner as 388.17provided in paragraph (c).388.18    (f) All premium variations must be justified in initial rate filings and upon request of 388.19the commissioner in rate revision filings. All rate variations are subject to approval by 388.20the commissioner.388.21    (g) The loss ratio must comply with the section 
         62A.021 requirements for individual 388.22health plans. 388.23    (h) The rates must not be approved, unless the commissioner has determined that the 388.24rates are reasonable. In determining reasonableness, the commissioner shall consider the 388.25growth rates applied under section 
         62J.04, subdivision 1, paragraph (b), to the calendar 388.26year or years that the proposed premium rate would be in effect, actuarially valid changes 388.27in risks associated with the enrollee populations, and actuarially valid changes as a result 388.28of statutory changes in Laws 1992, chapter 549. 388.29    (i) An insurer may, as part of a minimum lifetime loss ratio guarantee filing under 388.30section 
         62A.02, subdivision 3a, include a rating practices guarantee as provided in this 388.31paragraph. The rating practices guarantee must be in writing and must guarantee that 388.32the policy form will be offered, sold, issued, and renewed only with premium rates and 388.33premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices 388.34guarantee must be accompanied by an actuarial memorandum that demonstrates that the 388.35premium rates and premium rating system used in connection with the policy form will 388.36satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to 389.1policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4, 389.2or 5. An insurer that complies with this paragraph in connection with a policy form is 389.3exempt from the requirement of prior approval by the commissioner under paragraphs 389.4(c), (f), and (h).389.5    Sec. 2. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.389.6    Subdivision 1.Title; citation.This section may be cited as the "Minnesota Health 389.7Insurance Exchange."389.8    Subd. 2.Creation; tax exemption.The Minnesota Health Insurance Exchange 389.9is created for the limited purpose of providing individuals with greater access, choice, 389.10portability, and affordability of health insurance products. The Minnesota Health 389.11Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c) 389.12of the Internal Revenue Code.389.13    Subd. 3.Definitions.The following terms have the meanings given them unless 389.14otherwise provided in text.389.15    (a) "Board" means the board of directors of the Minnesota Health Insurance 389.16Exchange under subdivision 13.389.17    (b) "Commissioner" means: 389.18    (1) the commissioner of commerce for health insurers subject to the jurisdiction 389.19of the Department of Commerce; 389.20    (2) the commissioner of health for health insurers subject to the jurisdiction of the 389.21Department of Health; or 389.22    (3) either commissioner's designated representative.389.23    (c) "Exchange" means the Minnesota Health Insurance Exchange.389.24    (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.389.25    (e) "Individual market health plans," unless otherwise specified, means individual 389.26market health plans defined in section 62A.011.389.27    (f) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of 389.28the Internal Revenue Code that allows employees to pay for health insurance premiums 389.29with pretax dollars.389.30    Subd. 4.Insurer and health plan participation.All health plans as defined in 389.31section 62A.011, subdivision 3, issued or renewed in the individual market shall participate 389.32in the exchange. No health plans in the individual market may be issued or renewed 389.33outside of the exchange. Group health plans as defined in section 62A.10 shall not be 389.34offered through the exchange. Health plans offered through the Minnesota Comprehensive 389.35Health Association as defined in section 62E.10 are offered through the exchange to 390.1eligible enrollees as determined by the Minnesota Comprehensive Health Association. 390.2Health plans offered through MinnesotaCare under chapter 256L are offered through the 390.3exchange to eligible enrollees as determined by the commissioner of human services.390.4    Subd. 5.Approval of health plans.No health plan may be offered through the 390.5exchange unless the commissioner has first certified that:390.6    (1) the insurer seeking to offer the health plan is licensed to issue health insurance in 390.7the state; and390.8    (2) the health plan meets the requirements of this section, and the health plan and the 390.9insurer are in compliance with all other applicable health insurance laws.390.10    Subd. 6.Individual market health plans.Individual market health plans offered 390.11through the exchange continue to be regulated by the commissioner as specified in 390.12chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions 390.13that apply to all health plans issued or renewed through the exchange:390.14    (1) premiums for children under the age of 19 shall not vary by age in the exchange; 390.15and390.16    (2) premiums for children under the age of 19 must be excluded from rating factors 390.17under section 62A.65, subdivision 3, paragraph (b).390.18    Subd. 7.Individual participation and eligibility.Individuals are eligible to 390.19purchase health plans directly through the exchange or through an employer Section 390.20125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of 390.21individual market health plans offered through the exchange. Individuals are eligible to 390.22purchase individual market health plans through the exchange by meeting one or more 390.23of the following qualifications:390.24    (1) the individual is a Minnesota resident, meaning the individual is physically 390.25residing on a permanent basis in a place that is the person's principal residence and from 390.26which the person is absent only for temporary purposes;390.27    (2) the individual is a student attending an institution outside of Minnesota and 390.28maintains Minnesota residency;390.29    (3) the individual is not a Minnesota resident but is employed by an employer 390.30physically located within the state and the individual's employer is required to offer a 390.31Section 125 Plan under section 62A.68;390.32    (4) the individual is not a Minnesota resident but is self-employed and the 390.33individual's principal place of business is in the state; or390.34    (5) the individual is a dependent as defined in section 62L.02, of another individual 390.35who is eligible to participate in the exchange.391.1    Subd. 8.Continuation of coverage.Enrollment in a health plan may be canceled 391.2for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under 391.3chapter 256L. Enrollment in an individual market health plan may not be canceled or 391.4nonrenewed because of any change in employer or employment status, marital status, 391.5health status, age, residence, or any other change that does not affect eligibility as defined 391.6in this section.391.7    Subd. 9.Responsibilities of the exchange.The exchange shall serve as the sole 391.8entity for enrollment and collection and transfer of premium payments for health plans 391.9sold to individuals through the exchange. The exchange shall be responsible for the 391.10following functions:391.11    (1) publicize the exchange, including but not limited to its functions, eligibility 391.12rules, and enrollment procedures;391.13    (2) provide assistance to employers to establish Section 125 Plans under section 391.1462A.68;391.15    (3) provide education and assistance to employers to help them understand the 391.16requirements of Section 125 Plans and compliance with applicable regulations;391.17    (4) create a system to allow individuals to compare and enroll in health plans offered 391.18through the exchange;391.19    (5) create a system to collect and transmit to the applicable plans all premium 391.20payments made by individuals, including developing mechanisms to receive and process 391.21automatic payroll deductions for individuals who purchase coverage through employer 391.22Section 125 Plans;391.23    (6) not accept premium payments for individual market health plans from an 391.24employer Section 125 Plan if the employer offers a group health plan as defined in section 391.2562A.10, or if the employer is a self-insurer as defined in section 62E.02;391.26    (7) provide jointly with health insurers a cancellation notice directly to the primary 391.27insured at least ten days prior to termination of coverage for nonpayment of premium;391.28    (8) bill the employer for the premiums payable by an employee, provided that the 391.29employer is not liable for payment except from payroll deductions for that purpose;391.30    (9) refer individuals interested in MinnesotaCare under chapter 256L to the 391.31Department of Human Services to determine eligibility;391.32    (10) establish a mechanism with the Department of Human Services to transfer 391.33premiums and subsidies for MinnesotaCare to qualify for federal matching payments;391.34    (11) upon request, issue certificates of previous coverage according to the provisions 391.35of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be 391.36covered by a participating health plan through the exchange;392.1    (12) establish procedures to account for all funds received and disbursed by the 392.2exchange for individual participants of the exchange; 392.3    (13) make available to the public, at the end of each calendar year, a report of an 392.4independent audit of the exchange's accounts; and392.5    (14) provide copies of written and signed statements from employers stating that 392.6the employer is not contributing to the employee's premiums for health plans purchased 392.7by an employee through the exchange to all health insurers with enrolled employees of 392.8the employer.392.9    Health insurers may rely on the employer's statement in clause (4) provided by the 392.10Minnesota Health Insurance Exchange and are not required to guarantee-issue individual 392.11health plans to the employer's employees.392.12    Subd. 10.State not liable.The state of Minnesota shall not be liable for the actions 392.13of the Minnesota Health Insurance Exchange.392.14    Subd. 11.Powers of the exchange.The exchange shall have the power to:392.15    (1) contract with insurance producers licensed in accident and health insurance 392.16under chapter 60K and vendors to perform one or more of the functions specified in 392.17subdivision 10;392.18    (2) contract with employers to collect premiums through a Section 125 Plan for 392.19eligible individuals who purchase an individual market health plan through the exchange;392.20    (3) establish and assess fees on health plan premiums of health plans purchased 392.21through the exchange to fund the cost of administering the exchange;392.22    (4) seek and directly receive grant funding from government agencies or private 392.23philanthropic organizations to defray the costs of operating the exchange;392.24    (5) establish and administer rules and procedures governing the operations of the 392.25exchange;392.26    (6) establish one or more service centers within Minnesota;392.27    (7) sue or be sued or otherwise take any necessary or proper legal action;392.28    (8) establish bank accounts and borrow money; and392.29    (9) enter into agreements with the commissioners of commerce, health, human 392.30services, revenue, employment and economic development, and other state agencies as 392.31necessary for the exchange to implement the provisions of this section.392.32    Subd. 12.Dispute resolution.The exchange shall establish procedures for 392.33resolving disputes with respect to the eligibility of an individual to participate in the 392.34exchange. The exchange does not have the authority or responsibility to intervene in or 392.35resolve disputes between an individual and a health plan or health insurer. The exchange 393.1shall refer complaints from individuals participating in the exchange to the commissioner 393.2to be resolved according to sections 62Q.68 to 62Q.73.393.3    Subd. 13.Governance.The exchange shall be governed by a board of directors 393.4with 11 members. The board shall convene on or before July 1, 2007, after the initial board 393.5members have been selected. The initial board membership consists of the following:393.6    (1) the commissioner of commerce;393.7    (2) the commissioner of human services;393.8    (3) the commissioner of health;393.9    (4) four members appointed by a joint committee of the Minnesota senate and the 393.10Minnesota house of representatives to serve three-year terms; and393.11    (5) four members appointed by the governor to serve three-year terms.393.12    Subd. 14.Subsequent board membership.Ongoing membership of the exchange 393.13consists of the following effective July 1, 2010:393.14    (1) the commissioner of commerce;393.15    (2) the commissioner of human services;393.16    (3) the commissioner of health;393.17    (4) two members appointed by the governor with the approval of a joint committee 393.18of the senate and house of representatives to serve two-year terms; and393.19    (5) six members elected by the membership of the exchange of which three 393.20are elected to serve a two-year term and three are elected to serve a three-year term. 393.21Appointed and elected members may serve more than one term.393.22    Subd. 15.Operations of the board.Officers of the board of directors are elected by 393.23members of the board and serve one-year terms. Six members of the board constitutes a 393.24quorum, and the affirmative vote of six members of the board is necessary and sufficient 393.25for any action taken by the board. Board members serve without pay, but are reimbursed 393.26for actual expenses incurred in the performance of their duties.393.27    Subd. 16.Operations of the exchange.The board of directors shall appoint an 393.28exchange director who shall:393.29    (1) be a full-time employee of the exchange;393.30    (2) administer all of the activities and contracts of the exchange; and 393.31    (3) hire and supervise the staff of the exchange.393.32    Subd. 17.Insurance producers.An individual has the right to choose any 393.33insurance producer licensed in accident and health insurance under chapter 60K to assist 393.34them in purchasing an individual market health plan through the exchange. When a 393.35producer licensed in accident and health insurance under chapter 60K enrolls an eligible 394.1individual in the exchange, the health plan chosen by an individual may pay the producer 394.2a commission.394.3    Subd. 18.Implementation.Health plan coverage through the exchange begins on 394.4January 1, 2009. The exchange must be operational to assist employers and individuals 394.5by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees 394.6of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive 394.7Health Association as of December 2, 2008, are automatically enrolled in the exchange 394.8on January 1, 2009, in the same health plan and at the same premium that they were 394.9enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1, 394.102009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota 394.11Comprehensive Health Association shall make premium payments to the exchange.394.12    Sec. 3. [62A.68] SECTION 125 PLANS.394.13    Subdivision 1.Definitions.The following terms have the meanings given unless 394.14otherwise provided in text:394.15    (a) "Current employee" means an employee currently on an employer's payroll other 394.16than a retiree or disabled former employee.394.17    (b) "Employer" means a person, firm, corporation, partnership, association, business 394.18trust, or other entity employing one or more persons, including a political subdivision of 394.19the state, filing payroll tax information on such employed person or persons.394.20    (c) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 394.21of the Internal Revenue Code that allows employees to purchase health insurance with 394.22pretax dollars.394.23    (d) "Exchange" means the Minnesota Health Insurance Exchange under section 394.2462A.67.394.25    (e) "Exchange director" means the appointed director under section 62A.67, 394.26subdivision 16.394.27    Subd. 2.Section 125 Plan requirement.(a) Effective January 1, 2009, all 394.28employers with 11 or more current employees shall establish a Section 125 Plan to 394.29allow their employees to purchase individual market health plan coverage with pretax 394.30dollars. Nothing in this section requires or mandates employers to offer or purchase 394.31health insurance coverage for their employees. The following employers are exempt 394.32from the Section 125 Plan requirement:394.33    (1) employers that offer a group health insurance plan as defined in 62A.10;394.34    (2) employers that are self-insurers as defined in section 62E.02; and395.1    (3) employers with fewer than 11 current employees, except that employers under 395.2this clause may voluntarily offer a Section 125 Plan.395.3    (b) Employers that offer a Section 125 Plan may enter into an agreement with the 395.4exchange to administer the employer's Section 125 Plan.395.5    Subd. 3.Tracking compliance.By July 1, 2008, the exchange, in consultation with 395.6the commissioners of commerce, health, employment and economic development, and 395.7revenue shall establish a method for tracking employer compliance with the Section 125 395.8Plan requirement.395.9    Subd. 4.Employer requirements.Employers that are required to offer or choose 395.10to offer a Section 125 Plan shall:395.11    (1) allow employees to purchase any individual market health plan for themselves 395.12and their dependents through the exchange;395.13    (2) allow employees to choose any insurance producer licensed in accident and 395.14health insurance under chapter 60K to assist them in purchasing an individual market 395.15health plan through the exchange;395.16    (3) provide a written and signed statement to the exchange stating that the employer 395.17is not contributing to the employee's premiums for health plans purchased by an employee 395.18through the exchange;395.19    (4) upon an employee's request, deduct premium amounts on a pretax basis in an 395.20amount not to exceed an employee's wages, and remit these employee payments to the 395.21exchange; and395.22    (5) provide notice to employees that individual market health plans purchased 395.23through the exchange are not employer-sponsored or administered. Employers shall be 395.24held harmless from any and all liability claims related to the individual market health 395.25plans purchased through the exchange by employees under a Section 125 Plan.395.26    Subd. 5.Section 125 eligible health plans.Individuals who are eligible to use 395.27an employer Section 125 Plan to pay for health insurance coverage purchased through 395.28the exchange may enroll in any health plan offered through the exchange for which the 395.29individual is eligible including individual market health plans, MinnesotaCare, and the 395.30Minnesota Comprehensive Health Association.395.31    Sec. 4. Minnesota Statutes 2006, section 62E.141, is amended to read:395.3262E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.395.33    No employee of an employer that offers a group health plan, under which the 395.34employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in 395.35the comprehensive health association, except for enrollment or continued enrollment 396.1necessary to cover conditions that are subject to an unexpired preexisting condition 396.2limitation, preexisting condition exclusion, or exclusionary rider under the employer's 396.3health plan. This section does not apply to persons enrolled in the Comprehensive Health 396.4Association as of June 30, 1993. With respect to persons eligible to enroll in the health 396.5plan of an employer that has more than 29 current employees, as defined in section 396.662L.02
         , this section does not apply to persons enrolled in the Comprehensive Health 396.7Association as of December 31, 1994. 396.8    Sec. 5. Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:396.9    Subd. 3. Cost containment duties. The commissioner shall:396.10    (1) establish statewide and regional cost containment goals for total health care 396.11spending under this section and, collect data as described in sections 
         62J.38 to 
         62J.41 to 396.12monitor statewide achievement of the cost containment goals, and annually report to the 396.13legislature on whether the goals were achieved and, if not, what action should be taken to 396.14ensure that goals are achieved in the future; 396.15    (2) divide the state into no fewer than four regions, with one of those regions being 396.16the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 396.17Wright, and Sherburne Counties, for purposes of fostering the development of regional 396.18health planning and coordination of health care delivery among regional health care 396.19systems and working to achieve the cost containment goals;396.20    (3) monitor the quality of health care throughout the state and take action as 396.21necessary to ensure an appropriate level of quality;396.22    (4) issue recommendations regarding uniform billing forms, uniform electronic 396.23billing procedures and data interchanges, patient identification cards, and other uniform 396.24claims and administrative procedures for health care providers and private and public 396.25sector payers. In developing the recommendations, the commissioner shall review the 396.26work of the work group on electronic data interchange (WEDI) and the American National 396.27Standards Institute (ANSI) at the national level, and the work being done at the state and 396.28local level. The commissioner may adopt rules requiring the use of the Uniform Bill 396.2982/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 396.30version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 396.31forms or procedures;396.32    (5) undertake health planning responsibilities;396.33    (6) authorize, fund, or promote research and experimentation on new technologies 396.34and health care procedures;397.1    (7) within the limits of appropriations for these purposes, administer or contract for 397.2statewide consumer education and wellness programs that will improve the health of 397.3Minnesotans and increase individual responsibility relating to personal health and the 397.4delivery of health care services, undertake prevention programs including initiatives to 397.5improve birth outcomes, expand childhood immunization efforts, and provide start-up 397.6grants for worksite wellness programs;397.7    (8) undertake other activities to monitor and oversee the delivery of health care 397.8services in Minnesota with the goal of improving affordability, quality, and accessibility of 397.9health care for all Minnesotans; and397.10    (9) make the cost containment goal data available to the public in a 397.11consumer-oriented manner.397.12EFFECTIVE DATE.This section is effective July 1, 2007.397.13    Sec. 6. Minnesota Statutes 2006, section 62J.495, is amended to read:397.1462J.495 HEALTH INFORMATION TECHNOLOGY AND 397.15INFRASTRUCTURE ADVISORY COMMITTEE.397.16    Subdivision 1. Establishment; members; duties Implementation.By January 397.171, 2012, all hospitals and health care providers must have in place an interoperable 397.18electronic health records system within their hospital system or clinical practice setting. 397.19The commissioner of health, in consultation with the Health Information Technology and 397.20Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, 397.21including the adoption of uniform standards to be used for the interoperable system for 397.22sharing and synchronizing patient data across systems. The standards must be compatible 397.23with federal efforts. The uniform standards must be refined and adopted for use when 397.24a standard development organization accredited by the American National Standards 397.25Institute completes the development of a standard for sharing and synchronizing patient 397.26data across systems.397.27    Subd. 2. Health Information Technology and Infrastructure Advisory 397.28Committee. (a) The commissioner shall establish a Health Information Technology 397.29and Infrastructure Advisory Committee governed by section 
         15.059 to advise the 397.30commissioner on the following matters:397.31    (1) assessment of the use of health information technology by the state, licensed 397.32health care providers and facilities, and local public health agencies;397.33    (2) recommendations for implementing a statewide interoperable health information 397.34infrastructure, to include estimates of necessary resources, and for determining standards 398.1for administrative data exchange, clinical support programs, patient privacy requirements, 398.2and maintenance of the security and confidentiality of individual patient data; and398.3    (3) recommendations for encouraging use of innovative health care applications 398.4using information technology and systems to improve patient care and reduce the cost 398.5of care, including applications relating to disease management and personal health 398.6management that enable remote monitoring of patients' conditions, especially those with 398.7chronic conditions; and398.8    (3)(4) other related issues as requested by the commissioner.398.9    (b) The members of the Health Information Technology and Infrastructure Advisory 398.10Committee shall include the commissioners, or commissioners' designees, of health, 398.11human services, administration, and commerce and additional members to be appointed 398.12by the commissioner to include persons representing Minnesota's local public health 398.13agencies, licensed hospitals and other licensed facilities and providers, private purchasers, 398.14the medical and nursing professions, health insurers and health plans, the state quality 398.15improvement organization, academic and research institutions, consumer advisory 398.16organizations with an interest and expertise in health information technology, and other 398.17stakeholders as identified by the Health Information Technology and Infrastructure 398.18Advisory Committee.398.19    Subd. 2.Annual report.(c) The commissioner shall prepare and issue an annual 398.20report not later than January 30 of each year outlining progress to date in implementing a 398.21statewide health information infrastructure and recommending future projects.398.22    Subd. 3.Expiration.(d) Notwithstanding section 
         15.059, this sectionsubdivision 398.23expires June 30, 2009 2012.398.24    Sec. 7. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 398.25ACCOUNT AND LOAN PROGRAM.398.26    Subdivision 1.Account establishment.The commissioner of finance shall establish 398.27and implement a revolving account in the state government special revenue fund to 398.28provide loans to eligible borrowers to assist in financing the installation or support of 398.29an interoperable health record system. The system must provide for the interoperable 398.30exchange of health care information between the applicant and, at a minimum, a hospital 398.31system, pharmacy, and a health care clinic or other physician group.398.32    Subd. 2.Eligibility.(a) "Eligible borrower" means one of the following:398.33    (1) community clinics, as defined under section 145.9268;398.34    (2) hospitals eligible for rural hospital capital improvement grants, as defined 398.35in section 144.148;399.1    (3) physician clinics located in a community with a population of less than 50,000 399.2according to United States Census Bureau statistics and outside the seven-county 399.3metropolitan area;399.4    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and399.5    (5) other providers of health or health care services approved by the commissioner 399.6for which interoperable electronic health record capability would improve quality of 399.7care, patient safety, or community health.399.8    (b) To be eligible for a loan under this section, the applicant must submit a loan 399.9application to the commissioner of health on forms prescribed by the commissioner. The 399.10application must include, at a minimum:399.11    (1) the amount of the loan requested and a description of the purpose or project 399.12for which the loan proceeds will be used;399.13    (2) a quote from a vendor;399.14    (3) a description of the health care entities and other groups participating in the 399.15project;399.16    (4) evidence of financial stability and a demonstrated ability to repay the loan; and399.17    (5) a description of how the system to be financed interconnects or plans in the 399.18future to interconnect with other health care entities and provider groups located in the 399.19same geographical area.399.20    Subd. 3.Loans.(a) The commissioner of health may make a no interest loan 399.21to a provider or provider group who is eligible under subdivision 2 on a first-come, 399.22first-served basis provided that the applicant is able to comply with this section. The total 399.23accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of 399.24health has discretion over the size and number of loans made.399.25    (b) The commissioner of health may prescribe forms and establish an application 399.26process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 399.27application fee to cover the cost of administering the loan program.399.28    (c) The borrower must begin repaying the principal no later than two years from the 399.29date of the loan. Loans must be amortized no later than six years from the date of the loan.399.30    (d) Repayments must be credited to the account.399.31    Subd. 4.Data classification.Data collected by the commissioner of health on the 399.32application to determine eligibility under subdivision 2 and to monitor borrowers' default 399.33risk or collect payments owed under subdivision 3 are (1) private data on individuals as 399.34defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section 399.3513.02, subdivision 9. The names of borrowers and the amounts of the loans granted are 399.36public data.400.1    Sec. 8. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND 400.2IMPLEMENTATION GUIDE STANDARDS.400.3    Subdivision 1.Electronic claims and eligibility transactions required.(a) 400.4Beginning January 15, 2009, all group purchasers must accept from health care providers 400.5the eligibility for a health plan transaction described under Code of Federal Regulations, 400.6title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept 400.7from health care providers the health care claims or equivalent encounter information 400.8transaction described under Code of Federal Regulations, title 45, part 162, subpart K.400.9    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the 400.10eligibility for a health plan transaction described under Code of Federal Regulations, title 400.1145, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit 400.12to providers the health care payment and remittance advice transaction described under 400.13Code of Federal Regulations, title 45, part 162, subpart P.400.14    (c) Beginning January 15, 2009, all health care providers must submit to group 400.15purchasers the eligibility for a health plan transaction described under Code of Federal 400.16Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care 400.17providers must submit to group purchasers the health care claims or equivalent encounter 400.18information transaction described under Code of Federal Regulations, title 45, part 162, 400.19subpart K.400.20    (d) Beginning January 15, 2009, all health care providers must accept from group 400.21purchasers the eligibility for a health plan transaction described under Code of Federal 400.22Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care 400.23providers must accept from group purchasers the health care payment and remittance 400.24advice transaction described under Code of Federal Regulations, title 45, part 162, subpart 400.25P.400.26    (e) Each of the transactions described in paragraphs (a) to (d) shall require the use 400.27of a single, uniform companion guide to the implementation guides described under 400.28Code of Federal Regulations, title 45, part 162. The companion guides will be developed 400.29pursuant to subdivision 2.400.30    (f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group 400.31purchasers and health care providers must exchange claims and eligibility information 400.32electronically using the transactions, companion guides, implementation guides, and 400.33timelines required under this subdivision. Group purchasers may not impose any fee on 400.34providers for the use of the transactions prescribed in this subdivision.400.35    (g) Nothing in this subdivision shall prohibit group purchasers and health care 400.36providers from using a direct data entry, Web-based methodology for complying with 401.1the requirements of this subdivision. Any direct data entry method for conducting 401.2the transactions specified in this subdivision must be consistent with the data content 401.3component of the single, uniform companion guides required in paragraph (e) and the 401.4implementation guides described under Code of Federal Regulations, title 45, part 162.401.5    Subd. 2.Establishing uniform, standard companion guides.(a) At least 12 401.6months prior to the timelines required in subdivision 1, the commissioner of health shall 401.7promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers 401.8and health care providers to use the transactions and the uniform, standard companion 401.9guides required under subdivision 1, paragraph (e).401.10    (b) The commissioner of health must consult with the Minnesota Administrative 401.11Uniformity Committee on the development of the single, uniform companion guides 401.12required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1. 401.13The single uniform companion guides required under subdivision 1, paragraph (e), must 401.14specify uniform billing and coding standards. The commissioner of health shall base the 401.15companion guides required under subdivision 1, paragraph (e), billing and coding rules, 401.16and standards on the Medicare program, with modifications that the commissioner deems 401.17appropriate after consulting the Minnesota Administrative Uniformity Committee.401.18    (c) No group purchaser or health care provider may add to or modify the single, 401.19uniform companion guides defined in subdivision 1, paragraph (e), through additional 401.20companion guides or other requirements.401.21    (d) In promulgating the rules in paragraph (a), the commissioner shall not require 401.22data content that is not essential to accomplish the purpose of the transactions in 401.23subdivision 1.401.24    Sec. 9. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:401.25    Subdivision 1. Definitions. For purposes of this section, the following definitions 401.26apply:401.27    (a) "Accredited clinical training" means the clinical training provided by a 401.28medical education program that is accredited through an organization recognized by the 401.29Department of Education, the Centers for Medicare and Medicaid Services, or another 401.30national body who reviews the accrediting organizations for multiple disciplines and 401.31whose standards for recognizing accrediting organizations are reviewed and approved by 401.32the commissioner of health in consultation with the Medical Education and Research 401.33Advisory Committee.401.34    (b) "Commissioner" means the commissioner of health.402.1    (c) "Clinical medical education program" means the accredited clinical training of 402.2physicians (medical students and residents), doctor of pharmacy practitioners, doctors 402.3of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 402.4registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 402.5physician assistants.402.6    (d) "Sponsoring institution" means a hospital, school, or consortium located in 402.7Minnesota that sponsors and maintains primary organizational and financial responsibility 402.8for a clinical medical education program in Minnesota and which is accountable to the 402.9accrediting body.402.10    (e) "Teaching institution" means a hospital, medical center, clinic, or other 402.11organization that conducts a clinical medical education program in Minnesota.402.12    (f) "Trainee" means a student or resident involved in a clinical medical education 402.13program.402.14    (g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time 402.15equivalent counts, that are at training sites located in Minnesota with acurrently 402.16active medical assistance provider numberenrollment status and a National Provider 402.17Identification (NPI) number where training occurs in either an inpatient or ambulatory 402.18patient care setting and where the training is funded, in part, by patient care revenues.402.19    Sec. 10. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:402.20    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute 402.2190 percent of available medical education funds transferred according to section 402.22256B.69, subdivision 5c, paragraph (a), clause (1), to all qualifying applicants based on a 402.23distribution formula that reflects a summation of two factors:402.24    (1) an education factor, which is determined by the total number of eligible trainee 402.25FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical 402.26medical education program; and402.27    (2) a public program volume factor, which is determined by the total volume of 402.28public program revenue received by each training site as a percentage of all public 402.29program revenue received by all training sites in the fund pool.402.30    In this formula, the education factor is weighted at 67 percent and the public program 402.31volume factor is weighted at 33 percent.402.32    Public program revenue for the distribution formula includes revenue from medical 402.33assistance, prepaid medical assistance, general assistance medical care, and prepaid 402.34general assistance medical care. Training sites that receive no public program revenue 402.35are ineligible for funds available under this paragraph. Total statewide average costs per 403.1trainee for medical residents is based on audited clinical training costs per trainee in 403.2primary care clinical medical education programs for medical residents. Total statewide 403.3average costs per trainee for dental residents is based on audited clinical training costs 403.4per trainee in clinical medical education programs for dental students. Total statewide 403.5average costs per trainee for pharmacy residents is based on audited clinical training costs 403.6per trainee in clinical medical education programs for pharmacy students.403.7    (b) The commissioner shall annually distribute ten percent of total available medical 403.8education funds transferred according to section 256B.69, subdivision 5c, paragraph (a), 403.9clause (1), to all qualifying applicants based on the percentage received by each applicant 403.10under paragraph (a). These funds are to be used to offset clinical education costs at 403.11eligible clinical training sites based on criteria developed by the clinical medical education 403.12program. Applicants may choose to distribute funds allocated under this paragraph based 403.13on the distribution formula described in paragraph (a).403.14    (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated 403.15to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal 403.16financial participation on these funds and on funds transferred under subdivision 10, to all 403.17qualifying applicants based on a distribution formula that gives 100 percent weight to a 403.18public program volume factor, which is determined by the total volume of public program 403.19revenue received by each training site as a percentage of all public program revenue 403.20received by all training sites in the fund pool. If federal approval is not obtained for 403.21federal financial participation on any portion of funds distributed under this paragraph, 403.2290 percent of the unmatched funds shall be distributed by the commissioner based on 403.23the formula described in paragraph (a) and ten percent of the unmatched funds shall be 403.24distributed by the commissioner based on the formula described in paragraph (b).403.25    (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the 403.26commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving 403.27100 percent weight to an education factor, which is determined by the total number of 403.28eligible trainee full-time equivalents and the total statewide average costs per trainee, by 403.29type of trainee, in each clinical medical education program. If no matching funds are 403.30received on funds distributed under paragraph (c), funds distributed under this paragraph 403.31shall be distributed by the commissioner based on the formula described in paragraph (a).403.32    (e) The commissioner shall annually distribute $340,000 of funds dedicated to the 403.33commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants 403.34based on the percentage received by each applicant under paragraph (a). These funds are 403.35to be used to offset clinical education costs at eligible clinical training sites based on 403.36criteria developed by the clinical medical education program. Applicants may choose to 404.1distribute funds allocated under this paragraph based on the distribution formula described 404.2in paragraph (a). If no matching funds are received on funds distributed under paragraph 404.3(c), funds distributed under this paragraph shall be distributed by the commissioner based 404.4on the formula described in paragraph (b).404.5    (c) (f) Funds distributed shall not be used to displace current funding appropriations 404.6from federal or state sources.404.7    (d) (g) Funds shall be distributed to the sponsoring institutions indicating the amount 404.8to be distributed to each of the sponsor's clinical medical education programs based on 404.9the criteria in this subdivision and in accordance with the commissioner's approval letter. 404.10Each clinical medical education program must distribute funds allocated under paragraph 404.11(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 404.12institutions, which are accredited through an organization recognized by the Department 404.13of Education or the Centers for Medicare and Medicaid Services, may contract directly 404.14with training sites to provide clinical training. To ensure the quality of clinical training, 404.15those accredited sponsoring institutions must:404.16    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical 404.17training conducted at sites; and404.18    (2) take necessary action if the contract requirements are not met. Action may 404.19include the withholding of payments under this section or the removal of students from 404.20the site.404.21    (e) (h) Any funds not distributed in accordance with the commissioner's approval 404.22letter must be returned to the medical education and research fund within 30 days of 404.23receiving notice from the commissioner. The commissioner shall distribute returned funds 404.24to the appropriate training sites in accordance with the commissioner's approval letter.404.25    (f) (i) The commissioner shall distribute by June 30 of each year an amount equal to 404.26the funds transferred under subdivision 10, plus five percent interest to the University of 404.27Minnesota Board of Regents for the instructional costs of health professional programs 404.28at the Academic Health Center and for interdisciplinary academic initiatives within the 404.29Academic Health Center.404.30    (g) (j) A maximum of $150,000 of the funds dedicated to the commissioner 404.31under section 
         297F.10, subdivision 1, paragraph (b), clause (2), may be used by the 404.32commissioner for administrative expenses associated with implementing this section.404.33    Sec. 11. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:404.34    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner 404.35shall award grants to teaching institutions and clinical training sites for projects that 405.1increase dental access for underserved populations and promote innovative clinical 405.2training of dental professionals.405.3    (b) The commissioner shall award grants to teaching institutions and clinical training 405.4sites for projects that increase mental health access for underserved populations, promote 405.5innovative clinical training of mental health professionals, increase the number of mental 405.6health providers in rural or underserved areas, and promote the incorporation of patient 405.7safety principles into clinical medical education programs.405.8    (c) In awarding the grants, the commissioner, in consultation with the commissioner 405.9of human services, shall consider the following:405.10    (1) potential to successfully increase access to an underserved population;405.11    (2) the long-term viability of the project to improve access beyond the period 405.12of initial funding;405.13    (3) evidence of collaboration between the applicant and local communities;405.14    (4) the efficiency in the use of the funding; and405.15    (5) the priority level of the project in relation to state clinical education, access, 405.16patient safety, and workforce goals.; and405.17    (6) the potential of the project to impact the number or distribution of the health 405.18care workforce.405.19    (b) (d) The commissioner shall periodically evaluate the priorities in awarding the 405.20innovations grants in order to ensure that the priorities meet the changing workforce 405.21needs of the state.405.22    Sec. 12. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:405.23    Subd. 8. Federal financial participation. (a) The commissioner of human 405.24services shall seek to maximize federal financial participation in payments for medical 405.25education and research costs. If the commissioner of human services determines that 405.26federal financial participation is available for the medical education and research, the 405.27commissioner of health shall transfer to the commissioner of human services the amount 405.28of state funds necessary to maximize the federal funds available. The amount transferred 405.29to the commissioner of human services, plus the amount of federal financial participation, 405.30shall be distributed to medical assistance providers in accordance with the distribution 405.31methodology described in subdivision 4.405.32    (b) For the purposes of paragraph (a), the commissioner shall use physician clinic 405.33rates where possible to maximize federal financial participation.405.34    Sec. 13. Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:406.1    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the 406.2Academic Health Center under section 
         297F.10, subdivision 1, clause (1), $4,850,000 406.3shall be transferred annually to the commissioner of health no later than April 15 of each 406.4year for distribution under subdivision 4, paragraph (f) (i).406.5    Sec. 14. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:406.6    Subdivision 1. Required disclosure of estimated payment. (a) A health care 406.7provider, as defined in section 
         62J.03, subdivision 8, or the provider's designee as agreed 406.8to by that designee, shall, at the request of a consumer, provide that consumer with a good 406.9faith estimate of the reimbursementallowable payment the provider expects to receive 406.10from the health plan company in which the consumer is enrolled has agreed to accept from 406.11the consumer's health plan company for the services specified by the consumer, specifying 406.12the amount of the allowable payment due from the health plan company. Health plan 406.13companies must allow contracted providers, or their designee, to release this information. 406.14A good faith estimate must also be made available at the request of a consumer who 406.15is not enrolled in a health plan company.If a consumer has no applicable public or 406.16private coverage, the health care provider must give the consumer a good faith estimate 406.17of the average allowable reimbursement the provider accepts as payment from private 406.18third-party payers for the services specified by the consumer and the estimated amount 406.19the noncovered consumer will be required to pay. Payment information provided by a 406.20provider, or by the provider's designee as agreed to by that designee, to a patient pursuant 406.21to this subdivision does not constitute a legally binding estimate of the allowable charge 406.22for or cost to the consumer of services. 406.23    (b) A health plan company, as defined in section 
         62J.03, subdivision 10, shall, at 406.24the request of an enrollee or the enrollee's designee, provide that enrollee with a good 406.25faith estimate of the reimbursementallowable amount the health plan company would 406.26expect to pay tohas contracted for with a specified provider within the network as total 406.27payment for a health care service specified by the enrollee and the portion of the allowable 406.28amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the 406.29enrollee, the health plan company shall also provide to the enrollee a good faith estimate 406.30of the enrollee's out-of-pocket cost for the health care service. An estimate provided to 406.31an enrollee under this paragraph is not a legally binding estimate of the reimbursement406.32allowable amount or enrollee's out-of-pocket cost.406.33EFFECTIVE DATE.This section is effective August 1, 2007.407.1    Sec. 15. Minnesota Statutes 2006, section 62J.82, is amended to read:407.262J.82 HOSPITAL CHARGEINFORMATION REPORTING DISCLOSURE.407.3    Subdivision 1.Required information. The Minnesota Hospital Association shall 407.4develop a Web-based system, available to the public free of charge, for reporting charge 407.5information the following, for Minnesota residents,:407.6    (1) hospital-specific performance on the measures of care developed under section 407.7256B.072 for acute myocardial infarction, heart failure, and pneumonia; 407.8    (2) by January 1, 2009, hospital-specific performance on the public reporting 407.9measures for hospital-acquired infections as published by the National Quality Forum 407.10and collected by the Minnesota Hospital Association and Stratis Health in collaboration 407.11with infection control practitioners; and 407.12    (3) charge information, including, but not limited to, number of discharges, average 407.13length of stay, average charge, average charge per day, and median charge, for each of the 407.1450 most common inpatient diagnosis-related groups and the 25 most common outpatient 407.15surgical procedures as specified by the Minnesota Hospital Association. 407.16    Subd. 2.Web site. The Web site must provide information that compares 407.17hospital-specific data to hospital statewide data. The Web site must be established by 407.18October 1, 2006, and must be updated annually. The commissioner shall provide a link to 407.19this reporting information on the department's Web site.407.20    Subd. 3.Enforcement.The commissioner shall provide a link to this information 407.21on the department's Web site. If a hospital does not provide this information to the 407.22Minnesota Hospital Association, the commissioner of health may require the hospital to 407.23do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a 407.24link to this information on the department's Web site.407.25    Sec. 16. [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.407.26    Subdivision 1.Task force.The governor shall convene a health care transformation 407.27task force to advise and assist the governor and the Minnesota legislature. The task force 407.28shall consist of:407.29    (1) four legislators from the house of representatives appointed by the speaker, two 407.30from the majority party and two from the minority party, and four legislators from the 407.31senate appointed by the Subcommittee on Committees of the senate Committee on Rules 407.32and Administration, two from the majority party and two from the minority party;407.33    (2) four representatives of the governor and state agencies appointed by the governor;408.1    (3) at least four persons appointed by the governor who have demonstrated 408.2leadership in health care organizations, health improvement initiatives, health care trade or 408.3professional associations, or other collaborative health system improvement activities; and408.4    (4) at least two persons appointed by the governor who have demonstrated leadership 408.5in employer and group purchaser activities related to health system improvement, at least 408.6one of which must be from a labor organization.408.7    Subd. 2.Public input.The commissioner of health shall review available research, 408.8and conduct statewide, regional, and local surveys, focus groups, and other activities as 408.9needed to fill gaps in existing research, to determine Minnesotans' values, preferences, 408.10opinions, and perceptions related to health care and to the issues confronting the task 408.11force, and shall report the findings to the task force.408.12    Subd. 3.Inventory and assessment of existing activities; action plan.The task 408.13force shall complete an inventory and assessment of all public and private organized 408.14activities, coalitions, and collaboratives working on tasks relating to health system 408.15improvement including, but not limited to, patient safety, quality measurement and 408.16reporting, evidence-based practice, adoption of health information technology, disease 408.17management and chronic care coordination, medical homes, access to health care, 408.18cultural competence, prevention and public health, consumer incentives, price and cost 408.19transparency, nonprofit organization community benefits, education, research, and health 408.20care workforce.408.21    Subd. 4.Action plan.By December 15, 2007, the governor, with the advice 408.22and assistance of the task force, shall develop and present to the legislature a statewide 408.23action plan for transforming the health care system to improve affordability, quality, 408.24and access. The plan shall include draft legislation needed to implement the plan. The 408.25plan may consist of legislative actions, administrative actions of governmental entities, 408.26collaborative actions, and actions of individuals and individual organizations. Among 408.27other things, the action plan must include the following, with specific and measurable 408.28goals and deadlines for each:408.29    (1) proposed actions that will slow the rate of increase in health care costs to a rate 408.30that does not exceed the increase in the Consumer Price Index for urban consumers for the 408.31preceding calendar year plus two percentage points, plus an additional percentage based 408.32on the added costs necessary to implement legislation enacted in 2007;408.33    (2) actions that will increase the affordable health coverage options for uninsured 408.34and underinsured Minnesotans and other strategies that will ensure that all Minnesotans 408.35will have health coverage by January 2011;409.1    (3) actions to improve the quality and safety of health care and reduce racial and 409.2ethnic disparities in access and quality;409.3    (4) actions that will reduce the rate of preventable chronic illness through prevention 409.4and public health and wellness initiatives; and409.5    (5) proposed changes to state health care purchasing and payment strategies used for 409.6state health care programs and state employees that will promote higher quality, lower 409.7cost health care through incentives that reward prevention and early intervention, use 409.8of cost-effective primary care, effective care coordination, and management of chronic 409.9disease;409.10    (6) actions that will promote the appropriate and cost-effective investment in new 409.11facilities, technologies, and drugs;409.12    (7) actions to reduce administrative costs; and409.13    (8) the results of the inventory completed under subdivision 3 and recommendations 409.14for how these activities can be coordinated and improved.409.15    Subd. 5.Options for small employers.The task force shall study and report back 409.16to the legislature by December 15, 2007, on options for serving small employers and their 409.17employees, and self-employed individuals.409.18    Sec. 17. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:409.19    Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual 409.20conversion policies to eligible employees otherwise eligible for conversion coverage under 409.21section 
         62D.104 as a result of leaving a health maintenance organization's service area.409.22    (b) A health carrier may sell, issue, or renew individual conversion policies to 409.23eligible employees otherwise eligible for conversion coverage as a result of the expiration 409.24of any continuation of group coverage required under sections 
         62A.146, 
         62A.17, 
         62A.21, 409.2562C.142
         , 
         62D.101, and 
         62D.105.409.26    (c) A health carrier may sell, issue, or renew conversion policies under section 409.2762E.16
          to eligible employees.409.28    (d) A health carrier may sell, issue, or renew individual continuation policies to 409.29eligible employees as required.409.30    (e) A health carrier may sell, issue, or renew individual health plans if the coverage 409.31is appropriate due to an unexpired preexisting condition limitation or exclusion applicable 409.32to the person under the employer's group health plan or due to the person's need for health 409.33care services not covered under the employer's group health plan.409.34    (f) A health carrier may sell, issue, or renew an individual health plan, if the 409.35individual has elected to buy the individual health plan not as part of a general plan to 410.1substitute individual health plans for a group health plan nor as a result of any violation of 410.2subdivision 3 or 4.410.3    (g) Nothing in this subdivision relieves a health carrier of any obligation to provide 410.4continuation or conversion coverage otherwise required under federal or state law.410.5    (h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage 410.6issued as a supplement to Medicare under sections 
         62A.3099 to 
         62A.44, or policies or 410.7contracts that supplement Medicare issued by health maintenance organizations, or those 410.8contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social 410.9Security Act, United States Code, title 42, section 1395 et seq., as amended.410.10    (i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual 410.11health plans necessary to comply with a court order.410.12    (j) A health carrier may offer, issue, sell, or renew an individual health plan to 410.13persons eligible for an employer group health plan, if the individual health plan is a high 410.14deductible health plan for use in connection with an existing health savings account, in 410.15compliance with the Internal Revenue Code, section 223. In that situation, the same or 410.16a different health carrier may offer, issue, sell, or renew a group health plan to cover 410.17the other eligible employees in the group.410.18    (k) A health carrier may offer, sell, issue, or renew an individual health plan to one 410.19or more employees of a small employer if the individual health plan is marketed directly410.20through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 to 410.21all employees of the small employer and the small employer does not contribute directly 410.22or indirectly to the premiums or facilitate the administration of the individual health 410.23plan. The requirement to market an individual health plan to all employees through the 410.24Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 does not require 410.25the health carrier to offer or issue an individual health plan to any employee. For purposes 410.26of this paragraph, an employer is not contributing to the premiums or facilitating the 410.27administration of the individual health plan if the employer does not contribute to the 410.28premium and merely collects the premiums from an employee's wages or salary through 410.29payroll deductions and submits payment for the premiums of one or more employees in a 410.30lump sum to the health carrier to the Minnesota Health Insurance Exchange under section 410.3162A.67 or 62A.68. Except for coverage under section 
         62A.65, subdivision 5, paragraph 410.32(b), or 
         62E.16, at the request of an employee, the health carrier Minnesota Health Insurance 410.33Exchange under section 62A.67 or 62A.68 may bill the employer for the premiums 410.34payable by the employee, provided that the employer is not liable for payment except 410.35from payroll deductions for that purpose. If an employer is submitting payments under 410.36this paragraph, the health carrier and the Minnesota Health Insurance Exchange under 411.1section 62A.67 or 62A.68 shall jointly provide a cancellation notice directly to the primary 411.2insured at least ten days prior to termination of coverage for nonpayment of premium. 411.3Individual coverage under this paragraph may be offered only if the small employer has 411.4not provided coverage under section 62L.03 to the employees within the past 12 months.411.5    The employer must provide a written and signed statement to the health carrier411.6Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the employer 411.7is not contributing directly or indirectly to the employee's premiums. The Minnesota 411.8Health Insurance Exchange under section 62A.67 or 62A.68 shall provide all health 411.9carriers with enrolled employees of the employer with a copy of the employer's statement. 411.10The health carrier may rely on the employer's statement provided by the Minnesota Health 411.11Insurance Exchange under section 62A.67 or 62A.68 and is not required to guarantee-issue 411.12individual health plans to the employer's other current or future employees.411.13    Sec. 18. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:411.14    Subd. 4. Employer prohibition. A small employer offering a health benefit plan 411.15shall not encourage or direct an employee or applicant to:411.16    (1) refrain from filing an application for health coverage when other similarly 411.17situated employees may file an application for health coverage;411.18    (2) file an application for health coverage during initial eligibility for coverage, 411.19the acceptance of which is contingent on health status, when other similarly situated 411.20employees may apply for health coverage, the acceptance of which is not contingent on 411.21health status;411.22    (3) seek coverage from another health carrier, including, but not limited to, MCHA; 411.23or411.24    (4) cause coverage to be issued on different terms because of the health status or 411.25claims experience of that person or the person's dependents.411.26    Sec. 19. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:411.27    Subdivision 1. Definition. It is the commitment of the state to achieve universal 411.28health coverage for all Minnesotans by the year 2011. Universal coverage is achieved 411.29when:411.30    (1) every Minnesotan has access to a full range of quality health care services;411.31    (2) every Minnesotan is able to obtain affordable health coverage which pays for the 411.32full range of services, including preventive and primary care; and411.33    (3) every Minnesotan pays into the health care system according to that person's 411.34ability.412.1EFFECTIVE DATE.This section is effective July 1, 2007.412.2    Sec. 20. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:412.3    Subd. 2. Goal. It is the goal of the state to make continuous progress toward 412.4reducing the number of Minnesotans who do not have health coverage so that by January 412.51, 2000, fewer than four percent of the state's population will be without health coverage412.62011, all Minnesota residents have access to affordable health care. The goal will be 412.7achieved by improving access to private health coverage through insurance reforms and 412.8market reforms, by making health coverage more affordable for low-income Minnesotans 412.9through purchasing pools and state subsidies, and by reducing the cost of health coverage 412.10through cost containment programs and methods of ensuring that all Minnesotans are 412.11paying into the system according to their ability.412.12EFFECTIVE DATE.This section is effective July 1, 2007.412.13    Sec. 21. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:412.14    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 412.15coverage program, a community-based health initiative shall submit to the commissioner 412.16of health for approval the community-based health care coverage program developed by 412.17the initiative. The commissioner shall only approve a program that has been awarded 412.18a community access program grant from the United States Department of Health and 412.19Human Services. The commissioner shall ensure that the program meets the federal grant 412.20requirements and any requirements described in this section and is actuarially sound based 412.21on a review of appropriate records and methods utilized by the community-based health 412.22initiative in establishing premium rates for the community-based health care coverage 412.23program. 412.24    (b) Prior to approval, the commissioner shall also ensure that:412.25    (1) the benefits offered comply with subdivision 8 and that there are adequate 412.26numbers of health care providers participating in the community-based health network to 412.27deliver the benefits offered under the program;412.28    (2) the activities of the program are limited to activities that are exempt under this 412.29section or otherwise from regulation by the commissioner of commerce;412.30    (3) the complaint resolution process meets the requirements of subdivision 10; and 412.31    (4) the data privacy policies and procedures comply with state and federal law.412.32    Sec. 22. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:413.1    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 413.2by the commissioner of health a community-based health care coverage program. The 413.3operational structure established by the initiative shall include, but is not limited to: 413.4    (1) establishing a process for enrolling eligible individuals and their dependents; 413.5    (2) collecting and coordinating premiums from enrollees and employers of enrollees;413.6    (3) providing payment to participating providers; 413.7    (4) establishing a benefit set according to subdivision 8 and establishing premium 413.8rates and cost-sharing requirements; 413.9    (5) creating incentives to encourage primary care and wellness services; and 413.10    (6) initiating disease management services, as appropriate. 413.11    (b) The payments collected under paragraph (a), clause (2), may be used to capture 413.12available federal funds.413.13    Sec. 23. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:413.14    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 413.15commissioner of health on January 15, April 15, July 15, and October 15 of each year, 413.16with the first report due January 15, 2007 2008. The status report shall include:413.17    (1) the financial status of the program, including the premium rates, cost per member 413.18per month, claims paid out, premiums received, and administrative expenses; 413.19    (2) a description of the health care benefits offered and the services utilized; 413.20    (3) the number of employers participating, the number of employees and dependents 413.21covered under the program, and the number of health care providers participating; 413.22    (4) a description of the health outcomes to be achieved by the program and a status 413.23report on the performance measurements to be used and collected; and 413.24    (5) any other information requested by the commissioner of health or commerce or 413.25the legislature. 413.26    (b) The initiative shall contract with an independent entity to conduct an evaluation 413.27of the program to be submitted to the commissioners of health and commerce and the 413.28legislature by January 15, 2009 2010. The evaluation shall include:413.29    (1) an analysis of the health outcomes established by the initiative and the 413.30performance measurements to determine whether the outcomes are being achieved;413.31    (2) an analysis of the financial status of the program, including the claims to 413.32premiums loss ratio and utilization and cost experience; 413.33    (3) the demographics of the enrollees, including their age, gender, family income, 413.34and the number of dependents; 414.1    (4) the number of employers and employees who have been denied access to the 414.2program and the basis for the denial; 414.3    (5) specific analysis on enrollees who have aggregate medical claims totaling over 414.4$5,000 per year, including data on the enrollee's main diagnosis and whether all the 414.5medical claims were covered by the program; 414.6    (6) number of enrollees referred to state public assistance programs; 414.7    (7) a comparison of employer-subsidized health coverage provided in a comparable 414.8geographic area to the designated community-based geographic area served by the 414.9program, including, to the extent available: 414.10    (i) the difference in the number of employers with 50 or fewer employees offering 414.11employer-subsidized health coverage; 414.12    (ii) the difference in uncompensated care being provided in each area; and414.13    (iii) a comparison of health care outcomes and measurements established by the 414.14initiative; and 414.15    (8) any other information requested by the commissioner of health or commerce.414.16    Sec. 24. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:414.17    Subd. 14. Sunset. This section expires December 31, 2011 2012.414.18    Sec. 25. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:414.19    Subdivision 1. Yearly reports.(a) Each hospital and each outpatient surgical center, 414.20which has not filed the financial information required by this section with a voluntary, 414.21nonprofit reporting organization pursuant to section 
         144.702, shall file annually with the 414.22commissioner of health after the close of the fiscal year: 414.23    (1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or 414.24outpatient surgical center;414.25    (2) a detailed statement of income and expenses;414.26    (3) a copy of its most recent cost report, if any, filed pursuant to requirements of 414.27Title XVIII of the United States Social Security Act;414.28    (4) a copy of all changes to articles of incorporation or bylaws;414.29    (5) information on services provided to benefit the community, including services 414.30provided at no cost or for a reduced fee to patients unable to pay, teaching and research 414.31activities, or other community or charitable activities;414.32    (6) information required on the revenue and expense report form set in effect on 414.33July 1, 1989, or as amended by the commissioner in rule;414.34    (7) information on changes in ownership or control; and415.1    (8) other information required by the commissioner in rule.;415.2    (9) information on the number of available hospital beds that are dedicated to certain 415.3specialized services, as designated by the commissioner, and annual occupancy rates for 415.4those beds, separately for adult and pediatric care;415.5    (10) from outpatient surgical centers, the total number of surgeries; and415.6    (11) a report on health care capital expenditures during the previous year, as required 415.7by section 62J.17.415.8    (b) Beginning with hospital fiscal year 2009, each nonprofit hospital shall report on 415.9community benefits under paragraph (a), clause (5). "Community benefit" means the costs 415.10of community care, underpayment for services provided under state health care programs, 415.11research costs, community health services costs, financial and in-kind contributions, costs 415.12of community building activities, costs of community benefit operations, education, and 415.13the cost of operating subsidized services. The cost of bad debts and underpayment for 415.14Medicare services are not included in the calculation of community benefit.415.15    Sec. 26. Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision 415.16to read:415.17    Subd. 5.Annual reports on community benefit, community care amounts, 415.18and state program underfunding.(a) For each hospital reporting health care cost 415.19information under section 144.698 or 144.702, the commissioner shall report annually 415.20on the hospital's community benefit, community care, and underpayment for state public 415.21health care programs.415.22    (b) For purposes of this subdivision, "community benefits" has the definition given 415.23in section 144.698, paragraph (b).415.24    (c) For purposes of this subdivision, "community care" means the costs for medical 415.25care for which a hospital has determined is charity care, as defined under Minnesota Rules, 415.26part 4650.0115, or for which the hospital determines after billing for the services that there 415.27is a demonstrated inability to pay. Any costs forgiven under a hospital's community care 415.28plan or under section 62J.83 may be counted in the hospital's calculation of community 415.29care. Bad debt expenses and discounted charges available to the uninsured shall not be 415.30included in the calculation of community care. The amount of community care is the value 415.31of costs incurred and not the charges made for services.415.32    (d) For purposes of this subdivision, underpayment for services provided by state 415.33public health care programs is the difference between hospital costs and public program 415.34payments. The information shall be reported in terms of total dollars and as a percentage 415.35of total operating costs for each hospital.416.1    Sec. 27. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:416.2    Subd. 2b. Performance payments.(a) The commissioner shall develop and 416.3implement a pay-for-performance system to provide performance payments to:416.4    (1) eligible medical groups and clinics that demonstrate optimum care in serving 416.5individuals with chronic diseases who are enrolled in health care programs administered 416.6by the commissioner under chapters 256B, 256D, and 256L.;416.7    (2) medical groups that implement effective medical home models of patient care 416.8that improve quality and reduce costs through effective primary and preventive care, care 416.9coordination, and management of chronic conditions; and416.10    (3) eligible medical groups and clinics that evaluate medical provider usage patterns 416.11and provide feedback to individual medical providers on that provider's practice patterns 416.12relative to peer medical providers.416.13    (b) The commissioner shall also develop and implement a patient incentive health 416.14program to provide incentives and rewards to patients who are enrolled in health care 416.15programs administered by the commissioner under chapters 256B, 256D, and 256L, and 416.16who have agreed to and meet personal health goals established with their primary care 416.17provider to manage a chronic disease or condition including, but not limited to, diabetes, 416.18high blood pressure, and coronary artery disease.416.19    (c) The commissioner may receive any federal matching money that is made 416.20available through the medical assistance program for managed care oversight contracted 416.21through vendors including consumer surveys, studies, and external quality reviews as 416.22required by the Federal Balanced Budget Act of 1997, Code of Federal Regulations, 416.23title 42, part 438, subpart E. Any federal money received for managed care oversight is 416.24appropriated to the commissioner for this purpose. The commissioner may expend the 416.25federal money received in either year of the biennium.416.26EFFECTIVE DATE.This section is effective July 1, 2007.416.27    Sec. 28. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 416.28subdivision to read:416.29    Subd. 49.Provider-directed care coordination services.The commissioner 416.30shall develop and implement a provider-directed care coordination program for medical 416.31assistance recipients who are not enrolled in the prepaid medical assistance program and 416.32who are receiving services on a fee-for-service basis. This program provides payment 416.33to primary care clinics for care coordination for people who have complex and chronic 416.34medical conditions. Clinics must meet certain criteria such as the capacity to develop care 416.35plans; have a dedicated care coordinator; and have an adequate number of fee-for-service 417.1clients, evaluation mechanisms, and quality improvement processes to qualify for 417.2reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic 417.3designated as the patient's first point of contact for medical care, available 24 hours a 417.4day, seven days a week, that provides or arranges for the patient's comprehensive health 417.5care needs, and provides overall integration, coordination and continuity over time and 417.6referrals for specialty care.417.7    Sec. 29. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:417.8    Subd. 4. Gross individual or gross family income. (a) "Gross individual or gross 417.9family income" for nonfarm self-employed means income calculated for the six-month 417.10period of eligibility using the net profit or loss reported on the applicant's federal income 417.11tax form for the previous year and using the medical assistance families with children 417.12methodology for determining allowable and nonallowable self-employment expenses and 417.13countable income.417.14    (b) "Gross individual or gross family income" for farm self-employed means income 417.15calculated for the six-month period of eligibility using as the baseline the adjusted gross 417.16income reported on the applicant's federal income tax form for the previous year and 417.17adding back in reported depreciation amounts that apply to the business in which the 417.18family is currently engaged.417.19    (c) "Gross individual or gross family income" means the total income for all family 417.20members, calculated for the six-month period of eligibility.417.21EFFECTIVE DATE.This section is effective July 1, 2007.417.22    Sec. 30. HEALTH CARE PAYMENT SYSTEM REFORM.417.23    Subdivision 1.Payment reform plan.The commissioners of employee relations, 417.24human services, commerce, and health shall develop a plan for promoting and facilitating 417.25changes in payment rates and methods for paying for health care services, drugs, devices, 417.26supplies, and equipment in order to:417.27    (1) reward the provision of cost-effective primary and preventive care;417.28    (2) reward the use of evidence-based care;417.29    (3) discourage underutilization, overuse, and misuse;417.30    (4) reward the use of the most cost-effective settings, drugs, devices, providers, 417.31and treatments; and417.32    (5) encourage consumers to maintain good health and use the health care system 417.33appropriately.418.1    In developing the plan, the commissioners shall analyze existing data to determine 418.2specific services and health conditions for which changes in payment rates and methods 418.3would lead to significant improvements in quality of care.418.4    Subd. 2.Report.The commissioners shall submit a report to the legislature by 418.5December 15, 2007, describing the payment reform plan. The report must include 418.6proposed legislation for implementing those components of the plan requiring legislative 418.7action or appropriations of money.418.8EFFECTIVE DATE.This section is effective July 1, 2007.418.9    Sec. 31. COMMUNITY COLLABORATIVE PILOT PROJECTS TO COVER 418.10THE UNINSURED.418.11    Subdivision 1.Community collaboratives.The commissioner of human services 418.12shall provide grants to and authorization for up to three community collaboratives that 418.13satisfy the requirements in this section. To be eligible to receive a grant and authorization 418.14under this section, a community collaborative must include:418.15    (1) one or more counties;418.16    (2) one or more local hospitals;418.17    (3) one or more local employers who collectively provide at least 300 jobs in the 418.18community;418.19    (4) one or more health care clinics or physician groups; and418.20    (5) a third-party payer, which may be a county-based purchasing plan operating 418.21under Minnesota Statutes, section 256B.692, a self-insured employer, or a health plan 418.22company as defined in Minnesota Statutes, section 62Q.01, subdivision 4.418.23    Subd. 2.Pilot project requirements.(a) Community collaborative pilot projects 418.24must:418.25    (1) identify and enroll persons in the community who are uninsured, and who have, 418.26or are at risk of developing, one of the following chronic conditions: mental illness, 418.27diabetes, asthma, hypertension, or other chronic condition designated by the project;418.28    (2) assist uninsured persons to obtain private-sector health insurance coverage if 418.29possible or to enroll in any public health care programs for which they are eligible. If the 418.30uninsured individual is unable to obtain health coverage, the community collaborative 418.31must enroll the individual in a local health care assistance program that provides specified 418.32services to prevent or effectively manage the chronic condition;418.33    (3) include components to help uninsured persons retain employment or to become 418.34employable, if currently unemployed;419.1    (4) ensure that each uninsured person enrolled in the program has a medical home 419.2responsible for providing, or arranging for, health care services and assisting in the 419.3effective management of the chronic condition;419.4    (5) coordinate services between all providers and agencies serving an enrolled 419.5individual; and419.6    (6) be coordinated with the state's Q-Care initiative and improve the use of 419.7evidence-based treatments and effective disease management programs in the broader 419.8community, beyond those individuals enrolled in the project.419.9    (b) Projects established under this section are not insurance and are not subject to 419.10state-mandated benefit requirements or insurance regulations.419.11    Subd. 3.Criteria.Proposals must be evaluated by actuarial, financial, and clinical 419.12experts based on the likelihood that the project would produce a positive return on 419.13investment for the community. In awarding grants, the commissioner of human services 419.14shall give preference to proposals that:419.15    (1) have broad community support from local businesses, provider counties, and 419.16other public and private organizations;419.17    (2) would provide services to uninsured persons who have, or are at risk of 419.18developing, multiple, co-occurring chronic conditions;419.19    (3) integrate or coordinate resources from multiple sources, such as employer 419.20contributions, county funds, social service programs, and provider financial or in-kind 419.21support;419.22    (4) provide continuity of treatment and services when uninsured individuals in 419.23the program become eligible for public or private health insurance or when insured 419.24individuals lose their coverage;419.25    (5) demonstrate how administrative costs for health plan companies and providers 419.26can be reduced through greater simplification, coordination, consolidation, standardization, 419.27reducing billing errors, or other methods; and419.28    (6) involve local contributions to the cost of the pilot projects.419.29    Subd. 4.Grants.The commissioner of human services shall provide 419.30implementation grants of up to one-half of the community collaborative's costs for 419.31planning, administration, and evaluation. The commissioner shall also provide grants to 419.32community collaboratives to develop a fund to pay up to 50 percent of the cost of the 419.33services provided to uninsured individuals. The remaining costs must be paid for through 419.34other sources or by agreement of a health care provider to contribute the cost as charity 419.35care.420.1    Subd. 5.Evaluation.The commissioner of human services shall evaluate the 420.2effectiveness of each community collaborative project awarded a grant, by comparing 420.3actual costs for serving the identified uninsured persons to the predicted costs that would 420.4have been incurred in the absence of early intervention and consistent treatment to manage 420.5the chronic condition, including the costs to medical assistance, MinnesotaCare, and 420.6general assistance medical care. The commissioner shall require community collaborative 420.7projects, as a condition of receipt of a grant award, to provide the commissioner with all 420.8information necessary for this evaluation.420.9EFFECTIVE DATE.This section is effective July 1, 2007.420.10    Sec. 32. HEALTH CARE PAYMENT REFORM PILOT PROJECTS.420.11    Subdivision 1.Pilot projects.(a) The commissioners of health, human services, 420.12and employee relations shall develop and administer payment reform pilot projects for 420.13state employees and persons enrolled in medical assistance, MinnesotaCare, or general 420.14assistance medical care, to the extent permitted by federal requirements. The purpose of 420.15the projects is to promote and facilitate changes in payment rates and methods for paying 420.16for health care services, drugs, devices, supplies, and equipment in order to:420.17    (1) reward the provision of cost-effective primary and preventive care;420.18    (2) reward the use of evidence-based care;420.19    (3) reward coordination of care for patients with chronic conditions;420.20    (4) discourage overuse and misuse;420.21    (5) reward the use of the most cost-effective settings, drugs, devices, providers, 420.22and treatments;420.23    (6) encourage consumers to maintain good health and use the health care system 420.24appropriately.420.25    (b) The pilot projects must involve the use of designated care professionals or 420.26clinics to serve as a patient's medical home and be responsible for coordinating health 420.27care services across the continuum of care. The pilot projects must evaluate different 420.28payment reform models and must be coordinated with the Minnesota senior health options 420.29program and the Minnesota disability health options program. To the extent possible, the 420.30commissioners shall coordinate state purchasing activities with other public employers 420.31and with private purchasers, self-insured groups, and health plan companies to promote 420.32the use of pilot projects encompassing both public and private purchasers and markets.420.33    Subd. 2.Payment methods and incentives.The commissioners shall modify 420.34existing payment methods and rates for those enrollees and health care providers 420.35participating in the pilot project in order to provide incentives for care management, 421.1team-based care, and practice redesign, and increase resources for primary care, chronic 421.2condition care, and care provided to complex patients. The commissioners may create 421.3financial incentives for patients to select a medical home under the pilot project by 421.4reducing, modifying, or eliminating deductibles and co-payments for certain services, or 421.5through other incentives. The commissioners may require patients to remain with their 421.6designated medical home for a specified period of time. Alternative payment methods 421.7may include complete or partial capitation, fee-for-service payments, or other payment 421.8methodologies. The payment methods may provide for the payment of bonuses to medical 421.9home providers or other providers, or to patients, for the achievement of performance 421.10goals. The payment methods may include allocating a portion of the payment that 421.11would otherwise be paid to health plans under state prepaid health care programs to the 421.12designated medical home for specified services.421.13    Subd. 3.Requirements.In order to be designated a medical home under the pilot 421.14project, health care professionals or clinics must demonstrate their ability to:421.15    (1) be the patient's first point of contact by telephone or other means, 24 hours a 421.16day, seven days a week;421.17    (2) provide or arrange for patients' comprehensive health care needs, including the 421.18ability to structure planned chronic disease visits and to manage chronic disease through 421.19the use of disease registries;421.20    (3) coordinate patients' care when care must be provided outside the medical home;421.21    (4) provide longitudinal care, not just episodic care, including meeting long-term 421.22and unique personal needs;421.23    (5) utilize an electronic health record and incorporate a plan to develop and make 421.24available to patients that choose a medical home an electronic personal health record that 421.25is prepopulated with the patient's data, consumer-directed, connected to the provider, 421.2624-hour accessible, and owned and controlled by the patient;421.27    (6) systematically improve quality of care using, among other inputs, patient 421.28feedback; and421.29    (7) create a provider network that provides for increased reimbursement for a 421.30medical home in a cost-neutral manner.421.31    Subd. 4.Evaluation.Pilot projects must be evaluated based on patient satisfaction, 421.32provider satisfaction, clinical process and outcome measures, program costs and savings, 421.33and economic impact on health care providers. Pilot projects must be evaluated based 421.34on the extent to which the medical home:421.35    (1) coordinated health care services across the continuum of care and thereby 421.36reduced duplication of services and enhanced communication across providers;422.1    (2) provided safe and high-quality care by increasing utilization of effective 422.2treatments, reduced use of ineffective treatments, reduced barriers to essential care and 422.3services, and eliminated barriers to access;422.4    (3) reduced unnecessary hospitalizations and emergency room visits and increased 422.5use of cost-effective care and settings;422.6    (4) encouraged long-term patient and provider relationships by shifting from 422.7episodic care to consistent, coordinated communication and care with a specified team of 422.8providers or individual providers;422.9    (5) engaged and educated consumers by encouraging shared patient and provider 422.10responsibility and accountability for disease prevention, health promotion, chronic 422.11disease management, acute care, and overall well-being, encouraging informed medical 422.12decision-making, ensuring the availability of accurate medical information, and facilitated 422.13the transfer of accurate medical information;422.14    (6) encouraged innovation in payment methodologies by using patient and provider 422.15incentives to coordinate care and utilize medical home services and fostering the 422.16expansion of a technology infrastructure that supports collaboration; and422.17    (7) reduced overall health care costs as compared to conventional payment methods 422.18for similar patient populations.422.19    Subd. 5.Rulemaking.The commissioners are exempt from administrative 422.20rulemaking under chapter 14 for purposes of developing, administering, contracting 422.21for, and evaluating pilot projects under this section. The commissioner shall publish a 422.22proposed request for proposals in the State Register and allow 30 days for comment 422.23before issuing the final request for proposals.422.24    Subd. 6.Regulatory and payment barriers.The commissioners shall study state 422.25and federal statutory and regulatory barriers to the creation of medical homes and provide 422.26a report and recommendations to the legislature by December 15, 2007.422.27    Sec. 33. HEALTH CARE SYSTEM CONSOLIDATION.422.28    (a) The commissioner of health shall study the effect of health care provider and 422.29health plan company consolidation in the four metropolitan statistical areas in Minnesota 422.30on: health care costs, including provider payment rates; quality of care; and access to care. 422.31The commissioner shall separately consider hospitals, specialty groups, and primary care 422.32groups. The commissioner shall present findings and recommendations to the legislature 422.33by December 15, 2007.422.34    (b) For purposes of this study, health carriers, provider networks, and other health 422.35care providers shall provide data on network participation, contracted payment rates, 423.1charges, costs, payments received, patient referrals, and other information requested by 423.2the commissioner, in the form and manner specified by the commissioner. Provider-level 423.3information on contracted payment rates and payments from health plans provided to the 423.4commissioner of health for the purposes of this study are (1) private data on individuals as 423.5defined in Minnesota Statutes, section 13.02, subdivision 12, and (2) nonpublic data as 423.6defined in Minnesota Statutes, section 13.02, subdivision 9. The commissioner may not 423.7collect patient-identified data for purposes of this study. Data collected for purposes of 423.8this study may not be used for any other purposes.423.9    Sec. 34.  REPEALER.423.10Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective 423.11August 1, 2007.423.12ARTICLE 10423.13PUBLIC HEALTH423.14    Section 1. Minnesota Statutes 2006, section 13.3806, is amended by adding a 423.15subdivision to read:423.16    Subd. 21.Birth defects registry system.Data on individuals collected by the 423.17birth defects registry system are private data on individuals and classified pursuant to 423.18section 144.2215.423.19    Sec. 2. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision 423.20to read:423.21    Subd. 3b.Window fall prevention device code.The commissioner of labor and 423.22industry shall adopt rules for window fall prevention devices as part of the state Building 423.23Code. Window fall prevention devices include, but are not limited to, safety screens, 423.24hardware, guards, and other devices that comply with the standards established by the 423.25commissioner of labor and industry. The rules must require compliance with standards 423.26for window fall prevention devices developed by ASTM International, contained in the 423.27International Building Code as the model language with amendments deemed necessary to 423.28coordinate with the other adopted building codes in Minnesota. The rules must establish a 423.29scope that includes the applicable building occupancies, and the types, locations, and sizes 423.30of windows that will require the installation of fall devices. The rules will be effective July 423.311, 2009. The commissioner shall report to the legislature on the status of the rulemaking 423.32on or before February 15, 2008.424.1    Sec. 3. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:424.2    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable 424.3application fee of $175 $215 to cover the administrative cost of processing a request for a 424.4variance or modification of rules adopted by the commissioner under this chapter.424.5EFFECTIVE DATE.This section is effective July 1, 2008.424.6    Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:424.7    Subdivision 1. Well notification fee. The well notification fee to be paid by a 424.8property owner is:424.9    (1) for a new water supply well, $175 $215, which includes the state core function 424.10fee;424.11    (2) for a well sealing, $35 $50 for each well, which includes the state core function 424.12fee, except that for monitoring wells constructed on a single property, having depths 424.13within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of 424.14$35 $50; and424.15    (3) for construction of a dewatering well, $175 $215, which includes the state core 424.16function fee, for each dewatering well except a dewatering project comprising five or 424.17more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering 424.18wells recorded on the notification.424.19EFFECTIVE DATE.This section is effective July 1, 2008.424.20    Sec. 5. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:424.21    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:424.22    (1) for a water supply well that is not in use under a maintenance permit, $150 $175424.23annually;424.24    (2) for construction of a monitoring well, $175 $215, which includes the state 424.25core function fee;424.26    (3) for a monitoring well that is unsealed under a maintenance permit, $150 $175424.27annually;424.28    (4) for monitoring wells used as a leak detection device at a single motor fuel retail 424.29outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 424.30chemical facility site, the construction permit fee is $175 $215, which includes the state 424.31core function fee, per site regardless of the number of wells constructed on the site, and 424.32the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per 424.33site regardless of the number of monitoring wells located on site;425.1    (5) for a groundwater thermal exchange device, in addition to the notification fee for 425.2water supply wells, $175 $215, which includes the state core function fee;425.3    (6) for a vertical heat exchanger, $175 $215;425.4    (7) for a dewatering well that is unsealed under a maintenance permit, $150 $175425.5annually for each dewatering well, except a dewatering project comprising more than five 425.6dewatering wells shall be issued a single permit for $750 $875 annually for dewatering 425.7wells recorded on the permit; and425.8    (8) for an elevator boring, $175 $215 for each boring.425.9EFFECTIVE DATE.This section is effective July 1, 2008.425.10    Sec. 6. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:425.11    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to 425.12sell or transfer real property, the seller must disclose in writing to the buyer information 425.13about the status and location of all known wells on the property, by delivering to the buyer 425.14either a statement by the seller that the seller does not know of any wells on the property, 425.15or a disclosure statement indicating the legal description and county, and a map drawn 425.16from available information showing the location of each well to the extent practicable. 425.17In the disclosure statement, the seller must indicate, for each well, whether the well is in 425.18use, not in use, or sealed.425.19    (b) At the time of closing of the sale, the disclosure statement information, name and 425.20mailing address of the buyer, and the quartile, section, township, and range in which each 425.21well is located must be provided on a well disclosure certificate signed by the seller or a 425.22person authorized to act on behalf of the seller.425.23    (c) A well disclosure certificate need not be provided if the seller does not know 425.24of any wells on the property and the deed or other instrument of conveyance contains 425.25the statement: "The Seller certifies that the Seller does not know of any wells on the 425.26described real property."425.27    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate 425.28required by this subdivision shall be signed by the buyer or a person authorized to act on 425.29behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure 425.30certificate is not required if the following statement appears on the deed followed by the 425.31signature of the grantee or, if there is more than one grantee, the signature of at least one 425.32of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the 425.33described real property." The statement and signature of the grantee may be on the front 425.34or back of the deed or on an attached sheet and an acknowledgment of the statement by 425.35the grantee is not required for the deed to be recordable.426.1    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:426.2    (1) that consists solely of a sale or transfer of severed mineral interests; or426.3    (2) that consists of an individual condominium unit as described in chapters 515 426.4and 515B.426.5    (f) For an area owned in common under chapter 515 or 515B the association or other 426.6responsible person must report to the commissioner by July 1, 1992, the location and 426.7status of all wells in the common area. The association or other responsible person must 426.8notify the commissioner within 30 days of any change in the reported status of wells.426.9    (g) For real property sold by the state under section 
         92.67, the lessee at the time of 426.10the sale is responsible for compliance with this subdivision.426.11    (h) If the seller fails to provide a required well disclosure certificate, the buyer, or 426.12a person authorized to act on behalf of the buyer, may sign a well disclosure certificate 426.13based on the information provided on the disclosure statement required by this section 426.14or based on other available information.426.15    (i) A county recorder or registrar of titles may not record a deed or other instrument 426.16of conveyance dated after October 31, 1990, for which a certificate of value is required 426.17under section 
         272.115, or any deed or other instrument of conveyance dated after October 426.1831, 1990, from a governmental body exempt from the payment of state deed tax, unless 426.19the deed or other instrument of conveyance contains the statement made in accordance 426.20with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all 426.21the information required by paragraph (b) or (d). The county recorder or registrar of titles 426.22must not accept a certificate unless it contains all the required information. The county 426.23recorder or registrar of titles shall note on each deed or other instrument of conveyance 426.24accompanied by a well disclosure certificate that the well disclosure certificate was 426.25received. The notation must include the statement "No wells on property" if the disclosure 426.26certificate states there are no wells on the property. The well disclosure certificate shall not 426.27be filed or recorded in the records maintained by the county recorder or registrar of titles. 426.28After noting "No wells on property" on the deed or other instrument of conveyance, the 426.29county recorder or registrar of titles shall destroy or return to the buyer the well disclosure 426.30certificate. The county recorder or registrar of titles shall collect from the buyer or the 426.31person seeking to record a deed or other instrument of conveyance, a fee of $40 $45426.32for receipt of a completed well disclosure certificate. By the tenth day of each month, 426.33the county recorder or registrar of titles shall transmit the well disclosure certificates 426.34to the commissioner of health. By the tenth day after the end of each calendar quarter, 426.35the county recorder or registrar of titles shall transmit to the commissioner of health 426.36$32.50 $37.50 of the fee for each well disclosure certificate received during the quarter. 427.1The commissioner shall maintain the well disclosure certificate for at least six years. The 427.2commissioner may store the certificate as an electronic image. A copy of that image 427.3shall be as valid as the original.427.4    (j) No new well disclosure certificate is required under this subdivision if the buyer 427.5or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed 427.6or other instrument of conveyance that the status and number of wells on the property 427.7have not changed since the last previously filed well disclosure certificate. The following 427.8statement, if followed by the signature of the person making the statement, is sufficient 427.9to comply with the certification requirement of this paragraph: "I am familiar with the 427.10property described in this instrument and I certify that the status and number of wells on 427.11the described real property have not changed since the last previously filed well disclosure 427.12certificate." The certification and signature may be on the front or back of the deed or on 427.13an attached sheet and an acknowledgment of the statement is not required for the deed or 427.14other instrument of conveyance to be recordable.427.15    (k) The commissioner in consultation with county recorders shall prescribe the form 427.16for a well disclosure certificate and provide well disclosure certificate forms to county 427.17recorders and registrars of titles and other interested persons.427.18    (l) Failure to comply with a requirement of this subdivision does not impair:427.19    (1) the validity of a deed or other instrument of conveyance as between the parties 427.20to the deed or instrument or as to any other person who otherwise would be bound by 427.21the deed or instrument; or427.22    (2) the record, as notice, of any deed or other instrument of conveyance accepted for 427.23filing or recording contrary to the provisions of this subdivision.427.24EFFECTIVE DATE.This section is effective July 1, 2008.427.25    Sec. 7. Minnesota Statutes 2006, section 144.123, is amended to read:427.26144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES; 427.27EXCEPTIONS.427.28    Subdivision 1. Who must pay. Except for the limitation contained in this section, 427.29the commissioner of health shall charge a handling fee for each specimen submitted to 427.30the Department of Health for analysis for diagnostic purposes by any hospital, private 427.31laboratory, private clinic, or physician. No fee shall be charged to any entity which 427.32receives direct or indirect financial assistance from state or federal funds administered by 427.33the Department of Health, including any public health department, nonprofit community 427.34clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar 428.1entity. No fee will be charged for any biological materials submitted to the Department 428.2of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological 428.3materials requested by the department to gather information for disease prevention or 428.4control purposes. The commissioner of health may establish by rule other exceptions to 428.5the handling fee as may be necessary to gather information for epidemiologic purposes428.6protect the public's health. All fees collected pursuant to this section shall be deposited in 428.7the state treasury and credited to the state government special revenue fund.428.8    Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate 428.9rules, in accordance with chapter 14, which shall specify the amount of the charge a428.10handling fee prescribed in subdivision 1. The fee shall approximate the costs to the 428.11department of handling specimens including reporting, postage, specimen kit preparation, 428.12and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen 428.13until the commissioner promulgates rules pursuant to this subdivision.428.14    Sec. 8. Minnesota Statutes 2006, section 144.125, is amended to read:428.15144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL 428.16DISORDERS.428.17    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative 428.18officer or other person in charge of each institution caring for infants 28 days or less 428.19of age, (2) the person required in pursuance of the provisions of section 
         144.215, to 428.20register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 428.21birth, to arrange to have administered to every infant or child in its care tests for heritable 428.22and congenital disorders according to subdivision 2 and rules prescribed by the state 428.23commissioner of health. Testing and the recording and reporting of test results shall be 428.24performed at the times and in the manner prescribed by the commissioner of health. The 428.25commissioner shall charge laboratory service fees a fee so that the total of fees collected 428.26will approximate the costs of conducting the tests and implementing and maintaining 428.27a system to follow-up infants with heritable or congenital disorders. The laboratory 428.28service fee is $61 $101 per specimen. Costs associated with capital expenditures and 428.29the development of new procedures may be prorated over a three-year period when 428.30calculating the amount of the fees. 428.31    Subd. 2. Determination of tests to be administered. The commissioner shall 428.32periodically revise the list of tests to be administered for determining the presence of a 428.33heritable or congenital disorder. Revisions to the list shall reflect advances in medical 428.34science, new and improved testing methods, or other factors that will improve the public 428.35health. In determining whether a test must be administered, the commissioner shall take 429.1into consideration the adequacy of laboratory analytical methods to detect the heritable 429.2or congenital disorder, the ability to treat or prevent medical conditions caused by the 429.3heritable or congenital disorder, and the severity of the medical conditions caused by the 429.4heritable or congenital disorder. The list of tests to be performed may be revised if the 429.5changes are recommended by the advisory committee established under section 
         144.1255, 429.6approved by the commissioner, and published in the State Register. The revision is 429.7exempt from the rulemaking requirements in chapter 14, and sections 
         14.385 and 
         14.386429.8do not apply. 429.9    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under 429.10subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to 429.11perform testing thereunder as well as the results of such testing may be retained by the 429.12Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that 429.13the following options are available to them with respect to the testing: (i) to decline to 429.14have the tests, or (ii) to elect to have the tests but to require that all blood samples and 429.15records of test results be destroyed within 24 months of the testing. If the parents of 429.16an infant object in writing to testing for heritable and congenital disorders or elect to 429.17require that blood samples and test results be destroyed, the objection or election shall 429.18be recorded on a form that is signed by a parent or legal guardian and made part of the 429.19infant's medical record. A written objection exempts an infant from the requirements of 429.20this section and section 
         144.128. 429.21    Sec. 9. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to read:429.22    Subdivision 1. Establishment.Within the limits of available appropriations, the 429.23commissioner of health shall establish and maintain an information system containing data 429.24on the cause, treatment, prevention, and cure of major birth defects. The commissioner 429.25shall consult with representatives and experts in epidemiology, medicine, insurance, 429.26health maintenance organizations, genetics, consumers, and voluntary organizations in 429.27developing the system and may phase in the implementation of the system. After the 429.28parents have provided informed consent under section 144.2216, subdivision 4, the 429.29commissioner shall offer the parents with their informed consent a visit by a trained health 429.30care worker to interview the parents about:429.31    (1) all previous home addresses, occupations, and places of work including from 429.32childhood;429.33    (2) the time and place of any military service; and429.34    (3) known occasions or sites of toxic exposures.430.1    Sec. 10. Minnesota Statutes 2006, section 144.672, subdivision 1, is amended to read:430.2    Subdivision 1. Rule authority. The commissioner of health shall collect cancer 430.3incidence information, analyze the information, and conduct special studies designed to 430.4determine the potential public health significance of an increase in cancer incidence.430.5    The commissioner shall adopt rules to administer the system, collect information, 430.6and distribute data. The rules must include, but not be limited to, the following:430.7    (1) the type of data to be reported, which must include current and previous 430.8occupational data;430.9    (2) standards for reporting specific types of data;430.10    (3) payments allowed to hospitals, pathologists, and registry systems to defray their 430.11costs in providing information to the system;430.12    (4) criteria relating to contracts made with outside entities to conduct studies using 430.13data collected by the system. The criteria may include requirements for a written protocol 430.14outlining the purpose and public benefit of the study, the description, methods, and 430.15projected results of the study, peer review by other scientists, the methods and facilities 430.16to protect the privacy of the data, and the qualifications of the researcher proposing to 430.17undertake the study; and430.18    (5) specification of fees to be charged under section 
         13.03, subdivision 3, for all 430.19out-of-pocket expenses for data summaries or specific analyses of data requested by 430.20public and private agencies, organizations, and individuals, and which are not otherwise 430.21included in the commissioner's annual summary reports. Fees collected are appropriated 430.22to the commissioner to offset the cost of providing the data.430.23    Sec. 11. Minnesota Statutes 2006, section 144.9502, subdivision 3, is amended to read:430.24    Subd. 3. Reports of blood lead analysis required. (a) Every hospital, medical 430.25clinic, medical laboratory, other facility, or individual performing blood lead analysis 430.26shall report the results after the analysis of each specimen analyzed, for both capillary 430.27and venous specimens, and epidemiologic information required in this section to the 430.28commissioner of health, within the time frames set forth in clauses (1) and (2):430.29    (1) within two working days by telephone, fax, or electronic transmission, with 430.30written or electronic confirmation within one month, for a venous blood lead level equal to 430.31or greater than 15 ten micrograms of lead per deciliter of whole blood; or430.32    (2) within one month in writing or by electronic transmission, for any capillary 430.33result or for a venous blood lead level less than 15 ten micrograms of lead per deciliter of 430.34whole blood.431.1    (b) If a blood lead analysis is performed outside of Minnesota and the facility 431.2performing the analysis does not report the blood lead analysis results and epidemiological 431.3information required in this section to the commissioner, the provider who collected the 431.4blood specimen must satisfy the reporting requirements of this section. For purposes of 431.5this section, "provider" has the meaning given in section 
         62D.02, subdivision 9. 431.6    (c) The commissioner shall coordinate with hospitals, medical clinics, medical 431.7laboratories, and other facilities performing blood lead analysis to develop a universal 431.8reporting form and mechanism.431.9    Sec. 12. Minnesota Statutes 2006, section 144.9504, subdivision 2, is amended to read:431.10    Subd. 2. Lead risk assessment. (a) An assessing agency shall conduct a lead risk 431.11assessment of a residence according to the venous blood lead level and time frame set 431.12forth in clauses (1) to (4) for purposes of secondary prevention:431.13    (1) within 48 hours of a child or pregnant female in the residence being identified to 431.14the agency as having a venous blood lead level equal to or greater than 60 45 micrograms 431.15of lead per deciliter of whole blood;431.16    (2) within five working days of a child or pregnant female in the residence being 431.17identified to the agency as having a venous blood lead level equal to or greater than 45 15431.18micrograms of lead per deciliter of whole blood;431.19    (3) within ten working days of a child in the residence being identified to the agency 431.20as having a venous blood lead level equal to or greater than 15 ten micrograms of lead 431.21per deciliter of whole blood; or431.22    (4) within ten working days of a pregnant female in the residence being identified to 431.23the agency as having a venous blood lead level equal to or greater than ten micrograms of 431.24lead per deciliter of whole blood.431.25    (b) Within the limits of available local, state, and federal appropriations, an assessing 431.26agency may also conduct a lead risk assessment for children with any elevated blood 431.27lead level.431.28    (c) In a building with two or more dwelling units, an assessing agency shall assess 431.29the individual unit in which the conditions of this section are met and shall inspect all 431.30common areas accessible to a child. If a child visits one or more other sites such as another 431.31residence, or a residential or commercial child care facility, playground, or school, the 431.32assessing agency shall also inspect the other sites. The assessing agency shall have one 431.33additional day added to the time frame set forth in this subdivision to complete the lead 431.34risk assessment for each additional site.432.1    (d) Within the limits of appropriations, the assessing agency shall identify the 432.2known addresses for the previous 12 months of the child or pregnant female with venous 432.3blood lead levels of at least 15 ten micrograms per deciliter for the child or at least ten 432.4micrograms per deciliter for the pregnant female; notify the property owners, landlords, 432.5and tenants at those addresses that an elevated blood lead level was found in a person 432.6who resided at the property; and give them primary prevention information. Within the 432.7limits of appropriations, the assessing agency may perform a risk assessment and issue 432.8corrective orders in the properties, if it is likely that the previous address contributed to 432.9the child's or pregnant female's blood lead level. The assessing agency shall provide the 432.10notice required by this subdivision without identifying the child or pregnant female with 432.11the elevated blood lead level. The assessing agency is not required to obtain the consent of 432.12the child's parent or guardian or the consent of the pregnant female for purposes of this 432.13subdivision. This information shall be classified as private data on individuals as defined 432.14under section 
         13.02, subdivision 12.432.15    (e) The assessing agency shall conduct the lead risk assessment according to rules 432.16adopted by the commissioner under section 
         144.9508. An assessing agency shall have 432.17lead risk assessments performed by lead risk assessors licensed by the commissioner 432.18according to rules adopted under section 
         144.9508. If a property owner refuses to allow 432.19a lead risk assessment, the assessing agency shall begin legal proceedings to gain entry 432.20to the property and the time frame for conducting a lead risk assessment set forth in this 432.21subdivision no longer applies. A lead risk assessor or assessing agency may observe the 432.22performance of lead hazard reduction in progress and shall enforce the provisions of this 432.23section under section 
         144.9509. Deteriorated painted surfaces, bare soil, and dust must be 432.24tested with appropriate analytical equipment to determine the lead content, except that 432.25deteriorated painted surfaces or bare soil need not be tested if the property owner agrees to 432.26engage in lead hazard reduction on those surfaces. The lead content of drinking water 432.27must be measured if another probable source of lead exposure is not identified. Within a 432.28standard metropolitan statistical area, an assessing agency may order lead hazard reduction 432.29of bare soil without measuring the lead content of the bare soil if the property is in a 432.30census tract in which soil sampling has been performed according to rules established by 432.31the commissioner and at least 25 percent of the soil samples contain lead concentrations 432.32above the standard in section 
         144.9508.432.33    (f) Each assessing agency shall establish an administrative appeal procedure which 432.34allows a property owner to contest the nature and conditions of any lead order issued by 432.35the assessing agency. Assessing agencies must consider appeals that propose lower cost 433.1methods that make the residence lead safe. The commissioner shall use the authority and 433.2appeal procedure granted under sections 
         144.989 to 
         144.993.433.3    (g) Sections 
         144.9501 to 
         144.9509 neither authorize nor prohibit an assessing agency 433.4from charging a property owner for the cost of a lead risk assessment.433.5    Sec. 13. Minnesota Statutes 2006, section 144.9507, is amended by adding a 433.6subdivision to read:433.7    Subd. 6.Medical assistance.Medical assistance reimbursement for lead risk 433.8assessment services under section 256B.0625, subdivision 49, shall not be used to replace 433.9or decrease existing state or local funding for lead services and lead-related activities.433.10    Sec. 14. Minnesota Statutes 2006, section 144.9512, is amended to read:433.11144.9512 LEAD ABATEMENT PROGRAM.433.12    Subdivision 1. Definitions. (a) The definitions in section 
         144.9501 and in this 433.13subdivision apply to this section.433.14    (b) "Eligible organization" means a lead contractor, city, board of health, community 433.15health department, community action agency as defined in section 256E.30, or community 433.16development corporation.433.17    (c) "Commissioner" means the commissioner of health, or the commissioner of the 433.18Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.433.19    Subd. 2. Grants; administration. Within the limits of the available appropriation, 433.20the commissioner must develop a swab team services program which may shall make 433.21demonstration and training grants to eligible organizationsa nonprofit organization 433.22currently operating the CLEARCorps lead hazard reduction project to train workers to 433.23provide swab team services and swab team services for residential property. Grants may 433.24be awarded to nonprofit organizations to provide technical assistance and training to 433.25ensure quality and consistency within the statewide program. Grants must be awarded to 433.26help ensure full-time employment to workers providing swab team services and must be 433.27awarded for a two-year period.433.28    Grants awarded under this section must be made in consultation with the 433.29commissioner of the Housing Finance Agency and representatives of neighborhood 433.30groups from areas at high risk for toxic lead exposure, a labor organization, the lead 433.31coalition, community action agencies, and the legal aid society. The consulting team must 433.32review grant applications and recommend awards to eligible organizations that meet 433.33requirements for receiving a grant under this section.434.1    Subd. 3.Applicants.(a) Interested eligible organizations may apply to the 434.2commissioner for grants under this section. Two or more eligible organizations may 434.3jointly apply for a grant. Priority shall be given to community action agencies in greater 434.4Minnesota and to either community action agencies or neighborhood based nonprofit 434.5organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may 434.6be used for administrative purposes. The commissioner may deviate from this percentage 434.7if a grantee can justify the need for a larger administrative allowance. Of this amount, 434.8up to five percent may be used by the commissioner for state administrative purposes. 434.9Applications must provide information requested by the commissioner, including at least 434.10the information required to assess the factors listed in paragraph (d).434.11    (b) The commissioner must consult with boards of health to provide swab team 434.12services for purposes of secondary prevention. The priority for swab teams created 434.13by grants to eligible organizations under this section must be work assigned by the 434.14commissioner of health, or by a board of health if so designated by the commissioner of 434.15health, to provide secondary prevention swab team services to fulfill the requirements 434.16of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned 434.17work under this section by the commissioner, that are not engaged daily in fulfilling the 434.18requirements of section 144.9504, subdivision 6, must deliver swab team services in 434.19response to elevated blood lead levels as defined in section 144.9501, subdivision 9, 434.20where lead orders were not issued, and for purposes of primary prevention in census 434.21tracts known to be in areas at high risk for toxic lead exposure as described in section 434.22144.9503, subdivision 2.434.23    (c) Any additional money must be used for grants to establish swab teams for 434.24primary prevention under section 144.9503, in census tracts in areas at high risk for toxic 434.25lead exposure as determined under section 144.9503, subdivision 2.434.26    (d) In evaluating grant applications, the commissioner must consider the following 434.27criteria:434.28    (1) the use of lead contractors and lead workers for residential swab team services;434.29    (2) the participation of neighborhood groups and individuals, as swab team workers, 434.30in areas at high risk for toxic lead exposure;434.31    (3) plans for the provision of swab team services for primary and secondary 434.32prevention as required under subdivision 4;434.33    (4) plans for supervision, training, career development, and postprogram placement 434.34of swab team members;434.35    (5) plans for resident and property owner education on lead safety;435.1    (6) plans for distributing cleaning supplies to area residents and educating residents 435.2and property owners on cleaning techniques;435.3    (7) sources of other funding and cost estimates for training, lead inspections, swab 435.4team services, equipment, monitoring, testing, and administration;435.5    (8) measures of program effectiveness;435.6    (9) coordination of program activities with other federal, state, and local public 435.7health, job training, apprenticeship, and housing renovation programs including programs 435.8under sections 116L.86 to 116L.881; and435.9    (10) prior experience in providing swab team services.435.10    Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible 435.11organizations and lead supervisors or certified firms may participate in the swab team 435.12program. An eligible organization The nonprofit receiving a grant under this section 435.13must assure ensure that all participating lead supervisors or certified firms are licensed 435.14and that all swab team workers are certified by the Department of Health under section 435.15144.9505
         . Eligible organizations and lead supervisors or certified firms may distinguish 435.16between interior and exterior services in assigning duties and The nonprofit organization435.17may participate in the program by: 435.18    (1) providing on-the-job training for swab team workers;435.19    (2) providing swab team services to meet the requirements of sections 
         144.9503, 435.20subdivision 4
         , and 
         144.9504, subdivision 6; 435.21    (3) providing a removal and replacement component using skilled craft workers 435.22under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501, 435.23subdivision 17;435.24    (4) providing lead testing according to subdivision 8;435.25    (5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as 435.26described in section 
         144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or435.27    (6) (5) having a swab team worker instruct residents and property owners on 435.28appropriate lead control techniques, including the lead-safe directives developed by the 435.29commissioner of health.;435.30    (6) conducting blood lead testing events including screening children and pregnant 435.31women according to Department of Health screening guidelines;435.32    (7) performing case management services according to Department of Health case 435.33management guidelines; or435.34    (8) conducting mandated risk assessments under Minnesota Statutes, section 435.35144.9504, subdivision 2.435.36    (b) Participating lead supervisors or certified firms must:436.1    (1) demonstrate proof of workers' compensation and general liability insurance 436.2coverage;436.3    (2) be knowledgeable about lead abatement requirements established by the 436.4Department of Housing and Urban Development and the Occupational Safety and Health 436.5Administration and lead hazard reduction requirements and lead-safe directives of the 436.6commissioner of health;436.7    (3) demonstrate experience with on-the-job training programs;436.8    (4) demonstrate an ability to recruit employees from areas at high risk for toxic 436.9lead exposure; and436.10    (5) demonstrate experience in working with low-income clients.436.11    Subd. 5. Swab team workers. Each worker engaged in swab team services 436.12established under this section must have blood lead concentrations below 15 micrograms 436.13of lead per deciliter of whole blood as determined by a baseline blood lead screening. 436.14Any The nonprofit organization receiving a grant under this section is responsible for lead 436.15screening and must assure ensure that all swab team workers meet the standards established 436.16in this subdivision. Grantees The nonprofit organization must use appropriate workplace 436.17procedures including following the lead-safe directives developed by the commissioner of 436.18health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization436.19and participating contractors must report all employee blood lead levels that exceed 15 436.20micrograms of lead per deciliter of whole blood to the commissioner of health.436.21    Subd. 6.On-the-job training component.(a) Programs established under this 436.22section must provide on-the-job training for swab team workers.436.23    (b) Swab team workers must receive monetary compensation equal to the prevailing 436.24wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed 436.25contractor's principal business. 436.26    Subd. 7.Removal and replacement component.(a) Within the limits of the 436.27available appropriation and if a need is identified by a lead inspector, the commissioner 436.28may establish a component for removal and replacement of deteriorated paint in residential 436.29properties according to the following criteria:436.30    (1) components within a residence must have both deteriorated lead-based paint and 436.31substrate damage beyond repair or rotting wooden framework to be eligible for removal 436.32and replacement;436.33    (2) all removal and replacement must be done using least-cost methods and 436.34following lead-safe directives;436.35    (3) whenever windows and doors or other components covered with deteriorated 436.36lead-based paint have sound substrate or are not rotting, those components should be 437.1repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or 437.2covered with protective guards instead of being replaced, provided that such an activity is 437.3the least-cost method of providing the swab team service;437.4    (4) removal and replacement or repair must be done by lead contractors using skilled 437.5craft workers or trained swab team members; and437.6    (5) all craft work that requires a state license must be supervised by a person with 437.7a state license in the craft work being supervised. The grant recipient may contract for 437.8this supervision.437.9    (b) The program design must:437.10    (1) identify the need for on-the-job training of swab team workers to be removal and 437.11replacement workers; and437.12    (2) describe plans to involve appropriate groups in designing methods to meet the 437.13need for training swab team workers.437.14    Subd. 8.Testing and evaluation.(a) Testing of the environment is not necessary 437.15by swab teams whose work is assigned by the commissioner of health or a designated 437.16board of health under section 144.9504. The commissioner of health or designated board 437.17of health must share the analytical testing data collected on each residence for purposes 437.18of secondary prevention under section 144.9504 with the swab team workers in order to 437.19provide constructive feedback on their work and to the commissioner for the purposes 437.20set forth in paragraph (c).437.21    (b) For purposes of primary prevention evaluation, the following samples must be 437.22collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a 437.23notation of the extent and location of bare soil and of deteriorated lead-based paint. The 437.24analytical testing data collected on each residence for purposes of primary prevention 437.25under section 144.9503 must be shared with the swab team workers in order to provide 437.26constructive feedback on their work and to the commissioner for the purposes set forth in 437.27paragraph (c).437.28    (c) The commissioner of health must establish a program to collect appropriate data 437.29as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of 437.30swab team services for primary and secondary prevention. Within the limits of available 437.31appropriations, the commissioner of health must conduct on up to 1,000 residences which 437.32have received primary or secondary prevention swab team services, a postremediation 437.33evaluation, on at least a quarterly basis for a period of at least two years for each residence. 437.34The evaluation must note the condition of the paint within the residence, the extent of bare 437.35soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample. 437.36The data collected must be evaluated to determine the efficacy of providing swab team 438.1services as a method of reducing lead exposure in young children. In evaluating this data, 438.2the commissioner of health must consider city size, community location, historic traffic 438.3flow, soil lead level of the property by area or census tract, distance to industrial point 438.4sources that emit lead, season of the year, age of the housing, age and number of children 438.5living at the residence, the presence of pets that move in and out of the residence, and 438.6other relevant factors as the commissioner of health may determine.438.7    Subd. 9. Program benefits. As a condition of providing swab team services under 438.8this section, an the nonprofit organization may require a property owner to not increase 438.9rents on a property solely as a result of a substantial improvement made with public 438.10funds under the programs in this section.438.11    Subd. 10. Requirements of organizations receiving grants the nonprofit 438.12organization.An eligible The nonprofit organization that is awarded a training and 438.13demonstration grant under this section must prepare and submit a quarterly progress report 438.14to the commissioner beginning three months after receipt of the grant.438.15    Sec. 15. [144.966] EARLY HEARING DETECTION AND INTERVENTION 438.16ACT.438.17    Subdivision 1.Definitions.(a) "Child" means a person 18 years of age or younger.438.18    (b) "False positive rate" means the proportion of infants identified as having a 438.19significant hearing loss by the screening process who are ultimately found to not have a 438.20significant hearing loss.438.21    (c) "False negative rate" means the proportion of infants not identified as having 438.22a significant hearing loss by the screening process who are ultimately found to have a 438.23significant hearing loss.438.24    (d) "Hearing screening test" means automated auditory brain stem response, 438.25otoacoustic emissions, or another appropriate screening test approved by the Department 438.26of Health.438.27    (e) "Hospital" means a birthing health care facility or birthing center licensed in 438.28this state that provides obstetrical services.438.29    (f) "Infant" means a child who is not a newborn and has not attained the age of 438.30one year.438.31    (g) "Newborn" means an infant 28 days old or younger.438.32    (h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or 438.33custodian of a newborn or infant.439.1    Subd. 2.Newborn Hearing Screening Advisory Committee.(a) The 439.2commissioner of health shall appoint a Newborn Hearing Screening Advisory Committee 439.3to advise and assist the Department of Health and the Department of Education in:439.4    (1) developing protocols and timelines for screening, rescreening, and diagnostic 439.5audiological assessment and early medical, audiological, and educational intervention 439.6services for children who are deaf or hard-of-hearing;439.7    (2) designing protocols for tracking children from birth through age three that may 439.8have passed newborn screening but are at risk for delayed or late onset of permanent 439.9hearing loss;439.10    (3) designing a technical assistance program to support facilities implementing the 439.11screening program and facilities conducting rescreening and diagnostic audiological 439.12assessment;439.13    (4) designing implementation and evaluation of a system of follow-up and tracking; 439.14and439.15    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure 439.16culturally appropriate services for children with a confirmed hearing loss and their families.439.17    (b) Membership of the committee shall include at least one member from each of the 439.18following groups with no less than two of the members being deaf or hard-of-hearing:439.19    (1) a representative from a consumer organization representing culturally deaf 439.20persons;439.21    (2) a parent with a child with hearing loss representing a parent organization;439.22    (3) a consumer from an organization representing oral communication options;439.23    (4) a consumer from an organization representing cued speech communication 439.24options;439.25    (5) an audiologist who has experience in evaluation and intervention of infants 439.26and young children;439.27    (6) a speech-language pathologist who has experience in evaluation and intervention 439.28of infants and young children;439.29    (7) two primary care providers who have experience in the care of infants and young 439.30children, one of which shall be a pediatrician;439.31    (8) a representative from the early hearing detection intervention teams;439.32    (9) a representative from the Department of Education resource center for the deaf 439.33and hard-of-hearing or their designee;439.34    (10) a representative of the Minnesota Commission Serving Deaf and Hard of 439.35Hearing People;440.1    (11) a representative from the Department of Human Services Deaf and Hard of 440.2Hearing Services Division;440.3    (12) one or more of the Part C coordinators from the Department of Education, the 440.4Department of Health, or the Department of Human Services or their designee;440.5    (13) the Department of Health early hearing detection and intervention coordinator;440.6    (14) two birth hospital representatives from one rural and one urban hospital;440.7    (15) a pediatric geneticist;440.8    (16) an otolaryngologist;440.9    (17) a representative from the Newborn Screening Advisory Committee under 440.10this subdivision; and440.11    (18) a representative of the Department of Education regional low-incidence 440.12facilitators.440.13    The Department of Health member shall chair the first meeting of the committee. 440.14At the first meeting, the committee shall elect a chairperson from its membership. The 440.15committee shall meet at the call of the chairperson, at least four times a year. The 440.16committee shall adopt written bylaws to govern its activities. The Department of Health 440.17shall provide technical and administrative support services as required by the committee. 440.18These services shall include technical support from individuals qualified to administer 440.19infant hearing screening, rescreening, and diagnostic audiological assessments.440.20    Members of the committee shall receive no compensation for their service, but 440.21shall be reimbursed for expenses incurred as a result of their duties as members of the 440.22committee.440.23    Subd. 3.Newborn and infant hearing screening programs.All hospitals shall 440.24establish a Universal Newborn Hearing and Infant Screening (UNHS) program. Each 440.25UNHS program shall:440.26    (1) in advance of any hearing screening testing, provide to the newborn's or infant's 440.27parents information concerning the nature of the screening procedure, applicable costs of 440.28the screening procedure, the potential risks and effects of hearing loss, and the benefits of 440.29early detection and intervention;440.30    (2) comply with parental consent under section 144.125, subdivision 3;440.31    (3) develop policies and procedures for screening and rescreening based on 440.32Department of Health recommendations;440.33    (4) provide appropriate training and monitoring of individuals responsible for 440.34performing hearing screening tests as recommended by the Department of Health;441.1    (5) test the newborn's hearing prior to discharge, or, if the newborn is expected to 441.2remain in the hospital for a prolonged period, testing shall be performed prior to three 441.3months of age, or when medically feasible;441.4    (6) develop and implement procedures for documenting the results of all hearing 441.5screening tests;441.6    (7) inform the baby's parents or parent, primary care physician, and the Department 441.7of Health according to recommendations of the Department of Health of the results of the 441.8hearing screening test or rescreening if conducted, or if the newborn or infant was not 441.9successfully tested. The hospital that discharges the baby to home is responsible for 441.10the screening; and441.11    (8) collect performance data specified by the Department of Health. 441.12    Subd. 4.Notification and information.(a) Notification to the parents, primary 441.13care provider, and Department of Health shall occur prior to discharge or no later than ten 441.14days following the date of testing. Notification shall include information recommended by 441.15the Department of Health.441.16    (b) A physician, nurse, midwife, or other health professional attending a birth outside 441.17a hospital or institution shall provide information, orally and in writing, as established by 441.18the Department of Health, to parents regarding places where the parents may have their 441.19infants' hearing screened and the importance of such screening.441.20    (c) The professional conducting the diagnostic procedure to confirm the hearing loss 441.21must report the results to the parents, primary care provider, and Department of Health 441.22according to the Department of Health recommendations.441.23    Subd. 5.Oversight responsibility.The Department of Health shall exercise 441.24oversight responsibility for UNHS programs, including establishing a performance data 441.25set and reviewing performance data collected by each hospital.441.26    Subd. 6.Civil and criminal immunity and penalties.(a) No physician or hospital 441.27shall be civilly or criminally liable for failure to conduct hearing screening testing.441.28    (b) No physician, midwife, nurse, other health professional, or hospital acting in 441.29compliance with this section shall be civilly or criminally liable for any acts conforming 441.30with this section, including furnishing information required according to this section.441.31    Subd. 7.Laboratory service fees.The commissioner shall charge laboratory 441.32service fees according to section 16A.1285 so that the total of fees collected will 441.33approximate the costs of implementing and maintaining a system to follow up infants, 441.34provide technical assistance, a tracking system, data management, and evaluation.441.35EFFECTIVE DATE.This section is effective the day following final enactment.442.1    Sec. 16. [144.967] ARSENIC HEALTH RISK STANDARD.442.2    Subdivision 1.Arsenic health risk standard established.The commissioner of 442.3health in cooperation with the commissioners of agriculture and the Pollution Control 442.4Agency responsible for monitoring land and water cleanup and soil contamination 442.5information shall determine a health risk standard for human exposure to arsenic. The 442.6commissioner of health shall ensure that the established arsenic health risk standard is 442.7included in all information provided to the public.442.8    Subd. 2.Information.The commissioner of health, in consultation with the 442.9commissioners of agriculture and the Pollution Control Agency with jurisdiction over 442.10soil and water contamination, shall establish a central information source available to 442.11the public to provide accurate information on arsenic soil and water contamination in 442.12residential areas.442.13    Subd. 3.Testing for arsenic.(a) The commissioner of health shall ensure access 442.14to medical testing for arsenical pesticide exposure to persons living within one mile of 442.15the CMC Heartland Lite Yard Superfund site who are not covered by health insurance or 442.16medical assistance.442.17    (b) Through an agreement with the United States Environmental Protection Agency, 442.18the commissioner shall ensure soil testing is available to households within one mile of the 442.19CMC Heartland Lite Yard Superfund site at no cost to the residents.442.20    Subd. 4.Evaluation.The commissioner of health shall evaluate the cumulative 442.21health impact burdens of environmental toxins in the residential communities impacted by 442.22arsenic-contaminated soil from the CMC Heartland Lite Yard Superfund site. The first 442.23priority shall be to evaluate health burdens to those communities experiencing health 442.24disparities as documented by the Minority and Multicultural Health Division of the 442.25Minnesota Department of Health.442.26    Sec. 17. [144.995] DEFINITIONS.442.27    (a) For purposes of sections 144.995 to 144.998, the terms in this section have 442.28the meanings given.442.29    (b) "Advisory panel" means the Environmental Health Tracking and Biomonitoring 442.30Advisory Panel established under section 144.998.442.31    (c) "Biomonitoring" means the process by which chemicals and their metabolites are 442.32identified and measured within a biospecimen.442.33    (d) "Biospecimen" means a sample of human fluid, serum, or tissue that is reasonably 442.34available as a medium to measure the presence and concentration of chemicals or their 442.35metabolites in a human body.443.1    (e) "Commissioner" means the commissioner of the Department of Health.443.2    (f) "Community" means geographically or nongeographically-based populations 443.3that may participate in the biomonitoring program. A "nongeographical community" 443.4includes, but is not limited to, populations that may share a common chemical exposure 443.5through similar occupations, populations experiencing a common health outcome that 443.6may be linked to chemical exposures, or populations that may experience similar chemical 443.7exposures because of comparable consumption, lifestyle, product use, or subpopulations 443.8that share ethnicity, age, or gender.443.9    (g) "Department" means the Department of Health.443.10    (h) "Designated chemicals" means those chemicals that are known to, or strongly 443.11suspected of, adversely impacting human health or development, based upon scientific, 443.12peer-reviewed animal, human, or in vitro studies, and baseline human exposure data, 443.13and consists of chemical families or metabolites that are included in the federal Centers 443.14for Disease Control and Prevention studies that are known collectively as the National 443.15Reports on Human Exposure to Environmental Chemicals program and any substances 443.16specified under section 144.998, subdivision 3, clause (6).443.17    (i) "Environmental hazard" means a chemical, metal, or other substance for which 443.18scientific, peer-reviewed studies of humans, animals, or cells have demonstrated that the 443.19chemical is known or reasonably anticipated to adversely impact human health.443.20    (j) "Environmental health tracking" means collection, integration, analysis, and 443.21dissemination of data on human exposures to  chemicals in the environment and on 443.22diseases potentially caused or aggravated by those chemicals.443.23    Sec. 18. [144.996] ENVIRONMENTAL HEALTH TRACKING; 443.24BIOMONITORING.443.25    Subdivision 1.Environmental health tracking.In cooperation with the 443.26commissioner of the Pollution Control Agency, the commissioner shall establish an 443.27environmental health tracking program to:443.28    (1) coordinate data collection activities with the Pollution Control Agency, 443.29Department of Agriculture, University of Minnesota, and any other relevant state agency 443.30and work to promote the sharing of and access to health and environmental databases 443.31in order to develop an environmental health tracking system for Minnesota, consistent 443.32with applicable data practices laws;443.33    (2) facilitate the dissemination of public health tracking data to the public and 443.34researchers in accessible format and provide technical assistance on interpreting the data;444.1    (3) develop written data sharing agreements with the Minnesota Pollution Control 444.2Agency, Department of Agriculture, and other relevant state agencies and organizations, 444.3and develop additional procedures as needed to protect individual privacy;444.4    (4) develop a strategic plan that includes a mission statement, the identification of 444.5core priorities for research and epidemiologic surveillance, the identification of internal 444.6and external stakeholders, and a work plan describing future program development;444.7    (5) organize, analyze, and interpret available data, in order to:444.8    (i) characterize statewide and localized trends and geographic patterns of prevalence 444.9and incidence of chronic diseases, including, but not limited to, cancer, respiratory 444.10diseases, reproductive problems, birth defects, neurologic diseases, and developmental 444.11disorders;444.12    (ii) recommend to the commissioner methods to improve data collection on 444.13statewide population rates of chronic diseases and the occurrence of environmental 444.14hazards and exposures;444.15    (iii) characterize statewide and localized trends and geographic patterns in the 444.16occurrence of environmental hazards and exposures;444.17    (iv) assess the level of correlation with disease rate data and indicators of exposure 444.18such as biomonitoring data, and other health and environmental data;444.19    (v) incorporate newly collected and existing health tracking and biomonitoring 444.20data into efforts to identify communities with elevated rates of chronic disease, higher 444.21likelihood of exposure to environmental pollutants, or both;444.22    (vi) analyze occurrence of environmental hazards, exposures, and diseases with 444.23relation to socioeconomic status, race, and ethnicity;444.24    (vii) develop and implement targeted plans to conduct more intensive health tracking 444.25and biomonitoring among communities;444.26    (viii) work with the Pollution Control Agency, the Department of Agriculture, and 444.27other relevant state agency personnel and organizations to develop, implement, and 444.28evaluate preventive measures to reduce elevated rates of diseases and exposures identified 444.29through activities performed under sections 144.995 to 144.998; and444.30    (ix) provide baseline data and present descriptive information relevant to policy 444.31formation that are consistent with existing goals of the department; and444.32    (6) submit a biennial report to the legislature by January 15, beginning January 444.3315, 2009, on the status of environmental health tracking activities and related research 444.34programs, and making recommendations regarding the continuation and improvement of 444.35the programs.444.36    Subd. 2.Biomonitoring.The commissioner shall:445.1    (1) conduct biomonitoring of communities on a voluntary  basis by collecting and 445.2analyzing biospecimens, as appropriate, to assess environmental exposures to designated 445.3chemicals;445.4    (2) conduct biomonitoring of pregnant women and minors on a voluntary basis, 445.5when scientifically appropriate; 445.6    (3) communicate findings to the public, and plan ensuing stages of biomonitoring 445.7and disease tracking work to further develop and refine the integrated analysis;445.8    (4) share analytical results with the advisory panel and work with the panel 445.9to interpret results, communicate findings to the public, and plan ensuing stages of 445.10biomonitoring work; and445.11    (5) submit a biennial report to the legislature by January 15, beginning January 445.1215, 2009, on the status of the biomonitoring program and any recommendations for 445.13improvement.445.14    Subd. 3.Health data.Data collected under the biomonitoring program are health 445.15data under section 13.3805.445.16    Sec. 19. [144.997] BIOMONITORING PILOT PROGRAM.445.17    Subdivision 1.Pilot program.With advice from the advisory panel, the 445.18commissioner shall develop a biomonitoring pilot program. The program shall collect 445.19one biospecimen from each of the voluntary participants. The biospecimen selected must 445.20be the biospecimen that most accurately represents body concentration of the chemical 445.21of interest. Each biospecimen from the voluntary participants must be analyzed for one 445.22type or class of related chemicals or metals, based on recommendations from the advisory 445.23panel. The panel shall determine the chemical or class of chemicals that community 445.24members were most likely exposed to. The program shall collect and assess biospecimens 445.25in accordance with the following: 445.26    (1) 30 voluntary participants from each of three communities that the advisory panel 445.27identifies as likely to have been exposed to a designated chemical; 445.28    (2) 100 voluntary participants from each of two communities: (i) that the advisory 445.29panel identifies as likely to have been exposed to arsenic and (ii) that the advisory panel 445.30identifies as likely to have been exposed to mercury; and 445.31    (3) 100 voluntary participants from each of two communities that the advisory panel 445.32identifies as likely to have been exposed to perfluorinated chemicals.445.33    Subd. 2.Base program.Following the conclusion of the pilot program and within 445.34the appropriations available, the program shall:446.1    (1) collect and assess biospecimens from at least as many voluntary participants and 446.2communities as identified in subdivision 1, clause (1); and446.3    (2) work with the advisory panel to assess the usefulness of continuing biomonitoring 446.4among members of communities assessed during the initial phase of the program, 446.5and to identify other communities and other designated chemicals to be assessed via 446.6biomonitoring.446.7    Subd. 3.Participation.(a) Participation in the biomonitoring program by providing 446.8biospecimens is voluntary and requires written, informed consent. Minors may participate 446.9in the program if a written consent is signed by the minor's parent or legal guardian. 446.10The written consent must include the information required to be provided under this 446.11subdivision to all voluntary participants.446.12    (b) All participants shall be evaluated for the presence of the designated chemical 446.13of interest as a component of the biomonitoring process. Participants shall be provided 446.14with information and fact sheets about the program's activities and its findings. 446.15Individual participants shall, if requested, receive their complete results. Any results 446.16provided to participants shall be subject to the Department of Health Institutional 446.17Review Board protocols and guidelines. When either physiological or chemical data 446.18obtained from a participant indicate a significant known health risk, program staff 446.19experienced in communicating biomonitoring results shall consult with the individual 446.20and recommend follow-up steps, as appropriate. Program administrators shall receive 446.21training in administering the program in an ethical, culturally sensitive, participatory, 446.22and community-based manner.446.23    Subd. 4.Program guidelines.(a) The commissioner, in consultation with the 446.24advisory panel, shall develop:446.25    (1) protocols or program guidelines that address the science and practice of 446.26biomonitoring to be utilized and procedures for changing those protocols to incorporate 446.27new and more accurate or efficient technologies as they become available. The protocols 446.28shall be developed utilizing a peer-review process in a manner that is participatory and 446.29community-based in design, implementation, and evaluation;446.30    (2) guidelines for ensuring the privacy of information; informed consent; follow-up 446.31counseling and support; and communicating findings to participants, communities, and 446.32the general public. The informed consent used for the program must meet the informed 446.33consent protocols developed by the National Institutes of Health;446.34    (3) educational and outreach materials that are culturally appropriate for 446.35dissemination to program participants and communities. Priority shall be given to the 446.36development of materials specifically designed to ensure that parents are informed about 447.1all of the benefits of breastfeeding so that the program does not result in an unjustified fear 447.2of toxins in breast milk, which might inadvertently lead parents to avoid breastfeeding. 447.3The materials shall communicate relevant scientific findings; data on the accumulation 447.4of pollutants to community health; and the required responses by local, state, and other 447.5governmental entities in regulating toxicant exposures;447.6    (4) a training program that is culturally sensitive specifically for health care 447.7providers, health educators, and other program administrators; 447.8    (5) a designation process for state and private laboratories that are qualified to 447.9analyze biospecimens and report the findings; and 447.10    (6) a method for informing affected communities and local governments representing 447.11those communities concerning biomonitoring activities and for receiving comments from 447.12citizens concerning those activities.447.13    (b) The commissioner may enter into contractual agreements with health clinics, 447.14community-based organizations, or experts in a particular field to perform any of the 447.15activities described under this section.447.16    Sec. 20. [144.998] ENVIRONMENTAL HEALTH TRACKING AND 447.17BIOMONITORING ADVISORY PANEL.447.18    Subdivision 1.Creation.The commissioner shall establish the Environmental 447.19Health Tracking and Biomonitoring Advisory Panel. The commissioner shall appoint, 447.20from the panel's membership, a chair. The panel shall meet as often as it deems necessary 447.21but, at a minimum, on a quarterly basis. Members of the panel shall serve without 447.22compensation but shall be reimbursed for travel and other necessary expenses incurred 447.23through performance of their duties. Members appointed under this subdivision are 447.24appointed for a three-year term and may be reappointed.447.25    Subd. 2.Members.The commissioner shall appoint eight members, none of whom 447.26may be lobbyists registered under chapter 10A, who have backgrounds or training in 447.27designing, implementing, and interpreting health tracking and biomonitoring studies or 447.28in related fields of science, including epidemiology, biostatistics, environmental health, 447.29laboratory sciences, occupational health, industrial hygiene, toxicology, and public health, 447.30including:447.31    (1) two scientists who represent nongovernmental organizations with a focus on 447.32environmental health, environmental justice, children's health, or on specific chronic 447.33diseases; and447.34    (2) one scientist who is a representative of the University of Minnesota.448.1    In addition, the commissioner shall appoint one member representing each of the 448.2following departments or divisions: the department's health promotion and chronic disease 448.3division, the Pollution Control Agency, and the Department of Agriculture.448.4    Subd. 3.Duties.The advisory panel shall make recommendations to the 448.5commissioner and the legislature on:448.6    (1) priorities for health tracking;448.7    (2) priorities for biomonitoring that are based on sound science and practice, and 448.8that will advance the state of public health in Minnesota;448.9    (3) specific chronic diseases to study under the environmental health tracking system;448.10    (4) specific environmental pollutant exposures to study under the environmental 448.11health tracking system, with the agreement of at least seven of the advisory panel members;448.12    (5) specific communities and geographic areas on which to focus environmental 448.13health tracking and biomonitoring efforts;448.14    (6) specific chemicals and metals to study under the biomonitoring program that meet 448.15the following criteria, with the agreement of at least seven of the advisory panel members:448.16    (i) the degree of potential exposure to the public or specific subgroups, including, 448.17but not limited to, occupational;448.18    (ii) the likelihood of a chemical being a carcinogen or toxicant based on 448.19peer-reviewed health data, the chemical structure, or the toxicology of chemically related 448.20compounds;448.21    (iii) the limits of laboratory detection for the chemical, including the ability to detect 448.22the chemical at low enough levels that could be expected in the general population;448.23    (iv) exposure or potential exposure to the public or specific subgroups;448.24    (v) the known or suspected health effects resulting from the same level of exposure 448.25based on peer-reviewed scientific studies;448.26    (vi) the need to assess the efficacy of public health actions to reduce exposure to a 448.27chemical;448.28    (vii) the availability of a biomonitoring analytical method with adequate accuracy, 448.29precision, sensitivity, specificity, and speed;448.30    (viii) the availability of adequate biospecimen samples; and448.31    (ix) other criteria that the panel may agree to; and448.32    (7) other aspects of the design, implementation, and evaluation of the environmental 448.33health tracking and biomonitoring system, including, but not limited to:448.34    (i) identifying possible community partners and sources of additional public or 448.35private funding;448.36    (ii) developing outreach and educational methods and materials; and449.1    (iii) disseminating environmental health tracking and biomonitoring findings to 449.2the public.449.3    Subd. 4.Liability.No member of the panel shall be held civilly or criminally liable 449.4for an act or omission by that person if the act or omission was in good faith and within 449.5the scope of the member's responsibilities under sections 144.995 to 144.998.449.6    Sec. 21. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:449.7    Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life 449.8support ambulance shall be staffed by at least two ambulance service personnel, at least 449.9one of which must be an EMT, who provide a level of care so as to ensure that:449.10    (1) life-threatening situations and potentially serious injuries are recognized;449.11    (2) patients are protected from additional hazards;449.12    (3) basic treatment to reduce the seriousness of emergency situations is administered; 449.13and449.14    (4) patients are transported to an appropriate medical facility for treatment.449.15    (b) A basic life support service shall provide basic airway management.449.16    (c) By January 1, 2001, a basic life support service shall provide automatic 449.17defibrillation, as provided in section 
         144E.103, subdivision 1, paragraph (b). 449.18    (d) A basic life support service licensee's medical director may authorize the 449.19ambulance service personnel to carry and to use medical antishock trousers and to perform 449.20intravenous infusion if the ambulance service personnel have been properly trained.449.21    (e) Upon application from an ambulance service that includes evidence 449.22demonstrating hardship, the board may grant a temporary variance from the staff 449.23requirements in paragraph (a) and may authorize a basic life support ambulance to be 449.24staffed by one EMT and one first responder. The variance shall apply to basic life support 449.25ambulances operated by the ambulance service for up to one year from the date of the 449.26variance's issuance until the ambulance service renews its license. When a variance 449.27expires, an ambulance service may apply for a new variance under this paragraph. For 449.28purposes of this paragraph, "ambulance service" means either an ambulance service whose 449.29primary service area is located outside the metropolitan counties listed in section 
         473.121, 449.30subdivision 4
         , and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 449.31Cloud; or an ambulance service based in a community with a population of less than 1,000. 449.32    Sec. 22. Minnesota Statutes 2006, section 144E.127, is amended to read:449.33144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.450.1    Subdivision 1.Interhospital transfers. When transporting a patient from one 450.2licensed hospital to another, a licensee may substitute for one of the required ambulance 450.3service personnel, a physician, a registered nurse, or physician's assistant who has been 450.4trained to use the equipment in the ambulance and is knowledgeable of the licensee's 450.5ambulance service protocols.450.6    Subd. 2.Interfacility transfers.In an interfacility transport, a licensee whose 450.7primary service area is located outside the metropolitan counties listed in section 473.121, 450.8subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 450.9Cloud; or an ambulance service based in a community with a population of less than 1,000, 450.10may substitute one EMT with a registered first responder if an EMT or EMT-paramedic, 450.11physician, registered nurse, or physician's assistant is in the patient compartment. If using 450.12a physician, registered nurse, or physician's assistant as the sole provider in the patient 450.13compartment, the individual must be trained to use the equipment in the ambulance and be 450.14knowledgeable of the ambulance service protocols.450.15    Sec. 23. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:450.16    Subdivision 1. Repayment for volunteer training.Any political subdivision, or 450.17nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall 450.18be reimbursed by the board for the necessary expense of the initial training of a volunteer 450.19ambulance attendant upon successful completion by the attendant of a basic emergency 450.20care course, or a continuing education course for basic emergency care, or both, which has 450.21been approved by the board, pursuant to section 
         144E.285. Reimbursement may include 450.22tuition, transportation, food, lodging, hourly payment for the time spent in the training 450.23course, and other necessary expenditures, except that in no instance shall a volunteer 450.24ambulance attendant be reimbursed more than $450$600 for successful completion of a 450.25basic course, and $225$275 for successful completion of a continuing education course. 450.26    Sec. 24. [145.958] BISPHENOL-A IN PRODUCTS FOR CHILDREN.450.27    Subdivision. 1.Bisphenol-A and phthalates committee.The commissioner of 450.28health shall create a committee under the direction of the environmental health division of 450.29the Department of Health to study the scientific literature and make recommendations to 450.30the legislature on the health impact of bisphenol-A and phthalates on children in products 450.31intended for use by young children, including, but not limited to, toys, pacifiers, baby 450.32bottles, and teethers, and report back by January 15, 2008. The committee shall also 450.33identify least harmful alternatives. Of the seven committee members at least one shall be a 450.34representative of the Department of Health, one shall be a representative of environmental 451.1health sciences research, one shall be a representative of the Minnesota Nurses 451.2Association, one shall be a representative of environmental health consumer advocates, 451.3one shall be a member of a children's product manufacturer's association, and one shall be 451.4a representative of the University of Minnesota, chemical plastics research department.451.5    Subd. 2.Definitions.For the purposes of this section, the following terms have 451.6the meanings given them:451.7    (a) "Toy" means all products designed or intended by the manufacturer to be used by 451.8children when they play.451.9    (b) "Child care article" means all products designed or intended by the manufacturer 451.10to facilitate sleep, relaxation, or the feeding of children or to help children with sucking or 451.11teething.451.12    Sec. 25. Minnesota Statutes 2006, section 145A.17, is amended to read:451.13145A.17 FAMILY HOME VISITING PROGRAMS.451.14    Subdivision 1. Establishment; goals. The commissioner shall establish a program 451.15to fund family home visiting programs designed to foster a healthy beginning for children 451.16in families at or below 200 percent of the federal poverty guidelines beginnings, improve 451.17pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce 451.18juvenile delinquency, promote positive parenting and resiliency in children, and promote 451.19family health and economic self-sufficiency for children and families. The commissioner 451.20shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of 451.21professionals and paraprofessionals from the fields of public health nursing, social work, 451.22and early childhood education. A program funded under this section must serve families 451.23at or below 200 percent of the federal poverty guidelines, and other families determined 451.24to be at risk, including but not limited to being at risk for child abuse, child neglect, or 451.25juvenile delinquency. Programs must give priority for services to families considered to 451.26be in need of services, including but not limited tobegin prenatally whenever possible and 451.27must be targeted to families with:451.28    (1) adolescent parents;451.29    (2) a history of alcohol or other drug abuse;451.30    (3) a history of child abuse, domestic abuse, or other types of violence;451.31    (4) a history of domestic abuse, rape, or other forms of victimization;451.32    (5) reduced cognitive functioning;451.33    (6) a lack of knowledge of child growth and development stages;451.34    (7) low resiliency to adversities and environmental stresses; or451.35    (8) insufficient financial resources to meet family needs;452.1    (9) a history of homelessness;452.2    (10) a risk of long-term welfare dependence or family instability due to employment 452.3barriers; or452.4    (11) other risk factors as determined by the commissioner.452.5    Subd. 3. Requirements for programs; process. (a) Before a community health 452.6board or tribal government may receive an allocation under subdivision 2, a community 452.7health board or tribal government must submit a proposal to the commissioner that 452.8includes identification, based on a community assessment, of the populations at or below 452.9200 percent of the federal poverty guidelines that will be served and the other populations 452.10that will be served. Each program that receives funds must Community health boards 452.11and tribal governments that receive funding under this section must submit a plan to 452.12the commissioner describing a multidisciplinary approach to targeted home visiting for 452.13families. The plan must be submitted on forms provided by the commissioner. At a 452.14minimum, the plan must include the following:452.15    (1) a description of outreach strategies to families prenatally or at birth;452.16    (2) provisions for the seamless delivery of health, safety, and early learning services; 452.17    (3) methods to promote continuity of services when families move within the state;452.18    (4) a description of the community demographics;452.19    (5) a plan for meeting outcome measures; and452.20    (6) a proposed work plan that includes:452.21    (i) coordination to ensure nonduplication of services for children and families;452.22    (ii) a description of the strategies to ensure that children and families at greatest risk 452.23receive appropriate services; and452.24    (iii) collaboration with multidisciplinary partners including public health, 452.25ECFE, Head Start, community health workers, social workers, community home 452.26visiting programs, school districts, and other relevant partners. Letters of intent from 452.27multidisciplinary partners must be submitted with the plan.452.28    (b) Each program that receives funds must accomplish the following program 452.29requirements:452.30    (1) use either a broad community-based or selective community-based strategy to 452.31provide preventive and early intervention home visiting services;452.32    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 452.33home visit must occur prenatally or as soon after birth as possible and must include a 452.34public health nursing assessment by a public health nurse;453.1    (3) offer, at a minimum, information on infant care, child growth and development, 453.2positive parenting, preventing diseases, preventing exposure to environmental hazards, 453.3and support services available in the community;453.4    (4) provide information on and referrals to health care services, if needed, including 453.5information on and assistance in applying for health care coverage for which the child or 453.6family may be eligible; and provide information on preventive services, developmental 453.7assessments, and the availability of public assistance programs as appropriate;453.8    (5) provide youth development programs when appropriate;453.9    (6) recruit home visitors who will represent, to the extent possible, the races, 453.10cultures, and languages spoken by families that may be served;453.11    (7) train and supervise home visitors in accordance with the requirements established 453.12under subdivision 4;453.13    (8) maximize resources and minimize duplication by coordinating activitiesor 453.14contracting with local social and human services organizations, education organizations, 453.15and other appropriate governmental entities and community-based organizations and 453.16agencies; and453.17    (9) utilize appropriate racial and ethnic approaches to providing home visiting 453.18services; and453.19    (10) connect eligible families, as needed, to additional resources available in the 453.20community, including, but not limited to, early care and education programs, health or 453.21mental health services, family literacy programs, employment agencies, social services, 453.22and child care resources and referral agencies.453.23    (c) When available, programs that receive funds under this section must offer or 453.24provide the family with a referral to center-based or group meetings that meet at least 453.25once per month for those families identified with additional needs. The meetings must 453.26focus on further enhancing the information, activities, and skill-building addressed during 453.27home visitation; offering opportunities for parents to meet with and support each other; 453.28and offering infants and toddlers a safe, nurturing, and stimulating environment for 453.29socialization and supervised play with qualified teachers.453.30    (b)(d) Funds available under this section shall not be used for medical services. The 453.31commissioner shall establish an administrative cost limit for recipients of funds. The 453.32outcome measures established under subdivision 6 must be specified to recipients of 453.33funds at the time the funds are distributed.453.34    (c)(e) Data collected on individuals served by the home visiting programs must 453.35remain confidential and must not be disclosed by providers of home visiting services 453.36without a specific informed written consent that identifies disclosures to be made. 454.1Upon request, agencies providing home visiting services must provide recipients with 454.2information on disclosures, including the names of entities and individuals receiving the 454.3information and the general purpose of the disclosure. Prospective and current recipients 454.4of home visiting services must be told and informed in writing that written consent for 454.5disclosure of data is not required for access to home visiting services.454.6    Subd. 4. Training. The commissioner shall establish training requirements for 454.7home visitors and minimum requirements for supervision by a public health nurse. The 454.8requirements for nurses must be consistent with chapter 148. The commissioner must 454.9provide training for home visitors. Training must include child development, positive 454.10parenting techniques, screening and referrals for child abuse and neglect, and diverse 454.11cultural practices in child rearing and family systems the following:454.12    (1) effective relationships for engaging and retaining families and ensuring family 454.13health, safety, and early learning;454.14    (2) effective methods of implementing parent education, conducting home visiting, 454.15and promoting quality early childhood development;454.16    (3) early childhood development from birth to age five;454.17    (4) diverse cultural practices in child rearing and family systems;454.18    (5) recruiting, supervising, and retaining qualified staff;454.19    (6) increasing services for underserved populations; and 454.20    (7) relevant issues related to child welfare and protective services, with information 454.21provided being consistent with state child welfare agency training.454.22    Subd. 5. Technical assistance. The commissioner shall provide administrative 454.23and technical assistance to each program, including assistance in data collection and 454.24other activities related to conducting short- and long-term evaluations of the programs 454.25as required under subdivision 7. The commissioner may request research and evaluation 454.26support from the University of Minnesota.454.27    Subd. 6. Outcome and performance measures. The commissioner shall establish 454.28outcomesmeasures to determine the impact of family home visiting programs funded 454.29under this section on the following areas:454.30    (1) appropriate utilization of preventive health care;454.31    (2) rates of substantiated child abuse and neglect;454.32    (3) rates of unintentional child injuries;454.33    (4) rates of children who are screened and who pass early childhood screening; and454.34    (5) rates of children accessing early care and educational services;454.35    (6) program retention rates;454.36    (7) number of home visits provided compared to the number of home visits planned;455.1    (8) participant satisfaction;455.2    (9) rates of at-risk populations reached; and455.3    (10) any additional qualitative goals and quantitative measures established by the 455.4commissioner.455.5    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and 455.6performance measures established under subdivisions 1 and 6, the commissioner shall 455.7conduct ongoing evaluations of the programs funded under this section. Community 455.8health boards and tribal governments shall cooperate with the commissioner in the 455.9evaluations and shall provide the commissioner with the information necessary to conduct 455.10the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact 455.11of the programs on the outcome measures listed in subdivision 6, and shall periodically 455.12determine whether home visiting programs are the best way to achieve the qualitative 455.13goals established under subdivisions 1 and 6. If the commissioner determines that home 455.14visiting programs are not the best way to achieve these goals, the commissioner shall 455.15provide the legislature with alternative methods for achieving them.455.16    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered 455.17year thereafter, the commissioner shall submit a report to the legislature on the family 455.18home visiting programs funded under this section and on the results of the evaluations 455.19conducted under subdivision 7.455.20    Subd. 9. No supplanting of existing funds. Funding available under this section 455.21may be used only to supplement, not to replace, nonstate funds being used for home 455.22visiting services as of July 1, 2001.455.23    Sec. 26. Minnesota Statutes 2006, section 156.001, is amended by adding a subdivision 455.24to read:455.25    Subd. 10a.Program for the Assessment of Veterinary Education Equivalence; 455.26PAVE certificate.A "Program for the Assessment of Veterinary Education Equivalence" 455.27or "PAVE" certificate is issued by the American Association of Veterinary State Boards, 455.28indicating that the holder has demonstrated knowledge and skill equivalent to that 455.29possessed by a graduate of an accredited or approved college of veterinary medicine.455.30    Sec. 27. [156.015] FEES.455.31    Subdivision 1.Verification of licensure.The board may charge a fee of $25 per 455.32license verification to a licensee for verification of licensure status provided to other 455.33veterinary licensing boards.456.1    Subd. 2.Continuing education review.The board may charge a fee of $50 per 456.2submission to a sponsor for review and approval of individual continuing education 456.3seminars, courses, wet labs, and lectures. This fee does not apply to continuing education 456.4sponsors that already meet the criteria for preapproval under Minnesota Rules, part 456.59100.1000, subpart 3, item A.456.6    Sec. 28. Minnesota Statutes 2006, section 156.02, subdivision 1, is amended to read:456.7    Subdivision 1. License application. Application for a license to practice veterinary 456.8medicine in this state shall be made in writing to the Board of Veterinary Medicine upon a 456.9form furnished by the board, accompanied by satisfactory evidence that the applicant is at 456.10least 18 years of age, is of good moral character, and has one of the following:456.11    (1) a diploma conferring the degree of doctor of veterinary medicine, or an 456.12equivalent degree, from an accredited or approved college of veterinary medicine;456.13    (2) an ECFVG or PAVE certificate; or456.14    (3) a certificate from the dean of an accredited or approved college of veterinary 456.15medicine stating that the applicant is a student in good standing expecting to be graduated 456.16at the completion of the current academic year of the college in which the applicant is 456.17enrolled.456.18    The application shall contain the information and material required by subdivision 456.192 and any other information that the board may, in its sound judgment, require. The 456.20application shall be filed with the board at least 60 days before the date of the examination. 456.21If the board deems it advisable, it may require that such application be verified by the 456.22oath of the applicant.456.23    Sec. 29. Minnesota Statutes 2006, section 156.02, subdivision 2, is amended to read:456.24    Subd. 2. Required with application. Every application shall contain the following 456.25information and material:456.26    (1) the application fee set by the board in the form of a check or money order payable 456.27to the board, which fee is not returnable in the event permission to take the examination 456.28is denied for good cause;456.29    (2) a copy of a diploma from an accredited or approved college of veterinary 456.30medicine or a certificate from the dean or secretary of an accredited or approved college of 456.31veterinary medicine showing the time spent in the school and the date when the applicant 456.32was duly and regularly graduated or will duly and regularly graduate or verification of 456.33ECFVG or PAVE certification;457.1    (3) affidavits of at least two veterinarians and three adults who are not related to 457.2the applicant setting forth how long a time, when, and under what circumstances they 457.3have known the applicant, and any other facts as may be proper to enable the board to 457.4determine the qualifications of the applicant; and457.5    (4) if the applicant has served in the armed forces, a copy of discharge papers.457.6    Sec. 30. Minnesota Statutes 2006, section 156.04, is amended to read:457.7156.04 BOARD TO ISSUE LICENSE.457.8    The Board of Veterinary Medicine shall issue to every applicant who has successfully 457.9passed the required examination, who has received a diploma conferring the degree of 457.10doctor of veterinary medicine or an equivalent degree from an accredited or approved 457.11college of veterinary medicine or an ECFVG or PAVE certificate, and who shall have been 457.12adjudged to be duly qualified to practice veterinary medicine, a license to practice.457.13    Sec. 31. Minnesota Statutes 2006, section 156.072, subdivision 2, is amended to read:457.14    Subd. 2. Required with application. Such doctor of veterinary medicine shall 457.15accompany the application by the following:457.16    (1) a copy of a diploma from an accredited or approved college of veterinary 457.17medicine or certification from the dean, registrar, or secretary of an accredited or approved 457.18college of veterinary medicine attesting to the applicant's graduation from an accredited 457.19or approved college of veterinary medicine, or a certificate of satisfactory completion of 457.20the ECFVG or PAVE program.457.21    (2) affidavits of two licensed practicing doctors of veterinary medicine residing in 457.22the United States or Canadian licensing jurisdiction in which the applicant is currently 457.23practicing, attesting that they are well acquainted with the applicant, that the applicant is a 457.24person of good moral character, and has been actively engaged in practicing or teaching in 457.25such jurisdiction for the period above prescribed;457.26    (3) a certificate from the regulatory agency having jurisdiction over the conduct of 457.27practice of veterinary medicine that such applicant is in good standing and is not the 457.28subject of disciplinary action or pending disciplinary action;457.29    (4) a certificate from all other jurisdictions in which the applicant holds a currently 457.30active license or held a license within the past ten years, stating that the applicant is and 457.31was in good standing and has not been subject to disciplinary action;457.32    (5) in lieu of clauses (3) and (4), certification from the Veterinary Information 457.33Verification Agency that the applicant's licensure is in good standing;458.1    (6) a fee as set by the board in form of check or money order payable to the board, 458.2no part of which shall be refunded should the application be denied;458.3    (7) score reports on previously taken national examinations in veterinary medicine, 458.4certified by the Veterinary Information Verification Agency; and458.5    (8) if requesting waiver of examination, provide evidence of meeting licensure 458.6requirements in the state of the applicant's original licensure that were substantially equal 458.7to the requirements for licensure in Minnesota in existence at that time.458.8    Sec. 32. Minnesota Statutes 2006, section 156.073, is amended to read:458.9156.073 TEMPORARY PERMIT.458.10    The board may issue without examination a temporary permit to practice veterinary 458.11medicine in this state to a person who has submitted an application approved by the 458.12board for license pending examination, and holds a doctor of veterinary medicine degree 458.13or an equivalent degree from an approved or accredited college of veterinary medicine 458.14or an ECFVG or PAVE certification. The temporary permit shall expire the day after 458.15publication of the notice of results of the first examination given after the permit is 458.16issued. No temporary permit may be issued to any applicant who has previously failed 458.17the national examination and is currently not licensed in any licensing jurisdiction of the 458.18United States or Canada or to any person whose license has been revoked or suspended 458.19or who is currently subject to a disciplinary order in any licensing jurisdiction of the 458.20United States or Canada.458.21    Sec. 33. Minnesota Statutes 2006, section 156.12, subdivision 2, is amended to read:458.22    Subd. 2. Authorized activities. No provision of this chapter shall be construed to 458.23prohibit:458.24    (a) a person from rendering necessary gratuitous assistance in the treatment of any 458.25animal when the assistance does not amount to prescribing, testing for, or diagnosing, 458.26operating, or vaccinating and when the attendance of a licensed veterinarian cannot be 458.27procured;458.28    (b) a person who is a regular student in an accredited or approved college of 458.29veterinary medicine from performing duties or actions assigned by instructors or 458.30preceptors or working under the direct supervision of a licensed veterinarian;458.31    (c) a veterinarian regularly licensed in another jurisdiction from consulting with a 458.32licensed 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$5,559,283,000$6,079,358,000$11,638,641,000474.5474.6State Government Special Revenue55,737,00056,428,000112,165,000474.7Health Care Access435,700,000545,111,000980,811,000474.8Federal TANF266,863,000277,849,000544,712,000474.9Lottery Prize Fund2,184,0001,787,0003,971,000474.10Total$6,319,767,000$6,960,533,000$13,280,300,000

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$5,358,659,000$5,847,635,000

474.26Appropriations by Fund474.2720082009474.28General4,690,515,0005,053,601,000474.29474.30State Government Special Revenue545,000555,000474.31Health Care Access409,252,000525,193,000474.32Federal TANF255,513,000265,849,000474.33Lottery 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 Management57,727,00058,161,000

480.4Appropriations by Fund480.5General48,413,00048,882,000480.6480.7State 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 Fund480.19General13,037,00013,138,000480.20480.21State 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 Grants762,310,000743,417,000

481.33Appropriations by Fund481.34General564,474,000535,883,000482.1Federal TANF197,586,000207,534,000482.2Health 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

483.8General74,790,00073,684,000483.9Federal TANF4,871,0006,829,000

483.10483.11(d) Basic Sliding Fee Child Care Assistance Grants

483.12General43,012,00045,432,000

483.13Federal TANF5,461,0006,980,000

483.14Base Adjustment. The general fund base is 483.15increased by $3,583,000 in fiscal year 2010 483.16and $1,334,000 in fiscal year 2011 for basic 483.17sliding fee child care assistance grants.

483.18(e) Child Support Enforcement Grants

483.19General11,705,0003,705,000

483.20Child Support Enforcement. $8,000,000 483.21for fiscal year 2008 is to make grants to 483.22counties for child support enforcement 483.23programs to make up for the loss under the 483.242006 federal Deficit Reduction Act of federal 483.25matching funds for federal incentive funds 483.26passed on to the counties by the state.483.27This appropriation is available until spent.

483.28(f) Child Care Development Grants

483.29General5,865,0005,865,000

483.30Child Care Services Grants. $5,000,000 483.31is appropriated from the general fund to 483.32the commissioner of human services for 483.33the biennium beginning July 1, 2007, for 484.1purposes of providing child care services 484.2grants under Minnesota Statutes, section 484.3119B.21, subdivision 5. This appropriation 484.4is for the 2008-2009 biennium only, and does 484.5not increase the base funding.484.6Early Childhood Professional 484.7Development System. $2,000,000 is 484.8appropriated from the general fund to 484.9the commissioner of human services for 484.10the biennium beginning July 1, 2007, for 484.11purposes of the early childhood professional 484.12development system, which increases the 484.13quality and continuum of professional 484.14development opportunities for child care 484.15practitioners. This appropriation is for the 484.162008-2009 biennium only, and does not 484.17increase the base funding.484.18Family, Friend, and Neighbor Grant 484.19Program. $750,000 in fiscal year 2008 and 484.20$750,000 in fiscal year 2009 are appropriated 484.21from the general fund to the commissioner 484.22of human services for the family, friend, 484.23and neighbor grant program in section 31. 484.24Any balance in the first year does not cancel 484.25but is available in the second year. This 484.26appropriation is for the 2008-2009 biennium 484.27only, and does not increase the base funding. 484.28(g) Increased Child Care Provider 484.29Connections. (1) $200,000 is appropriated 484.30from the general fund to the commissioner of 484.31human services for the biennium beginning 484.32July 1, 2007, for the following purposes: 484.33$100,000 each year is for a grant to Hennepin 484.34County, and  $100,000 each year is for a grant 484.35to Ramsey County. The two counties shall 485.1each contract with a nonprofit organization 485.2to work with the contracting county 485.3and county-based licensed family child 485.4care providers to facilitate county-based 485.5information regarding family and children's 485.6resources and to make training and peer 485.7support available to licensed family child 485.8care providers consistent with clause (2). 485.9These appropriations are available until 485.10June 30, 2009, and shall not become part 485.11of base-level funding for the biennium 485.12beginning July 1, 2009.485.13(2) Programs to improve child care provider 485.14connections to county services shall be 485.15established in Hennepin and Ramsey 485.16counties to:485.17(i) improve county contact activities 485.18with county-licensed family child care 485.19providers that facilitate utilization of county 485.20educational, social service, public health, 485.21and economic assistance services by eligible 485.22families, parents, and children using licensed 485.23family child care; and485.24(ii) support licensed family child care 485.25providers to qualify as quality-rated child 485.26care providers through peer support and 485.27coaching networks. 485.28Hennepin and Ramsey Counties shall 485.29contract with a nonprofit organization under 485.30clause (1) that utilizes licensed family child 485.31care providers as contacts for families using 485.32licensed family child care and to provide 485.33peer support to licensed family child care 485.34providers.486.1(3) Hennepin and Ramsey Counties must 486.2report back on successful strategies for 486.3increasing contact with county-based 486.4licensed family child care providers and 486.5report their findings to the appropriate 486.6legislative committees by February 15, 2010.486.7Base Adjustment. The general fund base 486.8is $1,515,000 for each of fiscal years 2010 486.9and 2011.

486.10(h) Children's Services Grants

486.11Appropriations by Fund486.12General62,745,00073,133,000486.13Health Care Access250,000-0-

486.14Base Adjustment. The general fund base 486.15is decreased by $673,000 in fiscal year 486.162010 and $670,000 in fiscal year 2011 for 486.17children's services grants.486.18Privatized Adoption Grants. Federal 486.19reimbursement for privatized adoption grant 486.20and foster care recruitment grant expenditures 486.21is appropriated to the commissioner for 486.22adoption grants and foster care and adoption 486.23administrative purposes.486.24Adoption Assistance Incentive Grants.486.25Federal funds available during fiscal year 486.262008 and fiscal year 2009 for the adoption 486.27incentive grants are appropriated to the 486.28commissioner for these purposes.486.29Adoption Assistance and Relative Custody 486.30Assistance. The commissioner may transfer 486.31unencumbered appropriation balances for 486.32adoption assistance and relative custody 486.33assistance between fiscal years and between 486.34programs.487.1Adoption Assistance and Relative 487.2Custody Assistance Subsidy Payment 487.3Increase. Notwithstanding Minnesota 487.4Rules, part 9560.0083, subparts 5 and 6, the 487.5commissioner shall increase the payment 487.6schedules for basic and supplemental 487.7maintenance needs subsidies by 3.95 percent 487.8effective July 1, 2007. The commissioner 487.9may make cost-neutral adjustments between 487.10schedules and between brackets within 487.11schedules to allow for whole-dollar bracket 487.12levels and account for differential cost 487.13increases in caring for children with special 487.14needs. Counties have until December 31, 487.152007, to implement the relative custody 487.16assistance payment increases and shall make 487.17payment adjustments retroactive to July 1, 487.182007.487.19Crisis Nurseries. $1,100,000 in fiscal year 487.202008 and $1,100,000 in fiscal year 2009 are 487.21appropriated from the general fund for the 487.22crisis nurseries program. Of this amount, 487.23$100,000 each year is to be made available 487.24for capacity development and technical 487.25support for crisis nurseries.487.26Respite Care. Of the general fund 487.27appropriation, $1,250,000 in fiscal year 487.282008 and $2,500,000 in fiscal year 2009 are 487.29to the commissioner of human services to 487.30fund respite care for children who have a 487.31diagnosis of emotional disturbance or severe 487.32emotional disturbance.487.33Childhood Trauma; Grants. Of the general 487.34fund appropriation, $125,000 in fiscal year 487.352008 and $250,000 in fiscal year 2009 are 488.1to the commissioner of human services to 488.2make grants for the purpose of maintaining 488.3and expanding evidence-based practices that 488.4support children and youth who have been 488.5exposed to violence or who are refugees.488.6Collaborative Services for High-Risk 488.7Children. Of the general fund appropriation, 488.8$2,632,000 in fiscal year 2008 and 488.9$6,150,000 in fiscal year 2009 are to the 488.10commissioner of human services to fund 488.11early intervention collaborative programs.488.12Evidence-Based Practice. Of the general 488.13fund appropriation, $2,175,000 in fiscal year 488.142008 and $4,350,000 in fiscal year 2009 488.15are to the commissioner of human services 488.16to develop and implement evidence-based 488.17practice in children's mental health care and 488.18treatment.488.19MFIP and Children's Mental Health Pilot 488.20Project. Of the general fund appropriation, 488.21$100,000 in fiscal year 2008 and $200,000 488.22in fiscal year 2009 are to the commissioner 488.23of human services to fund the MFIP and 488.24children's mental health pilot project.488.25Regional Children's Mental Health 488.26Initiative. $700,000 in fiscal year 2008 and 488.27$700,000 in fiscal year 2009 are appropriated 488.28to the commissioner of human services to 488.29fund the Regional Children's Mental Health 488.30Initiative pilot project. This is a onetime 488.31appropriation.488.32Child Safety Efforts. $1,000,000 in fiscal 488.33year 2008 and $1,000,000 in fiscal year 2009 488.34are appropriated to counties based on their 488.35population of residents under age 18. Funds 489.1are to be used to maintain and improve child 489.2safety services. By February 1, 2008, each 489.3county shall submit a report regarding current 489.4child safety efforts, child safety funding, and 489.5unmet needs including investments needed. 489.6The report shall also include methods and 489.7community partners available to ensure 489.8early identification of at-risk families. The 489.9Association of Minnesota Counties and 489.10county agencies shall develop a uniform 489.11report structure so that statewide data can 489.12be easily summarized. This is a onetime 489.13appropriation.489.14Fetal Alcohol Syndrome. Of the general 489.15fund appropriation, $75,000 in fiscal year 489.162008 and $75,000 in fiscal year 2009 are 489.17for three programs that provide services 489.18to reduce fetal alcohol syndrome under 489.19Minnesota Statutes, section 145.9266. The 489.20three program grantees are the University 489.21of Minnesota, the Meeker-McLeod-Sibley 489.22Community, and the American Indian Family 489.23Center. This appropriation shall become part 489.24of the base appropriation.489.25Base Adjustment. The general fund base is 489.26increased by $366,000 in fiscal year 2010 and 489.27$369,000 in fiscal year 2011 for children's 489.28services grants.

489.29(i) Children and Community Services Grants

489.30General110,802,00069,567,000

489.31Base Adjustment. The general fund base is 489.32increased by $99,000 in each of fiscal years 489.332010 and 2011 for children and community 489.34services grants.490.1Targeted Case Management Temporary 490.2Funding. Of the general fund appropriation, 490.3$40,000,000 in fiscal year 2008 is allocated to 490.4counties and tribes affected by reductions in 490.5targeted case management federal Medicaid 490.6revenue as a result of the provisions in 490.7the federal Deficit Reduction Act of 2005, 490.8Public Law 109-171. The commissioner 490.9shall distribute the funds proportionate 490.10to each affected county or tribe's targeted 490.11case management federal earnings for 490.12calendar year 2005. Prior to distribution 490.13of funds, the commissioner shall estimate 490.14and certify the amount by which the federal 490.15regulations will reduce case management 490.16revenue over the 2008-2009 biennium. The 490.17commissioner may provide grants up to the 490.18amount of the estimated reduction, not to 490.19exceed $40,000,000 for the biennium. The 490.20commissioner may determine the timing and 490.21frequency of payments to counties. These 490.22funds are available in either year of the 490.23biennium. Counties shall use these funds to 490.24pay for social service-related costs, but the 490.25funds are not subject to provisions of the 490.26Children and Community Services Act grant 490.27under Minnesota Statutes, chapter 256M.490.28Child Welfare Project. Of the general fund 490.29appropriation, $2,000,000 for the biennium 490.30beginning July 1, 2007, is for expanding 490.31the American Indian chid welfare project 490.32under Minnesota Statutes, section 256.01, 490.33subdivision 14b, to include the Red Lake 490.34Band of Chippewa Indians Tribe, provided 490.35the tribe meets the criteria in Minnesota 490.36Statutes, section 256.01, subdivision 14b.

491.1(j) General Assistance Grants

491.2General37,876,00038,253,000

491.3General Assistance Standard. The 491.4commissioner shall set the monthly standard 491.5of assistance for general assistance units 491.6consisting of an adult recipient who is 491.7childless and unmarried or living apart 491.8from parents or a legal guardian at $203. 491.9The commissioner may reduce this amount 491.10according to Laws 1997, chapter 85, article 491.113, section 54.491.12Emergency General Assistance. The 491.13amount appropriated for emergency general 491.14assistance funds is limited to no more 491.15than $7,889,812 in fiscal year 2008 and 491.16$7,889,812 in fiscal year 2009. Funds 491.17to counties must be allocated by the 491.18commissioner using the allocation method 491.19specified in Minnesota Statutes, section 491.20256D.06.

491.21(k) Minnesota Supplemental Aid Grants

491.22General30,798,00031,439,000

491.23Emergency Minnesota Supplemental 491.24Aid Funds. The amount appropriated for 491.25emergency Minnesota supplemental aid 491.26funds is limited to no more than $1,100,000 491.27in fiscal year 2008 and $1,100,000 in fiscal 491.28year 2009. Funds to counties must be 491.29allocated by the commissioner using the 491.30allocation method specified in Minnesota 491.31Statutes, section 256D.46.

491.32(l) Group Residential Housing Grants

491.33General91,441,00099,304,000

492.1Base Adjustment. The general fund base is 492.2increased by $6,665,000 in fiscal year 2010 492.3and $13,419,000 in fiscal year 2011.492.4People Incorporated. $460,000 in fiscal 492.5year 2008 and $460,000 in fiscal year 2009 492.6are appropriated from the general fund to the 492.7commissioner of human services to augment 492.8community support and mental health 492.9services provided to individuals residing in 492.10facilities under Minnesota Statutes, section 492.11256I.05, subdivision 1h.

492.12492.13(m) Other Children and Economic Assistance Grants

492.14General24,625,00024,125,000

492.15Federal TANF1,340,0001,340,000

492.16New Chance. $140,000 in fiscal year 492.172008 and $140,000 in fiscal year 2009 are 492.18appropriated from federal TANF funds to the 492.19Hennepin County new chance program.492.20Mothers First. Of the TANF appropriation, 492.21$450,000 in fiscal year 2008 and $450,000 492.22in fiscal year 2009 are to fund the Ramsey 492.23County mothers first program. The 492.24appropriations are available until spent and 492.25are a onetime appropriation.492.26Homeless and Runaway Youth. $3,500,000 492.27in the first year and $3,500,000 in the second 492.28year are for the Runaway and Homeless 492.29Youth Act under Minnesota Statutes, section 492.30256K.45. Funds shall be spent in each area 492.31of the continuum of care to ensure that 492.32programs are meeting the greatest need. The 492.33base is decreased by $2,000,000 each year in 492.34fiscal year 2010 and fiscal year 2011. 493.1Transitional Housing and Emergency 493.2Services.493.3(1) $750,000 each year from the federal 493.4TANF fund is for transitional housing 493.5programs under Minnesota Statutes, section 493.6256E.33. The TANF appropriations 493.7are onetime. The general fund base for 493.8transitional housing is increased by $422,000 493.9each year for the fiscal 2010-2011 biennium. 493.10Up to ten percent of this appropriation may 493.11be used for housing and services which 493.12extend beyond 24 months. $300,000 in each 493.13year of this amount is for grants for safe 493.14housing pilot projects for battered women 493.15and families in Anoka County, Houston 493.16County, and Beltrami County; and493.17(2) $527,000 each year is added to the 493.18base for emergency services grants under 493.19Laws 1997, chapter 162, article 3, section 493.207. The base for emergency services grants 493.21is decreased each year by $300,000 in fiscal 493.22year 2010 and fiscal year 2011.493.23Foodshelf Programs. $575,000 each year 493.24is added to the base for foodshelf programs 493.25under Minnesota Statutes, section 256E.34. 493.26The base is decreased by $250,000 each year 493.27in fiscal year 2010 and fiscal year 2011.493.28Long-term Homeless Services. $2,440,000 493.29each year is added to the base for the 493.30long-term homeless services under 493.31Minnesota Statutes, section 256K.26. The 493.32base is decreased by $1,000,000 each year in 493.33fiscal year 2010 and fiscal year 2011.493.34Minnesota Community Action Grants.493.35$1,500,000 each year is added to the base for 494.1the purposes of Minnesota community action 494.2grants under Minnesota Statutes, sections 494.3256E.30 to 256E.32. The base is reduced by 494.4$500,000 each year in fiscal year 2010 and 494.5fiscal year 2011.494.6Tenant Hotline Services Program. $50,000 494.7each year is added to the base for a grant to 494.8HOME Line for the tenant hotline services 494.9program. This is a onetime appropriation.

494.10494.11Subd. 5.Children and Economic Assistance Management47,035,00046,884,000

494.12Appropriations by Fund494.13General45,492,00045,335,000494.14Health Care Access347,000354,000494.15Federal TANF1,196,0001,196,000

494.16The amounts that may be spent from the 494.17appropriation for each purpose are as follows:

494.18494.19(a) Children and Economic Assistance Administration

494.20Appropriations by Fund494.21General9,725,0009,612,000494.22Federal TANF1,196,0001,196,000

494.23Base Adjustment. The general fund base is 494.24$9,574,000 in each of fiscal years 2010 and 494.252011.

494.26494.27(b) Children and Economic Assistance Operations

494.28Appropriations by Fund494.29General35,767,00035,722,000494.30Health Care Access347,000354,000

494.31Spending Authority for Food Stamps 494.32Bonus Awards. In the event that Minnesota 494.33qualifies for the United States Department 494.34of Agriculture Food and Nutrition Services 494.35Food Stamp Program performance bonus 494.36awards, the funding is appropriated to the 495.1commissioner. The commissioner shall 495.2retain 25 percent of the funding, with the 495.3other 75 percent divided among the counties 495.4according to a formula that takes into account 495.5each county's impact on state performance in 495.6the applicable bonus categories.495.7Child Support Payment Center. Payments 495.8to the commissioner from other governmental 495.9units, private enterprises, and individuals 495.10for services performed by the child support 495.11payment center must be deposited in the state 495.12systems account authorized under Minnesota 495.13Statutes, section 256.014. These payments 495.14are appropriated to the commissioner for the 495.15operation of the child support payment center 495.16or system, according to Minnesota Statutes, 495.17section 256.014.495.18Financial Institution Data Match and 495.19Payment of Fees. The commissioner is 495.20authorized to allocate up to $310,000 each 495.21year in fiscal years 2008 and 2009 from the 495.22PRISM special revenue account to make 495.23payments to financial institutions in exchange 495.24for performing data matches between account 495.25information held by financial institutions 495.26and the public authority's database of child 495.27support obligors as authorized by Minnesota 495.28Statutes, section 13B.06, subdivision 7.495.29Base Adjustment. The general fund base is 495.30decreased by $22,000 in each of fiscal years 495.312010 and 2011.

495.32Subd. 6.Basic Health Care Grants2,396,290,0002,738,179,000

495.33Appropriations by Fund495.34General2,018,815,0002,250,190,000495.35Health Care Access377,475,000487,989,000

496.1The amounts that may be spent from the 496.2appropriation for each purpose are as follows:

496.3(a) MinnesotaCare Grants

496.4Health Care Access376,588,000455,429,000

496.5MinnesotaCare Federal Receipts. Receipts 496.6received as a result of federal participation 496.7in administering costs of the Minnesota 496.8health care reform waiver must be deposited 496.9as nondedicated revenue in the health care 496.10access fund. Receipts received as a result of 496.11federal participation in making grants must 496.12be deposited in the federal fund and must 496.13offset health care access funds for payments 496.14to providers.496.15MinnesotaCare Funding. The 496.16commissioner may expend money 496.17appropriated from the health care access fund 496.18for MinnesotaCare in either fiscal year of the 496.19biennium.496.20HealthMatch Delay. Of this appropriation, 496.21$2,560,000 in fiscal year 2008 and 496.22$25,508,000 in fiscal year 2009 are for 496.23MinnesotaCare program costs related to 496.24implementation of the HealthMatch program.

496.25496.26(b) MA Basic Health Care - Families and Children

496.27Appropriations by Fund496.28General759,866,000853,680,000496.29Health Care Access-0-31,661,000

496.30496.31(c) MA Basic Health Care - Elderly and Disabled

496.32General1,017,023,0001,142,719,000

496.33Provider-Directed Care Coordination. In 496.34addition to medical assistance reimbursement 497.1under Minnesota Statutes, sections 497.2256B.0625 and 256B.76, clinics participating 497.3in provider-directed care coordination under 497.4Minnesota Statutes, section 256B.0625, also 497.5receive a monthly payment per client when 497.6the clinic serves an eligible client. The 497.7payments across the program must average 497.8$50 per month per client.497.9Services for Developmentally Disabled.497.10The commissioner must serve: an additional 497.11200 persons in the MR/RC waiver program; 497.12an additional 200 persons in the family 497.13support grant program under Minnesota 497.14Statutes, section 252.32; and an additional 497.15200 persons in the semi-independent living 497.16services program under Minnesota Statutes, 497.17section 252.275.497.18County CADI allocation adjustment. (1) 497.19The commissioner shall adjust 2007 home 497.20and community-based allocations under 497.21section 256B.49 to qualifying counties 497.22that transferred persons to the community 497.23alternatives for disabled individuals 497.24(CADI) waiver program under Laws 2006, 497.25chapter 282, article 20, section 35. The 497.26adjustment shall reflect the amount that 497.27county-authorized funding for CADI waiver 497.28services exceeded the allowable amount 497.29as shown in the Medicaid Management 497.30Information System (MMIS) on March 1, 497.312007.497.32(2) A county that may qualify under 497.33paragraph (1) shall apply to the commissioner 497.34by June 10, 2007. Following a review of the 497.35county request and the MMIS documentation, 498.1the commissioner shall adjust the county 498.2allocation, as appropriate, by June 25, 2007.498.3(3) The amounts provided to a county under 498.4this section shall become part of the county's 498.5base level state allocation for the CADI 498.6waiver for the biennium beginning July 1, 498.72007.498.8(4) This rider is effective the day following 498.9final enactment.

498.10(d) General Assistance Medical Care Grants

498.11General238,887,000251,082,000

498.12(e) Other Health Care Grants

498.13General3,039,0002,709,000498.14Health Care Access887,000899,000

498.15Care Coordination. Of the general fund 498.16appropriation, $500,000 in fiscal year 2008 498.17and $1,000,000 in fiscal year 2009 are for 498.18the commissioner of human services for 498.19contracting for care coordination with the 498.20U special kids program under Minnesota 498.21Statutes, section 256B.0751.498.22Community-Based Health Care. Of the 498.23general fund appropriation, $1,050,000 498.24for the biennium beginning July 1, 2007, 498.25is to the commissioner of human services 498.26for the demonstration project grant 498.27described in Minnesota Statutes, section 498.2862Q.80, subdivision 1a. This is a onetime 498.29appropriation and is available until June 30, 498.302012.498.31Community Collaboratives. Of the general 498.32fund appropriation, $330,000 in fiscal year 498.332008 and $850,000 in fiscal year 2009 are to 498.34provide grants to community collaboratives 499.1to cover the uninsured. These are onetime 499.2appropriations.499.3Health Care Payment Reform Pilot. Of 499.4the general fund appropriation, $1,018,000 499.5in fiscal year 2008 and $1,027,000 in fiscal 499.6year 2009 are for the health care payment 499.7reform pilot project. These are onetime 499.8appropriations.499.9Patient Incentive Programs. Of the general 499.10fund appropriation, $500,000 in fiscal year 499.112008 and $500,000 in fiscal year 2009 are 499.12for patient incentive programs.499.13State Health Policies Grant. Of the general 499.14fund appropriation, $300,000 in fiscal year 499.152008 is to provide a grant to a research center 499.16associated with a safety net hospital and 499.17county-affiliated health system to develop 499.18the capabilities necessary for evaluating the 499.19effects of changes in state health policies 499.20on low-income and uninsured individuals, 499.21including the impact on state health care 499.22program costs, health outcomes, cost-shifting 499.23to different units and levels of government, 499.24and utilization patterns including use of 499.25emergency room care and hospitalization 499.26rates.499.27Neighborhood Health Care Network. Of 499.28the general fund appropriation, $150,000 in 499.29fiscal year 2008 and $150,000 in fiscal year 499.302009 are for a grant to the Neighborhood 499.31Health Care Network to maintain and staff a 499.32toll-free health care access telephone number.

499.33Subd. 7.Health Care Management54,536,00058,696,000

500.1Appropriations by Fund500.2General32,416,00030,571,000500.3Health Care Access22,120,00028,125,000

500.4The amounts that may be spent from the 500.5appropriation for each purpose are as follows:

500.6(a) Health Care Policy Administration

500.7Appropriations by Fund500.8General10,236,0008,813,000500.9Health Care Access2,323,00010,074,000

500.10Minnesota Senior Health Options 500.11Reimbursement. Federal administrative 500.12reimbursement resulting from the Minnesota 500.13senior health options project is appropriated 500.14to the commissioner for this activity.500.15Utilization Review. Federal administrative 500.16reimbursement resulting from prior 500.17authorization and inpatient admission 500.18certification by a professional review 500.19organization is dedicated to the commissioner 500.20for these purposes. A portion of these funds 500.21must be used for activities to decrease 500.22unnecessary pharmaceutical costs in medical 500.23assistance.500.24Dental Access for Persons with Disabilities.500.25Of the general fund appropriation, $82,000 500.26in fiscal year 2008 is for a study on access to 500.27dental services for persons with disabilities.500.28Base Adjustment. The health care access 500.29fund base is $10,716,000 in fiscal year 2010 500.30and $8,870,000 in fiscal year 2011, for health 500.31care administration.

500.32(b) Health Care Operations

501.1Appropriations by Fund501.2General22,180,00021,758,000501.3Health Care Access19,797,00018,051,000

501.4Base Adjustment. The general fund base is 501.5decreased by $214,000 in fiscal year 2010 501.6for health care operations.

501.7Subd. 8.Continuing Care Grants1,697,359,0001,858,283,000

501.8Appropriations by Fund501.9General1,694,876,0001,855,900,000501.10Health Care Access750,000750,000501.11Lottery Prize1,733,0001,633,000

501.12The amounts that may be spent from the 501.13appropriation for each purpose are as follows: 

501.14(a) Aging and Adult Services Grants

501.15General15,986,00016,605,000

501.16Information and Assistance 501.17Reimbursement. Federal administrative 501.18reimbursement obtained from information 501.19and assistance services provided by the 501.20Senior LinkAge Line to people who are 501.21identified as eligible for medical assistance 501.22are appropriated to the commissioner for this 501.23activity.501.24Senior Companion Program. Of the 501.25general fund appropriation, $191,000 in 501.26fiscal year 2008 and $191,000 in fiscal year 501.272009 are for the senior companion program 501.28under Minnesota Statutes, section 256.977.501.29Volunteer Senior Citizens. Of the general 501.30fund appropriation, $192,000 in fiscal year 501.312008 and $192,000 in fiscal year 2009 are 501.32for the volunteer programs for retired senior 501.33citizens under Minnesota Statutes, section 501.34256.9753.502.1Foster Grandparent Program. Of the 502.2general fund appropriation, $192,000 in 502.3fiscal year 2008 and $192,000 in fiscal year 502.42009 are for the foster grandparent program 502.5in Minnesota Statutes, section 256.976.502.6Senior Nutrition. Of the general fund 502.7appropriation, $250,000 in fiscal year 502.82008 and $250,000 in fiscal year 2009 are 502.9for the senior nutrition programs under 502.10Minnesota Statutes, section 256.9752. 502.11The commissioner shall give priority to 502.12increase services to: (1) persons facing 502.13language or cultural barriers, (2) persons with 502.14special diets, (3) persons living in isolated 502.15rural areas, and (4) other hard-to-serve 502.16populations.502.17Living At Home/Block Nurse Program. Of 502.18the general fund appropriation, $580,000 in 502.19fiscal year 2008 and $655,000 in fiscal year 502.202009 are for the living at home/block nurse 502.21program. The purpose of the appropriation is 502.22to increase base funding levels to $25,000 502.23per program year, provide base funding for 502.24nine programs currently operating without 502.25base funding, provide base funding for five 502.26new programs beginning July 1, 2007, and 502.27provide base funding for six additional 502.28programs beginning July 1, 2008.502.29$76,000 in fiscal year 2008 and $62,000 in 502.30fiscal year 2009 are for increased staff for 502.31the ombudsman for older Minnesotans and 502.32related costs.502.33$150,000 in fiscal year 2008 and $150,000 in 502.34fiscal year 2009 are to increase the base of 502.35the Senior LinkAge line program.503.1Minnesota Kinship Caregivers 503.2Association. (1) Of the general fund 503.3appropriation, $175,000 in fiscal year 503.42008 and $175,000 in fiscal year 2009 503.5are transferred to a nonprofit organization 503.6experienced in kinship caregiver programs, 503.7with at least 50 percent of its board 503.8composed of kinship caregivers for purposes 503.9of providing support to grandparents or 503.10relatives who are raising kinship children. 503.11(2) The demonstration grant sites must 503.12include the Minnesota Kinship Caregivers 503.13Association central site in the metropolitan 503.14area and another site in the Bemidji region. 503.15The support must provide a one-stop services 503.16program. The services that may be provided 503.17include but are not limited to legal services, 503.18education, information, family activities, 503.19support groups, mental health access, 503.20advocacy, mentors, and information related 503.21to foster care licensing. The funds may also 503.22be used for a media campaign to inform 503.23kinship families about available information 503.24and services, support sites, and other program 503.25development. The general fund base for the 503.26program shall be $160,000 in fiscal year 503.272010 and $160,000 in fiscal year 2011.503.28Base Adjustment. The general fund base 503.29is increased by $72,000 in fiscal year 2010 503.30and $72,000 in fiscal year 2011 for aging and 503.31adult services grants.

503.32(b) Alternative Care Grants

503.33General50,063,00052,511,000

503.34Alternative Care Transfer. Any money 503.35allocated to the alternative care program that 504.1is not spent for the purposes indicated does 504.2not cancel but is transferred to the medical 504.3assistance account.504.4Base Adjustment. The general fund base is 504.5increased by $547,000 in fiscal year 2010 and 504.6$784,000 in fiscal year 2011 for alternative 504.7care grants.

504.8504.9(c) Medical Assistance Grants - Long-Term Care Facilities

504.10General499,278,000513,016,000

504.11New Nursing Facility Reimbursement 504.12System Delay. Notwithstanding Minnesota 504.13Statutes, section 256B.441, subdivision 1, 504.14paragraph (c), the commissioner shall begin 504.15to phase in the new reimbursement system 504.16for nursing facilities on or after October 1, 504.172009.504.18Long-Term Care Consultation Funding 504.19Increase. For the rate year beginning 504.20October 1, 2008, the county long-term 504.21care consultation allocations in Minnesota 504.22Statutes, section 256B.0911, subdivision 504.236, must be increased based on the number 504.24of transitional long-term care consultation 504.25visits projected by the commissioner in 504.26each county. For the rate year beginning 504.27October 1, 2009, final allocations must be 504.28determined based on the average between 504.29the actual number of transitional long-term 504.30care visits that were conducted in the prior 504.3112-month period and the projected number 504.32of consultations that will be provided in 504.33the rate year beginning October 1, 2009. 504.34Notwithstanding section 7, this rider expires 504.35June 30, 2010.505.1Life Safety Code Compliance. Of the 505.2general fund appropriation, $1,000,000 in 505.3fiscal year 2008 is for payments to nursing 505.4facilities for life safety code compliance 505.5under Minnesota Statutes, section 256B.434, 505.6subdivision 4, paragraph (e). This is a 505.7onetime appropriation and available until 505.8spent.

505.9505.10(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

505.11General966,623,0001,099,540,000

505.12(e) Mental Health Grants

505.13Appropriations by Fund505.14General57,522,00060,678,000505.15Health Care Access750,000750,000505.16Lottery Prize1,733,0001,633,000

505.17Dual Diagnosis; Demonstration Project.505.18Of the general fund appropriation, $800,000 505.19in fiscal year 2008 and $1,600,000 in fiscal 505.20year 2009 are to the commissioner of 505.21human services to fund the dual diagnosis 505.22demonstration project.505.23Mobile Mental Health Crisis Services. Of 505.24the general fund appropriation, $2,500,000 505.25in fiscal year 2008 and $3,625,000 in fiscal 505.26year 2009 are to the commissioner of human 505.27services for statewide funding of adult mobile 505.28mental health crisis services. Providers must 505.29utilize all available funding streams.505.30National Council on Problem Gambling.505.31(1) $225,000 in fiscal year 2008 and $225,000 505.32in fiscal year 2009 are appropriated from 505.33the lottery prize fund to the commissioner 505.34of human services for a grant to the state 505.35affiliate recognized by the National Council 506.1on Problem Gambling. The affiliate must 506.2provide services to increase public awareness 506.3of problem gambling, education, and training 506.4for individuals and organizations providing 506.5effective treatment services to problem 506.6gamblers and their families, and research 506.7relating to problem gambling. These 506.8services must be complementary to and not 506.9duplicative of the services provided through 506.10the problem gambling program administered 506.11by the commissioner of human services. This 506.12grant does not prevent the commissioner 506.13from regular monitoring and oversight of the 506.14grant or the ability to reallocate the funds to 506.15other services within the problem gambling 506.16program for nonperformance of duties by 506.17the grantee.506.18(2) Of this appropriation, $100,000 in 506.19fiscal year 2008 and $100,000 in fiscal year 506.202009 are contingent on the contribution 506.21of nonstate matching funds. Matching 506.22funds may be either cash or qualifying 506.23in-kind contributions. The commissioner of 506.24finance may disburse the state portion of the 506.25matching funds in increments of $25,000 506.26upon receipt of a commitment for an equal 506.27amount of matching nonstate funds. The 506.28general fund base shall be $100,000 in fiscal 506.29year 2010 and $100,000 in fiscal year 2011506.30(3) $100,000 in fiscal year 2008 is 506.31appropriated from the lottery prize fund to 506.32the commissioner of human services for a 506.33grant or grants to be awarded competitively 506.34to develop programs and services for 506.35problem gambling treatment, prevention, 506.36and education in immigrant communities. 507.1This appropriation is available until June 507.230, 2009, at which time the project must 507.3be completed and final products delivered, 507.4unless an earlier completion date is specified 507.5in the work program.507.6Compulsive Gambling. $300,000 in fiscal 507.7year 2008 and $100,000 in fiscal year 2009 507.8are appropriated from the lottery prize fund 507.9to the commissioner of human services for 507.10purposes of compulsive gambling education, 507.11assessment, and treatment under Minnesota 507.12Statutes, section 245.98.507.13Compulsive Gambling Study. $100,000 507.14in fiscal year 2008 is to continue the 507.15study currently being done on compulsive 507.16gambling treatment effectiveness and 507.17long-term effects of gambling.507.18Base Adjustment. The general fund base is 507.19increased by $266,000 in fiscal year 2010.

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

507.21General1,932,0002,380,000

507.22Hearing Loss Mentors. Of the general fund 507.23appropriation, $80,000 is to provide mentors 507.24who have a hearing loss to parents of newly 507.25identified infants and children with hearing 507.26loss.507.27Base Adjustment. The general fund base 507.28is increased by $7,000 in fiscal year 2010 507.29and $7,000 in fiscal year 2011 for deaf and 507.30hard-of-hearing grants.

507.31(g) Chemical Dependency Entitlement Grants

507.32General78,749,00089,946,000

508.1508.2(h) Chemical Dependency Nonentitlement Grants

508.3General1,055,0001,055,000

508.4(i) Other Continuing Care Grants

508.5Appropriations by Fund508.6General23,668,00020,169,000

508.7Native American Juvenile Treatment 508.8Center. Of the general fund appropriation, 508.9$50,000 is to conduct a feasibility study 508.10of and to predesign a Native American 508.11juvenile treatment center on or near the 508.12White Earth Reservation. The facility must 508.13house and treat Native American juveniles 508.14and provide culturally specific programming 508.15to juveniles placed in the treatment center. 508.16The commissioner of human services may 508.17contract with parties who have experience 508.18in the design and construction of juvenile 508.19treatment centers to assist in the feasibility 508.20study and predesign. On or before January 508.2115, 2008, the commissioner shall present 508.22the results of the feasibility study and the 508.23predesign of the facility to the chairs of house 508.24of representatives and senate committees 508.25having jurisdiction over human services 508.26finance, public safety finance, and capital 508.27investment.508.28Leech Lake Youth Treatment Center. Of 508.29the general fund appropriation, $75,000 in 508.30fiscal year 2008 and $75,000 in fiscal year 508.312009 are for a grant to the Leech Lake Youth 508.32Treatment Center project partners, in order 508.33to pay the salaries and other directly related 508.34costs associated with the development of this 508.35project.509.1Assistive Technology. Of the general fund 509.2appropriation, $300,000 in fiscal year 2008 is 509.3to the Minnesota State Council on Disability 509.4for the purposes of providing $100,000 509.5in financial support to the Minnesota 509.6Regions Assistive Technology Collaborative 509.7and $200,000 in fiscal year 2008 is for 509.8a local match required to access the 509.9federal Technology-Related Assistance for 509.10Individuals with Disabilities Act, alternate 509.11finance project.509.12Repayment. For the fiscal year ending June 509.1330, 2008, $5,287,000 is appropriated to the 509.14commissioner of human services to repay 509.15the amount of overspending in the waiver 509.16program for persons with developmental 509.17disabilities incurred by affected counties in 509.18calendar years 2004 and 2005.509.19Base Adjustment. The general fund base 509.20is $20,276,000 in fiscal year 2010 and 509.21$20,332,000 in fiscal year 2011 for other 509.22continuing care grants.

509.23Subd. 9.Continuing Care Management20,248,00019,400,000

509.24Appropriations by Fund509.25General19,384,00019,123,000509.26509.27State Government Special Revenue121,000123,000509.28Health Care Access292,000-0-509.29Lottery Prize451,000154,000

509.30Community Trainee and Consultation.509.31Of the general fund appropriation, $125,000 509.32in fiscal year 2008 is to the commissioner 509.33of human services to contract for training 509.34and consultation for clinical supervisors and 509.35staff of community mental health centers 510.1who provide services to children and adults. 510.2The purpose of the training and consultation 510.3is to improve clinical supervision of 510.4staff, strengthen compliance with federal 510.5and state rules and regulations, and to 510.6recommend strategies for standardization and 510.7simplification of administrative functions 510.8among community mental health centers.510.9Mental Health Tracking System. Of the 510.10general fund appropriation, $448,000 in fiscal 510.11year 2008 and $324,000 in fiscal year 2009 510.12are to the commissioner of human services 510.13to fund implementation of the mental health 510.14services outcomes and tracking system.510.15Quality Management; Assurance; and 510.16Improvement System for Minnesotans 510.17Receiving Disability Services. Of the 510.18general fund appropriation, up to $300,000 510.19for the biennium beginning July 1, 2007, 510.20may be used for the purposes of the quality 510.21management, assurance, and improvement 510.22system for Minnesotans receiving disability 510.23services. Federal Medicaid matching funds 510.24obtained for this purpose shall be dedicated 510.25to the commissioner for this purpose.510.26Base Adjustment. The health care access 510.27fund base is $0 in each of the fiscal years 2010 510.28and 2011 for continuing care management.510.29Disability Linkage Line. Of the general 510.30fund appropriation, $650,000 in fiscal year 510.312008 and $626,000 in fiscal year 2009 are to 510.32establish and maintain the disability linkage 510.33line.

510.34Subd. 10.State-Operated Services266,645,000267,718,000

510.35General266,645,000267,718,000

511.1Remembering With Dignity Project. (1) 511.2$200,000 is appropriated from the general 511.3fund to the commissioner of human services 511.4to be available until September 30, 2008, to 511.5make a grant to Advocating Change Together 511.6for the purposes of the Remembering With 511.7Dignity project in paragraph (2).511.8(2) As part of the Remembering With Dignity 511.9project, the grant recipient shall:511.10(i) conduct necessary research on persons 511.11buried in state cemeteries who were residents 511.12of state hospitals or regional treatment 511.13centers and buried in numbered or unmarked 511.14graves;511.15(ii) purchase and install headstones that are 511.16properly inscribed with their names on the 511.17graves of those persons; and511.18(iii) collaborate with community groups 511.19and state and local government agencies to 511.20build community involvement and public 511.21awareness, ensure public access to the 511.22graves, and ensure appropriate perpetual 511.23maintenance of state cemeteries.511.24(3) This rider is effective the day following 511.25final enactment.511.26Transfer Authority Related to 511.27State-Operated Services. Money 511.28appropriated to finance state-operated 511.29services programs and administrative 511.30services may be transferred between fiscal 511.31years of the biennium with the approval of 511.32the commissioner of finance.511.33The amounts that may be spent from the 511.34appropriation for each purpose are as follows:

512.1(a) Mental Health Services

512.2General116,270,000120,095,000

512.3Appropriation Limitation. No part of 512.4the appropriation in this article to the 512.5commissioner for mental health treatment 512.6services at the regional treatment centers 512.7shall be used for the Minnesota sex offender 512.8program.

512.9(b) Minnesota Sex Offender Services

512.10General67,719,00062,787,000

512.11512.12(c) Minnesota Security Hospital and METO Services

512.13General82,656,00084,836,000

512.14Minnesota Security Hospital. For the 512.15purposes of enhancing the safety of 512.16the public, improving supervision, and 512.17enhancing community-based mental health 512.18treatment, state-operated services may 512.19establish additional community capacity 512.20for providing treatment and supervision 512.21of clients who have been ordered into a 512.22less restrictive alternative care from the 512.23state-operated services transitional services 512.24program consistent with Minnesota Statutes, 512.25section 246.014.

512.26Sec. 4. COMMISSIONER OF HEALTH

512.27Subdivision 1.Total Appropriation$176,386,000$165,389,000

512.28Appropriations by Fund512.2920082009512.30General98,737,00092,829,000512.31512.32State Government Special Revenue39,851,00040,642,000512.33Health Care Access26,448,00019,918,000512.34Federal TANF11,350,00012,000,000

513.1513.2Subd. 2.Community and Family Health Promotion

513.3Appropriations by Fund513.4General46,707,00046,443,000513.5513.6State Government Special Revenue468,000471,000513.7Health Care Access3,539,0003,562,000513.8Federal TANF8,667,0009,002,000

513.9TANF Appropriations. (a) $3,579,000 of 513.10the TANF funds is appropriated in each year 513.11of the biennium to the commissioner for 513.12home visiting and nutritional services listed 513.13under Minnesota Statutes, section 145.882, 513.14subdivision 7, clauses (6) and (7). Funding 513.15shall be distributed to community health 513.16boards based on Minnesota Statutes, section 513.17145A.131, subdivision 1.513.18(b) $5,088,000 in the first year and $5,423,000 513.19in the second year are appropriated to the 513.20commissioner of health for the family home 513.21visiting grant program. The commissioner 513.22shall distribute funds to community health 513.23boards using a formula developed in 513.24conjunction with the state Community 513.25Health Services Advisory Committee. The 513.26commissioner may use five percent of the 513.27funds appropriated in each fiscal year to 513.28conduct the ongoing evaluations required 513.29under Minnesota Statutes, section 145A.17, 513.30subdivision 7, and may use ten percent of 513.31the funds appropriated each fiscal year to 513.32provide training and technical assistance as 513.33required under Minnesota Statutes, section 513.34145A.17, subdivisions 4 and 5.513.35TANF Carryforward. Any unexpended 513.36balance of the TANF appropriation in the 514.1first year of the biennium does not cancel but 514.2is available for the second year.514.3Loan Forgiveness. $605,000 the first year 514.4and $775,000 the second year and thereafter 514.5are for the loan forgiveness program under 514.6Minnesota Statutes, section 144.1501. This 514.7funding is in addition to the loan forgiveness 514.8program base.514.9MN ENABL. Base level funding for the MN 514.10ENABL program, under Minnesota Statutes, 514.11section 145.9255, is reduced by $220,000 514.12each year of the biennium beginning July 1, 514.132007.514.14Fetal Alcohol Spectrum Disorder. (a) 514.15$900,000 each year is added to the base for 514.16fetal alcohol spectrum disorder. On July 1 514.17each fiscal year, the portion of the general 514.18fund appropriation to the commissioner of 514.19health for fetal alcohol spectrum disorder 514.20administration and grants shall be transferred 514.21to a statewide organization that focuses 514.22solely on prevention of and intervention with 514.23fetal alcohol spectrum disorder as follows:514.24(1) on July 1, 2007, $2,090,000; and514.25(2) on July 2, 2008, and annually thereafter, 514.26$2,090,000.514.27(b) The money shall be used for prevention 514.28and intervention services and programs, 514.29including, but not limited to, community 514.30grants, professional education, public 514.31awareness, and diagnosis. The organization 514.32may retain $60,000 of the transferred money 514.33for administrative costs. The organization 514.34shall report to the commissioner annually 515.1by January 15 on the services and programs 515.2funded by the appropriation.515.3Deaf or Hearing Loss Support. $100,000 515.4for the first year and $100,000 for the second 515.5year is for the purpose of providing family 515.6support and assistance to families with 515.7children who are deaf or have a hearing 515.8loss. The family support provided must 515.9include direct parent-to-parent assistance and 515.10information on communication, educational, 515.11and medical options. The commissioner 515.12may contract with a nonprofit organization 515.13that has the ability to provide these services 515.14throughout the state.515.15Heart Disease and Stroke Prevention.515.16$200,000 is appropriated in the first year for 515.17the heart disease and stroke prevention unit 515.18of the Department of Health to fund data 515.19collection and other activities to improve 515.20cardiovascular health and reduce the burden 515.21of heart disease and stroke in Minnesota. 515.22This is a onetime appropriation.515.23Family Planning Grants. $1,000,000 each 515.24year is for family planning grants under 515.25Minnesota Statutes, section 145.925.515.26Bright Smiles Pilot Project. (a) $384,000 515.27in the first year and $50,000 in the second 515.28year is to fund a grant for the Bright Smiles 515.29pilot project.515.30(b) Of these amounts, $50,000 each year is to 515.31fund a dental health coordinator position at 515.32the Minnesota Department of Health.515.33(c) The commissioner of health shall 515.34establish a pilot project to fund a Bright 515.35Smiles program designed to increase access 516.1to oral health care for low-income and 516.2immigrant children, ages birth to five 516.3years, and their families and to build the 516.4knowledge and ability of parents to care 516.5for the oral health of their children. Under 516.6this pilot project, a Bright Smiles program 516.7shall serve the medically underserved areas 516.8in Minneapolis and the Bemidji area, as 516.9determined by the commissioner of health.516.10(d) A grant shall be used to fund costs related 516.11to improving oral health outreach, education, 516.12screening, and access to care for families 516.13with children, ages birth to five years.516.14(e) Grant applicants shall submit to 516.15the commissioner a written plan that 516.16demonstrates the ability to provide the 516.17following:516.18(1) new programs or continued expansion 516.19of current access programs that have 516.20demonstrated success in providing dental 516.21services in underserved areas of Minneapolis 516.22and the Bemidji area;516.23(2) programs for screening children entering 516.24the Minneapolis and the Bemidji area public 516.25school systems and facilitating access to care 516.26for their families;516.27(3) programs testing new models of care 516.28that are sensitive to cultural needs of the 516.29recipients;516.30(4) programs creating new educational 516.31campaigns that inform individuals of the 516.32importance of good oral health and the 516.33link between dental diseases, overall health 516.34status, and success in school; and517.1(5) programs testing new delivery models 517.2by creating partnerships between local early 517.3childhood and school-age education and 517.4community clinic dental providers.517.5(f) Qualified applicants are partnerships 517.6among early childhood experts, Minneapolis 517.7or Bemidji area public schools, and nonprofit 517.8clinics that are established to provide health 517.9services to low-income patients, provide 517.10preventive and dental care services, and 517.11utilize a sliding-scale fee or other method of 517.12providing charity care that ensures that no 517.13person is denied services because of inability 517.14to pay.517.15(g) Applicants shall submit to the 517.16commissioner an application and supporting 517.17documentation, in the form and manner 517.18specified by the commissioner. Applicants 517.19must be able to provide culturally appropriate 517.20outreach, screenings, and access to dental 517.21care for children, ages birth to five years, 517.22their parents, and pregnant women most at 517.23risk of poor oral health due to lack of access 517.24to dental care. Applicants must also meet the 517.25following criteria:517.26(1) have the potential to successfully increase 517.27access to families with children, ages birth 517.28to five years;517.29(2) incorporate quality program evaluation;517.30(3) maximize use of grant funds; and517.31(4) have experience in providing services to 517.32the target populations of this program.517.33(h) The commissioner shall evaluate the 517.34effectiveness of this pilot program on the 518.1oral health of children and their families and 518.2report to the house of representatives and 518.3senate committees with jurisdiction over 518.4public health policy and finance by January 518.51, 2009, with recommendations as to how to 518.6develop programs throughout Minnesota that 518.7provide education and access to oral health 518.8care for low-income and immigrant children.518.9Suicide prevention programs. $600,000 518.10each year is to fund the suicide prevention 518.11program. The base for fiscal years 2010 and 518.122011 is reduced by $300,000.518.13Hearing Aid Loan Bank. Of the general 518.14fund appropriation, $70,000 in fiscal year 518.152008 and $70,000 in fiscal year 2009 are 518.16for the purpose of providing a statewide 518.17hearing aid and instrument loan bank to 518.18families with children newly diagnosed with 518.19hearing loss from birth to the age of ten. This 518.20appropriation shall cover the administrative 518.21costs of the program.518.22Medical Home Learning Collaborative.518.23Of the general fund appropriation, $500,000 518.24in fiscal year 2008 and $500,000 in fiscal 518.25year 2009 are to expand the medical 518.26home learning collaborative initiative in 518.27collaboration with the commissioner of 518.28human services. Services provided under this 518.29funding must support a medical home model 518.30for children with special health care needs. 518.31The collaborative shall report back to the 518.32legislature on use of the funds by January 15, 518.332010. This appropriation shall not become 518.34part of the base funding for the 2010-2011 518.35biennium.

519.1Subd. 3.Policy, Quality, and Compliance51,709,00046,090,000

519.2Appropriations by Fund519.3General15,397,00016,237,000519.4519.5State Government Special Revenue13,403,00013,497,000519.6Health Care Access22,909,00016,356,000

519.7Health Care Access Survey. Of the 519.8health care access fund appropriation, 519.9$600,000 in fiscal year 2008 is appropriated 519.10to the commissioner to conduct a health 519.11insurance survey of Minnesota households, 519.12in partnership with the State Health Access 519.13Data Assistance Center at the University 519.14of Minnesota. The commissioner shall 519.15contract with the State Health Access Data 519.16Assistance Center to conduct a survey that 519.17provides information on the characteristics 519.18of the uninsured in Minnesota and the 519.19reasons for changing patterns of insurance 519.20coverage and access to health care services. 519.21This appropriation shall become part of the 519.22agency's base budget for even-numbered 519.23fiscal years.519.24MERC. Of the general fund appropriation, 519.25$8,000,000 each fiscal year is for distribution 519.26of MERC grants as follows:519.27(1) $5,000,000 according to Minnesota 519.28Statutes, section 62J.692, subdivision 4, 519.29paragraph (c);519.30(2) $900,000 according to Minnesota 519.31Statutes, section 62J.692, subdivision 4, 519.32paragraph (d);519.33(3) $100,000 according to Minnesota 519.34Statutes, section 62J.692, subdivision 4, 519.35paragraph (e); and520.1(4) $2,000,000 according to Minnesota 520.2Statutes, section 62J.692, subdivision 7a, 520.3paragraph (b).520.4Health Information Technology. Of 520.5the health care access fund appropriation, 520.6$6,750,000 each fiscal year is to implement 520.7Minnesota Statutes, section 144.3345. Up 520.8to $350,000 each fiscal year is available for 520.9grant administration and health information 520.10technology technical assistance and 520.11$6,400,000 each year is to be transferred 520.12to the commissioner of finance to establish 520.13and implement a revolving account under 520.14Minnesota Statutes, section 62J.496. This 520.15appropriation shall not be included in the 520.16agency's base budget for the fiscal year 520.17beginning July 1, 2009.520.18Health Insurance Exchange. Of the health 520.19care access fund appropriation, $6,000,000 520.20in fiscal year 2008 is appropriated to 520.21the commissioner to establish the health 520.22insurance exchange in Minnesota Statutes, 520.23section 62A.76. Up to $50,000 in fiscal year 520.242008 is available for administrative costs 520.25incurred by the Department of Health in 520.26establishing and providing grant funding to 520.27the legal entity responsible for implementing 520.28the health insurance exchange. This is a 520.29onetime appropriation.520.30Uncompensated Care Fund. Of the general 520.31fund appropriation, $65,000 in fiscal year 520.322008 is for the commissioner of health to 520.33study and present recommendations to the 520.34governor and the legislature by January 520.3515, 2008, on the design, operation, and 521.1funding of an uncompensated care fund to 521.2be used to provide subsidies to hospitals, 521.3community clinics, federally qualified health 521.4centers, community mental health centers, 521.5and other health care providers that serve 521.6a disproportionately large percentage of 521.7uninsured patients. An organization must not 521.8provide or perform abortion services under 521.9this program.521.10Community Collaboratives. Of the 521.11general fund appropriation, $300,000 for the 521.12biennium beginning July 1, 2007, is to the 521.13commissioner of health to provide grants 521.14to community collaboratives to cover the 521.15uninsured. This is a onetime appropriation.521.16Uniform Electronic Transactions. Of the 521.17general fund appropriation, $146,000 in fiscal 521.18year 2008 is for development of uniform 521.19electronic transactions and implementation 521.20guide standards under Minnesota Statutes, 521.21section 62J.536.521.22Federally Qualified Health Centers. Of the 521.23general fund appropriation, $3,000,000 in 521.24fiscal year 2008 and $3,900,000 in fiscal year 521.252009 are for subsidies to federally qualified 521.26health centers under Minnesota Statutes, 521.27section 145.9269.

521.28Subd. 4.Health Protection

521.29Appropriations by Fund521.30General20,544,00013,900,000521.31521.32State Government Special Revenue25,980,00026,674,000

521.33Pandemic Influenza Preparedness. Of 521.34the general fund appropriation to the 521.35commissioner, $6,035,000 in fiscal year 2008 522.1is for preparation, planning, and response 522.2to a pandemic influenza outbreak. This 522.3appropriation is available until June 30, 2009.522.4Base funding for the 2010-2011 biennium is 522.5$0 each fiscal year.522.6Environmental Health Tracking and 522.7Biomonitoring. (a) $500,000 in the first 522.8year and $900,000 in the second year are 522.9for the environmental health tracking and 522.10biomonitoring program. The base for fiscal 522.11year 2010 and fiscal year 2011 is increased 522.12by $300,000 each year.522.13(b) $300,000 each year is from the 522.14environmental fund to the Pollution Control 522.15Agency for transfer to the Department 522.16of Health for the health tracking and 522.17biomonitoring program. The base for the 522.18environmental fund is $0 in fiscal year 2010 522.19and after.522.20AIDS Prevention Initiative Focusing 522.21on African-born Residents. $300,000 in 522.222008 is for an AIDS prevention initiative 522.23focusing on African-born residents. This 522.24appropriation is a onetime appropriation 522.25and shall not become part of the base-level 522.26funding for the 2010-2011 biennium.522.27The commissioner of health shall award 522.28grants in accordance with Minnesota Statutes, 522.29section 145.924, paragraph (b), for a public 522.30education and awareness campaign targeting 522.31communities of African-born Minnesota 522.32residents. The grants shall be designed to 522.33promote knowledge and understanding about 522.34HIV and to increase knowledge in order 522.35to eliminate and reduce the risk for HIV 523.1infection; to encourage screening and testing 523.2for HIV; and to link individuals to public 523.3health and health care resources. The grants 523.4must be awarded to collaborative efforts that 523.5bring together nonprofit community-based 523.6groups with demonstrated experience in 523.7addressing the public health, health care, 523.8and social service needs of African-born 523.9communities.523.10Arsenic Health Risk Standard. $920,000 in 523.11the first year and $461,000 in the second year 523.12is to fund the study relating to arsenic health 523.13risk standards, under Minnesota Statutes, 523.14section 144.967.523.15Lindane and Bisphenol-A Studies.523.16$114,000 in the first year is for the Lindane 523.17committee and the study of bisphenol-A, 523.18under Minnesota Statutes, section 145.958. 523.19This is a onetime appropriation.523.20Decabromodiphenyl Ether Study.523.21$118,000 in the first year is for transfer to the 523.22commissioner of the pollution control agency 523.23for the study of decabromodiphenyl ether 523.24under Minnesota Statutes, section 325E.387. 523.25This is a onetime appropriation.523.26Radiation Study. $45,000 in the first year 523.27from the general fund and $15,000 in the 523.28first year from the state government special 523.29revenue fund are for the radiation study in 523.30section 62. This is a onetime appropriation.523.31Lead Abatement. $925,000 in the first 523.32year and $950,000 in the second year are 523.33for changes in lead abatement requirements. 523.34Of this amount, $6,000 in the first year and 523.35$11,000 in the second year are for transfer 524.1to the commissioner of human services for 524.2increased medical assistance costs. A portion 524.3of this amount may be used to reimburse 524.4local governments for costs of implementing 524.5the new requirements.524.6Water Treatment. $40,000 in fiscal year 524.72008 is to augment any appropriation from the 524.8remediation fund to conduct an evaluation of 524.9point of use water treatment units at removing 524.10perfluorooctanoic acid, perfluorooctane 524.11sulfonate, and perfluorobutanoic acid from 524.12known concentrations of these compounds 524.13in drinking water. The evaluation shall be 524.14completed by December 31, 2007, and the 524.15commissioner may contract for services to 524.16complete the evaluation. This is a onetime 524.17appropriation.524.18Environmental Justice Mapping. $137,000 524.19in the first year and $53,000 in the second 524.20year is for environmental justice mapping.524.21HIV Information. $80,000 each year 524.22is to fund a community-based nonprofit 524.23organization with demonstrated capacity to 524.24operate a statewide HIV information and 524.25referral service using telephone, Internet, and 524.26other appropriate technologies.524.27Lead Hazard Reduction. $250,000 is 524.28appropriated each year of the biennium for a 524.29grant to a nonprofit organization operating 524.30the CLEARCorps to conduct a pilot project 524.31to determine the incidence of lead hazards in 524.32pre-1978 rental property. Any balance in the 524.33first year does not cancel but is available in 524.34the second year.525.1Minnesota Birth Defects Information 525.2System. $750,000 each year is to maintain 525.3the birth defects information system that was 525.4established by Minnesota Statutes, section 525.5144.2215.

525.6Subd. 5.Minority and Multicultural Health

525.7Appropriations by Fund525.8General5,042,0005,052,000525.9Federal TANF2,683,0002,998,000

525.10TANF Appropriations. (a) $2,421,000 of 525.11the TANF funds is appropriated in each year 525.12of the biennium to the commissioner for 525.13home visiting and nutritional services listed 525.14under Minnesota Statutes, section 145.882, 525.15subdivision 7, clauses (6) and (7). Funding 525.16shall be distributed to tribal governments 525.17based on Minnesota Statutes, section 525.18145A.14, subdivision 2a, paragraph (b).525.19(b) $262,000 in the first year and $577,000 525.20in the second year are appropriated 525.21to the commissioner of health for the 525.22family home visiting grant program. The 525.23commissioner shall distribute funds to tribal 525.24governments using a formula developed in 525.25conjunction with tribal governments. The 525.26commissioner may use five percent of the 525.27funds appropriated in each fiscal year to 525.28conduct the ongoing evaluations required 525.29under Minnesota Statutes, section 145A.17, 525.30subdivision 7, and may use ten percent of 525.31the funds appropriated each fiscal year to 525.32provide training and technical assistance as 525.33required under Minnesota Statutes, section 525.34145A.17, subdivisions 4 and 5.526.1TANF Carryforward. Any unexpended 526.2balance of the TANF appropriation in the 526.3first year of the biennium does not cancel but 526.4is available for the second year.

526.5Subd. 6.Administrative Support Services

526.6Appropriations by Fund526.7General 11,047,000 11,197,000

526.8Disease Surveillance. $2,000,000 each fiscal 526.9year is for redesigning and implementing 526.10coordinated and modern disease surveillance 526.11systems for the department, ensuring that 526.12occupational and residential histories are 526.13included in the database. Base level funding 526.14for the 2012-2013 biennium will be $600,000 526.15each fiscal year for maintaining and operating 526.16the systems.

526.17526.18Sec. 5. VETERANS NURSING HOMES BOARD$44,124,000$46,244,000

526.19Veterans Homes Special Revenue Account.526.20The general fund  appropriations made to 526.21the board may be transferred to a veterans 526.22homes special revenue account in the 526.23special revenue fund in the same manner 526.24as other receipts are deposited according to 526.25Minnesota Statutes, section 198.34, and are 526.26appropriated to the board for the operation of 526.27board facilities and programs.526.28Repair and Betterment. Of this 526.29appropriation, $4,000,000 in fiscal year 526.302008 and $4,000,000 in fiscal year 2009 526.31are to be used for repair, maintenance, 526.32rehabilitation, and betterment activities at 526.33facilities statewide.527.1Base Adjustment. The general fund base is 527.2decreased by $2,000,000 in fiscal year 2010 527.3and $2,000,000 in fiscal year 2011.

527.4Sec. 6. HEALTH-RELATED BOARDS

527.5527.6Subdivision 1.Total Appropriation; State Government Special Revenue Fund$14,654,000$14,527,000

527.7The commissioner of finance shall not permit 527.8the allotment, encumbrance, or expenditure 527.9of money appropriated in this section in 527.10excess of the anticipated biennial revenues 527.11or accumulated surplus revenues from fees 527.12collected by the boards.

527.13Subd. 2.Board of Chiropractic Examiners450,000447,000

527.14Subd. 3.Board of Dentistry987,0001,009,000

527.15527.16Subd. 4.Board of Dietetic and Nutrition Practice103,000119,000

527.17Base Adjustment. Of this appropriation in 527.18fiscal year 2009, $14,000 is onetime.

527.19527.20Subd. 5.Board of Marriage and Family Therapy134,000154,000

527.21Base Adjustment. Of this appropriation in 527.22fiscal year 2009, $17,000 is onetime.

527.23Subd. 6.Board of Medical Practice4,120,0003,674,000

527.24Subd. 7.Board of Nursing3,985,0004,146,000

527.25527.26Subd. 8.Board of Nursing Home Administrators633,000647,000

527.27Administrative Services Unit. Of this 527.28appropriation, $430,000 in fiscal year 527.292008 and $439,000 in fiscal year 2009 are 527.30for the administrative services unit. The 527.31administrative services unit may receive 527.32and expend reimbursements for services 527.33performed by other agencies.

528.1Subd. 9.Board of Optometry98,000114,000

528.2Base Adjustment. Of this appropriation in 528.3fiscal year 2009, $13,000 is onetime.

528.4Subd. 10.Board of Pharmacy1,375,0001,442,000

528.5Base Adjustment. Of this appropriation in 528.6fiscal year 2009, $29,000 is onetime.

528.7Subd. 11.Board of Physical Therapy306,000295,000

528.8Subd. 12.Board of Podiatry54,00063,000

528.9Base Adjustment. Of this appropriation in 528.10fiscal year 2009, $7,000 is onetime.

528.11Subd. 13.Board of Psychology788,000806,000

528.12Subd. 14.Board of Social Work997,0001,022,000

528.13Subd. 15.Board of Veterinary Medicine230,000195,000

528.14528.15Subd. 16.Board of Behavioral Health and Therapy394,000394,000

528.16528.17Sec. 7. EMERGENCY MEDICAL SERVICES BOARD$4,617,000$4,645,000

528.18Appropriations by Fund528.1920082009528.20General3,023,0003,041,000528.21528.22State Government Special Revenue687,000704,000

528.23Regional Emergency Medical Services 528.24Programs. $400,000 each year is for 528.25regional emergency medical services 528.26programs, to be distributed equally to the 528.27eight emergency medical service regions. 528.28This amount shall be added to the base 528.29funding. Notwithstanding Minnesota 528.30Statutes, section 144E.50, 100 percent of 528.31the appropriation shall be passed on to the 528.32emergency medical service regions.529.1Health Professional Services Program.529.2$687,000 in fiscal year 2008 and $704,000 in 529.3fiscal year 2009 from the state government 529.4special revenue fund are for the health 529.5professional services program.

529.6Sec. 8. COUNCIL ON DISABILITY$582,000$590,000

529.7Options Too. (a) $75,000 for the first 529.8year and $75,000 for the second year are 529.9to continue the work of the Options Too 529.10disability services interagency work group 529.11established under Laws 2005, First Special 529.12Session chapter 4, article 7, section 57. 529.13Funds shall be used to monitor and assist the 529.14work group and the Options Too Steering 529.15Committee in the implementation of the 529.16recommendations in the Options Too report 529.17dated February 15, 2007.529.18(b) For purposes of this section, the Options 529.19Too Steering Committee shall consist of the 529.20following members:529.21(1) a representative from the Minnesota 529.22Housing Finance Agency;529.23(2) a representative from the Minnesota State 529.24Council on Disability; 529.25(3) a representative from the Department of 529.26Veterans Affairs;529.27(4) a representative from the Department of 529.28Transportation;529.29(5) a representative from the Department of 529.30Human Services; and529.31(6) representatives from interested 529.32stakeholders including counties, local 529.33public housing authorities, the Metropolitan 530.1Council, disability service providers, and 530.2disability advocacy organizations who are 530.3appointed by the Minnesota State Council on 530.4Disability for two-year terms.530.5(c) Notwithstanding Laws 2005, First Special 530.6Session chapter 4, article 7, section 57, the 530.7interagency work group shall be administered 530.8by the Minnesota Housing Finance Agency, 530.9the Minnesota State Council on Disability, 530.10Department of Human Services, and the 530.11Department of Transportation.530.12(d) The Options Too Steering Committee 530.13shall report to the chairs of the health 530.14and human services policy and finance 530.15committees of the senate and house of 530.16representatives by October 15, 2007, and 530.17October 15, 2008, on the continued progress 530.18of the work group towards implementing the 530.19recommendations in the Options Too report 530.20dated February 15, 2007.

530.21530.22530.23Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES$1,567,000$1,621,000

530.24Sec. 10. OMBUDSMAN FOR FAMILIES$251,000$257,000

530.25    Sec. 11. TRANSFERS.530.26    Subdivision 1.Grants.The commissioner of human services, with the approval 530.27of the commissioner of finance and after notifying the chairs of the senate and house 530.28committees with jurisdiction, may transfer unencumbered appropriation balances for the 530.29biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance; 530.30general assistance medical care; medical assistance; MFIP child care assistance under 530.31Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential 530.32housing programs; and the entitlement portion of the chemical dependency consolidated 530.33treatment fund and between fiscal years of the biennium.531.1    Subd. 2.Administration.Positions, salary money, and nonsalary administrative 531.2money may be transferred within the Departments of Human Services and Health and 531.3within the programs operated by the Veterans Nursing Homes Board as the commissioners 531.4and the board consider necessary, with the advance approval of the commissioner of 531.5finance. The commissioner or the board shall inform the chairs of the house and senate 531.6committees with jurisdiction quarterly about transfers made under this provision.531.7    Sec. 12. INDIRECT COSTS NOT TO FUND PROGRAMS.531.8    The commissioners of health and of human services shall not use indirect cost 531.9allocations to pay for the operational costs of any program for which they are responsible.531.10    Sec. 13. SUNSET OF UNCODIFIED LANGUAGE.531.11    All uncodified language contained in this article expires on June 30, 2009, unless a 531.12different expiration date is explicit.531.13    Sec. 14. EFFECTIVE DATE.531.14    The provisions in this article are effective July 1, 2007, unless a different effective 531.15date is specified.