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; appropriating 1.15money for various state boards and councils;amending Minnesota Statutes 2006, 1.16sections 13.3806, by adding a subdivision; 13.46, subdivision 2; 16A.10, by 1.17adding a subdivision; 16B.61, by adding a subdivision; 16D.13, subdivision 1.183; 43A.316; 62A.65, subdivision 3; 62E.141; 62H.02; 62J.04, subdivision 1.193; 62J.17, subdivisions 2, 4a, 7; 62J.41, subdivision 1; 62J.495; 62J.52, 1.20subdivisions 1, 2; 62J.60, subdivisions 2, 3; 62J.692, subdivisions 1, 4, 7a, 8, 10; 1.2162J.81, subdivision 1; 62J.82; 62L.12, subdivisions 2, 4; 62Q.165, subdivisions 1.221, 2; 62Q.80, subdivisions 3, 4, 13, 14, by adding a subdivision; 103I.101, 1.23subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision 1; 119B.05, 1.24subdivision 1; 119B.09, subdivisions 1, 7, by adding subdivisions; 119B.12; 1.25119B.125, subdivision 2; 119B.13, subdivisions 1, 3a, 6, 7; 119B.21, subdivision 1.265; 144.05, by adding a subdivision; 144.123; 144.125; 144.2215, subdivision 1; 1.27144.3345; 144.565; 144.651, subdivision 26; 144.672, subdivision 1; 144.698, 1.28subdivision 1; 144.699, by adding a subdivision; 144.9502, subdivision 1.293; 144.9504, subdivision 2; 144.9507, by adding a subdivision; 144.9512; 1.30144A.071, subdivision 4c; 144D.03, subdivision 1; 144E.101, subdivision 6; 1.31144E.127; 144E.35, subdivision 1; 145A.17; 145C.05; 145C.07, by adding 1.32a subdivision; 148.235, by adding a subdivision; 148.6445, subdivisions 1, 1.332; 148B.53, subdivision 3; 149A.52, subdivision 3; 149A.97, subdivision 7; 1.34151.37, subdivision 2; 152.11, by adding a subdivision; 156.001, by adding a 1.35subdivision; 156.02, subdivisions 1, 2; 156.04; 156.072, subdivision 2; 156.073; 1.36156.12, subdivisions 2, 4, 6; 156.15, subdivision 2; 156.16, subdivisions 3, 10; 1.37156.18, subdivisions 1, 2; 156.19; 157.16, subdivision 1; 179A.03, subdivision 7; 1.38198.075; 245.462, subdivision 20; 245.465, by adding a subdivision; 245.4874; 1.39245.50, subdivision 5; 245.98, subdivisions 2, 5; 245A.035; 245A.10, subdivision 2.12; 245A.16, subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04, 2.2subdivision 1; 245C.05, subdivisions 1, 4, 5, 7, by adding a subdivision; 245C.08, 2.3subdivisions 1, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 2.4245C.12; 245C.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 256.969, subdivision 3a, is amended to 140.32read:140.33    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 140.34assistance program must not be submitted until the recipient is discharged. However, 141.1the commissioner shall establish monthly interim payments for inpatient hospitals that 141.2have individual patient lengths of stay over 30 days regardless of diagnostic category. 141.3Except as provided in section 
         256.9693, medical assistance reimbursement for treatment 141.4of mental illness shall be reimbursed based on diagnostic classifications. Individual 141.5hospital payments established under this section and sections 
         256.9685, 
         256.9686, and 141.6256.9695
         , in addition to third party and recipient liability, for discharges occurring during 141.7the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 141.8inpatient services paid for the same period of time to the hospital. This payment limitation 141.9shall be calculated separately for medical assistance and general assistance medical 141.10care services. The limitation on general assistance medical care shall be effective for 141.11admissions occurring on or after July 1, 1991. Services that have rates established under 141.12subdivision 11 or 12, must be limited separately from other services. After consulting with 141.13the affected hospitals, the commissioner may consider related hospitals one entity and 141.14may merge the payment rates while maintaining separate provider numbers. The operating 141.15and property base rates per admission or per day shall be derived from the best Medicare 141.16and claims data available when rates are established. The commissioner shall determine 141.17the best Medicare and claims data, taking into consideration variables of recency of the 141.18data, audit disposition, settlement status, and the ability to set rates in a timely manner. 141.19The commissioner shall notify hospitals of payment rates by December 1 of the year 141.20preceding the rate year. The rate setting data must reflect the admissions data used to 141.21establish relative values. Base year changes from 1981 to the base year established for the 141.22rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 141.23to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 141.241. The commissioner may adjust base year cost, relative value, and case mix index data 141.25to exclude the costs of services that have been discontinued by the October 1 of the year 141.26preceding the rate year or that are paid separately from inpatient services. Inpatient stays 141.27that encompass portions of two or more rate years shall have payments established based 141.28on payment rates in effect at the time of admission unless the date of admission preceded 141.29the rate year in effect by six months or more. In this case, operating payment rates for 141.30services rendered during the rate year in effect and established based on the date of 141.31admission shall be adjusted to the rate year in effect by the hospital cost index.141.32    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 141.33payment, before third-party liability and spenddown, made to hospitals for inpatient 141.34services is reduced by .5 percent from the current statutory rates.141.35    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 141.36admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 142.1before third-party liability and spenddown, is reduced five percent from the current 142.2statutory rates. Mental health services within diagnosis related groups 424 to 432, and142.3facilities defined under subdivision 16, and, effective for admissions occurring on or after 142.4July 1, 2007, a long-term hospital as designated by the Medicare program that is located in 142.5a city of the first class as defined in section 410.01, are excluded from this paragraph.142.6    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 142.7fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 142.8inpatient services before third-party liability and spenddown, is reduced 6.0 percent from 142.9the current statutory rates. Mental health services within diagnosis related groups 424 to 142.10432 and, facilities defined under subdivision 16, and, effective for admissions occurring 142.11on or after July 1, 2007, a long-term hospital as designated by the Medicare program 142.12that is located in a city of the first class as defined in section 410.01, are excluded from 142.13this paragraph. Notwithstanding section 
         256.9686, subdivision 7, for purposes of this 142.14paragraph, medical assistance does not include general assistance medical care. Payments 142.15made to managed care plans shall be reduced for services provided on or after January 142.161, 2006, to reflect this reduction.142.17    Sec. 2. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:142.18    Subd. 9. Disproportionate numbers of low-income patients served. (a) For 142.19admissions occurring on or after October 1, 1992, through December 31, 1992, the 142.20medical assistance disproportionate population adjustment shall comply with federal law 142.21and shall be paid to a hospital, excluding regional treatment centers and facilities of the 142.22federal Indian Health Service, with a medical assistance inpatient utilization rate in excess 142.23of the arithmetic mean. The adjustment must be determined as follows:142.24    (1) for a hospital with a medical assistance inpatient utilization rate above the 142.25arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 142.26federal Indian Health Service but less than or equal to one standard deviation above the 142.27mean, the adjustment must be determined by multiplying the total of the operating and 142.28property payment rates by the difference between the hospital's actual medical assistance 142.29inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 142.30treatment centers and facilities of the federal Indian Health Service; and142.31    (2) for a hospital with a medical assistance inpatient utilization rate above one 142.32standard deviation above the mean, the adjustment must be determined by multiplying 142.33the adjustment that would be determined under clause (1) for that hospital by 1.1. If 142.34federal matching funds are not available for all adjustments under this subdivision, the 142.35commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for 143.1federal match. The commissioner may establish a separate disproportionate population 143.2operating payment rate adjustment under the general assistance medical care program. 143.3For purposes of this subdivision medical assistance does not include general assistance 143.4medical care. The commissioner shall report annually on the number of hospitals likely to 143.5receive the adjustment authorized by this paragraph. The commissioner shall specifically 143.6report on the adjustments received by public hospitals and public hospital corporations 143.7located in cities of the first class.143.8    (b) For admissions occurring on or after July 1, 1993, the medical assistance 143.9disproportionate population adjustment shall comply with federal law and shall be paid to 143.10a hospital, excluding regional treatment centers and facilities of the federal Indian Health 143.11Service, with a medical assistance inpatient utilization rate in excess of the arithmetic 143.12mean. The adjustment must be determined as follows:143.13    (1) for a hospital with a medical assistance inpatient utilization rate above the 143.14arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 143.15federal Indian Health Service but less than or equal to one standard deviation above the 143.16mean, the adjustment must be determined by multiplying the total of the operating and 143.17property payment rates by the difference between the hospital's actual medical assistance 143.18inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 143.19treatment centers and facilities of the federal Indian Health Service;143.20    (2) for a hospital with a medical assistance inpatient utilization rate above one 143.21standard deviation above the mean, the adjustment must be determined by multiplying 143.22the adjustment that would be determined under clause (1) for that hospital by 1.1. The 143.23commissioner may establish a separate disproportionate population operating payment 143.24rate adjustment under the general assistance medical care program. For purposes of this 143.25subdivision, medical assistance does not include general assistance medical care. The 143.26commissioner shall report annually on the number of hospitals likely to receive the 143.27adjustment authorized by this paragraph. The commissioner shall specifically report on 143.28the adjustments received by public hospitals and public hospital corporations located 143.29in cities of the first class;143.30    (3) for a hospital that had medical assistance fee-for-service payment volume during 143.31calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service 143.32payment volume, a medical assistance disproportionate population adjustment shall be 143.33paid in addition to any other disproportionate payment due under this subdivision as 143.34follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. 143.35For a hospital that had medical assistance fee-for-service payment volume during calendar 143.36year 1991 in excess of eight percent of total medical assistance fee-for-service payment 144.1volume and was the primary hospital affiliated with the University of Minnesota, a 144.2medical assistance disproportionate population adjustment shall be paid in addition to any 144.3other disproportionate payment due under this subdivision as follows: $505,000 due on 144.4the 15th of each month after noon, beginning July 15, 1995; and144.5    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be 144.6reduced to zero.144.7    (c) The commissioner shall adjust rates paid to a health maintenance organization 144.8under contract with the commissioner to reflect rate increases provided in paragraph (b), 144.9clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those 144.10rates to reflect payments provided in clause (3).144.11    (d) If federal matching funds are not available for all adjustments under paragraph 144.12(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a 144.13pro rata basis so that all adjustments under paragraph (b) qualify for federal match.144.14    (e) For purposes of this subdivision, medical assistance does not include general 144.15assistance medical care.144.16    (f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, general 144.17assistance medical care expenditures for fee-for-service inpatient and outpatient hospital 144.18services made by the department and by prepaid health plans participating in general 144.19assistance medical careeffective July 1, 2007, payments under section 256B.199 shall be 144.20considered Medicaid disproportionate share hospital payments, except as limited below:144.21by clauses (1) to (5);144.22    (1) only the portion of Minnesota's disproportionate share hospital allotment under 144.23section 1923(f) of the Social Security Act that is not spent on the disproportionate 144.24population adjustments in paragraph (b), clauses (1) and (2), may be used for general 144.25assistance medical care expenditures;144.26    (2) only those general assistance medical care expenditures made to hospitals that 144.27qualify for disproportionate share payments under section 1923 of the Social Security Act 144.28and the Medicaid state plan may be considered disproportionate share hospital payments;144.29    (3) only those general assistance medical care expenditures made to an individual 144.30hospital that would not cause the hospital to exceed its individual hospital limits under 144.31section 1923 of the Social Security Act may be considered; and144.32    (4) general assistance medical care expenditures may be considered only to the 144.33extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.144.34All hospitals and prepaid health plans participating in general assistance medical care 144.35must provide any necessary expenditure, cost, and revenue information required by 144.36the commissioner as necessary for purposes of obtaining federal Medicaid matching 145.1funds for general assistance medical care expenditures. Medicaid disproportionate share 145.2payments; and145.3    (5) expenditures under general assistance medical care shall be used to the fullest 145.4extent before payments under section 256B.199.145.5    (g) Upon federal approval of the related state plan amendment, paragraph (f) is 145.6effective retroactively from July 1, 2005, or the earliest effective date approved by the 145.7Centers for Medicare and Medicaid Services.145.8    Sec. 3. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision 145.9to read:145.10    Subd. 28.Long-term hospital payment adjustment.For admissions occurring on 145.11or after July 1, 2009, the commissioner shall increase the medical assistance payments 145.12to a long-term hospital with a medical assistance inpatient utilization rate of 17.95 145.13percent of total patient days as of the base year in effect on July 1, 2005, by an amount 145.14equal to 13 percent of the total of the operating and property payment rates. Payments 145.15made to managed care plans shall not reflect this payment increase. For purposes of 145.16this subdivision, medical assistance does not include general assistance medical care. 145.17Payments to a hospital under this subdivision shall be reduced by the amount of any 145.18payments made under subdivision 27.145.19    Sec. 4. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:145.20    Subd. 14. Competitive bidding. (a) When determined to be effective, economical, 145.21and feasible, the commissioner may utilize volume purchase through competitive bidding 145.22and negotiation under the provisions of chapter 16C, to provide items under the medical 145.23assistance program including but not limited to the following:145.24    (1) eyeglasses;145.25    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency 145.26situation on a short-term basis, until the vendor can obtain the necessary supply from 145.27the contract dealer;145.28    (3) hearing aids and supplies; and145.29    (4) durable medical equipment, including but not limited to:145.30    (i) hospital beds;145.31    (ii) commodes;145.32    (iii) glide-about chairs;145.33    (iv) patient lift apparatus;145.34    (v) wheelchairs and accessories;146.1    (vi) oxygen administration equipment;146.2    (vii) respiratory therapy equipment;146.3    (viii) electronic diagnostic, therapeutic and life support systems;146.4    (5) specialnonemergency transportation services level of need determinations, 146.5disbursement of public transportation passes and tokens, and volunteer and recipient 146.6mileage and parking reimbursements; and146.7    (6) drugs.146.8    (b) Rate changes under this chapter and chapters 256D and 256L do not affect 146.9contract payments under this subdivision unless specifically identified.146.10    Sec. 5. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision 146.11to read:146.12    Subd. 14a.Level of need determination.Nonemergency medical transportation 146.13level of need determinations must be performed by a physician, a registered nurse working 146.14under direct supervision of a physician, a physician's assistant, a nurse practitioner, a 146.15licensed practical nurse, or a discharge planner. Nonemergency medical transportation 146.16level of need determinations must not be performed more than semiannually on any 146.17individual, unless the individual's circumstances have sufficiently changed so as to 146.18require a new level of need determination. Individuals residing in licensed nursing 146.19facilities and individuals requiring stretcher transportation are exempt from a level of need 146.20determination and are eligible for special transportation services until the individual no 146.21longer resides in a licensed nursing facility or no longer requires stretcher transportation.146.22    Sec. 6. Minnesota Statutes 2006, section 256B.056, is amended by adding a 146.23subdivision to read:146.24    Subd. 1d.Treatment of certain monetary gifts.The commissioner shall disregard 146.25as income any portion of a monetary gift received by an applicant or enrollee that is 146.26designated to purchase a prosthetic device not covered by insurance, other third-party 146.27payers, or medical assistance.146.28    Sec. 7. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to 146.29read:146.30    Subd. 3f. Circumcision for newborns.Newborn Circumcision is not covered, 146.31unless the procedure is medically necessary or required because of a well-established 146.32religious practice.147.1    Sec. 8. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 147.2subdivision to read:147.3    Subd. 8d.Chiropractic services.Medical assistance covers the following 147.4medically necessary chiropractic services: one initial or progress exam per year, manual 147.5manipulation of the spine, and x-rays.147.6EFFECTIVE DATE.This section is effective July 1, 2007.147.7    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to 147.8read:147.9    Subd. 13c. Formulary committee. The commissioner, after receiving 147.10recommendations from professional medical associations and professional pharmacy 147.11associations, and consumer groups shall designate a Formulary Committee to carry 147.12out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be 147.13comprised of four licensed physicians actively engaged in the practice of medicine in 147.14Minnesota one of whom must be actively engaged in the treatment of persons with mental 147.15illness; at least three licensed pharmacists actively engaged in the practice of pharmacy 147.16in Minnesota; and one consumer representative; the remainder to be made up of health 147.17care professionals who are licensed in their field and have recognized knowledge in the 147.18clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs. 147.19Members of the Formulary Committee shall not be employed by the Department of 147.20Human Services, but the committee shall be staffed by an employee of the department 147.21who shall serve as an ex officio, nonvoting member of the board committee. The 147.22department's medical director shall also serve as an ex officio, nonvoting member for the 147.23committee. Committee members shall serve three-year terms and may be reappointed 147.24by the commissioner. The Formulary Committee shall meet at least quarterly. The 147.25commissioner may require more frequent Formulary Committee meetings as needed. An 147.26honorarium of $100 per meeting and reimbursement for mileage shall be paid to each 147.27committee member in attendance.147.28    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to 147.29read:147.30    Subd. 13d. Drug formulary.(a) The commissioner shall establish a drug 147.31formulary. Its establishment and publication shall not be subject to the requirements of the 147.32Administrative Procedure Act, but the Formulary Committee shall review and comment 147.33on the formulary contents.147.34    (b) The formulary shall not include:148.1    (1) drugs or products for which there is no federal funding;148.2    (2) over-the-counter drugs, except as provided in subdivision 13;148.3    (3) drugs used for weight loss, except that medically necessary lipase inhibitors may 148.4be covered for a recipient with type II diabetes;148.5    (4) drugs when used for the treatment of impotence or erectile dysfunction;148.6    (5) drugs for which medical value has not been established; and148.7    (6) drugs from manufacturers who have not signed a rebate agreement with the 148.8Department of Health and Human Services pursuant to section 1927 of title XIX of the 148.9Social Security Act.148.10    (c) If a single-source drug used by at least two percent of the fee-for-service 148.11medical assistance recipients is removed from the formulary due to the failure of the 148.12manufacturer to sign a rebate agreement with the Department of Health and Human 148.13Services, the commissioner shall notify prescribing practitioners within 30 days of 148.14receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a 148.15rebate agreement was not signed.148.16EFFECTIVE DATE.This section is effective the day following final enactment.148.17    Sec. 11. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 148.18subdivision to read:148.19    Subd. 13i.Medicare Part D.Notwithstanding subdivision 13, paragraph (d), for 148.20recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare 148.21Advantage special needs plan, medical assistance covers co-payments which the recipient 148.22is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage 148.23special needs plan, once the recipient has paid $12 per month in prescription drug 148.24co-payments, and according to the requirements of the plan.148.25    Sec. 12. Minnesota Statutes 2006, section 256B.0625, subdivision 17, is amended to 148.26read:148.27    Subd. 17. Transportation costs. (a) Medical assistance covers transportation costs 148.28incurred solely for obtaining emergency medical care or transportation costs incurred 148.29by eligible persons in obtaining emergency or nonemergency medical care when paid 148.30directly to an ambulance company, common carrier, or other recognized providers of 148.31transportation services.148.32    (b) Medical assistance covers special transportation, as defined in Minnesota Rules, 148.33part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 149.1would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 149.2transportation, or private automobile.149.3The commissioner may use an order by the recipient's attending physician to certify that 149.4the recipient requires special transportation services. Special transportation includes 149.5driver-assisted service to eligible individuals. Driver-assisted service includes passenger 149.6pickup at and return to the individual's residence or place of business, assistance with 149.7admittance of the individual to the medical facility, and assistance in passenger securement 149.8or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers 149.9must obtain written documentation from the health care service provider who is serving 149.10the recipient being transported, identifying the time that the recipient arrived. Special 149.11transportation providers may not bill for separate base rates for the continuation of a trip 149.12beyond the original destination. Special transportation providers must take recipients 149.13to the nearest appropriate health care provider, using the most direct quickest route 149.14available as determined by a commercially available mileage software program approved 149.15by the commissioner. The maximum medical assistance reimbursement rates for special 149.16transportation services are:149.17    (1) $17 for the base rate and $1.35 $1.43 per mile for services to eligible persons 149.18who need a wheelchair-accessible van;149.19    (2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who 149.20do not need a wheelchair-accessible van; and149.21    (3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 149.22services to eligible persons who need a stretcher-accessible vehicle.149.23    Sec. 13. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 149.24read:149.25    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 149.26meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 149.27$6.50 for lunch, or $8 for dinner.149.28    (b) Medical assistance reimbursement for lodging for persons traveling to receive 149.29medical care may not exceed $50 per day unless prior authorized by the local agency.149.30    (c) Medical assistance direct mileage reimbursement to thean eligible person or the149.31an eligible person's driver may not exceed 20 cents per mile friend, neighbor, or relative 149.32that is providing direct transportation to a covered service shall be at 15 cents below the 149.33current Internal Revenue Service mileage reimbursement for business purposes.150.1    (d) Medical assistance covers oral language interpreter services when provided by 150.2an enrolled health care provider during the course of providing a direct, person-to-person 150.3covered health care service to an enrolled recipient with limited English proficiency.150.4    Sec. 14. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 150.5subdivision to read:150.6    Subd. 49.Community health worker.(a) Medical assistance covers the care 150.7coordination and patient education services provided by a community health worker if 150.8the community health worker has: 150.9    (1) received a certificate from the Minnesota State Colleges and Universities System 150.10approved community health worker curriculum; or150.11    (2) at least five years of supervised experience with an enrolled physician or 150.12advanced practice registered nurse.150.13Community health workers eligible for payment under clause (2) must complete the 150.14certification program by January 1, 2010, to continue to be eligible for payment.150.15    (b) Community health workers must work under the supervision of a medical 150.16assistance enrolled physician or advanced practice registered nurse.150.17    Sec. 15. Minnesota Statutes 2006, section 256B.0644, is amended to read:150.18256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 150.19PROGRAMS.150.20    (a) A vendor of medical care, as defined in section 
         256B.02, subdivision 7, and a 150.21health maintenance organization, as defined in chapter 62D, must participate as a provider 150.22or contractor in the medical assistance program, general assistance medical care program, 150.23and MinnesotaCare as a condition of participating as a provider in health insurance plans 150.24and programs or contractor for state employees established under section 
         43A.18, the 150.25public employees insurance program under section 
         43A.316, for health insurance plans 150.26offered to local statutory or home rule charter city, county, and school district employees, 150.27the workers' compensation system under section 
         176.135, and insurance plans provided 150.28through the Minnesota Comprehensive Health Association under sections 
         62E.01 to 150.2962E.19
         . The limitations on insurance plans offered to local government employees shall 150.30not be applicable in geographic areas where provider participation is limited by managed 150.31care contracts with the Department of Human Services. 150.32    (b) For providers other than health maintenance organizations, participation in the 150.33medical assistance program means that:151.1     (1) the provider accepts new medical assistance, general assistance medical care, 151.2and MinnesotaCare patients or;151.3    (2) for providers other than dental service providers, at least 20 percent of the 151.4provider's patients are covered by medical assistance, general assistance medical care, and 151.5MinnesotaCare as their primary source of coverage, or; or151.6    (3) for dental service providers, at least ten percent of the provider's patients are 151.7covered by medical assistance, general assistance medical care, and MinnesotaCare as 151.8their primary source of coverage, or the provider accepts new medical assistance and 151.9MinnesotaCare patients who are children with special health care needs. For purposes 151.10of this section, "children with special health care needs" means children up to age 18 151.11who: (i) require health and related services beyond that required by children generally; 151.12and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 151.13condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 151.14cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 151.15neurological diseases; visual impairment or deafness; Down syndrome and other genetic 151.16disorders; autism; fetal alcohol syndrome; and other conditions designated by the 151.17commissioner after consultation with representatives of pediatric dental providers and 151.18consumers. 151.19    (c) Patients seen on a volunteer basis by the provider at a location other than the 151.20provider's usual place of practice may be considered in meeting this the participation 151.21requirement in this section. The commissioner shall establish participation requirements 151.22for health maintenance organizations. The commissioner shall provide lists of 151.23participating medical assistance providers on a quarterly basis to the commissioner of 151.24employee relations, the commissioner of labor and industry, and the commissioner of 151.25commerce. Each of the commissioners shall develop and implement procedures to exclude 151.26as participating providers in the program or programs under their jurisdiction those 151.27providers who do not participate in the medical assistance program. The commissioner 151.28of employee relations shall implement this section through contracts with participating 151.29health and dental carriers. 151.30    Sec. 16. [256B.0751] CARE COORDINATION FOR CHILDREN WITH 151.31HIGH-COST MEDICAL CONDITIONS.151.32    Subdivision 1.Care coordination required.(a) The commissioner of human 151.33services shall contract with the U special kids program to provide care coordination, 151.34beginning October 1, 2007, for medical assistance enrollees who are children with 151.35high-cost medical conditions, and to perform the other duties specified in this section.152.1    (b) For purposes of this section, "care coordination" means collaboration with 152.2primary care physicians and specialists to manage care, development of medical 152.3management plans for recurrent acute illnesses, oversight and coordination of all aspects 152.4of care in partnership with families, organization of medical information into a summary 152.5of critical information, coordination and appropriate sequencing of tests and multiple 152.6appointments, information and assistance with accessing resources, and telephone triage 152.7for acute illnesses or problems.152.8    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer 152.9children to the U special kids program for care coordination. Beginning October 1, 2007, 152.10and subject to the limits on total program enrollment specified in subdivision 3, the 152.11commissioner shall refer to the U special kids program children who:152.12    (1) incur medical expenses that exceed the qualifying level specified in subdivision 3;152.13    (2) have medical conditions that involve four or more major systems; require 152.14multiple specialists; require use of technology such as G-tube, trach, central line, or 152.15oxygen; and require multiple medications;152.16    (3) do not have a medical case manager for cancer, organ transplantation, epilepsy, 152.17or bone marrow replacement; and152.18    (4) voluntarily agree to participate in the program.152.19    Subd. 3.Qualifying level of medical expenses.(a) For the period October 1, 2007, 152.20through September 30, 2008, the commissioner shall refer children for care coordination 152.21under this section if they incurred medical expenses of $500,000 or more during the 152.22fiscal year ending June 30, 2007.152.23    (b) For the period October 1, 2008, through September 30, 2009, the commissioner 152.24shall refer children for care coordination under this section if they incurred medical 152.25expenses of $400,000 or more during the fiscal year ending June 30, 2008.152.26    (c) For the period October 1, 2009, through September 30, 2010, the commissioner 152.27shall refer children for care coordination under this section if they incurred medical 152.28expenses of $300,000 or more during the fiscal year ending June 30, 2009.152.29    (d) Beginning October 1, 2010, the commissioner shall refer children for care 152.30coordination under this section if they incurred medical expenses of $250,000 or more 152.31during the previous fiscal year.152.32    (e) The commissioner shall limit referrals to the extent necessary to ensure that 152.33total enrollment in the U special kids program does not exceed 100 children for the 152.34period October 1, 2007, through September 30, 2008, and does not exceed 150 children 152.35beginning October 1, 2008.153.1    Subd. 4.Case management.Beginning October 1, 2007, the U special kids 153.2program shall coordinate all nonmedical case management services provided to children 153.3who are required to receive care coordination under this section. The program may 153.4require all nonmedical case managers, including, but not limited to, county case managers 153.5and case managers for children served under a home and community-based waiver, 153.6to submit care plans for approval, and to document client compliance with the care 153.7plans. The U special kids program, beginning October 1, 2008, may employ or contract 153.8with nonmedical case managers to provide all nonmedical case management services to 153.9children required to receive care coordination under this section. The commissioner shall 153.10reimburse the U special kids program for case management services through the medical 153.11assistance program.153.12    Subd. 5.Statewide availability of care coordination.The U special kids program 153.13may contract with other entities to provide care coordination services as defined in 153.14subdivision 1, in order to ensure the availability of these services in all regions of the state.153.15    Subd. 6.Advance practice nurse telephone triage system.The U special kids 153.16program shall establish and operate an advance practice nurse telephone triage system that 153.17is available statewide, 24 hours a day, seven days per week. The system must provide 153.18advance practice nurses with access to a Web-based information system to appropriately 153.19triage medical problems, manage care, and reduce unnecessary hospitalizations.153.20    Subd. 7.Monitoring and evaluation.The commissioner shall monitor program 153.21outcomes and evaluate the extent to which referrals to the U special kids program have 153.22improved the quality and coordination of care and provided financial savings to the 153.23medical assistance program. The U special kids program shall submit to the commissioner, 153.24in the form and manner specified by the commissioner, all data and information necessary 153.25to monitor program outcomes and evaluate the program. The commissioner shall present a 153.26preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 153.27legislature by January 15, 2010.153.28EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 153.29approval, whichever is later.153.30    Sec. 17. [256B.0752] CARE COORDINATION FOR CHILDREN WITH 153.31HIGH-COST MENTAL HEALTH CONDITIONS.153.32    Subdivision 1.Care coordination required.(a) The commissioner of human 153.33services shall contract with the U special kids program to provide care coordination, 153.34beginning October 1, 2007, for medical assistance enrollees who are children with 154.1high-cost mental health conditions and behavioral problems, and to perform the other 154.2duties specified in this section.154.3    (b) For purposes of this section, "care coordination" means: collaboration with 154.4primary care physicians and specialists to manage care; development of mental health 154.5management plans for recurrent mental health issues; oversight and coordination of all 154.6aspects of care in partnership with families; organization of medical, treatment, and 154.7therapy information into a summary of critical information; coordination and appropriate 154.8sequencing of evaluations and multiple appointments; information and assistance with 154.9accessing resources; and telephone triage for behavior or other problems.154.10    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer children 154.11to the program for care coordination. Beginning October 1, 2007, and subject to the limits 154.12on total program enrollment specified in subdivision 3, the commissioner shall refer to 154.13the U special kids program children who:154.14    (1) incur mental health expenses that exceed the qualifying level specified in 154.15subdivision 3;154.16    (2) are currently receiving or at risk of needing inpatient mental health treatment, 154.17foster home care, or both; and154.18    (3) voluntarily agree to participate in the program.154.19    Subd. 3.Qualifying level of medical expenses.(a) Beginning October 1, 2007, the 154.20commissioner shall refer children for care coordination under this section if they incurred 154.21medical and mental health expenses of $250,000 or more in the previous fiscal year.154.22    (b) The commissioner shall limit referrals to the extent necessary to ensure that total 154.23enrollment in the U special kids program does not exceed 25 children for the period 154.24October 1, 2007, through September 30, 2008; does not exceed 75 children for the 154.25period October 1, 2008, through September 30, 2009; and does not exceed 125 children 154.26beginning October 1, 2009.154.27    Subd. 4.Case management.The U special kids program, beginning October 1, 154.282007, shall coordinate all nonmedical case management services provided to children who 154.29are required to receive care coordination under this section. The program may require all 154.30nonmedical case managers, including but not limited to county case managers and case 154.31managers for children served under a home and community-based waiver, to submit care 154.32plans for approval, and to document client compliance with the care plans. The U special 154.33kids program, beginning October 1, 2008, may employ or contract with nonmedical case 154.34managers to provide all nonmedical case management services to children required to 154.35receive care coordination under this section. The commissioner shall reimburse the 155.1U special kids program for case management services through the medical assistance 155.2program.155.3    Subd. 5.Statewide availability of care coordination.The program may contract 155.4with other entities to provide care coordination services as defined in subdivision 1, in 155.5order to ensure the availability of these services in all regions of the state.155.6    Subd. 6.Monitoring and evaluation.The commissioner shall monitor program 155.7outcomes and shall evaluate the extent to which referrals to the U special kids program 155.8have improved the quality and coordination of care and provided financial savings to the 155.9medical assistance program. The U special kids program shall submit to the commissioner, 155.10in the form and manner specified by the commissioner, all data and information necessary 155.11to monitor program outcomes and evaluate the program. The commissioner shall present a 155.12preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 155.13legislature by January 15, 2010.155.14EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 155.15approval, whichever is later. The commissioner shall notify the Office of the Revisor of 155.16Statutes when federal approval is obtained.155.17    Sec. 18. [256B.194] FEDERAL PAYMENTS.155.18    Subdivision 1.Payments at actual cost.If the Centers for Medicare & Medicaid 155.19Services (CMS) promulgates a final rule consistent with its stated intent in the proposed 155.20rule published at 72 Federal Register, No. 11, January 18, 2007, regarding limiting 155.21payments to units of government, and notwithstanding Minnesota Statutes or Minnesota 155.22Rules to the contrary, for providers that are units of government, the commissioner may 155.23limit medical assistance and MinnesotaCare payments to a provider's actual cost of 155.24providing services, in accordance with the CMS final rule. If a final rule is promulgated, 155.25the commissioner may also require medical assistance and MinnesotaCare providers to 155.26provide any information necessary to determine Medicaid-related costs, and require the 155.27cooperation of providers in any audit or review necessary to ensure payments are limited 155.28to cost. This section does not apply to providers who are exempt from the provisions of 155.29the CMS final rule.155.30    Subd. 2.Loss of federal financial participation.For all transfers, certified 155.31expenditures, and medical assistance payments listed below, if the commissioner 155.32determines that federal financial participation is no longer available for the medical 155.33assistance payments listed, then related obligations for the nonfederal share of payments 155.34and the medical assistance payments shall terminate. The commissioner shall notify all 155.35affected parties of the loss of federal financial participation, and the resulting payments 156.1and obligations that are terminated. If the commissioner determines that federal financial 156.2participation is no longer available for any medical assistance payments or contributions 156.3to the nonfederal share of medical assistance payments that have already been made, the 156.4commissioner may collect the medical assistance payments from providers and return 156.5contributions of the nonfederal share to its source. The transfers, certified expenditures, 156.6and medical assistance payments subject to this section are those specified in: sections 156.762J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d; 156.8256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses 156.9(2), (3), and (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws 156.102005, First Special Session chapter 4, article 9, section 2, subdivision 1.156.11    Sec. 19. Minnesota Statutes 2006, section 256B.199, is amended to read:156.12256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.156.13    (a) Hennepin County,and Hennepin County Medical Center, Ramsey County, 156.14Regions Hospital, the University of Minnesota, and Fairview-University Medical Center156.15shall report quarterly to the commissioner beginning June 1, 2007, payments made during 156.16the second previous quarter that may qualify for reimbursement under federal law.156.17    (b) Based on these reports, the commissioner shall apply for federal matching funds. 156.18These funds are appropriated to the commissioner for the payments under section 256.969, 156.19subdivision 27 to Hennepin County Medical Center.156.20    (c) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform 156.21the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 156.22hospital payment money expected to be available in the current federal fiscal year.156.23    (d) This section sunsets on June 30, 2009. The commissioner shall report to 156.24the legislature by December 15, 2008, with recommendations for maximizing federal 156.25disproportionate share hospital payments after June 30, 2009.156.26    Sec. 20. Minnesota Statutes 2006, section 256B.75, is amended to read:156.27256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.156.28    (a) For outpatient hospital facility fee payments for services rendered on or after 156.29October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted 156.30charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those 156.31services for which there is a federal maximum allowable payment. Effective for services 156.32rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital 156.33facility fees and emergency room facility fees shall be increased by eight percent over the 156.34rates in effect on December 31, 1999, except for those services for which there is a federal 157.1maximum allowable payment. Services for which there is a federal maximum allowable 157.2payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum 157.3allowable payment. Total aggregate payment for outpatient hospital facility fee services 157.4shall not exceed the Medicare upper limit. If it is determined that a provision of this 157.5section conflicts with existing or future requirements of the United States government with 157.6respect to federal financial participation in medical assistance, the federal requirements 157.7prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to 157.8avoid reduced federal financial participation resulting from rates that are in excess of 157.9the Medicare upper limitations.157.10    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and 157.11ambulatory surgery hospital facility fee services for critical access hospitals designated 157.12under section 
         144.1483, clause (10), shall be paid on a cost-based payment system that 157.13is based on the cost-finding methods and allowable costs of the Medicare program. All 157.14hospital outpatient services provided by any hospital exclusively devoted to the care of 157.15pediatric patients under age 21 that is located in a Minnesota metropolitan statistical area 157.16must be paid for using the methodology established for critical access hospitals at a rate 157.17equal to fee-for-service rates plus 46 percent, as limited by allowable costs.157.18    (c) Effective for services provided on or after July 1, 2003, rates that are based 157.19on the Medicare outpatient prospective payment system shall be replaced by a budget 157.20neutral prospective payment system that is derived using medical assistance data. The 157.21commissioner shall provide a proposal to the 2003 legislature to define and implement 157.22this provision.157.23    (d) For fee-for-service services provided on or after July 1, 2002, the total payment, 157.24before third-party liability and spenddown, made to hospitals for outpatient hospital 157.25facility services is reduced by .5 percent from the current statutory rate.157.26    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 157.27services provided on or after July 1, 2003, made to hospitals for outpatient hospital 157.28facility services before third-party liability and spenddown, is reduced five percent from 157.29the current statutory rates. Facilities defined under section 
         256.969, subdivision 16, are 157.30excluded from this paragraph.157.31EFFECTIVE DATE.This section is effective July 1, 2007, and applies to services 157.32provided on or after that date.157.33    Sec. 21. Minnesota Statutes 2006, section 256B.76, is amended to read:157.34256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.158.1    (a) Effective for services rendered on or after October 1, 1992, the commissioner 158.2shall make payments for physician services as follows:158.3    (1) payment for level one Centers for Medicare and Medicaid Services' common 158.4procedural coding system codes titled "office and other outpatient services," "preventive 158.5medicine new and established patient," "delivery, antepartum, and postpartum care," 158.6"critical care," cesarean delivery and pharmacologic management provided to psychiatric 158.7patients, and level three codes for enhanced services for prenatal high risk, shall be paid 158.8at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 158.930, 1992. If the rate on any procedure code within these categories is different than the 158.10rate that would have been paid under the methodology in section 
         256B.74, subdivision 2, 158.11then the larger rate shall be paid; 158.12    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 158.13or (ii) 15.4 percent above the rate in effect on June 30, 1992;158.14    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 158.15percentile of 1989, less the percent in aggregate necessary to equal the above increases 158.16except that payment rates for home health agency services shall be the rates in effect 158.17on September 30, 1992;158.18    (4) effective for services rendered on or after January 1, 2000, payment rates for 158.19physician and professional services shall be increased by three percent over the rates in 158.20effect on December 31, 1999, except for home health agency and family planning agency 158.21services; and158.22    (5) the increases in clause (4) shall be implemented January 1, 2000, for managed 158.23care.158.24    (b) Effective for services rendered on or after October 1, 1992, the commissioner 158.25shall make payments for dental services as follows:158.26    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 158.27percent above the rate in effect on June 30, 1992;158.28    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 158.29percentile of 1989, less the percent in aggregate necessary to equal the above increases;158.30    (3) effective for services rendered on or after January 1, 2000, payment rates for 158.31dental services shall be increased by three percent over the rates in effect on December 158.3231, 1999;158.33    (4) the commissioner shall award grants to community clinics or other nonprofit 158.34community organizations, political subdivisions, professional associations, or other 158.35organizations that demonstrate the ability to provide dental services effectively to public 158.36program recipients. Grants may be used to fund the costs related to coordinating access for 159.1recipients, developing and implementing patient care criteria, upgrading or establishing 159.2new facilities, acquiring furnishings or equipment, recruiting new providers, or other 159.3development costs that will improve access to dental care in a region. In awarding grants, 159.4the commissioner shall give priority to applicants that plan to serve areas of the state in 159.5which the number of dental providers is not currently sufficient to meet the needs of 159.6recipients of public programs or uninsured individuals. The commissioner shall consider 159.7the following in awarding the grants:159.8    (i) potential to successfully increase access to an underserved population;159.9    (ii) the ability to raise matching funds;159.10    (iii) the long-term viability of the project to improve access beyond the period 159.11of initial funding;159.12    (iv) the efficiency in the use of the funding; and159.13    (v) the experience of the proposers in providing services to the target population.159.14    The commissioner shall monitor the grants and may terminate a grant if the grantee 159.15does not increase dental access for public program recipients. The commissioner shall 159.16consider grants for the following:159.17    (i) implementation of new programs or continued expansion of current access 159.18programs that have demonstrated success in providing dental services in underserved 159.19areas;159.20    (ii) a pilot program for utilizing hygienists outside of a traditional dental office to 159.21provide dental hygiene services; and159.22    (iii) a program that organizes a network of volunteer dentists, establishes a system to 159.23refer eligible individuals to volunteer dentists, and through that network provides donated 159.24dental care services to public program recipients or uninsured individuals;159.25    (5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 159.26shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;159.27    (6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, 159.28for managed care; and159.29    (7) effective for services provided on or after January 1, 2002, payment for 159.30diagnostic examinations and dental x-rays provided to children under age 21 shall be the 159.31lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.159.32    (c) Effective for dental services rendered on or after January 1, 2002, the 159.33commissioner may, within the limits of available appropriation, increase reimbursements 159.34to dentists and dental clinics deemed by the commissioner to be critical access dental 159.35providers. Reimbursement to a critical access dental provider may be increased by not 159.36more than 50 percent above the reimbursement rate that would otherwise be paid to the 160.1provider. Payments toFor dental services rendered after June 30, 2007, the commissioner 160.2shall increase reimbursement by 33 percent above the reimbursement rate that would 160.3otherwise be paid to the provider. The commissioner shall pay the health plan companies 160.4shall be adjustedin amounts sufficient to reflect increased reimbursements to critical 160.5access dental providers as approved by the commissioner. In determining which dentists 160.6and dental clinics shall be deemed critical access dental providers, the commissioner 160.7shall review:160.8    (1) the utilization rate in the service area in which the dentist or dental clinic operates 160.9for dental services to patients covered by medical assistance, general assistance medical 160.10care, or MinnesotaCare as their primary source of coverage;160.11    (2) the level of services provided by the dentist or dental clinic to patients covered 160.12by medical assistance, general assistance medical care, or MinnesotaCare as their primary 160.13source of coverage; and160.14    (3) whether the level of services provided by the dentist or dental clinic is critical to 160.15maintaining adequate levels of patient access within the service area.160.16In the absence of a critical access dental provider in a service area, the commissioner may 160.17designate a dentist or dental clinic as a critical access dental provider if the dentist or 160.18dental clinic is willing to provide care to patients covered by medical assistance, general 160.19assistance medical care, or MinnesotaCare at a level which significantly increases access 160.20to dental care in the service area.160.21    The commissioner shall annually establish a reimbursement schedule for critical 160.22access dental providers and provider-specific limits on total reimbursement received 160.23under the reimbursement schedule, and shall notify each critical access dental provider 160.24of the schedule and limit.160.25    (d) An entity that operates both a Medicare certified comprehensive outpatient 160.26rehabilitation facility and a facility which was certified prior to January 1, 1993, that is 160.27licensed under Minnesota Rules, parts 
         9570.2000 to 
         9570.3600, and for whom at least 33 160.28percent of the clients receiving rehabilitation services in the most recent calendar year are 160.29medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation 160.30services at rates that are 38 percent greater than the maximum reimbursement rate 160.31allowed under paragraph (a), clause (2), when those services are (1) provided within the 160.32comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing 160.33facilities owned by the entity.160.34    (e) Effective for services rendered on or after January 1, 2007, the commissioner 160.35shall make payments for physician and professional services based on the Medicare 161.1relative value units (RVU's). This change shall be budget neutral and the cost of 161.2implementing RVU's will be incorporated in the established conversion factor.161.3    Sec. 22. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:161.4    Subd. 4. General assistance medical care; services. (a)(i) For a person who is 161.5eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 161.6care covers, except as provided in paragraph (c):161.7    (1) inpatient hospital services;161.8    (2) outpatient hospital services;161.9    (3) services provided by Medicare certified rehabilitation agencies;161.10    (4) prescription drugs and other products recommended through the process 161.11established in section 
         256B.0625, subdivision 13;161.12    (5) equipment necessary to administer insulin and diagnostic supplies and equipment 161.13for diabetics to monitor blood sugar level;161.14    (6) eyeglasses and eye examinations provided by a physician or optometrist;161.15    (7) hearing aids;161.16    (8) prosthetic devices;161.17    (9) laboratory and X-ray services;161.18    (10) physician's services;161.19    (11) medical transportation except special transportation;161.20    (12) chiropractic services as covered under the medical assistance program;161.21    (13) podiatric services;161.22    (14) dental services as covered under the medical assistance program;161.23    (15) outpatient services provided by a mental health center or clinic that is under 161.24contract with the county board and is established under section 
         245.62;161.25    (16) day treatment services for mental illness provided under contract with the 161.26county board;161.27    (17) prescribed medications for persons who have been diagnosed as mentally ill as 161.28necessary to prevent more restrictive institutionalization;161.29    (18) psychological services, medical supplies and equipment, and Medicare 161.30premiums, coinsurance and deductible payments;161.31    (19) medical equipment not specifically listed in this paragraph when the use of 161.32the equipment will prevent the need for costlier services that are reimbursable under 161.33this subdivision;161.34    (20) services performed by a certified pediatric nurse practitioner, a certified family 161.35nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 162.1nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 162.2practitioner in independent practice, if (1) the service is otherwise covered under this 162.3chapter as a physician service, (2) the service provided on an inpatient basis is not included 162.4as part of the cost for inpatient services included in the operating payment rate, and (3) the 162.5service is within the scope of practice of the nurse practitioner's license as a registered 162.6nurse, as defined in section 
         148.171;162.7    (21) services of a certified public health nurse or a registered nurse practicing in 162.8a public health nursing clinic that is a department of, or that operates under the direct 162.9authority of, a unit of government, if the service is within the scope of practice of the 162.10public health nurse's license as a registered nurse, as defined in section 
         148.171;162.11    (22) telemedicine consultations, to the extent they are covered under section 162.12256B.0625, subdivision 3b
         ; and162.13    (23) mental health telemedicine and psychiatric consultation as covered under 162.14section 
         256B.0625, subdivisions 46 and 48.;162.15    (24) care coordination and patient education services provided by a community 162.16health worker according to section 256B.0625, subdivision 49; and162.17    (25) regardless of the number of employees that an enrolled health care provider 162.18may have, sign language interpreter services when provided by an enrolled health care 162.19provider during the course of providing a direct, person-to-person covered health care 162.20service to an enrolled recipient who has a hearing loss and uses interpreting services.162.21    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 162.22paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 162.23to inpatient hospital services, including physician services provided during the inpatient 162.24hospital stay. A $1,000 deductible is required for each inpatient hospitalization.162.25    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this 162.26subdivision.162.27    (c) In order to contain costs, the commissioner of human services shall select 162.28vendors of medical care who can provide the most economical care consistent with high 162.29medical standards and shall where possible contract with organizations on a prepaid 162.30capitation basis to provide these services. The commissioner shall consider proposals by 162.31counties and vendors for prepaid health plans, competitive bidding programs, block grants, 162.32or other vendor payment mechanisms designed to provide services in an economical 162.33manner or to control utilization, with safeguards to ensure that necessary services are 162.34provided. Before implementing prepaid programs in counties with a county operated or 162.35affiliated public teaching hospital or a hospital or clinic operated by the University of 162.36Minnesota, the commissioner shall consider the risks the prepaid program creates for the 163.1hospital and allow the county or hospital the opportunity to participate in the program in a 163.2manner that reflects the risk of adverse selection and the nature of the patients served by 163.3the hospital, provided the terms of participation in the program are competitive with the 163.4terms of other participants considering the nature of the population served. Payment for 163.5services provided pursuant to this subdivision shall be as provided to medical assistance 163.6vendors of these services under sections 
         256B.02, subdivision 8, and 
         256B.0625. For 163.7payments made during fiscal year 1990 and later years, the commissioner shall consult 163.8with an independent actuary in establishing prepayment rates, but shall retain final control 163.9over the rate methodology.163.10    (d) Effective January 1, 2008, drug coverage under general assistance medical care 163.11is limited to prescription drugs that:163.12    (i) are covered under the medical assistance program as described in section 163.13256B.0625, subdivisions 13 and 13d; and163.14    (ii) are provided by manufacturers that have fully executed general assistance 163.15medical care rebate agreements with the commissioner and comply with the agreements. 163.16Prescription drug coverage under general assistance medical care must conform to 163.17coverage under the medical assistance program according to section 256B.0625, 163.18subdivisions 13 to 13g.163.19    (d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 163.20co-payments for services provided on or after October 1, 2003:163.21    (1) $25 for eyeglasses;163.22    (2) $25 for nonemergency visits to a hospital-based emergency room;163.23    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, 163.24subject to a $12 per month maximum for prescription drug co-payments. No co-payments 163.25shall apply to antipsychotic drugs when used for the treatment of mental illness; and163.26    (4) 50 percent coinsurance on restorative dental services.163.27    (e) (f) Co-payments shall be limited to one per day per provider for nonpreventive 163.28visits, eyeglasses, and nonemergency visits to a hospital-based emergency room. 163.29Recipients of general assistance medical care are responsible for all co-payments in this 163.30subdivision. The general assistance medical care reimbursement to the provider shall be 163.31reduced by the amount of the co-payment, except that reimbursement for prescription 163.32drugs shall not be reduced once a recipient has reached the $12 per month maximum for 163.33prescription drug co-payments. The provider collects the co-payment from the recipient. 163.34Providers may not deny services to recipients who are unable to pay the co-payment, 163.35except as provided in paragraph (f).164.1    (f) (g) If it is the routine business practice of a provider to refuse service to an 164.2individual with uncollected debt, the provider may include uncollected co-payments 164.3under this section. A provider must give advance notice to a recipient with uncollected 164.4debt before services can be denied.164.5    (g) (h) Any county may, from its own resources, provide medical payments for 164.6which state payments are not made.164.7    (h) (i) Chemical dependency services that are reimbursed under chapter 254B must 164.8not be reimbursed under general assistance medical care.164.9    (i) (j) The maximum payment for new vendors enrolled in the general assistance 164.10medical care program after the base year shall be determined from the average usual and 164.11customary charge of the same vendor type enrolled in the base year.164.12    (j) (k) The conditions of payment for services under this subdivision are the same 164.13as the conditions specified in rules adopted under chapter 256B governing the medical 164.14assistance program, unless otherwise provided by statute or rule.164.15    (k) (l) Inpatient and outpatient payments shall be reduced by five percent, effective 164.16July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 164.172003, and incorporated by reference in paragraph (i).164.18    (l) (m) Payments for all other health services except inpatient, outpatient, and 164.19pharmacy services shall be reduced by five percent, effective July 1, 2003.164.20    (m) (n) Payments to managed care plans shall be reduced by five percent for services 164.21provided on or after October 1, 2003.164.22    (n) (o) A hospital receiving a reduced payment as a result of this section may apply 164.23the unpaid balance toward satisfaction of the hospital's bad debts.164.24    (o) (p) Fee-for-service payments for nonpreventive visits shall be reduced by $3 164.25for services provided on or after January 1, 2006. For purposes of this subdivision, a 164.26visit means an episode of service which is required because of a recipient's symptoms, 164.27diagnosis, or established illness, and which is delivered in an ambulatory setting by 164.28a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 164.29audiologist, optician, or optometrist.164.30    (p) (q) Payments to managed care plans shall not be increased as a result of the 164.31removal of the $3 nonpreventive visit co-payment effective January 1, 2006.164.32    Sec. 23. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:164.33    Subd. 4. Gross individual or gross family income. (a) "Gross individual or gross 164.34family income" for nonfarm self-employed means income calculated for the six-month 164.35period of eligibility using the net profit or loss reported on the applicant's federal income 165.1tax form for the previous year and using the medical assistance families with children 165.2methodology for determining allowable and nonallowable self-employment expenses and 165.3countable income.165.4    (b) "Gross individual or gross family income" for farm self-employed means income 165.5calculated for the six-month period of eligibility using as the baseline the adjusted gross 165.6income reported on the applicant's federal income tax form for the previous year and 165.7adding back in reported depreciation amounts that apply to the business in which the 165.8family is currently engaged.165.9    (c) "Gross individual or gross family income" means the total income for all family 165.10members, calculated for the six-month period of eligibility.165.11EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal 165.12approval, whichever is later.165.13    Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:165.14    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 165.15and (c), the MinnesotaCare benefit plan shall include the following co-payments and 165.16coinsurance requirements for all enrollees:165.17    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 165.18subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 165.19$3,000 per family;165.20    (2) $3 per prescription for adult enrollees;165.21    (3) $25 for eyeglasses for adult enrollees;165.22    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 165.23episode of service which is required because of a recipient's symptoms, diagnosis, or 165.24established illness, and which is delivered in an ambulatory setting by a physician or 165.25physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 165.26audiologist, optician, or optometrist; and165.27    (5) $6 for nonemergency visits to a hospital-based emergency room.165.28    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 165.29children under the age of 21 in households with family income equal to or less than 175 165.30percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 165.31parents and relative caretakers of children under the age of 21 in households with family 165.32income greater than 175 percent of the federal poverty guidelines for inpatient hospital 165.33admissions occurring on or after January 1, 2001.165.34    (c) Paragraph (a), clauses (1) to (4), dodoes not apply to pregnant women and 165.35children under the age of 21.166.1    (d) Adult enrollees with family gross income that exceeds 175 percent of the 166.2federal poverty guidelines and who are not pregnant shall be financially responsible for 166.3the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 166.4hospital benefit limit.166.5    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 166.6or changes from one prepaid health plan to another during a calendar year, any charges 166.7submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 166.8expenses incurred by the enrollee for inpatient services, that were submitted or incurred 166.9prior to enrollment, or prior to the change in health plans, shall be disregarded.166.10    Sec. 25. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:166.11    Subdivision 1. Families with children. (a) Families with children with family 166.12income equal to or less than 275 percent of the federal poverty guidelines for the 166.13applicable family size shall be eligible for MinnesotaCare according to this section. All 166.14other provisions of sections 
         256L.01 to 
         256L.18, including the insurance-related barriers 166.15to enrollment under section 
         256L.07, shall apply unless otherwise specified. 166.16    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, 166.17if the children are eligible. Children may be enrolled separately without enrollment by 166.18parents. However, if one parent in the household enrolls, both parents must enroll, unless 166.19other insurance is available. If one child from a family is enrolled, all children must 166.20be enrolled, unless other insurance is available. If one spouse in a household enrolls, 166.21the other spouse in the household must also enroll, unless other insurance is available. 166.22Families cannot choose to enroll only certain uninsured members.166.23    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies 166.24to the MinnesotaCare program. These persons are no longer counted in the parental 166.25household and may apply as a separate household.166.26    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents 166.27are not eligible for MinnesotaCare if their gross income exceeds $50,000 $25,000 for the 166.28six-month period of eligibility.166.29    Sec. 26. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:166.30    Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing 166.31in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee 166.32residing in a correctional or detention facility is not eligible at renewal of eligibility under 166.33section 
         256L.05, subdivision 3b 3a.167.1    Sec. 27. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:167.2    Subd. 7. Critical access dental providers. Effective for dental services provided 167.3to MinnesotaCare enrollees on or afterbetween January 1, 2007, and June 30, 2007, the 167.4commissioner shall increase payment rates to dentists and dental clinics deemed by the 167.5commissioner to be critical access providers under section 
         256B.76, paragraph (c), by 50 167.6percent above the payment rate that would otherwise be paid to the provider. Effective 167.7for dental services provided to MinnesotaCare enrollees on or after July 1, 2007, the 167.8commissioner shall increase payment rates to dentists and dental clinics deemed by the 167.9commissioner to be critical access providers under section 256B.76, paragraph (c), by 167.1033 percent above the payment rate that would otherwise be paid to the provider. The 167.11commissioner shall adjust the rates paid on or after January 1, 2007, topay the prepaid 167.12health plans under contract with the commissioner amounts sufficient to reflect this rate 167.13increase. The prepaid health plan must pass this rate increase to providers who have 167.14been identified by the commissioner as critical access dental providers under section 167.15256B.76
         , paragraph (c).167.16    Sec. 28. HENNEPIN COUNTY PILOT PROJECT.167.17    The commissioner of human services shall support a pilot project in Hennepin 167.18County to demonstrate the effectiveness of alternative strategies to redetermine eligibility 167.19for certain recipient populations in the medical assistance program. The target populations 167.20for the demonstration are persons who are eligible based upon disability or age, who have 167.21chronic medical conditions, and who are expected to experience minimal change in income 167.22or assets from month to month. The commissioner and the county shall analyze the issues 167.23and strategies employed and the outcomes to determine reasonable efforts to streamline 167.24eligibility statewide. The duration of the pilot project shall be no more than two years. 167.25The commissioner shall apply for any federal waivers needed to implement this section.167.26    Sec. 29. COUNTY-BASED PURCHASING STUDY.167.27    The commissioner of health shall study county-based purchasing initiatives 167.28established under Minnesota Statutes, section 256B.692, and compare these initiatives 167.29to managed care plans serving medical assistance, general assistance medical care, and 167.30MinnesotaCare enrollees. The study must:167.31    (1) provide a history and description of county-based purchasing initiatives, 167.32including state and federal requirements and any federal waivers Minnesota counties have 167.33applied for or received;168.1    (2) provide a history and description of managed care plan participation in the 168.2prepaid medical assistance, prepaid general assistance medical care, and prepaid 168.3Minnesota programs, and the provision by managed care plans of third-party administrator 168.4services for county-based purchasing initiatives;168.5    (3) provide relevant data, including limitations on data, data that was requested but 168.6not received, and explanations for why requested data was not received;168.7    (4) provide recommendations for further data collection and research;168.8    (5) summarize successes and challenges of the two service delivery methods;168.9    (6) provide recommendations for possible expansion of county-based purchasing 168.10in rural and urban settings; and168.11    (7) identify and describe features of county-based purchasing and managed care 168.12plans serving medical assistance, general assistance medical care, and MinnesotaCare 168.13enrollees, to provide a comparison of cost, quality, access, and community health 168.14improvement that includes, but is not limited to:168.15    (i) descriptions of how health care and social services are integrated and coordinated 168.16for persons with complex care needs, including persons with high-risk pregnancies, 168.17adolescents, persons who are disabled, persons who are elderly, and persons with chronic 168.18health care and social needs;168.19    (ii) use of monetary grants and surpluses to:168.20    (A) increase provider reimbursement, including dental care reimbursement, in order 168.21to improve health care access; and168.22    (B) improve community health beyond the requirements of the public health care 168.23programs, such as the funding of public education, research, and community initiatives to 168.24enhance utilization of preventive services, social services, or mental health care;168.25    (iii) administrative costs, including billing and collection of unpaid fees, co-pays or 168.26other charges, and top five management salaries;168.27    (iv) reporting requirements of contracts with the Department of Human Services;168.28    (v) public access to all information about management and administration, including 168.29but not limited to provider contracts and reimbursement, models of care management and 168.30coordination, utilization review, contracts with consultants and other vendors, handling of 168.31monetary grants and surpluses, and health outcomes data;168.32    (vi) provider reimbursement by clinical practice area;168.33    (vii) populations served, described by age, disability, income, race, language, 168.34occupation, and other demographic characteristics;168.35    (viii) utilization of community-based prevention interventions, including but not 168.36limited to public health nursing visits to new parents, use of nurse-managed interventions 169.1to reduce cardiac hospitalizations, and the use of medical homes for chronic disease 169.2management;169.3    (ix) utilization of cancer screening;169.4    (x) utilization of interpreter services;169.5    (xi) immunization rates for children age five and under;169.6    (xii) hospitalization rates for conditions related to diabetes, asthma, or cardiac 169.7illnesses;169.8    (xiii) rates of rehospitalization within a month of hospital discharge;169.9    (xiv) coordination with county agencies to increase enrollment;169.10    (xv) number of new program enrollees and the rate of enrollment, including the 169.11percentage of eligible persons who become enrollees;169.12    (xvi) enrollee satisfaction with their care; and169.13    (xvii) number of enrollees who do not receive care.169.14    Managed care plans, county-based purchasing initiatives, health care providers, 169.15counties, and the commissioner of human services shall, upon request, provide data to 169.16the commissioner of health that is necessary to complete the study. The commissioner of 169.17health shall submit the study to the legislature by December 31, 2007.169.18    Sec. 30. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.169.19    The commissioner of human services shall award a grant to the Neighborhood 169.20Health Care Network to pay the costs of maintaining and staffing a toll-free telephone 169.21number to provide callers with information on health coverage options, eligibility for 169.22MinnesotaCare and other health care programs, and health care providers that offer free or 169.23reduced-cost health care services.169.24    Sec. 31. IMPLEMENTATION OF PHARMACY DISPENSING FEE INCREASE.169.25    The commissioner, after consulting with the Pharmacy Payment Reform Advisory 169.26Committee established under Laws 2006, chapter 282, article 16, section 15, may 169.27proportionally increase or decrease the dispensing fee for multiple-source generic drugs 169.28under Minnesota Statutes, section 256B.0625, subdivision 13e, paragraph (a), to reflect 169.29the actual amount of reductions in program cost for ingredient reimbursement savings 169.30obtained.169.31EFFECTIVE DATE.This section is effective upon implementation of changes to 169.32the federal upper reimbursement limit under title VI, chapter IV of the federal Deficit 169.33Reduction Act of 2005, United States Code, title 42, section 1396r-8(e)(5).170.1    Sec. 32. REPEALER.170.2Minnesota Statutes 2006, section 256.969, subdivision 27, is repealed effective 170.3July 1, 2007.170.4ARTICLE 4170.5CONTINUING CARE170.6    Section 1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to 170.7read:170.8    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The 170.9commissioner of health, in coordination with the commissioner of human services, may 170.10approve the renovation, replacement, upgrading, or relocation of a nursing home or 170.11boarding care home, under the following conditions:170.12    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be 170.13constructed on the site of a new city-owned hospital to replace an existing 85-bed facility 170.14attached to a hospital that is also being replaced. The threshold allowed for this project 170.15under section 
         144A.073 shall be the maximum amount available to pay the additional 170.16medical assistance costs of the new facility; 170.17    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St. 170.18Louis County, provided that the 29 beds must be transferred from active or layaway status 170.19at an existing facility in St. Louis County that had 235 beds on April 1, 2003.170.20The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment 170.21rate at that facility shall not be adjusted as a result of this transfer. The operating payment 170.22rate of the facility adding beds after completion of this project shall be the same as it was 170.23on the day prior to the day the beds are licensed and certified. This project shall not 170.24proceed unless it is approved and financed under the provisions of section 
         144A.073;  170.25    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of 170.26the new beds are transferred from a 45-bed facility in Austin under common ownership 170.27that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea 170.28under common ownership; (ii) the commissioner of human services is authorized by the 170.292004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) 170.30money is available from planned closures of facilities under common ownership to make 170.31implementation of this clause budget-neutral to the state. The bed capacity of the Albert 170.32Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the 170.33new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's 170.34disease or related dementias; and171.1    (4) to license and certify up to 80 beds transferred from an existing state-owned 171.2nursing facility in Cass County to a new facility located on the grounds of the 171.3Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be 171.4determined based on the interim and settle-up payment provisions of Minnesota Rules, 171.5part 
         9549.0057, and the reimbursement provisions of section 
         256B.431. The property 171.6payment rate for the first three years of operation shall be $35 per day. For subsequent 171.7years, the property payment rate of $35 per day shall be adjusted for inflation as provided 171.8in section 
         256B.434, subdivision 4, paragraph (c), as long as the facility has a contract 171.9under section 
         256B.434.; and171.10    (5) to license and certify 180 beds transferred from an existing facility in 171.11Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred from a 171.12219-bed facility under common ownership that shall be closed following the transfer. The 171.13operating payment rate of the new facility after completion of this project shall be adjusted 171.14upward by $35 per day and the property payment rate shall be $34.049 per day.171.15    (b) Projects approved under this subdivision shall be treated in a manner equivalent 171.16to projects approved under subdivision 4a.171.17EFFECTIVE DATE.This section is effective the day following final enactment.171.18    Sec. 2. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:171.19    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 171.20child, including a child determined eligible for medical assistance without consideration of 171.21parental income, must contribute to the cost of services used by making monthly payments 171.22on a sliding scale based on income, unless the child is married or has been married, 171.23parental rights have been terminated, or the child's adoption is subsidized according to 171.24section 
         259.67 or through title IV-E of the Social Security Act. The parental contribution 171.25is a partial or full payment for medical services provided for diagnostic, therapeutic, 171.26curing, treating, mitigating, rehabilitation, and maintenance and personal care services as 171.27defined in United States Code, title 26, section 213, needed by the child with a chronic 171.28illness or disability.171.29    (b) For households with adjusted gross income equal to or greater than 100 percent 171.30of federal poverty guidelines, the parental contribution shall be computed by applying the 171.31following schedule of rates to the adjusted gross income of the natural or adoptive parents:171.32    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 171.33poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 171.34contribution is $4 per month;172.1    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 172.2poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 172.3the parental contribution shall be determined using a sliding fee scale established by the 172.4commissioner of human services which begins at one percent of adjusted gross income 172.5at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 172.6gross income for those with adjusted gross income up to 545 percent of federal poverty 172.7guidelines;172.8    (3) if the adjusted gross income is greater than 545 percent of federal poverty 172.9guidelines and less than 675 percent of federal poverty guidelines, the parental 172.10contribution shall be 7.5 percent of adjusted gross income;172.11    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 172.12poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 172.13contribution shall be determined using a sliding fee scale established by the commissioner 172.14of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 172.15federal poverty guidelines and increases to ten percent of adjusted gross income for those 172.16with adjusted gross income up to 975 percent of federal poverty guidelines; and172.17    (5) if the adjusted gross income is equal to or greater than 975 percent of federal 172.18poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 172.19income.172.20    If the child lives with the parent, the annual adjusted gross income parental 172.21contribution is reduced by $2,400 prior to calculating the parental contribution$100 172.22per month. If the child resides in an institution specified in section 
         256B.35, the parent 172.23is responsible for the personal needs allowance specified under that section in addition 172.24to the parental contribution determined under this section. The parental contribution is 172.25reduced by any amount required to be paid directly to the child pursuant to a court order, 172.26but only if actually paid.172.27    (c) The household size to be used in determining the amount of contribution under 172.28paragraph (b) includes natural and adoptive parents and their dependents, including the 172.29child receiving services. Adjustments in the contribution amount due to annual changes 172.30in the federal poverty guidelines shall be implemented on the first day of July following 172.31publication of the changes.172.32    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 172.33natural or adoptive parents determined according to the previous year's federal tax form, 172.34except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 172.35have been used to purchase a home shall not be counted as income.173.1    (e) The contribution shall be explained in writing to the parents at the time eligibility 173.2for services is being determined. The contribution shall be made on a monthly basis 173.3effective with the first month in which the child receives services. Annually upon 173.4redetermination or at termination of eligibility, if the contribution exceeded the cost of 173.5services provided, the local agency or the state shall reimburse that excess amount to 173.6the parents, either by direct reimbursement if the parent is no longer required to pay 173.7a contribution, or by a reduction in or waiver of parental fees until the excess amount 173.8is exhausted.173.9    (f) The monthly contribution amount must be reviewed at least every 12 months; 173.10when there is a change in household size; and when there is a loss of or gain in income 173.11from one month to another in excess of ten percent. The local agency shall mail a written 173.12notice 30 days in advance of the effective date of a change in the contribution amount. 173.13A decrease in the contribution amount is effective in the month that the parent verifies a 173.14reduction in income or change in household size.173.15    (g) Parents of a minor child who do not live with each other shall each pay the 173.16contribution required under paragraph (a). An amount equal to the annual court-ordered 173.17child support payment actually paid on behalf of the child receiving services shall be 173.18deducted from the adjusted gross income of the parent making the payment prior to 173.19calculating the parental contribution under paragraph (b).173.20    (h) The contribution under paragraph (b) shall be increased by an additional five 173.21percent if the local agency determines that insurance coverage is available but not 173.22obtained for the child. For purposes of this section, "available" means the insurance is a 173.23benefit of employment for a family member at an annual cost of no more than five percent 173.24of the family's annual income. For purposes of this section, "insurance" means health 173.25and accident insurance coverage, enrollment in a nonprofit health service plan, health 173.26maintenance organization, self-insured plan, or preferred provider organization.173.27    Parents who have more than one child receiving services shall not be required 173.28to pay more than the amount for the child with the highest expenditures. There shall 173.29be no resource contribution from the parents. The parent shall not be required to pay 173.30a contribution in excess of the cost of the services provided to the child, not counting 173.31payments made to school districts for education-related services. Notice of an increase in 173.32fee payment must be given at least 30 days before the increased fee is due.173.33    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 173.34in the 12 months prior to July 1:173.35    (1) the parent applied for insurance for the child;173.36    (2) the insurer denied insurance;174.1    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 174.2a complaint or appeal, in writing, to the commissioner of health or the commissioner of 174.3commerce, or litigated the complaint or appeal; and174.4    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.174.5    For purposes of this section, "insurance" has the meaning given in paragraph (h).174.6    A parent who has requested a reduction in the contribution amount under this 174.7paragraph shall submit proof in the form and manner prescribed by the commissioner or 174.8county agency, including, but not limited to, the insurer's denial of insurance, the written 174.9letter or complaint of the parents, court documents, and the written response of the insurer 174.10approving insurance. The determinations of the commissioner or county agency under this 174.11paragraph are not rules subject to chapter 14.174.12    Sec. 3. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:174.13    Subd. 3. Amount of support grant; use. Support grant amounts shall be 174.14determined by the county social service agency. Services and items purchased with a 174.15support grant must:174.16    (1) be over and above the normal costs of caring for the dependent if the dependent 174.17did not have a disability;174.18    (2) be directly attributable to the dependent's disabling condition; and174.19    (3) enable the family to delay or prevent the out-of-home placement of the dependent.174.20    The design and delivery of services and items purchased under this section must 174.21suit the dependent's chronological age and be provided in the least restrictive environment 174.22possible, consistent with the needs identified in the individual service plan.174.23    Items and services purchased with support grants must be those for which there 174.24are no other public or private funds available to the family. Fees assessed to parents 174.25for health or human services that are funded by federal, state, or county dollars are not 174.26reimbursable through this program.174.27    In approving or denying applications, the county shall consider the following factors:174.28    (1) the extent and areas of the functional limitations of the disabled child;174.29    (2) the degree of need in the home environment for additional support; and174.30    (3) the potential effectiveness of the grant to maintain and support the person in 174.31the family environment.174.32    The maximum monthly grant amount shall be $250 per eligible dependent, or 174.33$3,000 per eligible dependent per state fiscal year, within the limits of available funds and 174.34as adjusted by any legislatively authorized cost of living adjustment. The county social 175.1service agency may consider the dependent's supplemental security income in determining 175.2the amount of the support grant.175.3    Any adjustments to their monthly grant amount must be based on the needs of the 175.4family and funding availability.175.5    Sec. 4. Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision 175.6to read:175.7    Subd. 22.Provider rate increase; St. Louis County.A day training and 175.8habilitation provider in St. Louis County licensed to provide services to up to 80 175.9individuals shall receive a per diem rate increase that does not exceed 95 percent of the 175.10greater of 125 percent of the current statewide median or 125 percent of the regional 175.11average per diem rate, whichever is higher.175.12    Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 175.13to read:175.14    Subd. 24.Disability linkage line.The commissioner shall establish the disability 175.15linkage line, a statewide consumer information, referral, and assistance system for people 175.16with disabilities and chronic illnesses that: 175.17    (1) provides information about state and federal eligibility requirements, benefits, 175.18and service options; 175.19    (2) makes referrals to appropriate support entities; 175.20    (3) delivers information and assistance based on national and state standards; 175.21    (4) assists people to make well-informed decisions; and 175.22    (5) supports the timely resolution of service access and benefit issues.175.23    Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:175.24    Subdivision 1. Purpose and goals. The commissioner of human services shall 175.25establish a consumer support grant program for individuals with functional limitations and 175.26their families who wish to purchase and secure their own supports. The commissioner and 175.27local agencies shall jointly develop an implementation plan which must include a way to 175.28resolve the issues related to county liability. The program shall:175.29    (1) make support grants available to individuals or families as an effective alternative 175.30to the developmental disability family support program, personal care attendant services, 175.31home health aide services, and private duty nursing services;175.32    (2) provide consumers more control, flexibility, and responsibility over their services 175.33and supports;176.1    (3) promote local program management and decision making; and176.2    (4) encourage the use of informal and typical community supports.176.3    Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:176.4    Subd. 2. Definitions. For purposes of this section, the following terms have the 176.5meanings given them:176.6    (a) "County board" means the county board of commissioners for the county of 176.7financial responsibility as defined in section 
         256G.02, subdivision 4, or its designated 176.8representative. When a human services board has been established under sections 
         402.01176.9to 
         402.10, it shall be considered the county board for the purposes of this section. 176.10    (b) "Family" means the person's birth parents, adoptive parents or stepparents, 176.11siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece, 176.12nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is 176.13at least 18 years of age.176.14    (c) "Functional limitations" means the long-term inability to perform an activity or 176.15task in one or more areas of major life activity, including self-care, understanding and use 176.16of language, learning, mobility, self-direction, and capacity for independent living. For the 176.17purpose of this section, the inability to perform an activity or task results from a mental, 176.18emotional, psychological, sensory, or physical disability, condition, or illness.176.19    (d) "Informed choice" means a voluntary decision made by the person or,176.20the person's legal representative, or other authorized representative after becoming 176.21familiarized with the alternatives to:176.22    (1) select a preferred alternative from a number of feasible alternatives;176.23    (2) select an alternative which may be developed in the future; and176.24    (3) refuse any or all alternatives.176.25    (e) "Local agency" means the local agency authorized by the county board or, 176.26for counties not participating in the consumer grant program by July 1, 2002, the 176.27commissioner, to carry out the provisions of this section.176.28    (f) "Person" or "persons" means a person or persons meeting the eligibility criteria in 176.29subdivision 3.176.30    (g) "Authorized representative" means an individual designated by the person or 176.31their legal representative to act on their behalf. This individual may be a family member, 176.32guardian, representative payee, or other individual designated by the person or their legal 176.33representative, if any, to assist in purchasing and arranging for supports. For the purposes 176.34of this section, an authorized representative is at least 18 years of age.177.1    (h) "Screening" means the screening of a person's service needs under sections 177.2256B.0911
          and 
         256B.092. 177.3    (i) "Supports" means services, care, aids, environmental modifications, or assistance 177.4purchased by the person or the person's family, the person's legal representative, or other 177.5authorized representative. Examples of supports include respite care, assistance with daily 177.6living, and assistive technology. For the purpose of this section, notwithstanding the 177.7provisions of section 
         144A.43, supports purchased under the consumer support program 177.8are not considered home care services. 177.9    (j) "Program of origination" means the program the individual transferred from 177.10when approved for the consumer support grant program.177.11    Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:177.12    Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a 177.13consumer support grant if the person meets all of the following criteria:177.14    (1) the person is eligible for and has been approved to receive services under 177.15medical assistance as determined under sections 
         256B.055 and 
         256B.056 or the person 177.16has been approved to receive a grant under the developmental disability family support 177.17program under section 
         252.32; 177.18    (2) the person is able to direct and purchase the person's own care and supports, or 177.19the person has a family member, legal representative, or other authorized representative 177.20who can purchase and arrange supports on the person's behalf;177.21    (3) the person has functional limitations, requires ongoing supports to live in the 177.22community, and is at risk of or would continue institutionalization without such supports; 177.23and177.24    (4) the person will live in a home. For the purpose of this section, "home" means the 177.25person's own home or home of a person's family member. These homes are natural home 177.26settings and are not licensed by the Department of Health or Human Services.177.27    (b) Persons may not concurrently receive a consumer support grant if they are:177.28    (1) receiving personal care attendant and home health aide services, or private duty 177.29nursing under section 
         256B.0625; a developmental disability family support grant; or 177.30alternative care services under section 
         256B.0913; or 177.31    (2) residing in an institutional or congregate care setting.177.32    (c) A person or person's family receiving a consumer support grant shall not be 177.33charged a fee or premium by a local agency for participating in the program.177.34    (d) Individuals receiving home and community-based waivers under United States 177.35Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except 178.1for individuals receiving consumer support grants before July 1, 2003, as long as other 178.2eligibility criteria are met.178.3    (e) The commissioner shall establish a budgeted appropriation each fiscal year 178.4for the consumer support grant program. The number of individuals participating in 178.5the program will be adjusted so the total amount allocated to counties does not exceed 178.6the amount of the budgeted appropriation. The budgeted appropriation will be adjusted 178.7annually to accommodate changes in demand for the consumer support grants.178.8    Sec. 9. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:178.9    Subd. 4. Support grants; criteria and limitations. (a) A county board may 178.10choose to participate in the consumer support grant program. If a county has not chosen 178.11to participate by July 1, 2002, the commissioner shall contract with another county or 178.12other entity to provide access to residents of the nonparticipating county who choose 178.13the consumer support grant option. The commissioner shall notify the county board 178.14in a county that has declined to participate of the commissioner's intent to enter into 178.15a contract with another county or other entity at least 30 days in advance of entering 178.16into the contract. The local agency shall establish written procedures and criteria to 178.17determine the amount and use of support grants. These procedures must include, at least, 178.18the availability of respite care, assistance with daily living, and adaptive aids. The local 178.19agency may establish monthly or annual maximum amounts for grants and procedures 178.20where exceptional resources may be required to meet the health and safety needs of the 178.21person on a time-limited basis, however, the total amount awarded to each individual may 178.22not exceed the limits established in subdivision 11.178.23    (b) Support grants to a person or a person's family, a person's legal representative, 178.24or other authorized representative will be provided through a monthly subsidy payment 178.25and be in the form of cash, voucher, or direct county payment to vendor. Support grant 178.26amounts must be determined by the local agency. Each service and item purchased with a 178.27support grant must meet all of the following criteria:178.28    (1) it must be over and above the normal cost of caring for the person if the person 178.29did not have functional limitations;178.30    (2) it must be directly attributable to the person's functional limitations;178.31    (3) it must enable the person or the person's family, a person's legal representative, 178.32or other authorized representative to delay or prevent out-of-home placement of the 178.33person; and178.34    (4) it must be consistent with the needs identified in the service agreement, when 178.35applicable.179.1    (c) Items and services purchased with support grants must be those for which there 179.2are no other public or private funds available to the person or the person's family, a person's 179.3legal representative, or other authorized representative. Fees assessed to the person or the 179.4person's family for health and human services are not reimbursable through the grant.179.5    (d) In approving or denying applications, the local agency shall consider the 179.6following factors:179.7    (1) the extent and areas of the person's functional limitations;179.8    (2) the degree of need in the home environment for additional support; and179.9    (3) the potential effectiveness of the grant to maintain and support the person in the 179.10family environment or the person's own home.179.11    (e) At the time of application to the program or screening for other services, 179.12the person or the person's family, a person's legal representative, or other authorized 179.13representative shall be provided sufficient information to ensure an informed choice 179.14of alternatives by the person, the person's legal representative, or other authorized 179.15representative, if any, or the person's family. The application shall be made to the local 179.16agency and shall specify the needs of the person and family, the form and amount of 179.17grant requested, the items and services to be reimbursed, and evidence of eligibility for 179.18medical assistance.179.19    (f) Upon approval of an application by the local agency and agreement on a support 179.20plan for the person or person's family, the local agency shall make grants to the person or 179.21the person's family. The grant shall be in an amount for the direct costs of the services or 179.22supports outlined in the service agreement.179.23    (g) Reimbursable costs shall not include costs for resources already available, such as 179.24special education classes, day training and habilitation, case management, other services to 179.25which the person is entitled, medical costs covered by insurance or other health programs, 179.26or other resources usually available at no cost to the person or the person's family.179.27    (h) The state of Minnesota, the county boards participating in the consumer 179.28support grant program, or the agencies acting on behalf of the county boards in the 179.29implementation and administration of the consumer support grant program shall not be 179.30liable for damages, injuries, or liabilities sustained through the purchase of support by 179.31the individual, the individual's family, or the authorized representative under this section 179.32with funds received through the consumer support grant program. Liabilities include but 179.33are not limited to: workers' compensation liability, the Federal Insurance Contributions 179.34Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, 179.35participating county boards and agencies acting on behalf of county boards are exempt 179.36from the provisions of section 
         268.04.180.1    Sec. 10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:180.2    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of 180.3transferring persons to the consumer support grant program from the developmental 180.4disability family support program and personal care assistant services, home health 180.5aide services, or private duty nursing services, the amount of funds transferred by the 180.6commissioner between the developmental disability family support program account, the 180.7medical assistance account, or the consumer support grant account shall be based on each 180.8county's participation in transferring persons to the consumer support grant program 180.9from those programs and services.180.10    (b) At the beginning of each fiscal year, county allocations for consumer support 180.11grants shall be based on:180.12    (1) the number of persons to whom the county board expects to provide consumer 180.13supports grants;180.14    (2) their eligibility for current program and services;180.15    (3) the amount of nonfederal dollars allowed under subdivision 11; and180.16    (4) projected dates when persons will start receiving grants. County allocations shall 180.17be adjusted periodically by the commissioner based on the actual transfer of persons or 180.18service openings, and the nonfederal dollars associated with those persons or service 180.19openings, to the consumer support grant program.180.20    (c) The amount of funds transferred by the commissioner from the medical 180.21assistance account for an individual may be changed if it is determined by the county or its 180.22agent that the individual's need for support has changed.180.23    (d) The authority to utilize funds transferred to the consumer support grant account 180.24for the purposes of implementing and administering the consumer support grant program 180.25will not be limited or constrained by the spending authority provided to the program 180.26of origination.180.27    (e) The commissioner may use up to five percent of each county's allocation, as 180.28adjusted, for payments for administrative expenses, to be paid as a proportionate addition 180.29to reported direct service expenditures.180.30    (f) The county allocation for each individual or individual's family cannot exceed 180.31the amount allowed under subdivision 11.180.32    (g) The commissioner may recover, suspend, or withhold payments if the county 180.33board, local agency, or grantee does not comply with the requirements of this section.180.34    (h) Grant funds unexpended by consumers shall return to the state once a year. The 180.35annual return of unexpended grant funds shall occur in the quarter following the end of 180.36the state fiscal year.181.1    Sec. 11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:181.2    Subd. 10. Consumer responsibilities. Persons receiving grants under this section 181.3shall:181.4    (1) spend the grant money in a manner consistent with their agreement with the 181.5local agency;181.6    (2) notify the local agency of any necessary changes in the grant or the items on 181.7which it is spent;181.8    (3) notify the local agency of any decision made by the person, the a person's legal 181.9representative, or the person's family or other authorized representative that would change 181.10their eligibility for consumer support grants;181.11    (4) arrange and pay for supports; and181.12    (5) inform the local agency of areas where they have experienced difficulty securing 181.13or maintaining supports.181.14    Sec. 12. Minnesota Statutes 2006, section 256.974, is amended to read:181.15256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS181.16LONG-TERM CARE; LOCAL PROGRAMS.181.17    The ombudsman for older Minnesotans long-term care serves in the classified service 181.18under section 
         256.01, subdivision 7, in an office within the Minnesota Board on Aging that 181.19incorporates the long-term care ombudsman program required by the Older Americans 181.20Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12)181.21(9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota 181.22Board on Aging may make grants to and designate local programs for the provision of 181.23ombudsman services to clients in county or multicounty areas. The local program may not 181.24be an agency engaged in the provision of nursing home care, hospital care, or home care 181.25services either directly or by contract, or have the responsibility for planning, coordinating, 181.26funding, or administering nursing home care, hospital care, or home care services.181.27    Sec. 13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:181.28    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing 181.29home licensed under sections 
         144A.02 to 
         144A.10or; a boarding care home licensed 181.30under sections 
         144.50 to 
         144.56; or a licensed or registered residential setting which 181.31provides or arranges for the provision of home care services. 181.32    Sec. 14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:182.1    Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a 182.2request is made for, ombudsman services and is (a) a resident of a long-term care facility 182.3or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or 182.4denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or 182.5requesting a home care service.182.6    Sec. 15. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:182.7    Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a 182.8conspicuous place the address and telephone number of the office. A home care service 182.9provider shall provide all recipients, including those in elderly housing with services 182.10under chapter 144D, with the address and telephone number of the office. Counties shall 182.11provide clients receiving a consumer support grant or a service allowancelong-term care 182.12consultation services under section 256B.0911 or home and community-based services 182.13through a state or federally funded program with the name, address, and telephone number 182.14of the office. The posting or notice is subject to approval by the ombudsman.182.15    Sec. 16. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:182.16    Subd. 4. Access to long-term care and acute care facilities and clients. The 182.17ombudsman or designee may:182.18    (1) enter any long-term care facility without notice at any time;182.19    (2) enter any acute care facility without notice during normal business hours;182.20    (3) enter any acute care facility without notice at any time to interview a patient or 182.21observe services being provided to the patient as part of an investigation of a matter that is 182.22within the scope of the ombudsman's authority, but only if the ombudsman's or designee's 182.23presence does not intrude upon the privacy of another patient or interfere with routine 182.24hospital services provided to any patient in the facility;182.25    (4) communicate privately and without restriction with any client in accordance 182.26with section 144.651, as long as the ombudsman has the client's consent for such 182.27communication; 182.28    (5) inspect records of a long-term care facility, home care service provider, or acute 182.29care facility that pertain to the care of the client according to sectionssection 144.335and 182.30144.651; and 182.31    (6) with the consent of a client or client's legal guardian, the ombudsman or 182.32designated staff shall have access to review records pertaining to the care of the client 182.33according to sectionssection 144.335and 144.651. If a client cannot consent and has no 182.34legal guardian, access to the records is authorized by this section. 183.1    A person who denies access to the ombudsman or designee in violation of this 183.2subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a 183.3misdemeanor.183.4    Sec. 17. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:183.5    Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take 183.6discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a 183.7patient, resident, or guardian or family member of a patient, resident, or guardian for filing 183.8in good faith a complaint with or providing information to the ombudsman or designee 183.9including volunteers. A person who violates this subdivision or who aids, abets, invites, 183.10compels, or coerces another to do so is guilty of a misdemeanor.183.11    (b) There shall be a rebuttable presumption that any adverse action, as defined below, 183.12within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose 183.13of this clause, the term "adverse action" refers to action taken by the entity involved in a 183.14report against the person making the report or the person with respect to whom the report 183.15was made because of the report, and includes, but is not limited to:183.16    (1) discharge or transfer from a facility;183.17    (2) termination of service;183.18    (3) restriction or prohibition of access to the facility or its residents;183.19    (4) discharge from or termination of employment;183.20    (5) demotion or reduction in remuneration for services; and183.21    (6) any restriction of rights set forth in section 
         144.651or,144A.44, or 144A.751. 183.22    Sec. 18. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:183.23    Subdivision 1. Classification. Except as provided in this section, data maintained 183.24by the office under sections 
         256.974 to 
         256.9744 are private data on individuals or 183.25nonpublic data as defined in section 
         13.02, subdivision 9 or 12, and must be maintained 183.26in accordance with the requirements of Public Law 100-75 the Older Americans Act, as 183.27amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).183.28    Sec. 19. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:183.29    Subd. 7. Consumer information and assistance; senior linkage. (a) The 183.30Minnesota Board on Aging shall operate a statewide information and assistance service 183.31to aid older Minnesotans and their families in making informed choices about long-term 183.32care options and health care benefits. Language services to persons with limited English 183.33language skills may be made available. The service, known as Senior LinkAge Line, must 184.1be available during business hours through a statewide toll-free number and must also 184.2be available through the Internet.184.3    (b) The service must assist older adults, caregivers, and providers in accessing 184.4information about choices in long-term care services that are purchased through private 184.5providers or available through public options. The service must:184.6    (1) develop a comprehensive database that includes detailed listings in both 184.7consumer- and provider-oriented formats;184.8    (2) make the database accessible on the Internet and through other telecommunication 184.9and media-related tools;184.10    (3) link callers to interactive long-term care screening tools and make these tools 184.11available through the Internet by integrating the tools with the database;184.12    (4) develop community education materials with a focus on planning for long-term 184.13care and evaluating independent living, housing, and service options;184.14    (5) conduct an outreach campaign to assist older adults and their caregivers in 184.15finding information on the Internet and through other means of communication;184.16    (6) implement a messaging system for overflow callers and respond to these callers 184.17by the next business day;184.18    (7) link callers with county human services and other providers to receive more 184.19in-depth assistance and consultation related to long-term care options; and184.20    (8) link callers with quality profiles for nursing facilities and other providers 184.21developed by the commissioner of health.; and184.22    (9) incorporate information about housing with services and consumer rights 184.23within the MinnesotaHelp.info network long-term care database to facilitate consumer 184.24comparison of services and costs among housing with services establishments and with 184.25other in-home services and to support financial self-sufficiency as long as possible. 184.26Housing with services establishments and their arranged home care providers shall provide 184.27information to the commissioner of human services that is consistent with information 184.28required by the commissioner of health under section 144G.06, the Uniform Consumer 184.29Information Guide. The commissioner of human services shall provide the data to the 184.30Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term 184.31care database.184.32    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 184.33of the statewide information and assistance, and submit this evaluation to the legislature 184.34by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 184.35in service delivery, continuity in information between the service and identified linkages, 184.36and potential use of private funding to enhance the service.185.1EFFECTIVE DATE.This section is effective the day following final enactment.185.2    Sec. 20. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to 185.3read:185.4    Subd. 1a. Income and assets generally. Unless specifically required by state law or 185.5rule or federal law or regulation, the methodologies used in counting income and assets 185.6to determine eligibility for medical assistance for persons whose eligibility category is 185.7based on blindness, disability, or age of 65 or more years, the methodologies for the 185.8supplemental security income program shall be used, except as provided under subdivision 185.93, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be 185.10counted as income for purposes of this subdivision until July 1 of each year. Effective 185.11upon federal approval, for children eligible under section 
         256B.055, subdivision 12, or 185.12for home and community-based waiver services whose eligibility for medical assistance 185.13is determined without regard to parental income, child support payments, including any 185.14payments made by an obligor in satisfaction of or in addition to a temporary or permanent 185.15order for child support, and Social Security payments are not counted as income. For 185.16families and children, which includes all other eligibility categories, the methodologies 185.17under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal 185.18Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public 185.19Law 104-193, shall be used, except that effective October 1, 2003, the earned income 185.20disregards and deductions are limited to those in subdivision 1c. For these purposes, a 185.21"methodology" does not include an asset or income standard, or accounting method, 185.22or method of determining effective dates.185.23    Sec. 21. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:185.24    Subd. 3. Asset limitations for aged, blind, or disabled individuals and families.185.25    To be eligible for medical assistance, a person whose eligibility is based on blindness, 185.26disability, or age of 65 or more years must not individually own more than $3,000 $6,000185.27in assets, or if a member of a household with two family members, husband and wife, or 185.28parent and child, the household must not own more than $6,000 $12,000 in assets, plus 185.29$200 $400 for each additional legal dependent. In addition to these maximum amounts, 185.30an eligible individual or family may accrue interest on these amounts, but they must be 185.31reduced to the maximum at the time of an eligibility redetermination. The accumulation 185.32of the clothing and personal needs allowance according to section 
         256B.35 must also be 185.33reduced to the maximum at the time of the eligibility redetermination. The value of assets 185.34that are not considered in determining eligibility for medical assistance is the value of 186.1those assets excluded under the supplemental security income program for aged, blind, 186.2and disabled persons, with the following exceptions: 186.3    (a) Household goods and personal effects are not considered.186.4    (b) Capital and operating assets of a trade or business that the local agency 186.5determines are necessary to the person's ability to earn an income are not considered.186.6    (c) Motor vehicles are excluded to the same extent excluded by the supplemental 186.7security income program.186.8    (d) Assets designated as burial expenses are excluded to the same extent excluded by 186.9the supplemental security income program. Burial expenses funded by annuity contracts 186.10or life insurance policies must irrevocably designate the individual's estate as contingent 186.11beneficiary to the extent proceeds are not used for payment of selected burial expenses.186.12    (e) Effective upon federal approval, for a person who no longer qualifies as an 186.13employed person with a disability due to loss of earnings, assets allowed while eligible 186.14for medical assistance under section 
         256B.057, subdivision 9, are not considered for 12 186.15months, beginning with the first month of ineligibility as an employed person with a 186.16disability, to the extent that the person's total assets remain within the allowed limits of 186.17section 
         256B.057, subdivision 9, paragraph (b). 186.18    (f) When a person enrolled in medical assistance under section 256B.057, 186.19subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive 186.20months before the person's 65th birthday, the assets owned by the person and the person's 186.21spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph 186.22(b), when determining eligibility for medical assistance under section 256B.055, 186.23subdivision 7. The income of a spouse of a person enrolled in medical assistance under 186.24section 256B.057, subdivision 9, during each of the 24 consecutive months before the 186.25person's 65th birthday must be disregarded when determining eligibility for medical 186.26assistance under section 256B.055, subdivision 7, when the person reaches age 65. This 186.27paragraph does not apply at the time the person or the person's spouse requests medical 186.28assistance payment for long-term care services.186.29EFFECTIVE DATE.This section is effective July 1, 2007, except that the increase 186.30in the asset standard for persons whose eligibility for medical assistance is based on 186.31blindness, disability, or age of 65 or more years is effective July 1, 2008.186.32    Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 5c, is amended to 186.33read:186.34    Subd. 5c. Excess income standard. (a) The excess income standard for families 186.35with children is the standard specified in subdivision 4.187.1    (b) The excess income standard for a person whose eligibility is based on blindness, 187.2disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the 187.3family size. Effective July 1, 2002, the excess income standard for this paragraph shall 187.4equal 75 percent of the federal poverty guidelines. Effective July 1, 2007, the excess 187.5income standard for this paragraph shall equal 85 percent of the federal poverty guidelines. 187.6The excess income standard for this paragraph shall be increased by five percentage points 187.7on July 1 of each of the next three years, so that the excess income standard shall equal 187.8100 percent of the federal poverty guidelines effective July 1, 2010.187.9EFFECTIVE DATE.This section is effective July 1, 2007.187.10    Sec. 23. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to 187.11read:187.12    Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner 187.13shall execute a data use agreement with the Centers for Medicare and Medicaid Services 187.14to obtain the long-term care minimum data set data to assist residents of nursing facilities 187.15who have establish a process with the Centers for Independent Living that allows a person 187.16residing in a Minnesota nursing facility to receive needed information, consultation, and 187.17assistance from one of the centers about the available community support options that may 187.18enable the person to relocate to the community, if the person: (1) is under the age of 65, 187.19(2) has indicated a desire to live in the community. The commissioner shall in turn enter 187.20into agreements with the Centers for Independent Living to provide information about 187.21assistance for persons who want to move to the community. The commissioner shall work 187.22with the Centers for Independent Living on both the content of the information to be 187.23provided and privacy protections for the individual residents, and (3) has signed a release 187.24of information authorized by the person or the person's appointed legal representative. 187.25The process established under this subdivision shall be coordinated with the long-term 187.26care consultation service activities established in section 256B.0911.187.27    Sec. 24. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 187.28read:187.29    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 187.30meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 187.31$6.50 for lunch, or $8 for dinner.187.32    (b) Medical assistance reimbursement for lodging for persons traveling to receive 187.33medical care may not exceed $50 per day unless prior authorized by the local agency.188.1    (c) Medical assistance direct mileage reimbursement to the eligible person or the 188.2eligible person's driver may not exceed 20 cents per mile.188.3    (d) Regardless of the number of employees that an enrolled health care provider 188.4may have, medical assistance covers sign and oral language interpreter services when 188.5provided by an enrolled health care provider during the course of providing a direct, 188.6person-to-person covered health care service to an enrolled recipient with limited English 188.7proficiency or who has a hearing loss and uses interpreting services.188.8    Sec. 25. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 188.9subdivision to read:188.10    Subd. 49.Self-directed supports option.Upon federal approval, medical 188.11assistance covers the self-directed supports option as defined under section 256B.0657 and 188.12section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.188.13EFFECTIVE DATE.This section is effective upon federal approval of the state 188.14Medicaid plan amendment. The commissioner of human services shall inform the Office 188.15of the Revisor of Statutes when approval is obtained.188.16    Sec. 26. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.188.17    Subdivision 1.Definition."Self-directed supports option" means personal 188.18assistance, supports, items, and related services purchased under an approved budget 188.19plan and budget by a recipient.188.20    Subd. 2.Eligibility.(a) The self-directed supports option is available to a person 188.21who:188.22    (1) is a recipient of medical assistance as determined under sections 256B.055, 188.23256B.056, and 256B.057, subdivision 9;188.24    (2) is eligible for personal care assistant services under section 256B.0655;188.25    (3) lives in the person's own apartment or home, which is not owned, operated, or 188.26controlled by a provider of services not related by blood or marriage;188.27    (4) has the ability to hire, fire, supervise, establish staff compensation for, and 188.28manage the individuals providing services, and to choose and obtain items, related 188.29services, and supports as described in the participant's plan. If the recipient is not able to 188.30carry out these functions but has a legal guardian or parent to carry them out, the guardian 188.31or parent may fulfill these functions on behalf of the recipient; and188.32    (5) has not been excluded or disenrolled by the commissioner.188.33    (b) The commissioner may disenroll or exclude recipients, including guardians and 188.34parents, under the following circumstances:189.1    (1) recipients who have been restricted by the Primary Care Utilization Review 189.2Committee may be excluded for a specified time period; and 189.3    (2) recipients who exit the self-directed supports option during the recipient's 189.4service plan year shall not access the self-directed supports option for the remainder 189.5of that service plan year.189.6    Subd. 3.Eligibility for other services.Selection of the self-directed supports 189.7option by a recipient shall not restrict access to other medically necessary care and 189.8services furnished under the state plan medical assistance benefit, including home care 189.9targeted case management, except that a person receiving home and community-based 189.10waiver services, a family support grant or a consumer support grant is not eligible for 189.11funding under the self-directed supports option.189.12    Subd. 4.Assessment requirements.(a) The self-directed supports option 189.13assessment must meet the following requirements:189.14    (1) it shall be conducted by the county public health nurse or a certified public 189.15health nurse under contract with the county;189.16    (2) it shall be conducted face-to-face in the recipient's home initially, and at least 189.17annually thereafter; when there is a significant change in the recipient's condition; and 189.18when there is a change in the need for personal care assistant services. A recipient who is 189.19residing in a facility may be assessed for the self-directed support option for the purpose 189.20of returning to the community using this option; and 189.21    (3) it shall be completed using the format established by the commissioner.189.22    (b) The results of the assessment and recommendations shall be communicated to 189.23the commissioner and the recipient by the county public health nurse or certified public 189.24health nurse under contract with the county.189.25    Subd. 5.Self-directed supports option plan requirements.(a) The plan for the 189.26self-directed supports option must meet the following requirements:189.27    (1) the plan must be completed using a person-centered process that:189.28    (i) builds upon the recipient's capacity to engage in activities that promote 189.29community life;189.30    (ii) respects the recipient's preferences, choices, and abilities;189.31    (iii) involves families, friends, and professionals in the planning or delivery of 189.32services or supports as desired or required by the recipient; and 189.33    (iv) addresses the need for personal care assistant services identified in the recipient's 189.34self-directed supports option assessment;189.35    (2) the plan shall be developed by the recipient or by the guardian of an adult 189.36recipient or by a parent or guardian of a minor child, with the assistance of an enrolled 190.1medical assistance home care targeted case manager provider who meets the requirements 190.2established for using a person-centered planning process and shall be reviewed at least 190.3annually upon reassessment or when there is a significant change in the recipient's 190.4condition; and 190.5    (3) the plan must include the total budget amount available divided into monthly 190.6amounts that cover the number of months of personal care assistant services authorization 190.7included in the budget. The amount used each month may vary, but additional funds shall 190.8not be provided above the annual personal care assistant services authorized amount 190.9unless a change in condition is documented.190.10    (b) The commissioner shall:190.11    (1) establish the format and criteria for the plan as well as the requirements for 190.12providers who assist with plan development;190.13    (2) review the assessment and plan and, within 30 days after receiving the 190.14assessment and plan, make a decision on approval of the plan;190.15    (3) notify the recipient, parent, or guardian of approval or denial of the plan and 190.16provide notice of the right to appeal under section 256.045; and 190.17    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.190.18    Subd. 6.Services covered.(a) Services covered under the self-directed supports 190.19option include:190.20    (1) personal care assistant services under section 256B.0655; and 190.21    (2) items, related services, and supports, including assistive technology, that increase 190.22independence or substitute for human assistance to the extent expenditures would 190.23otherwise be used for human assistance.190.24    (b) Items, supports, and related services purchased under this option shall not be 190.25considered home care services for the purposes of section 144A.43.190.26    Subd. 7.Noncovered services.Services or supports that are not eligible for 190.27payment under the self-directed supports option include:190.28    (1) services, goods, or supports that do not benefit the recipient;190.29    (2) any fees incurred by the recipient, such as Minnesota health care program fees 190.30and co-pays, legal fees, or costs related to advocate agencies;190.31    (3) insurance, except for insurance costs related to employee coverage or fiscal 190.32support entity payments;190.33    (4) room and board and personal items that are not related to the disability, except 190.34that medically prescribed specialized diet items may be covered if they reduce the need for 190.35human assistance;190.36    (5) home modifications that add square footage;191.1    (6) home modifications for a residence other than the primary residence of the 191.2recipient, or in the event of a minor with parents not living together, the primary residences 191.3of the parents;191.4    (7) expenses for travel, lodging, or meals related to training the recipient, the parent 191.5or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or 191.6unpaid caregivers that exceed $500 in a 12-month period;191.7    (8) experimental treatment;191.8    (9) any service or item covered by other medical assistance state plan services, 191.9including prescription and over-the-counter medications, compounds, and solutions and 191.10related fees, including premiums and co-payments;191.11    (10) membership dues or costs, except when the service is necessary and appropriate 191.12to treat a physical condition or to improve or maintain the recipient's physical condition. 191.13The condition must be identified in the recipient's plan of care and monitored by a 191.14Minnesota health care program enrolled physician;191.15    (11) vacation expenses other than the cost of direct services;191.16    (12) vehicle maintenance or modifications not related to the disability;191.17    (13) tickets and related costs to attend sporting or other recreational events; and191.18    (14) costs related to Internet access, except when necessary for operation of assistive 191.19technology, to increase independence, or to substitute for human assistance.191.20    Subd. 8.Self-directed budget requirements.The budget for the provision of the 191.21self-directed service option shall be equal to the greater of either:191.22    (1) the annual amount of personal care assistant services under section 256B.0655 191.23that the recipient has used in the most recent 12-month period; or 191.24    (2) the amount determined using the consumer support grant methodology under 191.25section 256.476, subdivision 11, except that the budget amount shall include the federal 191.26and nonfederal share of the average service costs.191.27    Subd. 9.Quality assurance and risk management.(a) The commissioner 191.28shall establish quality assurance and risk management measures for use in developing 191.29and implementing self-directed plans and budgets that (1) recognize the roles and 191.30responsibilities involved in obtaining services in a self-directed manner, and (2) assure 191.31the appropriateness of such plans and budgets based upon a recipient's resources and 191.32capabilities. These measures must include (i) background studies, and (ii) backup and 191.33emergency plans, including disaster planning.191.34    (b) The commissioner shall provide ongoing technical assistance and resource and 191.35educational materials for families and recipients selecting the self-directed option.192.1    (c) Performance assessments measures, such as of a recipient's satisfaction with the 192.2services and supports, and ongoing monitoring of health and well-being shall be identified 192.3in consultation with the stakeholder group.192.4    Subd. 10.Fiscal support entity.(a) Each recipient shall choose a fiscal support 192.5entity provider certified by the commissioner to make payments for services, items, 192.6supports, and administrative costs related to managing a self-directed service plan 192.7authorized for payment in the approved plan and budget. Recipients shall also choose 192.8the payroll, agency with choice, or the fiscal conduit model of financial and service 192.9management.192.10    (b) The fiscal support entity:192.11    (1) may not limit or restrict the recipient's choice of service or support providers, 192.12including use of the payroll, agency with choice, or fiscal conduit model of financial 192.13and service management; 192.14    (2) must have a written agreement with the recipient or the recipient's representative 192.15that identifies the duties and responsibilities to be performed and the specific related 192.16charges; 192.17    (3) must provide the recipient and the home care targeted case manager with a 192.18monthly written summary of the self-directed supports option services that were billed, 192.19including charges from the fiscal support entity;192.20    (4) must be knowledgeable of and comply with Internal Revenue Service 192.21requirements necessary to process employer and employee deductions, provide appropriate 192.22and timely submission of employer tax liabilities, and maintain documentation to support 192.23medical assistance claims; 192.24    (5) must have current and adequate liability insurance and bonding and sufficient 192.25cash flow and have on staff or under contract a certified public accountant or an individual 192.26with a baccalaureate degree in accounting; and 192.27    (6) must maintain records to track all self-directed supports option services 192.28expenditures, including time records of persons paid to provide supports and receipts for 192.29any goods purchased. The records must be maintained for a minimum of five years from 192.30the claim date and be available for audit or review upon request. Claims submitted by 192.31the fiscal support entity must correspond with services, amounts, and time periods as 192.32authorized in the recipient's self-directed supports option plan.192.33    (c) The commissioner shall have authority to:192.34    (1) set or negotiate rates with fiscal support entities;192.35    (2) limit the number of fiscal support entities;193.1    (3) identify a process to certify and recertify fiscal support entities and assure fiscal 193.2support entities are available to recipients throughout the state; and 193.3    (4) establish a uniform format and protocol to be used by eligible fiscal support 193.4entities.193.5    Subd. 11.Stakeholder consultation.The commissioner shall consult with a 193.6statewide consumer-directed services stakeholder group, including representatives of 193.7all types of consumer-directed service users, advocacy organizations, counties, and 193.8consumer-directed service providers. The commissioner shall seek recommendations 193.9from this stakeholder group in developing:193.10    (1) the self-directed plan format;193.11    (2) requirements and guidelines for the person-centered plan assessment and 193.12planning process;193.13    (3) implementation of the option and the quality assurance and risk management 193.14techniques; and 193.15    (4) standards and requirements, including rates for the personal support plan 193.16development provider and the fiscal support entity; policies; training; and implementation. 193.17The stakeholder group shall provide recommendations on the repeal of the personal care 193.18assistant choice option, transition issues, and whether the consumer support grant program 193.19under section 256.476 should be modified. The stakeholder group shall meet at least 193.20three times each year to provide advice on policy, implementation, and other aspects of 193.21consumer and self-directed services.193.22EFFECTIVE DATE.Subdivisions 1 to 10 are effective upon federal approval of 193.23the state Medicaid plan amendment. The commissioner of human services shall inform 193.24the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11 193.25is effective July 1, 2007.193.26    Sec. 27. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to 193.27read:193.28    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 193.29services planning, or other assistance intended to support community-based living, 193.30including persons who need assessment in order to determine waiver or alternative care 193.31program eligibility, must be visited by a long-term care consultation team within ten 193.32working days after the date on which an assessment was requested or recommended. 193.33Assessments must be conducted according to paragraphs (b) to (g) (i).193.34    (b) The county may utilize a team of either the social worker or public health nurse, 193.35or both, to conduct the assessment in a face-to-face interview. The consultation team 194.1members must confer regarding the most appropriate care for each individual screened or 194.2assessed.194.3    (c) The long-term care consultation team must assess the health and social needs of 194.4the person, using an assessment form provided by the commissioner.194.5    (d) The team must conduct the assessment in a face-to-face interview with the 194.6person being assessed and the person's legal representative, if applicable.194.7    (e) The team must provide the person, or the person's legal representative, with 194.8written recommendations for facility- or community-based services. The team must 194.9document that the most cost-effective alternatives available were offered to the individual. 194.10For purposes of this requirement, "cost-effective alternatives" means community services 194.11and living arrangements that cost the same as or less than nursing facility care.194.12    (f) If the person chooses to use community-based services, the team must provide 194.13the person or the person's legal representative with a written community support plan, 194.14regardless of whether the individual is eligible for Minnesota health care programs. 194.15The person may request assistance in developing a community support plan without 194.16participating in a complete assessment.194.17    (g) The person has the right to make the final decision between nursing facility 194.18placement and community placement after the screening team's recommendation, except 194.19as provided in subdivision 4a, paragraph (c).194.20    (h) The team must give the person receiving assessment or support planning, or 194.21the person's legal representative, materials, and forms supplied by the commissioner 194.22containing the following information:194.23    (1) the need for and purpose of preadmission screening and assessment if the person 194.24selects nursing facility placement;194.25    (2) the role of the long-term care consultation assessment and support planning in 194.26waiver and alternative care program eligibility determination;194.27    (2) (3) information about Minnesota health care programs;194.28    (3) (4) the person's freedom to accept or reject the recommendations of the team;194.29    (4) (5) the person's right to confidentiality under the Minnesota Government Data 194.30Practices Act, chapter 13; and194.31    (6) the long-term care consultant's decision regarding the person's need for nursing 194.32facility level of care;194.33    (5) (7) the person's right to appeal the decision regarding the need for nursing facility 194.34level of care or the county's final decisions regarding public programs eligibility according 194.35to section 
         256.045, subdivision 3. 195.1    (i) Face-to-face assessment completed as part of eligibility determination for 195.2the alternative care, elderly waiver, community alternatives for disabled individuals, 195.3community alternative care, and traumatic brain injury waiver programs under sections 195.4256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 195.5than 60 calendar days after the date of assessment. The effective eligibility start date 195.6for these programs can never be prior to the date of assessment. If an assessment was 195.7completed more than 60 days before the effective waiver or alternative care program 195.8eligibility start date, assessment and support plan information must be updated in a 195.9face-to-face visit and documented in the department's Medicaid Management Information 195.10System (MMIS). The effective date of program eligibility in this case cannot be prior to 195.11the date the updated assessment is completed.195.12    Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to 195.13read:195.14    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall 195.15provide assistance to persons residing in a nursing facility, hospital, regional treatment 195.16center, or intermediate care facility for persons with developmental disabilities who 195.17request or are referred for assistance. Transition assistance must include assessment, 195.18community support plan development, referrals to Minnesota health care programs, 195.19and referrals to programs that provide assistance with housing. Transition assistance 195.20must also include information about the Centers for Independent Living and about other 195.21organizations that can provide assistance with relocation efforts, and information about 195.22contacting these organizations to obtain their assistance and support. 195.23    (b) The county shall develop transition processes with institutional social workers 195.24and discharge planners to ensure that:195.25    (1) persons admitted to facilities receive information about transition assistance 195.26that is available;195.27    (2) the assessment is completed for persons within ten working days of the date of 195.28request or recommendation for assessment; and195.29    (3) there is a plan for transition and follow-up for the individual's return to the 195.30community. The plan must require notification of other local agencies when a person 195.31who may require assistance is screened by one county for admission to a facility located 195.32in another county.195.33    (c) If a person who is eligible for a Minnesota health care program is admitted to a 195.34nursing facility, the nursing facility must include a consultation team member or the case 195.35manager in the discharge planning process.196.1    Sec. 29. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 196.2subdivision to read:196.3    Subd. 3c.Transition to housing with services.(a) Transitional consultation shall 196.4be offered to all prospective residents 65 years of age or older regardless of income, assets, 196.5or funding sources before housing with services establishments offering or providing 196.6assisted living execute a lease or contract with the prospective resident. The purpose of 196.7transitional long-term care consultation is to support persons with current or anticipated 196.8long-term care needs in making informed choices among options that include the most 196.9cost-effective and least restrictive settings, and to delay spenddown to eligibility for 196.10publicly funded programs by connecting people to alternative services in their homes 196.11before transition to housing with services.196.12    (b) Transitional consultation services are provided as determined by the 196.13commissioner of human services in partnership with county long-term care consultation 196.14units, and the Area Agencies on Aging, and are a combination of telephone-based 196.15and in-person assistance provided under models developed by the commissioner. The 196.16consultation is to be performed in a manner which provides objective and complete 196.17information. Transitional consultation must be provided within five working days of the 196.18request of the prospective resident as follows:196.19    (1) the consultation must be provided by a qualified professional as determined by 196.20the commissioner;196.21    (2) the consultation must include a review of the prospective resident's reasons for 196.22considering assisted living, the prospective resident's personal goals, a discussion of the 196.23prospective resident's immediate and projected long-term care needs, and alternative 196.24community services or assisted living settings that may meet the prospective resident's 196.25needs; and196.26    (3) the prospective resident will be informed of the availability of long-term care 196.27consultation services described in subdivision 3a that are available at no charge to the 196.28prospective resident to assist the prospective resident in assessment and planning to 196.29meet the prospective resident's long-term care needs. Regardless of the consultation, 196.30prospective residents maintain the right to choose housing with services or assisted living, 196.31if that is their choice.196.32EFFECTIVE DATE.This section is effective October 1, 2008.196.33    Sec. 30. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to 196.34read:197.1    Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the 197.2federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are 197.3limited to:197.4    (1) a person who, having entered an acute care facility from a certified nursing 197.5facility, is returning to a certified nursing facility;197.6    (2) a person transferring from one certified nursing facility in Minnesota to another 197.7certified nursing facility in Minnesota; and197.8    (3) a person, 21 years of age or older, who satisfies the following criteria, as specified 197.9in Code of Federal Regulations, title 42, section 483.106(b)(2):197.10    (i) the person is admitted to a nursing facility directly from a hospital after receiving 197.11acute inpatient care at the hospital;197.12    (ii) the person requires nursing facility services for the same condition for which 197.13care was provided in the hospital; and197.14    (iii) the attending physician has certified before the nursing facility admission that 197.15the person is likely to receive less than 30 days of nursing facility services.197.16    (b) Persons who are exempt from preadmission screening for purposes of level of 197.17care determination include:197.18    (1) persons described in paragraph (a);197.19    (2) an individual who has a contractual right to have nursing facility care paid for 197.20indefinitely by the veterans' administration;197.21    (3) an individual enrolled in a demonstration project under section 
         256B.69, 197.22subdivision 8
         , at the time of application to a nursing facility; and197.23    (4) an individual currently being served under the alternative care program or under 197.24a home and community-based services waiver authorized under section 1915(c) of the 197.25federal Social Security Act; and.197.26    (5) individuals admitted to a certified nursing facility for a short-term stay, which 197.27is expected to be 14 days or less in duration based upon a physician's certification, and 197.28who have been assessed and approved for nursing facility admission within the previous 197.29six months. This exemption applies only if the consultation team member determines at 197.30the time of the initial assessment of the six-month period that it is appropriate to use the 197.31nursing facility for short-term stays and that there is an adequate plan of care for return to 197.32the home or community-based setting. If a stay exceeds 14 days, the individual must be 197.33referred no later than the first county working day following the 14th resident day for a 197.34screening, which must be completed within five working days of the referral. The payment 197.35limitations in subdivision 7 apply to an individual found at screening to not meet the level 197.36of care criteria for admission to a certified nursing facility.198.1    (c) Persons admitted to a Medicaid-certified nursing facility from the community 198.2on an emergency basis as described in paragraph (d) or from an acute care facility on a 198.3nonworking day must be screened the first working day after admission.198.4    (d) Emergency admission to a nursing facility prior to screening is permitted when 198.5all of the following conditions are met:198.6    (1) a person is admitted from the community to a certified nursing or certified 198.7boarding care facility during county nonworking hours;198.8    (2) a physician has determined that delaying admission until preadmission screening 198.9is completed would adversely affect the person's health and safety;198.10    (3) there is a recent precipitating event that precludes the client from living safely in 198.11the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's 198.12inability to continue to provide care;198.13    (4) the attending physician has authorized the emergency placement and has 198.14documented the reason that the emergency placement is recommended; and198.15    (5) the county is contacted on the first working day following the emergency 198.16admission.198.17Transfer of a patient from an acute care hospital to a nursing facility is not considered 198.18an emergency except for a person who has received hospital services in the following 198.19situations: hospital admission for observation, care in an emergency room without hospital 198.20admission, or following hospital 24-hour bed care.198.21    (e) A nursing facility must provide a written notice to persons who satisfy the criteria 198.22in paragraph (a), clause (3),information to all persons admitted regarding the person's 198.23right to request and receive long-term care consultation services as defined in subdivision 198.241a. The noticeinformation must be provided prior to the person's discharge from the 198.25facility and in a format specified by the commissioner.198.26    Sec. 31. Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to 198.27read:198.28    Subd. 4c. Screening requirements. (a) A person may be screened for nursing 198.29facility admission by telephone or in a face-to-face screening interview. Consultation team 198.30members shall identify each individual's needs using the following categories:198.31    (1) the person needs no face-to-face screening interview to determine the need 198.32for nursing facility level of care based on information obtained from other health care 198.33professionals;199.1    (2) the person needs an immediate face-to-face screening interview to determine the 199.2need for nursing facility level of care and complete activities required under subdivision 199.34a; or199.4    (3) the person may be exempt from screening requirements as outlined in subdivision 199.54b, but will need transitional assistance after admission or in-person follow-along after 199.6a return home.199.7    (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing 199.8facility must be screened prior to admission.199.9    (c) The long-term care consultation team shall recommend a case mix classification 199.10for persons admitted to a certified nursing facility when sufficient information is received 199.11to make that classification. The nursing facility is authorized to conduct all case mix 199.12assessments for persons who have been screened prior to admission for whom the county 199.13did not recommend a case mix classification. The nursing facility is authorized to conduct 199.14all case mix assessments for persons admitted to the facility prior to a preadmission 199.15screening. The county retains the responsibility of distributing appropriate case mix 199.16forms to the nursing facility.199.17    (d) (c) The county screening or intake activity must include processes to identify 199.18persons who may require transition assistance as described in subdivision 3b.199.19    Sec. 32. Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to 199.20read:199.21    Subd. 6. Payment for long-term care consultation services. (a) The total payment 199.22for each county must be paid monthly by certified nursing facilities in the county. The 199.23monthly amount to be paid by each nursing facility for each fiscal year must be determined 199.24by dividing the county's annual allocation for long-term care consultation services by 12 199.25to determine the monthly payment and allocating the monthly payment to each nursing 199.26facility based on the number of licensed beds in the nursing facility. Payments to counties 199.27in which there is no certified nursing facility must be made by increasing the payment 199.28rate of the two facilities located nearest to the county seat.199.29    (b) The commissioner shall include the total annual payment determined under 199.30paragraph (a) for each nursing facility reimbursed under section 
         256B.431 or 
         256B.434199.31according to section 
         256B.431, subdivision 2b, paragraph (g), or 256B.435.199.32    (c) In the event of the layaway, delicensure and decertification, or removal from 199.33layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 199.34the per diem payment amount in paragraph (b) and may adjust the monthly payment 199.35amount in paragraph (a). The effective date of an adjustment made under this paragraph 200.1shall be on or after the first day of the month following the effective date of the layaway, 200.2delicensure and decertification, or removal from layaway.200.3    (d) Payments for long-term care consultation services are available to the county 200.4or counties to cover staff salaries and expenses to provide the services described in 200.5subdivision 1a. The county shall employ, or contract with other agencies to employ, within 200.6the limits of available funding, sufficient personnel to provide long-term care consultation 200.7services while meeting the state's long-term care outcomes and objectives as defined in 200.8section 
         256B.0917, subdivision 1. The county shall be accountable for meeting local 200.9objectives as approved by the commissioner in the biennial home and community-based 200.10services quality assurance plan on a form provided by the commissioner.200.11    (e) Notwithstanding section 
         256B.0641, overpayments attributable to payment of the 200.12screening costs under the medical assistance program may not be recovered from a facility.200.13    (f) The commissioner of human services shall amend the Minnesota medical 200.14assistance plan to include reimbursement for the local consultation teams.200.15    (g) The county may bill, as case management services, assessments, support 200.16planning, and follow-along provided to persons determined to be eligible for case 200.17management under Minnesota health care programs. No individual or family member 200.18shall be charged for an initial assessment or initial support plan development provided 200.19under subdivision 3a or 3b.200.20    Sec. 33. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 200.21subdivision to read:200.22    Subd. 6a.Withholding.If any provider obligated to pay the long-term care 200.23consultation amount as described in subdivision 6 is more than two months delinquent in 200.24the timely payment of the monthly installment, the commissioner may withhold payments, 200.25penalties, and interest in accordance with the methods outlined in section 256.9657, 200.26subdivision 7a. Any amount withheld under this provision must be returned to the county 200.27to whom the delinquent payments were due.200.28    Sec. 34. Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to 200.29read:200.30    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance 200.31reimbursement for nursing facilities shall be authorized for a medical assistance recipient 200.32only if a preadmission screening has been conducted prior to admission or the county has 200.33authorized an exemption. Medical assistance reimbursement for nursing facilities shall 200.34not be provided for any recipient who the local screener has determined does not meet the 201.1level of care criteria for nursing facility placement or, if indicated, has not had a level II 201.2OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 201.31987 completed unless an admission for a recipient with mental illness is approved by the 201.4local mental health authority or an admission for a recipient with developmental disability 201.5is approved by the state developmental disability authority.201.6    (b) The nursing facility must not bill a person who is not a medical assistance 201.7recipient for resident days that preceded the date of completion of screening activities as 201.8required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 201.9resident days in the nursing facility resident day totals reported to the commissioner.201.10    (c) The commissioner shall make a request to the Centers for Medicare and Medicaid 201.11Services for a waiver allowing team approval of Medicaid payments for certified nursing 201.12facility care. An individual has a choice and makes the final decision between nursing 201.13facility placement and community placement after the screening team's recommendation, 201.14except as provided in subdivision 4a, paragraph (c).201.15    Sec. 35. Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to 201.16read:201.17    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.201.18    (a) Funding for services under the alternative care program is available to persons who 201.19meet the following criteria:201.20    (1) the person has been determined by a community assessment under section 201.21256B.0911
          to be a person who would require the level of care provided in a nursing 201.22facility, but for the provision of services under the alternative care program;201.23    (2) the person is age 65 or older;201.24    (3) the person would be eligible for medical assistance within 135 days of admission 201.25to a nursing facility;201.26    (4) the person is not ineligible for the payment of long-term care services by the201.27medical assistance program due to an asset transfer penalty under section 256B.0595 or 201.28equity interest in the home exceeding $500,000 as stated in section 256B.056;201.29    (5) the person needs long-term care services that are not funded through other state 201.30or federal funding;201.31    (6) the monthly cost of the alternative care services funded by the program for 201.32this person does not exceed 75 percent of the monthly limit described under section 201.33256B.0915, subdivision 3a
         . This monthly limit does not prohibit the alternative care client 201.34from payment for additional services, but in no case may the cost of additional services 201.35purchased under this section exceed the difference between the client's monthly service 202.1limit defined under section 
         256B.0915, subdivision 3, and the alternative care program 202.2monthly service limit defined in this paragraph. If medical care-related supplies and 202.3equipment or environmental modifications and adaptations are or will be purchased for 202.4an alternative care services recipient, the costs may be prorated on a monthly basis for 202.5up to 12 consecutive months beginning with the month of purchase. If the monthly cost 202.6of a recipient's other alternative care services exceeds the monthly limit established in 202.7this paragraph, the annual cost of the alternative care services shall be determined. In this 202.8event, the annual cost of alternative care services shall not exceed 12 times the monthly 202.9limit described in this paragraph; and202.10    (7) the person is making timely payments of the assessed monthly fee.202.11A person is ineligible if payment of the fee is over 60 days past due, unless the person 202.12agrees to:202.13    (i) the appointment of a representative payee;202.14    (ii) automatic payment from a financial account;202.15    (iii) the establishment of greater family involvement in the financial management of 202.16payments; or202.17    (iv) another method acceptable to the county lead agency to ensure prompt fee 202.18payments.202.19    The county shall lead agency may extend the client's eligibility as necessary while 202.20making arrangements to facilitate payment of past-due amounts and future premium 202.21payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall 202.22not be reinstated for a period of 30 days.202.23    (b) Alternative care funding under this subdivision is not available for a person 202.24who is a medical assistance recipient or who would be eligible for medical assistance 202.25without a spenddown or waiver obligation. A person whose initial application for medical 202.26assistance and the elderly waiver program is being processed may be served under the 202.27alternative care program for a period up to 60 days. If the individual is found to be eligible 202.28for medical assistance, medical assistance must be billed for services payable under the 202.29federally approved elderly waiver plan and delivered from the date the individual was 202.30found eligible for the federally approved elderly waiver plan. Notwithstanding this 202.31provision, alternative care funds may not be used to pay for any service the cost of which: 202.32(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 202.33or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 202.34to participate in the federally approved elderly waiver program under the special income 202.35standard provision.203.1    (c) Alternative care funding is not available for a person who resides in a licensed 203.2nursing home, certified boarding care home, hospital, or intermediate care facility, except 203.3for case management services which are provided in support of the discharge planning 203.4process for a nursing home resident or certified boarding care home resident to assist with 203.5a relocation process to a community-based setting.203.6    (d) Alternative care funding is not available for a person whose income is greater 203.7than the maintenance needs allowance under section 
         256B.0915, subdivision 1d, but equal 203.8to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal203.9year for which alternative care eligibility is determined, who would be eligible for the 203.10elderly waiver with a waiver obligation.203.11    Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to 203.12read:203.13    Subd. 5. Services covered under alternative care. Alternative care funding may 203.14be used for payment of costs of:203.15    (1) adult day care;203.16    (2) home health aide;203.17    (3) homemaker services;203.18    (4) personal care;203.19    (5) case management;203.20    (6) respite care;203.21    (7) care-related supplies and equipment;203.22    (8) meals delivered to the home;203.23    (9) nonmedical transportation;203.24    (10) nursing services;203.25    (11) chore services;203.26    (12) companion services;203.27    (13) nutrition services;203.28    (14) training for direct informal caregivers;203.29    (15) telehome care to provide services in their own homes in conjunction with 203.30in-home visits;203.31    (16) discretionary services, for which counties may make payment from their 203.32alternative care program allocation or services not otherwise defined in this section 203.33or section 256B.0625, following approval by the commissioner consumer-directed 203.34community services under the alternative care programs which are available statewide and 203.35limited to the average monthly expenditures representative of all alternative care program 204.1participants for the same case mix resident class assigned in the most recent fiscal year for 204.2which complete expenditure data is available;204.3    (17) environmental modifications and adaptations; and204.4    (18) direct cash payments for which counties may make payment from their 204.5alternative care program allocation to clients for the purpose of purchasing services, 204.6following approval by the commissioner, and subject to the provisions of subdivision 5h, 204.7until approval and implementation of consumer-directed services through the federally 204.8approved elderly waiver plan. Upon implementation, consumer-directed services under 204.9the alternative care program are available statewide and limited to the average monthly 204.10expenditures representative of all alternative care program participants for the same case 204.11mix resident class assigned in the most recent fiscal year for which complete expenditure 204.12data is available discretionary services, for which lead agencies may make payment from 204.13their alternative care program allocation for services not otherwise defined in this section 204.14or section 256B.0625, following approval by the commissioner.204.15    Total annual payments for discretionary services and direct cash payments, until 204.16the federally approved consumer-directed service option is implemented statewide, for 204.17all clients within a county may served by a lead agency must not exceed 25 percent of 204.18that county's lead agency's annual alternative care program base allocation. Thereafter, 204.19discretionary services are limited to 25 percent of the county's annual alternative care 204.20program base allocation.204.21    Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to 204.22read:204.23    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in 204.24statute, the services, service definitions, and standards for alternative care services shall 204.25be the same as the services, service definitions, and standards specified in the federally 204.26approved elderly waiver plan, except foralternative care does not cover transitional 204.27support services, assisted living services, adult foster care services, and residential care 204.28services and benefits defined under section 256B.0625 that meet primary and acute 204.29health care needs.204.30    (b) The county lead agency must ensure that the funds are not used to supplant 204.31or supplement services available through other public assistance or services programs., 204.32including supplementation of client co-pays, deductibles, premiums, or other cost-sharing 204.33arrangements for health-related benefits and services or entitlement programs and services 204.34that are available to the person, but in which they have elected not to enroll. For a provider 204.35of supplies and equipment when the monthly cost of the supplies and equipment is less 205.1than $250, persons or agencies must be employed by or under a contract with the county205.2lead agency or the public health nursing agency of the local board of health in order to 205.3receive funding under the alternative care program. Supplies and equipment may be 205.4purchased from a vendor not certified to participate in the Medicaid program if the cost for 205.5the item is less than that of a Medicaid vendor.205.6    (c) Personal care services must meet the service standards defined in the federally 205.7approved elderly waiver plan, except that a county lead agency may contract with a 205.8client's relative who meets the relative hardship waiver requirements or a relative who 205.9meets the criteria and is also the responsible party under an individual service plan that 205.10ensures the client's health and safety and supervision of the personal care services by a 205.11qualified professional as defined in section 
         256B.0625, subdivision 19c. Relative hardship 205.12is established by the county lead agency when the client's care causes a relative caregiver 205.13to do any of the following: resign from a paying job, reduce work hours resulting in lost 205.14wages, obtain a leave of absence resulting in lost wages, incur substantial client-related 205.15expenses, provide services to address authorized, unstaffed direct care time, or meet 205.16special needs of the client unmet in the formal service plan.205.17    Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to 205.18read:205.19    Subd. 8. Requirements for individual care plan. (a) The case manager shall 205.20implement the plan of care for each alternative care client and ensure that a client's 205.21service needs and eligibility are reassessed at least every 12 months. The plan shall 205.22include any services prescribed by the individual's attending physician as necessary to 205.23allow the individual to remain in a community setting. In developing the individual's care 205.24plan, the case manager should include the use of volunteers from families and neighbors, 205.25religious organizations, social clubs, and civic and service organizations to support the 205.26formal home care services. The county lead agency shall be held harmless for damages or 205.27injuries sustained through the use of volunteers under this subdivision including workers' 205.28compensation liability. The county of service case manager shall provide documentation 205.29in each individual's plan of care and, if requested, to the commissioner that the most 205.30cost-effective alternatives available have been offered to the individual and that the 205.31individual was free to choose among available qualified providers, both public and private, 205.32including qualified case management or service coordination providers other than those 205.33employed by any county; however, the county or tribe maintains responsibility for prior 205.34authorizing services in accordance with statutory and administrative requirements. The 206.1case manager must give the individual a ten-day written notice of any denial, termination, 206.2or reduction of alternative care services.206.3    (b) The county of service or tribe must provide access to and arrange for case 206.4management services, including assuring implementation of the plan. "County of service" 206.5has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The county of 206.6service must notify the county of financial responsibility of the approved care plan and 206.7the amount of encumbered funds.206.8    Sec. 39. Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to 206.9read:206.10    Subd. 9. Contracting provisions for providers. Alternative care funds paid to 206.11service providers are subject to audit by the commissioner for fiscal and utilization control.206.12    The lead agency must select providers for contracts or agreements using the 206.13following criteria and other criteria established by the county lead agency:206.14    (1) the need for the particular services offered by the provider;206.15    (2) the population to be served, including the number of clients, the length of time 206.16services will be provided, and the medical condition of clients;206.17    (3) the geographic area to be served;206.18    (4) quality assurance methods, including appropriate licensure, certification, or 206.19standards, and supervision of employees when needed;206.20    (5) rates for each service and unit of service exclusive of county lead agency206.21administrative costs;206.22    (6) evaluation of services previously delivered by the provider; and206.23    (7) contract or agreement conditions, including billing requirements, cancellation, 206.24and indemnification.206.25    The county lead agency must evaluate its own agency services under the criteria 206.26established for other providers.206.27    Sec. 40. Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to 206.28read:206.29    Subd. 10. Allocation formula. (a) The alternative care appropriation for fiscal 206.30years 1992 and beyond shall cover only alternative care eligible clients. By July 1 15 of 206.31each year, the commissioner shall allocate to county agencies the state funds available for 206.32alternative care for persons eligible under subdivision 2.206.33    (b) The adjusted base for each county lead agency is the county's lead agency's206.34current fiscal year base allocation plus any targeted funds approved during the current 207.1fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each 207.2county lead agency, the determination of alternative care program expenditures shall be 207.3based on payments for services rendered from April 1 through March 31 in the base year, 207.4to the extent that claims have been submitted and paid by June 1 of that year.207.5    (c) If the alternative care program expenditures as defined in paragraph (b) are 95 207.6percent or more of the county's lead agency's adjusted base allocation, the allocation for 207.7the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that 207.8inflation is included in the state budget.207.9    (d) If the alternative care program expenditures as defined in paragraph (b) are less 207.10than 95 percent of the county's lead agency's adjusted base allocation, the allocation 207.11for the next fiscal year is the adjusted base allocation less the amount of unspent funds 207.12below the 95 percent level.207.13    (e) If the annual legislative appropriation for the alternative care program is 207.14inadequate to fund the combined county lead agency allocations for a biennium, the 207.15commissioner shall distribute to each county lead agency the entire annual appropriation 207.16as that county's lead agency's percentage of the computed base as calculated in paragraphs 207.17(c) and (d).207.18    (f) On agreement between the commissioner and the lead agency, the commissioner 207.19may have discretion to reallocate alternative care base allocations distributed to lead 207.20agencies in which the base amount exceeds program expenditures.207.21    Sec. 41. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to 207.22read:207.23    Subd. 11. Targeted funding. (a) The purpose of targeted funding is to make 207.24additional money available to counties lead agencies with the greatest need. Targeted 207.25funds are not intended to be distributed equitably among all counties lead agencies, but 207.26rather, allocated to those with long-term care strategies that meet state goals.207.27    (b) The funds available for targeted funding shall be the total appropriation for each 207.28fiscal year minus county lead agency allocations determined under subdivision 10 as 207.29adjusted for any inflation increases provided in appropriations for the biennium.207.30    (c) The commissioner shall allocate targeted funds to counties lead agencies that 207.31demonstrate to the satisfaction of the commissioner that they have developed feasible 207.32plans to increase alternative care spending. In making targeted funding allocations, the 207.33commissioner shall use the following priorities:208.1    (1) counties lead agencies that received a lower allocation in fiscal year 1991 than in 208.2fiscal year 1990. Counties remain in this priority until they have been restored to their 208.3fiscal year 1990 level plus inflation;208.4    (2) counties lead agencies that sustain a base allocation reduction for failure to spend 208.595 percent of the allocation if they demonstrate that the base reduction should be restored;208.6    (3) counties lead agencies that propose projects to divert community residents from 208.7nursing home placement or convert nursing home residents to community living; and208.8    (4) counties lead agencies that can otherwise justify program growth by 208.9demonstrating the existence of waiting lists, demographically justified needs, or other 208.10unmet needs.208.11    (d) Counties Lead agencies that would receive targeted funds according to 208.12paragraph (c) must demonstrate to the commissioner's satisfaction that the funds 208.13would be appropriately spent by showing how the funds would be used to further the 208.14state's alternative care goals as described in subdivision 1, and that the county has the 208.15administrative and service delivery capability to use them.208.16    (e) The commissioner shall request applications make applications available for 208.17targeted funds by November 1 of each year. The counties lead agencies selected for 208.18targeted funds shall be notified of the amount of their additional funding. Targeted funds 208.19allocated to a county lead agency in one year shall be treated as part of the county's lead 208.20agency's base allocation for that year in determining allocations for subsequent years. No 208.21reallocations between counties lead agencies shall be made.208.22    Sec. 42. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to 208.23read:208.24    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients 208.25to help pay for the cost of participating in the program. The amount of the fee for the 208.26alternative care client shall be determined as follows:208.27    (1) when the alternative care client's income less recurring and predictable medical 208.28expenses is less than 100 percent of the federal poverty guideline effective on July 1 of 208.29the state fiscal year in which the fee is being computed, and total assets are less than 208.30$10,000, the fee is zero;208.31    (2) when the alternative care client's income less recurring and predictable medical 208.32expenses is equal to or greater than 100 percent but less than 150 percent of the federal 208.33poverty guideline effective on July 1 of the state fiscal year in which the fee is being 208.34computed, and total assets are less than $10,000, the fee is five percent of the cost of 208.35alternative care services;209.1    (3) when the alternative care client's income less recurring and predictable medical 209.2expenses is equal to or greater than 150 percent but less than 200 percent of the federal 209.3poverty guidelines effective on July 1 of the state fiscal year in which the fee is being 209.4computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative 209.5care services;209.6    (4) when the alternative care client's income less recurring and predictable medical 209.7expenses is equal to or greater than 200 percent of the federal poverty guidelines effective 209.8on July 1 of the state fiscal year in which the fee is being computed and assets are less than 209.9$10,000, the fee is 30 percent of the cost of alternative care services; and209.10    (5) when the alternative care client's assets are equal to or greater than $10,000, the 209.11fee is 30 percent of the cost of alternative care services.209.12    For married persons, total assets are defined as the total marital assets less the 209.13estimated community spouse asset allowance, under section 
         256B.059, if applicable. For 209.14married persons, total income is defined as the client's income less the monthly spousal 209.15allotment, under section 
         256B.058. 209.16    All alternative care services shall be included in the estimated costs for the purpose 209.17of determining the fee.209.18    Fees are due and payable each month alternative care services are received unless the 209.19actual cost of the services is less than the fee, in which case the fee is the lesser amount.209.20    (b) The fee shall be waived by the commissioner when:209.21    (1) a person who is residing in a nursing facility is receiving case management only;209.22    (2) a married couple is requesting an asset assessment under the spousal 209.23impoverishment provisions;209.24    (3) a person is found eligible for alternative care, but is not yet receiving alternative 209.25care services including case management services; or209.26    (4) a person has chosen to participate in a consumer-directed service plan for which 209.27the cost is no greater than the total cost of the person's alternative care service plan less 209.28the monthly fee amount that would otherwise be assessed.209.29    (c) The county agency must record in the state's receivable system the client's 209.30assessed fee amount or the reason the fee has been waived. The commissioner will bill 209.31and collect the fee from the client. Money collected must be deposited in the general fund 209.32and is appropriated to the commissioner for the alternative care program. The client must 209.33supply the county lead agency with the client's Social Security number at the time of 209.34application. The county lead agency shall supply the commissioner with the client's Social 209.35Security number and other information the commissioner requires to collect the fee from 209.36the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in 210.1chapter 270A and other methods available to the commissioner. The commissioner may 210.2require counties lead agencies to inform clients of the collection procedures that may be 210.3used by the state if a fee is not paid. This paragraph does not apply to alternative care 210.4pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 210.5133, if a county operating under the pilot project reports the following dollar amounts 210.6to the commissioner quarterly:210.7    (1) total fees billed to clients;210.8    (2) total collections of fees billed; and210.9    (3) balance of fees owed by clients.210.10If a county lead agency does not adhere to these reporting requirements, the commissioner 210.11may terminate the billing, collecting, and remitting portions of the pilot project and require 210.12the county lead agency involved to operate under the procedures set forth in this paragraph.210.13    Sec. 43. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to 210.14read:210.15    Subd. 13. County Lead agency biennial plan. The county lead agency biennial 210.16plan for long-term care consultation services under section 
         256B.0911, the alternative 210.17care program under this section, and waivers for the elderly under section 
         256B.0915, 210.18shall be submitted by the lead agency as the home and community-based services quality 210.19assurance plan on a form provided by the commissioner.210.20    Sec. 44. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to 210.21read:210.22    Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless 210.23otherwise specified in statute, providers must be enrolled as Minnesota health care 210.24program providers and abide by the requirements for provider participation according to 210.25Minnesota Rules, part 9505.0195.210.26    (b) Payment for provided alternative care services as approved by the client's 210.27case manager shall occur through the invoice processing procedures of the department's 210.28Medicaid Management Information System (MMIS). To receive payment, the county lead 210.29agency or vendor must submit invoices within 12 months following the date of service. 210.30The county lead agency and its vendors under contract shall not be reimbursed for services 210.31which exceed the county allocation.210.32    (c) The county lead agency shall negotiate individual rates with vendors and may 210.33authorize service payment for actual costs up to the county's current approved rate. 210.34Notwithstanding any other rule or statutory provision to the contrary, the commissioner 211.1shall not be authorized to increase rates by an annual inflation factor, unless so authorized 211.2by the legislature. To improve access to community services and eliminate payment 211.3disparities between the alternative care program and the elderly waiver program, the 211.4commissioner shall establish statewide maximum service rate limits and eliminate 211.5county-specific service rate limits.211.6    (1) Effective July 1, 2001, for service rate limits, except those in subdivision 5, 211.7paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative 211.8care statewide maximum rate or the elderly waiver statewide maximum rate.211.9    (2) Counties Lead agencies may negotiate individual service rates with vendors for 211.10actual costs up to the statewide maximum service rate limit.211.11    Sec. 45. Minnesota Statutes 2006, section 256B.0915, is amended to read:211.12256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.211.13    Subdivision 1. Authority. The commissioner is authorized to apply for a home 211.14and community-based services waiver for the elderly, authorized under section 1915(c) 211.15of the Social Security Act, in order to obtain federal financial participation to expand 211.16the availability of services for persons who are eligible for medical assistance. The 211.17commissioner may apply for additional waivers or pursue other federal financial 211.18participation which is advantageous to the state for funding home care services for the 211.19frail elderly who are eligible for medical assistance. The provision of waivered services 211.20to elderly and disabled medical assistance recipients must comply with the criteria for 211.21service definitions and provider standards approved in the waiver.211.22    Subd. 1a. Elderly waiver case management services. (a) Elderly case management 211.23services under the home and community-based services waiver for elderly individuals are 211.24available from providers meeting qualification requirements and the standards specified 211.25in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case 211.26management services.211.27    Case management services assist individuals who receive waiver services in gaining 211.28access to needed waiver and other state plan services, as well as needed medical, social, 211.29educational, and other services regardless of the funding source for the services to which 211.30access is gained.211.31    A case aide shall provide assistance to the case manager in carrying out 211.32administrative activities of the case management function. The case aide may not assume 211.33responsibilities that require professional judgment including assessments, reassessments, 211.34and care plan development. The case manager is responsible for providing oversight of 211.35the case aide.212.1    Case managers shall be responsible for ongoing monitoring of the provision of 212.2services included in the individual's plan of care. Case managers shall initiate and oversee 212.3the process of assessment and reassessment of the individual's care and review plan of 212.4care at intervals specified in the federally approved waiver plan.212.5    (b) The county of service or tribe must provide access to and arrange for case 212.6management services. County of service has the meaning given it in Minnesota Rules, 212.7part 9505.0015, subpart 11.212.8    Subd. 1b. Provider qualifications and standards. The commissioner must 212.9enroll qualified providers of elderly case management services under the home 212.10and community-based waiver for the elderly under section 1915(c) of the Social 212.11Security Act. The enrollment process shall ensure the provider's ability to meet the 212.12qualification requirements and standards in this subdivision and other federal and state 212.13requirements of this service. An elderly case management provider is an enrolled medical 212.14assistance provider who is determined by the commissioner to have all of the following 212.15characteristics:212.16    (1) the demonstrated capacity and experience to provide the components of 212.17case management to coordinate and link community resources needed by the eligible 212.18population;212.19    (2) administrative capacity and experience in serving the target population for 212.20whom it will provide services and in ensuring quality of services under state and federal 212.21requirements;212.22    (3) a financial management system that provides accurate documentation of services 212.23and costs under state and federal requirements;212.24    (4) the capacity to document and maintain individual case records under state and 212.25federal requirements; and212.26    (5) the countylead agency may allow a case manager employed by the countylead 212.27agency to delegate certain aspects of the case management activity to another individual 212.28employed by the countylead agency provided there is oversight of the individual by 212.29the case manager. The case manager may not delegate those aspects which require 212.30professional judgment including assessments, reassessments, and care plan development.212.31Lead agencies include counties, health plans, and federally recognized tribes who 212.32authorize services under this section.212.33    Subd. 1c.Case management activities under the state plan.The commissioner 212.34shall seek an amendment to the home and community-based services waiver for the 212.35elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner 212.36is unable to secure the approval of the secretary of health and human services for the 213.1requested waiver amendment by December 31, 1993, the commissioner shall amend 213.2the medical assistance state plan to provide that case management provided under the 213.3home and community-based services waiver for the elderly is performed by counties 213.4as an administrative function for the proper and effective administration of the state 213.5medical assistance plan. The state shall reimburse counties for the nonfederal share of 213.6costs for case management performed as an administrative function under the home and 213.7community-based services waiver for the elderly.213.8    Subd. 1d. Posteligibility treatment of income and resources for elderly waiver.213.9    Notwithstanding the provisions of section 
         256B.056, the commissioner shall make the 213.10following amendment to the medical assistance elderly waiver program effective July 1, 213.111999, or upon federal approval, whichever is later. 213.12    A recipient's maintenance needs will be an amount equal to the Minnesota 213.13supplemental aid equivalent rate as defined in section 
         256I.03, subdivision 5, plus the 213.14medical assistance personal needs allowance as defined in section 
         256B.35, subdivision 213.151
         , paragraph (a), when applying posteligibility treatment of income rules to the gross 213.16income of elderly waiver recipients, except for individuals whose income is in excess of 213.17the special income standard according to Code of Federal Regulations, title 42, section 213.18435.236
         . Recipient maintenance needs shall be adjusted under this provision each July 1. 213.19    Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend 213.20the federal waiver and the medical assistance state plan to allowapply:213.21    (1) the spousal impoverishment criteria as authorized under United States Code, title 213.2242, section 1396r-5, and as implemented in sections 
         256B.0575, 
         256B.058, and 
         256B.059, 213.23except that the amendment shall seek to add to;213.24    (2)  the personal needs allowance permitted in section 
         256B.0575,; and213.25    (3) an amount equivalent to the group residential housing rate as set by section 213.26256I.03, subdivision 5
         , and according to the approved federal waiver and medical 213.27assistance state plan. 213.28    Subd. 3. Limits of cases. The number of medical assistance waiver recipients that 213.29a countylead agency may serve must be allocated according to the number of medical 213.30assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be 213.31served with the approval of the commissioner.213.32    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered 213.33services to an individual elderly waiver client shall be the weighted average monthly 213.34nursing facility rate of the case mix resident class to which the elderly waiver client would 213.35be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's 213.36maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first 214.1day of the state fiscal year in which the resident assessment system as described in section 214.2256B.437
          for nursing home rate determination is implemented. Effective on the first day 214.3of the state fiscal year in which the resident assessment system as described in section 214.4256B.437
          for nursing home rate determination is implemented and the first day of each 214.5subsequent state fiscal year, the monthly limit for the cost of waivered services to an 214.6individual elderly waiver client shall be the rate of the case mix resident class to which the 214.7waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 214.8in effect on the last day of the previous state fiscal year, adjusted by the greater of any 214.9legislatively adopted home and community-based services percentage rate increase or the 214.10average statewide percentage increase in nursing facility payment rates. 214.11    (b) If extended medical supplies and equipment or environmental modifications are 214.12or will be purchased for an elderly waiver client, the costs may be prorated for up to 214.1312 consecutive months beginning with the month of purchase. If the monthly cost of a 214.14recipient's waivered services exceeds the monthly limit established in paragraph (a), the 214.15annual cost of all waivered services shall be determined. In this event, the annual cost of 214.16all waivered services shall not exceed 12 times the monthly limit of waivered services as 214.17described in paragraph (a).214.18    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing 214.19facility. (a) For a person who is a nursing facility resident at the time of requesting a 214.20determination of eligibility for elderly waivered services, a monthly conversion limit for 214.21the cost of elderly waivered services may be requested. The monthly conversion limit for 214.22the cost of elderly waiver services shall be the resident class assigned under Minnesota 214.23Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where 214.24the resident currently resides until July 1 of the state fiscal year in which the resident 214.25assessment system as described in section 
         256B.437 for nursing home rate determination 214.26is implemented. Effective on July 1 of the state fiscal year in which the resident 214.27assessment system as described in section 
         256B.437 for nursing home rate determination 214.28is implemented, the monthly conversion limit for the cost of elderly waiver services 214.29shall be the per diem nursing facility rate as determined by the resident assessment 214.30system as described in section 
         256B.437 for that resident in the nursing facility where 214.31the resident currently resides multiplied by 365 and divided by 12, less the recipient's 214.32maintenance needs allowance as described in subdivision 1d. The initially approved 214.33conversion rate may be adjusted by the greater of any subsequent legislatively adopted 214.34home and community-based services percentage rate increase or the average statewide 214.35percentage increase in nursing facility payment rates. The limit under this subdivision 214.36only applies to persons discharged from a nursing facility after a minimum 30-day stay 215.1and found eligible for waivered services on or after July 1, 1997. For conversions from the 215.2nursing home to the elderly waiver with consumer directed community support services, 215.3the conversion rate limit is equal to the nursing facility rate reduced by a percentage equal 215.4to the percentage difference between the consumer directed services budget limit that 215.5would be assigned according to the federally approved waiver plan and the corresponding 215.6community case mix cap, but not to exceed 50 percent.215.7    (b) The following costs must be included in determining the total monthly costs 215.8for the waiver client:215.9    (1) cost of all waivered services, including extended medical supplies and equipment 215.10and environmental modifications and adaptations; and215.11    (2) cost of skilled nursing, home health aide, and personal care services reimbursable 215.12by medical assistance.215.13    Subd. 3c. Service approval and contracting provisions. (a) Medical assistance 215.14funding for skilled nursing services, private duty nursing, home health aide, and personal 215.15care services for waiver recipients must be approved by the case manager and included in 215.16the individual care plan.215.17    (b) A countylead agency is not required to contract with a provider of supplies and 215.18equipment if the monthly cost of the supplies and equipment is less than $250.215.19    Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered 215.20a difficulty of care payment and shall not include room and board. The adult foster 215.21care service rate shall be negotiated between the countylead agency and the foster care 215.22provider. The elderly waiver payment for the foster care service in combination with 215.23the payment for all other elderly waiver services, including case management, must not 215.24exceed the limit specified in subdivision 3a, paragraph (a).215.25    Subd. 3e. Assisted livingCustomized living service rate. (a) Payment for assisted 215.26living servicecustomize living services shall be a monthly rate negotiated and authorized 215.27by the county agency based on an individualized service plan for each resident and may 215.28not cover direct rent or food costs. lead agency within the parameters established by 215.29the commissioner. The payment agreement must delineate the services that have been 215.30customized for each recipient and specify the amount of each service to be provided. The 215.31lead agency shall ensure that there is a documented need for all services authorized. 215.32Customized living services must not include rent or raw food costs. The negotiated 215.33payment rate must be based on services to be provided. Negotiated rates must not exceed 215.34payment rates for comparable elderly waiver or medical assistance services and must 215.35reflect economies of scale.216.1    (b) The individualized monthly negotiated payment for assisted livingcustomized 216.2living services as described in section 256B.0913, subdivisions 5d to 5f, and residential 216.3care services as described in section 256B.0913, subdivision 5c, shall not exceed the 216.4nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit 216.5is being calculated, of the greater of either the statewide or any of the geographic 216.6groups' weighted average monthly nursing facility rate of the case mix resident class 216.7to which the elderly waiver eligible client would be assigned under Minnesota Rules, 216.8parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in 216.9subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident 216.10assessment system as described in section 
         256B.437 for nursing home rate determination 216.11is implemented. Effective on July 1 of the state fiscal year in which the resident 216.12assessment system as described in section 
         256B.437 for nursing home rate determination 216.13is implemented and July 1 of each subsequent state fiscal year, the individualized monthly 216.14negotiated payment for the services described in this clause shall not exceed the limit 216.15described in this clause which was in effect on June 30 of the previous state fiscal year 216.16and which has been adjusted by the greater of any legislatively adopted home and 216.17community-based services cost-of-living percentage increase or any legislatively adopted 216.18statewide percent rate increase for nursing facilities. 216.19    (c) The individualized monthly negotiated payment for assisted Customized living 216.20services described in section 144A.4605 and are delivered by a provider licensed by the 216.21Department of Health as a class A or class F home care provider or an assisted living 216.22home care provider and provided in a building that is registered as a housing with services 216.23establishment under chapter 144D and that provides 24-hour supervision in combination 216.24with the payment for other elderly waiver services, including case management, must not 216.25exceed the limit specified in subdivision 3a. 216.26    Subd. 3f. Individual service rates; expenditure forecasts. (a) The countylead 216.27agency shall negotiate individual service rates with vendors and may authorize payment 216.28for actual costs up to the county'slead agency's current approved rate. Persons or agencies 216.29must be employed by or under a contract with the countylead agency or the public health 216.30nursing agency of the local board of health in order to receive funding under the elderly 216.31waiver program, except as a provider of supplies and equipment when the monthly cost of 216.32the supplies and equipment is less than $250.216.33    (b) Reimbursement for the medical assistance recipients under the approved waiver 216.34shall be made from the medical assistance account through the invoice processing 216.35procedures of the department's Medicaid Management Information System (MMIS), 216.36only with the approval of the client's case manager. The budget for the state share of the 217.1Medicaid expenditures shall be forecasted with the medical assistance budget, and shall 217.2be consistent with the approved waiver.217.3    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access 217.4to community services and eliminate payment disparities between the alternative care 217.5program and the elderly waiver, the commissioner shall establish statewide maximum 217.6service rate limits and eliminate county-specificlead agency-specific service rate limits.217.7    (b) Effective July 1, 2001, for service rate limits, except those described or defined in 217.8subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative 217.9care statewide maximum rate or the elderly waiver statewide maximum rate.217.10    (c) CountiesLead agencies may negotiate individual service rates with vendors for 217.11actual costs up to the statewide maximum service rate limit.217.12    Subd. 3h.Service rate limits; 24-hour customized living services.The payment 217.13rates for 24-hour customized living services is a monthly rate negotiated and authorized by 217.14the lead agency within the parameters established by the commissioner of human services. 217.15The payment agreement must delineate the services that have been customized for each 217.16recipient and specify the amount of each service to be provided. The lead agency shall 217.17ensure that there is a documented need for all services authorized. The lead agency shall 217.18not authorize 24-hour customized living services unless there is a documented need for 217.1924-hour supervision. For purposes of this section, "24-hour supervision" means that the 217.20recipient requires assistance due to needs related to one or more of the following:217.21    (1) intermittent assistance with toileting or transferring;217.22    (2) cognitive or behavioral issues;217.23    (3) a medical condition that requires clinical monitoring; or217.24    (4) other conditions or needs as defined by the commissioner of human services. 217.25The lead agency shall ensure that the frequency and mode of supervision of the recipient 217.26and the qualifications of staff providing supervision are described and meet the needs 217.27of the recipient. Customized living services must not include rent or raw food costs. 217.28The negotiated payment rate for 24-hour customized living services must be based on 217.29services to be provided. Negotiated rates must not exceed payment rates for comparable 217.30elderly waiver or medical assistance services and must reflect economies of scale. The 217.31individually negotiated 24-hour customized living payments, in combination with the 217.32payment for other elderly waiver services, including case management, must not exceed 217.33the recipient's community budget cap specified in subdivision 3a.217.34    Subd. 4. Termination notice. The case manager must give the individual a ten-day 217.35written notice of any denial, reduction, or termination of waivered services.218.1    Subd. 5. Assessments and reassessments for waiver clients. Each client shall 218.2receive an initial assessment of strengths, informal supports, and need for services in 218.3accordance with section 
         256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 218.4client served under the elderly waiver must be conducted at least every 12 months and 218.5at other times when the case manager determines that there has been significant change 218.6in the client's functioning. This may include instances where the client is discharged 218.7from the hospital. 218.8    Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided 218.9a copy of a written care plan that meets the requirements outlined in section 
         256B.0913, 218.10subdivision 8
         . The care plan must be implemented by the county administering waivered 218.11servicesof service when it is different than the county of financial responsibility. The 218.12county of service administering waivered services must notify the county of financial 218.13responsibility of the approved care plan.218.14    Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health 218.15plan is liable for nursing home services or elderly waiver services according to section 218.16256B.69, subdivision 6a
         , is not eligible to also receive county-administered elderly waiver 218.17services under this section. 218.18    Subd. 8. Services and supports. (a) Services and supports shall meet the 218.19requirements set out in United States Code, title 42, section 1396n.218.20    (b) Services and supports shall promote consumer choice and be arranged and 218.21provided consistent with individualized, written care plans.218.22    (c) The state of Minnesota, county, managed care organization, or tribal government 218.23under contract to administer the elderly waiver shall not be liable for damages, injuries, 218.24or liabilities sustained through the purchase of direct supports or goods by the person, 218.25the person's family, or the authorized representatives with funds received through 218.26consumer-directed community support services under the federally approved waiver plan. 218.27Liabilities include, but are not limited to, workers' compensation liability, the Federal 218.28Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).218.29    Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary 218.30provisions of this section, or those in other state laws or rules, the commissioner may 218.31develop a model for tribal management of the elderly waiver program and implement this 218.32model through a contract between the state and any of the state's federally recognized tribal 218.33governments. The model shall include the provision of tribal waiver case management, 218.34assessment for personal care assistance, and administrative requirements otherwise carried 218.35out by countieslead agencies but shall not include tribal financial eligibility determination 218.36for medical assistance.219.1EFFECTIVE DATE.Subdivision 3h is effective the day following final enactment.219.2    Sec. 46. Minnesota Statutes 2006, section 256B.0917, subdivision 8, is amended to 219.3read:219.4    Subd. 8. Living-at-home/block nurse program grant. (a) The organization 219.5awarded the contract under subdivision 7, shall develop and administer a grant program 219.6to establish or expand up to 3351 community-based organizations that will implement 219.7living-at-home/block nurse programs that are designed to enable senior citizens to live as 219.8independently as possible in their homes and in their communities. At least one-half of 219.9the programs must be in counties outside the seven-county metropolitan area. Nonprofit 219.10organizations and units of local government are eligible to apply for grants to establish 219.11the community organizations that will implement living-at-home/block nurse programs. 219.12In awarding grants, the organization awarded the contract under subdivision 7 shall give 219.13preference to nonprofit organizations and units of local government from communities 219.14that:219.15    (1) have high nursing home occupancy rates;219.16    (2) have a shortage of health care professionals;219.17    (3) are located in counties adjacent to, or are located in, counties with existing 219.18living-at-home/block nurse programs; and219.19    (4) meet other criteria established by LAH/BN, Inc., in consultation with the 219.20commissioner.219.21    (b) Grant applicants must also meet the following criteria:219.22    (1) the local community demonstrates a readiness to establish a community model 219.23of care, including the formation of a board of directors, advisory committee, or similar 219.24group, of which at least two-thirds is comprised of community citizens interested in 219.25community-based care for older persons;219.26    (2) the program has sponsorship by a credible, representative organization within 219.27the community;219.28    (3) the program has defined specific geographic boundaries and defined its 219.29organization, staffing and coordination/delivery of services;219.30    (4) the program demonstrates a team approach to coordination and care, ensuring 219.31that the older adult participants, their families, the formal and informal providers are all 219.32part of the effort to plan and provide services; and219.33    (5) the program provides assurances that all community resources and funding will 219.34be coordinated and that other funding sources will be maximized, including a person's 219.35own resources.220.1    (c) Grant applicants must provide a minimum of five percent of total estimated 220.2development costs from local community funding. Grants shall be awarded for four-year 220.3periods, and the base amount shall not exceed $80,000 $100,000 per applicant for the grant 220.4period. The organization under contract may increase the grant amount for applicants from 220.5communities that have socioeconomic characteristics that indicate a higher level of need 220.6for assistance. Subject to the availability of funding, grants and grant renewals awarded or 220.7entered into on or after July 1, 1997, shall be renewed by LAH/BN, Inc. every four years, 220.8unless LAH/BN, Inc. determines that the grant recipient has not satisfactorily operated the 220.9living-at-home/block nurse program in compliance with the requirements of paragraphs 220.10(b) and (d). Grants provided to living-at-home/block nurse programs under this paragraph 220.11may be used for both program development and the delivery of services.220.12    (d) Each living-at-home/block nurse program shall be designed by representatives of 220.13the communities being served to ensure that the program addresses the specific needs of 220.14the community residents. The programs must be designed to:220.15    (1) incorporate the basic community, organizational, and service delivery principles 220.16of the living-at-home/block nurse program model;220.17    (2) provide senior citizens with registered nurse directed assessment, provision and 220.18coordination of health and personal care services on a sliding fee basis as an alternative 220.19to expensive nursing home care;220.20    (3) provide information, support services, homemaking services, counseling, and 220.21training for the client and family caregivers;220.22    (4) encourage the development and use of respite care, caregiver support, and 220.23in-home support programs, such as adult foster care and in-home adult day care;220.24    (5) encourage neighborhood residents and local organizations to collaborate in 220.25meeting the needs of senior citizens in their communities;220.26    (6) recruit, train, and direct the use of volunteers to provide informal services and 220.27other appropriate support to senior citizens and their caregivers; and220.28    (7) provide coordination and management of formal and informal services to senior 220.29citizens and their families using less expensive alternatives.220.30    Sec. 47. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to 220.31read:220.32    Subd. 3. County certification of persons providing adult foster care to related 220.33persons. A person exempt from licensure under section 
         245A.03, subdivision 2, who 220.34provides adult foster care to a related individual age 65 and older, and who meets the 220.35requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the 221.1county to provide adult foster care. A person certified by the county to provide adult foster 221.2care may be reimbursed for services provided and eligible for funding under sections 221.3256B.0913 and section256B.0915, if the relative would suffer a financial hardship as 221.4a result of providing care. For purposes of this subdivision, financial hardship refers 221.5to a situation in which a relative incurs a substantial reduction in income as a result of 221.6resigning from a full-time job or taking a leave of absence without pay from a full-time 221.7job to care for the client. 221.8    Sec. 48. Minnesota Statutes 2006, section 256B.095, is amended to read:221.9256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.221.10    (a) Effective July 1, 1998, a quality assurance system for persons with developmental 221.11disabilities, which includes an alternative quality assurance licensing system for programs, 221.12is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, 221.13Steele, Wabasha, and Winona Counties for the purpose of improving the quality of 221.14services provided to persons with developmental disabilities. A county, at its option, may 221.15choose to have all programs for persons with developmental disabilities located within 221.16the county licensed under chapter 245A using standards determined under the alternative 221.17quality assurance licensing system or may continue regulation of these programs under 221.18the licensing system operated by the commissioner. The project expires on June 30, 221.1920092014.221.20    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to 221.21participate in the quality assurance system established under paragraph (a). The 221.22commission established under section 
         256B.0951 may, at its option, allow additional 221.23counties to participate in the system.221.24    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) 221.25may establish a quality assurance system under this section. A new system established 221.26under this section shall have the same rights and duties as the system established 221.27under paragraph (a). A new system shall be governed by a commission under section 221.28256B.0951
         . The commissioner shall appoint the initial commission members based 221.29on recommendations from advocates, families, service providers, and counties in the 221.30geographic area included in the new system. Counties that choose to participate in a 221.31new system shall have the duties assigned under section 
         256B.0952. The new system 221.32shall establish a quality assurance process under section 
         256B.0953. The provisions of 221.33section 
         256B.0954 shall apply to a new system established under this paragraph. The 221.34commissioner shall delegate authority to a new system established under this paragraph 221.35according to section 
         256B.0955.222.1    (d) Effective July 1, 2007, the quality assurance system may be expanded to include 222.2programs for persons with disabilities and older adults.222.3    Sec. 49. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to 222.4read:222.5    Subdivision 1. Membership. The Quality Assurance Commission is established. 222.6The commission consists of at least 14 but not more than 21 members as follows: at 222.7least three but not more than five members representing advocacy organizations; at 222.8least three but not more than five members representing consumers, families, and their 222.9legal representatives; at least three but not more than five members representing service 222.10providers; at least three but not more than five members representing counties; and the 222.11commissioner of human services or the commissioner's designee. The first commission 222.12shall establish membership guidelines for the transition and recruitment of membership for 222.13the commission's ongoing existence. Members of the commission who do not receive a 222.14salary or wages from an employer for time spent on commission duties may receive a per 222.15diem payment when performing commission duties and functions. All members may be 222.16reimbursed for expenses related to commission activities. Notwithstanding the provisions 222.17of section 
         15.059, subdivision 5, the commission expires on June 30, 20092014.222.18    Sec. 50. [256B.096] QUALITY MANAGEMENT; ASSURANCE; AND 222.19IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY 222.20SERVICES.222.21    Subdivision 1.Scope.In order to improve the quality of services provided to 222.22Minnesotans with disabilities and to meet the requirements of the federally approved home 222.23and community-based waivers under section 1915c of the Social Security Act, a statewide 222.24quality assurance and improvement system for Minnesotans receiving disability services 222.25shall be developed. The disability services included are the home and community-based 222.26services waiver programs for persons with developmental disabilities under section 222.27256B.092, subdivision 4, and persons with disabilities under section 256B.49.222.28    Subd. 2.Stakeholder advisory group.The commissioner shall consult with a 222.29stakeholder advisory group on the development and implementation of the state quality 222.30management, assurance, and improvement system, including representatives from: 222.31disability service recipients, disability service providers, disability advocacy groups, 222.32county human service agencies, and state agency staff from the Departments of Human 222.33Services and Health and ombudsman for mental health and developmental disabilities on 222.34the development of a statewide quality assurance and improvement system.223.1    Subd. 3.Annual survey of service recipients.The commissioner, in consultation 223.2with the stakeholder advisory group, shall develop and conduct an annual independent 223.3random statewide survey of between five and ten percent of service recipients to determine 223.4the effectiveness and quality of disability services. The survey shall be consistent with 223.5the system performance expectations of the Centers for Medicare and Medicaid Services 223.6quality management requirements and framework. The survey shall analyze whether 223.7desired outcomes have been achieved for persons with different demographic, diagnostic, 223.8health, and functional needs and receiving different types of services, in different settings, 223.9with different costs. The survey shall be field tested during 2008 and implemented by 223.10February 1, 2009. Annual statewide and regional reports of the results shall be published 223.11for use by regions, counties, and providers to plan and measure the impact of quality 223.12improvement activities.223.13    Subd. 4.Improvements for incident reporting, investigation, analysis, and 223.14follow-up.In consultation with the stakeholder advisory group, the commissioner shall 223.15identify the information, data sources, and technology needed to improve the system 223.16of incident reporting, including:223.17    (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and223.18    (2) investigation, analysis, and follow-up for disability services.223.19    The commissioner must ensure that the federal home and community-based waiver 223.20requirements are met and that incidents that may have jeopardized safety; health; or 223.21violated service-related assurances, civil and human rights, and other protections designed 223.22to prevent abuse, neglect, and exploitation are reviewed, investigated, and acted upon 223.23in a timely manner.223.24    Subd. 5.Biennial report.The commissioner shall provide a biennial report to the 223.25chairs of the legislative committees with jurisdiction over health and human services 223.26policy and funding beginning January 15, 2009, on the development and activities of the 223.27quality management, assurance, and improvement system designed to meet the federal 223.28requirements under the home and community-based services waiver programs for persons 223.29with disabilities. By January 15, 2008, the commissioner shall provide a preliminary 223.30report on the priorities for meeting the federal requirements, progress on the annual 223.31survey, recommendations for improvements in the incident reporting system, and a plan 223.32for incorporating the quality assurance efforts under section 256B.095 and other regional 223.33efforts into the statewide system.223.34    Sec. 51. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:224.1    Subdivision 1. In general. The commissioner shall determine prospective 224.2payment rates for resident care costs. For rates established on or after July 1, 1985, the 224.3commissioner shall develop procedures for determining operating cost payment rates that 224.4take into account the mix of resident needs, geographic location, and other factors as 224.5determined by the commissioner. The commissioner shall consider whether the fact that a 224.6facility is attached to a hospital or has an average length of stay of 180 days or less should 224.7be taken into account in determining rates. The commissioner shall consider the use of the 224.8standard metropolitan statistical areas when developing groups by geographic location. 224.9The commissioner shall provide notice to each nursing facility on or before May 1 August 224.1015 of the rates effective for the following rate year except that if legislation is pending on 224.11May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the 224.12rates after the legislation is enacted and provide notice to each facility as soon as possible.224.13    Compensation for top management personnel shall continue to be categorized as a 224.14general and administrative cost and is subject to any limits imposed on that cost category.224.15    Sec. 52. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to 224.16read:224.17    Subd. 2e. Contracts for services for ventilator-dependent persons.(a) 224.18The commissioner may negotiate with a nursing facility eligible to receive medical 224.19assistance payments to provide services to a ventilator-dependent person identified by the 224.20commissioner according to criteria developed by the commissioner, including:224.21    (1) nursing facility care has been recommended for the person by a preadmission 224.22screening team;224.23    (2) the person has been hospitalized and no longer requires inpatient acute care 224.24hospital services; and224.25    (3) the commissioner has determined that necessary services for the person cannot 224.26be provided under existing nursing facility rates.224.27    The commissioner may negotiate an adjustment to the operating cost payment 224.28rate for a nursing facility with a resident who is ventilator-dependent, for that resident. 224.29The negotiated adjustment must reflect only the actual additional cost of meeting the 224.30specialized care needs of a ventilator-dependent person identified by the commissioner 224.31for whom necessary services cannot be provided under existing nursing facility rates and 224.32which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or 224.339505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before 224.34July 1, 2001, and have their payment rate under this subdivision negotiated after July 1, 224.352001, the negotiated payment rate must not exceed 200 percent of the highest multiple 225.1bedroom payment rate for the facility, as initially established by the commissioner for the 225.2rate year for case mix classification K; or, upon implementation of the RUG's-based case 225.3mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a 225.4nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300 225.5percent of the facility's multiple bedroom payment rate for case mix classification K; or, 225.6upon implementation of the RUG's-based case mix system, 300 percent of the highest 225.7RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private 225.8paying residents under the provisions of section   
         256B.48, subdivision 1. 225.9    (b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to 225.10care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever 225.11is later, the operating payment rates for residents determined eligible under paragraph (a) 225.12of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds 225.13and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300 225.14percent of the facility's highest RUG rate.225.15    Sec. 53. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to 225.16read:225.17    Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the 225.18rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571 225.19per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom. 225.20For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a 225.21single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060, 225.22subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per 225.23bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060, 225.24subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per 225.25bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060, 225.26subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the 225.27Census: Composite fixed-weighted price index as published in the C30 Report, Value 225.28of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed 225.29Investments in Structures; Special Care. 225.30    (b)  Rental factor. For the rate year beginning July 1, 1988, the commissioner shall 225.31increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8, 225.32item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing 225.33nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation 225.34services used by the state's contracted appraisers. For rate years beginning on or after July 226.11, 1989, the rental factor is the amount determined under this paragraph for the rate year 226.2beginning July 1, 1988. 226.3    (c)  Occupancy factor. For rate years beginning on or after July 1, 1988, in order 226.4to determine property-related payment rates under Minnesota Rules, part 9549.0060, 226.5for all nursing facilities except those whose average length of stay in a skilled level of 226.6care within a nursing facility is 180 days or less, the commissioner shall use 95 percent 226.7of capacity days. For a nursing facility whose average length of stay in a skilled level of 226.8care within a nursing facility is 180 days or less, the commissioner shall use the greater of 226.9resident days or 80 percent of capacity days but in no event shall the divisor exceed 95 226.10percent of capacity days. 226.11    (d)  Equipment allowance. For rate years beginning on July 1, 1988, and July 1, 226.121989, the commissioner shall add ten cents per resident per day to each nursing facility's 226.13property-related payment rate. The ten-cent property-related payment rate increase is not 226.14cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the 226.15commissioner shall increase each nursing facility's equipment allowance as established 226.16in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For 226.17rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be 226.18adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E. 226.19For the rate period beginning October 1, 1992, the equipment allowance for each nursing 226.20facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the 226.21allowance must be adjusted annually for inflation. 226.22    (e)  Post chapter 199 related-organization debts and interest expense. For rate 226.23years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item 226.24E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983, 226.25provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010 226.26to 9510.0480, the debt is subject to repayment through annual principal payments, and 226.27the nursing facility demonstrates to the commissioner's satisfaction that the interest rate 226.28on the debt was less than market interest rates for similar arm's-length transactions at 226.29the time the debt was incurred. If the debt was incurred due to a sale between family 226.30members, the nursing facility must also demonstrate that the seller no longer participates 226.31in the management or operation of the nursing facility. Debts meeting the conditions of 226.32this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010 226.33to 9549.0080. 226.34    (f)  Building capital allowance for nursing facilities with operating leases. For 226.35rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs 226.36incurred for the nursing facility's buildings shall receive its building capital allowance 227.1computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating 227.2lease provides that the lessee's rent is adjusted to recognize improvements made by the 227.3lessor and related debt, the costs for capital improvements and related debt shall be allowed 227.4in the computation of the lessee's building capital allowance, provided that reimbursement 227.5for these costs under an operating lease shall not exceed the rate otherwise paid. 227.6    Sec. 54. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to 227.7read:227.8    Subd. 17e. Replacement-costs-new per bed limit effective July 1, 2001.227.9    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), 227.10for a total replacement, as defined in paragraph (f) subdivision 17d, authorized under 227.11section   
         144A.071 or   
         144A.073 after July 1, 1999, or any building project that is a 227.12relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, the 227.13replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed 227.14rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating 227.15the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 227.169549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be 227.17adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000. 227.18    Sec. 55. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:227.19    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which 227.20have their payment rates determined under this section rather than section 
         256B.431, the 227.21commissioner shall establish a rate under this subdivision. The nursing facility must enter 227.22into a written contract with the commissioner.227.23    (b) A nursing facility's case mix payment rate for the first rate year of a facility's 227.24contract under this section is the payment rate the facility would have received under 227.25section 
         256B.431.227.26    (c) A nursing facility's case mix payment rates for the second and subsequent years 227.27of a facility's contract under this section are the previous rate year's contract payment 227.28rates plus an inflation adjustment and, for facilities reimbursed under this section or 227.29section 
         256B.431, an adjustment to include the cost of any increase in Health Department 227.30licensing fees for the facility taking effect on or after July 1, 2001. The index for the 227.31inflation adjustment must be based on the change in the Consumer Price Index-all items 227.32(United States City average) (CPI-U) forecasted by the commissioner of finance's national 227.33economic consultant, as forecasted in the fourth quarter of the calendar year preceding 227.34the rate year. The inflation adjustment must be based on the 12-month period from the 228.1midpoint of the previous rate year to the midpoint of the rate year for which the rate 228.2is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 228.31, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 228.42007, and July 1, 2008, July 1, 2009, and July 1, 2010, this paragraph shall apply only 228.5to the property-related payment rate, except that adjustments to include the cost of any 228.6increase in Health Department licensing fees taking effect on or after July 1, 2001, shall 228.7be provided. Beginning in 2005, adjustment to the property payment rate under this 228.8section and section 
         256B.431 shall be effective on October 1. In determining the amount 228.9of the property-related payment rate adjustment under this paragraph, the commissioner 228.10shall determine the proportion of the facility's rates that are property-related based on the 228.11facility's most recent cost report. 228.12    (d) The commissioner shall develop additional incentive-based payments of up to 228.13five percent above a facility's operating payment rate for achieving outcomes specified 228.14in a contract. The commissioner may solicit contract amendments and implement those 228.15which, on a competitive basis, best meet the state's policy objectives. The commissioner 228.16shall limit the amount of any incentive payment and the number of contract amendments 228.17under this paragraph to operate the incentive payments within funds appropriated for this 228.18purpose. The contract amendments may specify various levels of payment for various 228.19levels of performance. Incentive payments to facilities under this paragraph may be in the 228.20form of time-limited rate adjustments or onetime supplemental payments. In establishing 228.21the specified outcomes and related criteria, the commissioner shall consider the following 228.22state policy objectives:228.23    (1) successful diversion or discharge of residents to the residents' prior home or other 228.24community-based alternatives;228.25    (2) adoption of new technology to improve quality or efficiency; 228.26    (3) improved quality as measured in the Nursing Home Report Card; 228.27    (4) reduced acute care costs; and228.28    (5) any additional outcomes proposed by a nursing facility that the commissioner 228.29finds desirable.228.30    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 228.31take action to come into compliance with existing or pending requirements of the life 228.32safety code provisions or other federal regulations governing sprinkler systems shall 228.33receive reimbursement for the costs associated with compliance if all of the following 228.34conditions are met:228.35    (1) the expenses associated with compliance occurred on or after January 1, 2005, 228.36and before December 31, 2008;229.1    (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073, 229.2or 256B.434, subdivision 4f; and229.3    (3) the total allowable costs reported under this paragraph are less than the minimum 229.4threshold established under section 256B.431, subdivisions 15, paragraph (e), and 16.229.5The commissioner shall use funds appropriated for this purpose to provide to qualifying 229.6nursing facilities a rate adjustment beginning October 1, 2007, and ending September 229.730, 2008. Nursing facilities that have expended funds or anticipate the need to expend 229.8funds to satisfy the most recent life safety code requirements by (1) installing a sprinkler 229.9system or (2) replacing all or portions of an existing sprinkler system may submit to the 229.10commissioner by June 30, 2007, on a form provided by the commissioner the actual 229.11costs of a completed project or the estimated costs, based on a project bid, of a planned 229.12project. The commissioner shall calculate a rate adjustment equal to the allowable 229.13costs of the project divided by the resident days reported for the report year ending 229.14September 30, 2006. If the costs from all projects exceed the appropriation for this 229.15purpose, the commissioner shall allocate the funds appropriated on a pro rata basis to the 229.16qualifying facilities by reducing the rate adjustment determined for each facility by an 229.17equal percentage. If the rate adjustments under this subdivision are reduced to fit the 229.18appropriation, facilities may include the portion of the costs that are not reimbursed by 229.19the rate adjustment as part of a project that meets the requirements of subdivision 4f. 229.20If the commissioner determines that there are any unexpended funds for the purposes 229.21of this paragraph, the commissioner may allocate the remainder of the funds to the 229.22qualifying facilities on a pro rata basis for other physical plant changes required by the 229.23nursing facility in order to meet the most recent life safety code compliance standards. 229.24Facilities that used estimated costs when requesting the rate adjustment shall report to 229.25the commissioner by January 31, 2009, on the use of these funds on a form provided by 229.26the commissioner. If the nursing facility fails to provide the report, the commissioner 229.27shall recoup the funds appropriated to the facility for this purpose. If the facility reports 229.28expenditures allowable under this subdivision that are less than the amount received in the 229.29facility's annualized rate adjustment, the commissioner shall recoup the difference.229.30    Sec. 56. Minnesota Statutes 2006, section 256B.434, is amended by adding a 229.31subdivision to read:229.32    Subd. 4i.Nursing facility rate increase effective October 1, 2007; Hennepin 229.33County.For the rate year beginning October 1, 2007, the commissioner shall provide to 229.34a nursing facility in Hennepin County licensed for 268 beds as of February 1, 2007, an 229.35increase in the property payment rate of $6.52 per resident per day. The increase under 230.1this subdivision must be added following the determination under this chapter of the 230.2payment rate for the rate year beginning October 1, 2007, and must be included in the 230.3facility's total payment rate for purposes of determining future rates under this section or 230.4any other section.230.5    Sec. 57. Minnesota Statutes 2006, section 256B.434, is amended by adding a 230.6subdivision to read:230.7    Subd. 4j.Rate increase for facilities in Chisago County.Effective October 230.81, 2007, operating payment rates of all nursing facilities in Chisago County that are 230.9reimbursed under this section or section 256B.441 shall be increased to be equal, for 230.10a RUG's rate with a weight of 1.00, to the geographic group III median rate for the 230.11same RUG's weight. The percentage of the operating payment rate for each facility to 230.12be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that 230.13facility's September 30, 2007, operating payment rate. This subdivision applies only if it 230.14results in a rate increase. Increases provided by this subdivision shall be added to the rate 230.15determined under any new reimbursement system established under section 256B.441.230.16    Sec. 58. Minnesota Statutes 2006, section 256B.434, is amended by adding a 230.17subdivision to read:230.18    Subd. 4k.Nursing facility rate increase effective January 1, 2008; Hennepin 230.19County.Effective January 1, 2008, a nursing facility in Hennepin County licensed for 230.20137 beds as of February 1, 2007, shall receive an increase of $2.81 in each case mix 230.21payment rate to offset property tax payments due as a result of the facility's conversion 230.22from nonprofit to for-profit status. The increase under this subdivision must be added 230.23following the determination under this chapter of the payment rate for the rate year 230.24beginning October 1, 2007, and must be included in the facility's total payment rate for the 230.25purposes of determining future rates under this section or any other section.230.26    Sec. 59. Minnesota Statutes 2006, section 256B.434, is amended by adding a 230.27subdivision to read:230.28    Subd. 4l.Property rate adjustment; Kanabec County.The commissioner 230.29shall allow a property rate adjustment for a facility located in Kanabec County that 230.30was approved for a moratorium exception project in 2001, but experienced a delay and 230.31additional costs associated with the project, and completed the project in 2005. The 230.32property payment rate for the rate years beginning October 1, 2007, and ending September 230.3330, 2009, must be $22.73 per resident day. For subsequent years, the property rate of 231.1$22.73 per resident day shall be adjusted as provided in subdivision 4, paragraph (c), as 231.2long as the facility has a contract under this section.231.3    Sec. 60. Minnesota Statutes 2006, section 256B.434, is amended by adding a 231.4subdivision to read:231.5    Subd. 4m.Rate increase for facilities in Rice County.Effective July 1, 2007, 231.6operating payment rates of nursing facilities in Rice County located within two miles 231.7of Scott County or Dakota County that are reimbursed under this section or section 231.8256B.441 must be increased to be equal, for a RUG's rate with a weight of 1.00, to the 231.9geographic group III median rate for the same RUG's weight. The percentage of the 231.10operating payment rate for each facility to be case-mix adjusted must be equal to the 231.11percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment 231.12rate. This subdivision applies only if it results in a rate increase.231.13    Sec. 61. Minnesota Statutes 2006, section 256B.434, is amended by adding a 231.14subdivision to read:231.15    Subd. 4n.Facility rate increase.For the rate year beginning October 1, 2007, a 231.16nursing facility in Faribault County licensed for 50 beds as of April 19, 2006, shall receive 231.17a rate increase of $2.64 in each case mix payment rate to offset property tax payments 231.18due as a result of the facility's conversion from nonprofit to for-profit status. The increase 231.19under this subdivision shall be added to the payment rates in effect for the facility on 231.20September 30, 2007, and shall be included in the facility's total payment rates for the 231.21purposes of determining future rates under this section or any other section.231.22    Sec. 62. Minnesota Statutes 2006, section 256B.434, is amended by adding a 231.23subdivision to read:231.24    Subd. 19.Nursing facility rate increases beginning October 1, 2007, and 231.25October 1, 2008.(a) For the rate year beginning October 1, 2007, the commissioner 231.26shall make available to each nursing facility reimbursed under this section operating 231.27payment rate adjustments equal to three percent of the operating payment rates in effect 231.28on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner 231.29shall make available to each nursing facility reimbursed under this section operating 231.30payment rate adjustments equal to three percent of the operating payment rates in effect 231.31on September 30, 2008.232.1    (b) Seventy-five percent of the money resulting from the rate adjustments under 232.2paragraph (a) must be used for increases in compensation-related costs of eligible 232.3employees. 232.4    (c) For purposes of this subdivision, eligible employees includes all persons directly 232.5employed by the nursing facility on or after the effective date of the rate adjustments, 232.6except:232.7    (1) persons employed in the central office of a corporation that has an ownership 232.8interest in the nursing facility or exercises control over the nursing facility; and 232.9    (2) persons paid by the nursing facility under a management contract.232.10    (d) The commissioner shall allow as compensation-related costs all costs for:232.11    (1) wages and salaries;232.12    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 232.13compensation;232.14    (3) the employer's share of health and dental insurance, life insurance, disability 232.15insurance, long-term care insurance, uniform allowance, and pensions; and232.16    (4) other benefits provided, subject to the approval of the commissioner.232.17    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the 232.18requirements in paragraph (b) shall be provided to nursing facilities effective October 232.191 of each year.232.20    (f) Nursing facilities may apply for the portion of the rate adjustments under 232.21paragraph (a) that is subject to the requirements in paragraph (b). The application 232.22must be submitted to the commissioner within six months of the effective date of the 232.23rate adjustments, and the nursing facility must provide additional information required 232.24by the commissioner within nine months of the effective date of the rate adjustments. 232.25The commissioner must respond to all applications within three weeks of receipt. 232.26The commissioner may waive the deadlines in this paragraph under extraordinary 232.27circumstances, to be determined at the sole discretion of the commissioner. The 232.28application must contain:232.29    (1) an estimate of the amounts of money that must be used as specified in paragraph 232.30(b);232.31    (2) a detailed distribution plan specifying the allowable compensation-related 232.32increases the nursing facility will implement to use the funds available in clause (1);232.33    (3) a description of how the nursing facility will notify eligible employees of 232.34the contents of the approved application, which must provide for giving each eligible 232.35employee a copy of the approved application, excluding the information required in clause 232.36(1), or posting a copy of the approved application, excluding the information required in 233.1clause (1), for a period of at least six weeks in an area of the nursing facility to which all 233.2eligible employees have access; and233.3    (4) instructions for employees who believe they have not received the 233.4compensation-related increases specified in clause (2), as approved by the commissioner, 233.5and which must include a mailing address, e-mail address, and the telephone number 233.6that may be used by the employee to contact the commissioner or the commissioner's 233.7representative.233.8    (g) The commissioner shall ensure that cost increases in distribution plans under 233.9paragraph (f), clause (2), that may be included in approved applications, comply with 233.10requirements in clauses (1) to (4):233.11    (1) costs to be incurred during the applicable rate year resulting from wage and 233.12salary increases implemented prior to the first day of the nursing facility's payroll period 233.13that includes October 1 of each year shall be allowed if they were not used in a prior 233.14year's application;233.15    (2) a portion of the costs resulting from tenure-related wage or salary increases may 233.16be considered to be allowable compensation-related increases, in accordance with existing 233.17formulas that the commissioner shall provide;233.18    (3) the annualized amount of increases in costs for the employer's share of health 233.19and dental insurance, life insurance, disability insurance, and workers' compensation shall 233.20be allowable compensation-related increases if they are effective on or after April 1 of 233.21the year in which the rate adjustments are effective and prior to April 1 of the following 233.22year; and 233.23    (4) for nursing facilities in which employees are represented by an exclusive 233.24bargaining representative, an agreement negotiated and agreed to by the employer and 233.25the exclusive bargaining representative constitutes the plan. The commissioner shall not 233.26review and shall not require changes to the portions of the plan covered by collective 233.27bargaining agreements. A negotiated agreement may constitute the plan only if the 233.28agreement is finalized after the date of enactment of all increases for the rate year and 233.29signed by both parties prior to submission to the commissioner.233.30    (h) The commissioner shall review applications received under paragraph (f) and 233.31shall provide the portion of the rate adjustments under paragraph (b) if the requirements of 233.32this subdivision have been met. The rate adjustments shall be effective October 1 of each 233.33year. Notwithstanding paragraph (a), if the approved application distributes less money 233.34than is available, the amount of the rate adjustment shall be reduced so that the amount of 233.35money made available is equal to the amount to be distributed.234.1    Sec. 63. Minnesota Statutes 2006, section 256B.434, is amended by adding a 234.2subdivision to read:234.3    Subd. 20.Payment of Public Employees Retirement Association costs.Nursing 234.4facilities that participate in the Public Employees Retirement Association (PERA) shall 234.5have the component of their payment rate associated with the costs of PERA determined 234.6for each rate year. Effective for rate years beginning on and after October 1, 2007, the 234.7commissioner shall determine the portion of the payment rate in effect on September 30 234.8each year and shall subtract that amount from the payment rate to be effective on the 234.9following October 1. The portion that shall be deemed to be included in the September 30, 234.102007, rate that is associated with PERA costs shall be the allowed costs in the facility's 234.11base for determining rates under this section, divided by the resident days reported for that 234.12year. The commissioner shall add to the payment rate to be effective on October 1 each 234.13year an amount equal to the reported costs associated with PERA, for the year ended on 234.14the most recent September 30 for which data is available, divided by total resident days 234.15for that year, as reported by the facility and audited under section 256B.441.234.16    Sec. 64. Minnesota Statutes 2006, section 256B.437, is amended by adding a 234.17subdivision to read:234.18    Subd. 11.Big Stone County rate adjustment. Notwithstanding the time period 234.19specified in subdivision 3, the commissioner shall approve a planned closure rate 234.20adjustment in Big Stone County for an eight-bed facility in Clinton for reassignment to a 234.2150-bed facility in Graceville. The adjustment shall be calculated according to subdivisions 234.223 and 6.234.23    Sec. 65. Minnesota Statutes 2006, section 256B.438, subdivision 3, is amended to read:234.24    Subd. 3. Case mix indices. (a) The commissioner of human services shall assign a 234.25case mix index to each resident class based on the Centers for Medicare and Medicaid 234.26Services staff time measurement study and adjusted for Minnesota-specific wage indices. 234.27The case mix indices assigned to each resident class shall be published in the Minnesota 234.28State Register at least 120 days prior to the implementation of the 34 group, RUG-III 234.29resident classification system.234.30    (b) An index maximization approach shall be used to classify residents.234.31    (c) After implementation of the revised case mix system, the commissioner of 234.32human services may annually rebase case mix indices and base rates using more current 234.33data on average wage rates and staff time measurement studies. This rebasing shall be 234.34calculated under subdivision 7, paragraph (b). The commissioner shall publish in the 235.1Minnesota State Register adjusted case mix indices at least 45 days prior to the effective 235.2date of the adjusted case mix indices.235.3    Sec. 66. Minnesota Statutes 2006, section 256B.439, subdivision 1, is amended to read:235.4    Subdivision 1. Development and implementation of quality profiles. (a) The 235.5commissioner of human services, in cooperation with the commissioner of health, shall 235.6develop and implement a quality profile system for nursing facilities and, beginning not 235.7later than July 1, 2004, other providers of long-term care services, except when the quality 235.8profile system would duplicate requirements under section 
         256B.5011, 
         256B.5012, or 235.9256B.5013
         . Beginning July 1, 2008, the commissioners shall include quality profiles of 235.10nursing homes that are not medical assistance certified in the Minnesota Nursing Home 235.11Report Card. The nonmedical assistance certified nursing homes may provide to the 235.12commissioners information necessary to conduct consumer satisfaction surveys and to 235.13determine other quality measures. The system must be developed and implemented to the 235.14extent possible without the collection of significant amounts of new data. To the extent 235.15possible, the system must incorporate or be coordinated with information on quality 235.16maintained by area agencies on aging, long-term care trade associations, and other entities. 235.17The system must be designed to provide information on quality to: 235.18    (1) consumers and their families to facilitate informed choices of service providers;235.19    (2) providers to enable them to measure the results of their quality improvement 235.20efforts and compare quality achievements with other service providers; and235.21    (3) public and private purchasers of long-term care services to enable them to 235.22purchase high-quality care.235.23    (b) The system must be developed in consultation with the long-term care task force, 235.24area agencies on aging, and representatives of consumers, providers, and labor unions. 235.25Within the limits of available appropriations, the commissioners may employ consultants 235.26to assist with this project.235.27    Sec. 67. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:235.28    Subdivision 1. Rate determination Rebasing of nursing facility operating cost 235.29payment rates. (a) The commissioner shall establish a value-based nursing facility 235.30reimbursement system which will provide facility-specific, prospective rates for nursing 235.31facilities participating in the medical assistance program. The rates shall be determined 235.32using an annual statistical and cost report filed by each nursing facility. The total payment 235.33rate shall be composed of four rate components: direct care services, support services, 235.34external fixed, and property-related rate components. The payment rate shall be derived 236.1from statistical measures of actual costs incurred in facility operation of nursing facilities. 236.2From this cost basis, the components of the total payment rate shall be adjusted for quality 236.3of services provided, recognition of staffing levels, geographic variation in labor costs, and 236.4resident acuity. The commissioner shall rebase nursing facility operating cost payment 236.5rates to align payments to facilities with the cost of providing care. The rebased operating 236.6cost payment rates shall be calculated using the statistical and cost report filed by each 236.7nursing facility for the report period ending one year prior to the rate year.236.8    (b) Rates shall be rebased annually. The new operating cost payment rates based on 236.9this section shall take effect beginning with the rate year beginning October 1, 2009, and 236.10shall be phased in over three rate years through October 1, 2011.236.11    (c) Operating cost payment rates shall be rebased on October 1, 2012, and every 236.12two years after that date.236.13    (d) Operating cost payment rates for rate years in which rebasing does not occur 236.14shall be increased by the Global Insight SNF Market Basket inflation factor from the 236.15midpoint of the previous rate year to the midpoint of the next rate year.236.16    (e) Each cost reporting year shall begin on October 1 and end on the following 236.17September 30. Beginning in 2006, a statistical and cost report shall be filed by each 236.18nursing facility by January 15. Notice of rates shall be distributed by August 15 and the 236.19rates shall go into effect on October 1 for one year.236.20    (c) The commissioner shall begin to phase in the new reimbursement system 236.21beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.236.22    Sec. 68. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:236.23    Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to 236.2442 42a  have the meanings given unless otherwise provided for in this section.236.25    Sec. 69. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:236.26    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for 236.27administering the overall activities of the nursing home. These costs include salaries and 236.28wages of the administrator, assistant administrator, business office employees, security 236.29guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases 236.30related to business office functions, licenses, and permits except as provided in the 236.31external fixed costs category, employee recognition, travel including meals and lodging, 236.32training, voice and data communication or transmission, office supplies, liability insurance 236.33and other forms of insurance not designated to other areas, personnel recruitment, legal 236.34services, accounting services, management or business consultants, data processing, 237.1information technology, Web site, central or home office costs, business meetings and 237.2seminars, postage, fees for professional organizations, subscriptions, security services, 237.3advertising, board of director's fees, working capital interest expense, and bad debts and 237.4bad debt collection fees.237.5    Sec. 70. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:237.6    Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the facility 237.7which are necessary for the operation of the facility and the care of residents and which 237.8are reviewed by the department for accuracy, reasonableness, and compliance with this 237.9section and generally accepted accounting principles. All references to costs in this section 237.10shall be assumed to refer to allowed costs.237.11    Sec. 71. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to 237.12read:237.13    Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages 237.14of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees 237.15assigned to the kitchen and dining room, and associated fringe benefits and payroll 237.16taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs 237.17of raw food (both normal and special diet food), dietary supplies, and food preparation 237.18and serving. Also included are special dietary supplements used for tube feeding or oral 237.19feeding, such as elemental high nitrogen diet, even if written as a prescription item by a 237.20physician.237.21    Sec. 72. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to 237.22read:237.23    Subd. 11. Direct care costs category."Direct care costs category" "Direct care 237.24costs" means costs for nursing services, activities, and social services the wages of nursing 237.25administration, staff education, direct care registered nurses, licensed practical nurses, 237.26certified nursing assistants, trained medication aides, and associated fringe benefits and 237.27payroll taxes; services from a supplemental nursing services agency; supplies that are 237.28stocked at nursing stations or on the floor and distributed or used individually, including, 237.29but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice 237.30bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas, 237.31enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products, 237.32thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic 237.33agents, drugs that are not paid for on a separate fee schedule by the medical assistance 238.1program or any other payer, and technology related to the provision of nursing care to 238.2residents, such as electronic charting systems.238.3    Sec. 73. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to 238.4read:238.5    Subd. 13. External fixed costs category."External fixed costs category" "External 238.6fixed costs"  means costs related to the nursing home surcharge under section 
         256.9657, 238.7subdivision 1
         ; licensure fees under section 
         144.122; long-term care consultation fees 238.8under section 
         256B.0911, subdivision 6; family advisory council fee under section 238.9 144A.33
         ; scholarships under section 
         256B.431, subdivision 36; planned closure rate 238.10adjustments under section 256B.436 or256B.437; or single bed room incentives under 238.11section 256B.431, subdivision 42; property taxes and property insurance; and PERA.238.12    Sec. 74. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to 238.13read:238.14    Subd. 14. Facility average case mix index. "Facility average case mix index" or 238.15"CMI" means a numerical value score that describes the relative resource use for all 238.16residents within the groups under the resource utilization group (RUG-III) classification 238.17system prescribed by the commissioner based on an assessment of each resident. The 238.18facility average CMI shall be computed as the standardized days divided by total days for 238.19all residents in the facility. The RUG's weights used in this section shall be as follows 238.20for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB 238.211.109; RAA 0.957; SSC 1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2 238.221.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676; 238.23BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023; 238.24PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1 238.250.651; and DDF 1.000238.26    Sec. 75. Minnesota Statutes 2006, section 256B.441, is amended by adding a 238.27subdivision to read:238.28    Subd. 14a.Facility type groups.Facilities shall be classified into two groups, 238.29called "facility type groups," which shall consist of:238.30    (1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota 238.31Rules, parts 9570.2000 to 9570.3400; and 238.32    (2) freestanding: all other facilities.239.1    Sec. 76. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to 239.2read:239.3    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group 239.4life, health, dental, workers' compensation, and other employee insurances and pension, 239.5profit-sharing, and retirement plans for which the employer pays all or a portion of the 239.6costs and that are available to at least all employees who work at least 20 hours per week.239.7    Sec. 77. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to 239.8read:239.9    Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the 239.10salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning 239.11employees and associated fringe benefits and payroll taxes. It also includes the cost of 239.12housekeeping supplies, including, but not limited to,  cleaning and lavatory supplies and 239.13contract services.239.14    Sec. 78. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to 239.15read:239.16    Subd. 24. Maintenance and plant operations costs. "Maintenance and plant 239.17operations costs" means the costs for the salaries and wages of the maintenance supervisor, 239.18engineers, heating-plant employees, and other maintenance employees and associated 239.19fringe benefits and payroll taxes. It also includes direct costs for maintenance and 239.20operation of the building and grounds, including, but not limited to,  fuel, electricity, 239.21medical waste and garbage removal, water, sewer, supplies, tools, and repairs.239.22    Sec. 79. Minnesota Statutes 2006, section 256B.441, is amended by adding a 239.23subdivision to read:239.24    Subd. 28a.Other direct care costs."Other direct care costs" means the costs 239.25for the salaries and wages and associated fringe benefits and payroll taxes of mental 239.26health workers, religious personnel, and other direct care employees not specified in 239.27the definition of direct care costs. 239.28    Sec. 80. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to 239.29read:239.30    Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer 239.31groups," which by county. The groups  shall consist of:240.1    (1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed 240.2per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000 240.3to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota, 240.4Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott, 240.5Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;240.6    (2) boarding care homes - facilities that have more than 50 percent of their beds 240.7licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth, 240.8Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, 240.9Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, 240.10Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, 240.11Watonwan, or Wilkin County; and240.12    (3) standard - all other facilities group three: facilities in all other counties.240.13    Sec. 81. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to 240.14read:240.15    Subd. 31. Prior rate-setting method system operating cost payment rate."Prior 240.16rate-setting method" "Prior system operating cost payment rate"  means the operating cost 240.17payment rate determination process in effect prior to October 1, 2006 on September 30, 240.182009, under Minnesota Rules and Minnesota Statutes, not including planned closure rate 240.19adjustments under section 256B.436 or 256B.437, or single bed room incentives under 240.20section 256B.431, subdivision 42.240.21    Sec. 82. Minnesota Statutes 2006, section 256B.441, is amended by adding a 240.22subdivision to read:240.23    Subd. 33a.Raw food costs."Raw food costs" means the cost of food provided to 240.24nursing facility residents. Also included are special dietary supplements used for tube 240.25feeding or oral feeding, such as elemental high nitrogen diet.240.26    Sec. 83. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to 240.27read:240.28    Subd. 34. Related organization. "Related organization" means a person that 240.29furnishes goods or services to a nursing facility and that is a close relative of a nursing 240.30facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility, 240.31or an affiliate of a close relative of an affiliate of a nursing facility. As used in this 240.32subdivision, paragraphs (a) to (d) apply:241.1    (a) "Affiliate" means a person that directly, or indirectly through one or more 241.2intermediaries, controls or is controlled by, or is under common control with another 241.3person.241.4    (b) "Person" means an individual, a corporation, a partnership, an association, a 241.5trust, an unincorporated organization, or a government or political subdivision.241.6    (c) "Close relative of an affiliate of a nursing facility" means an individual whose 241.7relationship by blood, marriage, or adoption to an individual who is an affiliate of a 241.8nursing facility is no more remote than first cousin.241.9    (d) "Control" including the terms "controlling," "controlled by," and "under common 241.10control with" means the possession, direct or indirect, of the power to direct or cause the 241.11direction of the management, operations, or policies of a person, whether through the 241.12ownership of voting securities, by contract, or otherwise, or to influence in any manner 241.13other than through an arms length, legal transaction.241.14    Sec. 84. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to 241.15read:241.16    Subd. 38. Social services costs. "Social services costs" means the costs for the 241.17salaries and wages of the supervisor and other social work employees, associated fringe 241.18benefits and payroll taxes, supplies, services, and consultants. This category includes the 241.19cost of those employees who manage and process admission to the nursing facility.241.20    Sec. 85. Minnesota Statutes 2006, section 256B.441, is amended by adding a 241.21subdivision to read:241.22    Subd. 42a.Therapy costs."Therapy costs" means any costs related to medical 241.23assistance therapy services provided to residents that are not billed separately from the 241.24daily operating rate.241.25    Sec. 86. Minnesota Statutes 2006, section 256B.441, is amended by adding a 241.26subdivision to read:241.27    Subd. 48.Calculation of operating per diems.The direct care per diem for 241.28each facility shall be the facility's direct care costs divided by its standardized days. 241.29The other care-related per diem shall be the sum of the facility's activities costs, other 241.30direct care costs, raw food costs, therapy costs, and social services costs, divided by the 241.31facility's resident days. The other operating per diem shall be the sum of the facility's 241.32administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance 241.33and plant operations costs divided by the facility's resident days.242.1    Sec. 87. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.2subdivision to read:242.3    Subd. 49.Determination of total care-related per diem.The total care-related 242.4per diem for each facility shall be the sum of the direct care per diem and the other 242.5care-related per diem.242.6    Sec. 88. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.7subdivision to read:242.8    Subd. 50.Determination of total care-related limit.The limit on the total 242.9care-related per diem shall be determined for each peer group and facility type group 242.10combination. A facility's total care-related per diems shall be limited to 120 percent of the 242.11median for the facility's peer and facility type group. The facility-specific direct care costs 242.12used in making this comparison and in the calculation of the median shall be based on a 242.13RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per 242.14diem reduced to the limit. If a reduction of the total care-related per diem is necessary 242.15because of this limit, the reduction shall be made proportionally to both the direct care per 242.16diem and the other care-related per diem.242.17    Sec. 89. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.18subdivision to read:242.19    Subd. 51.Determination of other operating limit.The limit on the other operating 242.20per diem shall be determined for each peer group. A facility's other operating per diem 242.21shall be limited to 105 percent of the median for its peer group. A facility that is above 242.22that limit shall have its other operating per diem reduced to the limit.242.23    Sec. 90. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.24subdivision to read:242.25    Subd. 52.Determination of efficiency incentive.Each facility shall be eligible 242.26for an efficiency incentive based on its other operating per diem. A facility with an other 242.27operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency 242.28incentive. All other facilities shall receive an incentive calculated as 50 percent times the 242.29difference between the facility's other operating per diem and its other operating per diem 242.30limit, up to a maximum incentive of $3.242.31    Sec. 91. Minnesota Statutes 2006, section 256B.441, is amended by adding a 242.32subdivision to read:243.1    Subd. 53.Calculation of payment rate for external fixed costs.The commissioner 243.2shall calculate a payment rate for external fixed costs.243.3    (a) For a facility licensed as a nursing home, the portion related to section 256.9657 243.4shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care 243.5home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the 243.6result of its number of nursing home beds divided by its total number of licensed beds.243.7    (b) The portion related to the licensure fee under section 144.122, paragraph (d), 243.8shall be the amount of the fee divided by actual resident days.243.9    (c) The portion related to scholarships shall be determined under section 256B.431, 243.10subdivision 36.243.11    (d) The portion related to long-term care consultation shall be determined according 243.12to section 256B.0911, subdivision 6.243.13    (e) The portion related to development and education of resident and family advisory 243.14councils under section 144A.33 shall be $5 divided by 365.243.15    (f) The portion related to planned closure rate adjustments shall be as determined 243.16under sections 256B.436 and 256B.437, subdivision 6.243.17    (g) The portions related to property insurance, real estate taxes, special assessments, 243.18and payments made in lieu of real estate taxes directly identified or allocated to the nursing 243.19facility shall be the actual amounts divided by actual resident days.243.20    (h) The portion related to the Public Employees Retirement Association shall be 243.21actual costs divided by resident days.243.22    (i) The single bed room incentives shall be as determined under section 256B.431, 243.23subdivision 42.243.24    (j) The payment rate for external fixed costs shall be the sum of the amounts in 243.25paragraphs (a) to (i).243.26    Sec. 92. Minnesota Statutes 2006, section 256B.441, is amended by adding a 243.27subdivision to read:243.28    Subd. 54.Adjustment of per diem for inflation.The total care-related per diem 243.29and other operating per diem calculated under this section shall be adjusted for inflation to 243.30adjust for the delay between the reporting year and the rate year. The total care-related 243.31payment rate and other operating payment rate shall be calculated as the per diem 243.32increased by the Global Insight Consumer Price Index urban inflation factor for the period 243.33from the midpoint of the reporting year to the midpoint of the rate year. 244.1    Sec. 93. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.2subdivision to read:244.3    Subd. 55.Determination of total payment rates.In rate years when rates are 244.4rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total 244.5care-related payment rate, other operating payment rate, efficiency incentive, external 244.6fixed cost rate, and the property rate determined under section 256B.434. To determine 244.7a total payment rate for each RUG's level, the total care-related payment rate shall be 244.8divided into the direct care payment rate and the other care-related payment rate, and the 244.9direct care payment rate multiplied by the RUG's weight for each RUG's level using the 244.10weights in subdivision 14.244.11    Sec. 94. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.12subdivision to read:244.13    Subd. 56.Phase-in of rebased operating cost payment rates.For the rate years 244.14beginning October 1, 2009, October 1, 2010, and October 1, 2011, the operating cost 244.15payment rate calculated under this section shall be phased in by blending it with the 244.16operating cost payment rate determined under section 256B.434. For the rate year 244.17beginning October 1, 2009, the operating cost payment rate for each facility shall be 244.1825 percent of the operating cost payment rate from this section, and 75 percent of the 244.19operating cost payment rate from section 256B.434. For the rate year beginning October 1, 244.202010, the operating cost payment rate for each facility shall be 35 percent of the operating 244.21cost payment rate from this section, and 65 percent of the operating cost payment rate 244.22from section 256B.434. For the rate year beginning October 1, 2011, the operating cost 244.23payment rate for each facility shall be the operating cost payment rate determined under 244.24this section. The blending of operating cost payment rates under this section shall be 244.25performed separately for each RUG's class.244.26    Sec. 95. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.27subdivision to read:244.28    Subd. 57.Adjustment for inflation during phase-in of rebased operating cost 244.29payment rates.During the phase-in of operating cost payment rates under subdivision 244.3056, both the operating costs per diem under this section and the operating cost payment 244.31rate under section 256B.434 shall be adjusted for inflation. The adjustment for each year 244.32for the operating cost per diems shall be the Global Insight Consumer Price Index urban 244.33inflation factor from the midpoint of the reporting year to the midpoint of the current rate 244.34year. The adjustment for each year for the operating cost payment rate under section 245.1256B.434 shall be the Global Insight Consumer Price Index urban inflation factor from the 245.2midpoint of the October 1, 2007, rate year to the midpoint of the current rate year.245.3    Sec. 96. Minnesota Statutes 2006, section 256B.441, is amended by adding a 245.4subdivision to read:245.5    Subd. 58.Hold harmless.For the rate years beginning October 1, 2009, October 1, 245.62010, and October 1, 2011, no nursing facility shall receive an operating cost payment 245.7rate less than its operating cost payment rate under section 256B.434. The comparison 245.8of operating cost payment rates under this section shall be made for each of the RUG's 245.9classes separately, and the operating cost payment rates under section 256B.434 used 245.10under this section shall not include the inflation increases described in subdivision 57.245.11    Sec. 97. Minnesota Statutes 2006, section 256B.441, is amended by adding a 245.12subdivision to read:245.13    Subd. 59.Appeals.Nursing facilities may appeal, as defined under section 256B.50, 245.14the determination of a payment rate established under this chapter.245.15    Sec. 98. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:245.16    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and 245.17community-based service waivers, as authorized under section 1915(c) of the Social 245.18Security Act to serve persons under the age of 65 who are determined to require the level 245.19of care provided in a nursing home and persons who require the level of care provided in a 245.20hospital. The commissioner shall apply for the home and community-based waivers in 245.21order to:245.22    (i) promote the support of persons with disabilities in the most integrated settings;245.23    (ii) expand the availability of services for persons who are eligible for medical 245.24assistance;245.25    (iii) promote cost-effective options to institutional care; and245.26    (iv) obtain federal financial participation.245.27    (b) The provision of waivered services to medical assistance recipients with 245.28disabilities shall comply with the requirements outlined in the federally approved 245.29applications for home and community-based services and subsequent amendments, 245.30including provision of services according to a service plan designed to meet the needs of 245.31the individual. For purposes of this section, the approved home and community-based 245.32application is considered the necessary federal requirement.246.1    (c) The commissioner shall provide interested persons serving on agency advisory 246.2committees and, task forces, the Centers for Independent Living, and others upon who246.3request, with to be on a list to receive, notice of, and an opportunity to comment on, 246.4at least 30 days before any effective dates, (1) any substantive changes to the state's 246.5disability services program manual, or (2) changes or amendments to the federally 246.6approved applications for home and community-based waivers, prior to their submission 246.7to the federal Centers for Medicare and Medicaid Services.246.8    (d) The commissioner shall seek approval, as authorized under section 1915(c) of 246.9the Social Security Act, to allow medical assistance eligibility under this section for 246.10children under age 21 without deeming of parental income or assets.246.11    (e) The commissioner shall seek approval, as authorized under section 1915(c) of 246.12the Social Act, to allow medical assistance eligibility under this section for individuals 246.13under age 65 without deeming the spouse's income or assets.246.14    Sec. 99. Minnesota Statutes 2006, section 256B.49, is amended by adding a 246.15subdivision to read:246.16    Subd. 16a.Medical assistance reimbursement.(a) The commissioner shall 246.17seek federal approval for medical assistance reimbursement of independent living skills 246.18services, foster care waiver service, supported employment, prevocational service, 246.19structured day service, and adult day care under the home and community-based waiver 246.20for persons with a traumatic brain injury, the community alternatives for disabled 246.21individuals waivers, and the community alternative care waivers.246.22    (b) Medical reimbursement shall be made only when the provider demonstrates 246.23evidence of its capacity to meet basic health, safety, and protection standards through 246.24one of the methods in paragraphs (c) to (e).246.25    (c) The provider is licensed to provide services under chapter 245B and agrees to 246.26apply these standards to services funded through the traumatic brain injury, community 246.27alternatives for disabled, or community alternative care home and community-based 246.28waivers.246.29    (d) The local agency contracting for the services certifies on a form provided by the 246.30commissioner that the provider has the capacity to meet the individual needs as identified 246.31in each person's individual service plan. When certifying that the service provider meets 246.32the necessary provider qualifications, the local agency shall verify that the provider has 246.33policies and procedures governing the following:246.34    (1) protection of the consumer's rights and privacy;246.35    (2) risk assessment and planning;247.1    (3) record keeping and reporting of incidents and emergencies with documentation 247.2of corrective action if needed;247.3    (4) service outcomes, regular reviews of progress, and periodic reports;247.4    (5) complaint and grievance procedures;247.5    (6) service termination or suspension;247.6    (7) necessary training and supervision of direct care staff that includes:247.7    (i) documentation in personnel files of 20 hours of orientation training in providing 247.8training related to service provision;247.9    (ii) training in recognizing the symptoms and effects of certain disabilities, health 247.10conditions, and positive behavioral supports and interventions; and 247.11    (iii) a minimum of five hours of related training annually; and 247.12    (8) when applicable, the local agency shall verify that the provider has policies and 247.13procedures in place governing the following:247.14    (i) safe medication administration;247.15    (ii) proper handling of consumer funds; and 247.16    (iii) behavioral interventions that are in compliance with prohibitions and standards 247.17developed by the commissioner to meet federal requirements regarding the use of 247.18restraints and restrictive interventions.247.19    (e) For foster care waiver services or independent living skills services, the local 247.20agency contracting for the services certifies on a form provided by the commissioner that 247.21the provider meets the following:247.22    (1) the provider of foster care waiver services is licensed to provide adult foster 247.23care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under 247.24Minnesota Rules, parts 2960.3000 to 2960.3230;247.25    (2) the provider of independent living skills services also provides licensed foster 247.26care services and agrees to apply the foster care standards under Minnesota Rules, parts 247.279555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225, subpart 247.288; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts 10 247.29and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of those 247.30services; and247.31    (3) the provider has policies and procedures applying to the provision of foster 247.32care waiver services or independent living skills services that govern (i) behavioral 247.33interventions that are in compliance with prohibitions and standards developed by the 247.34commissioner to meet federal requirements regarding the use of restraints and restrictive 247.35interventions and (ii) documentation of service needs and outcomes, regular reviews 247.36of progress, and periodic reports.248.1    (f) The local agency shall review each provider's continued compliance with 248.2the basic health, safety, and protection standards on a regular basis. For the review 248.3of paragraph (e), the local agency shall coordinate the review with the county review 248.4of foster care licensure.248.5EFFECTIVE DATE.This section is effective the day following final enactment.248.6    Sec. 100. Minnesota Statutes 2006, section 256B.5012, is amended by adding a 248.7subdivision to read:248.8    Subd. 7.ICF/MR rate increases October 1, 2007, and October 1, 2008.(a) For 248.9the rate periods beginning October 1, 2007, and October 1, 2008, the commissioner shall 248.10make available to each facility reimbursed under this section an adjustment to the total 248.11operating payment rate of three percent.248.12    (b) Seventy-five percent of the money resulting from the rate adjustment under 248.13paragraph (a) must be used to increase wages and benefits and pay associated costs for 248.14employees, except for administrative and central office employees. Seventy-five percent 248.15of the money received by a facility as a result of the rate adjustment provided in paragraph 248.16(a) must be used only for wage, benefit, and staff increases implemented on or after 248.17the effective date of the rate increase each year, and must not be used for increases 248.18implemented prior to that date. The wage adjustment eligible employees may receive may 248.19vary based on merit, seniority, or other factors determined by the provider.248.20    (c) For each facility, the commissioner shall make available an adjustment, based 248.21on occupied beds, using the percentage specified in paragraph (a) multiplied by the total 248.22payment rate, including variable rate but excluding the property-related payment rate, in 248.23effect on the preceding day. The total payment rate must include the adjustment provided 248.24in section 256B.501, subdivision 12.248.25    (d) A facility whose payment rates are governed by closure agreements, receivership 248.26agreements, or Minnesota Rules, part 9553.0075, is not eligible for an adjustment 248.27otherwise granted under this subdivision.248.28    (e) A facility may apply for the portion of the payment rate adjustment provided 248.29under paragraph (a) for employee wages and benefits and associated costs. The application 248.30must be made to the commissioner and contain a plan by which the facility will distribute 248.31the funds according to paragraph (b). For facilities in which the employees are represented 248.32by an exclusive bargaining representative, an agreement negotiated and agreed to by 248.33the employer and the exclusive bargaining representative constitutes the plan. The 248.34commissioner shall not review, and shall not require changes, to the portion or portions 248.35of the plan covered by collective bargaining agreements. A negotiated agreement may 249.1constitute the plan only if the agreement is finalized after the date of enactment of all rate 249.2increases for the rate year. The commissioner shall review the plan to ensure that the 249.3payment rate adjustment per diem is used as provided in this subdivision. To be eligible, a 249.4facility must submit its plan by March 31, 2008, and December 31, 2008, respectively. 249.5If a facility's plan is effective for its employees after the first day of the applicable rate 249.6period that the funds are available, the payment rate adjustment per diem is effective 249.7the same date as its plan.249.8    (f) A copy of the approved distribution plan must be made available to all employees 249.9by giving each employee a copy or by posting it in an area of the facility to which all 249.10employees have access. If an employee does not receive the wage and benefit adjustment 249.11described in the facility's approved plan and is unable to resolve the problem with the 249.12facility's management or through the employee's union representative, the employee 249.13may contact the commissioner at an address or telephone number provided by the 249.14commissioner and included in the approved plan.249.15    Sec. 101. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to 249.16read:249.17    Subd. 23. Alternative services; elderly and disabled persons. (a) The 249.18commissioner may implement demonstration projects to create alternative integrated 249.19delivery systems for acute and long-term care services to elderly persons and persons 249.20with disabilities as defined in section 
         256B.77, subdivision 7a, that provide increased 249.21coordination, improve access to quality services, and mitigate future cost increases. 249.22The commissioner may seek federal authority to combine Medicare and Medicaid 249.23capitation payments for the purpose of such demonstrations and may contract with 249.24Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 249.25services shall be administered according to the terms and conditions of the federal contract 249.26and demonstration provisions. For the purpose of administering medical assistance funds, 249.27demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 249.28of Minnesota Rules, parts 
         9500.1450 to 
         9500.1464, apply to these demonstrations, 249.29with the exceptions of parts 
         9500.1452, subpart 2, item B; and 
         9500.1457, subpart 1, 249.30items B and C, which do not apply to persons enrolling in demonstrations under this 249.31section. An initial open enrollment period may be provided. Persons who disenroll from 249.32demonstrations under this subdivision remain subject to Minnesota Rules, parts 
         9500.1450249.33to 
         9500.1464. When a person is enrolled in a health plan under these demonstrations and 249.34the health plan's participation is subsequently terminated for any reason, the person shall 249.35be provided an opportunity to select a new health plan and shall have the right to change 250.1health plans within the first 60 days of enrollment in the second health plan. Persons 250.2required to participate in health plans under this section who fail to make a choice of 250.3health plan shall not be randomly assigned to health plans under these demonstrations. 250.4Notwithstanding section 
         256L.12, subdivision 5, and Minnesota Rules, part 
         9505.5220, 250.5subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 250.6the commissioner may contract with managed care organizations, including counties, to 250.7serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 250.8disabled persons only. For persons with a primary diagnosis of developmental disability, 250.9serious and persistent mental illness, or serious emotional disturbance, the commissioner 250.10must ensure that the county authority has approved the demonstration and contracting 250.11design. Enrollment in these projects for persons with disabilities shall be voluntary. The 250.12commissioner shall not implement any demonstration project under this subdivision for 250.13persons with a primary diagnosis of developmental disabilities, serious and persistent 250.14mental illness, or serious emotional disturbance, without approval of the county board of 250.15the county in which the demonstration is being implemented.250.16    (b) Notwithstanding chapter 245B, sections 
         252.40 to 
         252.46, 
         256B.092, 
         256B.501250.17to 
         256B.5015, and Minnesota Rules, parts 
         9525.0004 to 
         9525.0036, 
         9525.1200 to 250.189525.1330
         , 
         9525.1580, and 
         9525.1800 to 
         9525.1930, the commissioner may implement 250.19under this section projects for persons with developmental disabilities. The commissioner 250.20may capitate payments for ICF/MR services, waivered services for developmental 250.21disabilities, including case management services, day training and habilitation and 250.22alternative active treatment services, and other services as approved by the state and by 250.23the federal government. Case management and active treatment must be individualized 250.24and developed in accordance with a person-centered plan. Costs under these projects may 250.25not exceed costs that would have been incurred under fee-for-service. Beginning July 1, 250.262003, and until twofour years after the pilot project implementation date, subcontractor 250.27participation in the long-term care developmental disability pilot is limited to a nonprofit 250.28long-term care system providing ICF/MR services, home and community-based waiver 250.29services, and in-home services to no more than 120 consumers with developmental 250.30disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the 250.31legislature prior to expansion of the developmental disability pilot project. This paragraph 250.32expires twofour years after the implementation date of the pilot project.250.33    (c) Before implementation of a demonstration project for disabled persons, the 250.34commissioner must provide information to appropriate committees of the house of 250.35representatives and senate and must involve representatives of affected disability groups 250.36in the design of the demonstration projects.251.1    (d) A nursing facility reimbursed under the alternative reimbursement methodology 251.2in section 
         256B.434 may, in collaboration with a hospital, clinic, or other health care entity 251.3provide services under paragraph (a). The commissioner shall amend the state plan and 251.4seek any federal waivers necessary to implement this paragraph.251.5    (e) The commissioner, in consultation with the commissioners of commerce and 251.6health, may approve and implement programs for all-inclusive care for the elderly (PACE) 251.7according to federal laws and regulations governing that program and state laws or rules 251.8applicable to participating providers. The process for approval of these programs shall 251.9begin only after the commissioner receives grant money in an amount sufficient to cover 251.10the state share of the administrative and actuarial costs to implement the programs during 251.11state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 251.12account in the special revenue fund and are appropriated to the commissioner to be used 251.13solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 251.14not required to be licensed or certified as a health plan company as defined in section 251.1562Q.01, subdivision 4
         . Persons age 55 and older who have been screened by the county 251.16and found to be eligible for services under the elderly waiver or community alternatives 251.17for disabled individuals or who are already eligible for Medicaid but meet level of 251.18care criteria for receipt of waiver services may choose to enroll in the PACE program. 251.19Medicare and Medicaid services will be provided according to this subdivision and 251.20federal Medicare and Medicaid requirements governing PACE providers and programs. 251.21PACE enrollees will receive Medicaid home and community-based services through the 251.22PACE provider as an alternative to services for which they would otherwise be eligible 251.23through home and community-based waiver programs and Medicaid State Plan Services. 251.24The commissioner shall establish Medicaid rates for PACE providers that do not exceed 251.25costs that would have been incurred under fee-for-service or other relevant managed care 251.26programs operated by the state.251.27    (f) The commissioner shall seek federal approval to expand the Minnesota disability 251.28health options (MnDHO) program established under this subdivision in stages, first to 251.29regional population centers outside the seven-county metro area and then to all areas 251.30of the state. Until January 1, 2008July 1, 2009, expansion for MnDHO projects that 251.31include home and community-based services is limited to the two projects and service 251.32areas in effect on March 1, 2006.  Enrollment in integrated MnDHO programs that 251.33include home and community-based services shall remain voluntary. Costs for home 251.34and community-based services included under MnDHO must not exceed costs that 251.35would have been incurred under the fee-for-service program. In developing program 251.36specifications for expansion of integrated programs, the commissioner shall involve and 252.1consult the state-level stakeholder group established in subdivision 28, paragraph (d), 252.2including consultation on whether and how to include home and community-based waiver 252.3programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 252.4of the house and senate committees with jurisdiction over health and human services 252.5policy and finance by February 1, 2007.252.6    (g) Notwithstanding section 
         256B.0261, health plans providing services under this 252.7section are responsible for home care targeted case management and relocation targeted 252.8case management. Services must be provided according to the terms of the waivers and 252.9contracts approved by the federal government.252.10    Sec. 102. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to 252.11read:252.12    Subd. 28. Medicare special needs plans; medical assistance basic health care.252.13    (a) The commissioner may contract with qualified Medicare-approved special needs 252.14plans to provide medical assistance basic health care services to persons with disabilities, 252.15including those with developmental disabilities. Basic health care services include:252.16    (1) those services covered by the medical assistance state plan except for ICF/MR 252.17services, home and community-based waiver services, case management for persons with 252.18developmental disabilities under section 
         256B.0625, subdivision 20a, and personal care 252.19and certain home care services defined by the commissioner in consultation with the 252.20stakeholder group established under paragraph (d); and252.21    (2) basic health care services may also include risk for up to 100 days of nursing 252.22facility services for persons who reside in a noninstitutional setting and home health 252.23services related to rehabilitation as defined by the commissioner after consultation with 252.24the stakeholder group.252.25    The commissioner may exclude other medical assistance services from the basic 252.26health care benefit set. Enrollees in these plans can access any excluded services on the 252.27same basis as other medical assistance recipients who have not enrolled.252.28    Unless a person is otherwise required to enroll in managed care, enrollment in these 252.29plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 252.30enrollment with an option to opt out is not voluntary enrollment. 252.31    (b) Beginning January 1, 2007, the commissioner may contract with qualified 252.32Medicare special needs plans to provide basic health care services under medical 252.33assistance to persons who are dually eligible for both Medicare and Medicaid and those 252.34Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 252.35The commissioner shall consult with the stakeholder group under paragraph (d) (e) in 253.1developing program specifications for these services. The commissioner shall report to 253.2the chairs of the house and senate committees with jurisdiction over health and human 253.3services policy and finance by February 1, 2007, on implementation of these programs and 253.4the need for increased funding for the ombudsman for managed care and other consumer 253.5assistance and protections needed due to enrollment in managed care of persons with 253.6disabilities. Payment for Medicaid services provided under this subdivision for the months 253.7of May and June will be made no earlier than July 1 of the same calendar year.253.8    (c) Beginning January 1, 2008, the commissioner may expand contracting under this 253.9subdivision to all persons with disabilities not otherwise required to enroll in managed 253.10care.253.11    (d) By February 1, 2009, the commissioner shall report to the chairs of the house and 253.12senate committees with jurisdiction over health and human services policy and finance on 253.13the initial results of implementation of contracts with qualified Medicare special needs 253.14plans to provide basic health care services under medical assistance to persons who are 253.15dually eligible for both Medicare and Medicaid. This report shall include an overall 253.16assessment of the impact on quality of care including actual costs and benefits.253.17    (e) The commissioner shall establish a state-level stakeholder group to provide 253.18advice on managed care programs for persons with disabilities, including both MnDHO 253.19and contracts with special needs plans that provide basic health care services as described 253.20in paragraphs (a) and (b). The stakeholder group shall include representatives of the 253.21counties and labor organizations representing county social service workers, members, 253.22consumer advocates, and providers, and provide advice on program expansions under this 253.23subdivision and subdivision 23, including:253.24    (1) implementation efforts; 253.25    (2) consumer protections; and253.26    (3) program specifications such as quality assurance measures, data collection and 253.27reporting, and evaluation of costs, quality, and results.; and253.28    (4) county safety net protections for persons with disabilities.253.29    (e) (f) Each plan under contract to provide medical assistance basic health care 253.30services shall establish a local or regional stakeholder group, including representatives 253.31of the counties covered by the plan and labor organizations representing county social 253.32service workers, members, consumer advocates, and current providers, for advice on 253.33issues that arise in the local or regional area.253.34    Sec. 103. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.254.1     (a) The commissioner of human services shall combine the existing biennial base 254.2level funding for deaf-blind services into a single grant program. At least 35 percent 254.3of the total funding is awarded for services and other supports to deaf-blind children 254.4and their families and at least 25 percent is awarded for services and other supports to 254.5deaf-blind adults.254.6    The commissioner shall award grants for the purposes of: 254.7    (1) providing services and supports to individuals who are deaf-blind; and 254.8    (2) developing and providing training to counties and the network of senior citizen 254.9service providers. The purpose of the training grants is to teach counties how to use 254.10existing programs that capture federal financial participation to meet the needs of eligible 254.11deaf-blind persons and to build capacity of senior service programs to meet the needs of 254.12seniors with a dual sensory hearing and vision loss.254.13    (b) The commissioner may make grants:254.14    (1) for services and training provided by organizations; and254.15    (2) to develop and administer consumer-directed services.254.16    (c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant 254.17under paragraph (a).254.18    (d) Deaf-blind service providers are not required to, but may, provide intervenor 254.19services as part of the service package provided with grant funds under this section.254.20    Sec. 104. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:254.21    Subd. 2. Standard of assistance for persons eligible for medical assistance 254.22waivers or at risk of placement in a group residential housing facility. The state 254.23standard of assistance for a person (1) who is eligible for a medical assistance home 254.24and community-based services waiver or a person, (2) who has been determined by the 254.25local agency to meet the plan requirements for placement in a group residential housing 254.26facility under section 
         256I.04, subdivision 1a, or (3) who is eligible for a shelter needy 254.27payment under subdivision 5, paragraph (f), is the standard established in subdivision 3, 254.28paragraph (a) or (b).254.29    Sec. 105. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:254.30    Subd. 5. Special needs. In addition to the state standards of assistance established in 254.31subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 254.32Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 254.33center, or a group residential housing facility.255.1    (a) The county agency shall pay a monthly allowance for medically prescribed 255.2diets if the cost of those additional dietary needs cannot be met through some other 255.3maintenance benefit. The need for special diets or dietary items must be prescribed by 255.4a licensed physician. Costs for special diets shall be determined as percentages of the 255.5allotment for a one-person household under the thrifty food plan as defined by the United 255.6States Department of Agriculture. The types of diets and the percentages of the thrifty 255.7food plan that are covered are as follows:255.8    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;255.9    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 255.10of thrifty food plan;255.11    (3) controlled protein diet, less than 40 grams and requires special products, 125 255.12percent of thrifty food plan;255.13    (4) low cholesterol diet, 25 percent of thrifty food plan;255.14    (5) high residue diet, 20 percent of thrifty food plan;255.15    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;255.16    (7) gluten-free diet, 25 percent of thrifty food plan;255.17    (8) lactose-free diet, 25 percent of thrifty food plan;255.18    (9) antidumping diet, 15 percent of thrifty food plan;255.19    (10) hypoglycemic diet, 15 percent of thrifty food plan; or255.20    (11) ketogenic diet, 25 percent of thrifty food plan.255.21    (b) Payment for nonrecurring special needs must be allowed for necessary home 255.22repairs or necessary repairs or replacement of household furniture and appliances using 255.23the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 255.24as long as other funding sources are not available.255.25    (c) A fee for guardian or conservator service is allowed at a reasonable rate 255.26negotiated by the county or approved by the court. This rate shall not exceed five percent 255.27of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 255.28guardian or conservator is a member of the county agency staff, no fee is allowed.255.29    (d) The county agency shall continue to pay a monthly allowance of $68 for 255.30restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 255.311990, and who eats two or more meals in a restaurant daily. The allowance must continue 255.32until the person has not received Minnesota supplemental aid for one full calendar month 255.33or until the person's living arrangement changes and the person no longer meets the criteria 255.34for the restaurant meal allowance, whichever occurs first.255.35    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 255.36is allowed for representative payee services provided by an agency that meets the 256.1requirements under SSI regulations to charge a fee for representative payee services. This 256.2special need is available to all recipients of Minnesota supplemental aid regardless of 256.3their living arrangement.256.4    (f) Notwithstanding the language in this subdivision, an amount equal to the 256.5maximum allotment authorized by the federal Food Stamp Program for a single individual 256.6which is in effect on the first day of January July of the previous each year will be added to 256.7the standards of assistance established in subdivisions 1 to 4 for individuals adults under 256.8the age of 65 who qualify as shelter needy and are: (1) relocating from an institution, or 256.9an adult mental health residential treatment program under section 
         256B.0622, and who 256.10are shelter needy; (2) self-directed supports option participants defined under section 256.11256B.0657 if enacted in the 2007 legislative session; or (3) home and community-based 256.12waiver recipients living in their own rented, leased, or owned apartment or home not 256.13owned, operated, or controlled by a provider of service not related by blood or marriage. 256.14Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy 256.15benefit under subdivision 5, paragraph (f), is considered a household of one. An eligible 256.16individual who receives this benefit prior to age 65 may continue to receive the benefit 256.17after the age of 65.256.18    (g)(1) Persons eligible for shelter needy funding under paragraph (f), who are not 256.19receiving medial assistance home and community-based waiver services, are eligible for 256.20a state-funded transitional supports allowance under section 256B.49, subdivision 16, 256.21paragraph (e), to establish their own residence not owned, operated, or controlled by a 256.22provider of service not related by blood or marriage.256.23    (2) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 256.24exceed 40 percent of the assistance unit's gross income before the application of this 256.25special needs standard. "Gross income" for the purposes of this section is the applicant's or 256.26recipient's income as defined in section 
         256D.35, subdivision 10, or the standard specified 256.27in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 256.28state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 256.29considered shelter needy for purposes of this paragraph.256.30    Sec. 106. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:256.31    Subd. 3. Moratorium on the development of group residential housing beds. (a) 256.32County agencies shall not enter into agreements for new group residential housing beds 256.33with total rates in excess of the MSA equivalent rate except: (1) for group residential 256.34housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 256.35provided the facility is needed to meet the census reduction targets for persons with 257.1developmental disabilities at regional treatment centers; (2) to ensure compliance with 257.2the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements 257.3for inappropriately placed persons with developmental disabilities or mental illness; 257.4(3) up to 80 beds in a single, specialized facility located in Hennepin County that will 257.5provide housing for chronic inebriates who are repetitive users of detoxification centers 257.6and are refused placement in emergency shelters because of their state of intoxication, 257.7and planning for the specialized facility must have been initiated before July 1, 1991, in 257.8anticipation of receiving a grant from the Housing Finance Agency under section 
         462A.05, 257.9subdivision 20a
         , paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for 257.10up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County 257.11for homeless adults with a mental illness, a history of substance abuse, or human 257.12immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this 257.13section, "homeless adult" means a person who is living on the street or in a shelter or 257.14discharged from a regional treatment center, community hospital, or residential treatment 257.15program and has no appropriate housing available and lacks the resources and support 257.16necessary to access appropriate housing. At least 70 percent of the supportive housing 257.17units must serve homeless adults with mental illness, substance abuse problems, or human 257.18immunodeficiency virus or acquired immunodeficiency syndrome who are about to be 257.19or, within the previous six months, has been discharged from a regional treatment center, 257.20or a state-contracted psychiatric bed in a community hospital, or a residential mental 257.21health or chemical dependency treatment program. If a person meets the requirements of 257.22subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group 257.23residential housing rate for that person is limited to the supplementary rate under section 257.24256I.05, subdivision 1a
         , and is determined by subtracting the amount of the person's 257.25countable income that exceeds the MSA equivalent rate from the group residential housing 257.26supplementary rate. A resident in a demonstration project site who no longer participates 257.27in the demonstration program shall retain eligibility for a group residential housing 257.28payment in an amount determined under section 
         256I.06, subdivision 8, using the MSA 257.29equivalent rate. Service funding under section 
         256I.05, subdivision 1a, will end June 30, 257.301997, if federal matching funds are available and the services can be provided through a 257.31managed care entity. If federal matching funds are not available, then service funding will 257.32continue under section 
         256I.05, subdivision 1a; or (6) (5) for group residential housing 257.33beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which 257.34are used exclusively for recipients receiving home and community-based waiver services 257.35under sections 
         256B.0915, 
         256B.092, subdivision 5, 
         256B.093, and 
         256B.49, and who 257.36resided in a nursing facility for the six months immediately prior to the month of entry 258.1into the group residential housing setting. The group residential housing rate for these 258.2beds must be set so that the monthly group residential housing payment for an individual 258.3occupying the bed when combined with the nonfederal share of services delivered under 258.4the waiver for that person does not exceed the nonfederal share of the monthly medical 258.5assistance payment made for the person to the nursing facility in which the person resided 258.6prior to entry into the group residential housing establishment. The rate may not exceed 258.7the MSA equivalent rate plus $426.37 for any case.; or (6) for an additional two beds, 258.8resulting in a total of 32 beds, for a facility located in Hennepin County providing services 258.9for recovering and chemically dependent men that has had a group residential housing 258.10contract with the county and has been licensed as a board and lodge facility with special 258.11services since 1980; (7) for a group residential housing provider located in Stearns County 258.12that operates a 40-bed facility, that received financing through the Minnesota Housing 258.13Finance Agency Ending Long-Term Homelessness Initiative and serves chemically 258.14dependent clientele, providing 24-hour-a-day supervision; (8) for a group residential 258.15housing provider located in Crow Wing County that serves a chemically dependent 258.16clientele, providing 24-hour-a-day supervision and limiting a resident's maximum length 258.17of stay to 13 months out of a consecutive 24-month period; (9) for a 60-bed facility in 258.18St. Louis County which opened in January 2006 that will serve chemically dependent 258.19persons operated by a group residential housing provider that currently operates a 304-bed 258.20facility in Minneapolis; and (10) for a group residential housing provider that operates two 258.21ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 258.22which provide community support and serve the mental health needs of individuals who 258.23have chronically lived unsheltered, providing 24-hour-a-day supervision.258.24    (b) A county agency may enter into a group residential housing agreement for beds 258.25with rates in excess of the MSA equivalent rate in addition to those currently covered 258.26under a group residential housing agreement if the additional beds are only a replacement 258.27of beds with rates in excess of the MSA equivalent rate which have been made available 258.28due to closure of a setting, a change of licensure or certification which removes the beds 258.29from group residential housing payment, or as a result of the downsizing of a group 258.30residential housing setting. The transfer of available beds from one county to another can 258.31only occur by the agreement of both counties.258.32    Sec. 107. Minnesota Statutes 2006, section 256I.05, is amended by adding a 258.33subdivision to read:258.34    Subd. 1h.Supplementary rate for certain facilities serving chemically 258.35dependent males.Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a 259.1county agency shall negotiate a supplementary rate in addition to the rate specified in 259.2subdivision 1, not to exceed $737.87 per month, including any legislatively authorized 259.3inflationary adjustments, for a group residential housing provider that:259.4    (1) is located in Ramsey County and has had a group residential housing contract 259.5with the county since 1982 and has been licensed as a board and lodge facility with special 259.6services since 1979; and259.7    (2) serves recovering and chemically dependent males, providing 24-hour-a-day 259.8supervision.259.9    Sec. 108. Minnesota Statutes 2006, section 256I.05, is amended by adding a 259.10subdivision to read:259.11    Subd. 1i.Supplementary rate for certain facilities; Hennepin County.259.12    Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate 259.13a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 259.14per month, including any legislatively authorized inflationary adjustments, for a facility 259.15located in Hennepin County with a capacity of up to 48 beds that has been licensed since 259.161978 as a board and lodging facility and that until August 1, 2007, operated as a licensed 259.17chemical dependency treatment program.259.18EFFECTIVE DATE.This section is effective the day following final enactment.259.19    Sec. 109. Minnesota Statutes 2006, section 256I.05, is amended by adding a 259.20subdivision to read:259.21    Subd. 1j.Supplementary rate for certain facilities; St. Louis County.(a) 259.22Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 259.23county agency shall negotiate a supplementary rate in addition to the rate specified in 259.24subdivision 1, not to exceed $700 per month, including any legislatively authorized 259.25inflationary adjustments, for a 60-bed facility in St. Louis County which opened in 259.26January 2006 that will serve chemically dependent persons operated by a group residential 259.27housing provider that currently operates a 304-bed facility in Minneapolis.259.28    (b) The supplementary rate in paragraph (a) applies to the 48 beds which do not 259.29already receive a supplementary rate.259.30    Sec. 110. Minnesota Statutes 2006, section 256I.05, is amended by adding a 259.31subdivision to read:259.32    Subd. 1k.Supplementary rate for certain facilities; Crow Wing County.259.33    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 260.1county agency shall negotiate a supplementary rate in addition to the rate specified in 260.2subdivision 1, not to exceed $700 per month, including any legislatively authorized 260.3inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve 260.4chemically dependent persons operated by a group residential housing provider that 260.5currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which 260.6opened in January of 2006.260.7    Sec. 111. Minnesota Statutes 2006, section 256I.05, is amended by adding a 260.8subdivision to read:260.9    Subd. 1l.Supplementary rate for certain facilities; Stearns County.260.10    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 260.11shall negotiate a supplementary service rate in addition to the rate specified in subdivision 260.121, not to exceed $700 per month, including any legislatively authorized inflationary 260.13adjustments, for a group residential housing provider located in Stearns County that 260.14operates a 40-bed facility, that received financing through the Minnesota Housing Finance 260.15Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 260.16clientele, providing 24-hour-a-day supervision.260.17    Sec. 112. Minnesota Statutes 2006, section 256I.05, is amended by adding a 260.18subdivision to read:260.19    Subd. 1m.Supplementary rate for certain facilities; St. Louis County.260.20    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 260.21shall negotiate a supplementary service rate in addition to the rate specified in subdivision 260.221, not to exceed $700 per month, including any legislatively authorized inflationary 260.23adjustments, for a group residential housing provider located in St. Louis County that 260.24operates a 30-bed facility, that received financing through the Minnesota Housing Finance 260.25Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 260.26clientele, providing 24-hour-a-day supervision. 260.27    Sec. 113. Minnesota Statutes 2006, section 256I.05, is amended by adding a 260.28subdivision to read:260.29    Subd. 1n.Supplemental rate for certain facilities; Hennepin and Ramsey 260.30Counties.Notwithstanding the provisions of this section, beginning July 1, 2007, a county 260.31agency shall negotiate a supplemental service rate in addition to the rate specified in 260.32subdivision 1, not to exceed $715.78 per month, including any legislatively authorized 260.33inflationary adjustments, for a group residential housing provider that operates two 261.1ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 261.2which provide community support and serve the mental health needs of individuals who 261.3have chronically lived unsheltered, providing 24-hour-a-day supervision.261.4    Sec. 114. Laws 2000, chapter 340, section 19, is amended to read:261.5    Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.261.6    (a) Expenditures for housing with services and adult foster care shall be excluded 261.7when determining average monthly expenditures per client for alternative care pilot 261.8projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.261.9    (b) Alternative care pilot projects shall not expire on June 30, 2001, but shall 261.10continue until June 30, 2005 2007.261.11EFFECTIVE DATE.This section is effective retroactively from June 29, 2005, for 261.12activities related to discontinuing pilot projects under this section.261.13    Sec. 115. Laws 2006, chapter 282, article 20, section 37, is amended to read:261.14    Sec. 37. REPAYMENT DELAY.261.15    A county that overspent its allowed amounts in calendar year 2004 or 2005 under 261.16the waivered services program for persons with developmental disabilities shall not be 261.17required to pay back the amount of overspending until May 31, 2007.261.18EFFECTIVE DATE.This section is effective the day following final enactment.261.19    Sec. 116. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.261.20    (a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the 261.21recommendation of a county agency, the commissioner of human services shall grant a 261.22license with any necessary variances to a nonresidential program for youth which provides 261.23services to youth with disabilities under age 21 during nonschool hours established 261.24to ensure health and safety, prevent out-of-home placement, and increase community 261.25inclusion of youth with disabilities. The nonresidential youth program is subject to the 261.26conditions of any variances granted and with consumer rights under Minnesota Statutes, 261.27section 245B.04, consumer protection standards under Minnesota Statutes, section 261.28245B.05, service standards under Minnesota Statutes, section 245B.06, management 261.29standards under Minnesota Statutes, section 245B.07, and fire marshal inspections under 261.30Minnesota Statutes, section 245A.151, until the commissioner develops other licensure 261.31requirements for this type of program.262.1    (b) By February 1, 2008, the commissioner shall recommend amendments to 262.2licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of 262.3appropriate services for school-age youth with disabilities under age 21 who need 262.4supervision and services to develop skills necessary to maintain personal safety and 262.5increase their independence, productivity, and participation in their communities during 262.6nonschool hours. As part of developing the recommendations, the commissioner shall 262.7survey county agencies to determine how the needs of youth with disabilities under age 21 262.8who require supervision and support services are being met and the funding sources used. 262.9The recommendations must be provided to the house and senate chairs of the committees 262.10with jurisdiction over licensing of programs for youth with disabilities.262.11    Sec. 117. INDEPENDENT LIVING.262.12    An individual who has lived in one of the facilities under Minnesota Statutes, 262.13section 256I.05, subdivision 1n, who is being transitioned to independent living as 262.14part of the program plan continues to be eligible for group residential housing and the 262.15supplemental service rate negotiated with the county under Minnesota Statutes, section 262.16256I.05, subdivision 1n.262.17    Sec. 118. ASSISTIVE TECHNOLOGY RECOMMENDATIONS.262.18    Subdivision 1.Review.(a) During the biennium ending June 30, 2009, the Council 262.19on Disability shall facilitate a statewide review of the assistive technology needs of people 262.20with disabling conditions, and seniors. The council shall identify community-based 262.21service providers, state agencies, and other entities involved in providing assistive 262.22technology supports.262.23    (b) The council shall provide oversight and direction to the Minnesota Regions 262.24Assistive Technology Collaborative during the biennium ending June 30, 2009.262.25    Subd. 2.Recommendations.The council shall present to the chairs of the house 262.26and senate committees having jurisdiction over human services, by January 1, 2009, 262.27recommendations, including proposed legislation creating a statewide comprehensive plan 262.28to meet the assistive technology needs of people with disabling conditions and seniors. 262.29The statewide plan must include steps to coordinate and streamline assistive technology 262.30services.262.31    Sec. 119. COMMUNITY SERVICES PROVIDER RATE INCREASES.262.32    (a) The commissioner of human services shall increase allocations, reimbursement 262.33rates, or rate limits, as applicable, by three percent for the rate period beginning October 1, 263.12007, and the rate period beginning October 1, 2008, effective for services rendered on 263.2or after those dates.263.3    (b) The three percent annual rate increase described in this section must be provided 263.4to:263.5    (1) home and community-based waivered services for persons with developmental 263.6disabilities or related conditions under Minnesota Statutes, section 256B.501;263.7    (2) home and community-based waivered services for the elderly under Minnesota 263.8Statutes, section 256B.0915;263.9    (3) waivered services under community alternatives for disabled individuals under 263.10Minnesota Statutes, section 256B.49;263.11    (4) community alternative care waivered services under Minnesota Statutes, section 263.12256B.49;263.13    (5) traumatic brain injury waivered services under Minnesota Statutes, section 263.14256B.49;263.15    (6) nursing services and home health services under Minnesota Statutes, section 263.16256B.0625, subdivision 6a;263.17    (7) personal care services and nursing supervision of personal care services under 263.18Minnesota Statutes, section 256B.0625, subdivision 19a;263.19    (8) private duty nursing services under Minnesota Statutes, section 256B.0625, 263.20subdivision 7;263.21    (9) day training and habilitation services for adults with developmental disabilities 263.22or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 263.23additional cost of rate adjustments on day training and habilitation service, provided as a 263.24social service under Minnesota Statutes, section 256M.60;263.25    (10) alternative care services under Minnesota Statutes, section 256B.0913;263.26    (11) adult residential program grants under Minnesota Statutes, section 245.73;263.27    (12) adult and children's mental health grants under Minnesota Rules, parts 263.289535.1700 to 9535.1760;263.29    (13) the group residential housing supplementary service rate under Minnesota 263.30Statutes, section 256I.05, subdivision 1a;263.31    (14) adult mental health integrated fund grants under Minnesota Statutes, section 263.32245.4661;263.33    (15) semi-independent living services (SILS) under Minnesota Statutes, section 263.34252.275, including SILS funding under county social services grants formerly funded 263.35under Minnesota Statutes, chapter 256I;264.1    (16) community support services for deaf and hard-of-hearing adults with mental 264.2illness who use or wish to use sign language as their primary means of communication 264.3under Minnesota Statutes, section 256.01, subdivision 2;264.4    (17) living skills training programs for persons with intractable epilepsy who need 264.5assistance in the transition to independent living under Laws 1988, chapter 689;264.6    (18) physical therapy services under Minnesota Statutes, sections 256B.0625, 264.7subdivision 8, and 256D.03, subdivision 4;264.8    (19) occupational therapy services under Minnesota Statutes, sections 256B.0625, 264.9subdivision 8a, and 256D.03, subdivision 4;264.10    (20) speech-language therapy services under Minnesota Statutes, section 256D.03, 264.11subdivision 4, and Minnesota Rules, part 9505.0390; 264.12    (21) respiratory therapy services under Minnesota Statutes, section 256D.03, 264.13subdivision 4, and Minnesota Rules, part 9505.0295;264.14    (22) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, 264.15and 256B.0928;264.16    (23) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233; 264.17256C.25; Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter 264.185, section 20;264.19    (24) children's therapeutic services and supports under Minnesota Statutes, section 264.20256B.0943;264.21    (25) tier I chemical health services under Minnesota Statutes, chapter 254B;264.22    (26) consumer support grants under Minnesota Statutes, section 256.476;264.23    (27) family support grants under Minnesota Statutes, section 252.32;264.24    (28) case management services to persons with HIV or AIDS under Minnesota 264.25Statutes, section 256.01, subdivision 19; and264.26    (29) adult rehabilitative mental health services under Minnesota Statutes, section 264.27256B.0623.264.28    (c) Providers that receive a rate increase under this section shall use 75 percent of 264.29the additional revenue to increase wages and benefits and pay associated costs for all 264.30employees, except for management fees, the administrator, and central office staff.264.31    (d) For public employees, the increase for wages and benefits for certain staff is 264.32available and pay rates must be increased only to the extent that they comply with laws 264.33governing public employees' collective bargaining. Money received by a provider for pay 264.34increases under this section may be used only for increases implemented on or after the 264.35first day of the rate period in which the increase is available and must not be used for 264.36increases implemented prior to that date.265.1    (e) A copy of the provider's plan for complying with paragraph (c) must be made 265.2available to all employees by giving each employee a copy or by posting a copy in an area 265.3of the provider's operation to which all employees have access. If an employee does not 265.4receive the adjustment, if any, described in the plan and is unable to resolve the problem 265.5with the provider, the employee may contact the employee's union representative. If the 265.6employee is not covered by a collective bargaining agreement, the employee may contact 265.7the commissioner at a telephone number provided by the commissioner and included in 265.8the provider's plan. 265.9    (f) The commissioner and each county agency shall take steps necessary to 265.10implement the increases required by this section on the dates specified, and the increases 265.11must be effective on the dates specified, regardless of the client's service authorization date 265.12and notwithstanding the terms of any provider contract, service agreement, or schedule 265.13that limits when a county may increase payment rates.265.14    Sec. 120. DENTAL ACCESS FOR PERSONS WITH DISABILITIES.265.15    The commissioner of human services shall study access to dental services for 265.16persons with disabilities, and shall present recommendations for improving access to 265.17dental services to the legislature by January 15, 2008. The study must examine physical 265.18and geographic access, the willingness of dentists to serve persons with disabilities 265.19enrolled in state health care programs, reimbursement rates for dental service providers, 265.20and other factors identified by the commissioner.265.21    Sec. 121. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.265.22    By October 1, 2007, the commissioner shall seek federal approval to allow persons 265.23who have been eligible for medical assistance for employed persons with disabilities 265.24(MA-EPD) under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24 265.25consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility 265.26rules as long as they qualify.265.27    Sec. 122. MINNESOTA RULES.265.28    The Department of Administration shall publish adopted rules in the State Register 265.29making the terminology changes specified in section 92 in Minnesota Rules. Upon 265.30publication in the State Register, the terminology changes for Minnesota Rules are 265.31adopted without further administrative action.265.32    Sec. 123. REVISOR'S INSTRUCTION.266.1    The revisor of statutes shall change the terms in column A to the terms in column B 266.2wherever they appear in Minnesota Statutes:

266.3Column AColumn B266.4266.5266.6266.7266.8"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans""Office of Ombudsman for Long-Term Care"266.9266.10"ombudsman for older Minnesotans""ombudsman for long-term care"

266.11    Sec. 124. REPEALER.266.12Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 266.13252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h; 266.14and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.266.15ARTICLE 5266.16MENTAL HEALTH266.17    Section 1. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to 266.18read:266.19    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the 266.20brain or a clinically significant disorder of thought, mood, perception, orientation, 266.21memory, or behavior that is listed in the clinical manual of the International Classification 266.22of Diseases (ICD-9-CM), current edition, code range 290.0 to 
         302.99 or 306.0 to 316.0 266.23or the corresponding code in the American Psychiatric Association's Diagnostic and 266.24Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and 266.25that seriously limits a person's capacity to function in primary aspects of daily living such 266.26as personal relations, living arrangements, work, and recreation. 266.27    (b) An "adult with acute mental illness" means an adult who has a mental illness that 266.28is serious enough to require prompt intervention.266.29    (c) For purposes of case management and community support services, a "person 266.30with serious and persistent mental illness" means an adult who has a mental illness and 266.31meets at least one of the following criteria:266.32    (1) the adult has undergone two or more episodes of inpatient care for a mental 266.33illness within the preceding 24 months;266.34    (2) the adult has experienced a continuous psychiatric hospitalization or residential 266.35treatment exceeding six months' duration within the preceding 12 months;267.1    (3) the adult has been treated by a crisis team two or more times within the preceding 267.224 months;267.3    (4) the adult:267.4    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline 267.5personality disorder;267.6    (ii) indicates a significant impairment in functioning; and267.7    (iii) has a written opinion from a mental health professional, in the last three years, 267.8stating that the adult is reasonably likely to have future episodes requiring inpatient or 267.9residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 267.10management or community support services are provided;267.11    (4) (5) the adult has, in the last three years, been committed by a court as a person 267.12who is mentally ill under chapter 253B, or the adult's commitment has been stayed or 267.13continued; or267.14    (5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time 267.15period has expired or the adult was eligible as a child under section 
         245.4871, subdivision 267.166
         ; and (ii) has a written opinion from a mental health professional, in the last three years, 267.17stating that the adult is reasonably likely to have future episodes requiring inpatient or 267.18residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 267.19management or community support services are provided. 267.20    Sec. 2. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision 267.21to read:267.22    Subd. 3.Responsibility not duplicated.For individuals who have health care 267.23coverage, the county board is not responsible for providing mental health services which 267.24are within the limits of the individual's health care coverage.267.25    Sec. 3. Minnesota Statutes 2006, section 245.4874, is amended to read:267.26245.4874 DUTIES OF COUNTY BOARD.267.27    Subdivision 1.Duties of the county board. (a) The county board must:267.28    (1) develop a system of affordable and locally available children's mental health 267.29services according to sections 
         245.487 to 
         245.4887;267.30    (2) establish a mechanism providing for interagency coordination as specified in 267.31section 
         245.4875, subdivision 6;267.32    (3) consider the assessment of unmet needs in the county as reported by the local 267.33children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 268.1(b), clause (3). The county shall provide, upon request of the local children's mental health 268.2advisory council, readily available data to assist in the determination of unmet needs;268.3    (4) assure that parents and providers in the county receive information about how to 268.4gain access to services provided according to sections 
         245.487 to 
         245.4887;268.5    (5) coordinate the delivery of children's mental health services with services 268.6provided by social services, education, corrections, health, and vocational agencies to 268.7improve the availability of mental health services to children and the cost-effectiveness of 268.8their delivery;268.9    (6) assure that mental health services delivered according to sections 
         245.487268.10to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 268.11assessment and individual treatment plan;268.12    (7) provide the community with information about predictors and symptoms of 268.13emotional disturbances and how to access children's mental health services according to 268.14sections 
         245.4877 and 
         245.4878;268.15    (8) provide for case management services to each child with severe emotional 268.16disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 268.17subdivisions 1, 3, and 5
         ;268.18    (9) provide for screening of each child under section 
         245.4885 upon admission 268.19to a residential treatment facility, acute care hospital inpatient treatment, or informal 268.20admission to a regional treatment center;268.21    (10) prudently administer grants and purchase-of-service contracts that the county 268.22board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 268.23245.4887
         ;268.24    (11) assure that mental health professionals, mental health practitioners, and case 268.25managers employed by or under contract to the county to provide mental health services 268.26are qualified under section 
         245.4871;268.27    (12) assure that children's mental health services are coordinated with adult mental 268.28health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 268.29health services is available to serve persons with mental illness, regardless of the person's 268.30age;268.31    (13) assure that culturally informed mental health consultants are used as necessary 268.32to assist the county board in assessing and providing appropriate treatment for children of 268.33cultural or racial minority heritage; and268.34    (14) consistent with section 
         245.486, arrange for or provide a children's mental 268.35health screening to a child receiving child protective services or a child in out-of-home 268.36placement, a child for whom parental rights have been terminated, a child found to be 269.1delinquent, and a child found to have committed a juvenile petty offense for the third or 269.2subsequent time, unless a screening has been performed within the previous 180 days, or 269.3the child is currently under the care of a mental health professional. The court or county 269.4agency must notify a parent or guardian whose parental rights have not been terminated of 269.5the potential mental health screening and the option to prevent the screening by notifying 269.6the court or county agency in writing. The screening shall be conducted with a screening 269.7instrument approved by the commissioner of human services according to criteria that 269.8are updated and issued annually to ensure that approved screening instruments are valid 269.9and useful for child welfare and juvenile justice populations, and shall be conducted 269.10by a mental health practitioner as defined in section 
         245.4871, subdivision 26, or a 269.11probation officer or local social services agency staff person who is trained in the use of 269.12the screening instrument. Training in the use of the instrument shall include training in the 269.13administration of the instrument, the interpretation of its validity given the child's current 269.14circumstances, the state and federal data practices laws and confidentiality standards, the 269.15parental consent requirement, and providing respect for families and cultural values. 269.16If the screen indicates a need for assessment, the child's family, or if the family lacks 269.17mental health insurance, the local social services agency, in consultation with the child's 269.18family, shall have conducted a diagnostic assessment, including a functional assessment, 269.19as defined in section 
         245.4871. The administration of the screening shall safeguard the 269.20privacy of children receiving the screening and their families and shall comply with the 269.21Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance 269.22Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be 269.23considered private data and the commissioner shall not collect individual screening results.269.24    (b) When the county board refers clients to providers of children's therapeutic 269.25services and supports under section 
         256B.0943, the county board must clearly identify 269.26the desired services components not covered under section 
         256B.0943 and identify the 269.27reimbursement source for those requested services, the method of payment, and the 269.28payment rate to the provider.269.29    Subd. 2.Responsibility not duplicated.For individuals who have health care 269.30coverage, the county board is not responsible for providing mental health services which 269.31are within the limits of the individual's health care coverage.269.32    Sec. 4. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:269.33    Subd. 5. Special contracts; bordering states. (a) An individual who is detained, 269.34committed, or placed on an involuntary basis under chapter 253B may be confined or 269.35treated in a bordering state pursuant to a contract under this section. An individual who is 270.1detained, committed, or placed on an involuntary basis under the civil law of a bordering 270.2state may be confined or treated in Minnesota pursuant to a contract under this section. A 270.3peace or health officer who is acting under the authority of the sending state may transport 270.4an individual to a receiving agency that provides services pursuant to a contract under 270.5this section and may transport the individual back to the sending state under the laws 270.6of the sending state. Court orders valid under the law of the sending state are granted 270.7recognition and reciprocity in the receiving state for individuals covered by a contract 270.8under this section to the extent that the court orders relate to confinement for treatment 270.9or care of mental illness or chemical dependency. Such treatment or care may address 270.10other conditions that may be co-occurring with the mental illness or chemical dependency. 270.11These court orders are not subject to legal challenge in the courts of the receiving state. 270.12Individuals who are detained, committed, or placed under the law of a sending state and 270.13who are transferred to a receiving state under this section continue to be in the legal 270.14custody of the authority responsible for them under the law of the sending state. Except 270.15in emergencies, those individuals may not be transferred, removed, or furloughed from 270.16a receiving agency without the specific approval of the authority responsible for them 270.17under the law of the sending state.270.18    (b) While in the receiving state pursuant to a contract under this section, an 270.19individual shall be subject to the sending state's laws and rules relating to length of 270.20confinement, reexaminations, and extensions of confinement. No individual may be sent 270.21to another state pursuant to a contract under this section until the receiving state has 270.22enacted a law recognizing the validity and applicability of this section.270.23    (c) If an individual receiving services pursuant to a contract under this section leaves 270.24the receiving agency without permission and the individual is subject to involuntary 270.25confinement under the law of the sending state, the receiving agency shall use all 270.26reasonable means to return the individual to the receiving agency. The receiving agency 270.27shall immediately report the absence to the sending agency. The receiving state has the 270.28primary responsibility for, and the authority to direct, the return of these individuals 270.29within its borders and is liable for the cost of the action to the extent that it would be 270.30liable for costs of its own resident.270.31    (d) Responsibility for payment for the cost of care remains with the sending agency.270.32    (e) This subdivision also applies to county contracts under subdivision 2 which 270.33include emergency care and treatment provided to a county resident in a bordering state.270.34    (f) If a Minnesota resident is admitted to a facility in a bordering state under this 270.35chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or 270.36an advance practice registered nurse certified in mental health, who is licensed in the 271.1bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092, 271.2253B.12, and 253B.17 subject to the same requirements and limitations in section 271.3253B.02, subdivision 7.271.4    Sec. 5. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:271.5    Subd. 2. Program. The commissioner of human services shall establish a program 271.6for the treatment of compulsive gamblers. The commissioner may contract with an 271.7entity with expertise regarding the treatment of compulsive gambling to operate the 271.8program. The program may include the establishment of a statewide toll-free number, 271.9resource library, public education programs; regional in-service training programs and 271.10conferences for health care professionals, educators, treatment providers, employee 271.11assistance programs, and criminal justice representatives; and the establishment of 271.12certification standards for programs and service providers. The commissioner may enter 271.13into agreements with other entities and may employ or contract with consultants to 271.14facilitate the provision of these services or the training of individuals to qualify them to 271.15provide these services. The program may also include inpatient and outpatient treatment 271.16and rehabilitation services and for residents in a temporary or permanent residential 271.17setting for mental health or chemical dependency, and individuals in jails or correctional 271.18facilities. The program may also include research studies. The research studies must 271.19include baseline and prevalence studies for adolescents and adults to identify those at the 271.20highest risk. The program must be approved by the commissioner before it is established.271.21    Sec. 6. Minnesota Statutes 2006, section 245.98, subdivision 5, is amended to read:271.22    Subd. 5. Standards. The commissioner shall create standards for treatment and 271.23provider qualifications for the treatment component of the compulsive gambling program.271.24The commissioner, in coordination with the commissioner of corrections, shall create 271.25standards for the assessment and treatment of compulsive gamblers in programs operated 271.26by the commissioner of corrections.271.27    Sec. 7. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.271.28    Prior to placement of a child in a foster care home, the child foster care provider, if 271.29required to be licensed, must complete two hours of training that addresses the causes, 271.30symptoms, and key warning signs of mental health disorders; cultural considerations; and 271.31effective approaches for dealing with a child's behaviors. At least one hour of the annual 271.3212-hour training requirement for foster parents must be on children's mental health issues 272.1and treatment. Training curriculum shall be approved by the commissioner of human 272.2services.272.3    Sec. 8. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:272.4    Subdivision 1. County portion for cost of care. Except for chemical dependency 272.5services provided under sections 
         254B.01 to 
         254B.09, the client's county shall pay to the 272.6state of Minnesota a portion of the cost of care provided in a regional treatment center 272.7or a state nursing facility to a client legally settled in that county. A county's payment 272.8shall be made from the county's own sources of revenue and payments shall be paid as 272.9follows: payments to the state from the county shall equal 20 percent a percentage of the 272.10cost of care, as determined by the commissioner, for each day, or the portion thereof, that 272.11the client spends at a regional treatment center or a state nursing facility. according to 272.12the following schedule for each admission:272.13    (1) for the first 30 days: 20 percent until January 1, 2008, ten percent from January 272.141, 2008, to June 30, 2009, and zero percent thereafter;272.15    (2) 20 percent for days 31 to 60; and272.16    (3) for any days over 60: 20 percent until January 1, 2008, 30 percent from January 272.171, 2008, to June 30, 2009, 40 percent from July 1, 2009, to June 30, 2010, and 50 percent 272.18thereafter.272.19 If payments received by the state under sections 
         246.50 to 
         246.53 exceed 80 percent the 272.20noncounty portion of the cost of care, the county shall be responsible for paying the state 272.21only the remaining amount. The county shall not be entitled to reimbursement from 272.22the client, the client's estate, or from the client's relatives, except as provided in section 272.23246.53
         . No such payments shall be made for any client who was last committed prior to 272.24July 1, 1947.272.25    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to 272.26read:272.27    Subd. 20. Mental health case management. (a) To the extent authorized by rule 272.28of the state agency, medical assistance covers case management services to persons with 272.29serious and persistent mental illness and children with severe emotional disturbance. 272.30Services provided under this section must meet the relevant standards in sections 
         245.461272.31to 
         245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota 272.32Rules, parts 
         9520.0900 to 
         9520.0926, and 
         9505.0322, excluding subpart 10. 272.33    (b) Entities meeting program standards set out in rules governing family community 272.34support services as defined in section 
         245.4871, subdivision 17, are eligible for medical 273.1assistance reimbursement for case management services for children with severe 273.2emotional disturbance when these services meet the program standards in Minnesota 273.3Rules, parts 
         9520.0900 to 
         9520.0926 and 
         9505.0322, excluding subparts 6 and 10. 273.4    (c) Medical assistance and MinnesotaCare payment for mental health case 273.5management shall be made on a monthly basis. In order to receive payment for an eligible 273.6child, the provider must document at least a face-to-face contact with the child, the child's 273.7parents, or the child's legal representative. To receive payment for an eligible adult, the 273.8provider must document:273.9    (1) at least a face-to-face contact with the adult or the adult's legal representative; or273.10    (2) at least a telephone contact with the adult or the adult's legal representative and 273.11document a face-to-face contact with the adult or the adult's legal representative within 273.12the preceding two months.273.13    (d) Payment for mental health case management provided by county or state staff 273.14shall be based on the monthly rate methodology under section 
         256B.094, subdivision 6, 273.15paragraph (b), with separate rates calculated for child welfare and mental health, and 273.16within mental health, separate rates for children and adults. 273.17    (e) Payment for mental health case management provided by Indian health services 273.18or by agencies operated by Indian tribes may be made according to this section or other 273.19relevant federally approved rate setting methodology.273.20    (f) Payment for mental health case management provided by vendors who contract 273.21with a county or Indian tribe shall be based on a monthly rate negotiated by the host county 273.22or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 273.23service to other payers. If the service is provided by a team of contracted vendors, the 273.24county or tribe may negotiate a team rate with a vendor who is a member of the team. The 273.25team shall determine how to distribute the rate among its members. No reimbursement 273.26received by contracted vendors shall be returned to the county or tribe, except to reimburse 273.27the county or tribe for advance funding provided by the county or tribe to the vendor.273.28    (g) If the service is provided by a team which includes contracted vendors, tribal 273.29staff, and county or state staff, the costs for county or state staff participation in the team 273.30shall be included in the rate for county-provided services. In this case, the contracted 273.31vendor, the tribal agency, and the county may each receive separate payment for services 273.32provided by each entity in the same month. In order to prevent duplication of services, 273.33each entity must document, in the recipient's file, the need for team case management and 273.34a description of the roles of the team members.273.35    (h) The commissioner shall calculate the nonfederal share of actual medical 273.36assistance and general assistance medical care payments for each county, based on the 274.1higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999, 274.2and transfer one-half of the result from medical assistance and general assistance medical 274.3care to each county's mental health grants under section 
         256E.12 for calendar year 1999. 274.4The annualized minimum amount added to each county's mental health grant shall be 274.5$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce 274.6the statewide growth factor in order to fund these minimums. The annualized total amount 274.7transferred shall become part of the base for future mental health grants for each county. 274.8    (i) Notwithstanding section 
         256B.19, subdivision 1, the nonfederal share of costs 274.9for mental health case management shall be provided by the recipient's county of 274.10responsibility, as defined in sections 
         256G.01 to 
         256G.12, from sources other than federal 274.11funds or funds used to match other federal funds. If the service is provided by a tribal 274.12agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this 274.13service is paid by the state without a federal share through fee-for-service, 50 percent of 274.14the cost shall be provided by the recipient's county of responsibility.274.15    (j) Notwithstanding any administrative rule to the contrary, prepaid medical 274.16assistance, general assistance medical care, and MinnesotaCare include mental health case 274.17management. When the service is provided through prepaid capitation, the nonfederal 274.18share is paid by the state and the county pays no share.274.19    (j)(k) The commissioner may suspend, reduce, or terminate the reimbursement to a 274.20provider that does not meet the reporting or other requirements of this section. The county 274.21of responsibility, as defined in sections 
         256G.01 to 
         256G.12, or, if applicable, the tribal 274.22agency, is responsible for any federal disallowances. The county or tribe may share this 274.23responsibility with its contracted vendors. 274.24    (k)(l) The commissioner shall set aside a portion of the federal funds earned for 274.25county expenditures under this section to repay the special revenue maximization account 274.26under section 
         256.01, subdivision 2, clause (15). The repayment is limited to: 274.27    (1) the costs of developing and implementing this section; and274.28    (2) programming the information systems.274.29    (l)(m) Payments to counties and tribal agencies for case management expenditures 274.30under this section shall only be made from federal earnings from services provided 274.31under this section. When this service is paid by the state without a federal share through 274.32fee-for-service, 50 percent of the cost shall be provided by the state. Payments to 274.33county-contracted vendors shall include both the federal earnings, the state share, and the 274.34county share.274.35    (m)(n) Notwithstanding section 
         256B.041, county payments for the cost of mental 274.36health case management services provided by county or state staff shall not be made 275.1to the commissioner of finance. For the purposes of mental health case management 275.2services provided by county or state staff under this section, the centralized disbursement 275.3of payments to counties under section 
         256B.041 consists only of federal earnings from 275.4services provided under this section. 275.5    (n)(o) Case management services under this subdivision do not include therapy, 275.6treatment, legal, or outreach services.275.7    (o)(p) If the recipient is a resident of a nursing facility, intermediate care facility, 275.8or hospital, and the recipient's institutional care is paid by medical assistance, payment 275.9for case management services under this subdivision is limited to the last 180 days of 275.10the recipient's residency in that facility and may not exceed more than six months in a 275.11calendar year.275.12    (p)(q) Payment for case management services under this subdivision shall not 275.13duplicate payments made under other program authorities for the same purpose.275.14    (q)(r) By July 1, 2000, the commissioner shall evaluate the effectiveness of the 275.15changes required by this section, including changes in number of persons receiving 275.16mental health case management, changes in hours of service per person, and changes in 275.17caseload size.275.18    (r)(s) For each calendar year beginning with the calendar year 2001, the annualized 275.19amount of state funds for each county determined under paragraph (h) shall be adjusted by 275.20the county's percentage change in the average number of clients per month who received 275.21case management under this section during the fiscal year that ended six months prior to 275.22the calendar year in question, in comparison to the prior fiscal year.275.23    (s)(t) For counties receiving the minimum allocation of $3,000 or $5,000 described 275.24in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county 275.25receives the higher of the following amounts:275.26    (1) a continuation of the minimum allocation in paragraph (h); or275.27    (2) an amount based on that county's average number of clients per month who 275.28received case management under this section during the fiscal year that ended six months 275.29prior to the calendar year in question, times the average statewide grant per person per 275.30month for counties not receiving the minimum allocation.275.31    (t)(u) The adjustments in paragraphs (s) and (t) shall be calculated separately for 275.32children and adults.275.33EFFECTIVE DATE.This section is effective January 1, 2009, except the 275.34amendment to paragraph (i) is effective January 1, 2008.276.1    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to 276.2read:276.3    Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject 276.4to federal approval, medical assistance covers treatment foster care services according to 276.5section 
         256B.0946.276.6    Sec. 11. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to 276.7read:276.8    Subd. 4. Payment rates. (a) Notwithstanding sections 
         256B.19 and 
         256B.041, 276.9payments to counties for residential services provided by a residential facility shall only 276.10be made of federal earnings for services provided under this section, and the nonfederal 276.11share of costs for services provided under this section shall be paid by the county from 276.12sources other than federal funds or funds used to match other federal funds. Payment to 276.13counties for services provided according to this section shall be a proportion of the per 276.14day contract rate that relates to rehabilitative mental health services and shall not include 276.15payment for costs or services that are billed to the IV-E program as room and board. 276.16    (b) Per diem rates paid to providers under this section by prepaid plans shall be the 276.17proportion of the per-day contract rate that relates to rehabilitative mental health services 276.18and shall not include payment for group foster care costs or services that are billed to the 276.19county of financial responsibility.276.20    (c) The commissioner shall set aside a portion not to exceed five percent of the 276.21federal funds earned for county expenditures under this section to cover the state costs of 276.22administering this section. Any unexpended funds from the set-aside shall be distributed 276.23to the counties in proportion to their earnings under this section.276.24EFFECTIVE DATE.This section is effective January 1, 2009.276.25    Sec. 12. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:276.26    Subd. 5g. Payment for covered services. For services rendered on or after January 276.271, 2003, the total payment made to managed care plans for providing covered services 276.28under the medical assistance and general assistance medical care programs is reduced by 276.29.5 percent from their current statutory rates. This provision excludes payments for nursing 276.30home services, home and community-based waivers, and payments to demonstration 276.31projects for persons with disabilities, and mental health services added as covered benefits 276.32after December 31, 2007.276.33    Sec. 13. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:277.1    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g, 277.2the total payment made to managed care plans under the medical assistance program is 277.3reduced 1.0 percent for services provided on or after October 1, 2003, and an additional 277.41.0 percent for services provided on or after January 1, 2004. This provision excludes 277.5payments for nursing home services, home and community-based waivers, and payments 277.6to demonstration projects for persons with disabilities, and mental health services added as 277.7covered benefits after December 1, 2007.277.8    Sec. 14. Minnesota Statutes 2006, section 256B.763, is amended to read:277.9256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.277.10    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007, 277.11payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 277.122006, for:277.13    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;277.14    (2) community mental health centers under section 
         256B.0625, subdivision 5; and277.15    (3) mental health clinics and centers certified under Minnesota Rules, parts 277.169520.0750
          to 
         9520.0870, or hospital outpatient psychiatric departments that are designated 277.17as essential community providers under section 
         62Q.19.277.18    (b) This increase applies to group skills training when provided as a component of 277.19children's therapeutic services and support, psychotherapy, medication management, 277.20evaluation and management, diagnostic assessment, explanation of findings, psychological 277.21testing, neuropsychological services, direction of behavioral aides, and inpatient 277.22consultation.277.23    (c) This increase does not apply to rates that are governed by section 
         256B.0625, 277.24subdivision 30, or 
         256B.761, paragraph (b), other cost-based rates, rates that are 277.25negotiated with the county, rates that are established by the federal government, or rates 277.26that increased between January 1, 2004, and January 1, 2005.277.27    (d) The commissioner shall adjust rates paid to prepaid health plans under contract 277.28with the commissioner to reflect the rate increases provided in paragraph (a). The prepaid 277.29health plan must pass this rate increase to the providers identified in paragraph (a)277.30paragraphs (a), (e), and (f). The prepaid plan must pass this rate increase to the providers 277.31identified in paragraphs (a), (e), and (f).277.32    (e) For MinnesotaCare only, payment rates shall be increased by 23.7 percent over 277.33the rates in effect on December 31, 2007, for:277.34    (1) medication education services provided on or after January 1, 2008, by adult 277.35rehabilitative mental health services providers certified under section 256B.0623; and278.1    (2) mental health behavioral aide services provided on or after January 1, 2008, by 278.2children's therapeutic services and support providers certified under section 256B.0943.278.3    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by 278.4children's therapeutic services and support providers certified under section 256B.0943 278.5and not already included in paragraph (a), payment rates for MinnesotaCare shall be 278.6increased by 23.7 percent over the rates in effect on December 31, 2007.278.7    Sec. 15. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:278.8    Subdivision 1. Covered health services. For individuals under section 
         256L.04, 278.9subdivision 7
         , with income no greater than 75 percent of the federal poverty guidelines 278.10or for families with children under section 
         256L.04, subdivision 1, all subdivisions of 278.11this section apply. "Covered health services" means the health services reimbursed 278.12under chapter 256B, with the exception of inpatient hospital services, special education 278.13services, private duty nursing services, adult dental care services other than services 278.14covered under section 
         256B.0625, subdivision 9, orthodontic services, nonemergency 278.15medical transportation services, personal care assistant and case management services, 278.16nursing home or intermediate care facilities services, inpatient mental health services, 278.17and chemical dependency services. Outpatient mental health services covered under the 278.18MinnesotaCare program are limited to diagnostic assessments, psychological testing, 278.19explanation of findings, mental health telemedicine, psychiatric consultation, medication 278.20management by a physician, day treatment, partial hospitalization, and individual, family, 278.21and group psychotherapy.278.22    "Covered health services" also includes intensive mental health outpatient treatment 278.23for dialectical behavioral therapy for adults.278.24    No public funds shall be used for coverage of abortion under MinnesotaCare 278.25except where the life of the female would be endangered or substantial and irreversible 278.26impairment of a major bodily function would result if the fetus were carried to term; or 278.27where the pregnancy is the result of rape or incest.278.28    Covered health services shall be expanded as provided in this section.278.29EFFECTIVE DATE.This section is effective January 1, 2008, except coverage for 278.30mental health case management is effective January 1, 2009.278.31    Sec. 16. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:278.32    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 278.33and (c), the MinnesotaCare benefit plan shall include the following co-payments and 278.34coinsurance requirements for all enrollees:279.1    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 279.2subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 279.3$3,000 per family;279.4    (2) $3 per prescription for adult enrollees;279.5    (3) $25 for eyeglasses for adult enrollees;279.6    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 279.7episode of service which is required because of a recipient's symptoms, diagnosis, or 279.8established illness, and which is delivered in an ambulatory setting by a physician or 279.9physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 279.10audiologist, optician, or optometrist; and279.11    (5) $6 for nonemergency visits to a hospital-based emergency room.279.12    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 279.13children under the age of 21 in households with family income equal to or less than 175 279.14percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 279.15parents and relative caretakers of children under the age of 21 in households with family 279.16income greater than 175 percent of the federal poverty guidelines for inpatient hospital 279.17admissions occurring on or after January 1, 2001.279.18    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children 279.19under the age of 21.279.20    (d) Paragraph (a), clause (4), does not apply to mental health services.279.21    (e) Adult enrollees with family gross income that exceeds 175 percent of the 279.22federal poverty guidelines and who are not pregnant shall be financially responsible for 279.23the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 279.24hospital benefit limit.279.25    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 279.26or changes from one prepaid health plan to another during a calendar year, any charges 279.27submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 279.28expenses incurred by the enrollee for inpatient services, that were submitted or incurred 279.29prior to enrollment, or prior to the change in health plans, shall be disregarded.279.30    Sec. 17. Minnesota Statutes 2006, section 256L.035, is amended to read:279.31256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE 279.32ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.279.33    (a) "Covered health services" for individuals under section 
         256L.04, subdivision 279.347
         , with income above 75 percent, but not exceeding 175 percent, of the federal poverty 279.35guideline means:280.1    (1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and 280.2subject to an annual limitation of $10,000;280.3    (2) physician services provided during an inpatient stay; and280.4    (3) physician services not provided during an inpatient stay; outpatient hospital 280.5services; freestanding ambulatory surgical center services; chiropractic services; lab and 280.6diagnostic services; diabetic supplies and equipment; mental health services as covered 280.7under chapter 256B; and prescription drugs; subject to the following co-payments:280.8    (i) $50 co-pay per emergency room visit;280.9    (ii) $3 co-pay per prescription drug; and280.10    (iii) $5 co-pay per nonpreventive visit; except this co-pay does not apply to mental 280.11health services or community mental health services.280.12The services covered under this section may be provided by a physician, physician 280.13ancillary, chiropractor, psychologist, or licensed independent clinical social worker, or 280.14other mental health providers covered under chapter 256B if the services are within the 280.15scope of practice of that health care professional.280.16    For purposes of this section, "a visit" means an episode of service which is required 280.17because of a recipient's symptoms, diagnosis, or established illness, and which is delivered 280.18in an ambulatory setting by any health care provider identified in this paragraph.280.19    Enrollees are responsible for all co-payments in this section.280.20    (b) Reimbursement to the providers shall be reduced by the amount of the 280.21co-payment, except that reimbursement for prescription drugs shall not be reduced once a 280.22recipient has reached the $20 per month maximum for prescription drug co-payments. 280.23The provider collects the co-payment from the recipient. Providers may not deny services 280.24to recipients who are unable to pay the co-payment, except as provided in paragraph (c).280.25    (c) If it is the routine business practice of a provider to refuse service to an individual 280.26with uncollected debt, the provider may include uncollected co-payments under this 280.27section. A provider must give advance notice to a recipient with uncollected debt before 280.28services can be denied.280.29EFFECTIVE DATE.This section is effective January 1, 2008, except coverage 280.30for mental health case management under paragraph (a), clause (3), is effective January 280.311, 2009.280.32    Sec. 18. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:280.33    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after 280.34October 1, 2003, the total payment made to managed care plans under the MinnesotaCare 281.1program is reduced 1.0 percent. This provision excludes payments for mental health 281.2services added as covered benefits after December 31, 2007.281.3    Sec. 19. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:281.4    Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted 281.5of theft under section 
         609.52, embezzlement of public funds under section 
         609.54, or 281.6forgery under section 
         609.625, 
         609.63, or 
         609.631, the probation officer shall determine in 281.7the report prepared under subdivision 1 whether or not compulsive gambling contributed 281.8to the commission of the offense. If so, the report shall contain the results of a compulsive 281.9gambling assessment conducted in accordance with this subdivision. The probation officer 281.10shall make an appointment for the offender to undergo the assessment if so indicated. 281.11    (b) The compulsive gambling assessment report must include a recommended level 281.12of treatment for the offender if the assessor concludes that the offender is in need of 281.13compulsive gambling treatment. The assessment must be conducted by an assessor 281.14qualified under section 
         245.98, subdivision 2a, to perform these assessments or to 281.15provide compulsive gambling treatment. An assessor providing a compulsive gambling 281.16assessment may not have any direct or shared financial interest or referral relationship 281.17resulting in shared financial gain with a treatment provider. If an independent assessor is 281.18not available, the probation officer may use the services of an assessor with a financial 281.19interest or referral relationship as authorized under rules adopted by the commissioner 281.20of human services under section 
         245.98, subdivision 2a. 281.21    (c) The commissioner of human services shall reimburse the assessor for the 281.22costs associated with a compulsive gambling assessment at a rate established by the 281.23commissioner up to a maximum of $100 for each assessment. To the extent practicable, the 281.24commissioner shall standardize reimbursement rates for assessments. The commissioner 281.25shall reimburse these costs after receiving written verification from the probation officer 281.26that the assessment was performed and found acceptable.281.27    Sec. 20. REPORT.281.28    The commissioner shall make a report to the legislature by January 15, 2008, 281.29regarding the transfer of funds to counties for state registered nurses employed in 281.30community mental health pilot projects as part of the assertive community treatment 281.31teams under Minnesota Statutes, section 245.4661. The report shall address the impact 281.32of the nursing shortage on replacing these positions, continuity of patient care if these 281.33positions cannot be filled, and ways to maintain state registered nurses in these positions 282.1until the nurse retires or leaves employment. No funds for state registered nurse positions 282.2may be transferred before the report date.282.3    Sec. 21. CASE MANAGEMENT; BEST PRACTICES.282.4    The commissioner of human services, in consultation with consumers, families, 282.5counties, and other interested stakeholders, will develop recommendations for changes in 282.6the adult mental health act related to case management, consistent with evidence-based 282.7and best practices.282.8    Sec. 22. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.282.9    Subdivision 1.Pilot project authorized; purpose.A two-year Regional Children's 282.10Mental Health Initiative pilot project is established to improve children's mental health 282.11service coordination, communication, and processes in Blue Earth, Brown, Faribault, 282.12Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The 282.13purpose of the Regional Children's Mental Health Initiative will be to plan and develop 282.14new programs and services related to children's mental health in south central Minnesota.282.15    Subd. 2.Goals.To accomplish its purpose, the Regional Children's Mental Health 282.16Initiative shall have the following goals:282.17    (1) work to streamline delivery and regional access to services;282.18    (2) share strategies and resources for the management of out-of-home placements;282.19    (3) establish standard protocols and operating procedures for functions that are 282.20performed across all counties;282.21    (4) share information to improve resource allocation and service delivery across 282.22counties;282.23    (5) evaluate outcomes of various treatment alternatives;282.24    (6) create a network for and provide support to service delivery groups;282.25    (7) establish a regional process to match children in need of out-of-home placement 282.26with foster homes that can meet their needs; and282.27    (8) recruit and retain foster homes.282.28    Subd. 3.Director's Council.The Director's Council shall govern the operations of 282.29the Regional Children's Mental Health Initiative. Members of the Director's Council shall 282.30represent each of the 11 counties participating in the pilot project.282.31    Subd. 4.Regional Children's Mental Health Initiative Team.The members 282.32of the Regional Children's Mental Health Initiative Team shall conduct planning and 282.33development of new and modified children's mental health programs and services in the 282.34region. Members of the team shall reflect the cultural, demographic, and geographic 283.1diversity of the region and shall be composed of representatives from each of the 283.2following:283.3    (1) the medical community;283.4    (2) human services;283.5    (3) corrections;283.6    (4) education;283.7    (5) mental health providers and vendors;283.8    (6) advocacy organizations;283.9    (7) parents; and283.10    (8) children and youth.283.11    Subd. 5.Authority.The regional children's mental health initiative shall have the 283.12authority to develop and implement the following programs:283.13    (1) Flexible funding payments. This program will make funds available to respond to 283.14the unique and unpredictable needs of children with mental health issues such as the need 283.15for prescription drugs, transportation, clothing, and assessments not otherwise available.283.16    (2) Transition to self-sufficiency. This program will help youths between the ages of 283.1714 and 21 establish professional relationships, find jobs, build financial foundations, and 283.18learn to fulfill their roles as productive citizens.283.19    (3) Crisis response. This program will establish public and private partnerships 283.20to offer a range of options to meet the needs of children in crisis. Methods to meet 283.21these needs may include accessible local services, holistic assessments, urgent care and 283.22stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.283.23    (4) Integrated services for complex conditions. This program will design, develop, 283.24and implement packages of integrated services to meet the needs of children with specific, 283.25complex conditions.283.26    Subd. 6.Evaluation and report.The regional children's mental health initiative 283.27shall develop a method for evaluating the effectiveness of this pilot project focusing on 283.28identifiable goals and outcomes. An interim report on the pilot project's effectiveness 283.29shall be submitted to the house and senate finance committees having jurisdiction over 283.30mental health, the commissioner of human services, and the Minnesota Association of 283.31County Social Service Administrators no later than December 31, 2008. A final report 283.32is due no later than December 31, 2009.283.33    Sec. 23. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES TO 283.34CHILDREN.284.1    Organizations that are certified to provide children's therapeutic services and 284.2supports under Minnesota Statutes, section 256B.0943, are eligible to apply for a grant. 284.3Grants are to be used to provide trauma-focused evidence-based practices to children 284.4who are living in a battered women's shelter, homeless shelter, transitional housing, or 284.5supported housing. Children served must have been exposed to or witnessed domestic 284.6violence, have been exposed to or witnessed community violence, or be a refugee. Priority 284.7shall be given to organizations that demonstrate collaboration with battered women's 284.8shelters, homeless shelters, or providers of transitional housing or supported housing. The 284.9commissioner shall specify which constitutes evidence-based practice. Organizations shall 284.10use all available funding streams.284.11    Sec. 24. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.284.12    (a) The commissioner of human services shall fund demonstration projects for high 284.13risk adults with serious mental illness and co-occurring substance abuse problems. The 284.14projects must include, but not be limited to, the following:284.15    (1) housing services, including rent or housing subsidies, housing with clinical 284.16staff, or housing support;284.17    (2) assertive outreach services; and284.18    (3) intensive direct therapeutic, rehabilitative, and care management services 284.19oriented to harm reduction.284.20    (b) The commissioner shall work with providers to ensure proper licensure or 284.21certification to meet medical assistance or third-party payor reimbursement requirements.284.22    Sec. 25. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S 284.23MENTAL HEALTH PILOT PROJECT.284.24    Subdivision 1.Pilot project authorized.The commissioner of human services 284.25shall fund a three-year pilot project to measure the effect of children's identified mental 284.26health needs, including social and emotional needs, on Minnesota family investment 284.27program (MFIP) participants' ability to obtain and retain employment. The project shall 284.28also measure the effect on work activity of MFIP participants' needs to address their 284.29children's identified mental health needs.284.30    Subd. 2.Provider and agency proposals.(a) Interested MFIP providers and 284.31agencies shall: 284.32    (1) submit proposals defining how they will identify participants whose children 284.33have mental health needs that hinder the employment process; 285.1    (2) connect families with appropriate developmental, social, and emotional 285.2screenings and services; and 285.3    (3) incorporate those services into the participant's employment plan.285.4Each proposal under this paragraph must include an evaluation component.285.5    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP 285.6participants of the following: 285.7    (1) the availability of developmental, social, and emotional screening tools for 285.8children and youth; 285.9    (2) the purpose of the screenings; 285.10    (3) how the information will be used to assist the participants in identifying and 285.11addressing potential barriers to employment; and 285.12    (4) that their employment plan may be modified based on the screening results.285.13    Subd. 3.Program components.(a) MFIP providers shall obtain the participant's 285.14written consent for participation in the pilot project, including consent for developmental, 285.15social, and emotional screening.285.16    (b) MFIP providers shall coordinate with county social service agencies and health 285.17plans to assist recipients in arranging referrals indicated by the screening results.285.18    (c) Tools used for developmental, social, and emotional screenings shall be approved 285.19by the commissioner of human services.285.20    Subd. 4.Program evaluation.The commissioner of human services shall conduct 285.21an evaluation of the pilot project to determine:285.22    (1) the number of participants who took part in the screening;285.23    (2) the number of children who were screened and what screening tools were used;285.24    (3) the number of children who were identified in the screening who needed referral 285.25or follow-up services;285.26    (4) the number of children who received services, what agency provided the services, 285.27and what type of services were provided;285.28    (5) the number of employment plans that were adjusted to include the activities 285.29recommended in the screenings;285.30    (6) the changes in work participation rates;285.31    (7) the changes in earned income;285.32    (8) the changes in sanction rates; and285.33    (9) the participants' report of program effectiveness.285.34    Subd. 5.Work activity.Participant involvement in screenings and subsequent 285.35referral and follow-up services shall count as work activity under Minnesota Statutes, 285.36section 256J.49, subdivision 13.286.1    Sec. 26. SOCIAL AND ECONOMIC COSTS OF GAMBLING.286.2    Subdivision 1.Report.The commissioner of human services, in consultation with 286.3the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed 286.4vendors, shall prepare a report that provides a process and funding mechanism to study the 286.5issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate 286.6of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall 286.7include in the report potential financial commitments made by stakeholders and others in 286.8order to fund the study. The report is due to the legislative committees having jurisdiction 286.9over compulsive gambling issues by December 1, 2007. 286.10    Subd. 2.Issues to be addressed.The study must address:286.11    (1) state, local, and tribal government policies and practices in Minnesota to legalize 286.12or prohibit gambling;286.13    (2) the relationship between gambling and crime in Minnesota, including: (i) the 286.14relationship between gambling and overall crime rates; (ii) the relationship between 286.15gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child 286.16neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement 286.17and regulation practices that are intended to address the relationship between gambling 286.18and levels of crime;286.19    (3) the relationship between expanded gambling and increased rates of problem 286.20gambling in Minnesota, including the impact of pathological or problem gambling on 286.21individuals, families, businesses, social institutions, and the economy;286.22    (4) the social impact of gambling on individuals, families, businesses, and social 286.23institutions in Minnesota, including an analysis of the relationship between gambling and 286.24depression, abuse, divorce, homelessness, suicide, and bankruptcy;286.25    (5) the economic impact of gambling on state, local, and tribal economies in 286.26Minnesota; and286.27    (6) any other issues deemed necessary in assessing the social and economic impact 286.28of gambling in Minnesota.286.29    Subd. 3.Quantification of social and economic impact.The study shall quantify 286.30the social and economic impact on both (1) state, local, and tribal governments in 286.31Minnesota, and (2) Minnesota's communities and social institutions, including individuals, 286.32families, and businesses within those communities and institutions.286.33    Sec. 27.  REPEALER.286.34Minnesota Rules, part 9585.0030, is repealed.287.1ARTICLE 6287.2DEPARTMENT OF HEALTH287.3    Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:287.4    Subd. 2. Definitions. For purposes of this section, the terms defined in this 287.5subdivision have the meanings given.287.6    (a) "Access" means the financial, temporal, and geographic availability of health 287.7care to individuals who need it.287.8    (b)(a) "Capital expenditure" means an expenditure which, under generally accepted 287.9accounting principles, is not properly chargeable as an expense of operation and 287.10maintenance.287.11    (c) "Cost" means the amount paid by consumers or third party payers for health 287.12care services or products.287.13    (d) "Date of the major spending commitment" means the date the provider formally 287.14obligated itself to the major spending commitment. The obligation may be incurred 287.15by entering into a contract, making a down payment, issuing bonds or entering a loan 287.16agreement to provide financing for the major spending commitment, or taking some other 287.17formal, tangible action evidencing the provider's intention to make the major spending 287.18commitment.287.19    (e)(b) "Health care service" means:287.20    (1) a service or item that would be covered by the medical assistance program 287.21under chapter 256B if provided in accordance with medical assistance requirements to an 287.22eligible medical assistance recipient; and287.23    (2) a service or item that would be covered by medical assistance except that it is 287.24characterized as experimental, cosmetic, or voluntary.287.25    "Health care service" does not include retail, over-the-counter sales of 287.26nonprescription drugs and other retail sales of health-related products that are not generally 287.27paid for by medical assistance and other third-party coverage.287.28    (f)(c) "Major spending commitment" means an expenditure in excess of $1,000,000 287.29for:287.30    (1) acquisition of a unit of medical equipment;287.31    (2) a capital expenditure for a single project for the purposes of providing health 287.32care services, other than for the acquisition of medical equipment;287.33    (3) offering a new specialized service not offered before;287.34    (4) planning for an activity that would qualify as a major spending commitment 287.35under this paragraph; or288.1    (5) a project involving a combination of two or more of the activities in clauses 288.2(1) to (4).288.3    The cost of acquisition of medical equipment, and the amount of a capital 288.4expenditure, is the total cost to the provider regardless of whether the cost is distributed 288.5over time through a lease arrangement or other financing or payment mechanism.288.6    (g)(d) "Medical equipment" means fixed and movable equipment that is used by 288.7a provider in the provision of a health care service. "Medical equipment" includes, but 288.8is not limited to, the following:288.9    (1) an extracorporeal shock wave lithotripter;288.10    (2) a computerized axial tomography (CAT) scanner;288.11    (3) a magnetic resonance imaging (MRI) unit;288.12    (4) a positron emission tomography (PET) scanner; and288.13    (5) emergency and nonemergency medical transportation equipment and vehicles.288.14    (h)(e) "New specialized service" means a specialized health care procedure or 288.15treatment regimen offered by a provider that was not previously offered by the provider, 288.16including, but not limited to:288.17    (1) cardiac catheterization services involving high-risk patients as defined in the 288.18Guidelines for Coronary Angiography established by the American Heart Association 288.19and the American College of Cardiology;288.20    (2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or 288.21any other service for transplantation of any other organ;288.22    (3) megavoltage radiation therapy;288.23    (4) open heart surgery;288.24    (5) neonatal intensive care services; and288.25    (6) any new medical technology for which premarket approval has been granted by 288.26the United States Food and Drug Administration, excluding implantable and wearable 288.27devices.288.28    (f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic, 288.29obstetrics, mental health, chemical dependency, and emergency services.288.30    Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:288.31    Subd. 4a. Expenditure reporting.(a) A provider making a major spending 288.32commitment after April 1, 1992, shall submit notification of the expenditure to the 288.33commissioner and provide the commissioner with any relevant background information.289.1    (b) Notification must include a report, submitted within 60 days after the date of the 289.2major spending commitment, using terms conforming to the definitions in section 62J.03289.3and this section. Each report is subject to retrospective review and must contain: 289.4    (1) a detailed description of the major spending commitment, including the specific 289.5dollar amount of each expenditure, and its purpose;289.6    (2) the date of the major spending commitment;289.7    (3) a statement of the expected impact that the major spending commitment will 289.8have on charges by the provider to patients and third party payers;289.9    (4) a statement of the expected impact on the clinical effectiveness or quality of care 289.10received by the patients that the provider expects to serve;289.11    (5) a statement of the extent to which equivalent services or technology are already 289.12available to the provider's actual and potential patient population;289.13    (6) a statement of the distance from which the nearest equivalent services or 289.14technology are already available to the provider's actual and potential population;289.15    (7) a statement describing the pursuit of any lawful collaborative arrangements; and289.16    (8) a statement of assurance that the provider will not use, purchase, or perform 289.17health care technologies and procedures that are not clinically effective and cost-effective, 289.18unless the technology is used for experimental or research purposes to determine whether 289.19a technology or procedure is clinically effective and cost-effective.289.20    The provider may submit any additional information that it deems relevant.289.21    (c) The commissioner may request additional information from a provider for the 289.22purpose of review of a report submitted by that provider, and may consider relevant 289.23information from other sources. A provider shall provide any information requested by 289.24the commissioner within the time period stated in the request, or within 30 days after the 289.25date of the request if the request does not state a time.289.26    (d) If the provider fails to submit a complete and timely expenditure report, including 289.27any additional information requested by the commissioner, the commissioner may make 289.28the provider's subsequent major spending commitments subject to the procedures of 289.29prospective review and approval under subdivision 6a.289.30    Each hospital, outpatient surgical center, diagnostic imaging center, and physician 289.31clinic shall report annually to the commissioner on all major spending commitments, 289.32in the form and manner specified by the commissioner. The report shall include the 289.33following information:289.34    (a) a description of major spending commitments made during the previous year, 289.35including the total dollar amount of major spending commitments and purpose of the 289.36expenditures;290.1    (b) the cost of land acquisition, construction of new facilities, and renovation of 290.2existing facilities;290.3    (c) the cost of purchased or leased medical equipment, by type of equipment;290.4    (d) expenditures by type for specialty care and new specialized services;290.5    (e) information on the amount and types of added capacity for diagnostic imaging 290.6services, outpatient surgical services, and new specialized services; and290.7    (f) information on investments in electronic medical records systems.290.8For hospitals and outpatient surgical centers, this information shall be included in reports 290.9to the commissioner that are required under section 144.698. For diagnostic imaging 290.10centers, this information shall be included in reports to the commissioner that are required 290.11under section 144.565. For physician clinics, this information shall be included in reports 290.12to the commissioner that are required under section 62J.41. For all other health care 290.13providers that are subject to this reporting requirement, reports must be submitted to the 290.14commissioner by March 1 each year for the preceding calendar year.290.15    Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:290.16    Subd. 7. Exceptions. (a) The retrospective review process as described in 290.17subdivision 5a and the prospective review and approval process as described in subdivision 290.186a reporting requirement in subdivision 4adodoes not apply to:290.19    (1) a major spending commitment to replace existing equipment with comparable 290.20equipment used for direct patient care, upgrades of equipment beyond the current model, 290.21or comparable model must be reported;290.22    (2) (1) a major spending commitment made by a research and teaching institution 290.23for purposes of conducting medical education, medical research supported or sponsored 290.24by a medical school, or by a federal or foundation grant or clinical trials;290.25    (3) a major spending commitment to repair, remodel, or replace existing buildings or 290.26fixtures if, in the judgment of the commissioner, the project does not involve a substantial 290.27expansion of service capacity or a substantial change in the nature of health care services 290.28provided;290.29    (4) (2) a major spending commitment for building maintenance including heating, 290.30water, electricity, and other maintenance-related expenditures; and290.31    (5) (3) a major spending commitment for activities, not directly related to the 290.32delivery of patient care services, including food service, laundry, housekeeping, and 290.33other service-related activities; and.291.1    (6) a major spending commitment for computer equipment or data systems not 291.2directly related to the delivery of patient care services, including computer equipment or 291.3data systems related to medical record automation.291.4    (b) In addition to the exceptions listed in paragraph (a), the prospective review and 291.5approval process described in subdivision 6a reporting requirement in subdivision 4a does 291.6not apply to mergers, acquisitions, and other changes in ownership or control that, in the 291.7judgment of the commissioner, do not involve a substantial expansion of service capacity 291.8or a substantial change in the nature of health care services provided.291.9    Sec. 4. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:291.10    Subdivision 1. Cost containment data to be collected from providers. The 291.11commissioner shall require health care providers to collect and provide both patient 291.12specific information and descriptive and financial aggregate data on:291.13    (1) the total number of patients served;291.14    (2) the total number of patients served by state of residence and Minnesota county;291.15    (3) the site or sites where the health care provider provides services;291.16    (4) the number of individuals employed, by type of employee, by the health care 291.17provider;291.18    (5) the services and their costs for which no payment was received;291.19    (6) total revenue by type of payer or by groups of payers, including but not limited 291.20to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service 291.21plan corporations, commercial insurers, health maintenance organizations, and individual 291.22patients;291.23    (7) revenue from research activities;291.24    (8) revenue from educational activities;291.25    (9) revenue from out-of-pocket payments by patients;291.26    (10) revenue from donations; and291.27    (11) a report on health care capital expenditures during the previous year, as required 291.28by section 62J.17; and291.29    (11) (12) any other data required by the commissioner, including data in 291.30unaggregated form, for the purposes of developing spending estimates, setting spending 291.31limits, monitoring actual spending, and monitoring costs.291.32The commissioner may, by rule, modify the data submission categories listed above if the 291.33commissioner determines that this will reduce the reporting burden on providers without 291.34having a significant negative effect on necessary data collection efforts.292.1    Sec. 5. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:292.2    Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1, 292.31996, all institutional inpatient hospital services, ancillary services, institutionally owned 292.4or operated outpatient services rendered by providers in Minnesota, and institutional 292.5or noninstitutional home health services that are not being billed using an equivalent 292.6electronic billing format, must be billed using the uniform billing form CMS 1450, except 292.7as provided in subdivision 5.292.8    (b) The instructions and definitions for the use of the uniform billing form CMS 292.91450 shall be in accordance with the uniform billing form manual specified by the 292.10commissioner. In promulgating these instructions, the commissioner may utilize the 292.11manual developed by the National Uniform Billing Committee, as adopted and finalized 292.12by the Minnesota Uniform Billing Committee.292.13    (c) Services to be billed using the uniform billing form CMS 1450 include: 292.14institutional inpatient hospital services and distinct units in the hospital such as psychiatric 292.15unit services, physical therapy unit services, swing bed (SNF) services, inpatient state 292.16psychiatric hospital services, inpatient skilled nursing facility services, home health 292.17services (Medicare part A), and hospice services; ancillary services, where benefits are 292.18exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals, 292.19skilled nursing facilities, and home health (Medicare part B); institutional owned or 292.20operated outpatient services such as waivered services, hospital outpatient services, 292.21including ambulatory surgical center services, hospital referred laboratory services, 292.22hospital-based ambulance services, and other hospital outpatient services, skilled nursing 292.23facilities, home health, freestanding renal dialysis centers, comprehensive outpatient 292.24rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health 292.25clinics, and community mental health centers; home health services such as home health 292.26intravenous therapy providers, waivered services, personal care attendants, and hospice; 292.27and any other health care provider certified by the Medicare program to use this form.292.28    (d) On and after January 1, 1996, a mother and newborn child must be billed 292.29separately, and must not be combined on one claim form.292.30    (e) Services provided by Medicare Critical Access Hospitals electing Method 292.31II billing will be allowed an exception to this provision to allow the inclusion of the 292.32professional fees on the CMS 1450.292.33    Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:292.34    Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all 292.35noninstitutional health care services rendered by providers in Minnesota except dental 293.1or pharmacy providers, that are not currently being billed using an equivalent electronic 293.2billing format, must be billed using the health insurance claim form CMS 1500, except as 293.3provided in subdivision 5.293.4    (b) The instructions and definitions for the use of the uniform billing form CMS 293.51500 shall be in accordance with the manual developed by the Administrative Uniformity 293.6Committee entitled standards for the use of the CMS 1500 form, dated February 1994, 293.7as further defined by the commissioner.293.8    (c) Services to be billed using the uniform billing form CMS 1500 include physician 293.9services and supplies, durable medical equipment, noninstitutional ambulance services, 293.10independent ancillary services including occupational therapy, physical therapy, speech 293.11therapy and audiology, home infusion therapy, podiatry services, optometry services, 293.12mental health licensed professional services, substance abuse licensed professional 293.13services, nursing practitioner professional services, certified registered nurse anesthetists, 293.14chiropractors, physician assistants, laboratories, medical suppliers, and other health care 293.15providers such as day activity centers and freestanding ambulatory surgical centers.293.16    (d) Services provided by Medicare Critical Access Hospitals electing Method 293.17II billing will be allowed an exception to this provision to allow the inclusion of the 293.18professional fees on the CMS 1450.293.19    Sec. 7. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:293.20    Subd. 2. General characteristics. (a) The Minnesota uniform health care 293.21identification card must be a preprinted card constructed of plastic, paper, or any other 293.22medium that conforms with ANSI and ISO 7810 physical characteristics standards. The 293.23card dimensions must also conform to ANSI and ISO 7810 physical characteristics 293.24standard. The use of a signature panel is optional. The uniform prescription drug 293.25information contained on the card must conform with the format adopted by the NCPDP 293.26and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of 293.27the fields required to submit a claim in conformance with the most recent pharmacy 293.28identification card implementation guide produced by the NCPDP. All information 293.29required to submit a prescription drug claim, exclusive of information provided on a 293.30prescription that is required by law, must be included on the card in a clear, readable, and 293.31understandable manner. If a health benefit plan requires a conditional or situational field, 293.32as defined by the NCPDP, the conditional or situational field must conform to the most 293.33recent pharmacy information card implementation guide produced by the NCPDP.293.34    (b) The Minnesota uniform health care identification card must have an essential 293.35information window on the front side with the following data elements: card issuer name, 294.1electronic transaction routing information, card issuer identification number, cardholder 294.2(insured) identification number, and cardholder (insured) identification name. No optional 294.3data may be interspersed between these data elements. 294.4    (c) Standardized labels are required next to human readable data elements and 294.5must come before the human data elements.294.6    Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:294.7    Subd. 3. Human readable data elements. (a) The following are the minimum 294.8human readable data elements that must be present on the front side of the Minnesota 294.9uniform health care identification card:294.10    (1) card issuer name or logo, which is the name or logo that identifies the card issuer. 294.11The card issuer name or logo may be located at the top of the card. No standard label 294.12is required for this data element;294.13    (2) complete electronic transaction routing information including, at a minimum, 294.14the international identification number. The standardized label of this data element 294.15is "RxBIN." Processor control numbers and group numbers are required if needed to 294.16electronically process a prescription drug claim. The standardized label for the process 294.17control numbers data element is "RxPCN" and the standardized label for the group 294.18numbers data element is "RxGrp," except that if the group number data element is a 294.19universal element to be used by all health care providers, the standardized label may be 294.20"Grp." To conserve vertical space on the card, the international identification number and 294.21the processor control number may be printed on the same line;294.22     (3) cardholder (insured) identification number, which is the unique identification 294.23number of the individual card holder established and defined under this section. The 294.24standardized label for the data element is "ID";294.25    (4) cardholder (insured) identification name, which is the name of the individual 294.26card holder. The identification name must be formatted as follows: first name, space, 294.27optional middle initial, space, last name, optional space and name suffix. The standardized 294.28label for this data element is "Name";294.29    (5) care type, which is the description of the group purchaser's plan product under 294.30which the beneficiary is covered. The description shall include the health plan company 294.31name and the plan or product name. The standardized label for this data element is 294.32"Care Type";294.33    (6) service type, which is the description of coverage provided such as hospital, 294.34dental, vision, prescription, or mental health. The standard label for this data element 294.35is "Svc Type"; and295.1    (7) provider/clinic name, which is the name of the primary care clinic the card 295.2holder is assigned to by the health plan company. The standard label for this field is 295.3"PCP." This information is mandatory only if the health plan company assigns a specific 295.4primary care provider to the card holder.295.5    (b) The following human readable data elements shall be present on the back side 295.6of the Minnesota uniform health care identification card. These elements must be left 295.7justified, and no optional data elements may be interspersed between them:295.8    (1) claims submission names and addresses, which are the names and addresses of 295.9the entity or entities to which claims should be submitted. If different destinations are 295.10required for different types of claims, this must be labeled;295.11    (2) telephone numbers and names that pharmacies and other health care providers 295.12may call for assistance. These telephone numbers and names are required on the back 295.13side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies 295.14or other providers with assistance or with the telephone numbers and names of contacts 295.15for assistance; and295.16    (3) telephone numbers and names; which are the telephone numbers and names of the 295.17following contacts with a standardized label describing the service function as applicable:295.18    (i) eligibility and benefit information;295.19    (ii) utilization review;295.20    (iii) precertification; or295.21    (iv) customer services.295.22    (c) The following human readable data elements are mandatory on the back 295.23side of the Minnesota uniform health care identification card for health maintenance 295.24organizations:295.25    (1) emergency care authorization telephone number or instruction on how to receive 295.26authorization for emergency care. There is no standard label required for this information; 295.27and295.28    (2) one of the following:295.29    (i) telephone number to call to appeal to or file a complaint with the commissioner of 295.30health; or295.31    (ii) for persons enrolled under section 
         256B.69, 
         256D.03, or 
         256L.12, the telephone 295.32number to call to file a complaint with the ombudsperson designated by the commissioner 295.33of human services under section 
         256B.69 and the address to appeal to the commissioner of 295.34human services. There is no standard label required for this information. 295.35    (d) All human readable data elements not required under paragraphs (a) to (c) are 295.36optional and may be used at the issuer's discretion.296.1    Sec. 9. Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision 296.2to read:296.3    Subd. 1a.Demonstration project.The commissioner of health shall award a 296.4demonstration project grant to a community-based health care initiative to develop and 296.5operate a community-based health care coverage program to operate within Carlton, 296.6Cook, Lake, and St. Louis Counties. The demonstration project shall extend for five years 296.7and must comply with all the requirements of this section.296.8    Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:296.9    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 296.10coverage program, a community-based health initiative shall submit to the commissioner 296.11of health for approval the community-based health care coverage program developed by 296.12the initiative. The commissioner shall only approve a program that has been awarded 296.13a community access program grant from the United States Department of Health and 296.14Human Services. The commissioner shall ensure that the program meets the federal grant 296.15requirements and any requirements described in this section and is actuarially sound based 296.16on a review of appropriate records and methods utilized by the community-based health 296.17initiative in establishing premium rates for the community-based health care coverage 296.18program. 296.19    (b) Prior to approval, the commissioner shall also ensure that:296.20    (1) the benefits offered comply with subdivision 8 and that there are adequate 296.21numbers of health care providers participating in the community-based health network to 296.22deliver the benefits offered under the program;296.23    (2) the activities of the program are limited to activities that are exempt under this 296.24section or otherwise from regulation by the commissioner of commerce;296.25    (3) the complaint resolution process meets the requirements of subdivision 10; and 296.26    (4) the data privacy policies and procedures comply with state and federal law.296.27    Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:296.28    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 296.29by the commissioner of health a community-based health care coverage program. The 296.30operational structure established by the initiative shall include, but is not limited to: 296.31    (1) establishing a process for enrolling eligible individuals and their dependents; 296.32    (2) collecting and coordinating premiums from enrollees and employers of enrollees;296.33    (3) providing payment to participating providers; 297.1    (4) establishing a benefit set according to subdivision 8 and establishing premium 297.2rates and cost-sharing requirements; 297.3    (5) creating incentives to encourage primary care and wellness services; and 297.4    (6) initiating disease management services, as appropriate. 297.5    (b) The payments collected under paragraph (a), clause (2), may be used to capture 297.6available federal funds.297.7    Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:297.8    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 297.9commissioner of health on January 15, April 15, July 15, and October 15 of each year, 297.10with the first report due January 15, 2007 2008. The status report shall include:297.11    (1) the financial status of the program, including the premium rates, cost per member 297.12per month, claims paid out, premiums received, and administrative expenses; 297.13    (2) a description of the health care benefits offered and the services utilized; 297.14    (3) the number of employers participating, the number of employees and dependents 297.15covered under the program, and the number of health care providers participating; 297.16    (4) a description of the health outcomes to be achieved by the program and a status 297.17report on the performance measurements to be used and collected; and 297.18    (5) any other information requested by the commissioner of health or commerce or 297.19the legislature. 297.20    (b) The initiative shall contract with an independent entity to conduct an evaluation 297.21of the program to be submitted to the commissioners of health and commerce and the 297.22legislature by January 15, 2009 2010. The evaluation shall include:297.23    (1) an analysis of the health outcomes established by the initiative and the 297.24performance measurements to determine whether the outcomes are being achieved;297.25    (2) an analysis of the financial status of the program, including the claims to 297.26premiums loss ratio and utilization and cost experience; 297.27    (3) the demographics of the enrollees, including their age, gender, family income, 297.28and the number of dependents; 297.29    (4) the number of employers and employees who have been denied access to the 297.30program and the basis for the denial; 297.31    (5) specific analysis on enrollees who have aggregate medical claims totaling over 297.32$5,000 per year, including data on the enrollee's main diagnosis and whether all the 297.33medical claims were covered by the program; 297.34    (6) number of enrollees referred to state public assistance programs; 298.1    (7) a comparison of employer-subsidized health coverage provided in a comparable 298.2geographic area to the designated community-based geographic area served by the 298.3program, including, to the extent available: 298.4    (i) the difference in the number of employers with 50 or fewer employees offering 298.5employer-subsidized health coverage; 298.6    (ii) the difference in uncompensated care being provided in each area; and298.7    (iii) a comparison of health care outcomes and measurements established by the 298.8initiative; and 298.9    (8) any other information requested by the commissioner of health or commerce.298.10    Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:298.11    Subd. 14. Sunset. This section expires December 31, 2011 2012.298.12    Sec. 14. [144.291] MINNESOTA HEALTH RECORDS ACT.298.13    Subdivision 1.Short title.Sections 144.291 to 144.298 may be cited as the 298.14Minnesota Health Records Act.298.15    Subd. 2.Definitions.For the purposes of sections 144.291 to 144.298, the following 298.16terms have the meanings given.298.17    (a) Affiliate. "Affiliate" has the meaning given in section 144.6521, subdivision 3, 298.18paragraph (b).298.19    (b) Group purchaser. "Group purchaser" has the meaning given in section 62J.03, 298.20subdivision 6.298.21    (c) Health record. "Health record" means any information, whether oral or recorded 298.22in any form or medium, that relates to the past, present, or future physical or mental health 298.23or condition of a patient; the provision of health care to a patient; or the past, present, or 298.24future payment for the provision of health care to a patient.298.25    (d) Identifying information. "Identifying information" means the patient's name, 298.26address, date of birth, gender, parent's or guardian's name regardless of the age of the 298.27patient, and other nonclinical data which can be used to uniquely identify a patient.298.28    (e) Individually identifiable form. "Individually identifiable form" means a form in 298.29which the patient is or can be identified as the subject of the health records.298.30    (f) Medical emergency. "Medical emergency" means medically necessary care 298.31which is immediately needed to preserve life, prevent serious impairment to bodily 298.32functions, organs, or parts, or prevent placing the physical or mental health of the patient 298.33in serious jeopardy.299.1    (g) Patient. "Patient" means a natural person who has received health care services 299.2from a provider for treatment or examination of a medical, psychiatric, or mental 299.3condition, the surviving spouse and parents of a deceased patient, or a person the patient 299.4appoints in writing as a representative, including a health care agent acting according to 299.5chapter 145C, unless the authority of the agent has been limited by the principal in the 299.6principal's health care directive. Except for minors who have received health care services 299.7under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or 299.8guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.299.9    (h) Provider. "Provider" means: 299.10    (1) any person who furnishes health care services and is regulated to furnish the 299.11services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 299.12151, 153, or 153A; 299.13    (2) a home care provider licensed under section 144A.46; 299.14    (3) a health care facility licensed under this chapter or chapter 144A; 299.15    (4) a physician assistant registered under chapter 147A; and 299.16    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to 299.17148B.71.299.18    (i) Record locator service. "Record locator service" means an electronic index of 299.19patient identifying information that directs providers in a health information exchange to 299.20the location of patient health records held by providers and group purchasers.299.21    (j) Related health care entity. "Related health care entity" means an affiliate of 299.22the provider releasing the health records.299.23    Sec. 15. [144.292] PATIENT RIGHTS.299.24    Subdivision 1.Scope.Patients have the rights specified in this section regarding the 299.25treatment the patient receives and the patient's health record.299.26    Subd. 2.Patient access.Upon request, a provider shall supply to a patient complete 299.27and current information possessed by that provider concerning any diagnosis, treatment, 299.28and prognosis of the patient in terms and language the patient can reasonably be expected 299.29to understand.299.30    Subd. 3.Additional patient rights.A patient's right specified in this section and 299.31sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and 299.32144.652 and any other provision of law relating to the access of a patient to the patient's 299.33health records.300.1    Subd. 4.Notice of rights; information on release.A provider shall provide to 300.2patients, in a clear and conspicuous manner, a written notice concerning practices and 300.3rights with respect to access to health records. The notice must include an explanation of:300.4    (1) disclosures of health records that may be made without the written consent of the 300.5patient, including the type of records and to whom the records may be disclosed; and300.6    (2) the right of the patient to have access to and obtain copies of the patient's health 300.7records and other information about the patient that is maintained by the provider.300.8    The notice requirements of this subdivision are satisfied if the notice is included with 300.9the notice and copy of the patient and resident bill of rights under section 144.652 or if it 300.10is displayed prominently in the provider's place of business. The commissioner of health 300.11shall develop the notice required in this subdivision and publish it in the State Register.300.12    Subd. 5.Copies of health records to patients.Except as provided in section 300.13144.296, upon a patient's written request, a provider, at a reasonable cost to the patient, 300.14shall promptly furnish to the patient:300.15    (1) copies of the patient's health record, including but not limited to laboratory 300.16reports, x-rays, prescriptions, and other technical information used in assessing the 300.17patient's health conditions; or300.18    (2) the pertinent portion of the record relating to a condition specified by the patient.300.19    With the consent of the patient, the provider may instead furnish only a summary 300.20of the record. The provider may exclude from the health record written speculations 300.21about the patient's health condition, except that all information necessary for the patient's 300.22informed consent must be provided.300.23    Subd. 6.Cost.(a) When a patient requests a copy of the patient's record for 300.24purposes of reviewing current medical care, the provider must not charge a fee.300.25    (b) When a provider or its representative makes copies of patient records upon a 300.26patient's request under this section, the provider or its representative may charge the 300.27patient or the patient's representative no more than 75 cents per page, plus $10 for time 300.28spent retrieving and copying the records, unless other law or a rule or contract provide for 300.29a lower maximum charge. This limitation does not apply to x-rays. The provider may 300.30charge a patient no more than the actual cost of reproducing x-rays, plus no more than 300.31$10 for the time spent retrieving and copying the x-rays.300.32    (c) The respective maximum charges of 75 cents per page and $10 for time provided 300.33in this subdivision are in effect for calendar year 1992 and may be adjusted annually each 300.34calendar year as provided in this subdivision. The permissible maximum charges shall 300.35change each year by an amount that reflects the change, as compared to the previous year, 301.1in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 301.2published by the Department of Labor.301.3    (d) A provider or its representative must not charge a fee to provide copies of records 301.4requested by a patient or the patient's authorized representative if the request for copies 301.5of records is for purposes of appealing a denial of Social Security disability income or 301.6Social Security disability benefits under title II or title XVI of the Social Security Act. For 301.7the purpose of further appeals, a patient may receive no more than two medical record 301.8updates without charge, but only for medical record information previously not provided. 301.9For purposes of this paragraph, a patient's authorized representative does not include units 301.10of state government engaged in the adjudication of Social Security disability claims.301.11    Subd. 7.Withholding health records from patient.(a) If a provider reasonably 301.12determines that the information is detrimental to the physical or mental health of the 301.13patient, or is likely to cause the patient to inflict self harm, or to harm another, the provider 301.14may withhold the information from the patient and may supply the information to an 301.15appropriate third party or to another provider. The other provider or third party may 301.16release the information to the patient.301.17    (b) A provider shall release information upon written request unless, prior to the 301.18request, a provider has designated and described a specific basis for withholding the 301.19information as authorized by paragraph (a).301.20    Sec. 16. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.301.21    Subdivision 1.Release or disclosure of health records.Health records can be 301.22released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.301.23    Subd. 2.Patient consent to release of records.A provider, or a person who 301.24receives health records from a provider, may not release a patient's health records to a 301.25person without:301.26    (1) a signed and dated consent from the patient or the patient's legally authorized 301.27representative authorizing the release;301.28    (2) specific authorization in law; or301.29    (3) a representation from a provider that the provider holds a consent from the 301.30patient.301.31    Subd. 3.Release from one provider to another.A patient's health record, 301.32including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical 301.33information used in assessing the patient's condition, or the pertinent portion of the record 301.34relating to a specific condition, or a summary of the record, shall promptly be furnished to 301.35another provider upon the written request of the patient. The written request shall specify 302.1the name of the provider to whom the health record is to be furnished. The provider who 302.2furnishes the health record or summary may retain a copy of the materials furnished. The 302.3patient shall be responsible for the reasonable costs of furnishing the information.302.4    Subd. 4.Duration of consent.Except as provided in this section, a consent is 302.5valid for one year or for a lesser period specified in the consent or for a different period 302.6provided by law.302.7    Subd. 5.Exceptions to consent requirement.This section does not prohibit the 302.8release of health records:302.9    (1) for a medical emergency when the provider is unable to obtain the patient's 302.10consent due to the patient's condition or the nature of the medical emergency;302.11    (2) to other providers within related health care entities when necessary for the 302.12current treatment of the patient; or302.13    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same 302.14types of health care facilities licensed by this chapter and chapter 144A that are licensed 302.15in another state when a patient:302.16    (i) is returning to the health care facility and unable to provide consent; or302.17    (ii) who resides in the health care facility, has services provided by an outside 302.18resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable 302.19to provide consent.302.20    Subd. 6.Consent does not expire.Notwithstanding subdivision 4, if a patient 302.21explicitly gives informed consent to the release of health records for the purposes and 302.22restrictions in clauses (1) and (2), the consent does not expire after one year for:302.23    (1) the release of health records to a provider who is being advised or consulted with 302.24in connection with the releasing provider's current treatment of the patient;302.25    (2) the release of health records to an accident and health insurer, health service plan 302.26corporation, health maintenance organization, or third-party administrator for purposes of 302.27payment of claims, fraud investigation, or quality of care review and studies, provided that:302.28    (i) the use or release of the records complies with sections 72A.49 to 72A.505;302.29    (ii) further use or release of the records in individually identifiable form to a person 302.30other than the patient without the patient's consent is prohibited; and302.31    (iii) the recipient establishes adequate safeguards to protect the records from 302.32unauthorized disclosure, including a procedure for removal or destruction of information 302.33that identifies the patient.302.34    Subd. 7.Exception to consent.Subdivision 2 does not apply to the release of health 302.35records to the commissioner of health or the Health Data Institute under chapter 62J, 302.36provided that the commissioner encrypts the patient identifier upon receipt of the data.303.1    Subd. 8.Record locator service.(a) A provider or group purchaser may send 303.2patient identifying information and information about the location of the patient's health 303.3records to a record locator service without consent from the patient. Except in the case of 303.4a medical emergency, a provider participating in a health information exchange using a 303.5record locator service cannot access patient identifying information and information 303.6about the location of the patient's health records until the patient has provided consent. 303.7The Minnesota Department of Health may not access the record locator service or receive 303.8data from the record locator service. Only a provider may access patient identifying 303.9information in a record locator service. The consent does not expire and may be revoked 303.10by the patient at any time by providing written notice of the revocation to the provider.303.11    (b) A health information exchange maintaining a record locator service or an entity 303.12maintaining a record locator service for a health information exchange must maintain an 303.13audit log of providers accessing information in a record locator service that minimally 303.14contains information on: 303.15    (1) the identity of the provider accessing the information; 303.16    (2) the identity of the patient whose information was accessed by the provider; and 303.17    (3) the date the information was accessed. 303.18    (c) No group purchaser may in any way require a provider to participate in any 303.19record locator service as a condition of payment or participation.303.20    (d) A record locator service must provide a mechanism for patients to opt out of 303.21including their identifying information and information about the location of their health 303.22records in a record locator service. At a minimum, any consent form that permits a 303.23provider to access a record locator service must include a check-box option that allows a 303.24patient to completely opt out of the record locator service which shall be clearly displayed 303.25to the patient. A provider participating in a health information exchange with a record 303.26locator service who receives a patient's request to completely opt out of the record locator 303.27service or to not have a specific provider contact in the record locator service shall be 303.28responsible for removing the patient's information from the record locator service.303.29    Subd. 9.Documentation of release.(a) In cases where a provider releases health 303.30records without patient consent as authorized by law, the release must be documented in 303.31the patient's health record. In the case of a release under section 144.294, subdivision 2, the 303.32documentation must include the date and circumstances under which the release was made, 303.33the person or agency to whom the release was made, and the records that were released.303.34    (b) When a health record is released using a representation from a provider that 303.35holds a consent from the patient, the releasing provider shall document: 303.36    (1) the provider requesting the health records; 304.1    (2) the identity of the patient;304.2    (3) the health records requested; and 304.3    (4) the date the health records were requested.304.4    Sec. 17. [144.294] RECORDS RELATING TO MENTAL HEALTH.304.5    Subdivision 1.Provider inquiry.Upon the written request of a spouse, parent, 304.6child, or sibling of a patient being evaluated for or diagnosed with mental illness, a 304.7provider shall inquire of a patient whether the patient wishes to authorize a specific 304.8individual to receive information regarding the patient's current and proposed course of 304.9treatment. If the patient so authorizes, the provider shall communicate to the designated 304.10individual the patient's current and proposed course of treatment. Section 144.293, 304.11subdivisions 2 and 4, apply to consents given under this subdivision.304.12    Subd. 2.Disclosure to law enforcement agency.Notwithstanding section 144.293, 304.13subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental 304.14health to a law enforcement agency if the law enforcement agency provides the name 304.15of the patient and communicates that the:304.16    (1) patient is currently involved in an emergency interaction with the law 304.17enforcement agency; and304.18    (2) disclosure of the records is necessary to protect the health or safety of the patient 304.19or of another person. 304.20    The scope of disclosure under this subdivision is limited to the minimum necessary 304.21for law enforcement to respond to the emergency. A law enforcement agency that obtains 304.22health records under this subdivision shall maintain a record of the requestor, the provider 304.23of the information, and the patient's name. Health records obtained by a law enforcement 304.24agency under this subdivision are private data on individuals as defined in section 13.02, 304.25subdivision 12, and must not be used by law enforcement for any other purpose.304.26    Subd. 3.Records release for family and caretaker; mental health care.(a) 304.27Notwithstanding section 144.293, a provider providing mental health care and treatment 304.28may disclose health record information described in paragraph (b) about a patient to a 304.29family member of the patient or other person who requests the information if:304.30    (1) the request for information is in writing;304.31    (2) the family member or other person lives with, provides care for, or is directly 304.32involved in monitoring the treatment of the patient;304.33    (3) the involvement under clause (2) is verified by the patient's mental health care 304.34provider, the patient's attending physician, or a person other than the person requesting the 304.35information, and is documented in the patient's medical record;305.1    (4) before the disclosure, the patient is informed in writing of the request, the name 305.2of the person requesting the information, the reason for the request, and the specific 305.3information being requested;305.4    (5) the patient agrees to the disclosure, does not object to the disclosure, or is 305.5unable to consent or object, and the patient's decision or inability to make a decision is 305.6documented in the patient's medical record; and305.7    (6) the disclosure is necessary to assist in the provision of care or monitoring of the 305.8patient's treatment. 305.9    (b) The information disclosed under this paragraph is limited to diagnosis, admission 305.10to or discharge from treatment, the name and dosage of the medications prescribed, side 305.11effects of the medication, consequences of failure of the patient to take the prescribed 305.12medication, and a summary of the discharge plan. 305.13    (c) If a provider reasonably determines that providing information under this 305.14subdivision would be detrimental to the physical or mental health of the patient or is 305.15likely to cause the patient to inflict self harm or to harm another, the provider must not 305.16disclose the information. 305.17    (d) This subdivision does not apply to disclosures for a medical emergency or 305.18to family members as authorized or required under subdivision 1 or section 144.293, 305.19subdivision 5, clause (1).305.20    Sec. 18. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL 305.21RESEARCH.305.22    Subdivision 1.Methods of release.(a) Notwithstanding section 144.293, 305.23subdivisions 2 and 4, health records may be released to an external researcher solely for 305.24purposes of medical or scientific research only as follows:305.25    (1) health records generated before January 1, 1997, may be released if the patient 305.26has not objected or does not elect to object after that date;305.27    (2) for health records generated on or after January 1, 1997, the provider must:305.28    (i) disclose in writing to patients currently being treated by the provider that health 305.29records, regardless of when generated, may be released and that the patient may object, in 305.30which case the records will not be released; and305.31    (ii) use reasonable efforts to obtain the patient's written general authorization that 305.32describes the release of records in item (i), which does not expire but may be revoked or 305.33limited in writing at any time by the patient or the patient's authorized representative; 305.34    (3) the provider must advise the patient of the rights specified in clause (4); and306.1    (4) the provider must, at the request of the patient, provide information on how the 306.2patient may contact an external researcher to whom the health record was released and 306.3the date it was released.306.4    (b) Authorization may be established if an authorization is mailed at least two 306.5times to the patient's last known address with a postage prepaid return envelope and a 306.6conspicuous notice that the patient's medical records may be released if the patient does 306.7not object, and at least 60 days have expired since the second notice was sent.306.8    Subd. 2.Duties of researcher.In making a release for research purposes, the 306.9provider shall make a reasonable effort to determine that:306.10    (1) the use or disclosure does not violate any limitations under which the record 306.11was collected;306.12    (2) the use or disclosure in individually identifiable form is necessary to accomplish 306.13the research or statistical purpose for which the use or disclosure is to be made;306.14    (3) the recipient has established and maintains adequate safeguards to protect the 306.15records from unauthorized disclosure, including a procedure for removal or destruction of 306.16information that identifies the patient; and306.17    (4) further use or release of the records in individually identifiable form to a person 306.18other than the patient without the patient's consent is prohibited.306.19    Sec. 19. [144.296] COPIES OF VIDEOTAPES.306.20    A provider may not release a copy of a videotape of a child victim or alleged victim 306.21of physical or sexual abuse without a court order under section 13.03, subdivision 6, or 306.22as provided in section 611A.90. This section does not limit the right of a patient to view 306.23the videotape.306.24    Sec. 20. [144.297] INDEPENDENT MEDICAL EXAMINATION.306.25    This section applies to the subject and provider of an independent medical 306.26examination requested by or paid for by a third party. Notwithstanding section 144.293, a 306.27provider may release health records created as part of an independent medical examination 306.28to the third party who requested or paid for the examination.306.29    Sec. 21. [144.298] PENALTIES.306.30    Subdivision 1.Licensing action.A violation of sections 144.291 to 144.298 may 306.31be grounds for disciplinary action against a provider by the appropriate licensing board 306.32or agency.307.1    Subd. 2.Allocation of liability.In adjudicating a dispute involving the disclosure 307.2of patient health records, a court shall use the criteria in this subdivision in determining 307.3how liability will be allocated.307.4    (a) When requesting health records using consent, a person warrants that the consent:307.5    (1) contains no information known to the person to be false; and307.6    (2) accurately states the patient's desire to have health records disclosed or that there 307.7is specific authorization in law.307.8    (b) When requesting health records using consent or the representation authorized in 307.9section 144.293, subdivision 2, a provider warrants that the request:307.10    (1) contains no information known to the provider to be false;307.11    (2) accurately states the patient's desire to have health records disclosed or that 307.12there is specific authorization in law; and307.13    (3) does not exceed any limits imposed by the patient in the consent.307.14    (c) When disclosing health records, a person releasing health records warrants that 307.15the person:307.16    (1) has complied with the requirements of this section regarding disclosure of 307.17health records;307.18    (2) knows of no information related to the request that is false; and307.19    (3) has complied with the limits set by the patient in the consent or as described 307.20in the representation of consent.307.21    (d) A court of this state presumes that:307.22    (1) a request made by a person that complies with the provisions of this section is 307.23valid and represents the wishes of the patient;307.24    (2) the information listed in a consent or representation of consent is accurate;307.25    (3) the recipient of a consent or representation of consent has no knowledge or 307.26notice that the person making the request breached a duty to the patient or does not 307.27rightfully have a consent;307.28    (4) the signature on the consent or representation of consent is not forged;307.29    (5) the consent or representation of consent was not obtained under false pretenses; 307.30and307.31    (6) the consent or representation of consent was not altered without the patient's 307.32permission.307.33    (e) No person or provider may disclaim or contractually limit the application of this 307.34section, or obtain indemnity for its effects, if the disclaimer, limitation, or indemnity 307.35restricts liability for misrepresentation against persons reasonably relying on the consent, 307.36representation of consent, or disclosure.308.1    (f) A court of this state shall give effect to liability allocations between the parties 308.2provided by contract that does not allocate liability to the detriment of the patient and the 308.3allocation is consistent with the requirements of sections 144.291 to 144.298.308.4    (g) A patient is eligible to receive compensatory damages plus costs and reasonable 308.5attorney fees if there is a negligent or intentional violation of sections 144.293 to 144.295.308.6    Subd. 3.Liability for a record locator service.A patient is eligible to receive 308.7compensatory damages plus costs and reasonable attorney fees if a health information 308.8exchange maintaining a record locator service, or an entity maintaining a record locator 308.9service for a health information exchange, negligently or intentionally violates the 308.10provisions of section 144.293, subdivision 8.308.11    Sec. 22. Minnesota Statutes 2006, section 144.3345, is amended to read:308.12144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD 308.13GRANTS.308.14    Subdivision 1. Definitions. The following definitions are used for the purposes 308.15of this section.308.16    (a) "Eligible community e-health collaborative" means an existing or newly 308.17established collaborative to support the adoption and use of interoperable electronic 308.18health records. A collaborative must consist of at least three two or more eligible health 308.19care entities in at least two of the categories listed in paragraph (b) and have a focus on 308.20interconnecting the members of the collaborative for secure and interoperable exchange of 308.21health care information.308.22    (b) "Eligible health care entity" means one of the following:308.23    (1) community clinics, as defined under section 
         145.9268; 308.24    (2) hospitals eligible for rural hospital capital improvement grants, as defined 308.25in section 
         144.148;308.26    (3) physician clinics located in a community with a population of less than 50,000 308.27according to United States Census Bureau statistics and outside the seven-county 308.28metropolitan area; 308.29    (4) nursing facilities licensed under sections 
         144A.01 to 
         144A.27; 308.30    (5) community health boards or boards of health as established under chapter 145A; 308.31    (6) nonprofit entities with a purpose to provide health information exchange 308.32coordination governed by a representative, multi-stakeholder board of directors; and308.33    (7) other providers of health or health care services approved by the commissioner 308.34for which interoperable electronic health record capability would improve quality of 308.35care, patient safety, or community health.309.1    Subd. 2. Grants authorized. The commissioner of health shall award grants to:309.2    (a) eligible community e-health collaborative projects to improve the implementation 309.3and use of interoperable electronic health records including but not limited to the 309.4following projects:309.5    (1) collaborative efforts to host and support fully functional interoperable electronic 309.6health records in multiple care settings; 309.7    (2) electronic medication history and electronic patient registration medical history309.8information; 309.9    (3) electronic personal health records for persons with chronic diseases and for 309.10prevention services; 309.11    (4) rural and underserved community models for electronic prescribing; and309.12    (5) enabling modernize local public health information systems to rapidly and 309.13electronically exchange information needed to participate in community e-health 309.14collaboratives or for public health emergency preparedness and response.; and309.15    (6) implement regional or community-based health information exchange 309.16organizations;309.17    (b) community clinics, as defined under section 145.9268, to implement and use 309.18interoperable electronic health records, including but not limited to the following projects:309.19    (1) efforts to plan for and implement fully functional, standards-based interoperable 309.20electronic health records; and309.21    (2) purchases and implementation of computer hardware, software, and technology 309.22to fully implement interoperable electronic health records;309.23    (c) regional or community-based health information exchange organizations to 309.24connect and facilitate the exchange of health information between eligible health care 309.25entities, including but not limited to the development, testing, and implementation of:309.26    (1) data exchange standards, including data, vocabulary, and messaging standards, 309.27for the exchange of health information, provided that such standards are consistent with 309.28state and national standards;309.29    (2) security standards necessary to ensure the confidentiality and integrity of health 309.30records;309.31    (3) computer interfaces and mechanisms for standardizing health information 309.32exchanged between eligible health care entities;309.33    (4) a record locator service for identifying the location of patient health records; or309.34    (5) interfaces and mechanisms for implementing patient consent requirements; and309.35    (d) community health boards and boards of health as established under chapter 309.36145A to modernize local public health information systems to be standards-based and 310.1interoperable with other electronic health records and information systems, or for 310.2enhanced public health emergency preparedness and response.310.3    Grant funds may not be used for construction of health care or other buildings or 310.4facilities.310.5    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible 310.6community e-health collaborative, community clinic, regional or community-based health 310.7information exchange, or community health boards and boards of health must submit an 310.8application to the commissioner of health by the deadline established by the commissioner. 310.9A grant may be awarded upon the signing of a grant contract. In awarding grants, the 310.10commissioner shall give preference to projects benefiting providers located in rural and 310.11underserved areas of Minnesota which the commissioner has determined have an unmet 310.12need for the development and funding of electronic health records. Applicants may apply 310.13for and the commissioner may award grants for one-year, two-year, or three-year periods.310.14    (b) An application must be on a form and contain information as specified by the 310.15commissioner but at a minimum must contain:310.16    (1) a description of the purpose or project for which grant funds will be used; 310.17    (2) a description of the problem or problems the grant funds will be used to address, 310.18including an assessment of the likelihood of the project occurring absent grant funding; 310.19    (3) a description of achievable objectives, a workplan, budget, budget narrative, a 310.20project communications plan, a timeline for implementation and completion of processes 310.21or projects enabled by the grant, and an assessment of privacy and security issues and a 310.22proposed approach to address these issues;310.23    (4) a description of the health care entities and other groups participating in the 310.24project, including identification of the lead entity responsible for applying for and 310.25receiving grant funds; 310.26    (5) a plan for how patients and consumers will be involved in development of 310.27policies and procedures related to the access to and interchange of information; 310.28    (6) evidence of consensus and commitment among the health care entities and others 310.29who developed the proposal and are responsible for its implementation; and310.30    (7) a plan for documenting and evaluating results of the grant. ; and310.31    (8) a plan for use of data exchange standards, including data and vocabulary.310.32    (c) The commissioner shall review each application to determine whether the 310.33application is complete and whether the applicant and the project are eligible for a 310.34grant. In evaluating applications, the commissioner shall take into consideration factors, 310.35including but not limited to, the following:311.1    (1) the degree to which the proposal interconnects the various providers of care with 311.2other health care entities in the applicant's geographic community; 311.3    (2) the degree to which the project provides for the interoperability of electronic 311.4health records or related health information technology between the members of the 311.5collaborative, and presence and scope of a description of how the project intends to 311.6interconnect with other providers not part of the project into the future;311.7    (3) the degree to which the project addresses current unmet needs pertaining 311.8to interoperable electronic health records in a geographic area of Minnesota and the 311.9likelihood that the needs would not be met absent grant funds; 311.10    (4) the applicant's thoroughness and clarity in describing the project, how the project 311.11will improve patient safety, quality of care, and consumer empowerment, and the role of 311.12the various collaborative members;311.13    (5) the recommendations of the Health Information and Technology Infrastructure 311.14Advisory Committee; and311.15    (6) other factors that the commissioner deems relevant.311.16    (d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall 311.17be required to provide $1 in the form of cash or in-kind staff or services for each $3 311.18provided under the grant program.311.19    (e) Grants shall not exceed $900,000 per grant. The commissioner has discretion 311.20over the size and number of grants awarded.311.21    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the 311.22overall effectiveness of the grant program. The commissioner shall collect progress 311.23and expenditure reports to evaluate the grant program from the eligible community 311.24collaboratives receiving grants.311.25    Sec. 23. Minnesota Statutes 2006, section 144.565, is amended to read:311.26144.565 DIAGNOSTIC IMAGING FACILITIES.311.27    Subdivision 1. Utilization and services data; economic and financial interests.311.28    The commissioner shall require diagnostic imaging facilities and providers of diagnostic 311.29imaging services in Minnesota to annually report by March 1 each year for the preceding 311.30fiscal year to the commissioner, in the form and manner specified by the commissioner:311.31    (1) utilization data for each health plan company and each public program, 311.32including workers' compensation, as follows: of diagnostic imaging services as defined 311.33in subdivision 4, paragraph (b);311.34    (i) the number of computerized tomography (CT) procedures performed;311.35    (ii) the number of magnetic resonance imaging (MRI) procedures performed; and312.1    (iii) the number of positron emission tomography (PET) procedures performed; and312.2    (2) the names of all physicians with any financial or economic interest and all other 312.3individuals with a ten percent or greater financial or economic interest in the facility.;312.4    (3) the location where procedures were performed;312.5    (4) the number of units of each type of fixed, portable, and mobile scanner used at 312.6each location;312.7    (5) the average number of hours per month each mobile scanner was operated at 312.8each location;312.9    (6) the number of hours per month each scanner was leased, if applicable;312.10    (7) the total number of diagnostic imaging procedures billed for by the provider at 312.11each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph 312.12(b); and312.13    (8) a report on major health care capital expenditures during the previous year, as 312.14required by section 62J.17.312.15    Subd. 2. Commissioner's right to inspect records. If the report is not filed or 312.16the commissioner of health has reason to believe the report is incomplete or false, the 312.17commissioner shall have the right to inspect diagnostic imaging facility books, audits, 312.18and records.312.19    Subd. 3. Separate reports.For a diagnostic imaging facility that is not attached 312.20or not contiguous to a hospital or a hospital affiliate, the commissioner shall require 312.21the information in subdivision 1 be reported separately for each detached diagnostic 312.22imaging facility as part of the report required under section 144.702. If any entity owns 312.23more than one diagnostic imaging facility, that entity must report by individual facility. 312.24Reports must include only services that were billed by the provider of diagnostic imaging 312.25services submitting the report. If a diagnostic imaging facility leases capacity, technical 312.26services, or professional services to one or more other providers of diagnostic imaging 312.27services, each provider must submit a separate annual report to the commissioner for all 312.28diagnostic imaging services that it provided and billed. The owner of the leased capacity 312.29must provide a report listing the names and addresses of providers to whom the diagnostic 312.30imaging services and equipment were leased.312.31    Subd. 4. Definitions. For purposes of this section, the following terms have the 312.32meanings given:312.33    (a) "Diagnostic imaging facility" means a health care facility that providesis not 312.34a hospital or location licensed as a hospital which offers diagnostic imaging services 312.35through the use of ionizing radiation or other imaging technique including, but not limited 312.36to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a 313.1freestanding or mobile basis in Minnesota, regardless of whether the equipment used 313.2to provide the service is owned or leased. For the purposes of this section, diagnostic 313.3imaging facility includes, but is not limited to, facilities such as a physician's office, clinic, 313.4mobile transport vehicle, outpatient imaging center, or surgical center.313.5    (b) "Diagnostic imaging service" means the use of ionizing radiation or other 313.6imaging technique on a human patient including, but not limited to, magnetic resonance 313.7imaging (MRI) or computerized tomography (CT), positron emission tomography (PET), 313.8or single photon emission computerized tomography (SPECT) scans using fixed, portable, 313.9or mobile equipment.313.10    (b)(c) "Financial or economic interest" means a direct or indirect:313.11    (1) equity or debt security issued by an entity, including, but not limited to, shares of 313.12stock in a corporation, membership in a limited liability company, beneficial interest in 313.13a trust, units or other interests in a partnership, bonds, debentures, notes or other equity 313.14interests or debt instruments, or any contractual arrangements;313.15    (2) membership, proprietary interest, or co-ownership with an individual, group, or 313.16organization to which patients, clients, or customers are referred to; or313.17    (3) employer-employee or independent contractor relationship, including, but not 313.18limited to, those that may occur in a limited partnership, profit-sharing arrangement, or 313.19other similar arrangement with any facility to which patients are referred, including any 313.20compensation between a facility and a health care provider, the group practice of which 313.21the provider is a member or employee or a related party with respect to any of them.313.22    (c)(d) "Freestanding Fixed equipment" means a stationary diagnostic imaging 313.23facility that is not located within a: machine installed in a permanent location.313.24    (1) hospital;313.25    (2) location licensed as a hospital; or313.26    (3) physician's office or clinic where the professional practice of medicine by 313.27licensed physicians is the primary purpose and not the provision of ancillary services 313.28such as diagnostic imaging.313.29    (d)(e) "Mobile equipment" means a diagnostic imaging facility that is transported to 313.30various sites not including movement within a hospital or a physician's office or clinic313.31machine in a self-contained transport vehicle designed to be brought to a temporary offsite 313.32location to perform diagnostic imaging services.313.33    (f) "Portable equipment" means a diagnostic imaging machine designed to be 313.34temporarily transported within a permanent location to perform diagnostic imaging 313.35services.314.1    (g) "Provider of diagnostic imaging services" means a diagnostic imaging facility 314.2or an entity that offers and bills for diagnostic imaging services at a facility owned or 314.3leased by the entity.314.4    Subd. 5.Reports open to public inspection.All reports filed pursuant to this 314.5section shall be open to public inspection.314.6    Sec. 24. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS 314.7CONTROL PROGRAMS.314.8    In order to improve the prevention of hospital-associated bloodstream infections due 314.9to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall establish 314.10an MRSA control program that meets Minnesota Department of Health best practices 314.11standards as published January 15, 2008, including considerations of: 314.12    (1) identification of all MRSA-colonized patients in all intensive care units, and 314.13other at-risk patients identified by the hospital, through active surveillance testing; 314.14    (2) isolation of identified MRSA-colonized or MRSA-infected patients in an 314.15appropriate manner; 314.16    (3) monitoring and strict enforcement of hand hygiene requirements; and 314.17    (4) maintenance of records.314.18    Sec. 25. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:314.19    Subd. 26. Right to associate.(a) Residents may meet with and receive visitors 314.20and participate in activities of commercial, religious, political, as defined in section 314.21203B.11
          and community groups without interference at their discretion if the activities 314.22do not infringe on the right to privacy of other residents or are not programmatically 314.23contraindicated. This includes:314.24    (1) the right to join with other individuals within and outside the facility to work for 314.25improvements in long-term care;314.26    (2) the right to visitation by an individual the patient has appointed as the patient's 314.27health care agent under chapter 145C;314.28    (3) the right to visitation and health care decision making by an individual designated 314.29by the patient under paragraph (c).314.30    (b) Upon admission to a facility where federal law prohibits unauthorized disclosure 314.31of patient or resident identifying information to callers and visitors, the patient or 314.32resident, or the legal guardian or conservator of the patient or resident, shall be given the 314.33opportunity to authorize disclosure of the patient's or resident's presence in the facility 314.34to callers and visitors who may seek to communicate with the patient or resident. To the 315.1extent possible, the legal guardian or conservator of a patient or resident shall consider the 315.2opinions of the patient or resident regarding the disclosure of the patient's or resident's 315.3presence in the facility. 315.4    (c) Upon admission to a facility, the patient or resident, or the legal guardian 315.5or conservator of the patient or resident, must be given the opportunity to designate 315.6a person who is not related who will have the status of the patient's next of kin with 315.7respect to visitation and making a health care decision. A designation must be included 315.8in the patient's health record. With respect to making a health care decision, a health 315.9care directive or appointment of a health care agent under chapter 145C prevails over a 315.10designation made under this paragraph. The unrelated person may also be identified as 315.11such by the patient or by the patient's family.315.12    Sec. 26. Minnesota Statutes 2006, section 144D.03, subdivision 1, is amended to read:315.13    Subdivision 1. Registration procedures. The commissioner shall establish forms 315.14and procedures for annual registration of housing with services establishments. The 315.15commissioner shall charge an annual registration fee of $35 $155. No fee shall be 315.16refunded. A registered establishment shall notify the commissioner within 30 days of the 315.17date it is no longer required to be registered under this chapter or of any change in the 315.18business name or address of the establishment, the name or mailing address of the owner 315.19or owners, or the name or mailing address of the managing agent. There shall be no 315.20fee for submission of the notice.315.21    Sec. 27. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.315.22    Subdivision 1.Definitions.For purposes of this section, "federally qualified health 315.23center" means an entity that is receiving a grant under United States Code, title 42, 315.24section 254b, or, based on the recommendation of the Health Resources and Services 315.25Administration within the Public Health Service, is determined by the secretary to meet 315.26the requirements for receiving such a grant.315.27    Subd. 2.Allocation of subsidies.The commissioner of health shall distribute 315.28subsidies to federally qualified health centers operating in Minnesota to continue, expand, 315.29and improve federally qualified health center services to low-income populations. The 315.30commissioner shall distribute the funds appropriated under this section to federally 315.31qualified health centers operating in Minnesota as of January 1, 2007. The amount of 315.32each subsidy shall be in proportion to each federally qualified health center's amount of 315.33discounts granted to patients during calendar year 2006 as reported on the federal Uniform 315.34Data System report in conformance with the Bureau of Primary Health Care Program 316.1Expectations Policy Information Notice 98-23, except that each eligible federally qualified 316.2health center shall receive at least two percent but no more than 30 percent of the total 316.3amount of money available under this section.316.4    Sec. 28. Minnesota Statutes 2006, section 145C.05, is amended to read:316.5145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.316.6    Subdivision 1. Content. A health care directive executed pursuant to this chapter 316.7may, but need not, be in the form contained in section 
         145C.16. 316.8    Subd. 2. Provisions that may be included. (a) A health care directive may include 316.9provisions consistent with this chapter, including, but not limited to:316.10    (1) the designation of one or more alternate health care agents to act if the named 316.11health care agent is not reasonably available to serve;316.12    (2) directions to joint health care agents regarding the process or standards by which 316.13the health care agents are to reach a health care decision for the principal, and a statement 316.14whether joint health care agents may act independently of one another;316.15    (3) limitations, if any, on the right of the health care agent or any alternate health 316.16care agents to receive, review, obtain copies of, and consent to the disclosure of the 316.17principal's medical records or to visit the principal when the principal is a patient in a 316.18health care facility;316.19    (4) limitations, if any, on the nomination of the health care agent as guardian for 316.20purposes of sections 
         524.5-202, 
         524.5-211, 
         524.5-302, and 
         524.5-303; 316.21    (5) a document of gift for the purpose of making an anatomical gift, as set forth in 316.22sections 
         525.921 to 
         525.9224, or an amendment to, revocation of, or refusal to make 316.23an anatomical gift; 316.24    (6) a declaration regarding intrusive mental health treatment under section 
         253B.03, 316.25subdivision 6d
         , or a statement that the health care agent is authorized to give consent for 316.26the principal under section 
         253B.04, subdivision 1a; 316.27    (7) a funeral directive as provided in section 
         149A.80, subdivision 2; 316.28    (8) limitations, if any, to the effect of dissolution or annulment of marriage or 316.29termination of domestic partnership on the appointment of a health care agent under 316.30section 
         145C.09, subdivision 2; 316.31    (9) specific reasons why a principal wants a health care provider or an employee 316.32of a health care provider attending the principal to be eligible to act as the principal's 316.33health care agent;316.34    (10) health care instructions by a woman of child bearing age regarding how she 316.35would like her pregnancy, if any, to affect health care decisions made on her behalf; and317.1    (11) health care instructions regarding artificially administered nutrition or hydration.317.2    (b) A health care directive may include a statement of the circumstances under 317.3which the directive becomes effective other than upon the judgment of the principal's 317.4attending physician in the following situations:317.5    (1) a principal who in good faith generally selects and depends upon spiritual means 317.6or prayer for the treatment or care of disease or remedial care and does not have an 317.7attending physician, may include a statement appointing an individual who may determine 317.8the principal's decision-making capacity; and317.9    (2) a principal who in good faith does not generally select a physician or a health 317.10care facility for the principal's health care needs may include a statement appointing an 317.11individual who may determine the principal's decision-making capacity, provided that if 317.12the need to determine the principal's capacity arises when the principal is receiving care 317.13under the direction of an attending physician in a health care facility, the determination 317.14must be made by an attending physician after consultation with the appointed individual.317.15    If a person appointed under clause (1) or (2) is not reasonably available and the 317.16principal is receiving care under the direction of an attending physician in a health care 317.17facility, an attending physician shall determine the principal's decision-making capacity.317.18    (c) A health care directive may authorize a health care agent to make health care 317.19decisions for a principal even though the principal retains decision-making capacity.317.20    Sec. 29. Minnesota Statutes 2006, section 145C.07, is amended by adding a 317.21subdivision to read:317.22    Subd. 5.Visitation.A health care agent may visit the principal when the 317.23principal is a patient in a health care facility regardless of whether the principal retains 317.24decision-making capacity, unless:317.25    (1) the principal has otherwise specified in the health care directive;317.26    (2) a principal who retains decision-making capacity indicates otherwise; or317.27    (3) a health care provider reasonably determines that the principal must be isolated 317.28from all visitors or that the presence of the health care agent would endanger the health or 317.29safety of the principal, other patients, or the facility in which the care is being provided.317.30    Sec. 30. Minnesota Statutes 2006, section 148.6445, subdivision 1, is amended to read:317.31    Subdivision 1. Initial licensure fee. The initial licensure fee for occupational 317.32therapists is $180 $145. The initial licensure fee for occupational therapy assistants is 317.33$100 $80. The commissioner shall prorate fees based on the number of quarters remaining 317.34in the biennial licensure period.318.1    Sec. 31. Minnesota Statutes 2006, section 148.6445, subdivision 2, is amended to read:318.2    Subd. 2. Licensure renewal fee. The biennial licensure renewal fee for 318.3occupational therapists is $180 $145. The biennial licensure renewal fee for occupational 318.4therapy assistants is $100 $80.318.5    Sec. 32. [148.785] FEES.318.6    The fees charged by the board are fixed at the following rates:318.7    (1) application fee for physical therapists and physical therapist assistants, $100;318.8    (2) annual licensure for physical therapists and physical therapist assistants, $60;318.9    (3) licensure renewal late fee, $20;318.10    (4) temporary permit, $25;318.11    (5) duplicate license or registration, $20;318.12    (6) certification letter, $25;318.13    (7) education or training program approval, $100;318.14    (8) report creation and generation, $60 per hour billed in quarter-hour increments 318.15with a quarter-hour minimum; and318.16    (9) examination administration:318.17    (i) half day, $50; and318.18    (ii) full day, $80.318.19    Sec. 33. Minnesota Statutes 2006, section 148B.53, subdivision 3, is amended to read:318.20    Subd. 3. Fee. Nonrefundable fees are as follows:318.21    (1) initial license application fee for licensed professional counseling (LPC) - $250318.22$150;318.23    (2) initial license fee for LPC - $250;318.24    (3) annual active license renewal fee for LPC - $200 $250 or equivalent;318.25    (3) (4) annual inactive license renewal fee for LPC - $100 $125;318.26    (5) initial license application fee for licensed professional clinical counseling 318.27(LPCC) - $150;318.28    (6) initial license fee for LPCC - $250;318.29    (7) annual active license renewal fee for LPCC - $250 or equivalent;318.30    (8) annual inactive license renewal fee for LPCC - $125;318.31    (4) (9) license renewal late fee - $100 per month or portion thereof;318.32    (5) (10) copy of board order or stipulation - $10;318.33    (6) (11) certificate of good standing or license verification - $10 $25;318.34    (7) (12) duplicate certificate fee - $10 $25;319.1    (8) (13) professional firm renewal fee - $25;319.2    (9) (14) sponsor application for approval of a continuing education course - $60;319.3    (15) initial registration fee - $50; and319.4    (10) (16) annual registration renewal fee - $25; and319.5    (17) approved supervisor application processing fee - $30.319.6    Sec. 34. Minnesota Statutes 2006, section 149A.52, subdivision 3, is amended to read:319.7    Subd. 3. Application procedure; documentation; initial inspection. An applicant 319.8for a license to operate a crematory shall submit to the commissioner a completed 319.9application. A completed application includes:319.10    (1) a completed application form, as provided by the commissioner;319.11    (2) proof of business form and ownership; and319.12    (3) proof of liability insurance coverage or other financial documentation, as 319.13determined by the commissioner, that demonstrates the applicant's ability to respond in 319.14damages for liability arising from the ownership, maintenance, management, or operation 319.15of a crematory.319.16    Upon receipt of the application and appropriate fee, the commissioner shall review 319.17and verify all information. Upon completion of the verification process and resolution 319.18of any deficiencies in the application information, the commissioner shall conduct an 319.19initial inspection of the premises to be licensed. After the inspection and resolution of 319.20any deficiencies found and any reinspections as may be necessary, the commissioner shall 319.21make a determination, based on all the information available, to grant or deny licensure. If 319.22the commissioner's determination is to grant the license, the applicant shall be notified and 319.23the license shall issue and remain valid for a period prescribed on the license, but not to 319.24exceed one calendar year from the date of issuance of the license. If the commissioner's 319.25determination is to deny the license, the commissioner must notify the applicant, in 319.26writing, of the denial and provide the specific reason for denial.319.27    Sec. 35. [149A.65] FEES.319.28    Subdivision 1.Generally.This section establishes the fees for registrations, 319.29examinations, initial and renewal licenses, and late fees authorized under the provisions 319.30of this chapter.319.31    Subd. 2.Mortuary science fees.Fees for mortuary science are:319.32    (1) $50 for the initial and renewal registration of a mortuary science intern;319.33    (2) $100 for the mortuary science examination;319.34    (3) $125 for issuance of initial and renewal mortuary science licenses;320.1    (4) $25 late fee charge for a license renewal; and320.2    (5) $200 for issuing a mortuary science license by endorsement.320.3    Subd. 3.Funeral directors.The license renewal fee for funeral directors is $125. 320.4The late fee charge for a license renewal is $25.320.5    Subd. 4.Funeral establishments.The initial and renewal fee for funeral 320.6establishments is $300. The late fee charge for a license renewal is $25.320.7    Subd. 5.Crematories.The initial and renewal fee for a crematory is $300. The 320.8late fee charge for a license renewal is $25.320.9    Sec. 36. Minnesota Statutes 2006, section 149A.97, subdivision 7, is amended to read:320.10    Subd. 7. Reports to commissioner. Every funeral provider lawfully doing business 320.11in Minnesota that accepts funds under subdivision 2 must make a complete annual report 320.12to the commissioner. The reports may be on forms provided by the commissioner or 320.13substantially similar forms containing, at least, identification and the state of each trust 320.14account, including all transactions involving principal and accrued interest, and must be 320.15filed by March 31 of the calendar year following the reporting year along with a filing 320.16fee of $15 $25 for each report. Fees shall be paid to the commissioner of finance, state of 320.17Minnesota, for deposit in the state government special revenue fund in the state treasury. 320.18Reports must be signed by an authorized representative of the funeral provider and 320.19notarized under oath. All reports to the commissioner shall be reviewed for account 320.20inaccuracies or possible violations of this section. If the commissioner has a reasonable 320.21belief to suspect that there are account irregularities or possible violations of this section, 320.22the commissioner shall report that belief, in a timely manner, to the state auditor. The 320.23commissioner shall also file an annual letter with the state auditor disclosing whether or 320.24not any irregularities or possible violations were detected in review of the annual trust 320.25fund reports filed by the funeral providers. This letter shall be filed with the state auditor 320.26by May 31 of the calendar year following the reporting year.320.27    Sec. 37. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:320.28    Subdivision 1. License required annually. A license is required annually for every 320.29person, firm, or corporation engaged in the business of conducting a food and beverage 320.30service establishment, hotel, motel, lodging establishment, or resort. Any person wishing 320.31to operate a place of business licensed in this section shall first make application, pay the 320.32required fee specified in this section, and receive approval for operation, including plan 320.33review approval. Seasonal and temporary food stands and special event food stands are 320.34not required to submit plans. Nonprofit organizations operating a special event food 321.1stand with multiple locations at an annual one-day event shall be issued only one license. 321.2Application shall be made on forms provided by the commissioner and shall require 321.3the applicant to state the full name and address of the owner of the building, structure, 321.4or enclosure, the lessee and manager of the food and beverage service establishment, 321.5hotel, motel, lodging establishment, or resort; the name under which the business is to 321.6be conducted; and any other information as may be required by the commissioner to 321.7complete the application for license.321.8    Sec. 38. HEALTH PROMOTION PROGRAM.321.9    The State Community Health Services Advisory Committee established in 321.10Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to fund and 321.11implement an ongoing comprehensive health promotion program that can effect change 321.12more effectively and at lower cost at a community level rather than through individual 321.13counseling and change promotion. The program shall use proven public health strategies 321.14to promote healthy lifestyles and behaviors in order to establish a sustainable, long-term 321.15approach to reducing preventable disability, chronic health conditions, and disease. The 321.16focus shall be on community based initiatives that address childhood and adult obesity, 321.17tobacco and substance abuse, improved activity levels among senior citizens, and other 321.18lifestyle issues that impact health and healthcare costs. Because of its population health 321.19focus, funding shall be related to the size of the population to be served. The plan shall be 321.20completed by September 15, 2007, and shared with the Legislative Health Care Access 321.21Commission.321.22    Sec. 39. INJUNCTIVE RELIEF REPORT.321.23    The commissioner of health shall present to the 2008 legislature, by December 15, 321.242007, recommendations to fund the cost of bringing actions for injunctive relief under 321.25Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).321.26    Sec. 40. DIAGNOSTIC IMAGING SERVICES ADVISORY COMMITTEE; 321.27ESTABLISHMENT.321.28    (a) The commissioner of health shall establish a Diagnostic Imaging Services 321.29Advisory Committee to perform the following duties:321.30    (1) gather and analyze data to understand the factors driving utilization of diagnostic 321.31imaging services, including computed tomography (CT), magnetic resonance imaging 321.32(MRI), positron emission tomography (PET), magnetic resonance angiography (MRA), 321.33and nuclear cardiology, in the state relative to evidence-based guidelines; and322.1    (2) develop recommendations, based on the data collected, on how to improve 322.2the delivery of evidence-based diagnostic imaging services. In developing these 322.3recommendations, the advisory committee shall consider the impacts on patient care, 322.4premium costs, and administrative simplicity.322.5    (b) The members of the Diagnostic Imaging Services Advisory Committee shall 322.6include the commissioners of health and human services or the commissioners' designees 322.7and the following:322.8    (1) three physicians representing speciality and geographic diversity, appointed by 322.9the Minnesota Medical Association;322.10    (2) two hospital representatives, one from a metropolitan hospital and one from a 322.11rural hospital, appointed by the Minnesota Hospital Association;322.12    (3) three health plan company representatives appointed by the Minnesota Council 322.13of Health Plans;322.14    (4) two representatives appointed by the Institute for Clinical System Improvement; 322.15and322.16    (5) one clinic manager appointed by the Minnesota Medical Group Management 322.17Association.322.18    (c) The Diagnostic Imaging Services Advisory Committee shall convene no later 322.19than September 1, 2007. The commissioner shall report back to the legislature no later 322.20than January 15, 2008. The advisory committee is governed under Minnesota Statutes, 322.21section 15.059, except that members shall not receive a per diem and may only be 322.22reimbursed for expenses.322.23    (d) A strategy to improve the delivery of evidence-based diagnostic imaging services 322.24may be developed by health plans. The commissioner of health shall report the agreement 322.25to the chairs of the senate and house health care committees immediately.322.26EFFECTIVE DATE.This section is effective July 1, 2007.322.27    Sec. 41. HEARING AID DISPENSER FEES.322.28    Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section 322.29153A.17, may not be increased until after the Department of Health provides a report to 322.30the legislature regarding the need and reasons for fee increases.322.31    Sec. 42. REVISOR'S INSTRUCTION.322.32    In Minnesota Statutes and Minnesota Rules, the revisor shall change the references 322.33in column A with the references in column B.

323.1Column AColumn B323.2section 144.335sections 144.291 to 144.298323.3section 144.335, subdivision 1section 144.291, subdivision 2323.4323.5section 144.335, subdivision 1, paragraph (b)section 144.291, subdivision 2, paragraph (h)323.6323.7section 144.335, subdivision 2, paragraphs (a) and (b)section 144.292, subdivisions 2 and 5323.8section 144.335, subdivision 2section 144.292323.9section 144.335, subdivision 3asection 144.294, subdivision 2323.10323.11section 144.335, subdivision 3a, paragraph (d)section 144.295323.12323.13section 144.335, subdivision 3a, paragraph (f)section 144.294323.14section 144.335, subdivision 3bsection 144.293, subdivision 7

323.15    Sec. 43.  REPEALER.323.16(a) Minnesota Statutes 2006, section 144.335, is repealed.323.17(b) Minnesota Statutes 2006, section 62J.17, subdivisions 1, 5a, 6a, and 8, are 323.18repealed.323.19(c) Minnesota Rules, part 4610.2800, is repealed.323.20ARTICLE 7323.21MISCELLANEOUS323.22    Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a 323.23subdivision to read:323.24    Subd. 2a.Base budget detail.Within one week of the release of the budget forecasts 323.25required in section 16A.102 in November of an even-numbered year and February of an 323.26odd-numbered year, the commissioner, after consulting with the commissioners of human 323.27services and health, must provide to the legislature information at the program, budget 323.28activity and management activity level for the base level budget of the Department of 323.29Human Services and the Department of Health for the next biennium. The information 323.30must be organized in a manner that explains how base level budget appropriations are 323.31projected to be spent. Within one week of the release of the budget forecasts required in 323.32section 16A.102 in November of an even-numbered year, the commissioner must also 323.33provide the legislature with the information submitted by the commissioners of human 323.34services and health under subdivision 2, clauses (3) and (4).324.1    Sec. 2. Minnesota Statutes 2006, section 43A.316, is amended to read:324.243A.316 PUBLIC EMPLOYEES INSURANCE PROGRAM.324.3    Subdivision 1. Intent. The legislature finds that the creation of a statewide program 324.4to provide public employees and other eligible persons with life insurance and hospital, 324.5medical, and dental benefit coverage through provider organizations would result in a 324.6greater utilization more efficient use of government resources and would advance the 324.7health and welfare of the citizens of the state.324.8    Subd. 2. Definitions. For the purpose of this section, the terms defined in this 324.9subdivision have the meaning given them.324.10    (a)  Commissioner. "Commissioner" means the commissioner of employee relations. 324.11    (b)  Employee. "Employee" means: 324.12    (1) a person who is a public employee within the definition of section 
         179A.03, 324.13subdivision 14
         , who is insurance eligible and is employed by an eligible employer; 324.14    (2) an elected public official of an eligible employer who is insurance eligible;324.15    (3) a person employed by a labor organization or employee association certified as 324.16an exclusive representative of employees of an eligible employer or by another public 324.17employer approved by the commissioner, so long as the plan meets the requirements of a 324.18governmental plan under United States Code, title 29, section 1002(32); or324.19    (4) a person employed by a county or municipal hospital.324.20    (c)  Eligible employer. "Eligible employer" means: 324.21    (1) a public employer within the definition of section 
         179A.03, subdivision 15, that 324.22is a town, county, city, school district as defined in section 
         120A.05, service cooperative 324.23as defined in section 
         123A.21, intermediate district as defined in section 
         136D.01, 324.24Cooperative Center for Vocational Education as defined in section 
         123A.22, regional 324.25management information center as defined in section 
         123A.23, or an education unit 324.26organized under the joint powers action, section 
         471.59; or 324.27    (2) an exclusive representative of employees, as defined in paragraph (b);324.28    (3) a county or municipal hospital; or324.29    (4) another public employer approved by the commissioner; or324.30    (5) a nursing home as defined in section 144A.01, subdivision 5, located in this state.324.31    (d)  Exclusive representative. "Exclusive representative" means an exclusive 324.32representative as defined in section 
         179A.03, subdivision 8. 324.33    (e)  Labor-Management Committee. "Labor-Management Committee" means the 324.34committee established by subdivision 4. 324.35    (f)  Program. "Program" means the statewide public employees insurance program 324.36created by subdivision 3. 325.1    Subd. 3. Public employee insurance program. The commissioner shall be the 325.2administrator of the public employee insurance program and may determine its funding 325.3arrangements. The commissioner may contract with a qualified entity to perform the 325.4administrative functions. The commissioner shall model the program after the plan 325.5established in section 
         43A.18, subdivision 2, but may modify adopt variations from that 325.6plan, in consultation with the Labor-Management Committee. The variations may include 325.7different deductibles, coinsurance, co-pays, or other enrollee cost-sharing provisions.325.8    Subd. 4. Labor-Management Committee.(a) The Labor-Management Committee 325.9consists of ten members appointed by the commissioner. The Labor-Management 325.10Committee must comprise five members who represent employees, including at least 325.11one retired employee, and five members who represent eligible employers. Committee 325.12members are eligible for expense reimbursement in the same manner and amount as 325.13authorized by the commissioner's plan adopted under section 
         43A.18, subdivision 2. The 325.14commissioner shall consult with the labor-management committee in major decisions 325.15that affect the program. The committee shall study issues and make recommendations 325.16relating to the insurance program including, but not limited to, flexible benefits, utilization 325.17review, quality assessment, and cost efficiency. The committee continues to exist while 325.18the program remains in operation. 325.19    (b) The five members of the Labor-Management Committee who represent 325.20employees must be chosen by the commissioner from among persons nominated as 325.21provided in this paragraph. Exclusive representatives of employees of counties, cities, 325.22school districts, and nursing homes are entitled to nominate two candidates for the 325.23Labor-Management Committee from each of those four categories, and the commissioner 325.24shall appoint one of those two nominees from each category. The commissioner shall 325.25choose the fifth employee to represent retired employees.325.26    (c) The five members of the Labor-Management Committee who represent employers 325.27must be chosen by the commissioner from among persons nominated as provided in 325.28this paragraph. The Association of Minnesota Counties, Minnesota League of Cities, 325.29Minnesota School Boards Association, and the Minnesota Association of Nursing Homes 325.30are each entitled to nominate two candidates for the committee, and the commissioner 325.31shall appoint one of those from each group. The commissioner shall select the fifth 325.32employer member from an employer participating in the program and not represented 325.33by the other four employer members, if any, or if that is not reasonably possible, the 325.34commissioner may appoint any other person as the fifth employer representative.325.35    Subd. 5. Public employee participation. (a) Participation in the program is subject 325.36to the conditions in this subdivision.326.1    (b) Each exclusive representative for an eligible employer determines whether the 326.2employees it represents will participate in the program. The exclusive representative shall 326.3give the employer notice of intent to participate at least 30 60 days before the expiration 326.4date of the collective bargaining agreement preceding the collective bargaining agreement 326.5that covers the date of entry into the program. Either all or none of the employees 326.6represented by an exclusive representative must participate. The exclusive representative 326.7and the eligible employer shall give notice to the commissioner of the determination to 326.8participate in the program at least 30 60 days before entry into the program. Entry into the 326.9program is governed by a schedule established by the commissioner.326.10    (c) Employees not represented by exclusive representatives may become members 326.11of the program upon a determination of an eligible employer to include these employees 326.12in the program. Either all or none of the employer's unrepresented employees must 326.13participate. The eligible employer shall give at least 30 60 days' notice to the commissioner 326.14before entering the program. Entry into the program is governed by a schedule established 326.15by the commissioner.326.16    (d) Participation in the program is for a two-year three-year term. Participation is 326.17automatically renewed for an additional two-year three-year term unless the exclusive 326.18representative, or the employer for unrepresented employees, gives the commissioner 326.19notice of withdrawal at least 30 60 days before expiration of the participation period. A 326.20group that withdraws must wait two years before rejoining, except with the approval of 326.21the commissioner. An exclusive representative, or employer for unrepresented employees, 326.22may also withdraw if premiums increase 50 percent by more than 20 percent in excess of 326.23the Consumer Price Index for all urban consumers or more from one insurance year to 326.24the next.326.25    (e) The exclusive representative shall give the employer notice of intent to withdraw 326.26to the commissioner at least 30 60 days before the expiration date of a collective 326.27bargaining agreement that includes the date on which the term of participation expires.326.28    (f) Each participating eligible employer shall notify the commissioner of the names 326.29of individuals who will be participating within two weeks of after the commissioner 326.30receiving receives notice of the parties' intent to participate. The employer shall also 326.31submit other information as required by the commissioner for administration of the 326.32program.326.33    (g) An employer that withdraws from the program under circumstances that do not 326.34permit withdrawal under this subdivision is liable to the board for premiums payable by 326.35the employer until the time that the employer is eligible to withdraw, and the employer 326.36shall pay those premiums voluntarily and no later than their due date. If the premiums are 327.1not paid voluntarily, the board has authority to and shall collect these premiums under any 327.2method permitted by law for a governmental or nongovernmental creditor of the employer.327.3    Subd. 6. Coverage. (a) By January 1, 1989, The commissioner shall announce the 327.4benefits of the program. The program shall include employee hospital, medical, dental, 327.5and life insurance for employees and hospital and medical benefits for dependents. Health 327.6maintenance organization options and other delivery system options may be provided if 327.7they are available, cost-effective, and capable of servicing the number of people covered 327.8in the program. Participation in optional coverages may be provided by collective 327.9bargaining agreements. For employees not represented by an exclusive representative, the 327.10employer may offer the optional coverages to eligible employees and their dependents 327.11provided in the program. Health coverage must include at least the benefits required of a 327.12health plan company regulated under chapter 62A, 62C, or 62D.327.13    (b) The commissioner, with the assistance of the Labor-Management Committee, 327.14shall periodically assess whether it is financially feasible for the program to offer or to 327.15continue an individual retiree program that has competitive premium rates and benefits. 327.16If the commissioner determines it to be feasible to offer an individual retiree program, 327.17the commissioner shall announce the applicable benefits, premium rates, and terms of 327.18participation. Eligibility to participate in the individual retiree program is governed by 327.19subdivision 8, but applies to retirees of eligible employers that do not participate in the 327.20program and to those retirees' dependents and surviving spouses.327.21    Subd. 6a. Chiropractic services Choice of type of provider. All benefits provided 327.22by the program or a successor program relating to expenses incurred for medical treatment 327.23or services of a physician health care provider must also include chiropractic treatment 327.24and services of a chiropractor any other type of licensed, certified, or registered health care 327.25provider to the extent that the chiropractic services and treatment are within the scope of 327.26chiropractic licensure the provider's licensure, certification, or registration.327.27    This subdivision is intended to provide equal access to benefits for program members 327.28who choose to obtain treatment for illness or injury from a doctor of chiropractic, as long 327.29as the treatment falls within the chiropractor's scope of practice. This subdivision is not 327.30intended to change or add to the benefits provided for in the program.327.31    Subd. 7. Premiums.(a) The proportion of premium paid by the employer and 327.32employee is subject to collective bargaining or personnel policies. If, at the beginning of 327.33the coverage period, no collective bargaining agreement has been finalized, the increased 327.34dollar costs, if any, from the previous year is the sole responsibility of the individual 327.35participant until a collective bargaining agreement states otherwise. Premiums, including 327.36an administration fee, shall be established by the commissioner. The commissioner may 328.1decide to rate specific employers separately for premium purposes, if the commissioner 328.2determines that doing so is in the best interests of the program. Each employer shall pay 328.3monthly the amounts due for employee benefits including the amounts under subdivision 328.48 to the commissioner no later than the dates established by the commissioner. If an 328.5employer fails to make the payments as required, the commissioner may shall cancel 328.6program benefits and pursue other civil remedies, as provided in subdivision 5, paragraph 328.7(d).328.8    (b) The premium charged for an employer's first month in the program must be 328.9three times the regular monthly premium charged to that employer, to help establish 328.10and maintain the program's financial resources. The extra two months premium must 328.11be refunded to the employer if the employer leaves the program, if the refund would 328.12not reduce the program's reserves below the level determined to be appropriate by the 328.13commissioner.328.14    Subd. 8. Continuation of coverage. (a) A former employee of an employer 328.15participating in the program who is receiving a public pension disability benefit or an 328.16annuity or has met the age and service requirements necessary to receive an annuity under 328.17chapter 353, 353C, 354, 354A, 356, 422A, 423, 423A, or 424, and the former employee's 328.18dependents, are eligible to participate in the program. This participation is at the person's 328.19expense unless a collective bargaining agreement or personnel policy provides otherwise. 328.20Premiums for these participants must be established by the commissioner.328.21    The commissioner may provide policy exclusions for preexisting conditions 328.22only when there is a break in coverage between a participant's coverage under the 328.23employment-based group insurance program and the participant's coverage under this 328.24section. An employer shall notify an employee of the option to participate under this 328.25paragraph no later than the effective date of retirement. The retired employee or the 328.26employer of a participating group on behalf of a current or retired employee shall notify 328.27the commissioner within 30 days of the effective date of retirement of intent to participate 328.28in the program according to the rules established by the commissioner.328.29    (b) The spouse of a deceased employee or former employee may purchase the 328.30benefits provided at premiums established by the commissioner if the spouse was a 328.31dependent under the employee's or former employee's coverage under this section at the 328.32time of the death. The spouse remains eligible to participate in the program as long as 328.33the group that included the deceased employee or former employee participates in the 328.34program. Coverage under this clause must be coordinated with relevant insurance benefits 328.35provided through the federally sponsored Medicare program.329.1    (c) The program benefits must continue in the event of strike permitted by section 329.2179A.18
         , if the exclusive representative chooses to have coverage continue and the 329.3employee pays the total monthly premiums when due. 329.4    (d) A participant who discontinues coverage may not reenroll.329.5    (d) Persons participating under these paragraphs this subdivision shall make 329.6appropriate premium payments in the time and manner established by the commissioner.329.7They are not subject to the payment of the extra payments required under subdivision 7, 329.8paragraph (b).329.9    Subd. 9. Insurance trust fund. The insurance trust fund in the state treasury 329.10consists of deposits of the premiums received from employers participating in the 329.11program and transfers before July 1, 1994, from the excess contributions holding account 329.12established by section 
         353.65, subdivision 7. All money in the fund is appropriated to 329.13the commissioner to pay insurance premiums, approved claims, refunds, administrative 329.14costs, and other related service costs. Premiums paid by employers to the fund are exempt 329.15from the taxes imposed by chapter 297I. The commissioner shall reserve an amount of 329.16money to cover the estimated costs of claims incurred but unpaid. The State Board of 329.17Investment shall invest the money according to section 
         11A.24. Investment income and 329.18losses attributable to the fund must be credited to the fund. 329.19    Subd. 10. Exemption. The public employee insurance program and, where 329.20applicable, the employers participating in it are exempt from chapters 60A, 62A, 62C, 329.2162D, 62E, and 62H, section 
         471.617, subdivisions 2 and 3, and the bidding requirements 329.22of section 
         471.6161, except as otherwise provided in subdivision 6, paragraph (a). 329.23    Subd. 11.Reinsurance.The commissioner may, on behalf of the program, 329.24participate in an insured or self-insured reinsurance pool.329.25    Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:329.2662H.02 REQUIRED PROVISIONS.329.27    (a) A joint self-insurance plan must include aggregate excess stop-loss coverage and 329.28individual excess stop-loss coverage provided by an insurance company licensed by the 329.29state of Minnesota. 329.30    (b) Aggregate excess stop-loss coverage must include provisions to cover incurred, 329.31unpaid claim liability in the event of plan termination. In addition,329.32    (c) The plan of self-insurance must have participating employers fund an amount at 329.33least equal to the point at which the excess or stop-loss insurer has contracted to assume 329.34100 percent of additional liability. 330.1    (d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance 330.2contract to the commissioner of commerce at least 30 days prior to the proposed plan's 330.3effective date and at least 30 days subsequent to any renewal date. The commissioner shall 330.4review the contract to determine if they meet the standards established by sections 
         62H.01330.5to 
         62H.08 and respond within a 30-day period. 330.6    (e) Any excess or stop-loss insurance plan must contain a provision that the excess 330.7or stop-loss insurer will give the plan and the commissioner of commerce a minimum of 330.8180 days' notice of termination or nonrenewal. If the plan fails to secure replacement 330.9coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the 330.10commissioner shall issue an order providing for the orderly termination of the plan. 330.11    (f) The commissioner may waive the requirements of this section and of any rule 330.12relating to the requirements of this section, if the commissioner determines that a joint 330.13self-insurance plan has established alternative arrangements that fully fund the plan's 330.14liability or incurred but unpaid claims. The commissioner may not waive the requirement 330.15that a joint self-insurance plan have excess stop-loss coverage. 330.16EFFECTIVE DATE.This section is effective the day following final enactment.330.17    Sec. 4. [62Q.40] LANGUAGE INTERPRETER SERVICES.330.18    (a) A health plan must cover sign language interpreter services provided to deaf and 330.19hard-of-hearing enrollees and language interpreter services provided to enrollees with 330.20limited English proficiency in order to facilitate the provision of health care services by a 330.21provider. For purposes of this section, "provider" has the meaning given in section 62J.03, 330.22subdivision 8, and includes a health care provider facility; and "health plan" includes 330.23coverage excluded under section 62A.011, subdivision 3, clauses (6), (7), (9), and (10). 330.24Interpreter services may be provided in person, by telephone, facsimile, video or audio 330.25streaming, or by video conference. In accordance with paragraphs (b) and (c), a health 330.26plan company shall reimburse either the party providing interpreter services directly 330.27for the costs of language interpreter services provided to the enrollee or the provider 330.28arranging for the provision of interpreter services. Providers that employ or contract 330.29with interpreters may bill and shall be reimbursed directly by health plan companies for 330.30such services in accordance with paragraph (b). A health plan company shall provide to 330.31enrollees, upon request, the policies and procedures for addressing the needs of deaf and 330.32hard-of-hearing enrollees and enrollees with limited English proficiency. All parties 330.33providing interpreter services must disclose their methods for ensuring competency upon 330.34request of any health plan company, provider, or consumer.331.1    (b) A health plan company shall pay for interpreter services as required in paragraph 331.2(a) by establishing a network of interpreter service providers and requiring use of its own 331.3network of interpreter services providers. The health plan company shall consider, as part 331.4of its interpreter service provider network, entering into an agreement with a provider for 331.5use of an interpreter service provider employed by or under contract with the provider if:331.6    (1) the provider accepts as reimbursement for services rendered by the provider's 331.7employed or contracted interpreter service provider the lesser of either the health plan 331.8company's reimbursement rate for its in-network interpreter service providers or the 331.9provider's fee for services rendered by the provider's interpreter service provider; and331.10    (2) the interpreter service provider meets the published quality standards of the 331.11health plan company.331.12    (c) If a health plan company's or a provider's employed or contracted interpreter 331.13service provider is unavailable to provide interpreter services, the health plan company 331.14shall reimburse the interpreter service provider at the lesser of the health plan company's 331.15median reimbursement rate for its in-network interpreter service providers or the 331.16interpreter service provider's fee. An interpreter service provider not employed or under 331.17contract with a health plan company or provider who fails to meet the quality standards 331.18of a health plan company or as required by law, shall be ineligible for reimbursement 331.19under this section.331.20    (d) If the health plan company pays the interpreter service provider directly, it has no 331.21obligation to pay the provider under this section.331.22    (e) Nothing in this section requires a health plan company to establish a network 331.23of interpreter service providers.331.24EFFECTIVE DATE.This section is effective July 1, 2008, and applies to plans 331.25issued or renewed to provide coverage to Minnesota residents on or after that date unless 331.26the legislature enacts alternative funding sources based on the recommendations of the 331.27commissioner.331.28    Sec. 5. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision 331.29to read:331.30    Subd. 5.Base budget detail.The commissioner shall provide the commissioner 331.31of finance with the information necessary to provide base budget detail to the legislature 331.32under section 16A.10, subdivision 2a.331.33    Sec. 6. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision 331.34to read:332.1    Subd. 11.Dispensing by protocol.A registered nurse in a family planning agency 332.2as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives 332.3prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant 332.4to a dispensing protocol established by the agency's medical director or under the direction 332.5of a physician. The dispensing protocol must address the requirements of sections 151.01, 332.6subdivision 30, and 151.212, subdivision 1.332.7    Sec. 7. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:332.8    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of 332.9professional practice only, may prescribe, administer, and dispense a legend drug, and may 332.10cause the same to be administered by a nurse, a physician assistant, or medical student or 332.11resident under the practitioner's direction and supervision, and may cause a person who 332.12is an appropriately certified, registered, or licensed health care professional to prescribe, 332.13dispense, and administer the same within the expressed legal scope of the person's practice 332.14as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, 332.15without reference to a specific patient, by directing a nurse, pursuant to section 
         148.235, 332.16subdivisions 8 and 9
         , physician assistant, or medical student or resident to adhere to 332.17a particular practice guideline or protocol when treating patients whose condition falls 332.18within such guideline or protocol, and when such guideline or protocol specifies the 332.19circumstances under which the legend drug is to be prescribed and administered. An 332.20individual who verbally, electronically, or otherwise transmits a written, oral, or electronic 332.21order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. 332.22This paragraph applies to a physician assistant only if the physician assistant meets the 332.23requirements of section 
         147A.18. 332.24    (b) A licensed practitioner that dispenses for profit a legend drug that is to be 332.25administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must 332.26file with the practitioner's licensing board a statement indicating that the practitioner 332.27dispenses legend drugs for profit, the general circumstances under which the practitioner 332.28dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to 332.29dispense legend drugs for profit after July 31, 1990, unless the statement has been filed 332.30with the appropriate licensing board. For purposes of this paragraph, "profit" means (1) 332.31any amount received by the practitioner in excess of the acquisition cost of a legend drug 332.32for legend drugs that are purchased in prepackaged form, or (2) any amount received 332.33by the practitioner in excess of the acquisition cost of a legend drug plus the cost of 332.34making the drug available if the legend drug requires compounding, packaging, or other 332.35treatment. The statement filed under this paragraph is public data under section 
         13.03. 333.1This paragraph does not apply to a licensed doctor of veterinary medicine or a registered 333.2pharmacist. Any person other than a licensed practitioner with the authority to prescribe, 333.3dispense, and administer a legend drug under paragraph (a) shall not dispense for profit. 333.4To dispense for profit does not include dispensing by a community health clinic when the 333.5profit from dispensing is used to meet operating expenses. 333.6    (c) A prescription or drug order for a legend drug is not valid unless it is issued 333.7for a legitimate medical purpose arising from a prescriber-patient relationship that 333.8includes a documented patient evaluation adequate to establish diagnoses and identify 333.9underlying conditions and contraindications to the treatment. Treatment, including issuing 333.10a prescription or drug order, based solely on an online questionnaire does not constitute a 333.11legitimate medical purpose.333.12    Sec. 8. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to 333.13read:333.14    Subd. 2d.Identification requirement for schedule II or III controlled substance.333.15    No person may dispense a controlled substance included in schedule II or III without 333.16requiring the person purchasing the controlled substance, who need not be the person for 333.17whom the controlled substance prescription is written, to present valid photographic 333.18identification, unless the person purchasing the controlled substance, or if applicable the 333.19person for whom the controlled substance prescription is written, is known to the dispenser.333.20    Sec. 9. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES 333.21PRESCRIPTION ELECTRONIC REPORTING SYSTEM.333.22    Subdivision 1.Definitions.For purposes of this section, the terms defined in this 333.23subdivision have the meanings given.333.24    (a) "Board" means the Minnesota State Board of Pharmacy established under 333.25chapter 151.333.26    (b) "Controlled substances" means those substances listed in section 152.02, 333.27subdivisions 3 and 4, and those substances defined by the board pursuant to section 333.28152.02, subdivisions 8 and 12.333.29    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 333.3030. Dispensing does not include the direct administering of a controlled substance to a 333.31patient by a licensed health care professional.333.32    (d) "Dispenser" means a person authorized by law to dispense a controlled substance, 333.33pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy 333.34that distributes controlled substances for inpatient hospital care.334.1    (e) "Prescriber" means a licensed health care professional who is authorized to 334.2prescribe a controlled substance under section 152.12, subdivision 1.334.3    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.334.4    Subd. 2.Prescription electronic reporting system.(a) By January 1, 2009, 334.5or upon enactment of legislation that implements the recommendations of the Board 334.6of Pharmacy under subdivision 3, paragraph (c), whichever is later, the board shall 334.7establish an electronic system for reporting the information required under subdivision 334.84 for all controlled substances dispensed within the state. Data for controlled substance 334.9prescriptions that are dispensed in a quantity small enough to provide treatment to a 334.10patient for a period of 48 hours or less need not be reported.334.11    (b) The board may contract with a vendor for the purpose of obtaining technical 334.12assistance in the design, implementation, and maintenance of the electronic reporting 334.13system. The vendor's role shall be limited to providing technical support to the board 334.14concerning the software, databases, and computer systems required to interface with the 334.15existing systems currently used by pharmacies to dispense prescriptions and transmit 334.16prescription data to other third parties.334.17    (c) The board may issue a waiver to a dispenser that is unable to submit dispensing 334.18information by electronic means. The waiver may permit the dispenser to submit 334.19dispensing information by paper form or other means, provided all information required 334.20by subdivision 4 is submitted in this alternative format.334.21    Subd. 3.Prescription Electronic Reporting Advisory Committee.(a) The 334.22board shall convene an advisory committee. The committee must include at least one 334.23representative of:334.24    (1) the Department of Health;334.25    (2) the Department of Human Services;334.26    (3) each health-related licensing board that licenses prescribers;334.27    (4) a professional medical association, which may include an association of pain 334.28management and chemical dependency specialists;334.29    (5) a professional pharmacy association; 334.30    (6) a consumer privacy or security advocate; and 334.31    (7) a consumer or patient rights organization.334.32    (b) The advisory committee shall advise the board on the development and operation 334.33of the electronic reporting system, including, but not limited to:334.34    (1) technical standards for electronic prescription drug reporting;334.35    (2) proper analysis and interpretation of prescription monitoring data; and334.36    (3) an evaluation process for the program.335.1    (c) The Board of Pharmacy, after consultation with the advisory committee, shall 335.2present recommendations and draft legislation on the issues addressed by the advisory 335.3committee under paragraph (b), to the legislature by December 15, 2007.335.4    Subd. 4.Reporting requirements and notice.(a) Each dispenser must submit the 335.5following data to the board or its designated vendor, subject to the notice required under 335.6paragraph (d):335.7    (1) prescriber DEA number;335.8    (2) dispenser DEA number;335.9    (3) name of the patient for whom the prescription was written;335.10    (4) date of birth of the patient for whom the prescription was written;335.11    (5) date the prescription was written;335.12    (6) date the prescription was filled;335.13    (7) NDC code for drug dispensed; and335.14    (8) quantity of controlled substance dispensed.335.15    (b) The dispenser must submit the required information according to the format and 335.16protocols specified in the "ASAP Telecommunications Format for Controlled Substances," 335.17May 1995 edition, published by the American Society for Automation in Pharmacy, which 335.18is hereby adopted by reference, by a procedure established by the board.335.19    (c) A dispenser is not required to submit this data for those controlled substance 335.20prescriptions dispensed for:335.21    (1) individuals residing in licensed skilled nursing or intermediate care facilities;335.22    (2) individuals receiving assisted living services under chapter 144G or through a 335.23medical assistance home and community-based waiver;335.24    (3) individuals receiving medication intravenously;335.25    (4) individuals receiving hospice and other palliative or end-of-life care; and335.26    (5) individuals receiving services from a home care provider regulated under chapter 335.27144A.335.28    (d) A dispenser must not submit data under this subdivision unless a conspicuous 335.29notice of the reporting requirements of this section is given to the patient for whom the 335.30prescription was written.335.31    Subd. 5.Use of data by board.(a) The board shall develop and maintain a database 335.32of the data reported under subdivision 4. The board shall maintain data that could identify 335.33an individual prescriber or dispenser in encrypted form. The database may be used by 335.34permissible users identified under subdivision 6 for the identification of:335.35    (1) individuals receiving prescriptions for controlled substances from prescribers 335.36who subsequently obtain controlled substances from dispensers in quantities or with a 336.1frequency inconsistent with generally recognized standards of dosage for those controlled 336.2substances; and 336.3    (2) individuals presenting forged or otherwise false or altered prescriptions for 336.4controlled substances to dispensers. 336.5    (b) No permissible user identified under subdivision 6 may access the database 336.6for the sole purpose of identifying prescribers of controlled substances for unusual or 336.7excessive prescribing patterns without a valid search warrant or court order.336.8    (c) No personnel of a state or federal occupational licensing board or agency may 336.9access the database for the purpose of obtaining information to be used to initiate or 336.10substantiate a disciplinary action against a prescriber.336.11    (d) Data reported under subdivision 4 shall be retained by the board in the database 336.12for a six-month period, and shall be removed from the database six months from the 336.13date the data was received.336.14    Subd. 6.Access to reporting system data.(a) Except as indicated in this 336.15subdivision, the data submitted to the board under subdivision 4 is private data on 336.16individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.336.17    (b) Except as specified in subdivision 5, the following persons shall be considered 336.18permissible users and may access the data submitted under subdivision 4 in the same or 336.19similar manner, and for the same or similar purposes, as those persons who are authorized 336.20to access similar private data on individuals under federal and state law:336.21    (1) a prescriber, to the extent the information relates specifically to a current patient 336.22of the prescriber, to whom the practitioner is prescribing or considering prescribing any 336.23controlled substance;336.24    (2) a dispenser to the extent the information relates specifically to a current patient to 336.25whom that dispenser is dispensing or considering dispensing any controlled substance;336.26    (3) an individual who is the recipient of a controlled substance prescription for 336.27which data was submitted under subdivision 4;336.28    (4) personnel of the board specifically assigned to conduct a bona fide investigation 336.29of a specific board licensee;336.30    (5) personnel of the board engaged in the collection of controlled substance 336.31prescription information as part of the assigned duties and responsibilities under this 336.32section;336.33    (6) authorized personnel of a vendor under contract with the board who are engaged 336.34in the design, implementation, and maintenance of the electronic reporting system as part 336.35of the assigned duties and responsibilities of their employment, provided that access to data 336.36is limited to the minimum amount necessary to test and maintain the system databases;337.1    (7) federal, state, and local law enforcement authorities engaged in a bona fide 337.2investigation of a specific person; and337.3    (8) personnel of the medical assistance program assigned to use the data collected 337.4under this section to identify recipients whose usage of controlled substances may warrant 337.5restriction to a single primary care physician, a single outpatient pharmacy, or a single 337.6hospital.337.7    (c) Any permissible user identified in paragraph (b), who directly accesses 337.8the data electronically, shall implement and maintain a comprehensive information 337.9security program that contains administrative, technical, and physical safeguards that 337.10are appropriate to the user's size and complexity, and the sensitivity of the personal 337.11information obtained. The permissible user shall identify reasonably foreseeable internal 337.12and external risks to the security, confidentiality, and integrity of personal information 337.13that could result in the unauthorized disclosure, misuse, or other compromise of the 337.14information and assess the sufficiency of any safeguards in place to control the risks.337.15    (d) The board shall not release data submitted under this section unless it is provided 337.16with evidence, satisfactory to the board, that the person requesting the information is 337.17entitled to receive the data. Access to the data by law enforcement authorities must be 337.18accompanied by a valid search warrant.337.19    (e) The board shall not release the name of a prescriber without the written consent 337.20of the prescriber or a valid search warrant or court order. The board shall provide a 337.21mechanism for a prescriber to submit to the board a signed consent authorizing the release 337.22of the prescriber's name when data containing the prescriber's name is requested.337.23    (f) The board shall maintain a log of all persons who access the data and shall ensure 337.24that any permissible user complies with paragraph (c) prior to attaining direct access to 337.25the data.337.26    Subd. 7.Disciplinary action.(a) A dispenser who knowingly fails to submit data to 337.27the board as required under this section is subject to disciplinary action by the appropriate 337.28health-related licensing board.337.29    (b) A prescriber or dispenser authorized to access the data who knowingly discloses 337.30the data in violation of state or federal laws relating to the privacy of health care data 337.31shall be subject to disciplinary action by the appropriate health-related licensing board, 337.32and appropriate civil penalties.337.33    Subd. 8.Evaluation and reporting.(a) The board shall evaluate the prescription 337.34electronic reporting system to determine if the system is cost-effective and whether it is 337.35negatively impacting appropriate prescribing practices of controlled substances. The 337.36board may contract with a vendor to design and conduct the evaluation.338.1    (b) The board shall submit the evaluation of the system to the legislature by January 338.215, 2010.338.3    Subd. 9.Immunity from liability; no requirement to obtain information.(a) A 338.4pharmacist, prescriber, or other dispenser making a report to the program in good faith 338.5under this section is immune from any civil, criminal, or administrative liability, which 338.6might otherwise be incurred or imposed as a result of the report, or on the basis that the 338.7pharmacist or prescriber did or did not seek or obtain or use information from the program.338.8    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser 338.9to obtain information about a patient from the program, and the pharmacist, prescriber, 338.10or other dispenser, if acting in good faith, is immune from any civil, criminal, or 338.11administrative liability that might otherwise be incurred or imposed for requesting, 338.12receiving, or using information from the program.338.13EFFECTIVE DATE.This section is effective July 1, 2007, or upon receiving 338.14sufficient nonstate funds to implement the prescription electronic reporting program, 338.15whichever is later. In the event that nonstate funds are not secured by the Board of 338.16Pharmacy to adequately fund the implementation of the prescription electronic reporting 338.17program, the board is not required to implement this section without a subsequent 338.18appropriation from the legislature.338.19    Sec. 10. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:338.20    Subd. 7. Essential employee. "Essential employee" means firefighters, peace 338.21officers subject to licensure under sections 
         626.84 to 
         626.863, 911 system and police and 338.22fire department public safety dispatchers, guards at correctional facilities, confidential 338.23employees, supervisory employees, assistant county attorneys, assistant city attorneys, 338.24principals, and assistant principals. However, for state employees, "essential employee" 338.25means all employees, except for nonprofessional employees employed by the Department 338.26of Human Services in mental health facilities for the treatment of psychopathic 338.27personalities, sexual predators, and the criminally insane, in law enforcement, public 338.28safety radio communications operators, health care professionals, correctional guards, 338.29professional engineering, and supervisory collective bargaining units, irrespective of 338.30severance, and no other employees. For University of Minnesota employees, "essential 338.31employee" means all employees in law enforcement, nursing professional and supervisory 338.32units, irrespective of severance, and no other employees. "Firefighters" means salaried 338.33employees of a fire department whose duties include, directly or indirectly, controlling, 338.34extinguishing, preventing, detecting, or investigating fires. Employees for whom the state 339.1court administrator is the negotiating employer are not essential employees. For Hennepin 339.2Healthcare System, Inc. employees, "essential employees" means all employees.339.3EFFECTIVE DATE.This section is effective the day following final enactment.339.4    Sec. 11. Minnesota Statutes 2006, section 245.4874, is amended to read:339.5245.4874 DUTIES OF COUNTY BOARD.339.6    (a) The county board must:339.7    (1) develop a system of affordable and locally available children's mental health 339.8services according to sections 
         245.487 to 
         245.4887;339.9    (2) establish a mechanism providing for interagency coordination as specified in 339.10section 
         245.4875, subdivision 6;339.11    (3) consider the assessment of unmet needs in the county as reported by the local 339.12children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 339.13(b), clause (3). The county shall provide, upon request of the local children's mental health 339.14advisory council, readily available data to assist in the determination of unmet needs;339.15    (4) assure that parents and providers in the county receive information about how to 339.16gain access to services provided according to sections 
         245.487 to 
         245.4887;339.17    (5) coordinate the delivery of children's mental health services with services 339.18provided by social services, education, corrections, health, and vocational agencies to 339.19improve the availability of mental health services to children and the cost-effectiveness of 339.20their delivery;339.21    (6) assure that mental health services delivered according to sections 
         245.487339.22to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 339.23assessment and individual treatment plan;339.24    (7) provide the community with information about predictors and symptoms of 339.25emotional disturbances and how to access children's mental health services according to 339.26sections 
         245.4877 and 
         245.4878;339.27    (8) provide for case management services to each child with severe emotional 339.28disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 339.29subdivisions 1, 3, and 5
         ;339.30    (9) provide for screening of each child under section 
         245.4885 upon admission 339.31to a residential treatment facility, acute care hospital inpatient treatment, or informal 339.32admission to a regional treatment center;340.1    (10) prudently administer grants and purchase-of-service contracts that the county 340.2board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 340.3245.4887
         ;340.4    (11) assure that mental health professionals, mental health practitioners, and case 340.5managers employed by or under contract to the county to provide mental health services 340.6are qualified under section 
         245.4871;340.7    (12) assure that children's mental health services are coordinated with adult mental 340.8health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 340.9health services is available to serve persons with mental illness, regardless of the person's 340.10age;340.11    (13) assure that culturally informed mental health consultants are used as necessary 340.12to assist the county board in assessing and providing appropriate treatment for children of 340.13cultural or racial minority heritage; and340.14    (14) consistent with section 
         245.486, arrange for or provide a children's mental 340.15health screening to a child receiving child protective services or a child in out-of-home 340.16placement, a child for whom parental rights have been terminated, a child found to be 340.17delinquent, and a child found to have committed a juvenile petty offense for the third 340.18or subsequent time, unless a screening or diagnostic assessment has been performed 340.19within the previous 180 days, or the child is currently under the care of a mental health 340.20professional. The court or county agency must notify a parent or guardian whose 340.21parental rights have not been terminated of the potential mental health screening and the 340.22option to prevent the screening by notifying the court or county agency in writing. The 340.23screening shall be conducted with a screening instrument approved by the commissioner 340.24of human services according to criteria that are updated and issued annually to ensure 340.25that approved screening instruments are valid and useful for child welfare and juvenile 340.26justice populations, and shall be conducted by a mental health practitioner as defined in 340.27section 
         245.4871, subdivision 26, or a probation officer or local social services agency 340.28staff person who is trained in the use of the screening instrument. Training in the use of the 340.29instrument shall include training in the administration of the instrument, the interpretation 340.30of its validity given the child's current circumstances, the state and federal data practices 340.31laws and confidentiality standards, the parental consent requirement, and providing respect 340.32for families and cultural values. If the screen indicates a need for assessment, the child's 340.33family, or if the family lacks mental health insurance, the local social services agency, 340.34in consultation with the child's family, shall have conducted a diagnostic assessment, 340.35including a functional assessment, as defined in section 
         245.4871. The administration of 340.36the screening shall safeguard the privacy of children receiving the screening and their 341.1families and shall comply with the Minnesota Government Data Practices Act, chapter 341.213, and the federal Health Insurance Portability and Accountability Act of 1996, Public 341.3Law 104-191. Screening results shall be considered private data and the commissioner 341.4shall not collect individual screening results.341.5    (b) When the county board refers clients to providers of children's therapeutic 341.6services and supports under section 
         256B.0943, the county board must clearly identify 341.7the desired services components not covered under section 
         256B.0943 and identify the 341.8reimbursement source for those requested services, the method of payment, and the 341.9payment rate to the provider.341.10    Sec. 12. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:341.11    Subd. 2. Transfer to correctional facility. (a) If a person has been committed 341.12under this section and later is committed to the custody of the commissioner of corrections 341.13for any reason, including but not limited to, being sentenced for a crime or revocation of 341.14the person's supervised release or conditional release under section 
         244.05, 609.108, 341.15subdivision 6, or 
         609.109, subdivision 7, the person shall be transferred to a facility 341.16designated by the commissioner of corrections without regard to the procedures provided 341.17in section 
         253B.18. 341.18    (b) If a person is committed under this section after a commitment to the 341.19commissioner of corrections, the person shall first serve the sentence in a facility 341.20designated by the commissioner of corrections. After the person has served the sentence, 341.21the person shall be transferred to a treatment program designated by the commissioner 341.22of human services.341.23    Sec. 13. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:341.24    Subd. 3. Rules for chemical dependency care. The commissioner of human 341.25services shall establish by rule criteria to be used in determining the appropriate level 341.26of chemical dependency care, whether outpatient, inpatient or short-term treatment 341.27programs, for each recipient of public assistance seeking treatment for alcohol or other 341.28drug dependency and abuse problems. The criteria shall address, at least, the family 341.29relationship, past treatment history, medical or physical problems, arrest record, and 341.30employment situation.341.31    Sec. 14. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:341.32    Subd. 2. Program and service guidelines. (a) The commissioner shall provide 341.33program and service guidelines and technical assistance to the county boards in carrying 342.1out services authorized under sections section254A.08, 254A.12, 254A.14, and their 342.2responsibilities under chapter 256E. 342.3    (b) The commissioner shall recommend to the governor means of improving 342.4the efficiency and effectiveness of comprehensive program services in the state and 342.5maximizing the use of nongovernmental funds for providing comprehensive programs.342.6    Sec. 15. [254A.20] CHEMICAL USE ASSESSMENTS; FINANCIAL CONFLICT 342.7OF INTEREST.342.8    (a) Except as provided in paragraph (b), an assessor conducting a chemical use 342.9assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any 342.10direct or shared financial interest or referral relationship resulting in shared financial 342.11interest or referral relationship resulting in shared financial gain with a treatment provider. 342.12    (b) A county may contract with an assessor having a conflict described in paragraph 342.13(a) if the county documents that: 342.14    (1) the assessor is employed by a culturally specific service provider or a service 342.15provider with a program designed to treat individuals of a specific age, sex, or sexual 342.16preference; 342.17    (2) the county does not employ a sufficient number of qualified assessors and the 342.18only qualified assessors available in the county have a direct or shared financial interest or 342.19a referral relationship resulting in shared financial gain with a treatment provider; or 342.20    (3) the county social service agency has an existing relationship with an assessor 342.21or service provider and elects to enter into a contract with that assessor to provide both 342.22assessment and treatment under circumstances specified in the county's contract, provided 342.23the county retains responsibility for making placement decisions.342.24EFFECTIVE DATE.This section is effective the day following final enactment.342.25    Sec. 16. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:342.26    Subdivision 1. Chemical dependency treatment allocation. The chemical 342.27dependency funds appropriated for allocation shall be placed in a special revenue account. 342.28The commissioner shall annually transfer funds from the chemical dependency fund to pay 342.29for operation of the drug and alcohol abuse normative evaluation system and to pay for all 342.30costs incurred by adding two positions for licensing of chemical dependency treatment 342.31and rehabilitation programs located in hospitals for which funds are not otherwise 342.32appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall 342.33allocate funds to the American Indian chemical dependency tribal account for treatment 342.34of American Indians by eligible vendors under section 254B.05, equal to the amount 343.1allocated in fiscal year 1997. Six percent of the remaining money must be reserved for 343.2tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall 343.3annually divide the money available in the chemical dependency fund that is not held 343.4in reserve by counties from a previous allocation, or allocated to the American Indian 343.5chemical dependency tribal account. Six percent of the remaining money must be 343.6reserved for the nonreservation American Indian chemical dependency allocation for 343.7treatment of American Indians by eligible vendors under section 
         254B.05, subdivision 343.81
         . The remainder of the money must be allocated among the counties according to the 343.9following formula, using state demographer data and other data sources determined by 343.10the commissioner: 343.11    (a) For purposes of this formula, American Indians and children under age 14 are 343.12subtracted from the population of each county to determine the restricted population.343.13    (b) The amount of chemical dependency fund expenditures for entitled persons for 343.14services not covered by prepaid plans governed by section 
         256B.69 in the previous year is 343.15divided by the amount of chemical dependency fund expenditures for entitled persons for 343.16all services to determine the proportion of exempt service expenditures for each county. 343.17    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 343.18service expenditures to determine the adjusted prepaid plan months of eligibility for 343.19each county.343.20    (d) The adjusted prepaid plan months of eligibility is added to the number of 343.21restricted population fee for service months of eligibility for the Minnesota family 343.22investment program, general assistance, and medical assistance and divided by the county 343.23restricted population to determine county per capita months of covered service eligibility.343.24    (e) The number of adjusted prepaid plan months of eligibility for the state is added 343.25to the number of fee for service months of eligibility for the Minnesota family investment 343.26program, general assistance, and medical assistance for the state restricted population and 343.27divided by the state restricted population to determine state per capita months of covered 343.28service eligibility.343.29    (f) The county per capita months of covered service eligibility is divided by the 343.30state per capita months of covered service eligibility to determine the county welfare 343.31caseload factor.343.32    (g) The median married couple income for the most recent three-year period 343.33available for the state is divided by the median married couple income for the same period 343.34for each county to determine the income factor for each county.343.35    (h) The county restricted population is multiplied by the sum of the county welfare 343.36caseload factor and the county income factor to determine the adjusted population.344.1    (i) $15,000 shall be allocated to each county.344.2    (j) The remaining funds shall be allocated proportional to the county adjusted 344.3population.344.4    Sec. 17. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:344.5    Subd. 5. Administrative adjustment. The commissioner may make payments to 344.6local agencies from money allocated under this section to support administrative activities 344.7under sections 
         254B.03 and 
         254B.04. The administrative payment must not exceed 344.8five percent of the first $50,000, four percent of the next $50,000, and three percent of 344.9the remaining payments for services from the allocation. Twenty-five percent of the 344.10administrative allowance shall be advanced at the beginning of each quarter, based on 344.11the payments for services made in the most recent quarter for which data is available. 344.12Adjustment of any overestimate or underestimate based on actual expenditures shall be 344.13made by the state agency by adjusting the administrative allowance for any succeeding 344.14quarter.344.15    Sec. 18. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:344.16    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical 344.17dependency services to persons residing within its jurisdiction who meet criteria 344.18established by the commissioner for placement in a chemical dependency residential or 344.19nonresidential treatment service. Chemical dependency money must be administered 344.20by the local agencies according to law and rules adopted by the commissioner under 344.21sections 
         14.001 to 
         14.69. 344.22    (b) In order to contain costs, the county board shall, with the approval of the 344.23commissioner of human services, select eligible vendors of chemical dependency services 344.24who can provide economical and appropriate treatment. Unless the local agency is a social 344.25services department directly administered by a county or human services board, the local 344.26agency shall not be an eligible vendor under section 
         254B.05. The commissioner may 344.27approve proposals from county boards to provide services in an economical manner or to 344.28control utilization, with safeguards to ensure that necessary services are provided. If a 344.29county implements a demonstration or experimental medical services funding plan, the 344.30commissioner shall transfer the money as appropriate. If a county selects a vendor located 344.31in another state, the county shall ensure that the vendor is in compliance with the rules 344.32governing licensure of programs located in the state. 344.33    (c) The calendar year 2002 rate for vendors may not increase more than three 344.34percent above the rate approved in effect on January 1, 2001. The calendar year 2003 345.1rate for vendors may not increase more than three percent above the rate in effect on 345.2January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in 345.3effect on January 1, 2003.345.4    (d) (c) A culturally specific vendor that provides assessments under a variance under 345.5Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 345.6persons not covered by the variance.345.7    Sec. 19. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:345.8    Subd. 3. Local agencies to pay state for county share.Local agencies shall submit 345.9invoices to the state on forms supplied by the commissioner and according to procedures 345.10established by the commissioner. Local agencies shall pay the state for the county share 345.11of the invoiced services authorized by the local agency. Payments shall be made at the 345.12beginning of each month for services provided in the previous month. The commissioner 345.13shall bill the county monthly for services, based on the most recent month for which 345.14expenditure information is available. Adjustment of any overestimate or underestimate 345.15based on actual expenditures shall be made by the state agency by adjusting the estimate 345.16for any succeeding month.345.17    Sec. 20. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:345.18    Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for 345.19placements made by local agencies under section 
         254B.03, subdivision 1, and placements 345.20by tribal designated agencies according to section 
         254B.09. The commissioner may 345.21reduce or deny payment of the state share when services are not provided according to the 345.22placement criteria established by the commissioner. The commissioner may pay for all or 345.23a portion of improper county chemical dependency placements and bill the county for the 345.24entire payment made when the placement did not comply with criteria established by the 345.25commissioner. The commissioner may make payments to vendors and charge the county 345.26100 percent of the payments if documentation of a county approved placement is received 345.27more than 30 working days, exclusive of weekends and holidays, after the date services 345.28began; or if the county approved invoice is received by the commissioner more than 120 345.29days after the last date of service provided. The commissioner shall not pay vendors until 345.30private insurance company claims have been settled. 345.31    Sec. 21. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 345.32to read:346.1    Subd. 25.Base budget detail.The commissioner shall provide the commissioner 346.2of finance with the information necessary to provide base budget detail to the legislature 346.3under section 16A.10, subdivision 2a.346.4    Sec. 22. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to 346.5read:346.6    Subd. 23. Day treatment services. Medical assistance covers day treatment 346.7services as specified in sections 
         245.462, subdivision 8, and 
         245.4871, subdivision 10, that 346.8are provided under contract with the county board. Notwithstanding Minnesota Rules, 346.9part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day 346.10treatment for adults according to section 
         256B.0625, subdivision 25. Notwithstanding 346.11Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance 346.12covers day treatment services for children as specified under section 
         256B.0943. 346.13    Sec. 23. [256B.0636] PRESCRIBING OF CONTROLLED SUBSTANCES; 346.14ABUSE PREVENTION.346.15    The commissioner shall develop and implement a plan to:346.16    (1) monitor the prescribing of controlled substances listed in section 152.02, 346.17subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 346.18section 152.02, subdivisions 8 and 12, by enrolled providers and providers under contract 346.19with participating managed care plans;346.20    (2) require enrolled providers and providers under contract with participating 346.21managed care plans to report information related to potential patient abuse of the 346.22controlled substances to the commissioner, and the Board of Pharmacy; and346.23    (3) provide education to Minnesota health care program enrollees on the proper use 346.24of controlled substances.346.25    Sec. 24. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to 346.26read:346.27    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be 346.28an eligible provider entity under this section, a provider entity must have a clinical 346.29infrastructure that utilizes diagnostic assessment, an individualized treatment plan, 346.30service delivery, and individual treatment plan review that are culturally competent, 346.31child-centered, and family-driven to achieve maximum benefit for the client. The provider 346.32entity must review and update the clinical policies and procedures every three years and 347.1must distribute the policies and procedures to staff initially and upon each subsequent 347.2update.347.3    (b) The clinical infrastructure written policies and procedures must include policies 347.4and procedures for:347.5    (1) providing or obtaining a client's diagnostic assessment that identifies acute and 347.6chronic clinical disorders, co-occurring medical conditions, sources of psychological and 347.7environmental problems, and a functional assessment. The functional assessment must 347.8clearly summarize the client's individual strengths and needs;347.9    (2) developing an individual treatment plan that is:347.10    (i) based on the information in the client's diagnostic assessment;347.11    (ii) developed no later than the end of the first psychotherapy session after the 347.12completion of the client's diagnostic assessment by the mental health professional who 347.13provides the client's psychotherapy;347.14    (iii) developed through a child-centered, family-driven planning process that 347.15identifies service needs and individualized, planned, and culturally appropriate 347.16interventions that contain specific treatment goals and objectives for the client and the 347.17client's family or foster family;347.18    (iv) reviewed at least once every 90 days and revised, if necessary; and347.19    (v) signed by the client or, if appropriate, by the client's parent or other person 347.20authorized by statute to consent to mental health services for the client;347.21    (3) developing an individual behavior plan that documents services to be provided 347.22by the mental health behavioral aide. The individual behavior plan must include:347.23    (i) detailed instructions on the service to be provided;347.24    (ii) time allocated to each service;347.25    (iii) methods of documenting the child's behavior;347.26    (iv) methods of monitoring the child's progress in reaching objectives; and347.27    (v) goals to increase or decrease targeted behavior as identified in the individual 347.28treatment plan;347.29    (4) clinical supervision of the mental health practitioner and mental health behavioral 347.30aide. A mental health professional must document the clinical supervision the professional 347.31provides by cosigning individual treatment plans and making entries in the client's record 347.32on supervisory activities. Clinical supervision does not include the authority to make or 347.33terminate court-ordered placements of the child. A clinical supervisor must be available 347.34for urgent consultation as required by the individual client's needs or the situation. Clinical 347.35supervision may occur individually or in a small group to discuss treatment and review 347.36progress toward goals. The focus of clinical supervision must be the client's treatment 348.1needs and progress and the mental health practitioner's or behavioral aide's ability to 348.2provide services;348.3    (4a) CTSS certified provider entities providing day treatment programs must meet 348.4the conditions in items (i) to (iii):348.5    (i) the provider supervisor must be present and available on the premises more 348.6than 50 percent of the time in a five-working-day period during which the supervisee is 348.7providing a mental health service;348.8    (ii) the diagnosis and the client's individual treatment plan or a change in the 348.9diagnosis or individual treatment plan must be made by or reviewed, approved, and signed 348.10by the provider supervisor; and348.11    (iii) every 30 days, the supervisor must review and sign the record of the client's care 348.12for all activities in the preceding 30-day period;348.13    (4b) for all other services provided under CTSS, clinical supervision standards 348.14provided in items (i) to (iii) must be used:348.15    (i) medical assistance shall reimburse a mental health practitioner who maintains a 348.16consulting relationship with a mental health professional who accepts full professional 348.17responsibility and is present on site for at least one observation during the first 12 hours 348.18in which the mental health practitioner provides the individual, family, or group skills 348.19training to the child or the child's family;348.20    (ii) thereafter, the mental health professional is required to be present on site for 348.21observation as clinically appropriate when the mental health practitioner is providing 348.22individual, family, or group skills training to the child or the child's family; and348.23    (iii) the observation must be a minimum of one clinical unit. The on-site presence of 348.24the mental health professional must be documented in the child's record and signed by the 348.25mental health professional who accepts full professional responsibility;348.26    (5) providing direction to a mental health behavioral aide. For entities that employ 348.27mental health behavioral aides, the clinical supervisor must be employed by the provider 348.28entity or other certified children's therapeutic supports and services provider entity to 348.29ensure necessary and appropriate oversight for the client's treatment and continuity 348.30of care. The mental health professional or mental health practitioner giving direction 348.31must begin with the goals on the individualized treatment plan, and instruct the mental 348.32health behavioral aide on how to construct therapeutic activities and interventions that 348.33will lead to goal attainment. The professional or practitioner giving direction must also 348.34instruct the mental health behavioral aide about the client's diagnosis, functional status, 348.35and other characteristics that are likely to affect service delivery. Direction must also 348.36include determining that the mental health behavioral aide has the skills to interact with 349.1the client and the client's family in ways that convey personal and cultural respect and 349.2that the aide actively solicits information relevant to treatment from the family. The aide 349.3must be able to clearly explain the activities the aide is doing with the client and the 349.4activities' relationship to treatment goals. Direction is more didactic than is supervision 349.5and requires the professional or practitioner providing it to continuously evaluate the 349.6mental health behavioral aide's ability to carry out the activities of the individualized 349.7treatment plan and the individualized behavior plan. When providing direction, the 349.8professional or practitioner must:349.9    (i) review progress notes prepared by the mental health behavioral aide for accuracy 349.10and consistency with diagnostic assessment, treatment plan, and behavior goals and the 349.11professional or practitioner must approve and sign the progress notes;349.12    (ii) identify changes in treatment strategies, revise the individual behavior plan, 349.13and communicate treatment instructions and methodologies as appropriate to ensure 349.14that treatment is implemented correctly;349.15    (iii) demonstrate family-friendly behaviors that support healthy collaboration among 349.16the child, the child's family, and providers as treatment is planned and implemented;349.17    (iv) ensure that the mental health behavioral aide is able to effectively communicate 349.18with the child, the child's family, and the provider; and349.19    (v) record the results of any evaluation and corrective actions taken to modify the 349.20work of the mental health behavioral aide;349.21    (6) providing service delivery that implements the individual treatment plan and 349.22meets the requirements under subdivision 9; and349.23    (7) individual treatment plan review. The review must determine the extent to which 349.24the services have met the goals and objectives in the previous treatment plan. The review 349.25must assess the client's progress and ensure that services and treatment goals continue to 349.26be necessary and appropriate to the client and the client's family or foster family. Revision 349.27of the individual treatment plan does not require a new diagnostic assessment unless the 349.28client's mental health status has changed markedly. The updated treatment plan must be 349.29signed by the client, if appropriate, and by the client's parent or other person authorized by 349.30statute to give consent to the mental health services for the child.349.31    Sec. 25. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to 349.32read:349.33    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a 349.34certified provider entity must ensure that:350.1    (1) each individual provider's caseload size permits the provider to deliver services 350.2to both clients with severe, complex needs and clients with less intensive needs. The 350.3provider's caseload size should reasonably enable the provider to play an active role in 350.4service planning, monitoring, and delivering services to meet the client's and client's 350.5family's needs, as specified in each client's individual treatment plan;350.6    (2) site-based programs, including day treatment and preschool programs, provide 350.7staffing and facilities to ensure the client's health, safety, and protection of rights, and that 350.8the programs are able to implement each client's individual treatment plan;350.9    (3) a day treatment program is provided to a group of clients by a multidisciplinary 350.10team under the clinical supervision of a mental health professional. The day treatment 350.11program must be provided in and by: (i) an outpatient hospital accredited by the Joint 350.12Commission on Accreditation of Health Organizations and licensed under sections 350.13144.50
          to 
         144.55; (ii) a community mental health center under section 
         245.62; and (iii) 350.14an entity that is under contract with the county board to operate a program that meets 350.15the requirements of sections 
         245.4712, subdivision 2, and 
         245.4884, subdivision 2, 350.16and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must 350.17stabilize the client's mental health status while developing and improving the client's 350.18independent living and socialization skills. The goal of the day treatment program must be 350.19to reduce or relieve the effects of mental illness and provide training to enable the client 350.20to live in the community. The program must be available at least one day a week for a 350.21minimum three-hour time block. The three-hour time block must include at least one 350.22hour, but no more than two hours, of individual or group psychotherapy. The remainder 350.23of the three-hour time block may include recreation therapy, socialization therapy, or 350.24independent living skills therapy, but only if the therapies are included in the client's 350.25individual treatment plan. Day treatment programs are not part of inpatient or residential 350.26treatment services; and 350.27    (4) a preschool program is a structured treatment program offered to a child who 350.28is at least 33 months old, but who has not yet reached the first day of kindergarten, by a 350.29preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts 350.309503.0005 to 9503.0175. The program must be available at least one day a week for a 350.31minimum two-hour time block. The structured treatment program may include individual 350.32or group psychotherapy and recreation therapy, socialization therapy, or independent 350.33living skills therapy, if included in the client's individual treatment plan.350.34    (b) A provider entity must deliver the service components of children's therapeutic 350.35services and supports in compliance with the following requirements:351.1    (1) individual, family, and group psychotherapy must be delivered as specified in 351.2Minnesota Rules, part 9505.0323;351.3    (2) individual, family, or group skills training must be provided by a mental health 351.4professional or a mental health practitioner who has a consulting relationship with a 351.5mental health professional who accepts full professional responsibility for the training;351.6    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis 351.7through arrangements for direct intervention and support services to the child and the 351.8child's family. Crisis assistance must utilize resources designed to address abrupt or 351.9substantial changes in the functioning of the child or the child's family as evidenced by 351.10a sudden change in behavior with negative consequences for well being, a loss of usual 351.11coping mechanisms, or the presentation of danger to self or others;351.12    (4) medically necessary services that are provided by a mental health behavioral 351.13aide must be designed to improve the functioning of the child and support the family in 351.14activities of daily and community living. A mental health behavioral aide must document 351.15the delivery of services in written progress notes. The mental health behavioral aide 351.16must implement goals in the treatment plan for the child's emotional disturbance that 351.17allow the child to acquire developmentally and therapeutically appropriate daily living 351.18skills, social skills, and leisure and recreational skills through targeted activities. These 351.19activities may include:351.20    (i) assisting a child as needed with skills development in dressing, eating, and 351.21toileting;351.22    (ii) assisting, monitoring, and guiding the child to complete tasks, including 351.23facilitating the child's participation in medical appointments;351.24    (iii) observing the child and intervening to redirect the child's inappropriate behavior;351.25    (iv) assisting the child in using age-appropriate self-management skills as related 351.26to the child's emotional disorder or mental illness, including problem solving, decision 351.27making, communication, conflict resolution, anger management, social skills, and 351.28recreational skills;351.29    (v) implementing deescalation techniques as recommended by the mental health 351.30professional;351.31    (vi) implementing any other mental health service that the mental health professional 351.32has approved as being within the scope of the behavioral aide's duties; or351.33    (vii) assisting the parents to develop and use parenting skills that help the child 351.34achieve the goals outlined in the child's individual treatment plan or individual behavioral 351.35plan. Parenting skills must be directed exclusively to the child's treatment; and351.36    (5) direction of a mental health behavioral aide must include the following:352.1    (i) a total of one hour of on-site observation by a mental health professional during 352.2the first 12 hours of service provided to a child;352.3    (ii) ongoing on-site observation by a mental health professional or mental health 352.4practitioner for at least a total of one hour during every 40 hours of service provided 352.5to a child; and352.6    (iii) immediate accessibility of the mental health professional or mental health 352.7practitioner to the mental health behavioral aide during service provision.352.8    Sec. 26. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to 352.9read:352.10    Subd. 11. Documentation and billing. (a) A provider entity must document the 352.11services it provides under this section. The provider entity must ensure that the entity's 352.12documentation standards meet the requirements of federal and state laws. Services billed 352.13under this section that are not documented according to this subdivision shall be subject to 352.14monetary recovery by the commissioner. The provider entity may not bill for anything 352.15other than direct service time.352.16    (b) An individual mental health provider must promptly document the following 352.17in a client's record after providing services to the client:352.18    (1) each occurrence of the client's mental health service, including the date, type, 352.19length, and scope of the service;352.20    (2) the name of the person who gave the service;352.21    (3) contact made with other persons interested in the client, including representatives 352.22of the courts, corrections systems, or schools. The provider must document the name 352.23and date of each contact;352.24    (4) any contact made with the client's other mental health providers, case manager, 352.25family members, primary caregiver, legal representative, or the reason the provider did 352.26not contact the client's family members, primary caregiver, or legal representative, if 352.27applicable; and352.28    (5) required clinical supervision, as appropriate.352.29    Sec. 27. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to 352.30read:352.31    Subd. 12. Excluded services. The following services are not eligible for medical 352.32assistance payment as children's therapeutic services and supports:353.1    (1) service components of children's therapeutic services and supports 353.2simultaneously provided by more than one provider entity unless prior authorization is 353.3obtained;353.4    (2) children's therapeutic services and supports provided in violation of medical 353.5assistance policy in Minnesota Rules, part 9505.0220;353.6    (3) mental health behavioral aide services provided by a personal care assistant who 353.7is not qualified as a mental health behavioral aide and employed by a certified children's 353.8therapeutic services and supports provider entity;353.9    (4) service components of CTSS that are the responsibility of a residential or 353.10program license holder, including foster care providers under the terms of a service 353.11agreement or administrative rules governing licensure; and353.12    (5) adjunctive activities that may be offered by a provider entity but are not 353.13otherwise covered by medical assistance, including:353.14    (i) a service that is primarily recreation oriented or that is provided in a setting that 353.15is not medically supervised. This includes sports activities, exercise groups, activities 353.16such as craft hours, leisure time, social hours, meal or snack time, trips to community 353.17activities, and tours;353.18    (ii) a social or educational service that does not have or cannot reasonably be 353.19expected to have a therapeutic outcome related to the client's emotional disturbance;353.20    (iii) consultation with other providers or service agency staff about the care or 353.21progress of a client;353.22    (iv) prevention or education programs provided to the community; and353.23    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and353.24    (6) activities that are not direct service time.353.25    Sec. 28. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.353.26    Effective for services rendered on or after July 1, 2007, payment rates for family 353.27planning services shall be increased by 25 percent over the rates in effect July 30, 2007, 353.28when these services are provided by a community clinic as defined in section 145.9268, 353.29subdivision 1.353.30    Sec. 29. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:353.31    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.353.32    (b) "Family asset account" means a savings account opened by a household 353.33participating in the Minnesota family assets for independence initiative.353.34    (c) "Fiduciary organization" means:354.1    (1) a community action agency that has obtained recognition under section 
         268.53354.2256E.31;354.3    (2) a federal community development credit union serving the seven-county 354.4metropolitan area; or354.5    (3) a women-oriented economic development agency serving the seven-county 354.6metropolitan area.354.7    (d) "Financial institution" means a bank, bank and trust, savings bank, savings 354.8association, or credit union, the deposits of which are insured by the Federal Deposit 354.9Insurance Corporation or the National Credit Union Administration.354.10    (e) "Permissible use" means:354.11    (1) postsecondary educational expenses at an accredited public postsecondary 354.12institution including books, supplies, and equipment required for courses of instruction;354.13    (2) acquisition costs of acquiring, constructing, or reconstructing a residence, 354.14including any usual or reasonable settlement, financing, or other closing costs;354.15    (3) business capitalization expenses for expenditures on capital, plant, equipment, 354.16working capital, and inventory expenses of a legitimate business pursuant to a business 354.17plan approved by the fiduciary organization; and354.18    (4) acquisition costs of a principal residence within the meaning of section 1034 of 354.19the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area 354.20purchase price applicable to the residence determined according to section 143(e)(2) and 354.21(3) of the Internal Revenue Code of 1986.354.22    (f) "Household" means all individuals who share use of a dwelling unit as primary 354.23quarters for living and eating separate from other individuals.354.24    Sec. 30. [525A.01] SHORT TITLE.354.25    This chapter may be cited as the "Darlene Luther Revised Uniform Anatomical 354.26Gift Act."354.27    Sec. 31. [525A.02] DEFINITIONS.354.28    Subdivision 1.Scope.The definitions in this section apply to this chapter.354.29    Subd. 2.Adult."Adult" means an individual who is at least 18 years of age.354.30    Subd. 3.Agent."Agent" means an individual who is:354.31    (1) authorized to make health care decisions on the principal's behalf by a power of 354.32attorney for health care; or354.33    (2) expressly authorized to make an anatomical gift on the principal's behalf by 354.34any other record signed by the principal.355.1    Subd. 4.Anatomical gift."Anatomical gift" means a donation of all or part of 355.2a human body to take effect after the donor's death for the purpose of transplantation, 355.3therapy, research, or education.355.4    Subd. 5.Decedent."Decedent" means a deceased individual and includes a stillborn 355.5infant or an embryo or fetus that has died of natural causes in utero.355.6    Subd. 6.Disinterested witness."Disinterested witness" means a witness other than 355.7the spouse, child, parent, sibling, grandchild, grandparent, or guardian of the individual 355.8who makes, amends, revokes, or refuses to make an anatomical gift, or another adult who 355.9exhibited special care and concern for the individual. The term does not include a person 355.10to which an anatomical gift could pass under section 525A.11.355.11    Subd. 7.Document of gift."Document of gift" means a donor card or other record 355.12used to make an anatomical gift. The term includes a statement or symbol on a driver's 355.13license, identification card, or donor registry.355.14    Subd. 8.Donor."Donor" means an individual whose body or part is the subject of 355.15an anatomical gift.355.16    Subd. 9.Donor registry."Donor registry" means a database that contains records 355.17of anatomical gifts and amendments to or revocations of anatomical gifts.355.18    Subd. 10.Driver's license."Driver's license" means a license or permit issued 355.19under chapter 171 to operate a vehicle, whether or not conditions are attached to the 355.20license or permit.355.21    Subd. 11.Eye bank."Eye bank" means a person that is licensed, accredited, 355.22or regulated under federal or state law to engage in the recovery, screening, testing, 355.23processing, storage, or distribution of human eyes or portions of human eyes.355.24    Subd. 12.Guardian."Guardian" means a person appointed by a court to make 355.25decisions regarding the support, care, education, health, or welfare of an individual. The 355.26term does not include a guardian ad litem.355.27    Subd. 13.Hospital."Hospital" means a facility licensed as a hospital under the 355.28law of any state or a facility operated as a hospital by the United States, a state, or a 355.29subdivision of a state.355.30    Subd. 14.Identification card."Identification card" means a Minnesota 355.31identification card issued under chapter 171.355.32    Subd. 15.Know."Know" means to have actual knowledge.355.33    Subd. 16.Medical examiner."Medical examiner" includes coroner.355.34    Subd. 17.Minor."Minor" means an individual who is under 18 years of age.356.1    Subd. 18.Organ procurement organization."Organ procurement organization" 356.2means a person designated by the secretary of the United States Department of Health and 356.3Human Services as an organ procurement organization.356.4    Subd. 19.Parent."Parent" means a parent whose parental rights have not been 356.5terminated.356.6    Subd. 20.Part."Part" means an organ, an eye, or tissue of a human being. The term 356.7does not include the whole body.356.8    Subd. 21.Person."Person" means an individual, corporation, business trust, estate, 356.9trust, partnership, limited liability company, association, joint venture, public corporation, 356.10government or governmental subdivision, agency, or instrumentality, or any other legal or 356.11commercial entity.356.12    Subd. 22.Physician."Physician" means an individual authorized to practice 356.13medicine or osteopathy under the law of any state.356.14    Subd. 23.Procurement organization."Procurement organization" means an eye 356.15bank, organ procurement organization, or tissue bank.356.16    Subd. 24.Prospective donor."Prospective donor" means an individual who is dead 356.17or near death and has been determined by a procurement organization to have a part that 356.18could be medically suitable for transplantation, therapy, research, or education. The term 356.19does not include an individual who has made a refusal.356.20    Subd. 25.Reasonably available."Reasonably available" means able to be 356.21contacted by a procurement organization without undue effort and willing and able to act 356.22in a timely manner consistent with existing medical criteria necessary for the making of 356.23an anatomical gift.356.24    Subd. 26.Recipient."Recipient" means an individual into whose body a decedent's 356.25part has been or is intended to be transplanted.356.26    Subd. 27.Record."Record" means information that is inscribed on a tangible 356.27medium or that is stored in an electronic or other medium and is retrievable in perceivable 356.28form.356.29    Subd. 28.Refusal."Refusal" means a record created under section 525A.07 that 356.30expressly states an intent to bar other persons from making an anatomical gift of an 356.31individual's body or part.356.32    Subd. 29.Sign."Sign" means, with the present intent to authenticate or adopt 356.33a record:356.34    (1) to execute or adopt a tangible symbol; or356.35    (2) to attach to or logically associate with the record an electronic symbol, sound, 356.36or process.357.1    Subd. 30.State."State" means a state of the United States, the District of Columbia, 357.2Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject 357.3to the jurisdiction of the United States.357.4    Subd. 31.Technician."Technician" means an individual determined to be qualified 357.5to remove or process parts by an appropriate organization that is licensed, accredited, or 357.6regulated under federal or state law. The term includes an enucleator.357.7    Subd. 32.Tissue."Tissue" means a portion of the human body other than an organ 357.8or an eye. The term does not include blood unless the blood is donated for the purpose 357.9of research or education.357.10    Subd. 33.Tissue bank."Tissue bank" means a person that is licensed, accredited, 357.11or regulated under federal or state law to engage in the recovery, screening, testing, 357.12processing, storage, or distribution of tissue.357.13    Subd. 34.Transplant hospital."Transplant hospital" means a hospital that 357.14furnishes organ transplants and other medical and surgical specialty services required 357.15for the care of transplant patients.357.16    Sec. 32. [525A.03] APPLICABILITY.357.17    This chapter applies to an anatomical gift or amendment to, revocation of, or refusal 357.18to make an anatomical gift, whenever made.357.19    Sec. 33. [525A.04] WHO MAY MAKE ANATOMICAL GIFT BEFORE 357.20DONOR'S DEATH.357.21    Subject to section 525A.08, an anatomical gift of a donor's body or part may be 357.22made during the life of the donor for the purpose of transplantation, therapy, research, or 357.23education in the manner provided in section 525A.05 by:357.24    (1) the donor, if the donor is an adult or if the donor is a minor and is:357.25    (i) emancipated; or357.26    (ii) authorized under state law to apply for a driver's license because the donor is 357.27at least 16 years of age;357.28    (2) an agent of the donor, unless the power of attorney for health care or other record 357.29prohibits the agent from making an anatomical gift;357.30    (3) a parent of the donor, if the donor is an unemancipated minor; or357.31    (4) the donor's guardian.357.32    Sec. 34. [525A.05] MANNER OF MAKING ANATOMICAL GIFT BEFORE 357.33DONOR'S DEATH.358.1    (a) A donor may make an anatomical gift:358.2    (1) by authorizing a statement or symbol indicating that the donor has made an 358.3anatomical gift to be imprinted on the donor's driver's license or identification card;358.4    (2) in a will;358.5    (3) during a terminal illness or injury of the donor, by any form of communication 358.6addressed to at least two adults, at least one of whom is a disinterested witness; or358.7    (4) as provided in paragraph (b).358.8    (b) A donor or other person authorized to make an anatomical gift under section 358.9525A.04 may make a gift by a donor card or other record signed by the donor or other 358.10person making the gift or by authorizing that a statement or symbol indicating that the 358.11donor has made an anatomical gift be included on a donor registry. If the donor or 358.12other person is physically unable to sign a record, the record may be signed by another 358.13individual at the direction of the donor or other person and must:358.14    (1) be witnessed by at least two adults, at least one of whom is a disinterested 358.15witness, who have signed at the request of the donor or the other person; and358.16    (2) state that it has been signed and witnessed as provided in clause (1).358.17    (c) Revocation, suspension, expiration, or cancellation of a driver's license or 358.18identification card upon which an anatomical gift is indicated does not invalidate the gift.358.19    (d) An anatomical gift made by will takes effect upon the donor's death whether or 358.20not the will is probated. Invalidation of the will after the donor's death does not invalidate 358.21the gift.358.22    (e) The making of an anatomical gift shall not itself authorize or direct the denial 358.23of health care.358.24    Sec. 35. [525A.06] AMENDING OR REVOKING ANATOMICAL GIFT 358.25BEFORE DONOR'S DEATH.358.26    (a) Subject to section 525A.08, a donor or other person authorized to make an 358.27anatomical gift under section 525A.04 may amend or revoke an anatomical gift by:358.28    (1) a record signed by:358.29    (i) the donor;358.30    (ii) the other person; or358.31    (iii) subject to paragraph (b), another individual acting at the direction of the donor 358.32or the other person if the donor or other person is physically unable to sign; or358.33    (2) a later-executed document of gift that amends or revokes a previous anatomical 358.34gift or portion of an anatomical gift, either expressly or by inconsistency.358.35    (b) A record signed pursuant to paragraph (a), clause (1), item (iii), must:359.1    (1) be witnessed by at least two adults, at least one of whom is a disinterested 359.2witness, who have signed at the request of the donor or the other person; and359.3    (2) state that it has been signed and witnessed as provided in clause (1).359.4    (c) Subject to section 525A.08, a donor or other person authorized to make an 359.5anatomical gift under section 525A.04 may revoke an anatomical gift by the destruction or 359.6cancellation of the document of gift, or the portion of the document of gift used to make 359.7the gift, with the intent to revoke the gift.359.8    (d) A donor may amend or revoke an anatomical gift that was not made in a will 359.9by any form of communication during a terminal illness or injury addressed to at least 359.10two adults, at least one of whom is a disinterested witness.359.11    (e) A donor who makes an anatomical gift in a will may amend or revoke the gift in 359.12the manner provided for amendment or revocation of wills or as provided in paragraph (a).359.13    Sec. 36. [525A.07] REFUSAL TO MAKE ANATOMICAL GIFT; EFFECT OF 359.14REFUSAL.359.15    (a) An individual may refuse to make an anatomical gift of the individual's body 359.16or part by:359.17    (1) a record signed by:359.18    (i) the individual; or359.19    (ii) subject to paragraph (b), another individual acting at the direction of the 359.20individual if the individual is physically unable to sign;359.21    (2) the individual's will, whether or not the will is admitted to probate or invalidated 359.22after the individual's death; or359.23    (3) any form of communication made by the individual during the individual's 359.24terminal illness or injury addressed to at least two adults, at least one of whom is a 359.25disinterested witness.359.26    (b) A record signed pursuant to paragraph (a), clause (1), item (ii), must:359.27    (1) be witnessed by at least two adults, at least one of whom is a disinterested 359.28witness, who have signed at the request of the individual; and359.29    (2) state that it has been signed and witnessed as provided in clause (1).359.30    (c) An individual who has made a refusal may amend or revoke the refusal:359.31    (1) in the manner provided in paragraph (a) for making a refusal;359.32    (2) by subsequently making an anatomical gift pursuant to section 525A.05 that is 359.33inconsistent with the refusal; or359.34    (3) by destroying or canceling the record evidencing the refusal, or the portion of the 359.35record used to make the refusal, with the intent to revoke the refusal.360.1    (d) Except as otherwise provided in section 525A.08, paragraph (h), in the absence 360.2of an express, contrary indication by the individual set forth in the refusal, an individual's 360.3unrevoked refusal to make an anatomical gift of the individual's body or part bars all other 360.4persons from making an anatomical gift of the individual's body or part.360.5    Sec. 37. [525A.08] PRECLUSIVE EFFECT OF ANATOMICAL GIFT, 360.6AMENDMENT, OR REVOCATION.360.7    (a) Except as otherwise provided in paragraph (g) and subject to paragraph (f), in the 360.8absence of an express, contrary indication by the donor, a person other than the donor is 360.9barred from making, amending, or revoking an anatomical gift of a donor's body or part if 360.10the donor made an anatomical gift of the donor's body or part under section 525A.05 or an 360.11amendment to an anatomical gift of the donor's body or part under section 525A.06. An 360.12anatomical gift made in a will, a designation on a driver's license or identification card, or 360.13a health care directive under chapter 145C, and not revoked, establishes the intent of the 360.14person making the designation and may not be overridden by any other person.360.15    (b) A donor's revocation of an anatomical gift of the donor's body or part under 360.16section 525A.06 is not a refusal and does not bar another person specified in section 360.17525A.04 or 525A.09 from making an anatomical gift of the donor's body or part under 360.18section 525A.05 or 525A.10.360.19    (c) If a person other than the donor makes an unrevoked anatomical gift of the 360.20donor's body or part under section 525A.05 or an amendment to an anatomical gift of the 360.21donor's body or part under section 525A.06, another person may not make, amend, or 360.22revoke the gift of the donor's body or part under section 525A.10.360.23    (d) A revocation of an anatomical gift of a donor's body or part under section 360.24525A.06 by a person other than the donor does not bar another person from making an 360.25anatomical gift of the body or part under section 525A.05 or 525A.10.360.26    (e) In the absence of an express, contrary indication by the donor or other person 360.27authorized to make an anatomical gift under section 525A.04, an anatomical gift of a part 360.28is neither a refusal to give another part nor a limitation on the making of an anatomical gift 360.29of another part at a later time by the donor or another person.360.30    (f) In the absence of an express, contrary indication by the donor or other person 360.31authorized to make an anatomical gift under section 525A.04, an anatomical gift of a 360.32part for one or  more of the purposes set forth in section 525A.04 is not a limitation on 360.33the making of an anatomical gift of the part for any of the other purposes by the donor 360.34or any other person under section 525A.05 or 525A.10.361.1    (g) If a donor who is an unemancipated minor dies, a parent of the donor who is 361.2reasonably available may revoke or amend an anatomical gift of the donor's body or part.361.3    (h) If an unemancipated minor who signed a refusal dies, a parent of the minor who 361.4is reasonably available may revoke the minor's refusal.361.5    Sec. 38. [525A.09] WHO MAY MAKE ANATOMICAL GIFT OF DECEDENT'S 361.6BODY OR PART.361.7    (a) Subject to paragraphs (b) and (c) and unless barred by section 525A.07 or 361.8525A.08, an anatomical gift of a decedent's body or part for the purpose of transplantation, 361.9therapy, research, or education may be made by any member of the following classes of 361.10persons who is reasonably available, in the order of priority listed:361.11    (1) an agent of the decedent at the time of death who could have made an anatomical 361.12gift under section 525A.04, clause (2), immediately before the decedent's death;361.13    (2) the spouse of the decedent;361.14    (3) adult children of the decedent;361.15    (4) parents of the decedent;361.16    (5) adult siblings of the decedent;361.17    (6) adult grandchildren of the decedent;361.18    (7) grandparents of the decedent;361.19    (8) an adult who exhibited special care and concern for the decedent;361.20    (9) the persons who were acting as the guardians of the person of the decedent 361.21at the time of death; and 361.22    (10) any other person having the authority to dispose of the decedent's body.361.23    (b) If there is more than one member of a class listed in paragraph (a), clause (1), 361.24(3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an anatomical gift may 361.25be made by a member of the class unless that member or a person to which the gift may 361.26pass under section 525A.11 knows of an objection by another member of the class. If 361.27an objection is known, the gift may be made only by a majority of the members of the 361.28class who are reasonably available.361.29    (c) A person may not make an anatomical gift if, at the time of the decedent's death, 361.30a person in a prior class under paragraph (a) is reasonably available to make or to object to 361.31the making of an anatomical gift.361.32    Sec. 39. [525A.10] MANNER OF MAKING, AMENDING, OR REVOKING 361.33ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.362.1    (a) A person authorized to make an anatomical gift under section 525A.09 may 362.2make an anatomical gift by a document of gift signed by the person making the gift or by 362.3that person's oral communication that is electronically recorded or is contemporaneously 362.4reduced to a record and signed by the individual receiving the oral communication.362.5    (b) Subject to paragraph (c), an anatomical gift by a person authorized under section 362.6525A.09 may be amended or revoked orally or in a record by any member of a prior class 362.7who is reasonably available. If more than one member of the prior class is reasonably 362.8available, the gift made by a person authorized under section 525A.09 may be:362.9    (1) amended only if a majority of the reasonably available members agree to the 362.10amending of the gift; or362.11    (2) revoked only if a majority of the reasonably available members agree to the 362.12revoking of the gift or if they are equally divided as to whether to revoke the gift.362.13    (c) A revocation under paragraph (b) is effective only if, before an incision has been 362.14made to remove a part from the donor's body or before invasive procedures have begun to 362.15prepare the recipient, the procurement organization, transplant hospital, or physician or 362.16technician knows of the revocation.362.17    Sec. 40. [525A.11] PERSONS THAT MAY RECEIVE ANATOMICAL GIFT; 362.18PURPOSE OF ANATOMICAL GIFT.362.19    (a) An anatomical gift may be made to the following persons named in the document 362.20of gift:362.21    (1) a hospital; accredited medical school, dental school, college, or university; organ 362.22procurement organization; or nonprofit organization in medical education or research, 362.23for research or education;362.24    (2) subject to paragraph (b), an individual designated by the person making the 362.25anatomical gift if the individual is the recipient of the part; and 362.26    (3) an eye bank or tissue bank.362.27    (b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be 362.28transplanted into the individual, the part passes in accordance with paragraph (g) in the 362.29absence of an express, contrary indication by the person making the anatomical gift.362.30    (c) If an anatomical gift of one or more specific parts or of all parts is made in a 362.31document of gift that does not name a person described in paragraph (a) but identifies the 362.32purpose for which an anatomical gift may be used, the following rules apply:362.33    (1) if the part is an eye and the gift is for the purpose of transplantation or therapy, 362.34the gift passes to the appropriate eye bank;363.1    (2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the 363.2gift passes to the appropriate tissue bank;363.3    (3) if the part is an organ and the gift is for the purpose of transplantation or therapy, 363.4the gift passes to the appropriate organ procurement organization as custodian of the 363.5organ; and363.6    (4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research 363.7or education, the gift passes to the appropriate procurement organization.363.8    (d) For the purpose of paragraph (c), if there is more than one purpose of an 363.9anatomical gift set forth in the document of gift but the purposes are not set forth in any 363.10priority, the gift must be used for transplantation or therapy, if suitable. If the gift cannot 363.11be used for transplantation or therapy, the gift may be used for research or education. 363.12    (e) If an anatomical gift of one or more specific parts is made in a document of gift 363.13that does not name a person described in paragraph (a) and does not identify the purpose 363.14of the gift, the gift may be used only for transplantation or therapy, and the gift passes in 363.15accordance with paragraph (g).363.16    (f) If a document of gift specifies only a general intent to make an anatomical gift 363.17by words such as "donor," "organ donor," or "body donor," or by a symbol or statement 363.18of similar import, the gift may be used only for transplantation or therapy, and the gift 363.19passes in accordance with paragraph (g).363.20    (g) For purposes of paragraphs (b), (e), and (f), the following rules apply:363.21    (1) if the part is an eye, the gift passes to the appropriate eye bank;363.22    (2) if the part is tissue, the gift passes to the appropriate tissue bank; and363.23    (3) if the part is an organ, the gift passes to the appropriate organ procurement 363.24organization as custodian of the organ.363.25    (h) An anatomical gift of an organ for transplantation or therapy, other than 363.26an anatomical gift under paragraph (a), clause (2), passes to the organ procurement 363.27organization as custodian of the organ.363.28    (i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the 363.29decedent's body or part is not used for transplantation, therapy, research, or education, 363.30custody of the body or part passes to the person under obligation to dispose of the body or 363.31part.363.32    (j) A person may not accept an anatomical gift if the person knows that the gift was 363.33not effectively made under section 525A.05 or 525A.10 or if the person knows that the 363.34decedent made a refusal under section 525A.07 that was not revoked. For purposes of 363.35this paragraph, if a person knows that an anatomical gift was made on a document of gift, 364.1the person is deemed to know of any amendment or revocation of the gift or any refusal 364.2to make an anatomical gift on the same document of gift.364.3    (k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter 364.4affects the allocation of organs for transplantation or therapy.364.5    Sec. 41. [525A.12] SEARCH AND NOTIFICATION.364.6    (a) The following persons shall make a reasonable search of an individual who 364.7the person reasonably believes is dead or near death for a document of gift or other 364.8information identifying the individual as a donor or as an individual who made a refusal:364.9    (1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer 364.10finding the individual; and364.11    (2) if no other source of the information is immediately available, a hospital, as soon 364.12as practical after the individual's arrival at the hospital.364.13    (b) If a document of gift or a refusal to make an anatomical gift is located by the 364.14search required by paragraph (a), clause (1), and the individual or deceased individual to 364.15whom it relates is taken to a hospital, the person responsible for conducting the search 364.16shall send the document of gift or refusal to the hospital. If a body is transferred to 364.17the custody of the medical examiner, the person who discovered the body must notify 364.18the person's dispatcher. A dispatcher notified under this section must notify the state's 364.19federally designated organ procurement organization and inform the organization of the 364.20deceased's name, donor status, and location.364.21    (c) A person is not subject to criminal or civil liability for failing to discharge the 364.22duties imposed by this section but may be subject to administrative sanctions.364.23    Sec. 42. [525A.13] DELIVERY OF DOCUMENT OF GIFT NOT REQUIRED; 364.24RIGHT TO EXAMINE.364.25    (a) A document of gift need not be delivered during the donor's lifetime to be 364.26effective.364.27    (b) Upon or after an individual's death, a person in possession of a document of 364.28gift or a refusal to make an anatomical gift with respect to the individual shall allow 364.29examination and copying of the document of gift or refusal by a person authorized to 364.30make or object to the making of an anatomical gift with respect to the individual or by a 364.31person to which the gift could pass under section 525A.11.364.32    Sec. 43. [525A.14] RIGHTS AND DUTIES OF PROCUREMENT 364.33ORGANIZATION AND OTHERS.365.1    (a) When a hospital refers an individual at or near death to a procurement 365.2organization, the organization shall make a reasonable search of the records of the 365.3Department of Public Safety and any donor registry that it knows exists for the 365.4geographical area in which the individual resides to ascertain whether the individual has 365.5made an anatomical gift.365.6    (b) A procurement organization must be allowed reasonable access to information 365.7in the records of the Department of Public Safety to ascertain whether an individual at 365.8or near death is a donor.365.9    (c) When a hospital refers an individual at or near death to a procurement 365.10organization, the organization may conduct any reasonable examination necessary to 365.11ensure the medical suitability of a part that is or could be the subject of an anatomical gift 365.12for transplantation, therapy, research, or education from a donor or a prospective donor. 365.13During the examination period, measures necessary to ensure the medical suitability of the 365.14part may not be withdrawn unless the hospital or procurement organization knows that 365.15the individual expressed a contrary intent.365.16    (d) Unless prohibited by law other than this chapter, at any time after a donor's death, 365.17the person to which a part passes under section 525A.11 may conduct any reasonable 365.18examination necessary to ensure the medical suitability of the body or part for its intended 365.19purpose.365.20    (e) Unless prohibited by law other than this chapter, an examination under paragraph 365.21(c) or (d) may include an examination of all medical and dental records of the donor or 365.22prospective donor.365.23    (f) Upon the death of a minor who was a donor or had signed a refusal, unless a 365.24procurement organization knows the minor is emancipated, the procurement organization 365.25shall conduct a reasonable search for the parents of the minor and provide the parents with 365.26an opportunity to revoke or amend the anatomical gift or revoke the refusal.365.27    (g) Upon referral by a hospital under paragraph (a), a procurement organization shall 365.28make a reasonable search for any person listed in section 525A.09 having priority to make 365.29an anatomical gift on behalf of a prospective donor. If a procurement organization receives 365.30information that an anatomical gift to any other person was made, amended, or revoked, it 365.31shall promptly advise the other person of all relevant information.365.32    (h) Subject to sections 525A.11, paragraph (i), and 525A.23, the rights of the person 365.33to which a part passes under section 525A.11 are superior to the rights of all others with 365.34respect to the part. The person may accept or reject an anatomical gift in whole or in part. 365.35Subject to the terms of the document of gift and this chapter, a person that accepts an 365.36anatomical gift of an entire body may allow embalming, burial, or cremation, and use of 366.1remains in a funeral service. If the gift is of a part, the person to which the part passes 366.2under section 525A.11, upon the death of the donor and before embalming, burial, or 366.3cremation, shall cause the part to be removed without unnecessary mutilation.366.4    (i) Neither the physician who attends the decedent at death nor the physician who 366.5determines the time of the decedent's death may participate in the procedures for removing 366.6or transplanting a part from the decedent.366.7    (j) A physician or technician may remove a donated part from the body of a donor 366.8that the physician or technician is qualified to remove.366.9    Sec. 44. [525A.15] COORDINATION OF PROCUREMENT AND USE.366.10    Each hospital in this state shall enter into agreements or affiliations with procurement 366.11organizations for coordination of procurement and use of anatomical gifts.366.12    Sec. 45. [525A.16] SALE OR PURCHASE OF PARTS PROHIBITED; FELONY.366.13    (a) Except as otherwise provided in paragraph (b), a person that, for valuable 366.14consideration, knowingly purchases or sells a part for transplantation or therapy if removal 366.15of a part from an individual is intended to occur after the individual's death, commits a 366.16felony and upon conviction is subject to a fine not exceeding $10,000 or imprisonment 366.17not exceeding five years, or both.366.18    (b) A person may charge a reasonable amount for the removal, processing, 366.19preservation, quality control, storage, transportation, implantation, or disposal of a part.366.20    Sec. 46. [525A.17] PROHIBITED ACTS; FELONY.366.21    A person that, in order to obtain a financial gain, intentionally falsifies, forges, 366.22conceals, defaces, or obliterates a document of gift, an amendment or revocation of a 366.23document of gift, or a refusal commits a felony and upon conviction is subject to a fine not 366.24exceeding $10,000 or imprisonment not exceeding five years, or both.366.25    Sec. 47. [525A.18] IMMUNITY.366.26    (a) A person that acts in accordance with this chapter or with the applicable 366.27anatomical gift law of another state, or attempts in good faith to do so, is not liable for the 366.28act in a civil action, criminal prosecution, or administrative proceeding.366.29    (b) Neither the person making an anatomical gift nor the donor's estate is liable for 366.30any injury or damage that results from the making or use of the gift.366.31    (c) In determining whether an anatomical gift has been made, amended, or revoked 366.32under this chapter, a person may rely upon representations of an individual listed in 367.1section 525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating to the 367.2individual's relationship to the donor or prospective donor unless the person knows that 367.3the representation is untrue.367.4    (d) An anatomical gift under this chapter is not a sale of goods as that term is defined 367.5in section 336.2-105, paragraph (1), or the sale of a product.367.6    Sec. 48. [525A.19] LAW GOVERNING VALIDITY; CHOICE OF LAW AS TO 367.7EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.367.8    (a) A document of gift is valid if executed in accordance with:367.9    (1) this chapter;367.10    (2) the laws of the state or country where it was executed; or367.11    (3) the laws of the state or country where the person making the anatomical gift 367.12was domiciled, has a place of residence, or was a national at the time the document of 367.13gift was executed.367.14    (b) If a document of gift is valid under this section, the law of this state governs 367.15the interpretation of the document of gift.367.16    (c) A person may presume that a document of gift or amendment of an anatomical 367.17gift is valid unless that person knows that it was not validly executed or was revoked.367.18    Sec. 49. [525A.20] DONOR REGISTRY.367.19    (a) The Department of Health may establish or contract for the establishment of a 367.20donor registry.367.21    (b) The Department of Public Safety shall cooperate with a person that administers 367.22any donor registry that this state establishes, contracts for, or recognizes for the purpose 367.23of transferring to the donor registry all relevant information regarding a donor's making, 367.24amendment to, or revocation of an anatomical gift.367.25    (c) A donor registry must:367.26    (1) allow a donor or other person authorized under section 525A.04 to include on 367.27the donor registry a statement or symbol that the donor has made, amended, or revoked 367.28an anatomical gift;367.29    (2) be accessible to a procurement organization to allow it to obtain relevant 367.30information on the donor registry to determine, at or near death of the donor or a 367.31prospective donor, whether the donor or prospective donor has made, amended, or revoked 367.32an anatomical gift; and367.33    (3) be accessible, for purposes of clauses (1) and (2), seven days a week on a 367.3424-hour basis.368.1    (d) Personally identifiable information on a donor registry about a donor or 368.2prospective donor may not be used or disclosed without the express consent of the donor, 368.3prospective donor, or person that made the anatomical gift for any purpose other than 368.4to determine, at or near death of the donor or prospective donor, whether the donor or 368.5prospective donor has made, amended, or revoked an anatomical gift.368.6    (e) This section does not prohibit any person from creating or maintaining a donor 368.7registry that is not established by or under contract with the state. Any such registry 368.8must comply with paragraphs (c) and (d).368.9    Sec. 50. [525A.21] EFFECT OF ANATOMICAL GIFT ON ADVANCE HEALTH 368.10CARE DIRECTIVE.368.11    (a) In this section:368.12    (1) "advance health care directive" means a power of attorney for health care 368.13or a record signed by a prospective donor containing the prospective donor's direction 368.14concerning a health care decision for the prospective donor;368.15    (2) "declaration" means a record signed by a prospective donor specifying the 368.16circumstances under which a life support system may be withheld or withdrawn from 368.17the prospective donor; and368.18    (3) "health care decision" means any decision made regarding the health care of the 368.19prospective donor.368.20    (b) If a prospective donor has a declaration or advance health care directive, 368.21measures necessary to ensure the medical suitability of an organ for transplantation 368.22or therapy may not be withheld or withdrawn from the prospective donor, unless the 368.23declaration expressly provides to the contrary.368.24    Sec. 51. [525A.22] COOPERATION BETWEEN MEDICAL EXAMINER AND 368.25PROCUREMENT ORGANIZATION.368.26    (a) A medical examiner shall cooperate with procurement organizations to maximize 368.27the opportunity to recover anatomical gifts for the purpose of transplantation, therapy, 368.28research, or education.368.29    (b) If a medical examiner receives notice from a procurement organization that an 368.30anatomical gift might be available or was made with respect to a decedent whose body is 368.31under the jurisdiction of the medical examiner and a postmortem examination is going to 368.32be performed, unless the medical examiner denies recovery in accordance with section 368.33525A.23, the medical examiner or designee shall conduct a postmortem examination of 369.1the body or the part in a manner and within a period compatible with its preservation for 369.2the purposes of the gift.369.3    (c) A part may not be removed from the body of a decedent under the jurisdiction 369.4of a medical examiner for transplantation, therapy, research, or education unless the part 369.5is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the 369.6medical examiner may not be delivered to a person for research or education unless the 369.7body is the subject of an anatomical gift. This paragraph does not preclude a medical 369.8examiner from performing the medicolegal investigation upon the body or parts of a 369.9decedent under the jurisdiction of the medical examiner.369.10    Sec. 52. [525A.23] FACILITATION OF ANATOMICAL GIFT FROM 369.11DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL 369.12EXAMINER.369.13    (a) Upon request of a procurement organization, a medical examiner shall release to 369.14the procurement organization the name, contact information, and available medical and 369.15social history of a decedent whose body is under the jurisdiction of the medical examiner. 369.16If the decedent's body or part is medically suitable for transplantation, therapy, research, 369.17or education, the medical examiner shall release postmortem examination results to 369.18the procurement organization. The procurement organization may make a subsequent 369.19disclosure of the postmortem examination results or other information received from the 369.20medical examiner only if relevant to transplantation or therapy.369.21    (b) The medical examiner may conduct a medicolegal examination by reviewing 369.22all medical records, laboratory test results, x-rays, other diagnostic results, and other 369.23information that any person possesses about a donor or prospective donor whose body is 369.24under the jurisdiction of the medical examiner which the medical examiner determines 369.25may be relevant to the investigation.369.26    (c) A person that has any information requested by a medical examiner pursuant 369.27to paragraph (b) shall provide that information as expeditiously as possible to allow the 369.28medical examiner to conduct the medicolegal investigation within a period compatible 369.29with the preservation of parts for the purpose of transplantation, therapy, research, or 369.30education.369.31    (d) If an anatomical gift has been or might be made of a part of a decedent whose 369.32body is under the jurisdiction of the medical examiner and a postmortem examination 369.33is not required, or the medical examiner determines that a postmortem examination is 369.34required but that the recovery of the part that is the subject of an anatomical gift will 369.35not interfere with the examination, the medical examiner and procurement organization 370.1shall cooperate in the timely removal of the part from the decedent for the purpose of 370.2transplantation, therapy, research, or education.370.3    (e) If an anatomical gift of a part from the decedent under the jurisdiction of 370.4the medical examiner has been or might be made, but the medical examiner initially 370.5believes that the recovery of the part could interfere with the postmortem investigation 370.6into the decedent's cause or manner of death, the medical examiner shall consult with 370.7the procurement organization or physician or technician designated by the procurement 370.8organization about the proposed recovery. After consultation, the medical examiner may 370.9allow the recovery.370.10    (f) Following the consultation under paragraph (e), in the absence of mutually 370.11agreed-upon protocols to resolve conflict between the medical examiner and the 370.12procurement organization, if the medical examiner intends to deny recovery of an organ 370.13for transplantation, the medical examiner or designee, at the request of the procurement 370.14organization, shall attend the removal procedure for the part before making a final 370.15determination not to allow the procurement organization to recover the part. During 370.16the removal procedure, the medical examiner or designee may allow recovery by the 370.17procurement organization to proceed, or, if the medical examiner or designee reasonably 370.18believes that the part may be involved in determining the decedent's cause or manner of 370.19death, deny recovery by the procurement organization.370.20    (g) If the medical examiner or designee denies recovery under paragraph (f), the 370.21medical examiner or designee shall:370.22    (1) explain in a record the specific reasons for not allowing recovery of the part;370.23    (2) include the specific reasons in the records of the medical examiner; and370.24    (3) provide a record with the specific reasons to the procurement organization.370.25    (h) If the medical examiner or designee allows recovery of a part under paragraph 370.26(d), (e), or (f), the procurement organization, upon request, shall cause the physician 370.27or technician who removes the part to provide the medical examiner with a record 370.28describing the condition of the part, a biopsy, a photograph, and any other information and 370.29observations that would assist in the postmortem examination.370.30    (i) If a medical examiner or designee is required to be present at a removal procedure 370.31under paragraph (f), upon request the procurement organization requesting the recovery 370.32of the part shall reimburse the medical examiner or designee for the additional costs 370.33incurred in complying with paragraph (f).370.34    Sec. 53. [525A.24] RELATION TO ELECTRONIC SIGNATURES IN GLOBAL 370.35AND NATIONAL COMMERCE ACT.371.1    This chapter modifies, limits, and supersedes the Electronic Signatures in Global and 371.2National Commerce Act, United States Code, title 15, section 7001 et seq., but does not 371.3modify, limit, or supersede section 101(a) of that act, United States Code, title 15, section 371.47001, or authorize electronic delivery of any of the notices described in section 103(b) 371.5of that act, United States Code, title 15, section 7003(b).371.6    Sec. 54. Laws 2005, chapter 98, article 3, section 25, is amended to read:371.7    Sec. 25. REPEALER.371.8    Minnesota Statutes 2004, sections 
         245.713, subdivisions 2 and subdivision 4; 371.9245.716
         ; and 
         626.5551, subdivision 4, are repealed.371.10EFFECTIVE DATE.This section is effective retroactively from August 1, 2005.371.11    Sec. 55. SOBER HOUSES.371.12    Subdivision 1.Sober house defined.For purposes of this section, a "sober house" 371.13means a cooperative living residence that:371.14    (1) provides temporary housing to persons with alcohol or other drug dependency 371.15and abuse problems in exchange for compensation;371.16    (2) stipulates residents must abstain from using alcohol or drugs and meet other 371.17requirements as a condition of living in the residence; and371.18    (3) does not provide counseling or treatment services to those residents within the 371.19meaning of Minnesota Statutes, chapter 148C or 254A.371.20    Subd. 2.Work group creation; membership.The commissioner of human services 371.21shall convene a sober house work group which is comprised of the following members:371.22    (1) sober house landlords;371.23    (2) sober house residents;371.24    (3) community members with knowledge of sober housing;371.25    (4) representatives of cities and counties;371.26    (5) a representative from the Department of Human Services, Chemical Health 371.27Division;371.28    (6) a representative from the Department of Human Services, Licensing Division;371.29    (7) a representative of chemical dependency treatment providers; and371.30    (8) a representative from the Department of Health.371.31    Subd. 3.Report.The work group created in subdivision 2 is directed to study the 371.32issue of sober houses in the state and determine whether state licensing or other regulation 371.33of sober houses is appropriate. Based on findings of the work group, the commissioner of 372.1human services shall submit a report of recommendations to the legislature by January 372.21, 2008.372.3    Sec. 56. INTERPRETER SERVICES WORK GROUP.372.4    (a) The commissioner of health shall, in consultation with the commissioners of 372.5commerce, human services, and employee relations, convene a work group to study the 372.6provision of interpreter services to patients in medical and dental care settings. The work 372.7group shall include one representative from each of the following groups:372.8    (1) consumers;372.9    (2) interpreters;372.10    (3) interpreter service providers or agencies;372.11    (4) health plan companies;372.12    (5) self-insured purchasers;372.13    (6) hospitals;372.14    (7) health care providers;372.15    (8) dental providers;372.16    (9) clinic administrators;372.17    (10) state agency staff from the Departments of Health, Human Services, and 372.18Employee Relations;372.19    (11) Minnesota Registry of Interpreters for the Deaf;372.20    (12) local county social services agencies;372.21    (13) local public health agencies;372.22    (14) interpreting stakeholders group;372.23    (15) one interpreter trainer; and372.24    (16) one interpreter certification examiner.372.25    (b) The work group shall develop findings and recommendations on the following: 372.26    (1) assuring access to interpreter services;372.27    (2) compliance with requirements of federal law and guidance;372.28    (3) developing a quality assurance program to ensure the quality of health care 372.29interpreting services, including requirements for training and establishing a certification 372.30process; and 372.31    (4) identifying broad-based funding mechanisms for interpreter services.372.32    (c) Based on the discussions of the work group, the commissioner shall make 372.33recommendations to the chairs of the health policy and finance committees in the house 372.34and senate by January 15, 2008, on how to ensure high quality interpreter services for 373.1patients in medical and dental settings, and for a broad-based funding mechanism for 373.2delivering these services.373.3EFFECTIVE DATE.This section is effective the day following final enactment.373.4    Sec. 57. FEDERAL GRANTS.373.5    The Board of Pharmacy shall apply for any applicable federal grants or other nonstate 373.6funds to establish and fully implement the prescription electronic reporting system.373.7EFFECTIVE DATE.This section is effective the day following final enactment.373.8    Sec. 58. BOARD OF PHARMACY.373.9    The Board of Pharmacy shall not increase the license fees of pharmacists or 373.10pharmacies in order to adequately fund the prescription electronic reporting system under 373.11Minnesota Statutes, section 152.126, without specific authority from the legislature.373.12EFFECTIVE DATE.This section is effective the day following final enactment.373.13    Sec. 59. BOARD OF MEDICAL PRACTICE.373.14    The Board of Medical Practice shall convene a work group to discuss the appropriate 373.15prescribing of controlled substances listed in Minnesota Statutes, section 152.02, 373.16subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 373.17Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and 373.18shall report to the legislature by December 15, 2007.373.19    Sec. 60. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.373.20    Subdivision 1.Pilot project requirements.The commissioner of commerce shall 373.21authorize a joint self-insurance pilot project administered by a trust sponsored by one 373.22or more agricultural cooperatives organized under Minnesota Statutes, chapter 308A, 373.23or under a federal charter for the purpose of offering health coverage to members of 373.24the cooperatives and their families, provided the project satisfies the requirements of 373.25Minnesota Statutes, chapter 62H, except as follows:373.26    (1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;373.27    (2) the notice period required under Minnesota Statutes, section 62H.02, paragraph 373.28(e), is 90 days;373.29    (3) the commissioner shall grant necessary waivers and approve an alternative 373.30arrangement that fully funds the plan's liability or incurred but unpaid claims under 373.31Minnesota Statutes, section 62H.02, paragraph (f), unless the commissioner provides 374.1evidence demonstrating that the insolvency protection proposed is substantially less than 374.2that typically provided by self-insured group plans of a similar size in Minnesota;374.3    (4) notwithstanding Minnesota Statutes, section 62H.04, paragraph (a), the joint 374.4self-insurance plan shall be considered a large group and not subject to the small group 374.5insurance requirements in Minnesota Statutes, chapter 62L, even if some employer 374.6groups enrolled in the plan would be defined as small employers, except that the joint 374.7self-insurance plan may elect to treat the sale of a health plan to or for an employer that 374.8has only one eligible employee who has not waived coverage as the sale of an individual 374.9health plan as allowed under Minnesota Statutes, section 62L.02, subdivision 26;374.10    (5) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), does not 374.11apply; and 374.12    (6) the trust must pay the assessment for the Minnesota comprehensive health 374.13association as provided under Minnesota Statutes, section 62E.11.374.14    Subd. 2.Evaluation and renewal.The pilot project authorized under this section 374.15is for a period of four years from the date of initial enrollment. The commissioner shall 374.16grant an extension of four additional years if the trust provides evidence that it remains in 374.17compliance with the requirements of this section and other applicable laws and rules. If the 374.18commissioner determines that the operation of the trust has not improved access, expanded 374.19health plan choices, or improved affordability of health coverage for farm families, or 374.20that it has significantly damaged access, choice, or affordability for other consumers not 374.21enrolled in the trust, the commissioner shall provide at least 180 days' advance written 374.22notice to the trust and to the chairs of the senate and house finance and policy committees 374.23with jurisdiction over health and insurance matters of the commissioner's intention not to 374.24renew the pilot project at the expiration of a four-year period.374.25EFFECTIVE DATE.This section is effective the day following final enactment.374.26    Sec. 61. HEALTH PLAN PURCHASING POOL STUDY GROUP.374.27    Subdivision 1.Creation; membership.A health care purchasing pool study group 374.28is created to study and make recommendations regarding the creation of a voluntary, 374.29statewide health care purchasing pool that would contract directly with providers to 374.30provide affordable health coverage to eligible Minnesota residents. The study group is 374.31composed of:374.32    (1) the chief house and senate authors of this act;374.33    (2) the chairs of the senate Committee on Health, Housing, and Family Security and 374.34the Health and Human Services Budget Division;375.1    (3) the chairs of the house Health Care and Human Services Committee and the 375.2Health Care and Human Services Division;375.3    (4) the attorney general or the attorney general's designated representative; 375.4    (5) three representatives of health care providers appointed as follows:375.5    (i) one member appointed by the governor;375.6    (ii) one member appointed by the speaker of the house; and375.7    (iii) one member appointed by the Subcommittee on Committees of the senate 375.8Committee on Rules and Administration; and375.9    (6) two consumers of health care appointed by the governor.375.10    All appointments to be made under this subdivision must be made within 30 days 375.11of the effective date of this act.375.12    Subd. 2.Study; report.The study group shall study and make recommendations 375.13on the following issues related to the creation, maintenance, and funding of a voluntary, 375.14statewide health plan purchasing pool to provide comprehensive, cost-effective, and 375.15medically appropriate health coverage to all public and private employees in Minnesota 375.16and all Minnesota residents:375.17    (1) the creation of an independent public entity to administer the pool; 375.18    (2) eligibility and participation requirements for existing public and private health 375.19care purchasing pools, public and private employers, and residents of this state; 375.20    (3) how to contract directly with providers to provide comprehensive coverage for 375.21preventive, mental health, dental and other medical services, and comprehensive drug 375.22benefits to enrollees and maximize the cost savings and other efficiencies that a large 375.23purchasing pool would be expected to generate without the need for a public subsidy; 375.24    (4) provisions that allow the pool to contract directly with health care providers 375.25to provide coverage to enrollees;375.26    (5) incentives designed to attract and retain the maximum number of enrollees; 375.27    (6) recommendations for the administration of the pool and the plans that will be 375.28available to enrollees including, but not limited to, recommendations to keep the pool 375.29solvent and profitable so that public subsidies are not necessary; and 375.30    (7) other elements the study group concludes are necessary or desirable for the 375.31pool to possess. 375.32    The study group shall submit its report and the draft legislation necessary to 375.33implement its recommendations to the chairs of the legislative committees and divisions 375.34with jurisdiction over health care policy and finance, the Health Care Access Commission, 375.35and the governor by February 1, 2008. 376.1    Subd. 3.Staffing.State agencies shall assist the study group with any requests for 376.2information the study group considers necessary to complete the study and report under 376.3subdivision 2.376.4    Subd. 4.Removal; vacancies; expenses.Removal of members, vacancies, and 376.5expenses for members shall be as provided in Minnesota Statutes, section 15.059.376.6    Subd. 5.Expiration.This section expires after the submission of the report as 376.7required in subdivision 2.376.8EFFECTIVE DATE.This section is effective the day following final enactment.376.9    Sec. 62.  REPEALER.376.10(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16; 376.11254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 376.12254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.376.13(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.376.14(c) Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213; 376.15525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222; 376.16525.9223; and 525.9224, are repealed.376.17ARTICLE 8376.18CHILDREN'S HEALTH SECURITY PROGRAM376.19    Section 1. [16A.726] CHILDREN'S HEALTH SECURITY ACCOUNT.376.20    A children's health security account is created in a special revenue fund in the 376.21state treasury. The commissioner shall deposit to the credit of the account money made 376.22available to the account. Notwithstanding section 11A.20, any investment income 376.23attributable to the investment of the children's health security account not currently needed 376.24shall be credited to the children's health security account.376.25    Sec. 2. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended to read:376.26    Subd. 8. Children under age two. Medical assistance may be paid for a child under 376.27two years of age whose countable family income is above 275 300 percent of the federal 376.28poverty guidelines for the same size family but less than or equal to 280 305 percent of the 376.29federal poverty guidelines for the same size family.376.30EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal 376.31approval, whichever is later.377.1    Sec. 3. [256N.01] CITATION.377.2    This chapter may be cited as the "Children's Health Security Act."377.3    Sec. 4. [256N.02] DEFINITIONS.377.4    Subdivision 1.Applicability.The terms used in this chapter have the following 377.5meanings unless otherwise provided for by text.377.6    Subd. 2.Child."Child" means an individual under age 21.377.7    Subd. 3.Commissioner."Commissioner" means the commissioner of human 377.8services.377.9    Subd. 4.Dependent child."Dependent child" means an unmarried child under 377.10age 25 who is claimed as a dependent for federal income tax purposes by a parent, 377.11grandparent, foster parent, relative caretaker, or legal guardian.377.12    Sec. 5. [256N.03] ESTABLISHMENT.377.13    The commissioner shall establish the children's health security program. The 377.14commissioner shall begin implementation of the program on October 1, 2008, or upon 377.15federal approval, whichever is later. The children's health security program must comply 377.16with title XIX of the federal Social Security Act, and waivers granted under title XIX.377.17    Sec. 6. [256N.05] ELIGIBILITY.377.18    Subdivision 1.General requirements.Children meeting the eligibility 377.19requirements of this section are eligible for the children's health security program.377.20    Subd. 2.Income limit.(a) Effective October 1, 2008, children in families with 377.21gross household incomes equal to or less than 225 percent of the federal poverty 377.22guidelines are eligible for the children's health security program. In determining gross 377.23income, the commissioner shall use the income methodology applied to children under the 377.24MinnesotaCare program.377.25    (b) Effective October 1, 2008, a dependent child who meets the program income 377.26limits under paragraph (a) and all other program eligibility requirements is eligible for 377.27state-funded benefits under this section. 377.28    (c) Effective January 1, 2011, or upon federal approval, whichever is later, children 377.29in families with household incomes equal to or less than 300 percent of the federal poverty 377.30guidelines must be included in the children's health security program.377.31    (d) The Legislative Task Force On Children's Health Care Coverage established 377.32under section 19 shall develop recommendations on options for extending health insurance 378.1coverage to children in families with household incomes in excess of 300 percent of the 378.2federal poverty guidelines.378.3    Subd. 3.Residency.Program participants must meet the residency requirements of 378.4section 256B.056, subdivision 1.378.5    Subd. 4.Enrollment voluntary.Enrollment in the children's health security 378.6program is voluntary. Parents or guardians may retain private sector or Medicare coverage 378.7for a child as the sole source of coverage. Parents or guardians who have private sector or 378.8Medicare coverage for children may also enroll children in the children's health security 378.9program. If private sector or Medicare coverage is available, coverage under the children's 378.10health security program is secondary to the private sector or Medicare coverage.378.11    Subd. 5.Emergency services.Payment must be made for care and services that 378.12are furnished to noncitizens, regardless of immigration status, who otherwise meet the 378.13eligibility requirements of this chapter, if the care and services are necessary for the 378.14treatment of an emergency medical condition, except for organ transplants and related 378.15care and services and routine prenatal care. For purposes of this subdivision, "emergency 378.16medical condition" means a medical condition that meets the requirements of United 378.17States Code, title 42, section 1396b(v).378.18    Subd. 6.Medical assistance standards and procedures.(a) Unless otherwise 378.19specified in this chapter, the commissioner shall use medical assistance procedures and 378.20methodology when determining initial eligibility and redetermining eligibility for the 378.21children's health security program.378.22    (b) The procedures and income standard specified in section 256B.056, subdivisions 378.235 and 5c, paragraph (a), apply to children who would be eligible for the children's health 378.24security program, except for excess income.378.25    (c) Retroactive coverage for the children's health security program must be provided 378.26as specified in section 256B.056, subdivision 7.378.27    Sec. 7. [256N.07] COVERED SERVICES.378.28    Covered services under the children's health security program must consist of all 378.29covered services under chapter 256B.378.30    Sec. 8. [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.378.31    In order to ensure broad access to coverage, the children's health security program 378.32has no enrollee premium or cost-sharing requirements.379.1    Sec. 9. [256N.11] APPLICATION PROCEDURES; ELIGIBILITY 379.2DETERMINATION.379.3    Subdivision 1.Application procedure.The application form for the program 379.4must be easily understandable and must not exceed two pages in length. Applications for 379.5the program must be made available to provider offices, local human services agencies, 379.6school districts, schools, community health offices, and other sites willing to cooperate in 379.7program outreach. These sites may accept applications and forward applications to the 379.8commissioner, and counties where applicable. Applications may also be made directly to 379.9the commissioner and to counties that determine eligibility.379.10    Subd. 2.Eligibility determination.Counties that determine eligibility for 379.11MinnesotaCare as of March 1, 2007, shall determine eligibility for the children's health 379.12security program. The commissioner, and counties where applicable, shall determine an 379.13applicant's eligibility for the program within 30 days of the date the application is received, 379.14according to the procedures in Code of Federal Regulations, title 42, section 435.911.379.15    Subd. 3.Presumptive eligibility.Coverage under the program is available during a 379.16presumptive eligibility period for children under age 19 whose family income does not 379.17exceed the applicable income standard. The presumptive eligibility period begins on the 379.18date on which a health care provider enrolled in the program, or other entity designated by 379.19the commissioner, determines, based on preliminary information, that the child's family 379.20income does not exceed the applicable income standard. The presumptive eligibility period 379.21ends the earlier of the day on which a determination is made of eligibility under this section 379.22or the last day of the month following the month presumptive eligibility was determined. 379.23    Subd. 4.Renewal of eligibility.The commissioner shall require enrollees to renew 379.24eligibility every 12 months.379.25    Subd. 5.Continuous eligibility.Children under the age of 19 who are eligible 379.26under this section shall be continuously eligible until the earlier of the next renewal period, 379.27or the time that a child exceeds age 19.379.28    Sec. 10. [256N.12] COUNTY ROLE.379.29    Counties not required to determine eligibility under section 256N.11, subdivision 379.302, may choose to determine eligibility under that section. Counties may also choose 379.31to provide assistance to applicants under section 256N.17, subdivision 1, and provide 379.32ombudsperson services under section 256N.17, subdivision 2. This must not limit the 379.33ability of the commissioner to establish reasonable staffing standards that relate to the 379.34number of persons served, and that provide a county option to hire part-time staff or pursue 379.35multicounty implementation models. If a county chooses not to deliver these services, they 380.1must be delivered by the commissioner. State and federal funding to support these services 380.2must be the same, whether delivered by the state or by a county or group of counties.380.3    Sec. 11. [256N.13] SERVICE DELIVERY.380.4    Subdivision 1.Contracts for service delivery.The commissioner, within each 380.5county, may contract with managed care organizations, including health maintenance 380.6organizations licensed under chapter 62D, community integrated service networks licensed 380.7under chapter 62N, accountable provider networks licensed under chapter 62T, and 380.8county-based purchasing plans established under section 256B.692, to provide covered 380.9health care services to program enrollees under a managed care system, and may contract 380.10with health care and social service providers to provide services on a fee-for-service basis. 380.11Section 256B.69, subdivision 26, applies to contracts with managed care organizations. In 380.12determining the method for service delivery, the commissioner shall consider the cost and 380.13quality of health care services; the breadth of services offered, including medical, dental 380.14and mental health services; the breadth of choice of medical providers for enrollees; the 380.15ease of access to quality medical care for enrollees; the efficiency and cost-effectiveness of 380.16service delivery; and the integration of best medical practice standards into the children's 380.17health security program.380.18    Subd. 2.Managed care organization requirements.(a) Managed care 380.19organizations under contract are responsible for coordinating covered health care services 380.20provided to eligible individuals. Managed care organizations under contract:380.21    (1) shall authorize and arrange for the provision of all needed covered health 380.22services under chapter 256B, with the exception of services available only under a medical 380.23assistance home and community-based waiver, in order to ensure appropriate health care 380.24is delivered to enrollees;380.25    (2) shall comply with the requirements of section 256B.69, subdivision 26;380.26    (3) shall accept the prospective, per capita payment from the commissioner in return 380.27for the provision of comprehensive and coordinated health care services for enrollees;380.28    (4) may contract with health care and social service providers to provide covered 380.29services to enrollees; and380.30    (5) shall institute enrollee grievance procedures according to the method established 380.31by the commissioner, utilizing applicable requirements of chapter 62D and Code of 380.32Federal Regulations, title 42, section 438, subpart F. Disputes may also be appealed to 380.33the commissioner using the procedures in section 256.045.380.34    (b) Upon implementation of the children's health security program, the commissioner 380.35shall withhold five percent of managed care organization payments pending completion 381.1of performance targets, including lead screening, well child services, immunizations, 381.2vision screening, and customer service performance targets. Effective January 1, 2011, 381.3the commissioner shall add treatment of asthma and screening for mental health as new 381.4performance targets. Each performance target must apply uniformly to all managed care 381.5organizations, and be qualitative, objective, measurable, and reasonably attainable, except 381.6in the case of a performance target based on federal or state law or rule. Criteria for 381.7assessment of each performance target must be outlined in writing prior to the contract 381.8effective date. The withhold funds must be returned no sooner than July of the following 381.9year if performance targets in the contract are achieved. The success of each managed care 381.10organization in reaching performance targets must be reported to the legislature annually.381.11    Subd. 3.Fee-for-service delivery.Disputes related to services provided under 381.12the fee-for-service system may be appealed to the commissioner using the procedures 381.13in section 256.045.381.14    Subd. 4.Contracts for waiver services.The commissioner, when services 381.15are delivered through managed care, may contract with health care and social service 381.16providers on a fee-for-service basis to provide program enrollees with covered services 381.17available only under a medical assistance home and community-based waiver. The 381.18commissioner shall determine eligibility for home and community-based waiver services 381.19using the criteria and procedures in chapter 256B. Disputes related to services provided 381.20on a fee-for-service basis may be appealed to the commissioner using the procedures 381.21in section 256.045.381.22    Subd. 5.Service delivery for Minnesota disabilities health option recipient.381.23    Individuals who voluntarily enroll in the Minnesota Disability Health Option (MnDHO), 381.24established under section 256B.69, subdivision 23, shall continue to receive their home 381.25and community-based waiver services through MnDHO.381.26    Subd. 6.Disabled or blind children.Children eligible for medical assistance due 381.27to blindness or disability as determined by the Social Security Administration or the state 381.28medical review team are exempt from enrolling in a managed care organization and shall 381.29be provided health benefits on a fee-for-service basis.381.30    Sec. 12. [256N.15] PAYMENT RATES.381.31    Subdivision 1.Establishment.The commissioner, in consultation with a health 381.32care actuary, shall establish the method and amount of payments for services. The 381.33commissioner shall annually contract with eligible entities to provide services to program 381.34enrollees. The commissioner, in consultation with the Risk Adjustment Association 382.1established under section 62Q.03, subdivision 6, shall develop and implement a risk 382.2adjustment system for the program.382.3    Subd. 2.Provider rates.In establishing the payment amount under subdivision 382.41, the commissioner shall ensure that fee-for-service payment rates for preventative 382.5care services provided on or after October 1, 2008, are at least five percent above the 382.6medical assistance rates for preventative services in effect on September 30, 2008, and 382.7shall ensure that fee-for-service payment rates for all other services provided on or after 382.8October 1, 2008, are at least three percent above the medical assistance rates for those 382.9services in effect on September 30, 2008. The commissioner shall adjust managed care 382.10capitation rates to reflect these increases, and shall require managed care organizations, as 382.11a condition of contract, to pass these increases on to providers under contract.382.12    Sec. 13. [256N.17] CONSUMER ASSISTANCE.382.13    Subdivision 1.Assistance to applicants.The commissioner shall assist applicants 382.14in choosing a managed care organization or fee-for-service provider by:382.15    (1) establishing a Web site to provide information about managed care organizations 382.16and fee-for-service providers and to allow online enrollment;382.17    (2) make information on managed care organizations and fee-for-service providers 382.18available at the sites specified in section 256N.11, subdivision 1;382.19    (3) make applications and information on managed care organizations and 382.20fee-for-service providers available to applicants and enrollees according to Title VI of the 382.21Civil Rights Act and federal regulations adopted under that law or any guidance from the 382.22United States Department of Health and Human Services; and382.23    (4) make benefit educators available to assist applicants in choosing a managed care 382.24organization or fee-for-service provider.382.25    Subd. 2.Ombudsperson.The commissioner shall designate an ombudsperson 382.26to advocate for children enrolled in the children's health security program. The 382.27ombudsperson shall assist enrollees in understanding and making use of complaint and 382.28appeal procedures and ensure that necessary medical services are provided to enrollees. At 382.29the time of enrollment, the commissioner shall inform enrollees about the ombudsperson 382.30program, the right to a resolution of the enrollee's complaint by the managed care 382.31organization if the enrollee experiences a problem with the managed care organization 382.32or its providers, and appeal rights under section 256.045.382.33    Sec. 14. [256N.19] MONITORING AND EVALUATION OF QUALITY AND 382.34COSTS.383.1    (a) The commissioner, as a condition of contract, shall require each participating 383.2managed care organization and participating provider to submit, in the form and manner 383.3specified by the commissioner, data required for assessing enrollee satisfaction, quality 383.4of care, cost, and utilization of services. The commissioner shall evaluate this data, in 383.5order to:383.6    (1) make summary information on the quality of care across managed care 383.7organizations, medical clinics, and providers available to consumers;383.8    (2) require managed care organizations and providers, as a condition of contract, to 383.9implement quality improvement plans; and383.10    (3) compare the cost and quality of services under the program to the cost and 383.11quality of services provided to private sector enrollees.383.12    (b) The commissioner shall implement this section to the extent allowed by federal 383.13and state laws on data privacy.383.14    Sec. 15. [256N.21] FEDERAL APPROVAL.383.15    The commissioner shall seek all federal waivers and approvals necessary to 383.16implement this chapter including, but not limited to, waivers and approvals necessary to:383.17    (1) coordinate medical assistance and MinnesotaCare coverage for children with the 383.18children's health security program;383.19    (2) use federal medical assistance and MinnesotaCare dollars to pay for health care 383.20services under the children's health security program;383.21    (3) maximize receipt of the federal medical assistance match for covered children, 383.22by increasing income standards through the use of more liberal income methodologies as 383.23provided under United States Code, title 42, sections 1396a and 1396u-1;383.24    (4) extend presumptive eligibility and continuous eligibility to children under age 383.2521; and383.26    (5) use federal medical assistance and MinnesotaCare dollars to provide benefits to 383.27dependent children.383.28    Sec. 16. [256N.23] RULEMAKING.383.29    The commissioner shall adopt rules to implement this chapter.383.30    Sec. 17. [256N.25] CHILDREN'S HEALTH SECURITY PROGRAM 383.31OUTREACH.383.32    Subdivision 1.Grant awards.The commissioner shall award grants to public or 383.33private organizations to:384.1    (1) provide information, in areas of the state with high uninsured populations, on the 384.2importance of maintaining insurance coverage and on how to obtain coverage through 384.3the children's health security program; and384.4    (2) monitor and provide ongoing support to ensure enrolled children remain covered.384.5    Subd. 2.Criteria.In awarding the grants, the commissioner shall consider the 384.6following:384.7    (1) geographic areas and populations with high uninsured rates;384.8    (2) the ability to raise matching funds;384.9    (3) the ability to contact, effectively communicate with, or serve eligible populations; 384.10and384.11    (4) the applicant's plan to monitor and provide support to ensure enrolled children 384.12remain covered.384.13    Subd. 3.Monitoring and termination.The commissioner shall monitor the grants 384.14and may terminate a grant if the outreach effort does not increase enrollment in the 384.15children's health security program.384.16    Sec. 18. IMPLEMENTATION PLAN.384.17    The commissioner of human services shall develop an implementation plan for the 384.18children's health security program, which includes a health delivery plan based on the 384.19criteria specified in Minnesota Statutes, section 256N.13, subdivision 1. The commissioner 384.20shall present this plan, any necessary draft legislation, and a draft of proposed rules 384.21to the legislature by December 15, 2007. The plan must include recommendations 384.22for any additional legislative changes necessary to coordinate medical assistance and 384.23MinnesotaCare coverage for children with the children's health security program. The 384.24commissioner shall evaluate the provision of services under the program to children with 384.25disabilities and shall present recommendations to the legislature by December 15, 2009, 384.26for any program changes necessary to ensure the quality and continuity of care.384.27    Sec. 19. LEGISLATIVE TASK FORCE ON CHILDREN'S HEALTH CARE 384.28COVERAGE.384.29    Subdivision 1.Establishment; membership.(a) The Legislative Task Force on 384.30Children's Health Care Coverage is established. The task force is made up of 12 voting 384.31members and six nonvoting members.384.32    (b) The voting members are:384.33    (1) six members of the house of representatives appointed by the speaker, three from 384.34the majority party and three from the minority party; and385.1    (2) six members of the senate appointed by the Subcommittee on Committees of the 385.2senate Committee on Rules and Administration, three from the majority party and three 385.3from the minority party.385.4    (c) The nonvoting members are one representative selected by each of the following 385.5organizations:385.6    (1) the American Academy of Pediatrics, Minnesota chapter;385.7    (2) the Minnesota Nurses Association;385.8    (3) the Minnesota Council of Health Plans;385.9    (4) the Minnesota Children's Platform Coalition;385.10    (5) the Minnesota Universal Health Care Coalition; and385.11    (6) the Minnesota Business Partnership.385.12    (d) The task force members must be appointed by September 1, 2007. The majority 385.13leader of the senate and the speaker of the house of representatives must each designate 385.14a chair from their appointments. The chair appointed by the speaker of the house of 385.15representatives shall convene and chair the first meeting of the task force. The chair 385.16appointed by the majority leader of the senate shall chair the next meeting of the task 385.17force. The chairs shall then alternate for the duration of the task force.385.18    Subd. 2.Study; staff support.(a) The task force shall study viable options to extend 385.19coverage to all children as provided in Minnesota Statutes, section 256N.05, subdivision 385.202, paragraph (d), and provide recommendations to the legislature. The study must:385.21    (1) evaluate methods to achieve universal coverage for children, including, but not 385.22limited to, changes to the employer-based coverage system and an expansion of eligibility 385.23for the children's health security program established under Minnesota Statutes, chapter 385.24256N;385.25    (2) examine health care reform and cost containment methods that will contain costs 385.26and increase access and improve health outcomes;385.27    (3) examine how to increase access to preventive care and health care services; and385.28    (4) examine how to reduce health disparities among minority populations. 385.29    (b) The task force, through the Legislative Coordinating Commission, may hire staff 385.30or contract for staff support for the study.385.31    (c) The task force, in developing recommendations, shall hold meetings to hear 385.32public testimony at locations throughout the state, including locations outside of the 385.33seven-county metropolitan area.385.34    Subd. 3.Recommendations.The task force shall report its recommendations to 385.35the legislature by December 15, 2009. Recommendations must be consistent with the 385.36following criteria:386.1    (1) health care coverage must include preventive care and all other medically 386.2necessary services;386.3    (2) health care coverage must be affordable for families, with the family share of 386.4premium costs and cost-sharing in total not exceeding five percent of family income;386.5    (3) the system of coverage must give priority to ensuring access to and the quality 386.6and continuity of care; and386.7    (4) enrollment must be simple and seamless for families.386.8    Subd. 4.Expiration.This section expires December 16, 2009.386.9ARTICLE 9386.10HEALTH CARE REFORM386.11    Section 1. Minnesota Statutes 2006, section 62A.65, subdivision 3, is amended to read:386.12    Subd. 3. Premium rate restrictions. No individual health plan may be offered, 386.13sold, issued, or renewed to a Minnesota resident unless the premium rate charged is 386.14determined in accordance with the following requirements:386.15    (a) Premium rates must be no more than 25 percent above and no more than 25 386.16percent below the index rate charged to individuals for the same or similar coverage, 386.17adjusted pro rata for rating periods of less than one year. The premium variations 386.18permitted by this paragraph must be based only upon health status, claims experience, 386.19and occupation. For purposes of this paragraph, health status includes refraining from 386.20tobacco use or other actuarially valid lifestyle factors associated with good health, 386.21provided that the lifestyle factor and its effect upon premium rates have been determined 386.22by the commissioner to be actuarially valid and have been approved by the commissioner. 386.23Variations permitted under this paragraph must not be based upon age or applied 386.24differently at different ages. This paragraph does not prohibit use of a constant percentage 386.25adjustment for factors permitted to be used under this paragraph.386.26    (b) Premium rates may vary based upon the ages of covered persons only as 386.27provided in this paragraph. In addition to the variation permitted under paragraph (a), 386.28each health carrier may use an additional premium variation based upon age for adults 386.29aged 19 and above of up to plus or minus 50 percent of the index rate. Premium rates for 386.30children under the age of 19 may not vary based on age, regardless of whether the child is 386.31covered as a dependent or as a primary insured.386.32    (c) A health carrier may request approval by the commissioner to establish separate 386.33geographic regions determined by the health carrier and to establish separate index rates 386.34for each such region. The commissioner shall grant approval if the following conditions 386.35are met: 387.1    (1) the geographic regions must be applied uniformly by the health carrier;387.2    (2) each geographic region must be composed of no fewer than seven counties that 387.3create a contiguous region; and387.4    (3) the health carrier provides actuarial justification acceptable to the commissioner 387.5for the proposed geographic variations in index rates, establishing that the variations are 387.6based upon differences in the cost to the health carrier of providing coverage.387.7    (d) Health carriers may use rate cells and must file with the commissioner the rate 387.8cells they use. Rate cells must be based upon the number of adults or children covered 387.9under the policy and may reflect the availability of Medicare coverage. The rates for 387.10different rate cells must not in any way reflect generalized differences in expected costs 387.11between principal insureds and their spouses.387.12    (e) In developing its index rates and premiums for a health plan, a health carrier shall 387.13take into account only the following factors:387.14    (1) actuarially valid differences in rating factors permitted under paragraphs (a) 387.15and (b); and387.16    (2) actuarially valid geographic variations if approved by the commissioner as 387.17provided in paragraph (c).387.18    (f) All premium variations must be justified in initial rate filings and upon request of 387.19the commissioner in rate revision filings. All rate variations are subject to approval by 387.20the commissioner.387.21    (g) The loss ratio must comply with the section 
         62A.021 requirements for individual 387.22health plans. 387.23    (h) The rates must not be approved, unless the commissioner has determined that the 387.24rates are reasonable. In determining reasonableness, the commissioner shall consider the 387.25growth rates applied under section 
         62J.04, subdivision 1, paragraph (b), to the calendar 387.26year or years that the proposed premium rate would be in effect, actuarially valid changes 387.27in risks associated with the enrollee populations, and actuarially valid changes as a result 387.28of statutory changes in Laws 1992, chapter 549. 387.29    (i) An insurer may, as part of a minimum lifetime loss ratio guarantee filing under 387.30section 
         62A.02, subdivision 3a, include a rating practices guarantee as provided in this 387.31paragraph. The rating practices guarantee must be in writing and must guarantee that 387.32the policy form will be offered, sold, issued, and renewed only with premium rates and 387.33premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices 387.34guarantee must be accompanied by an actuarial memorandum that demonstrates that the 387.35premium rates and premium rating system used in connection with the policy form will 387.36satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to 388.1policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4, 388.2or 5. An insurer that complies with this paragraph in connection with a policy form is 388.3exempt from the requirement of prior approval by the commissioner under paragraphs 388.4(c), (f), and (h).388.5    Sec. 2. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.388.6    Subdivision 1.Title; citation.This section may be cited as the "Minnesota Health 388.7Insurance Exchange."388.8    Subd. 2.Creation; tax exemption.The Minnesota Health Insurance Exchange 388.9is created for the limited purpose of providing individuals with greater access, choice, 388.10portability, and affordability of health insurance products. The Minnesota Health 388.11Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c) 388.12of the Internal Revenue Code.388.13    Subd. 3.Definitions.The following terms have the meanings given them unless 388.14otherwise provided in text.388.15    (a) "Board" means the board of directors of the Minnesota Health Insurance 388.16Exchange under subdivision 13.388.17    (b) "Commissioner" means: 388.18    (1) the commissioner of commerce for health insurers subject to the jurisdiction 388.19of the Department of Commerce; 388.20    (2) the commissioner of health for health insurers subject to the jurisdiction of the 388.21Department of Health; or 388.22    (3) either commissioner's designated representative.388.23    (c) "Exchange" means the Minnesota Health Insurance Exchange.388.24    (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.388.25    (e) "Individual market health plans," unless otherwise specified, means individual 388.26market health plans defined in section 62A.011.388.27    (f) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of 388.28the Internal Revenue Code that allows employees to pay for health insurance premiums 388.29with pretax dollars.388.30    Subd. 4.Insurer and health plan participation.All health plans as defined in 388.31section 62A.011, subdivision 3, issued or renewed in the individual market shall participate 388.32in the exchange. No health plans in the individual market may be issued or renewed 388.33outside of the exchange. Group health plans as defined in section 62A.10 shall not be 388.34offered through the exchange. Health plans offered through the Minnesota Comprehensive 388.35Health Association as defined in section 62E.10 are offered through the exchange to 389.1eligible enrollees as determined by the Minnesota Comprehensive Health Association. 389.2Health plans offered through MinnesotaCare under chapter 256L are offered through the 389.3exchange to eligible enrollees as determined by the commissioner of human services.389.4    Subd. 5.Approval of health plans.No health plan may be offered through the 389.5exchange unless the commissioner has first certified that:389.6    (1) the insurer seeking to offer the health plan is licensed to issue health insurance in 389.7the state; and389.8    (2) the health plan meets the requirements of this section, and the health plan and the 389.9insurer are in compliance with all other applicable health insurance laws.389.10    Subd. 6.Individual market health plans.Individual market health plans offered 389.11through the exchange continue to be regulated by the commissioner as specified in 389.12chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions 389.13that apply to all health plans issued or renewed through the exchange:389.14    (1) premiums for children under the age of 19 shall not vary by age in the exchange; 389.15and389.16    (2) premiums for children under the age of 19 must be excluded from rating factors 389.17under section 62A.65, subdivision 3, paragraph (b).389.18    Subd. 7.Individual participation and eligibility.Individuals are eligible to 389.19purchase health plans directly through the exchange or through an employer Section 389.20125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of 389.21individual market health plans offered through the exchange. Individuals are eligible to 389.22purchase individual market health plans through the exchange by meeting one or more 389.23of the following qualifications:389.24    (1) the individual is a Minnesota resident, meaning the individual is physically 389.25residing on a permanent basis in a place that is the person's principal residence and from 389.26which the person is absent only for temporary purposes;389.27    (2) the individual is a student attending an institution outside of Minnesota and 389.28maintains Minnesota residency;389.29    (3) the individual is not a Minnesota resident but is employed by an employer 389.30physically located within the state and the individual's employer is required to offer a 389.31Section 125 Plan under section 62A.68;389.32    (4) the individual is not a Minnesota resident but is self-employed and the 389.33individual's principal place of business is in the state; or389.34    (5) the individual is a dependent as defined in section 62L.02, of another individual 389.35who is eligible to participate in the exchange.390.1    Subd. 8.Continuation of coverage.Enrollment in a health plan may be canceled 390.2for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under 390.3chapter 256L. Enrollment in an individual market health plan may not be canceled or 390.4nonrenewed because of any change in employer or employment status, marital status, 390.5health status, age, residence, or any other change that does not affect eligibility as defined 390.6in this section.390.7    Subd. 9.Responsibilities of the exchange.The exchange shall serve as the sole 390.8entity for enrollment and collection and transfer of premium payments for health plans 390.9sold to individuals through the exchange. The exchange shall be responsible for the 390.10following functions:390.11    (1) publicize the exchange, including but not limited to its functions, eligibility 390.12rules, and enrollment procedures;390.13    (2) provide assistance to employers to establish Section 125 Plans under section 390.1462A.68;390.15    (3) provide education and assistance to employers to help them understand the 390.16requirements of Section 125 Plans and compliance with applicable regulations;390.17    (4) create a system to allow individuals to compare and enroll in health plans offered 390.18through the exchange;390.19    (5) create a system to collect and transmit to the applicable plans all premium 390.20payments made by individuals, including developing mechanisms to receive and process 390.21automatic payroll deductions for individuals who purchase coverage through employer 390.22Section 125 Plans;390.23    (6) not accept premium payments for individual market health plans from an 390.24employer Section 125 Plan if the employer offers a group health plan as defined in section 390.2562A.10, or if the employer is a self-insurer as defined in section 62E.02;390.26    (7) provide jointly with health insurers a cancellation notice directly to the primary 390.27insured at least ten days prior to termination of coverage for nonpayment of premium;390.28    (8) bill the employer for the premiums payable by an employee, provided that the 390.29employer is not liable for payment except from payroll deductions for that purpose;390.30    (9) refer individuals interested in MinnesotaCare under chapter 256L to the 390.31Department of Human Services to determine eligibility;390.32    (10) establish a mechanism with the Department of Human Services to transfer 390.33premiums and subsidies for MinnesotaCare to qualify for federal matching payments;390.34    (11) upon request, issue certificates of previous coverage according to the provisions 390.35of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be 390.36covered by a participating health plan through the exchange;391.1    (12) establish procedures to account for all funds received and disbursed by the 391.2exchange for individual participants of the exchange; 391.3    (13) make available to the public, at the end of each calendar year, a report of an 391.4independent audit of the exchange's accounts; and391.5    (14) provide copies of written and signed statements from employers stating that 391.6the employer is not contributing to the employee's premiums for health plans purchased 391.7by an employee through the exchange to all health insurers with enrolled employees of 391.8the employer.391.9    Health insurers may rely on the employer's statement in clause (4) provided by the 391.10Minnesota Health Insurance Exchange and are not required to guarantee-issue individual 391.11health plans to the employer's employees.391.12    Subd. 10.State not liable.The state of Minnesota shall not be liable for the actions 391.13of the Minnesota Health Insurance Exchange.391.14    Subd. 11.Powers of the exchange.The exchange shall have the power to:391.15    (1) contract with insurance producers licensed in accident and health insurance 391.16under chapter 60K and vendors to perform one or more of the functions specified in 391.17subdivision 10;391.18    (2) contract with employers to collect premiums through a Section 125 Plan for 391.19eligible individuals who purchase an individual market health plan through the exchange;391.20    (3) establish and assess fees on health plan premiums of health plans purchased 391.21through the exchange to fund the cost of administering the exchange;391.22    (4) seek and directly receive grant funding from government agencies or private 391.23philanthropic organizations to defray the costs of operating the exchange;391.24    (5) establish and administer rules and procedures governing the operations of the 391.25exchange;391.26    (6) establish one or more service centers within Minnesota;391.27    (7) sue or be sued or otherwise take any necessary or proper legal action;391.28    (8) establish bank accounts and borrow money; and391.29    (9) enter into agreements with the commissioners of commerce, health, human 391.30services, revenue, employment and economic development, and other state agencies as 391.31necessary for the exchange to implement the provisions of this section.391.32    Subd. 12.Dispute resolution.The exchange shall establish procedures for 391.33resolving disputes with respect to the eligibility of an individual to participate in the 391.34exchange. The exchange does not have the authority or responsibility to intervene in or 391.35resolve disputes between an individual and a health plan or health insurer. The exchange 392.1shall refer complaints from individuals participating in the exchange to the commissioner 392.2to be resolved according to sections 62Q.68 to 62Q.73.392.3    Subd. 13.Governance.The exchange shall be governed by a board of directors 392.4with 11 members. The board shall convene on or before July 1, 2007, after the initial board 392.5members have been selected. The initial board membership consists of the following:392.6    (1) the commissioner of commerce;392.7    (2) the commissioner of human services;392.8    (3) the commissioner of health;392.9    (4) four members appointed by a joint committee of the Minnesota senate and the 392.10Minnesota house of representatives to serve three-year terms; and392.11    (5) four members appointed by the governor to serve three-year terms.392.12    Subd. 14.Subsequent board membership.Ongoing membership of the exchange 392.13consists of the following effective July 1, 2010:392.14    (1) the commissioner of commerce;392.15    (2) the commissioner of human services;392.16    (3) the commissioner of health;392.17    (4) two members appointed by the governor with the approval of a joint committee 392.18of the senate and house of representatives to serve two-year terms; and392.19    (5) six members elected by the membership of the exchange of which three 392.20are elected to serve a two-year term and three are elected to serve a three-year term. 392.21Appointed and elected members may serve more than one term.392.22    Subd. 15.Operations of the board.Officers of the board of directors are elected by 392.23members of the board and serve one-year terms. Six members of the board constitutes a 392.24quorum, and the affirmative vote of six members of the board is necessary and sufficient 392.25for any action taken by the board. Board members serve without pay, but are reimbursed 392.26for actual expenses incurred in the performance of their duties.392.27    Subd. 16.Operations of the exchange.The board of directors shall appoint an 392.28exchange director who shall:392.29    (1) be a full-time employee of the exchange;392.30    (2) administer all of the activities and contracts of the exchange; and 392.31    (3) hire and supervise the staff of the exchange.392.32    Subd. 17.Insurance producers.An individual has the right to choose any 392.33insurance producer licensed in accident and health insurance under chapter 60K to assist 392.34them in purchasing an individual market health plan through the exchange. When a 392.35producer licensed in accident and health insurance under chapter 60K enrolls an eligible 393.1individual in the exchange, the health plan chosen by an individual may pay the producer 393.2a commission.393.3    Subd. 18.Implementation.Health plan coverage through the exchange begins on 393.4January 1, 2009. The exchange must be operational to assist employers and individuals 393.5by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees 393.6of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive 393.7Health Association as of December 2, 2008, are automatically enrolled in the exchange 393.8on January 1, 2009, in the same health plan and at the same premium that they were 393.9enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1, 393.102009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota 393.11Comprehensive Health Association shall make premium payments to the exchange.393.12    Sec. 3. [62A.68] SECTION 125 PLANS.393.13    Subdivision 1.Definitions.The following terms have the meanings given unless 393.14otherwise provided in text:393.15    (a) "Current employee" means an employee currently on an employer's payroll other 393.16than a retiree or disabled former employee.393.17    (b) "Employer" means a person, firm, corporation, partnership, association, business 393.18trust, or other entity employing one or more persons, including a political subdivision of 393.19the state, filing payroll tax information on such employed person or persons.393.20    (c) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 393.21of the Internal Revenue Code that allows employees to purchase health insurance with 393.22pretax dollars.393.23    (d) "Exchange" means the Minnesota Health Insurance Exchange under section 393.2462A.67.393.25    (e) "Exchange director" means the appointed director under section 62A.67, 393.26subdivision 16.393.27    Subd. 2.Section 125 Plan requirement.(a) Effective January 1, 2009, all 393.28employers with 11 or more current employees shall establish a Section 125 Plan to 393.29allow their employees to purchase individual market health plan coverage with pretax 393.30dollars. Nothing in this section requires or mandates employers to offer or purchase 393.31health insurance coverage for their employees. The following employers are exempt 393.32from the Section 125 Plan requirement:393.33    (1) employers that offer a group health insurance plan as defined in 62A.10;393.34    (2) employers that are self-insurers as defined in section 62E.02; and394.1    (3) employers with fewer than 11 current employees, except that employers under 394.2this clause may voluntarily offer a Section 125 Plan.394.3    (b) Employers that offer a Section 125 Plan may enter into an agreement with the 394.4exchange to administer the employer's Section 125 Plan.394.5    Subd. 3.Tracking compliance.By July 1, 2008, the exchange, in consultation with 394.6the commissioners of commerce, health, employment and economic development, and 394.7revenue shall establish a method for tracking employer compliance with the Section 125 394.8Plan requirement.394.9    Subd. 4.Employer requirements.Employers that are required to offer or choose 394.10to offer a Section 125 Plan shall:394.11    (1) allow employees to purchase any individual market health plan for themselves 394.12and their dependents through the exchange;394.13    (2) allow employees to choose any insurance producer licensed in accident and 394.14health insurance under chapter 60K to assist them in purchasing an individual market 394.15health plan through the exchange;394.16    (3) provide a written and signed statement to the exchange stating that the employer 394.17is not contributing to the employee's premiums for health plans purchased by an employee 394.18through the exchange;394.19    (4) upon an employee's request, deduct premium amounts on a pretax basis in an 394.20amount not to exceed an employee's wages, and remit these employee payments to the 394.21exchange; and394.22    (5) provide notice to employees that individual market health plans purchased 394.23through the exchange are not employer-sponsored or administered. Employers shall be 394.24held harmless from any and all liability claims related to the individual market health 394.25plans purchased through the exchange by employees under a Section 125 Plan.394.26    Subd. 5.Section 125 eligible health plans.Individuals who are eligible to use 394.27an employer Section 125 Plan to pay for health insurance coverage purchased through 394.28the exchange may enroll in any health plan offered through the exchange for which the 394.29individual is eligible including individual market health plans, MinnesotaCare, and the 394.30Minnesota Comprehensive Health Association.394.31    Sec. 4. Minnesota Statutes 2006, section 62E.141, is amended to read:394.3262E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.394.33    No employee of an employer that offers a group health plan, under which the 394.34employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in 394.35the comprehensive health association, except for enrollment or continued enrollment 395.1necessary to cover conditions that are subject to an unexpired preexisting condition 395.2limitation, preexisting condition exclusion, or exclusionary rider under the employer's 395.3health plan. This section does not apply to persons enrolled in the Comprehensive Health 395.4Association as of June 30, 1993. With respect to persons eligible to enroll in the health 395.5plan of an employer that has more than 29 current employees, as defined in section 395.662L.02
         , this section does not apply to persons enrolled in the Comprehensive Health 395.7Association as of December 31, 1994. 395.8    Sec. 5. Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:395.9    Subd. 3. Cost containment duties. The commissioner shall:395.10    (1) establish statewide and regional cost containment goals for total health care 395.11spending under this section and, collect data as described in sections 
         62J.38 to 
         62J.41 to 395.12monitor statewide achievement of the cost containment goals, and annually report to the 395.13legislature on whether the goals were achieved and, if not, what action should be taken to 395.14ensure that goals are achieved in the future; 395.15    (2) divide the state into no fewer than four regions, with one of those regions being 395.16the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 395.17Wright, and Sherburne Counties, for purposes of fostering the development of regional 395.18health planning and coordination of health care delivery among regional health care 395.19systems and working to achieve the cost containment goals;395.20    (3) monitor the quality of health care throughout the state and take action as 395.21necessary to ensure an appropriate level of quality;395.22    (4) issue recommendations regarding uniform billing forms, uniform electronic 395.23billing procedures and data interchanges, patient identification cards, and other uniform 395.24claims and administrative procedures for health care providers and private and public 395.25sector payers. In developing the recommendations, the commissioner shall review the 395.26work of the work group on electronic data interchange (WEDI) and the American National 395.27Standards Institute (ANSI) at the national level, and the work being done at the state and 395.28local level. The commissioner may adopt rules requiring the use of the Uniform Bill 395.2982/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 395.30version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 395.31forms or procedures;395.32    (5) undertake health planning responsibilities;395.33    (6) authorize, fund, or promote research and experimentation on new technologies 395.34and health care procedures;396.1    (7) within the limits of appropriations for these purposes, administer or contract for 396.2statewide consumer education and wellness programs that will improve the health of 396.3Minnesotans and increase individual responsibility relating to personal health and the 396.4delivery of health care services, undertake prevention programs including initiatives to 396.5improve birth outcomes, expand childhood immunization efforts, and provide start-up 396.6grants for worksite wellness programs;396.7    (8) undertake other activities to monitor and oversee the delivery of health care 396.8services in Minnesota with the goal of improving affordability, quality, and accessibility of 396.9health care for all Minnesotans; and396.10    (9) make the cost containment goal data available to the public in a 396.11consumer-oriented manner.396.12EFFECTIVE DATE.This section is effective July 1, 2007.396.13    Sec. 6. Minnesota Statutes 2006, section 62J.495, is amended to read:396.1462J.495 HEALTH INFORMATION TECHNOLOGY AND 396.15INFRASTRUCTURE ADVISORY COMMITTEE.396.16    Subdivision 1. Establishment; members; duties Implementation.By January 396.171, 2012, all hospitals and health care providers must have in place an interoperable 396.18electronic health records system within their hospital system or clinical practice setting. 396.19The commissioner of health, in consultation with the Health Information Technology and 396.20Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, 396.21including the adoption of uniform standards to be used for the interoperable system for 396.22sharing and synchronizing patient data across systems. The standards must be compatible 396.23with federal efforts. The uniform standards must be refined and adopted for use when 396.24a standard development organization accredited by the American National Standards 396.25Institute completes the development of a standard for sharing and synchronizing patient 396.26data across systems.396.27    Subd. 2. Health Information Technology and Infrastructure Advisory 396.28Committee. (a) The commissioner shall establish a Health Information Technology 396.29and Infrastructure Advisory Committee governed by section 
         15.059 to advise the 396.30commissioner on the following matters:396.31    (1) assessment of the use of health information technology by the state, licensed 396.32health care providers and facilities, and local public health agencies;396.33    (2) recommendations for implementing a statewide interoperable health information 396.34infrastructure, to include estimates of necessary resources, and for determining standards 397.1for administrative data exchange, clinical support programs, patient privacy requirements, 397.2and maintenance of the security and confidentiality of individual patient data; and397.3    (3) recommendations for encouraging use of innovative health care applications 397.4using information technology and systems to improve patient care and reduce the cost 397.5of care, including applications relating to disease management and personal health 397.6management that enable remote monitoring of patients' conditions, especially those with 397.7chronic conditions; and397.8    (3)(4) other related issues as requested by the commissioner.397.9    (b) The members of the Health Information Technology and Infrastructure Advisory 397.10Committee shall include the commissioners, or commissioners' designees, of health, 397.11human services, administration, and commerce and additional members to be appointed 397.12by the commissioner to include persons representing Minnesota's local public health 397.13agencies, licensed hospitals and other licensed facilities and providers, private purchasers, 397.14the medical and nursing professions, health insurers and health plans, the state quality 397.15improvement organization, academic and research institutions, consumer advisory 397.16organizations with an interest and expertise in health information technology, and other 397.17stakeholders as identified by the Health Information Technology and Infrastructure 397.18Advisory Committee.397.19    Subd. 2.Annual report.(c) The commissioner shall prepare and issue an annual 397.20report not later than January 30 of each year outlining progress to date in implementing a 397.21statewide health information infrastructure and recommending future projects.397.22    Subd. 3.Expiration.(d) Notwithstanding section 
         15.059, this sectionsubdivision 397.23expires June 30, 2009 2012.397.24    Sec. 7. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 397.25ACCOUNT AND LOAN PROGRAM.397.26    Subdivision 1.Account establishment.The commissioner of finance shall establish 397.27and implement a revolving account in the state government special revenue fund to 397.28provide loans to eligible borrowers to assist in financing the installation or support of 397.29an interoperable health record system. The system must provide for the interoperable 397.30exchange of health care information between the applicant and, at a minimum, a hospital 397.31system, pharmacy, and a health care clinic or other physician group.397.32    Subd. 2.Eligibility.(a) "Eligible borrower" means one of the following:397.33    (1) community clinics, as defined under section 145.9268;397.34    (2) hospitals eligible for rural hospital capital improvement grants, as defined 397.35in section 144.148;398.1    (3) physician clinics located in a community with a population of less than 50,000 398.2according to United States Census Bureau statistics and outside the seven-county 398.3metropolitan area;398.4    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and398.5    (5) other providers of health or health care services approved by the commissioner 398.6for which interoperable electronic health record capability would improve quality of 398.7care, patient safety, or community health.398.8    (b) To be eligible for a loan under this section, the applicant must submit a loan 398.9application to the commissioner of health on forms prescribed by the commissioner. The 398.10application must include, at a minimum:398.11    (1) the amount of the loan requested and a description of the purpose or project 398.12for which the loan proceeds will be used;398.13    (2) a quote from a vendor;398.14    (3) a description of the health care entities and other groups participating in the 398.15project;398.16    (4) evidence of financial stability and a demonstrated ability to repay the loan; and398.17    (5) a description of how the system to be financed interconnects or plans in the 398.18future to interconnect with other health care entities and provider groups located in the 398.19same geographical area.398.20    Subd. 3.Loans.(a) The commissioner of health may make a no interest loan 398.21to a provider or provider group who is eligible under subdivision 2 on a first-come, 398.22first-served basis provided that the applicant is able to comply with this section. The total 398.23accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of 398.24health has discretion over the size and number of loans made.398.25    (b) The commissioner of health may prescribe forms and establish an application 398.26process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 398.27application fee to cover the cost of administering the loan program.398.28    (c) The borrower must begin repaying the principal no later than two years from the 398.29date of the loan. Loans must be amortized no later than six years from the date of the loan.398.30    (d) Repayments must be credited to the account.398.31    Subd. 4.Data classification.Data collected by the commissioner of health on the 398.32application to determine eligibility under subdivision 2 and to monitor borrowers' default 398.33risk or collect payments owed under subdivision 3 are (1) private data on individuals as 398.34defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section 398.3513.02, subdivision 9. The names of borrowers and the amounts of the loans granted are 398.36public data.399.1    Sec. 8. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND 399.2IMPLEMENTATION GUIDE STANDARDS.399.3    Subdivision 1.Electronic claims and eligibility transactions required.(a) 399.4Beginning January 15, 2009, all group purchasers must accept from health care providers 399.5the eligibility for a health plan transaction described under Code of Federal Regulations, 399.6title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept 399.7from health care providers the health care claims or equivalent encounter information 399.8transaction described under Code of Federal Regulations, title 45, part 162, subpart K.399.9    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the 399.10eligibility for a health plan transaction described under Code of Federal Regulations, title 399.1145, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit 399.12to providers the health care payment and remittance advice transaction described under 399.13Code of Federal Regulations, title 45, part 162, subpart P.399.14    (c) Beginning January 15, 2009, all health care providers must submit to group 399.15purchasers the eligibility for a health plan transaction described under Code of Federal 399.16Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care 399.17providers must submit to group purchasers the health care claims or equivalent encounter 399.18information transaction described under Code of Federal Regulations, title 45, part 162, 399.19subpart K.399.20    (d) Beginning January 15, 2009, all health care providers must accept from group 399.21purchasers the eligibility for a health plan transaction described under Code of Federal 399.22Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care 399.23providers must accept from group purchasers the health care payment and remittance 399.24advice transaction described under Code of Federal Regulations, title 45, part 162, subpart 399.25P.399.26    (e) Each of the transactions described in paragraphs (a) to (d) shall require the use 399.27of a single, uniform companion guide to the implementation guides described under 399.28Code of Federal Regulations, title 45, part 162. The companion guides will be developed 399.29pursuant to subdivision 2.399.30    (f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group 399.31purchasers and health care providers must exchange claims and eligibility information 399.32electronically using the transactions, companion guides, implementation guides, and 399.33timelines required under this subdivision. Group purchasers may not impose any fee on 399.34providers for the use of the transactions prescribed in this subdivision.399.35    (g) Nothing in this subdivision shall prohibit group purchasers and health care 399.36providers from using a direct data entry, Web-based methodology for complying with 400.1the requirements of this subdivision. Any direct data entry method for conducting 400.2the transactions specified in this subdivision must be consistent with the data content 400.3component of the single, uniform companion guides required in paragraph (e) and the 400.4implementation guides described under Code of Federal Regulations, title 45, part 162.400.5    Subd. 2.Establishing uniform, standard companion guides.(a) At least 12 400.6months prior to the timelines required in subdivision 1, the commissioner of health shall 400.7promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers 400.8and health care providers to use the transactions and the uniform, standard companion 400.9guides required under subdivision 1, paragraph (e).400.10    (b) The commissioner of health must consult with the Minnesota Administrative 400.11Uniformity Committee on the development of the single, uniform companion guides 400.12required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1. 400.13The single uniform companion guides required under subdivision 1, paragraph (e), must 400.14specify uniform billing and coding standards. The commissioner of health shall base the 400.15companion guides required under subdivision 1, paragraph (e), billing and coding rules, 400.16and standards on the Medicare program, with modifications that the commissioner deems 400.17appropriate after consulting the Minnesota Administrative Uniformity Committee.400.18    (c) No group purchaser or health care provider may add to or modify the single, 400.19uniform companion guides defined in subdivision 1, paragraph (e), through additional 400.20companion guides or other requirements.400.21    (d) In promulgating the rules in paragraph (a), the commissioner shall not require 400.22data content that is not essential to accomplish the purpose of the transactions in 400.23subdivision 1.400.24    Sec. 9. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:400.25    Subdivision 1. Definitions. For purposes of this section, the following definitions 400.26apply:400.27    (a) "Accredited clinical training" means the clinical training provided by a 400.28medical education program that is accredited through an organization recognized by the 400.29Department of Education, the Centers for Medicare and Medicaid Services, or another 400.30national body who reviews the accrediting organizations for multiple disciplines and 400.31whose standards for recognizing accrediting organizations are reviewed and approved by 400.32the commissioner of health in consultation with the Medical Education and Research 400.33Advisory Committee.400.34    (b) "Commissioner" means the commissioner of health.401.1    (c) "Clinical medical education program" means the accredited clinical training of 401.2physicians (medical students and residents), doctor of pharmacy practitioners, doctors 401.3of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 401.4registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 401.5physician assistants.401.6    (d) "Sponsoring institution" means a hospital, school, or consortium located in 401.7Minnesota that sponsors and maintains primary organizational and financial responsibility 401.8for a clinical medical education program in Minnesota and which is accountable to the 401.9accrediting body.401.10    (e) "Teaching institution" means a hospital, medical center, clinic, or other 401.11organization that conducts a clinical medical education program in Minnesota.401.12    (f) "Trainee" means a student or resident involved in a clinical medical education 401.13program.401.14    (g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time 401.15equivalent counts, that are at training sites located in Minnesota with acurrently 401.16active medical assistance provider numberenrollment status and a National Provider 401.17Identification (NPI) number where training occurs in either an inpatient or ambulatory 401.18patient care setting and where the training is funded, in part, by patient care revenues.401.19    Sec. 10. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:401.20    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute 401.2190 percent of available medical education funds transferred according to section 401.22256B.69, subdivision 5c, paragraph (a), clause (1), to all qualifying applicants based on a 401.23distribution formula that reflects a summation of two factors:401.24    (1) an education factor, which is determined by the total number of eligible trainee 401.25FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical 401.26medical education program; and401.27    (2) a public program volume factor, which is determined by the total volume of 401.28public program revenue received by each training site as a percentage of all public 401.29program revenue received by all training sites in the fund pool.401.30    In this formula, the education factor is weighted at 67 percent and the public program 401.31volume factor is weighted at 33 percent.401.32    Public program revenue for the distribution formula includes revenue from medical 401.33assistance, prepaid medical assistance, general assistance medical care, and prepaid 401.34general assistance medical care. Training sites that receive no public program revenue 401.35are ineligible for funds available under this paragraph. Total statewide average costs per 402.1trainee for medical residents is based on audited clinical training costs per trainee in 402.2primary care clinical medical education programs for medical residents. Total statewide 402.3average costs per trainee for dental residents is based on audited clinical training costs 402.4per trainee in clinical medical education programs for dental students. Total statewide 402.5average costs per trainee for pharmacy residents is based on audited clinical training costs 402.6per trainee in clinical medical education programs for pharmacy students.402.7    (b) The commissioner shall annually distribute ten percent of total available medical 402.8education funds transferred according to section 256B.69, subdivision 5c, paragraph (a), 402.9clause (1), to all qualifying applicants based on the percentage received by each applicant 402.10under paragraph (a). These funds are to be used to offset clinical education costs at 402.11eligible clinical training sites based on criteria developed by the clinical medical education 402.12program. Applicants may choose to distribute funds allocated under this paragraph based 402.13on the distribution formula described in paragraph (a).402.14    (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated 402.15to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal 402.16financial participation on these funds and on funds transferred under subdivision 10, to all 402.17qualifying applicants based on a distribution formula that gives 100 percent weight to a 402.18public program volume factor, which is determined by the total volume of public program 402.19revenue received by each training site as a percentage of all public program revenue 402.20received by all training sites in the fund pool. If federal approval is not obtained for 402.21federal financial participation on any portion of funds distributed under this paragraph, 402.2290 percent of the unmatched funds shall be distributed by the commissioner based on 402.23the formula described in paragraph (a) and ten percent of the unmatched funds shall be 402.24distributed by the commissioner based on the formula described in paragraph (b).402.25    (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the 402.26commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving 402.27100 percent weight to an education factor, which is determined by the total number of 402.28eligible trainee full-time equivalents and the total statewide average costs per trainee, by 402.29type of trainee, in each clinical medical education program. If no matching funds are 402.30received on funds distributed under paragraph (c), funds distributed under this paragraph 402.31shall be distributed by the commissioner based on the formula described in paragraph (a).402.32    (e) The commissioner shall annually distribute $340,000 of funds dedicated to the 402.33commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants 402.34based on the percentage received by each applicant under paragraph (a). These funds are 402.35to be used to offset clinical education costs at eligible clinical training sites based on 402.36criteria developed by the clinical medical education program. Applicants may choose to 403.1distribute funds allocated under this paragraph based on the distribution formula described 403.2in paragraph (a). If no matching funds are received on funds distributed under paragraph 403.3(c), funds distributed under this paragraph shall be distributed by the commissioner based 403.4on the formula described in paragraph (b).403.5    (c) (f) Funds distributed shall not be used to displace current funding appropriations 403.6from federal or state sources.403.7    (d) (g) Funds shall be distributed to the sponsoring institutions indicating the amount 403.8to be distributed to each of the sponsor's clinical medical education programs based on 403.9the criteria in this subdivision and in accordance with the commissioner's approval letter. 403.10Each clinical medical education program must distribute funds allocated under paragraph 403.11(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 403.12institutions, which are accredited through an organization recognized by the Department 403.13of Education or the Centers for Medicare and Medicaid Services, may contract directly 403.14with training sites to provide clinical training. To ensure the quality of clinical training, 403.15those accredited sponsoring institutions must:403.16    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical 403.17training conducted at sites; and403.18    (2) take necessary action if the contract requirements are not met. Action may 403.19include the withholding of payments under this section or the removal of students from 403.20the site.403.21    (e) (h) Any funds not distributed in accordance with the commissioner's approval 403.22letter must be returned to the medical education and research fund within 30 days of 403.23receiving notice from the commissioner. The commissioner shall distribute returned funds 403.24to the appropriate training sites in accordance with the commissioner's approval letter.403.25    (f) (i) The commissioner shall distribute by June 30 of each year an amount equal to 403.26the funds transferred under subdivision 10, plus five percent interest to the University of 403.27Minnesota Board of Regents for the instructional costs of health professional programs 403.28at the Academic Health Center and for interdisciplinary academic initiatives within the 403.29Academic Health Center.403.30    (g) (j) A maximum of $150,000 of the funds dedicated to the commissioner 403.31under section 
         297F.10, subdivision 1, paragraph (b), clause (2), may be used by the 403.32commissioner for administrative expenses associated with implementing this section.403.33    Sec. 11. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:403.34    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner 403.35shall award grants to teaching institutions and clinical training sites for projects that 404.1increase dental access for underserved populations and promote innovative clinical 404.2training of dental professionals.404.3    (b) The commissioner shall award grants to teaching institutions and clinical training 404.4sites for projects that increase mental health access for underserved populations, promote 404.5innovative clinical training of mental health professionals, increase the number of mental 404.6health providers in rural or underserved areas, and promote the incorporation of patient 404.7safety principles into clinical medical education programs.404.8    (c) In awarding the grants, the commissioner, in consultation with the commissioner 404.9of human services, shall consider the following:404.10    (1) potential to successfully increase access to an underserved population;404.11    (2) the long-term viability of the project to improve access beyond the period 404.12of initial funding;404.13    (3) evidence of collaboration between the applicant and local communities;404.14    (4) the efficiency in the use of the funding; and404.15    (5) the priority level of the project in relation to state clinical education, access, 404.16patient safety, and workforce goals.; and404.17    (6) the potential of the project to impact the number or distribution of the health 404.18care workforce.404.19    (b) (d) The commissioner shall periodically evaluate the priorities in awarding the 404.20innovations grants in order to ensure that the priorities meet the changing workforce 404.21needs of the state.404.22    Sec. 12. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:404.23    Subd. 8. Federal financial participation. (a) The commissioner of human 404.24services shall seek to maximize federal financial participation in payments for medical 404.25education and research costs. If the commissioner of human services determines that 404.26federal financial participation is available for the medical education and research, the 404.27commissioner of health shall transfer to the commissioner of human services the amount 404.28of state funds necessary to maximize the federal funds available. The amount transferred 404.29to the commissioner of human services, plus the amount of federal financial participation, 404.30shall be distributed to medical assistance providers in accordance with the distribution 404.31methodology described in subdivision 4.404.32    (b) For the purposes of paragraph (a), the commissioner shall use physician clinic 404.33rates where possible to maximize federal financial participation.404.34    Sec. 13. Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:405.1    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the 405.2Academic Health Center under section 
         297F.10, subdivision 1, clause (1), $4,850,000 405.3shall be transferred annually to the commissioner of health no later than April 15 of each 405.4year for distribution under subdivision 4, paragraph (f) (i).405.5    Sec. 14. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:405.6    Subdivision 1. Required disclosure of estimated payment. (a) A health care 405.7provider, as defined in section 
         62J.03, subdivision 8, or the provider's designee as agreed 405.8to by that designee, shall, at the request of a consumer, provide that consumer with a good 405.9faith estimate of the reimbursementallowable payment the provider expects to receive 405.10from the health plan company in which the consumer is enrolled has agreed to accept from 405.11the consumer's health plan company for the services specified by the consumer, specifying 405.12the amount of the allowable payment due from the health plan company. Health plan 405.13companies must allow contracted providers, or their designee, to release this information. 405.14A good faith estimate must also be made available at the request of a consumer who 405.15is not enrolled in a health plan company.If a consumer has no applicable public or 405.16private coverage, the health care provider must give the consumer a good faith estimate 405.17of the average allowable reimbursement the provider accepts as payment from private 405.18third-party payers for the services specified by the consumer and the estimated amount 405.19the noncovered consumer will be required to pay. Payment information provided by a 405.20provider, or by the provider's designee as agreed to by that designee, to a patient pursuant 405.21to this subdivision does not constitute a legally binding estimate of the allowable charge 405.22for or cost to the consumer of services. 405.23    (b) A health plan company, as defined in section 
         62J.03, subdivision 10, shall, at 405.24the request of an enrollee or the enrollee's designee, provide that enrollee with a good 405.25faith estimate of the reimbursementallowable amount the health plan company would 405.26expect to pay tohas contracted for with a specified provider within the network as total 405.27payment for a health care service specified by the enrollee and the portion of the allowable 405.28amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the 405.29enrollee, the health plan company shall also provide to the enrollee a good faith estimate 405.30of the enrollee's out-of-pocket cost for the health care service. An estimate provided to 405.31an enrollee under this paragraph is not a legally binding estimate of the reimbursement405.32allowable amount or enrollee's out-of-pocket cost.405.33EFFECTIVE DATE.This section is effective August 1, 2007.406.1    Sec. 15. Minnesota Statutes 2006, section 62J.82, is amended to read:406.262J.82 HOSPITAL CHARGEINFORMATION REPORTING DISCLOSURE.406.3    Subdivision 1.Required information. The Minnesota Hospital Association shall 406.4develop a Web-based system, available to the public free of charge, for reporting charge 406.5information the following, for Minnesota residents,:406.6    (1) hospital-specific performance on the measures of care developed under section 406.7256B.072 for acute myocardial infarction, heart failure, and pneumonia; 406.8    (2) by January 1, 2009, hospital-specific performance on the public reporting 406.9measures for hospital-acquired infections as published by the National Quality Forum 406.10and collected by the Minnesota Hospital Association and Stratis Health in collaboration 406.11with infection control practitioners; and 406.12    (3) charge information, including, but not limited to, number of discharges, average 406.13length of stay, average charge, average charge per day, and median charge, for each of the 406.1450 most common inpatient diagnosis-related groups and the 25 most common outpatient 406.15surgical procedures as specified by the Minnesota Hospital Association. 406.16    Subd. 2.Web site. The Web site must provide information that compares 406.17hospital-specific data to hospital statewide data. The Web site must be established by 406.18October 1, 2006, and must be updated annually. The commissioner shall provide a link to 406.19this reporting information on the department's Web site.406.20    Subd. 3.Enforcement.The commissioner shall provide a link to this information 406.21on the department's Web site. If a hospital does not provide this information to the 406.22Minnesota Hospital Association, the commissioner of health may require the hospital to 406.23do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a 406.24link to this information on the department's Web site.406.25    Sec. 16. [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.406.26    Subdivision 1.Task force.The governor shall convene a health care transformation 406.27task force to advise and assist the governor and the Minnesota legislature. The task force 406.28shall consist of:406.29    (1) four legislators from the house of representatives appointed by the speaker, two 406.30from the majority party and two from the minority party, and four legislators from the 406.31senate appointed by the Subcommittee on Committees of the senate Committee on Rules 406.32and Administration, two from the majority party and two from the minority party;406.33    (2) four representatives of the governor and state agencies appointed by the governor;407.1    (3) at least four persons appointed by the governor who have demonstrated 407.2leadership in health care organizations, health improvement initiatives, health care trade or 407.3professional associations, or other collaborative health system improvement activities; and407.4    (4) at least two persons appointed by the governor who have demonstrated leadership 407.5in employer and group purchaser activities related to health system improvement, at least 407.6one of which must be from a labor organization.407.7    Subd. 2.Public input.The commissioner of health shall review available research, 407.8and conduct statewide, regional, and local surveys, focus groups, and other activities as 407.9needed to fill gaps in existing research, to determine Minnesotans' values, preferences, 407.10opinions, and perceptions related to health care and to the issues confronting the task 407.11force, and shall report the findings to the task force.407.12    Subd. 3.Inventory and assessment of existing activities; action plan.The task 407.13force shall complete an inventory and assessment of all public and private organized 407.14activities, coalitions, and collaboratives working on tasks relating to health system 407.15improvement including, but not limited to, patient safety, quality measurement and 407.16reporting, evidence-based practice, adoption of health information technology, disease 407.17management and chronic care coordination, medical homes, access to health care, 407.18cultural competence, prevention and public health, consumer incentives, price and cost 407.19transparency, nonprofit organization community benefits, education, research, and health 407.20care workforce.407.21    Subd. 4.Action plan.By December 15, 2007, the governor, with the advice 407.22and assistance of the task force, shall develop and present to the legislature a statewide 407.23action plan for transforming the health care system to improve affordability, quality, 407.24and access. The plan shall include draft legislation needed to implement the plan. The 407.25plan may consist of legislative actions, administrative actions of governmental entities, 407.26collaborative actions, and actions of individuals and individual organizations. Among 407.27other things, the action plan must include the following, with specific and measurable 407.28goals and deadlines for each:407.29    (1) proposed actions that will slow the rate of increase in health care costs to a rate 407.30that does not exceed the increase in the Consumer Price Index for urban consumers for the 407.31preceding calendar year plus two percentage points, plus an additional percentage based 407.32on the added costs necessary to implement legislation enacted in 2007;407.33    (2) actions that will increase the affordable health coverage options for uninsured 407.34and underinsured Minnesotans and other strategies that will ensure that all Minnesotans 407.35will have health coverage by January 2011;408.1    (3) actions to improve the quality and safety of health care and reduce racial and 408.2ethnic disparities in access and quality;408.3    (4) actions that will reduce the rate of preventable chronic illness through prevention 408.4and public health and wellness initiatives; and408.5    (5) proposed changes to state health care purchasing and payment strategies used for 408.6state health care programs and state employees that will promote higher quality, lower 408.7cost health care through incentives that reward prevention and early intervention, use 408.8of cost-effective primary care, effective care coordination, and management of chronic 408.9disease;408.10    (6) actions that will promote the appropriate and cost-effective investment in new 408.11facilities, technologies, and drugs;408.12    (7) actions to reduce administrative costs; and408.13    (8) the results of the inventory completed under subdivision 3 and recommendations 408.14for how these activities can be coordinated and improved.408.15    Subd. 5.Options for small employers.The task force shall study and report back 408.16to the legislature by December 15, 2007, on options for serving small employers and their 408.17employees, and self-employed individuals.408.18    Sec. 17. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:408.19    Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual 408.20conversion policies to eligible employees otherwise eligible for conversion coverage under 408.21section 
         62D.104 as a result of leaving a health maintenance organization's service area.408.22    (b) A health carrier may sell, issue, or renew individual conversion policies to 408.23eligible employees otherwise eligible for conversion coverage as a result of the expiration 408.24of any continuation of group coverage required under sections 
         62A.146, 
         62A.17, 
         62A.21, 408.2562C.142
         , 
         62D.101, and 
         62D.105.408.26    (c) A health carrier may sell, issue, or renew conversion policies under section 408.2762E.16
          to eligible employees.408.28    (d) A health carrier may sell, issue, or renew individual continuation policies to 408.29eligible employees as required.408.30    (e) A health carrier may sell, issue, or renew individual health plans if the coverage 408.31is appropriate due to an unexpired preexisting condition limitation or exclusion applicable 408.32to the person under the employer's group health plan or due to the person's need for health 408.33care services not covered under the employer's group health plan.408.34    (f) A health carrier may sell, issue, or renew an individual health plan, if the 408.35individual has elected to buy the individual health plan not as part of a general plan to 409.1substitute individual health plans for a group health plan nor as a result of any violation of 409.2subdivision 3 or 4.409.3    (g) Nothing in this subdivision relieves a health carrier of any obligation to provide 409.4continuation or conversion coverage otherwise required under federal or state law.409.5    (h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage 409.6issued as a supplement to Medicare under sections 
         62A.3099 to 
         62A.44, or policies or 409.7contracts that supplement Medicare issued by health maintenance organizations, or those 409.8contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social 409.9Security Act, United States Code, title 42, section 1395 et seq., as amended.409.10    (i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual 409.11health plans necessary to comply with a court order.409.12    (j) A health carrier may offer, issue, sell, or renew an individual health plan to 409.13persons eligible for an employer group health plan, if the individual health plan is a high 409.14deductible health plan for use in connection with an existing health savings account, in 409.15compliance with the Internal Revenue Code, section 223. In that situation, the same or 409.16a different health carrier may offer, issue, sell, or renew a group health plan to cover 409.17the other eligible employees in the group.409.18    (k) A health carrier may offer, sell, issue, or renew an individual health plan to one 409.19or more employees of a small employer if the individual health plan is marketed directly409.20through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 to 409.21all employees of the small employer and the small employer does not contribute directly 409.22or indirectly to the premiums or facilitate the administration of the individual health 409.23plan. The requirement to market an individual health plan to all employees through the 409.24Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 does not require 409.25the health carrier to offer or issue an individual health plan to any employee. For purposes 409.26of this paragraph, an employer is not contributing to the premiums or facilitating the 409.27administration of the individual health plan if the employer does not contribute to the 409.28premium and merely collects the premiums from an employee's wages or salary through 409.29payroll deductions and submits payment for the premiums of one or more employees in a 409.30lump sum to the health carrier to the Minnesota Health Insurance Exchange under section 409.3162A.67 or 62A.68. Except for coverage under section 
         62A.65, subdivision 5, paragraph 409.32(b), or 
         62E.16, at the request of an employee, the health carrier Minnesota Health Insurance 409.33Exchange under section 62A.67 or 62A.68 may bill the employer for the premiums 409.34payable by the employee, provided that the employer is not liable for payment except 409.35from payroll deductions for that purpose. If an employer is submitting payments under 409.36this paragraph, the health carrier and the Minnesota Health Insurance Exchange under 410.1section 62A.67 or 62A.68 shall jointly provide a cancellation notice directly to the primary 410.2insured at least ten days prior to termination of coverage for nonpayment of premium. 410.3Individual coverage under this paragraph may be offered only if the small employer has 410.4not provided coverage under section 62L.03 to the employees within the past 12 months.410.5    The employer must provide a written and signed statement to the health carrier410.6Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the employer 410.7is not contributing directly or indirectly to the employee's premiums. The Minnesota 410.8Health Insurance Exchange under section 62A.67 or 62A.68 shall provide all health 410.9carriers with enrolled employees of the employer with a copy of the employer's statement. 410.10The health carrier may rely on the employer's statement provided by the Minnesota Health 410.11Insurance Exchange under section 62A.67 or 62A.68 and is not required to guarantee-issue 410.12individual health plans to the employer's other current or future employees.410.13    Sec. 18. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:410.14    Subd. 4. Employer prohibition. A small employer offering a health benefit plan 410.15shall not encourage or direct an employee or applicant to:410.16    (1) refrain from filing an application for health coverage when other similarly 410.17situated employees may file an application for health coverage;410.18    (2) file an application for health coverage during initial eligibility for coverage, 410.19the acceptance of which is contingent on health status, when other similarly situated 410.20employees may apply for health coverage, the acceptance of which is not contingent on 410.21health status;410.22    (3) seek coverage from another health carrier, including, but not limited to, MCHA; 410.23or410.24    (4) cause coverage to be issued on different terms because of the health status or 410.25claims experience of that person or the person's dependents.410.26    Sec. 19. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:410.27    Subdivision 1. Definition. It is the commitment of the state to achieve universal 410.28health coverage for all Minnesotans by the year 2011. Universal coverage is achieved 410.29when:410.30    (1) every Minnesotan has access to a full range of quality health care services;410.31    (2) every Minnesotan is able to obtain affordable health coverage which pays for the 410.32full range of services, including preventive and primary care; and410.33    (3) every Minnesotan pays into the health care system according to that person's 410.34ability.411.1EFFECTIVE DATE.This section is effective July 1, 2007.411.2    Sec. 20. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:411.3    Subd. 2. Goal. It is the goal of the state to make continuous progress toward 411.4reducing the number of Minnesotans who do not have health coverage so that by January 411.51, 2000, fewer than four percent of the state's population will be without health coverage411.62011, all Minnesota residents have access to affordable health care. The goal will be 411.7achieved by improving access to private health coverage through insurance reforms and 411.8market reforms, by making health coverage more affordable for low-income Minnesotans 411.9through purchasing pools and state subsidies, and by reducing the cost of health coverage 411.10through cost containment programs and methods of ensuring that all Minnesotans are 411.11paying into the system according to their ability.411.12EFFECTIVE DATE.This section is effective July 1, 2007.411.13    Sec. 21. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:411.14    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 411.15coverage program, a community-based health initiative shall submit to the commissioner 411.16of health for approval the community-based health care coverage program developed by 411.17the initiative. The commissioner shall only approve a program that has been awarded 411.18a community access program grant from the United States Department of Health and 411.19Human Services. The commissioner shall ensure that the program meets the federal grant 411.20requirements and any requirements described in this section and is actuarially sound based 411.21on a review of appropriate records and methods utilized by the community-based health 411.22initiative in establishing premium rates for the community-based health care coverage 411.23program. 411.24    (b) Prior to approval, the commissioner shall also ensure that:411.25    (1) the benefits offered comply with subdivision 8 and that there are adequate 411.26numbers of health care providers participating in the community-based health network to 411.27deliver the benefits offered under the program;411.28    (2) the activities of the program are limited to activities that are exempt under this 411.29section or otherwise from regulation by the commissioner of commerce;411.30    (3) the complaint resolution process meets the requirements of subdivision 10; and 411.31    (4) the data privacy policies and procedures comply with state and federal law.411.32    Sec. 22. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:412.1    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 412.2by the commissioner of health a community-based health care coverage program. The 412.3operational structure established by the initiative shall include, but is not limited to: 412.4    (1) establishing a process for enrolling eligible individuals and their dependents; 412.5    (2) collecting and coordinating premiums from enrollees and employers of enrollees;412.6    (3) providing payment to participating providers; 412.7    (4) establishing a benefit set according to subdivision 8 and establishing premium 412.8rates and cost-sharing requirements; 412.9    (5) creating incentives to encourage primary care and wellness services; and 412.10    (6) initiating disease management services, as appropriate. 412.11    (b) The payments collected under paragraph (a), clause (2), may be used to capture 412.12available federal funds.412.13    Sec. 23. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:412.14    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 412.15commissioner of health on January 15, April 15, July 15, and October 15 of each year, 412.16with the first report due January 15, 2007 2008. The status report shall include:412.17    (1) the financial status of the program, including the premium rates, cost per member 412.18per month, claims paid out, premiums received, and administrative expenses; 412.19    (2) a description of the health care benefits offered and the services utilized; 412.20    (3) the number of employers participating, the number of employees and dependents 412.21covered under the program, and the number of health care providers participating; 412.22    (4) a description of the health outcomes to be achieved by the program and a status 412.23report on the performance measurements to be used and collected; and 412.24    (5) any other information requested by the commissioner of health or commerce or 412.25the legislature. 412.26    (b) The initiative shall contract with an independent entity to conduct an evaluation 412.27of the program to be submitted to the commissioners of health and commerce and the 412.28legislature by January 15, 2009 2010. The evaluation shall include:412.29    (1) an analysis of the health outcomes established by the initiative and the 412.30performance measurements to determine whether the outcomes are being achieved;412.31    (2) an analysis of the financial status of the program, including the claims to 412.32premiums loss ratio and utilization and cost experience; 412.33    (3) the demographics of the enrollees, including their age, gender, family income, 412.34and the number of dependents; 413.1    (4) the number of employers and employees who have been denied access to the 413.2program and the basis for the denial; 413.3    (5) specific analysis on enrollees who have aggregate medical claims totaling over 413.4$5,000 per year, including data on the enrollee's main diagnosis and whether all the 413.5medical claims were covered by the program; 413.6    (6) number of enrollees referred to state public assistance programs; 413.7    (7) a comparison of employer-subsidized health coverage provided in a comparable 413.8geographic area to the designated community-based geographic area served by the 413.9program, including, to the extent available: 413.10    (i) the difference in the number of employers with 50 or fewer employees offering 413.11employer-subsidized health coverage; 413.12    (ii) the difference in uncompensated care being provided in each area; and413.13    (iii) a comparison of health care outcomes and measurements established by the 413.14initiative; and 413.15    (8) any other information requested by the commissioner of health or commerce.413.16    Sec. 24. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:413.17    Subd. 14. Sunset. This section expires December 31, 2011 2012.413.18    Sec. 25. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:413.19    Subdivision 1. Yearly reports.(a) Each hospital and each outpatient surgical center, 413.20which has not filed the financial information required by this section with a voluntary, 413.21nonprofit reporting organization pursuant to section 
         144.702, shall file annually with the 413.22commissioner of health after the close of the fiscal year: 413.23    (1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or 413.24outpatient surgical center;413.25    (2) a detailed statement of income and expenses;413.26    (3) a copy of its most recent cost report, if any, filed pursuant to requirements of 413.27Title XVIII of the United States Social Security Act;413.28    (4) a copy of all changes to articles of incorporation or bylaws;413.29    (5) information on services provided to benefit the community, including services 413.30provided at no cost or for a reduced fee to patients unable to pay, teaching and research 413.31activities, or other community or charitable activities;413.32    (6) information required on the revenue and expense report form set in effect on 413.33July 1, 1989, or as amended by the commissioner in rule;413.34    (7) information on changes in ownership or control; and414.1    (8) other information required by the commissioner in rule.;414.2    (9) information on the number of available hospital beds that are dedicated to certain 414.3specialized services, as designated by the commissioner, and annual occupancy rates for 414.4those beds, separately for adult and pediatric care;414.5    (10) from outpatient surgical centers, the total number of surgeries; and414.6    (11) a report on health care capital expenditures during the previous year, as required 414.7by section 62J.17.414.8    (b) Beginning with hospital fiscal year 2009, each nonprofit hospital shall report on 414.9community benefits under paragraph (a), clause (5). "Community benefit" means the costs 414.10of community care, underpayment for services provided under state health care programs, 414.11research costs, community health services costs, financial and in-kind contributions, costs 414.12of community building activities, costs of community benefit operations, education, and 414.13the cost of operating subsidized services. The cost of bad debts and underpayment for 414.14Medicare services are not included in the calculation of community benefit.414.15    Sec. 26. Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision 414.16to read:414.17    Subd. 5.Annual reports on community benefit, community care amounts, 414.18and state program underfunding.(a) For each hospital reporting health care cost 414.19information under section 144.698 or 144.702, the commissioner shall report annually 414.20on the hospital's community benefit, community care, and underpayment for state public 414.21health care programs.414.22    (b) For purposes of this subdivision, "community benefits" has the definition given 414.23in section 144.698, paragraph (b).414.24    (c) For purposes of this subdivision, "community care" means the costs for medical 414.25care for which a hospital has determined is charity care, as defined under Minnesota Rules, 414.26part 4650.0115, or for which the hospital determines after billing for the services that there 414.27is a demonstrated inability to pay. Any costs forgiven under a hospital's community care 414.28plan or under section 62J.83 may be counted in the hospital's calculation of community 414.29care. Bad debt expenses and discounted charges available to the uninsured shall not be 414.30included in the calculation of community care. The amount of community care is the value 414.31of costs incurred and not the charges made for services.414.32    (d) For purposes of this subdivision, underpayment for services provided by state 414.33public health care programs is the difference between hospital costs and public program 414.34payments. The information shall be reported in terms of total dollars and as a percentage 414.35of total operating costs for each hospital.415.1    Sec. 27. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:415.2    Subd. 2b. Performance payments.(a) The commissioner shall develop and 415.3implement a pay-for-performance system to provide performance payments to:415.4    (1) eligible medical groups and clinics that demonstrate optimum care in serving 415.5individuals with chronic diseases who are enrolled in health care programs administered 415.6by the commissioner under chapters 256B, 256D, and 256L.;415.7    (2) medical groups that implement effective medical home models of patient care 415.8that improve quality and reduce costs through effective primary and preventive care, care 415.9coordination, and management of chronic conditions; and415.10    (3) eligible medical groups and clinics that evaluate medical provider usage patterns 415.11and provide feedback to individual medical providers on that provider's practice patterns 415.12relative to peer medical providers.415.13    (b) The commissioner shall also develop and implement a patient incentive health 415.14program to provide incentives and rewards to patients who are enrolled in health care 415.15programs administered by the commissioner under chapters 256B, 256D, and 256L, and 415.16who have agreed to and meet personal health goals established with their primary care 415.17provider to manage a chronic disease or condition including, but not limited to, diabetes, 415.18high blood pressure, and coronary artery disease.415.19    (c) The commissioner may receive any federal matching money that is made 415.20available through the medical assistance program for managed care oversight contracted 415.21through vendors including consumer surveys, studies, and external quality reviews as 415.22required by the Federal Balanced Budget Act of 1997, Code of Federal Regulations, 415.23title 42, part 438, subpart E. Any federal money received for managed care oversight is 415.24appropriated to the commissioner for this purpose. The commissioner may expend the 415.25federal money received in either year of the biennium.415.26EFFECTIVE DATE.This section is effective July 1, 2007.415.27    Sec. 28. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 415.28subdivision to read:415.29    Subd. 49.Provider-directed care coordination services.The commissioner 415.30shall develop and implement a provider-directed care coordination program for medical 415.31assistance recipients who are not enrolled in the prepaid medical assistance program and 415.32who are receiving services on a fee-for-service basis. This program provides payment 415.33to primary care clinics for care coordination for people who have complex and chronic 415.34medical conditions. Clinics must meet certain criteria such as the capacity to develop care 415.35plans; have a dedicated care coordinator; and have an adequate number of fee-for-service 416.1clients, evaluation mechanisms, and quality improvement processes to qualify for 416.2reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic 416.3designated as the patient's first point of contact for medical care, available 24 hours a 416.4day, seven days a week, that provides or arranges for the patient's comprehensive health 416.5care needs, and provides overall integration, coordination and continuity over time and 416.6referrals for specialty care.416.7    Sec. 29. HEALTH CARE PAYMENT SYSTEM REFORM.416.8    Subdivision 1.Payment reform plan.The commissioners of employee relations, 416.9human services, commerce, and health shall develop a plan for promoting and facilitating 416.10changes in payment rates and methods for paying for health care services, drugs, devices, 416.11supplies, and equipment in order to:416.12    (1) reward the provision of cost-effective primary and preventive care;416.13    (2) reward the use of evidence-based care;416.14    (3) discourage underutilization, overuse, and misuse;416.15    (4) reward the use of the most cost-effective settings, drugs, devices, providers, 416.16and treatments; and416.17    (5) encourage consumers to maintain good health and use the health care system 416.18appropriately.416.19    In developing the plan, the commissioners shall analyze existing data to determine 416.20specific services and health conditions for which changes in payment rates and methods 416.21would lead to significant improvements in quality of care.416.22    Subd. 2.Report.The commissioners shall submit a report to the legislature by 416.23December 15, 2007, describing the payment reform plan. The report must include 416.24proposed legislation for implementing those components of the plan requiring legislative 416.25action or appropriations of money.416.26EFFECTIVE DATE.This section is effective July 1, 2007.416.27    Sec. 30. COMMUNITY COLLABORATIVE PILOT PROJECTS TO COVER 416.28THE UNINSURED.416.29    Subdivision 1.Community collaboratives.The commissioner of human services 416.30shall provide grants to and authorization for up to three community collaboratives that 416.31satisfy the requirements in this section. To be eligible to receive a grant and authorization 416.32under this section, a community collaborative must include:416.33    (1) one or more counties;416.34    (2) one or more local hospitals;417.1    (3) one or more local employers who collectively provide at least 300 jobs in the 417.2community;417.3    (4) one or more health care clinics or physician groups; and417.4    (5) a third-party payer, which may be a county-based purchasing plan operating 417.5under Minnesota Statutes, section 256B.692, a self-insured employer, or a health plan 417.6company as defined in Minnesota Statutes, section 62Q.01, subdivision 4.417.7    Subd. 2.Pilot project requirements.(a) Community collaborative pilot projects 417.8must:417.9    (1) identify and enroll persons in the community who are uninsured, and who have, 417.10or are at risk of developing, one of the following chronic conditions: mental illness, 417.11diabetes, asthma, hypertension, or other chronic condition designated by the project;417.12    (2) assist uninsured persons to obtain private-sector health insurance coverage if 417.13possible or to enroll in any public health care programs for which they are eligible. If the 417.14uninsured individual is unable to obtain health coverage, the community collaborative 417.15must enroll the individual in a local health care assistance program that provides specified 417.16services to prevent or effectively manage the chronic condition;417.17    (3) include components to help uninsured persons retain employment or to become 417.18employable, if currently unemployed;417.19    (4) ensure that each uninsured person enrolled in the program has a medical home 417.20responsible for providing, or arranging for, health care services and assisting in the 417.21effective management of the chronic condition;417.22    (5) coordinate services between all providers and agencies serving an enrolled 417.23individual; and417.24    (6) be coordinated with the state's Q-Care initiative and improve the use of 417.25evidence-based treatments and effective disease management programs in the broader 417.26community, beyond those individuals enrolled in the project.417.27    (b) Projects established under this section are not insurance and are not subject to 417.28state-mandated benefit requirements or insurance regulations.417.29    Subd. 3.Criteria.Proposals must be evaluated by actuarial, financial, and clinical 417.30experts based on the likelihood that the project would produce a positive return on 417.31investment for the community. In awarding grants, the commissioner of human services 417.32shall give preference to proposals that:417.33    (1) have broad community support from local businesses, provider counties, and 417.34other public and private organizations;417.35    (2) would provide services to uninsured persons who have, or are at risk of 417.36developing, multiple, co-occurring chronic conditions;418.1    (3) integrate or coordinate resources from multiple sources, such as employer 418.2contributions, county funds, social service programs, and provider financial or in-kind 418.3support;418.4    (4) provide continuity of treatment and services when uninsured individuals in 418.5the program become eligible for public or private health insurance or when insured 418.6individuals lose their coverage;418.7    (5) demonstrate how administrative costs for health plan companies and providers 418.8can be reduced through greater simplification, coordination, consolidation, standardization, 418.9reducing billing errors, or other methods; and418.10    (6) involve local contributions to the cost of the pilot projects.418.11    Subd. 4.Grants.The commissioner of human services shall provide 418.12implementation grants of up to one-half of the community collaborative's costs for 418.13planning, administration, and evaluation. The commissioner shall also provide grants to 418.14community collaboratives to develop a fund to pay up to 50 percent of the cost of the 418.15services provided to uninsured individuals. The remaining costs must be paid for through 418.16other sources or by agreement of a health care provider to contribute the cost as charity 418.17care.418.18    Subd. 5.Evaluation.The commissioner of human services shall evaluate the 418.19effectiveness of each community collaborative project awarded a grant, by comparing 418.20actual costs for serving the identified uninsured persons to the predicted costs that would 418.21have been incurred in the absence of early intervention and consistent treatment to manage 418.22the chronic condition, including the costs to medical assistance, MinnesotaCare, and 418.23general assistance medical care. The commissioner shall require community collaborative 418.24projects, as a condition of receipt of a grant award, to provide the commissioner with all 418.25information necessary for this evaluation.418.26EFFECTIVE DATE.This section is effective July 1, 2007.418.27    Sec. 31. HEALTH CARE PAYMENT REFORM PILOT PROJECTS.418.28    Subdivision 1.Pilot projects.(a) The commissioners of health, human services, 418.29and employee relations shall develop and administer payment reform pilot projects for 418.30state employees and persons enrolled in medical assistance, MinnesotaCare, or general 418.31assistance medical care, to the extent permitted by federal requirements. The purpose of 418.32the projects is to promote and facilitate changes in payment rates and methods for paying 418.33for health care services, drugs, devices, supplies, and equipment in order to:418.34    (1) reward the provision of cost-effective primary and preventive care;418.35    (2) reward the use of evidence-based care;419.1    (3) reward coordination of care for patients with chronic conditions;419.2    (4) discourage overuse and misuse;419.3    (5) reward the use of the most cost-effective settings, drugs, devices, providers, 419.4and treatments;419.5    (6) encourage consumers to maintain good health and use the health care system 419.6appropriately.419.7    (b) The pilot projects must involve the use of designated care professionals or 419.8clinics to serve as a patient's medical home and be responsible for coordinating health 419.9care services across the continuum of care. The pilot projects must evaluate different 419.10payment reform models and must be coordinated with the Minnesota senior health options 419.11program and the Minnesota disability health options program. To the extent possible, the 419.12commissioners shall coordinate state purchasing activities with other public employers 419.13and with private purchasers, self-insured groups, and health plan companies to promote 419.14the use of pilot projects encompassing both public and private purchasers and markets.419.15    Subd. 2.Payment methods and incentives.The commissioners shall modify 419.16existing payment methods and rates for those enrollees and health care providers 419.17participating in the pilot project in order to provide incentives for care management, 419.18team-based care, and practice redesign, and increase resources for primary care, chronic 419.19condition care, and care provided to complex patients. The commissioners may create 419.20financial incentives for patients to select a medical home under the pilot project by 419.21reducing, modifying, or eliminating deductibles and co-payments for certain services, or 419.22through other incentives. The commissioners may require patients to remain with their 419.23designated medical home for a specified period of time. Alternative payment methods 419.24may include complete or partial capitation, fee-for-service payments, or other payment 419.25methodologies. The payment methods may provide for the payment of bonuses to medical 419.26home providers or other providers, or to patients, for the achievement of performance 419.27goals. The payment methods may include allocating a portion of the payment that 419.28would otherwise be paid to health plans under state prepaid health care programs to the 419.29designated medical home for specified services.419.30    Subd. 3.Requirements.In order to be designated a medical home under the pilot 419.31project, health care professionals or clinics must demonstrate their ability to:419.32    (1) be the patient's first point of contact by telephone or other means, 24 hours a 419.33day, seven days a week;419.34    (2) provide or arrange for patients' comprehensive health care needs, including the 419.35ability to structure planned chronic disease visits and to manage chronic disease through 419.36the use of disease registries;420.1    (3) coordinate patients' care when care must be provided outside the medical home;420.2    (4) provide longitudinal care, not just episodic care, including meeting long-term 420.3and unique personal needs;420.4    (5) utilize an electronic health record and incorporate a plan to develop and make 420.5available to patients that choose a medical home an electronic personal health record that 420.6is prepopulated with the patient's data, consumer-directed, connected to the provider, 420.724-hour accessible, and owned and controlled by the patient;420.8    (6) systematically improve quality of care using, among other inputs, patient 420.9feedback; and420.10    (7) create a provider network that provides for increased reimbursement for a 420.11medical home in a cost-neutral manner.420.12    Subd. 4.Evaluation.Pilot projects must be evaluated based on patient satisfaction, 420.13provider satisfaction, clinical process and outcome measures, program costs and savings, 420.14and economic impact on health care providers. Pilot projects must be evaluated based 420.15on the extent to which the medical home:420.16    (1) coordinated health care services across the continuum of care and thereby 420.17reduced duplication of services and enhanced communication across providers;420.18    (2) provided safe and high-quality care by increasing utilization of effective 420.19treatments, reduced use of ineffective treatments, reduced barriers to essential care and 420.20services, and eliminated barriers to access;420.21    (3) reduced unnecessary hospitalizations and emergency room visits and increased 420.22use of cost-effective care and settings;420.23    (4) encouraged long-term patient and provider relationships by shifting from 420.24episodic care to consistent, coordinated communication and care with a specified team of 420.25providers or individual providers;420.26    (5) engaged and educated consumers by encouraging shared patient and provider 420.27responsibility and accountability for disease prevention, health promotion, chronic 420.28disease management, acute care, and overall well-being, encouraging informed medical 420.29decision-making, ensuring the availability of accurate medical information, and facilitated 420.30the transfer of accurate medical information;420.31    (6) encouraged innovation in payment methodologies by using patient and provider 420.32incentives to coordinate care and utilize medical home services and fostering the 420.33expansion of a technology infrastructure that supports collaboration; and420.34    (7) reduced overall health care costs as compared to conventional payment methods 420.35for similar patient populations.421.1    Subd. 5.Rulemaking.The commissioners are exempt from administrative 421.2rulemaking under chapter 14 for purposes of developing, administering, contracting 421.3for, and evaluating pilot projects under this section. The commissioner shall publish a 421.4proposed request for proposals in the State Register and allow 30 days for comment 421.5before issuing the final request for proposals.421.6    Subd. 6.Regulatory and payment barriers.The commissioners shall study state 421.7and federal statutory and regulatory barriers to the creation of medical homes and provide 421.8a report and recommendations to the legislature by December 15, 2007.421.9    Sec. 32. HEALTH CARE SYSTEM CONSOLIDATION.421.10    (a) The commissioner of health shall study the effect of health care provider and 421.11health plan company consolidation in the four metropolitan statistical areas in Minnesota 421.12on: health care costs, including provider payment rates; quality of care; and access to care. 421.13The commissioner shall separately consider hospitals, specialty groups, and primary care 421.14groups. The commissioner shall present findings and recommendations to the legislature 421.15by December 15, 2007.421.16    (b) For purposes of this study, health carriers, provider networks, and other health 421.17care providers shall provide data on network participation, contracted payment rates, 421.18charges, costs, payments received, patient referrals, and other information requested by 421.19the commissioner, in the form and manner specified by the commissioner. Provider-level 421.20information on contracted payment rates and payments from health plans provided to the 421.21commissioner of health for the purposes of this study are (1) private data on individuals as 421.22defined in Minnesota Statutes, section 13.02, subdivision 12, and (2) nonpublic data as 421.23defined in Minnesota Statutes, section 13.02, subdivision 9. The commissioner may not 421.24collect patient-identified data for purposes of this study. Data collected for purposes of 421.25this study may not be used for any other purposes.421.26    Sec. 33.  REPEALER.421.27Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective 421.28August 1, 2007.421.29ARTICLE 10421.30PUBLIC HEALTH421.31    Section 1. Minnesota Statutes 2006, section 13.3806, is amended by adding a 421.32subdivision to read:422.1    Subd. 21.Birth defects registry system.Data on individuals collected by the 422.2birth defects registry system are private data on individuals and classified pursuant to 422.3section 144.2215.422.4    Sec. 2. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision 422.5to read:422.6    Subd. 3b.Window fall prevention device code.The commissioner of labor and 422.7industry shall adopt rules for window fall prevention devices as part of the state Building 422.8Code. Window fall prevention devices include, but are not limited to, safety screens, 422.9hardware, guards, and other devices that comply with the standards established by the 422.10commissioner of labor and industry. The rules must require compliance with standards 422.11for window fall prevention devices developed by ASTM International, contained in the 422.12International Building Code as the model language with amendments deemed necessary to 422.13coordinate with the other adopted building codes in Minnesota. The rules must establish a 422.14scope that includes the applicable building occupancies, and the types, locations, and sizes 422.15of windows that will require the installation of fall devices. The rules will be effective July 422.161, 2009. The commissioner shall report to the legislature on the status of the rulemaking 422.17on or before February 15, 2008.422.18    Sec. 3. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:422.19    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable 422.20application fee of $175 $215 to cover the administrative cost of processing a request for a 422.21variance or modification of rules adopted by the commissioner under this chapter.422.22EFFECTIVE DATE.This section is effective July 1, 2008.422.23    Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:422.24    Subdivision 1. Well notification fee. The well notification fee to be paid by a 422.25property owner is:422.26    (1) for a new water supply well, $175 $215, which includes the state core function 422.27fee;422.28    (2) for a well sealing, $35 $50 for each well, which includes the state core function 422.29fee, except that for monitoring wells constructed on a single property, having depths 422.30within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of 422.31$35 $50; and422.32    (3) for construction of a dewatering well, $175 $215, which includes the state core 422.33function fee, for each dewatering well except a dewatering project comprising five or 423.1more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering 423.2wells recorded on the notification.423.3EFFECTIVE DATE.This section is effective July 1, 2008.423.4    Sec. 5. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:423.5    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:423.6    (1) for a water supply well that is not in use under a maintenance permit, $150 $175423.7annually;423.8    (2) for construction of a monitoring well, $175 $215, which includes the state 423.9core function fee;423.10    (3) for a monitoring well that is unsealed under a maintenance permit, $150 $175423.11annually;423.12    (4) for monitoring wells used as a leak detection device at a single motor fuel retail 423.13outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 423.14chemical facility site, the construction permit fee is $175 $215, which includes the state 423.15core function fee, per site regardless of the number of wells constructed on the site, and 423.16the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per 423.17site regardless of the number of monitoring wells located on site;423.18    (5) for a groundwater thermal exchange device, in addition to the notification fee for 423.19water supply wells, $175 $215, which includes the state core function fee;423.20    (6) for a vertical heat exchanger, $175 $215;423.21    (7) for a dewatering well that is unsealed under a maintenance permit, $150 $175423.22annually for each dewatering well, except a dewatering project comprising more than five 423.23dewatering wells shall be issued a single permit for $750 $875 annually for dewatering 423.24wells recorded on the permit; and423.25    (8) for an elevator boring, $175 $215 for each boring.423.26EFFECTIVE DATE.This section is effective July 1, 2008.423.27    Sec. 6. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:423.28    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to 423.29sell or transfer real property, the seller must disclose in writing to the buyer information 423.30about the status and location of all known wells on the property, by delivering to the buyer 423.31either a statement by the seller that the seller does not know of any wells on the property, 423.32or a disclosure statement indicating the legal description and county, and a map drawn 423.33from available information showing the location of each well to the extent practicable. 424.1In the disclosure statement, the seller must indicate, for each well, whether the well is in 424.2use, not in use, or sealed.424.3    (b) At the time of closing of the sale, the disclosure statement information, name and 424.4mailing address of the buyer, and the quartile, section, township, and range in which each 424.5well is located must be provided on a well disclosure certificate signed by the seller or a 424.6person authorized to act on behalf of the seller.424.7    (c) A well disclosure certificate need not be provided if the seller does not know 424.8of any wells on the property and the deed or other instrument of conveyance contains 424.9the statement: "The Seller certifies that the Seller does not know of any wells on the 424.10described real property."424.11    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate 424.12required by this subdivision shall be signed by the buyer or a person authorized to act on 424.13behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure 424.14certificate is not required if the following statement appears on the deed followed by the 424.15signature of the grantee or, if there is more than one grantee, the signature of at least one 424.16of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the 424.17described real property." The statement and signature of the grantee may be on the front 424.18or back of the deed or on an attached sheet and an acknowledgment of the statement by 424.19the grantee is not required for the deed to be recordable.424.20    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:424.21    (1) that consists solely of a sale or transfer of severed mineral interests; or424.22    (2) that consists of an individual condominium unit as described in chapters 515 424.23and 515B.424.24    (f) For an area owned in common under chapter 515 or 515B the association or other 424.25responsible person must report to the commissioner by July 1, 1992, the location and 424.26status of all wells in the common area. The association or other responsible person must 424.27notify the commissioner within 30 days of any change in the reported status of wells.424.28    (g) For real property sold by the state under section 
         92.67, the lessee at the time of 424.29the sale is responsible for compliance with this subdivision.424.30    (h) If the seller fails to provide a required well disclosure certificate, the buyer, or 424.31a person authorized to act on behalf of the buyer, may sign a well disclosure certificate 424.32based on the information provided on the disclosure statement required by this section 424.33or based on other available information.424.34    (i) A county recorder or registrar of titles may not record a deed or other instrument 424.35of conveyance dated after October 31, 1990, for which a certificate of value is required 424.36under section 
         272.115, or any deed or other instrument of conveyance dated after October 425.131, 1990, from a governmental body exempt from the payment of state deed tax, unless 425.2the deed or other instrument of conveyance contains the statement made in accordance 425.3with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all 425.4the information required by paragraph (b) or (d). The county recorder or registrar of titles 425.5must not accept a certificate unless it contains all the required information. The county 425.6recorder or registrar of titles shall note on each deed or other instrument of conveyance 425.7accompanied by a well disclosure certificate that the well disclosure certificate was 425.8received. The notation must include the statement "No wells on property" if the disclosure 425.9certificate states there are no wells on the property. The well disclosure certificate shall not 425.10be filed or recorded in the records maintained by the county recorder or registrar of titles. 425.11After noting "No wells on property" on the deed or other instrument of conveyance, the 425.12county recorder or registrar of titles shall destroy or return to the buyer the well disclosure 425.13certificate. The county recorder or registrar of titles shall collect from the buyer or the 425.14person seeking to record a deed or other instrument of conveyance, a fee of $40 $45425.15for receipt of a completed well disclosure certificate. By the tenth day of each month, 425.16the county recorder or registrar of titles shall transmit the well disclosure certificates 425.17to the commissioner of health. By the tenth day after the end of each calendar quarter, 425.18the county recorder or registrar of titles shall transmit to the commissioner of health 425.19$32.50 $37.50 of the fee for each well disclosure certificate received during the quarter. 425.20The commissioner shall maintain the well disclosure certificate for at least six years. The 425.21commissioner may store the certificate as an electronic image. A copy of that image 425.22shall be as valid as the original.425.23    (j) No new well disclosure certificate is required under this subdivision if the buyer 425.24or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed 425.25or other instrument of conveyance that the status and number of wells on the property 425.26have not changed since the last previously filed well disclosure certificate. The following 425.27statement, if followed by the signature of the person making the statement, is sufficient 425.28to comply with the certification requirement of this paragraph: "I am familiar with the 425.29property described in this instrument and I certify that the status and number of wells on 425.30the described real property have not changed since the last previously filed well disclosure 425.31certificate." The certification and signature may be on the front or back of the deed or on 425.32an attached sheet and an acknowledgment of the statement is not required for the deed or 425.33other instrument of conveyance to be recordable.425.34    (k) The commissioner in consultation with county recorders shall prescribe the form 425.35for a well disclosure certificate and provide well disclosure certificate forms to county 425.36recorders and registrars of titles and other interested persons.426.1    (l) Failure to comply with a requirement of this subdivision does not impair:426.2    (1) the validity of a deed or other instrument of conveyance as between the parties 426.3to the deed or instrument or as to any other person who otherwise would be bound by 426.4the deed or instrument; or426.5    (2) the record, as notice, of any deed or other instrument of conveyance accepted for 426.6filing or recording contrary to the provisions of this subdivision.426.7EFFECTIVE DATE.This section is effective July 1, 2008.426.8    Sec. 7. Minnesota Statutes 2006, section 144.123, is amended to read:426.9144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES; 426.10EXCEPTIONS.426.11    Subdivision 1. Who must pay. Except for the limitation contained in this section, 426.12the commissioner of health shall charge a handling fee for each specimen submitted to 426.13the Department of Health for analysis for diagnostic purposes by any hospital, private 426.14laboratory, private clinic, or physician. No fee shall be charged to any entity which 426.15receives direct or indirect financial assistance from state or federal funds administered by 426.16the Department of Health, including any public health department, nonprofit community 426.17clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar 426.18entity. No fee will be charged for any biological materials submitted to the Department 426.19of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological 426.20materials requested by the department to gather information for disease prevention or 426.21control purposes. The commissioner of health may establish by rule other exceptions to 426.22the handling fee as may be necessary to gather information for epidemiologic purposes426.23protect the public's health. All fees collected pursuant to this section shall be deposited in 426.24the state treasury and credited to the state government special revenue fund.426.25    Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate 426.26rules, in accordance with chapter 14, which shall specify the amount of the charge a426.27handling fee prescribed in subdivision 1. The fee shall approximate the costs to the 426.28department of handling specimens including reporting, postage, specimen kit preparation, 426.29and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen 426.30until the commissioner promulgates rules pursuant to this subdivision.426.31    Sec. 8. Minnesota Statutes 2006, section 144.125, is amended to read:426.32144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL 426.33DISORDERS.427.1    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative 427.2officer or other person in charge of each institution caring for infants 28 days or less 427.3of age, (2) the person required in pursuance of the provisions of section 
         144.215, to 427.4register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 427.5birth, to arrange to have administered to every infant or child in its care tests for heritable 427.6and congenital disorders according to subdivision 2 and rules prescribed by the state 427.7commissioner of health. Testing and the recording and reporting of test results shall be 427.8performed at the times and in the manner prescribed by the commissioner of health. The 427.9commissioner shall charge laboratory service fees a fee so that the total of fees collected 427.10will approximate the costs of conducting the tests and implementing and maintaining 427.11a system to follow-up infants with heritable or congenital disorders. The laboratory 427.12service fee is $61 $101 per specimen. Costs associated with capital expenditures and 427.13the development of new procedures may be prorated over a three-year period when 427.14calculating the amount of the fees. 427.15    Subd. 2. Determination of tests to be administered. The commissioner shall 427.16periodically revise the list of tests to be administered for determining the presence of a 427.17heritable or congenital disorder. Revisions to the list shall reflect advances in medical 427.18science, new and improved testing methods, or other factors that will improve the public 427.19health. In determining whether a test must be administered, the commissioner shall take 427.20into consideration the adequacy of laboratory analytical methods to detect the heritable 427.21or congenital disorder, the ability to treat or prevent medical conditions caused by the 427.22heritable or congenital disorder, and the severity of the medical conditions caused by the 427.23heritable or congenital disorder. The list of tests to be performed may be revised if the 427.24changes are recommended by the advisory committee established under section 
         144.1255, 427.25approved by the commissioner, and published in the State Register. The revision is 427.26exempt from the rulemaking requirements in chapter 14, and sections 
         14.385 and 
         14.386427.27do not apply. 427.28    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under 427.29subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to 427.30perform testing thereunder as well as the results of such testing may be retained by the 427.31Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that 427.32the following options are available to them with respect to the testing: (i) to decline to 427.33have the tests, or (ii) to elect to have the tests but to require that all blood samples and 427.34records of test results be destroyed within 24 months of the testing. If the parents of 427.35an infant object in writing to testing for heritable and congenital disorders or elect to 427.36require that blood samples and test results be destroyed, the objection or election shall 428.1be recorded on a form that is signed by a parent or legal guardian and made part of the 428.2infant's medical record. A written objection exempts an infant from the requirements of 428.3this section and section 
         144.128. 428.4    Sec. 9. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to read:428.5    Subdivision 1. Establishment.Within the limits of available appropriations, the 428.6commissioner of health shall establish and maintain an information system containing data 428.7on the cause, treatment, prevention, and cure of major birth defects. The commissioner 428.8shall consult with representatives and experts in epidemiology, medicine, insurance, 428.9health maintenance organizations, genetics, consumers, and voluntary organizations in 428.10developing the system and may phase in the implementation of the system. After the 428.11parents have provided informed consent under section 144.2216, subdivision 4, the 428.12commissioner shall offer the parents with their informed consent a visit by a trained health 428.13care worker to interview the parents about:428.14    (1) all previous home addresses, occupations, and places of work including from 428.15childhood;428.16    (2) the time and place of any military service; and428.17    (3) known occasions or sites of toxic exposures.428.18    Sec. 10. Minnesota Statutes 2006, section 144.672, subdivision 1, is amended to read:428.19    Subdivision 1. Rule authority. The commissioner of health shall collect cancer 428.20incidence information, analyze the information, and conduct special studies designed to 428.21determine the potential public health significance of an increase in cancer incidence.428.22    The commissioner shall adopt rules to administer the system, collect information, 428.23and distribute data. The rules must include, but not be limited to, the following:428.24    (1) the type of data to be reported, which must include current and previous 428.25occupational data;428.26    (2) standards for reporting specific types of data;428.27    (3) payments allowed to hospitals, pathologists, and registry systems to defray their 428.28costs in providing information to the system;428.29    (4) criteria relating to contracts made with outside entities to conduct studies using 428.30data collected by the system. The criteria may include requirements for a written protocol 428.31outlining the purpose and public benefit of the study, the description, methods, and 428.32projected results of the study, peer review by other scientists, the methods and facilities 428.33to protect the privacy of the data, and the qualifications of the researcher proposing to 428.34undertake the study; and429.1    (5) specification of fees to be charged under section 
         13.03, subdivision 3, for all 429.2out-of-pocket expenses for data summaries or specific analyses of data requested by 429.3public and private agencies, organizations, and individuals, and which are not otherwise 429.4included in the commissioner's annual summary reports. Fees collected are appropriated 429.5to the commissioner to offset the cost of providing the data.429.6    Sec. 11. Minnesota Statutes 2006, section 144.9502, subdivision 3, is amended to read:429.7    Subd. 3. Reports of blood lead analysis required. (a) Every hospital, medical 429.8clinic, medical laboratory, other facility, or individual performing blood lead analysis 429.9shall report the results after the analysis of each specimen analyzed, for both capillary 429.10and venous specimens, and epidemiologic information required in this section to the 429.11commissioner of health, within the time frames set forth in clauses (1) and (2):429.12    (1) within two working days by telephone, fax, or electronic transmission, with 429.13written or electronic confirmation within one month, for a venous blood lead level equal to 429.14or greater than 15 ten micrograms of lead per deciliter of whole blood; or429.15    (2) within one month in writing or by electronic transmission, for any capillary 429.16result or for a venous blood lead level less than 15 ten micrograms of lead per deciliter of 429.17whole blood.429.18    (b) If a blood lead analysis is performed outside of Minnesota and the facility 429.19performing the analysis does not report the blood lead analysis results and epidemiological 429.20information required in this section to the commissioner, the provider who collected the 429.21blood specimen must satisfy the reporting requirements of this section. For purposes of 429.22this section, "provider" has the meaning given in section 
         62D.02, subdivision 9. 429.23    (c) The commissioner shall coordinate with hospitals, medical clinics, medical 429.24laboratories, and other facilities performing blood lead analysis to develop a universal 429.25reporting form and mechanism.429.26    Sec. 12. Minnesota Statutes 2006, section 144.9504, subdivision 2, is amended to read:429.27    Subd. 2. Lead risk assessment. (a) An assessing agency shall conduct a lead risk 429.28assessment of a residence according to the venous blood lead level and time frame set 429.29forth in clauses (1) to (4) for purposes of secondary prevention:429.30    (1) within 48 hours of a child or pregnant female in the residence being identified to 429.31the agency as having a venous blood lead level equal to or greater than 60 45 micrograms 429.32of lead per deciliter of whole blood;430.1    (2) within five working days of a child or pregnant female in the residence being 430.2identified to the agency as having a venous blood lead level equal to or greater than 45 15430.3micrograms of lead per deciliter of whole blood;430.4    (3) within ten working days of a child in the residence being identified to the agency 430.5as having a venous blood lead level equal to or greater than 15 ten micrograms of lead 430.6per deciliter of whole blood; or430.7    (4) within ten working days of a pregnant female in the residence being identified to 430.8the agency as having a venous blood lead level equal to or greater than ten micrograms of 430.9lead per deciliter of whole blood.430.10    (b) Within the limits of available local, state, and federal appropriations, an assessing 430.11agency may also conduct a lead risk assessment for children with any elevated blood 430.12lead level.430.13    (c) In a building with two or more dwelling units, an assessing agency shall assess 430.14the individual unit in which the conditions of this section are met and shall inspect all 430.15common areas accessible to a child. If a child visits one or more other sites such as another 430.16residence, or a residential or commercial child care facility, playground, or school, the 430.17assessing agency shall also inspect the other sites. The assessing agency shall have one 430.18additional day added to the time frame set forth in this subdivision to complete the lead 430.19risk assessment for each additional site.430.20    (d) Within the limits of appropriations, the assessing agency shall identify the 430.21known addresses for the previous 12 months of the child or pregnant female with venous 430.22blood lead levels of at least 15 ten micrograms per deciliter for the child or at least ten 430.23micrograms per deciliter for the pregnant female; notify the property owners, landlords, 430.24and tenants at those addresses that an elevated blood lead level was found in a person 430.25who resided at the property; and give them primary prevention information. Within the 430.26limits of appropriations, the assessing agency may perform a risk assessment and issue 430.27corrective orders in the properties, if it is likely that the previous address contributed to 430.28the child's or pregnant female's blood lead level. The assessing agency shall provide the 430.29notice required by this subdivision without identifying the child or pregnant female with 430.30the elevated blood lead level. The assessing agency is not required to obtain the consent of 430.31the child's parent or guardian or the consent of the pregnant female for purposes of this 430.32subdivision. This information shall be classified as private data on individuals as defined 430.33under section 
         13.02, subdivision 12.430.34    (e) The assessing agency shall conduct the lead risk assessment according to rules 430.35adopted by the commissioner under section 
         144.9508. An assessing agency shall have 430.36lead risk assessments performed by lead risk assessors licensed by the commissioner 431.1according to rules adopted under section 
         144.9508. If a property owner refuses to allow 431.2a lead risk assessment, the assessing agency shall begin legal proceedings to gain entry 431.3to the property and the time frame for conducting a lead risk assessment set forth in this 431.4subdivision no longer applies. A lead risk assessor or assessing agency may observe the 431.5performance of lead hazard reduction in progress and shall enforce the provisions of this 431.6section under section 
         144.9509. Deteriorated painted surfaces, bare soil, and dust must be 431.7tested with appropriate analytical equipment to determine the lead content, except that 431.8deteriorated painted surfaces or bare soil need not be tested if the property owner agrees to 431.9engage in lead hazard reduction on those surfaces. The lead content of drinking water 431.10must be measured if another probable source of lead exposure is not identified. Within a 431.11standard metropolitan statistical area, an assessing agency may order lead hazard reduction 431.12of bare soil without measuring the lead content of the bare soil if the property is in a 431.13census tract in which soil sampling has been performed according to rules established by 431.14the commissioner and at least 25 percent of the soil samples contain lead concentrations 431.15above the standard in section 
         144.9508.431.16    (f) Each assessing agency shall establish an administrative appeal procedure which 431.17allows a property owner to contest the nature and conditions of any lead order issued by 431.18the assessing agency. Assessing agencies must consider appeals that propose lower cost 431.19methods that make the residence lead safe. The commissioner shall use the authority and 431.20appeal procedure granted under sections 
         144.989 to 
         144.993.431.21    (g) Sections 
         144.9501 to 
         144.9509 neither authorize nor prohibit an assessing agency 431.22from charging a property owner for the cost of a lead risk assessment.431.23    Sec. 13. Minnesota Statutes 2006, section 144.9507, is amended by adding a 431.24subdivision to read:431.25    Subd. 6.Medical assistance.Medical assistance reimbursement for lead risk 431.26assessment services under section 256B.0625, subdivision 49, shall not be used to replace 431.27or decrease existing state or local funding for lead services and lead-related activities.431.28    Sec. 14. Minnesota Statutes 2006, section 144.9512, is amended to read:431.29144.9512 LEAD ABATEMENT PROGRAM.431.30    Subdivision 1. Definitions. (a) The definitions in section 
         144.9501 and in this 431.31subdivision apply to this section.431.32    (b) "Eligible organization" means a lead contractor, city, board of health, community 431.33health department, community action agency as defined in section 256E.30, or community 431.34development corporation.432.1    (c) "Commissioner" means the commissioner of health, or the commissioner of the 432.2Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.432.3    Subd. 2. Grants; administration. Within the limits of the available appropriation, 432.4the commissioner must develop a swab team services program which may shall make 432.5demonstration and training grants to eligible organizationsa nonprofit organization 432.6currently operating the CLEARCorps lead hazard reduction project to train workers to 432.7provide swab team services and swab team services for residential property. Grants may 432.8be awarded to nonprofit organizations to provide technical assistance and training to 432.9ensure quality and consistency within the statewide program. Grants must be awarded to 432.10help ensure full-time employment to workers providing swab team services and must be 432.11awarded for a two-year period.432.12    Grants awarded under this section must be made in consultation with the 432.13commissioner of the Housing Finance Agency and representatives of neighborhood 432.14groups from areas at high risk for toxic lead exposure, a labor organization, the lead 432.15coalition, community action agencies, and the legal aid society. The consulting team must 432.16review grant applications and recommend awards to eligible organizations that meet 432.17requirements for receiving a grant under this section.432.18    Subd. 3.Applicants.(a) Interested eligible organizations may apply to the 432.19commissioner for grants under this section. Two or more eligible organizations may 432.20jointly apply for a grant. Priority shall be given to community action agencies in greater 432.21Minnesota and to either community action agencies or neighborhood based nonprofit 432.22organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may 432.23be used for administrative purposes. The commissioner may deviate from this percentage 432.24if a grantee can justify the need for a larger administrative allowance. Of this amount, 432.25up to five percent may be used by the commissioner for state administrative purposes. 432.26Applications must provide information requested by the commissioner, including at least 432.27the information required to assess the factors listed in paragraph (d).432.28    (b) The commissioner must consult with boards of health to provide swab team 432.29services for purposes of secondary prevention. The priority for swab teams created 432.30by grants to eligible organizations under this section must be work assigned by the 432.31commissioner of health, or by a board of health if so designated by the commissioner of 432.32health, to provide secondary prevention swab team services to fulfill the requirements 432.33of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned 432.34work under this section by the commissioner, that are not engaged daily in fulfilling the 432.35requirements of section 144.9504, subdivision 6, must deliver swab team services in 432.36response to elevated blood lead levels as defined in section 144.9501, subdivision 9, 433.1where lead orders were not issued, and for purposes of primary prevention in census 433.2tracts known to be in areas at high risk for toxic lead exposure as described in section 433.3144.9503, subdivision 2.433.4    (c) Any additional money must be used for grants to establish swab teams for 433.5primary prevention under section 144.9503, in census tracts in areas at high risk for toxic 433.6lead exposure as determined under section 144.9503, subdivision 2.433.7    (d) In evaluating grant applications, the commissioner must consider the following 433.8criteria:433.9    (1) the use of lead contractors and lead workers for residential swab team services;433.10    (2) the participation of neighborhood groups and individuals, as swab team workers, 433.11in areas at high risk for toxic lead exposure;433.12    (3) plans for the provision of swab team services for primary and secondary 433.13prevention as required under subdivision 4;433.14    (4) plans for supervision, training, career development, and postprogram placement 433.15of swab team members;433.16    (5) plans for resident and property owner education on lead safety;433.17    (6) plans for distributing cleaning supplies to area residents and educating residents 433.18and property owners on cleaning techniques;433.19    (7) sources of other funding and cost estimates for training, lead inspections, swab 433.20team services, equipment, monitoring, testing, and administration;433.21    (8) measures of program effectiveness;433.22    (9) coordination of program activities with other federal, state, and local public 433.23health, job training, apprenticeship, and housing renovation programs including programs 433.24under sections 116L.86 to 116L.881; and433.25    (10) prior experience in providing swab team services.433.26    Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible 433.27organizations and lead supervisors or certified firms may participate in the swab team 433.28program. An eligible organization The nonprofit receiving a grant under this section 433.29must assure ensure that all participating lead supervisors or certified firms are licensed 433.30and that all swab team workers are certified by the Department of Health under section 433.31144.9505
         . Eligible organizations and lead supervisors or certified firms may distinguish 433.32between interior and exterior services in assigning duties and The nonprofit organization433.33may participate in the program by: 433.34    (1) providing on-the-job training for swab team workers;433.35    (2) providing swab team services to meet the requirements of sections 
         144.9503, 433.36subdivision 4
         , and 
         144.9504, subdivision 6; 434.1    (3) providing a removal and replacement component using skilled craft workers 434.2under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501, 434.3subdivision 17;434.4    (4) providing lead testing according to subdivision 8;434.5    (5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as 434.6described in section 
         144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or434.7    (6) (5) having a swab team worker instruct residents and property owners on 434.8appropriate lead control techniques, including the lead-safe directives developed by the 434.9commissioner of health.;434.10    (6) conducting blood lead testing events including screening children and pregnant 434.11women according to Department of Health screening guidelines;434.12    (7) performing case management services according to Department of Health case 434.13management guidelines; or434.14    (8) conducting mandated risk assessments under Minnesota Statutes, section 434.15144.9504, subdivision 2.434.16    (b) Participating lead supervisors or certified firms must:434.17    (1) demonstrate proof of workers' compensation and general liability insurance 434.18coverage;434.19    (2) be knowledgeable about lead abatement requirements established by the 434.20Department of Housing and Urban Development and the Occupational Safety and Health 434.21Administration and lead hazard reduction requirements and lead-safe directives of the 434.22commissioner of health;434.23    (3) demonstrate experience with on-the-job training programs;434.24    (4) demonstrate an ability to recruit employees from areas at high risk for toxic 434.25lead exposure; and434.26    (5) demonstrate experience in working with low-income clients.434.27    Subd. 5. Swab team workers. Each worker engaged in swab team services 434.28established under this section must have blood lead concentrations below 15 micrograms 434.29of lead per deciliter of whole blood as determined by a baseline blood lead screening. 434.30Any The nonprofit organization receiving a grant under this section is responsible for lead 434.31screening and must assure ensure that all swab team workers meet the standards established 434.32in this subdivision. Grantees The nonprofit organization must use appropriate workplace 434.33procedures including following the lead-safe directives developed by the commissioner of 434.34health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization434.35and participating contractors must report all employee blood lead levels that exceed 15 434.36micrograms of lead per deciliter of whole blood to the commissioner of health.435.1    Subd. 6.On-the-job training component.(a) Programs established under this 435.2section must provide on-the-job training for swab team workers.435.3    (b) Swab team workers must receive monetary compensation equal to the prevailing 435.4wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed 435.5contractor's principal business. 435.6    Subd. 7.Removal and replacement component.(a) Within the limits of the 435.7available appropriation and if a need is identified by a lead inspector, the commissioner 435.8may establish a component for removal and replacement of deteriorated paint in residential 435.9properties according to the following criteria:435.10    (1) components within a residence must have both deteriorated lead-based paint and 435.11substrate damage beyond repair or rotting wooden framework to be eligible for removal 435.12and replacement;435.13    (2) all removal and replacement must be done using least-cost methods and 435.14following lead-safe directives;435.15    (3) whenever windows and doors or other components covered with deteriorated 435.16lead-based paint have sound substrate or are not rotting, those components should be 435.17repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or 435.18covered with protective guards instead of being replaced, provided that such an activity is 435.19the least-cost method of providing the swab team service;435.20    (4) removal and replacement or repair must be done by lead contractors using skilled 435.21craft workers or trained swab team members; and435.22    (5) all craft work that requires a state license must be supervised by a person with 435.23a state license in the craft work being supervised. The grant recipient may contract for 435.24this supervision.435.25    (b) The program design must:435.26    (1) identify the need for on-the-job training of swab team workers to be removal and 435.27replacement workers; and435.28    (2) describe plans to involve appropriate groups in designing methods to meet the 435.29need for training swab team workers.435.30    Subd. 8.Testing and evaluation.(a) Testing of the environment is not necessary 435.31by swab teams whose work is assigned by the commissioner of health or a designated 435.32board of health under section 144.9504. The commissioner of health or designated board 435.33of health must share the analytical testing data collected on each residence for purposes 435.34of secondary prevention under section 144.9504 with the swab team workers in order to 435.35provide constructive feedback on their work and to the commissioner for the purposes 435.36set forth in paragraph (c).436.1    (b) For purposes of primary prevention evaluation, the following samples must be 436.2collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a 436.3notation of the extent and location of bare soil and of deteriorated lead-based paint. The 436.4analytical testing data collected on each residence for purposes of primary prevention 436.5under section 144.9503 must be shared with the swab team workers in order to provide 436.6constructive feedback on their work and to the commissioner for the purposes set forth in 436.7paragraph (c).436.8    (c) The commissioner of health must establish a program to collect appropriate data 436.9as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of 436.10swab team services for primary and secondary prevention. Within the limits of available 436.11appropriations, the commissioner of health must conduct on up to 1,000 residences which 436.12have received primary or secondary prevention swab team services, a postremediation 436.13evaluation, on at least a quarterly basis for a period of at least two years for each residence. 436.14The evaluation must note the condition of the paint within the residence, the extent of bare 436.15soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample. 436.16The data collected must be evaluated to determine the efficacy of providing swab team 436.17services as a method of reducing lead exposure in young children. In evaluating this data, 436.18the commissioner of health must consider city size, community location, historic traffic 436.19flow, soil lead level of the property by area or census tract, distance to industrial point 436.20sources that emit lead, season of the year, age of the housing, age and number of children 436.21living at the residence, the presence of pets that move in and out of the residence, and 436.22other relevant factors as the commissioner of health may determine.436.23    Subd. 9. Program benefits. As a condition of providing swab team services under 436.24this section, an the nonprofit organization may require a property owner to not increase 436.25rents on a property solely as a result of a substantial improvement made with public 436.26funds under the programs in this section.436.27    Subd. 10. Requirements of organizations receiving grants the nonprofit 436.28organization.An eligible The nonprofit organization that is awarded a training and 436.29demonstration grant under this section must prepare and submit a quarterly progress report 436.30to the commissioner beginning three months after receipt of the grant.436.31    Sec. 15. [144.966] EARLY HEARING DETECTION AND INTERVENTION 436.32ACT.436.33    Subdivision 1.Definitions.(a) "Child" means a person 18 years of age or younger.437.1    (b) "False positive rate" means the proportion of infants identified as having a 437.2significant hearing loss by the screening process who are ultimately found to not have a 437.3significant hearing loss.437.4    (c) "False negative rate" means the proportion of infants not identified as having 437.5a significant hearing loss by the screening process who are ultimately found to have a 437.6significant hearing loss.437.7    (d) "Hearing screening test" means automated auditory brain stem response, 437.8otoacoustic emissions, or another appropriate screening test approved by the Department 437.9of Health.437.10    (e) "Hospital" means a birthing health care facility or birthing center licensed in 437.11this state that provides obstetrical services.437.12    (f) "Infant" means a child who is not a newborn and has not attained the age of 437.13one year.437.14    (g) "Newborn" means an infant 28 days old or younger.437.15    (h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or 437.16custodian of a newborn or infant.437.17    Subd. 2.Newborn Hearing Screening Advisory Committee.(a) The 437.18commissioner of health shall appoint a Newborn Hearing Screening Advisory Committee 437.19to advise and assist the Department of Health and the Department of Education in:437.20    (1) developing protocols and timelines for screening, rescreening, and diagnostic 437.21audiological assessment and early medical, audiological, and educational intervention 437.22services for children who are deaf or hard-of-hearing;437.23    (2) designing protocols for tracking children from birth through age three that may 437.24have passed newborn screening but are at risk for delayed or late onset of permanent 437.25hearing loss;437.26    (3) designing a technical assistance program to support facilities implementing the 437.27screening program and facilities conducting rescreening and diagnostic audiological 437.28assessment;437.29    (4) designing implementation and evaluation of a system of follow-up and tracking; 437.30and437.31    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure 437.32culturally appropriate services for children with a confirmed hearing loss and their families.437.33    (b) Membership of the committee shall include at least one member from each of the 437.34following groups with no less than two of the members being deaf or hard-of-hearing:437.35    (1) a representative from a consumer organization representing culturally deaf 437.36persons;438.1    (2) a parent with a child with hearing loss representing a parent organization;438.2    (3) a consumer from an organization representing oral communication options;438.3    (4) a consumer from an organization representing cued speech communication 438.4options;438.5    (5) an audiologist who has experience in evaluation and intervention of infants 438.6and young children;438.7    (6) a speech-language pathologist who has experience in evaluation and intervention 438.8of infants and young children;438.9    (7) two primary care providers who have experience in the care of infants and young 438.10children, one of which shall be a pediatrician;438.11    (8) a representative from the early hearing detection intervention teams;438.12    (9) a representative from the Department of Education resource center for the deaf 438.13and hard-of-hearing or their designee;438.14    (10) a representative of the Minnesota Commission Serving Deaf and Hard of 438.15Hearing People;438.16    (11) a representative from the Department of Human Services Deaf and Hard of 438.17Hearing Services Division;438.18    (12) one or more of the Part C coordinators from the Department of Education, the 438.19Department of Health, or the Department of Human Services or their designee;438.20    (13) the Department of Health early hearing detection and intervention coordinator;438.21    (14) two birth hospital representatives from one rural and one urban hospital;438.22    (15) a pediatric geneticist;438.23    (16) an otolaryngologist;438.24    (17) a representative from the Newborn Screening Advisory Committee under 438.25this subdivision; and438.26    (18) a representative of the Department of Education regional low-incidence 438.27facilitators.438.28    The Department of Health member shall chair the first meeting of the committee. 438.29At the first meeting, the committee shall elect a chairperson from its membership. The 438.30committee shall meet at the call of the chairperson, at least four times a year. The 438.31committee shall adopt written bylaws to govern its activities. The Department of Health 438.32shall provide technical and administrative support services as required by the committee. 438.33These services shall include technical support from individuals qualified to administer 438.34infant hearing screening, rescreening, and diagnostic audiological assessments.439.1    Members of the committee shall receive no compensation for their service, but 439.2shall be reimbursed for expenses incurred as a result of their duties as members of the 439.3committee.439.4    Subd. 3.Newborn and infant hearing screening programs.All hospitals shall 439.5establish a Universal Newborn Hearing and Infant Screening (UNHS) program. Each 439.6UNHS program shall:439.7    (1) in advance of any hearing screening testing, provide to the newborn's or infant's 439.8parents information concerning the nature of the screening procedure, applicable costs of 439.9the screening procedure, the potential risks and effects of hearing loss, and the benefits of 439.10early detection and intervention;439.11    (2) comply with parental consent under section 144.125, subdivision 3;439.12    (3) develop policies and procedures for screening and rescreening based on 439.13Department of Health recommendations;439.14    (4) provide appropriate training and monitoring of individuals responsible for 439.15performing hearing screening tests as recommended by the Department of Health;439.16    (5) test the newborn's hearing prior to discharge, or, if the newborn is expected to 439.17remain in the hospital for a prolonged period, testing shall be performed prior to three 439.18months of age, or when medically feasible;439.19    (6) develop and implement procedures for documenting the results of all hearing 439.20screening tests;439.21    (7) inform the baby's parents or parent, primary care physician, and the Department 439.22of Health according to recommendations of the Department of Health of the results of the 439.23hearing screening test or rescreening if conducted, or if the newborn or infant was not 439.24successfully tested. The hospital that discharges the baby to home is responsible for 439.25the screening; and439.26    (8) collect performance data specified by the Department of Health. 439.27    Subd. 4.Notification and information.(a) Notification to the parents, primary 439.28care provider, and Department of Health shall occur prior to discharge or no later than ten 439.29days following the date of testing. Notification shall include information recommended by 439.30the Department of Health.439.31    (b) A physician, nurse, midwife, or other health professional attending a birth outside 439.32a hospital or institution shall provide information, orally and in writing, as established by 439.33the Department of Health, to parents regarding places where the parents may have their 439.34infants' hearing screened and the importance of such screening.440.1    (c) The professional conducting the diagnostic procedure to confirm the hearing loss 440.2must report the results to the parents, primary care provider, and Department of Health 440.3according to the Department of Health recommendations.440.4    Subd. 5.Oversight responsibility.The Department of Health shall exercise 440.5oversight responsibility for UNHS programs, including establishing a performance data 440.6set and reviewing performance data collected by each hospital.440.7    Subd. 6.Civil and criminal immunity and penalties.(a) No physician or hospital 440.8shall be civilly or criminally liable for failure to conduct hearing screening testing.440.9    (b) No physician, midwife, nurse, other health professional, or hospital acting in 440.10compliance with this section shall be civilly or criminally liable for any acts conforming 440.11with this section, including furnishing information required according to this section.440.12    Subd. 7.Laboratory service fees.The commissioner shall charge laboratory 440.13service fees according to section 16A.1285 so that the total of fees collected will 440.14approximate the costs of implementing and maintaining a system to follow up infants, 440.15provide technical assistance, a tracking system, data management, and evaluation.440.16EFFECTIVE DATE.This section is effective the day following final enactment.440.17    Sec. 16. [144.967] ARSENIC HEALTH RISK STANDARD.440.18    Subdivision 1.Arsenic health risk standard established.The commissioner of 440.19health in cooperation with the commissioners of agriculture and the Pollution Control 440.20Agency responsible for monitoring land and water cleanup and soil contamination 440.21information shall determine a health risk standard for human exposure to arsenic. The 440.22commissioner of health shall ensure that the established arsenic health risk standard is 440.23included in all information provided to the public.440.24    Subd. 2.Information.The commissioner of health, in consultation with the 440.25commissioners of agriculture and the Pollution Control Agency with jurisdiction over 440.26soil and water contamination, shall establish a central information source available to 440.27the public to provide accurate information on arsenic soil and water contamination in 440.28residential areas.440.29    Subd. 3.Testing for arsenic.(a) The commissioner of health shall ensure access 440.30to medical testing for arsenical pesticide exposure to persons living within one mile of 440.31the CMC Heartland Lite Yard Superfund site who are not covered by health insurance or 440.32medical assistance.440.33    (b) Through an agreement with the United States Environmental Protection Agency, 440.34the commissioner shall ensure soil testing is available to households within one mile of the 440.35CMC Heartland Lite Yard Superfund site at no cost to the residents.441.1    Subd. 4.Evaluation.The commissioner of health shall evaluate the cumulative 441.2health impact burdens of environmental toxins in the residential communities impacted by 441.3arsenic-contaminated soil from the CMC Heartland Lite Yard Superfund site. The first 441.4priority shall be to evaluate health burdens to those communities experiencing health 441.5disparities as documented by the Minority and Multicultural Health Division of the 441.6Minnesota Department of Health.441.7    Sec. 17. [144.995] DEFINITIONS.441.8    (a) For purposes of sections 144.995 to 144.998, the terms in this section have 441.9the meanings given.441.10    (b) "Advisory panel" means the Environmental Health Tracking and Biomonitoring 441.11Advisory Panel established under section 144.998.441.12    (c) "Biomonitoring" means the process by which chemicals and their metabolites are 441.13identified and measured within a biospecimen.441.14    (d) "Biospecimen" means a sample of human fluid, serum, or tissue that is reasonably 441.15available as a medium to measure the presence and concentration of chemicals or their 441.16metabolites in a human body.441.17    (e) "Commissioner" means the commissioner of the Department of Health.441.18    (f) "Community" means geographically or nongeographically-based populations 441.19that may participate in the biomonitoring program. A "nongeographical community" 441.20includes, but is not limited to, populations that may share a common chemical exposure 441.21through similar occupations, populations experiencing a common health outcome that 441.22may be linked to chemical exposures, or populations that may experience similar chemical 441.23exposures because of comparable consumption, lifestyle, product use, or subpopulations 441.24that share ethnicity, age, or gender.441.25    (g) "Department" means the Department of Health.441.26    (h) "Designated chemicals" means those chemicals that are known to, or strongly 441.27suspected of, adversely impacting human health or development, based upon scientific, 441.28peer-reviewed animal, human, or in vitro studies, and baseline human exposure data, 441.29and consists of chemical families or metabolites that are included in the federal Centers 441.30for Disease Control and Prevention studies that are known collectively as the National 441.31Reports on Human Exposure to Environmental Chemicals program and any substances 441.32specified under section 144.998, subdivision 3, clause (6).441.33    (i) "Environmental hazard" means a chemical, metal, or other substance for which 441.34scientific, peer-reviewed studies of humans, animals, or cells have demonstrated that the 441.35chemical is known or reasonably anticipated to adversely impact human health.442.1    (j) "Environmental health tracking" means collection, integration, analysis, and 442.2dissemination of data on human exposures to  chemicals in the environment and on 442.3diseases potentially caused or aggravated by those chemicals.442.4    Sec. 18. [144.996] ENVIRONMENTAL HEALTH TRACKING; 442.5BIOMONITORING.442.6    Subdivision 1.Environmental health tracking.In cooperation with the 442.7commissioner of the Pollution Control Agency, the commissioner shall establish an 442.8environmental health tracking program to:442.9    (1) coordinate data collection activities with the Pollution Control Agency, 442.10Department of Agriculture, University of Minnesota, and any other relevant state agency 442.11and work to promote the sharing of and access to health and environmental databases 442.12in order to develop an environmental health tracking system for Minnesota, consistent 442.13with applicable data practices laws;442.14    (2) facilitate the dissemination of public health tracking data to the public and 442.15researchers in accessible format and provide technical assistance on interpreting the data;442.16    (3) develop written data sharing agreements with the Minnesota Pollution Control 442.17Agency, Department of Agriculture, and other relevant state agencies and organizations, 442.18and develop additional procedures as needed to protect individual privacy;442.19    (4) develop a strategic plan that includes a mission statement, the identification of 442.20core priorities for research and epidemiologic surveillance, the identification of internal 442.21and external stakeholders, and a work plan describing future program development;442.22    (5) organize, analyze, and interpret available data, in order to:442.23    (i) characterize statewide and localized trends and geographic patterns of prevalence 442.24and incidence of chronic diseases, including, but not limited to, cancer, respiratory 442.25diseases, reproductive problems, birth defects, neurologic diseases, and developmental 442.26disorders;442.27    (ii) recommend to the commissioner methods to improve data collection on 442.28statewide population rates of chronic diseases and the occurrence of environmental 442.29hazards and exposures;442.30    (iii) characterize statewide and localized trends and geographic patterns in the 442.31occurrence of environmental hazards and exposures;442.32    (iv) assess the level of correlation with disease rate data and indicators of exposure 442.33such as biomonitoring data, and other health and environmental data;443.1    (v) incorporate newly collected and existing health tracking and biomonitoring 443.2data into efforts to identify communities with elevated rates of chronic disease, higher 443.3likelihood of exposure to environmental pollutants, or both;443.4    (vi) analyze occurrence of environmental hazards, exposures, and diseases with 443.5relation to socioeconomic status, race, and ethnicity;443.6    (vii) develop and implement targeted plans to conduct more intensive health tracking 443.7and biomonitoring among communities;443.8    (viii) work with the Pollution Control Agency, the Department of Agriculture, and 443.9other relevant state agency personnel and organizations to develop, implement, and 443.10evaluate preventive measures to reduce elevated rates of diseases and exposures identified 443.11through activities performed under sections 144.995 to 144.998; and443.12    (ix) provide baseline data and present descriptive information relevant to policy 443.13formation that are consistent with existing goals of the department; and443.14    (6) submit a biennial report to the legislature by January 15, beginning January 443.1515, 2009, on the status of environmental health tracking activities and related research 443.16programs, and making recommendations regarding the continuation and improvement of 443.17the programs.443.18    Subd. 2.Biomonitoring.The commissioner shall:443.19    (1) conduct biomonitoring of communities on a voluntary  basis by collecting and 443.20analyzing biospecimens, as appropriate, to assess environmental exposures to designated 443.21chemicals;443.22    (2) conduct biomonitoring of pregnant women and minors on a voluntary basis, 443.23when scientifically appropriate; 443.24    (3) communicate findings to the public, and plan ensuing stages of biomonitoring 443.25and disease tracking work to further develop and refine the integrated analysis;443.26    (4) share analytical results with the advisory panel and work with the panel 443.27to interpret results, communicate findings to the public, and plan ensuing stages of 443.28biomonitoring work; and443.29    (5) submit a biennial report to the legislature by January 15, beginning January 443.3015, 2009, on the status of the biomonitoring program and any recommendations for 443.31improvement.443.32    Subd. 3.Health data.Data collected under the biomonitoring program are health 443.33data under section 13.3805.443.34    Sec. 19. [144.997] BIOMONITORING PILOT PROGRAM.444.1    Subdivision 1.Pilot program.With advice from the advisory panel, the 444.2commissioner shall develop a biomonitoring pilot program. The program shall collect 444.3one biospecimen from each of the voluntary participants. The biospecimen selected must 444.4be the biospecimen that most accurately represents body concentration of the chemical 444.5of interest. Each biospecimen from the voluntary participants must be analyzed for one 444.6type or class of related chemicals or metals, based on recommendations from the advisory 444.7panel. The panel shall determine the chemical or class of chemicals that community 444.8members were most likely exposed to. The program shall collect and assess biospecimens 444.9in accordance with the following: 444.10    (1) 30 voluntary participants from each of three communities that the advisory panel 444.11identifies as likely to have been exposed to a designated chemical; 444.12    (2) 100 voluntary participants from each of two communities: (i) that the advisory 444.13panel identifies as likely to have been exposed to arsenic and (ii) that the advisory panel 444.14identifies as likely to have been exposed to mercury; and 444.15    (3) 100 voluntary participants from each of two communities that the advisory panel 444.16identifies as likely to have been exposed to perfluorinated chemicals.444.17    Subd. 2.Base program.Following the conclusion of the pilot program and within 444.18the appropriations available, the program shall:444.19    (1) collect and assess biospecimens from at least as many voluntary participants and 444.20communities as identified in subdivision 1, clause (1); and444.21    (2) work with the advisory panel to assess the usefulness of continuing biomonitoring 444.22among members of communities assessed during the initial phase of the program, 444.23and to identify other communities and other designated chemicals to be assessed via 444.24biomonitoring.444.25    Subd. 3.Participation.(a) Participation in the biomonitoring program by providing 444.26biospecimens is voluntary and requires written, informed consent. Minors may participate 444.27in the program if a written consent is signed by the minor's parent or legal guardian. 444.28The written consent must include the information required to be provided under this 444.29subdivision to all voluntary participants.444.30    (b) All participants shall be evaluated for the presence of the designated chemical 444.31of interest as a component of the biomonitoring process. Participants shall be provided 444.32with information and fact sheets about the program's activities and its findings. 444.33Individual participants shall, if requested, receive their complete results. Any results 444.34provided to participants shall be subject to the Department of Health Institutional 444.35Review Board protocols and guidelines. When either physiological or chemical data 444.36obtained from a participant indicate a significant known health risk, program staff 445.1experienced in communicating biomonitoring results shall consult with the individual 445.2and recommend follow-up steps, as appropriate. Program administrators shall receive 445.3training in administering the program in an ethical, culturally sensitive, participatory, 445.4and community-based manner.445.5    Subd. 4.Program guidelines.(a) The commissioner, in consultation with the 445.6advisory panel, shall develop:445.7    (1) protocols or program guidelines that address the science and practice of 445.8biomonitoring to be utilized and procedures for changing those protocols to incorporate 445.9new and more accurate or efficient technologies as they become available. The protocols 445.10shall be developed utilizing a peer-review process in a manner that is participatory and 445.11community-based in design, implementation, and evaluation;445.12    (2) guidelines for ensuring the privacy of information; informed consent; follow-up 445.13counseling and support; and communicating findings to participants, communities, and 445.14the general public. The informed consent used for the program must meet the informed 445.15consent protocols developed by the National Institutes of Health;445.16    (3) educational and outreach materials that are culturally appropriate for 445.17dissemination to program participants and communities. Priority shall be given to the 445.18development of materials specifically designed to ensure that parents are informed about 445.19all of the benefits of breastfeeding so that the program does not result in an unjustified fear 445.20of toxins in breast milk, which might inadvertently lead parents to avoid breastfeeding. 445.21The materials shall communicate relevant scientific findings; data on the accumulation 445.22of pollutants to community health; and the required responses by local, state, and other 445.23governmental entities in regulating toxicant exposures;445.24    (4) a training program that is culturally sensitive specifically for health care 445.25providers, health educators, and other program administrators; 445.26    (5) a designation process for state and private laboratories that are qualified to 445.27analyze biospecimens and report the findings; and 445.28    (6) a method for informing affected communities and local governments representing 445.29those communities concerning biomonitoring activities and for receiving comments from 445.30citizens concerning those activities.445.31    (b) The commissioner may enter into contractual agreements with health clinics, 445.32community-based organizations, or experts in a particular field to perform any of the 445.33activities described under this section.445.34    Sec. 20. [144.998] ENVIRONMENTAL HEALTH TRACKING AND 445.35BIOMONITORING ADVISORY PANEL.446.1    Subdivision 1.Creation.The commissioner shall establish the Environmental 446.2Health Tracking and Biomonitoring Advisory Panel. The commissioner shall appoint, 446.3from the panel's membership, a chair. The panel shall meet as often as it deems necessary 446.4but, at a minimum, on a quarterly basis. Members of the panel shall serve without 446.5compensation but shall be reimbursed for travel and other necessary expenses incurred 446.6through performance of their duties. Members appointed under this subdivision are 446.7appointed for a three-year term and may be reappointed.446.8    Subd. 2.Members.The commissioner shall appoint eight members, none of whom 446.9may be lobbyists registered under chapter 10A, who have backgrounds or training in 446.10designing, implementing, and interpreting health tracking and biomonitoring studies or 446.11in related fields of science, including epidemiology, biostatistics, environmental health, 446.12laboratory sciences, occupational health, industrial hygiene, toxicology, and public health, 446.13including:446.14    (1) two scientists who represent nongovernmental organizations with a focus on 446.15environmental health, environmental justice, children's health, or on specific chronic 446.16diseases; and446.17    (2) one scientist who is a representative of the University of Minnesota.446.18    In addition, the commissioner shall appoint one member representing each of the 446.19following departments or divisions: the department's health promotion and chronic disease 446.20division, the Pollution Control Agency, and the Department of Agriculture.446.21    Subd. 3.Duties.The advisory panel shall make recommendations to the 446.22commissioner and the legislature on:446.23    (1) priorities for health tracking;446.24    (2) priorities for biomonitoring that are based on sound science and practice, and 446.25that will advance the state of public health in Minnesota;446.26    (3) specific chronic diseases to study under the environmental health tracking system;446.27    (4) specific environmental pollutant exposures to study under the environmental 446.28health tracking system, with the agreement of at least seven of the advisory panel members;446.29    (5) specific communities and geographic areas on which to focus environmental 446.30health tracking and biomonitoring efforts;446.31    (6) specific chemicals and metals to study under the biomonitoring program that meet 446.32the following criteria, with the agreement of at least seven of the advisory panel members:446.33    (i) the degree of potential exposure to the public or specific subgroups, including, 446.34but not limited to, occupational;447.1    (ii) the likelihood of a chemical being a carcinogen or toxicant based on 447.2peer-reviewed health data, the chemical structure, or the toxicology of chemically related 447.3compounds;447.4    (iii) the limits of laboratory detection for the chemical, including the ability to detect 447.5the chemical at low enough levels that could be expected in the general population;447.6    (iv) exposure or potential exposure to the public or specific subgroups;447.7    (v) the known or suspected health effects resulting from the same level of exposure 447.8based on peer-reviewed scientific studies;447.9    (vi) the need to assess the efficacy of public health actions to reduce exposure to a 447.10chemical;447.11    (vii) the availability of a biomonitoring analytical method with adequate accuracy, 447.12precision, sensitivity, specificity, and speed;447.13    (viii) the availability of adequate biospecimen samples; and447.14    (ix) other criteria that the panel may agree to; and447.15    (7) other aspects of the design, implementation, and evaluation of the environmental 447.16health tracking and biomonitoring system, including, but not limited to:447.17    (i) identifying possible community partners and sources of additional public or 447.18private funding;447.19    (ii) developing outreach and educational methods and materials; and447.20    (iii) disseminating environmental health tracking and biomonitoring findings to 447.21the public.447.22    Subd. 4.Liability.No member of the panel shall be held civilly or criminally liable 447.23for an act or omission by that person if the act or omission was in good faith and within 447.24the scope of the member's responsibilities under sections 144.995 to 144.998.447.25    Sec. 21. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:447.26    Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life 447.27support ambulance shall be staffed by at least two ambulance service personnel, at least 447.28one of which must be an EMT, who provide a level of care so as to ensure that:447.29    (1) life-threatening situations and potentially serious injuries are recognized;447.30    (2) patients are protected from additional hazards;447.31    (3) basic treatment to reduce the seriousness of emergency situations is administered; 447.32and447.33    (4) patients are transported to an appropriate medical facility for treatment.447.34    (b) A basic life support service shall provide basic airway management.448.1    (c) By January 1, 2001, a basic life support service shall provide automatic 448.2defibrillation, as provided in section 
         144E.103, subdivision 1, paragraph (b). 448.3    (d) A basic life support service licensee's medical director may authorize the 448.4ambulance service personnel to carry and to use medical antishock trousers and to perform 448.5intravenous infusion if the ambulance service personnel have been properly trained.448.6    (e) Upon application from an ambulance service that includes evidence 448.7demonstrating hardship, the board may grant a temporary variance from the staff 448.8requirements in paragraph (a) and may authorize a basic life support ambulance to be 448.9staffed by one EMT and one first responder. The variance shall apply to basic life support 448.10ambulances operated by the ambulance service for up to one year from the date of the 448.11variance's issuance until the ambulance service renews its license. When a variance 448.12expires, an ambulance service may apply for a new variance under this paragraph. For 448.13purposes of this paragraph, "ambulance service" means either an ambulance service whose 448.14primary service area is located outside the metropolitan counties listed in section 
         473.121, 448.15subdivision 4
         , and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 448.16Cloud; or an ambulance service based in a community with a population of less than 1,000. 448.17    Sec. 22. Minnesota Statutes 2006, section 144E.127, is amended to read:448.18144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.448.19    Subdivision 1.Interhospital transfers. When transporting a patient from one 448.20licensed hospital to another, a licensee may substitute for one of the required ambulance 448.21service personnel, a physician, a registered nurse, or physician's assistant who has been 448.22trained to use the equipment in the ambulance and is knowledgeable of the licensee's 448.23ambulance service protocols.448.24    Subd. 2.Interfacility transfers.In an interfacility transport, a licensee whose 448.25primary service area is located outside the metropolitan counties listed in section 473.121, 448.26subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 448.27Cloud; or an ambulance service based in a community with a population of less than 1,000, 448.28may substitute one EMT with a registered first responder if an EMT or EMT-paramedic, 448.29physician, registered nurse, or physician's assistant is in the patient compartment. If using 448.30a physician, registered nurse, or physician's assistant as the sole provider in the patient 448.31compartment, the individual must be trained to use the equipment in the ambulance and be 448.32knowledgeable of the ambulance service protocols.448.33    Sec. 23. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:449.1    Subdivision 1. Repayment for volunteer training.Any political subdivision, or 449.2nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall 449.3be reimbursed by the board for the necessary expense of the initial training of a volunteer 449.4ambulance attendant upon successful completion by the attendant of a basic emergency 449.5care course, or a continuing education course for basic emergency care, or both, which has 449.6been approved by the board, pursuant to section 
         144E.285. Reimbursement may include 449.7tuition, transportation, food, lodging, hourly payment for the time spent in the training 449.8course, and other necessary expenditures, except that in no instance shall a volunteer 449.9ambulance attendant be reimbursed more than $450$600 for successful completion of a 449.10basic course, and $225$275 for successful completion of a continuing education course. 449.11    Sec. 24. [145.958] BISPHENOL-A IN PRODUCTS FOR CHILDREN.449.12    Subdivision. 1.Bisphenol-A and phthalates committee.The commissioner of 449.13health shall create a committee under the direction of the environmental health division of 449.14the Department of Health to study the scientific literature and make recommendations to 449.15the legislature on the health impact of bisphenol-A and phthalates on children in products 449.16intended for use by young children, including, but not limited to, toys, pacifiers, baby 449.17bottles, and teethers, and report back by January 15, 2008. The committee shall also 449.18identify least harmful alternatives. Of the seven committee members at least one shall be a 449.19representative of the Department of Health, one shall be a representative of environmental 449.20health sciences research, one shall be a representative of the Minnesota Nurses 449.21Association, one shall be a representative of environmental health consumer advocates, 449.22one shall be a member of a children's product manufacturer's association, and one shall be 449.23a representative of the University of Minnesota, chemical plastics research department.449.24    Subd. 2.Definitions.For the purposes of this section, the following terms have 449.25the meanings given them:449.26    (a) "Toy" means all products designed or intended by the manufacturer to be used by 449.27children when they play.449.28    (b) "Child care article" means all products designed or intended by the manufacturer 449.29to facilitate sleep, relaxation, or the feeding of children or to help children with sucking or 449.30teething.449.31    Sec. 25. Minnesota Statutes 2006, section 145A.17, is amended to read:449.32145A.17 FAMILY HOME VISITING PROGRAMS.449.33    Subdivision 1. Establishment; goals. The commissioner shall establish a program 449.34to fund family home visiting programs designed to foster a healthy beginning for children 450.1in families at or below 200 percent of the federal poverty guidelines beginnings, improve 450.2pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce 450.3juvenile delinquency, promote positive parenting and resiliency in children, and promote 450.4family health and economic self-sufficiency for children and families. The commissioner 450.5shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of 450.6professionals and paraprofessionals from the fields of public health nursing, social work, 450.7and early childhood education. A program funded under this section must serve families 450.8at or below 200 percent of the federal poverty guidelines, and other families determined 450.9to be at risk, including but not limited to being at risk for child abuse, child neglect, or 450.10juvenile delinquency. Programs must give priority for services to families considered to 450.11be in need of services, including but not limited tobegin prenatally whenever possible and 450.12must be targeted to families with:450.13    (1) adolescent parents;450.14    (2) a history of alcohol or other drug abuse;450.15    (3) a history of child abuse, domestic abuse, or other types of violence;450.16    (4) a history of domestic abuse, rape, or other forms of victimization;450.17    (5) reduced cognitive functioning;450.18    (6) a lack of knowledge of child growth and development stages;450.19    (7) low resiliency to adversities and environmental stresses; or450.20    (8) insufficient financial resources to meet family needs;450.21    (9) a history of homelessness;450.22    (10) a risk of long-term welfare dependence or family instability due to employment 450.23barriers; or450.24    (11) other risk factors as determined by the commissioner.450.25    Subd. 3. Requirements for programs; process. (a) Before a community health 450.26board or tribal government may receive an allocation under subdivision 2, a community 450.27health board or tribal government must submit a proposal to the commissioner that 450.28includes identification, based on a community assessment, of the populations at or below 450.29200 percent of the federal poverty guidelines that will be served and the other populations 450.30that will be served. Each program that receives funds must Community health boards 450.31and tribal governments that receive funding under this section must submit a plan to 450.32the commissioner describing a multidisciplinary approach to targeted home visiting for 450.33families. The plan must be submitted on forms provided by the commissioner. At a 450.34minimum, the plan must include the following:450.35    (1) a description of outreach strategies to families prenatally or at birth;450.36    (2) provisions for the seamless delivery of health, safety, and early learning services; 451.1    (3) methods to promote continuity of services when families move within the state;451.2    (4) a description of the community demographics;451.3    (5) a plan for meeting outcome measures; and451.4    (6) a proposed work plan that includes:451.5    (i) coordination to ensure nonduplication of services for children and families;451.6    (ii) a description of the strategies to ensure that children and families at greatest risk 451.7receive appropriate services; and451.8    (iii) collaboration with multidisciplinary partners including public health, 451.9ECFE, Head Start, community health workers, social workers, community home 451.10visiting programs, school districts, and other relevant partners. Letters of intent from 451.11multidisciplinary partners must be submitted with the plan.451.12    (b) Each program that receives funds must accomplish the following program 451.13requirements:451.14    (1) use either a broad community-based or selective community-based strategy to 451.15provide preventive and early intervention home visiting services;451.16    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 451.17home visit must occur prenatally or as soon after birth as possible and must include a 451.18public health nursing assessment by a public health nurse;451.19    (3) offer, at a minimum, information on infant care, child growth and development, 451.20positive parenting, preventing diseases, preventing exposure to environmental hazards, 451.21and support services available in the community;451.22    (4) provide information on and referrals to health care services, if needed, including 451.23information on and assistance in applying for health care coverage for which the child or 451.24family may be eligible; and provide information on preventive services, developmental 451.25assessments, and the availability of public assistance programs as appropriate;451.26    (5) provide youth development programs when appropriate;451.27    (6) recruit home visitors who will represent, to the extent possible, the races, 451.28cultures, and languages spoken by families that may be served;451.29    (7) train and supervise home visitors in accordance with the requirements established 451.30under subdivision 4;451.31    (8) maximize resources and minimize duplication by coordinating activitiesor 451.32contracting with local social and human services organizations, education organizations, 451.33and other appropriate governmental entities and community-based organizations and 451.34agencies; and451.35    (9) utilize appropriate racial and ethnic approaches to providing home visiting 451.36services; and452.1    (10) connect eligible families, as needed, to additional resources available in the 452.2community, including, but not limited to, early care and education programs, health or 452.3mental health services, family literacy programs, employment agencies, social services, 452.4and child care resources and referral agencies.452.5    (c) When available, programs that receive funds under this section must offer or 452.6provide the family with a referral to center-based or group meetings that meet at least 452.7once per month for those families identified with additional needs. The meetings must 452.8focus on further enhancing the information, activities, and skill-building addressed during 452.9home visitation; offering opportunities for parents to meet with and support each other; 452.10and offering infants and toddlers a safe, nurturing, and stimulating environment for 452.11socialization and supervised play with qualified teachers.452.12    (b)(d) Funds available under this section shall not be used for medical services. The 452.13commissioner shall establish an administrative cost limit for recipients of funds. The 452.14outcome measures established under subdivision 6 must be specified to recipients of 452.15funds at the time the funds are distributed.452.16    (c)(e) Data collected on individuals served by the home visiting programs must 452.17remain confidential and must not be disclosed by providers of home visiting services 452.18without a specific informed written consent that identifies disclosures to be made. 452.19Upon request, agencies providing home visiting services must provide recipients with 452.20information on disclosures, including the names of entities and individuals receiving the 452.21information and the general purpose of the disclosure. Prospective and current recipients 452.22of home visiting services must be told and informed in writing that written consent for 452.23disclosure of data is not required for access to home visiting services.452.24    Subd. 4. Training. The commissioner shall establish training requirements for 452.25home visitors and minimum requirements for supervision by a public health nurse. The 452.26requirements for nurses must be consistent with chapter 148. The commissioner must 452.27provide training for home visitors. Training must include child development, positive 452.28parenting techniques, screening and referrals for child abuse and neglect, and diverse 452.29cultural practices in child rearing and family systems the following:452.30    (1) effective relationships for engaging and retaining families and ensuring family 452.31health, safety, and early learning;452.32    (2) effective methods of implementing parent education, conducting home visiting, 452.33and promoting quality early childhood development;452.34    (3) early childhood development from birth to age five;452.35    (4) diverse cultural practices in child rearing and family systems;452.36    (5) recruiting, supervising, and retaining qualified staff;453.1    (6) increasing services for underserved populations; and 453.2    (7) relevant issues related to child welfare and protective services, with information 453.3provided being consistent with state child welfare agency training.453.4    Subd. 5. Technical assistance. The commissioner shall provide administrative 453.5and technical assistance to each program, including assistance in data collection and 453.6other activities related to conducting short- and long-term evaluations of the programs 453.7as required under subdivision 7. The commissioner may request research and evaluation 453.8support from the University of Minnesota.453.9    Subd. 6. Outcome and performance measures. The commissioner shall establish 453.10outcomesmeasures to determine the impact of family home visiting programs funded 453.11under this section on the following areas:453.12    (1) appropriate utilization of preventive health care;453.13    (2) rates of substantiated child abuse and neglect;453.14    (3) rates of unintentional child injuries;453.15    (4) rates of children who are screened and who pass early childhood screening; and453.16    (5) rates of children accessing early care and educational services;453.17    (6) program retention rates;453.18    (7) number of home visits provided compared to the number of home visits planned;453.19    (8) participant satisfaction;453.20    (9) rates of at-risk populations reached; and453.21    (10) any additional qualitative goals and quantitative measures established by the 453.22commissioner.453.23    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and 453.24performance measures established under subdivisions 1 and 6, the commissioner shall 453.25conduct ongoing evaluations of the programs funded under this section. Community 453.26health boards and tribal governments shall cooperate with the commissioner in the 453.27evaluations and shall provide the commissioner with the information necessary to conduct 453.28the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact 453.29of the programs on the outcome measures listed in subdivision 6, and shall periodically 453.30determine whether home visiting programs are the best way to achieve the qualitative 453.31goals established under subdivisions 1 and 6. If the commissioner determines that home 453.32visiting programs are not the best way to achieve these goals, the commissioner shall 453.33provide the legislature with alternative methods for achieving them.453.34    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered 453.35year thereafter, the commissioner shall submit a report to the legislature on the family 454.1home visiting programs funded under this section and on the results of the evaluations 454.2conducted under subdivision 7.454.3    Subd. 9. No supplanting of existing funds. Funding available under this section 454.4may be used only to supplement, not to replace, nonstate funds being used for home 454.5visiting services as of July 1, 2001.454.6    Sec. 26. Minnesota Statutes 2006, section 156.001, is amended by adding a subdivision 454.7to read:454.8    Subd. 10a.Program for the Assessment of Veterinary Education Equivalence; 454.9PAVE certificate.A "Program for the Assessment of Veterinary Education Equivalence" 454.10or "PAVE" certificate is issued by the American Association of Veterinary State Boards, 454.11indicating that the holder has demonstrated knowledge and skill equivalent to that 454.12possessed by a graduate of an accredited or approved college of veterinary medicine.454.13    Sec. 27. [156.015] FEES.454.14    Subdivision 1.Verification of licensure.The board may charge a fee of $25 per 454.15license verification to a licensee for verification of licensure status provided to other 454.16veterinary licensing boards.454.17    Subd. 2.Continuing education review.The board may charge a fee of $50 per 454.18submission to a sponsor for review and approval of individual continuing education 454.19seminars, courses, wet labs, and lectures. This fee does not apply to continuing education 454.20sponsors that already meet the criteria for preapproval under Minnesota Rules, part 454.219100.1000, subpart 3, item A.454.22    Sec. 28. Minnesota Statutes 2006, section 156.02, subdivision 1, is amended to read:454.23    Subdivision 1. License application. Application for a license to practice veterinary 454.24medicine in this state shall be made in writing to the Board of Veterinary Medicine upon a 454.25form furnished by the board, accompanied by satisfactory evidence that the applicant is at 454.26least 18 years of age, is of good moral character, and has one of the following:454.27    (1) a diploma conferring the degree of doctor of veterinary medicine, or an 454.28equivalent degree, from an accredited or approved college of veterinary medicine;454.29    (2) an ECFVG or PAVE certificate; or454.30    (3) a certificate from the dean of an accredited or approved college of veterinary 454.31medicine stating that the applicant is a student in good standing expecting to be graduated 454.32at the completion of the current academic year of the college in which the applicant is 454.33enrolled.455.1    The application shall contain the information and material required by subdivision 455.22 and any other information that the board may, in its sound judgment, require. The 455.3application shall be filed with the board at least 60 days before the date of the examination. 455.4If the board deems it advisable, it may require that such application be verified by the 455.5oath of the applicant.455.6    Sec. 29. Minnesota Statutes 2006, section 156.02, subdivision 2, is amended to read:455.7    Subd. 2. Required with application. Every application shall contain the following 455.8information and material:455.9    (1) the application fee set by the board in the form of a check or money order payable 455.10to the board, which fee is not returnable in the event permission to take the examination 455.11is denied for good cause;455.12    (2) a copy of a diploma from an accredited or approved college of veterinary 455.13medicine or a certificate from the dean or secretary of an accredited or approved college of 455.14veterinary medicine showing the time spent in the school and the date when the applicant 455.15was duly and regularly graduated or will duly and regularly graduate or verification of 455.16ECFVG or PAVE certification;455.17    (3) affidavits of at least two veterinarians and three adults who are not related to 455.18the applicant setting forth how long a time, when, and under what circumstances they 455.19have known the applicant, and any other facts as may be proper to enable the board to 455.20determine the qualifications of the applicant; and455.21    (4) if the applicant has served in the armed forces, a copy of discharge papers.455.22    Sec. 30. Minnesota Statutes 2006, section 156.04, is amended to read:455.23156.04 BOARD TO ISSUE LICENSE.455.24    The Board of Veterinary Medicine shall issue to every applicant who has successfully 455.25passed the required examination, who has received a diploma conferring the degree of 455.26doctor of veterinary medicine or an equivalent degree from an accredited or approved 455.27college of veterinary medicine or an ECFVG or PAVE certificate, and who shall have been 455.28adjudged to be duly qualified to practice veterinary medicine, a license to practice.455.29    Sec. 31. Minnesota Statutes 2006, section 156.072, subdivision 2, is amended to read:455.30    Subd. 2. Required with application. Such doctor of veterinary medicine shall 455.31accompany the application by the following:455.32    (1) a copy of a diploma from an accredited or approved college of veterinary 455.33medicine or certification from the dean, registrar, or secretary of an accredited or approved 456.1college of veterinary medicine attesting to the applicant's graduation from an accredited 456.2or approved college of veterinary medicine, or a certificate of satisfactory completion of 456.3the ECFVG or PAVE program.456.4    (2) affidavits of two licensed practicing doctors of veterinary medicine residing in 456.5the United States or Canadian licensing jurisdiction in which the applicant is currently 456.6practicing, attesting that they are well acquainted with the applicant, that the applicant is a 456.7person of good moral character, and has been actively engaged in practicing or teaching in 456.8such jurisdiction for the period above prescribed;456.9    (3) a certificate from the regulatory agency having jurisdiction over the conduct of 456.10practice of veterinary medicine that such applicant is in good standing and is not the 456.11subject of disciplinary action or pending disciplinary action;456.12    (4) a certificate from all other jurisdictions in which the applicant holds a currently 456.13active license or held a license within the past ten years, stating that the applicant is and 456.14was in good standing and has not been subject to disciplinary action;456.15    (5) in lieu of clauses (3) and (4), certification from the Veterinary Information 456.16Verification Agency that the applicant's licensure is in good standing;456.17    (6) a fee as set by the board in form of check or money order payable to the board, 456.18no part of which shall be refunded should the application be denied;456.19    (7) score reports on previously taken national examinations in veterinary medicine, 456.20certified by the Veterinary Information Verification Agency; and456.21    (8) if requesting waiver of examination, provide evidence of meeting licensure 456.22requirements in the state of the applicant's original licensure that were substantially equal 456.23to the requirements for licensure in Minnesota in existence at that time.456.24    Sec. 32. Minnesota Statutes 2006, section 156.073, is amended to read:456.25156.073 TEMPORARY PERMIT.456.26    The board may issue without examination a temporary permit to practice veterinary 456.27medicine in this state to a person who has submitted an application approved by the 456.28board for license pending examination, and holds a doctor of veterinary medicine degree 456.29or an equivalent degree from an approved or accredited college of veterinary medicine 456.30or an ECFVG or PAVE certification. The temporary permit shall expire the day after 456.31publication of the notice of results of the first examination given after the permit is 456.32issued. No temporary permit may be issued to any applicant who has previously failed 456.33the national examination and is currently not licensed in any licensing jurisdiction of the 456.34United States or Canada or to any person whose license has been revoked or suspended 457.1or who is currently subject to a disciplinary order in any licensing jurisdiction of the 457.2United States or Canada.457.3    Sec. 33. Minnesota Statutes 2006, section 156.12, subdivision 2, is amended to read:457.4    Subd. 2. Authorized activities. No provision of this chapter shall be construed to 457.5prohibit:457.6    (a) a person from rendering necessary gratuitous assistance in the treatment of any 457.7animal when the assistance does not amount to prescribing, testing for, or diagnosing, 457.8operating, or vaccinating and when the attendance of a licensed veterinarian cannot be 457.9procured;457.10    (b) a person who is a regular student in an accredited or approved college of 457.11veterinary medicine from performing duties or actions assigned by instructors or 457.12preceptors or working under the direct supervision of a licensed veterinarian;457.13    (c) a veterinarian regularly licensed in another jurisdiction from consulting with a 457.14licensed veterinarian in this state;457.15    (d) the owner of an animal and the owner's regular employee from caring for and 457.16administering to the animal belonging to the owner, except where the ownership of the 457.17animal was transferred for purposes of circumventing this chapter;457.18    (e) veterinarians who are in compliance with subdivision 6 and who are employed by 457.19the University of Minnesota from performing their duties with the College of Veterinary 457.20Medicine, College of Agriculture, Agricultural Experiment Station, Agricultural Extension 457.21Service, Medical School, School of Public Health, or other unit within the university; or 457.22a person from lecturing or giving instructions or demonstrations at the university or in 457.23connection with a continuing education course or seminar to veterinarians or pathologists 457.24at the University of Minnesota Veterinary Diagnostic Laboratory;457.25    (f) any person from selling or applying any pesticide, insecticide or herbicide;457.26    (g) any person from engaging in bona fide scientific research or investigations which 457.27reasonably requires experimentation involving animals;457.28    (h) any employee of a licensed veterinarian from performing duties other than 457.29diagnosis, prescription or surgical correction under the direction and supervision of the 457.30veterinarian, who shall be responsible for the performance of the employee;457.31    (i) a graduate of a foreign college of veterinary medicine from working under the 457.32direct personal instruction, control, or supervision of a veterinarian faculty member of 457.33the College of Veterinary Medicine, University of Minnesota in order to complete the 457.34requirements necessary to obtain an ECFVG or PAVE certificate.458.1    Sec. 34. Minnesota Statutes 2006, section 156.12, subdivision 4, is amended to read:458.2    Subd. 4. Titles. It is unlawful for a person who has not received a professional 458.3degree from an accredited or approved college of veterinary medicine, or ECFVG or PAVE 458.4certification, to use any of the following titles or designations: Veterinary, veterinarian, 458.5animal doctor, animal surgeon, animal dentist, animal chiropractor, animal acupuncturist, 458.6or any other title, designation, word, letter, abbreviation, sign, card, or device tending to 458.7indicate that the person is qualified to practice veterinary medicine.458.8    Sec. 35. Minnesota Statutes 2006, section 156.12, subdivision 6, is amended to read:458.9    Subd. 6. Faculty licensure. (a) Veterinary Medical Center clinicians at the College 458.10of Veterinary Medicine, University of Minnesota, who are engaged in the practice of 458.11veterinary medicine as defined in subdivision 1 and who treat animals owned by clients of 458.12the Veterinary Medical Center must possess the same license required by other veterinary 458.13practitioners in the state of Minnesota except for persons covered by paragraphs (b) and (c).458.14    (b) A specialty practitioner in a hard-to-fill faculty position who has been employed 458.15at the College of Veterinary Medicine, University of Minnesota, for five years or 458.16more prior to 2003 or is specialty board certified by the American Veterinary Medical 458.17Association or the European Board of Veterinary Specialization may be granted a specialty 458.18faculty Veterinary Medical Center clinician license which will allow the licensee to 458.19practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's 458.20training and only within the scope of employment at the Veterinary Medical Center.458.21    (c) A specialty practitioner in a hard-to-fill faculty position at the College of 458.22Veterinary Medicine, University of Minnesota, who has graduated from a board-approved 458.23foreign veterinary school may be granted a temporary faculty Veterinary Medical Center 458.24clinician license. The temporary faculty Veterinary Medical Center clinician license 458.25expires in two years and allows the licensee to practice veterinary medicine as defined 458.26in subdivision 1 and treat animals owned by clients of the Veterinary Medical Center. 458.27The temporary faculty Veterinary Medical Center clinician license allows the licensee to 458.28practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's 458.29training and only within the scope of employment at the Veterinary Medical Center while 458.30under the direct supervision of a veterinarian currently licensed and actively practicing 458.31veterinary medicine in Minnesota, as defined in section 156.04. The direct supervising 458.32veterinarian shall not have any current or past conditions, restrictions, or probationary 458.33status imposed on the veterinarian's license by the board within the past five years. The 458.34holder of a temporary faculty Veterinary Medical Center clinician license who is enrolled 458.35in a PhD program may apply for up to two additional consecutive two-year extensions 459.1of an expiring temporary faculty Veterinary Medical Center clinician license. Any other 459.2holder of a temporary faculty Veterinary Medical Center clinician license may apply for 459.3one two-year extension of the expiring temporary faculty Veterinary Medical Center 459.4clinician license. Temporary faculty Veterinary Medical Center clinician licenses that are 459.5allowed to expire may not be renewed. The board shall grant an extension to a licensee 459.6who demonstrates suitable progress toward completing the requirements of their academic 459.7program, specialty board certification, or full licensure in Minnesota by a graduate of a 459.8foreign veterinary college.459.9    (d) Temporary and specialty faculty Veterinary Medical Center clinician licensees 459.10must abide by all the laws governing the practice of veterinary medicine in the state 459.11of Minnesota and are subject to the same disciplinary action as any other veterinarian 459.12licensed in the state of Minnesota.459.13    (e) The fee for a license issued under this subdivision is the same as for a regular 459.14license to practice veterinary medicine in Minnesota. License payment deadlines, late 459.15payment fees, and other license requirements are also the same as for regular licenses.459.16    Sec. 36. Minnesota Statutes 2006, section 156.15, subdivision 2, is amended to read:459.17    Subd. 2. Service. Service of an order under this section is effective if the order is 459.18served on the person or counsel of record personally or by certified United States mail to 459.19the most recent address provided to the board for the person or counsel of record.459.20    Sec. 37. Minnesota Statutes 2006, section 156.16, subdivision 3, is amended to read:459.21    Subd. 3. Dispensing. "Dispensing" means distribution of veterinary prescription 459.22drugs or over-the-counter drugs for extra-label use or human drugs for extra-label use by a 459.23person licensed as a pharmacist by the Board of Pharmacy or a person licensed by the 459.24Board of Veterinary Medicine.459.25    Sec. 38. Minnesota Statutes 2006, section 156.16, subdivision 10, is amended to read:459.26    Subd. 10. Prescription. "Prescription" means an order from a veterinarian to a 459.27pharmacist or another veterinarian authorizing the dispensing of a veterinary prescription 459.28drug drugs, human drugs for extra-label use, or over-the-counter drugs for extra-label use459.29to a client for use on or in a patient.459.30    Sec. 39. Minnesota Statutes 2006, section 156.18, subdivision 1, is amended to read:459.31    Subdivision 1. Prescription. (a) A person may not dispense a veterinary 459.32prescription drug to a client without a prescription or other veterinary authorization. A 460.1person may not make extra-label use of an animal or human drug for an animal without a 460.2prescription from a veterinarian. A veterinarian or the veterinarian's authorized employee 460.3may dispense a veterinary prescription drug todrugs, human drugs for extra-label use, or 460.4an over-the-counter drug for extra-label use by a client or oversee the extra-label use of 460.5a veterinary drug directly by a client without a separate written prescription, providing 460.6there is documentation of the prescription in the medical record and there is an existing 460.7veterinarian-client-patient relationship. The prescribing veterinarian must monitor the use 460.8of veterinary prescription drugs, human drugs for extra-label use, or over-the-counter 460.9drugs for extra-label use by a client.460.10    (b) A veterinarian may dispense prescription veterinary drugs and prescribe and 460.11dispense extra-label use drugs to a client without personally examining the animal if 460.12a bona fide veterinarian-client-patient relationship exists and in the judgment of the 460.13veterinarian the client has sufficient knowledge to use the drugs properly.460.14    (c) A veterinarian may issue a prescription or other veterinary authorization by oral or 460.15written communication to the dispenser, or by computer connection. If the communication 460.16is oral, the veterinarian must enter it into the patient's record. The dispenser must record 460.17the veterinarian's prescription or other veterinary authorization within 72 hours.460.18    (d) A prescription or other veterinary authorization must include:460.19    (1) the name, address, and, if written, the signature of the prescriber;460.20    (2) the name and address of the client;460.21    (3) identification of the species for which the drug is prescribed or ordered;460.22    (4) the name, strength, and quantity of the drug;460.23    (5) the date of issue;460.24    (6) directions for use; and460.25    (7) withdrawal time., if applicable; and460.26    (8) number of authorized refills.460.27    (e) A veterinarian may, in the course of professional practice and an existing 460.28veterinarian-client-patient relationship, prepare medicaments that combine drugs approved 460.29by the United States Food and Drug Administration and other legally obtained ingredients 460.30with appropriate vehicles.460.31    (f) A veterinarian or a bona fide employee of a veterinarian may dispense veterinary 460.32prescription drugs to a person on the basis of a prescription issued by a licensed 460.33veterinarian. The provisions of paragraphs (c) and (d) apply.460.34    (g) This section does not limit the authority of the Minnesota Racing Commission to 460.35regulate veterinarians providing services at a licensed racetrack.461.1    Sec. 40. Minnesota Statutes 2006, section 156.18, subdivision 2, is amended to read:461.2    Subd. 2. Label of dispensed veterinary drugs. (a) A veterinarian or the 461.3veterinarian's authorized agent or employee dispensing a veterinary prescription drug 461.4or prescribing the extra-label use of an over-the-counter drug, an over-the-counter drug 461.5for extra-label use, or a human drug for extra-label use must provide written information 461.6which includes the name and address of the veterinarian, date of filling, species of patient, 461.7name or names of drug, strength of drug or drugs, directions for use, withdrawal time, 461.8and cautionary statements, if any, appropriate for the drug.461.9    (b) If the veterinary drug has been prepared, mixed, formulated, or packaged by the 461.10dispenser, all of the information required in paragraph (a) must be provided on a label 461.11affixed to the container.461.12    (c) If the veterinary drug is in the manufacturer's original package, the information 461.13required in paragraph (a) must be supplied in writing but need not be affixed to the 461.14container. Information required in paragraph (a) that is provided by the manufacturer on 461.15the original package does not need to be repeated in the separate written information. 461.16Written information required by this paragraph may be written on the sales invoice.461.17    Sec. 41. Minnesota Statutes 2006, section 156.19, is amended to read:461.18156.19 EXTRA-LABEL USE.461.19    A person, other than a veterinarian or a person working under the controlan 461.20employee of a veterinarian, must not make extra-label use of a veterinary drug in or 461.21on a food-producing animal, unless permitted by the prescription of a veterinarian. A 461.22veterinarian may prescribe the extra-label use of a veterinary drug if:461.23    (1) the veterinarian makes a careful medical diagnosis within the context of a valid 461.24veterinarian-client-patient relationship;461.25    (2) the veterinarian determines that there is no marketed drug specifically labeled to 461.26treat the condition diagnosed, or that drug therapy as recommended by the labeling has, in 461.27the judgment of the attending veterinarian, been found to be clinically ineffective;461.28    (3) the veterinarian recommends procedures to ensure that the identity of the treated 461.29animal will be carefully maintained; and461.30    (4) the veterinarian prescribes a significantly extended time period for drug 461.31withdrawal before marketing meat, milk, or eggs.; and461.32    (5) the veterinarian has met the criteria established in Code of Federal Regulations, 461.33title 21, part 530, which define the extra-label use of medication in or on animals.462.1    Sec. 42. Minnesota Statutes 2006, section 198.075, is amended to read:462.2198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED 462.3FROM COMMISSARY PRIVILEGES.462.4    Except as provided in this section, no commissary privileges including food, laundry 462.5service, janitorial service, and household supplies shall be furnished to any employee of 462.6the Minnesota veterans homes. An employee of the Minnesota veterans homes who works 462.7a second shift that is consecutive with a regularly scheduled shift may be allowed one free 462.8meal at the veterans home on the day of that extra shift.462.9    Sec. 43. Minnesota Statutes 2006, section 256B.0625, subdivision 14, is amended to 462.10read:462.11    Subd. 14. Diagnostic, screening, and preventive services. (a) Medical assistance 462.12covers diagnostic, screening, and preventive services.462.13    (b) "Preventive services" include services related to pregnancy, including:462.14    (1) services for those conditions which may complicate a pregnancy and which may 462.15be available to a pregnant woman determined to be at risk of poor pregnancy outcome;462.16    (2) prenatal HIV risk assessment, education, counseling, and testing; and462.17    (3) alcohol abuse assessment, education, and counseling on the effects of alcohol 462.18usage while pregnant. Preventive services available to a woman at risk of poor pregnancy 462.19outcome may differ in an amount, duration, or scope from those available to other 462.20individuals eligible for medical assistance.462.21    (c) "Screening services" include, but are not limited to, blood lead tests. Screening 462.22services also include, for children with blood lead levels equal to or greater than five 462.23micrograms of lead per deciliter of whole blood, environmental investigations to 462.24determine the source of lead exposure. Reimbursement is limited to a health professional's 462.25time and activities during an on-site investigation of a child's home or primary residence.462.26    Sec. 44. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 462.27subdivision to read:462.28    Subd. 49.Lead risk assessments.(a) Effective October 1, 2007, or six months after 462.29federal approval, whichever is later, medical assistance covers lead risk assessments 462.30provided by a lead risk assessor who is licensed by the commissioner of health under 462.31section 144.9505 and employed by an assessing agency as defined in section 144.9501. 462.32Medical assistance covers a onetime on-site investigation of a recipient's home or primary 462.33residence to determine the existence of lead so long as the recipient is under the age 463.1of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2, 463.2paragraph (a).463.3    (b) Medical assistance reimbursement covers the lead risk assessor's time to 463.4complete the following activities:463.5    (1) gathering samples;463.6    (2) interviewing family members;463.7    (3) gathering data, including meter readings; and463.8    (4) providing a report with the results of the investigation and options for reducing 463.9lead-based paint hazards.463.10    Medical assistance coverage of lead risk assessment does not include testing of 463.11environmental substances such as water, paint, or soil or any other laboratory services. 463.12Medical assistance coverage of lead risk assessments is not included in the capitated 463.13services for children enrolled in health plans through the prepaid medical assistance 463.14program and the MinnesotaCare program.463.15    (c) Payment for lead risk assessment must be cost-based and must meet the criteria 463.16for federal financial participation under the Medicaid program. The rate must be based 463.17on allowable expenditures from cost information gathered. Under section 144.9507, 463.18subdivision 5, federal medical assistance funds may not replace existing funding for 463.19lead-related activities. The nonfederal share of costs for services provided under this 463.20subdivision must be from state or local funds and is the responsibility of the agency 463.21providing the risk assessment. Eligible expenditures for the nonfederal share of costs may 463.22not be made from federal funds or funds used to match other federal funds. Any federal 463.23disallowances are the responsibility of the agency providing risk assessment services.463.24    Sec. 45. [325E.385] PRODUCTS CONTAINING POLYBROMINATED 463.25DIPHENYL ETHER.463.26    Subdivision 1.Definitions.For the purposes of sections 325E.386 to 325E.388, 463.27the terms in this section have the meanings given them.463.28    Subd. 2.Commercial decabromodiphenyl ether."Commercial 463.29decabromodiphenyl ether" means the chemical mixture of decabromodiphenyl ether, 463.30including associated polybrominated diphenyl ether impurities not intentionally added.463.31    Subd. 3.Commissioner."Commissioner" means the commissioner of the Pollution 463.32Control Agency.463.33    Subd. 4.Manufacturer."Manufacturer" means any person, firm, association, 463.34partnership, corporation, governmental entity, organization, or joint venture that produces 464.1a product containing polybrominated diphenyl ethers or an importer or domestic 464.2distributor of a noncomestible product containing polybrominated diphenyl ethers.464.3    Subd. 5.Polybrominated diphenyl ethers or PBDE's."Polybrominated diphenyl 464.4ethers" or "PBDE's" means chemical forms that consist of diphenyl ethers bound with 464.5bromine atoms. Polybrominated diphenyl ethers include, but are not limited to, the 464.6three primary forms of the commercial mixtures known as pentabromodiphenyl ether, 464.7octabromodiphenyl ether, and decabromodiphenyl ether.464.8    Subd. 6.Retailer."Retailer" means a person who offers a product for sale at retail 464.9through any means, including, but not limited to, remote offerings such as sales outlets, 464.10catalogs, or the Internet, but does not include a sale that is a wholesale transaction with a 464.11distributor or a retailer.464.12    Subd. 7.Used product."Used product" means any product that has been previously 464.13owned, purchased, or sold in commerce. Used product does not include any product 464.14manufactured after January 1, 2008.464.15    Sec. 46. [325E.386] PRODUCTS CONTAINING CERTAIN 464.16POLYBROMINATED DIPHENYL ETHERS BANNED; EXEMPTIONS.464.17    Subdivision 1.Penta- and octabromodiphenyl ethers.Except as provided in 464.18subdivision 3, beginning January 1, 2008, a person may not manufacture, process, or 464.19distribute in commerce a product or flame-retardant part of a product containing more 464.20than one-tenth of one percent of pentabromodiphenyl ether or octabromodiphenyl ether 464.21by mass.464.22    Subd. 2.Exemptions.The following products containing polybrominated diphenyl 464.23ethers are exempt from subdivision 1:464.24    (1) the sale or distribution of any used transportation vehicle with component parts 464.25containing polybrominated diphenyl ethers;464.26    (2) the sale or distribution of any used transportation vehicle parts or new 464.27transportation vehicle parts manufactured before January 1, 2008, that contain 464.28polybrominated diphenyl ethers;464.29    (3) the manufacture, sale, repair, distribution, maintenance, refurbishment, or 464.30modification of equipment containing polybrominated diphenyl ethers and used primarily 464.31for military or federally funded space program applications. This exemption does not 464.32cover consumer-based goods with broad applicability;464.33    (4) the sale or distribution by a business, charity, public entity, or private party of 464.34any used product containing polybrominated diphenyl ethers;465.1    (5) the manufacture, sale, or distribution of new carpet cushion made from recycled 465.2foam containing more than one-tenth of one percent penta polybrominated diphenyl 465.3ether; or465.4    (6) medical devices.465.5    In-state retailers in possession of products on January 1, 2008, that are banned for 465.6sale under subdivision 1 may exhaust their stock through sales to the public. Nothing in 465.7this section restricts the ability of a manufacturer, importer, or distributor  from transporting 465.8products containing polybrominated diphenyl ethers through the state,  or storing such 465.9products in the state for later distribution outside the state.465.10    Sec. 47. [325E.387] REVIEW OF DECABROMODIPHENYL ETHER.465.11    Subdivision 1.Commissioner duties.The commissioner in consultation 465.12with the commissioners of health and public safety shall review uses of commercial 465.13decabromodiphenyl ether, availability of technically feasible and safer alternatives, fire 465.14safety and any evidence regarding the potential harm to public health and the environment 465.15posed by commercial decabromodiphenyl ether and the alternatives. The commissioner 465.16must consult with key stakeholders. The commissioner must also review the findings from 465.17similar state and federal agencies and must report their findings and recommendations to 465.18the appropriate committees of the legislature no later than January 15, 2008.465.19    Subd. 2.State procurement.By January 1, 2008, the commissioner of 465.20administration shall make available for purchase and use by all state agencies only 465.21equipment, supplies, and other products that do not contain polybrominated diphenyl 465.22ethers, unless exempted under section 325E.386, subdivision 2.465.23    Sec. 48. [325E.388] PENALTIES.465.24    A manufacturer who violates sections 325E.386 to 325E.388 is subject to a 465.25civil penalty not to exceed $1,000 for each violation in the case of a first offense. A 465.26manufacturer is subject to a civil penalty not to exceed $5,000 for each repeat offense. 465.27Penalties collected under this section must be deposited in an account in the special 465.28revenue fund and are appropriated in fiscal years 2008 and 2009 to the commissioner to 465.29implement and enforce this section.465.30    Sec. 49. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2, 465.31is amended to read:

465.32465.33Subd. 2.Community and Family Health Improvement

466.1Summary by Fund466.2General40,413,00040,382,000466.3466.4State Government 
                  		Special Revenue141,000128,000466.5Health Care Access3,510,0003,516,000466.6Federal TANF6,000,0006,000,000

466.7Family Planning Base Reduction. Base 466.8level funding for the family planning 466.9special projects grant program is reduced 466.10by $1,877,000 each year of the biennium 466.11beginning July 1, 2007, provided that 466.12this reduction shall only take place 466.13upon full implementation of the family 466.14planning project section of the 1115 waiver. 466.15Notwithstanding Minnesota Statutes, section 466.16145.925, the commissioner shall give priority 466.17to community health care clinics providing 466.18family planning services that either serve a 466.19high number of women who do not qualify 466.20for medical assistance or are unable to 466.21participate in the medical assistance program 466.22as a medical assistance provider when 466.23allocating the remaining appropriations. 466.24Notwithstanding section 15, this paragraph 466.25shall not expire.466.26Shaken Baby Video. Of the state 466.27government special revenue fund 466.28appropriation, $13,000 in 2006 is 466.29appropriated to the commissioner of health 466.30to provide a video to hospitals on shaken 466.31baby syndrome. The commissioner of health 466.32shall assess a fee to hospitals to cover the 466.33cost of the approved shaken baby video and 466.34the revenue received is to be deposited in the 466.35state government special revenue fund.467.1    Sec. 50. FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.467.2    The commissioner of health, in conjunction with the commissioner of the Pollution 467.3Control Agency, shall establish an environmental justice mapping program and shall 467.4apply for federal funding to renew and expand the state's environmental justice mapping 467.5capacity in order to promote public health tracking. The commissioner shall coordinate 467.6the project with the Pollution Control Agency and the Department of Agriculture in order 467.7to explore possible links between environmental health and toxic exposures and to help 467.8create a system for environmental public health tracking. The commissioner shall also 467.9make recommendations to the legislature for additional sources of funding within the state.467.10EFFECTIVE DATE.This section is effective the day following final enactment.467.11    Sec. 51. LEGISLATIVE FINDINGS AND PURPOSE.467.12    The legislature hereby finds that hearing loss occurs in newborn infants more 467.13frequently than any other health condition for which newborn infant screening is required. 467.14Early detection of hearing loss in a child and early intervention and treatment has been 467.15demonstrated to be highly effective in facilitating a child's healthy development in a 467.16manner consistent with the child's age, language acquisition, and cognitive ability. 467.17Without early hearing detection and intervention, children with hearing loss experience 467.18serious delays in language acquisition and social and cognitive development. With 467.19appropriate testing and identification of newborn infants, hearing loss screening will 467.20facilitate early intervention and treatment and will serve the public purpose of promoting 467.21the healthy development of children.467.22    For these reasons, the legislature hereby determines that it is beneficial and in the 467.23best interests of the development of the children of the state of Minnesota that newborn 467.24infants' hearing be screened.467.25    Sec. 52. INFORMATION SHARING.467.26    By August 1, 2007, the commissioner of health, the Pollution Control Agency, the 467.27commissioner of agriculture, and the University of Minnesota are requested to jointly 467.28develop and sign a memorandum of understanding declaring their intent to share new 467.29and existing environmental hazard, exposure, and health outcome data, consistent with 467.30applicable data practices laws, and to cooperate and communicate effectively to ensure 467.31sufficient clarity and understanding of the data between these organizations.467.32    Sec. 53. COMMISSIONER OF HEALTH REPORT; ROUTINE RADIATION 467.33EMISSIONS.468.1    The commissioner of health, within the limits of available appropriations, in 468.2cooperation with the utilities that own the Monticello and Prairie Island nuclear plants, 468.3shall issue a report detailing where routine radiation releases go and the health impacts of 468.4the radiation emissions on affected communities. By April 1, 2008, the report must be 468.5distributed to house and senate committees having jurisdiction over public health and to 468.6all communities that are part of the emergency response planning.468.7    Sec. 54. FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.468.8    Subdivision 1.Purpose.Recognizing that scented products may trigger asthma or 468.9chemical sensitivity reactions in students and school staff, which can contribute to learning 468.10and breathing problems, the commissioner of health shall develop a fragrance-free schools 468.11education pilot project.468.12    Subd. 2.Education.The commissioner of health, in collaboration with the 468.13commissioner of education and the Minneapolis Board of Education, shall establish a 468.14working group composed of at least three students, two teachers, one school administrator, 468.15and one member of the Minneapolis Board of Education to recommend an education 468.16campaign in Minneapolis public schools to inform students and parents about the 468.17potentially harmful effects of the use of fragrance products on sensitive students and 468.18school personnel in Minneapolis schools. The commissioner shall report findings to the 468.19legislature by February 1, 2008.468.20EFFECTIVE DATE.This section is effective the day following final enactment.468.21    Sec. 55. LINDANE COMMITTEE.468.22    The commissioner of health shall create a committee of stakeholders, including 468.23at least one environmental health research scientist and at least one parent consumer 468.24advocate, to review the scientific literature and make recommendations to the legislature 468.25on the health impact of Lindane on children and report back by January 15, 2008.468.26    Sec. 56. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.468.27    The commissioner of human services shall ensure that testing for arsenic under 468.28Minnesota Statutes, section 144.967, is covered under medical assistance.468.29    Sec. 57. BLOOD LEAD TESTING STUDY.468.30    The commissioner of health, in consultation with the Department of Human 468.31Services; cities of the first class; health care providers; and other interested parties shall 469.1conduct a study to evaluate blood lead testing methods used to confirm elevated blood 469.2lead status. The study shall examine and/or develop:469.3    (1) the false positive rate of capillary tests for children less than 72 months old;469.4    (2) current protocols for conducting capillary testing, including filter paper 469.5methodology;469.6    (3) existing guidelines and regulations from other states and federal agencies 469.7regarding lead testing;469.8    (4) recommendations regarding the use of capillary tests to initiate environmental 469.9investigations and case management, including number and timing of tests and fiscal 469.10implications for state and local lead programs; and469.11    (5) recommendations regarding reducing the state mandatory intervention to ten 469.12micrograms of lead per deciliter of whole blood.469.13    The commissioner shall submit the results of the study and any recommendations, 469.14including any necessary legislative changes, to the legislature by February 15, 2008.469.15    Sec. 58. WINDOW SAFETY EDUCATION.469.16    The commissioner of health shall create in the department's current educational 469.17safety program a component targeted at parents and caregivers of young children to 469.18provide awareness of the need to take precautions to prevent children from falling 469.19through open windows. The commissioner of health shall consult with representatives 469.20of the residential building industry, the window products industry, the child safety 469.21advocacy community, and the Department of Labor and Industry to create the window 469.22safety program component. The program must include the gathering of data about 469.23falls from windows that result in severe injury in order to measure the effectiveness of 469.24the safety program. The commissioner of health may consult with other child safety 469.25advocacy groups, experts, and interested parties in the development and implementation 469.26of the window safety program. The commissioner of health shall prepare and submit 469.27a final report on the window safety program to the legislature by March 1, 2011. The 469.28commissioner shall prepare and submit a yearly progress report to the legislature by 469.29March 1 of each year beginning in 2008 until the submission of the final report. The 469.30final report must include a summary of the safety program, the impact of the program on 469.31children falling from windows, and any recommendations for further study or action.469.32    Sec. 59. REVISOR'S INSTRUCTION.470.1    The revisor of statutes shall change the range reference "144.9501 to 144.9509" 470.2to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and 470.3Minnesota Rules.470.4    Sec. 60.  REPEALER.470.5Laws 2004, chapter 288, article 6, section 27, is repealed.470.6ARTICLE 11470.7HUMAN SERVICES FORECAST ADJUSTMENTS

470.8470.9Section 1.  SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

470.10    The dollar amounts shown are added to or, if shown in parentheses, are subtracted 470.11from the appropriations in Laws 2006, chapter 282, from the general fund, or any other 470.12fund named, to the Department of Human Services for the purposes specified in this 470.13article, to be available for the fiscal year indicated for each purpose. The figure "2007" 470.14used in this article means that the appropriation or appropriations listed are available 470.15for the fiscal year ending June 30, 2007.

470.162007470.17General Fund$(25,226,000)470.18Health Care Access$(53,980,000)470.19TANF$(24,805,000)470.20Total$(104,011,000)

470.21470.22Sec. 2. COMMISSIONER OF HUMAN SERVICES

470.23Subdivision 1.Total Appropriation$(104,011,000)

470.24Appropriations by Fund470.252007470.26General(25,226,000)470.27Health Care Access(53,980,000)470.28TANF(24,805,000)

470.29Subd. 2.Revenue and Pass Through

470.30TANF(106,000)

470.31470.32Subd. 3.Children and Economic Assistance Grants

470.33General3,221,000470.34TANF(24,699,000)

471.1The amounts that may be spent from this 471.2appropriation for each purpose are as follows:

471.3(a) MFIP/DWP Grants471.4General13,827,000471.5TANF(24,699,000)

471.6(b) MFIP Child Care Assistance Grants471.7General(4,733,000)

471.8(c) General Assistance Grants471.9General1,081,000

471.10(d) Minnesota Supplemental Aid Grants471.11General(1,099,000)

471.12(e) Group Residential Housing Grants471.13General(5,855,000)

471.14Subd. 4.Basic Health Care Grants

471.15General17,592,000471.16Health Care Access(53,980,000)

471.17The amounts that may be spent from this 471.18appropriation for each purpose are as follows:

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

471.20(b) MA Basic Health Care - Families and Children471.21General15,729,000

471.22(c) MA Basic Health Care - Elderly and Disabled471.23General(4,540,000)

471.24(d) General Assistance Medical Care471.25General6,403,000

471.26Subd. 5.Continuing Care Grants

471.27General(46,039,000)

471.28The amounts that may be spent from this 471.29appropriation for each purpose are as follows:

471.30(a) MA Long-Term Care Facilities471.31General(15,028,000)

471.32(b) MA Long-Term Care Waivers471.33General(20,677,000)

472.1(c) Chemical Dependency Entitlement Grants472.2General(10,334,000)

472.3    Sec. 3. EFFECTIVE DATE.472.4    Sections 1 and 2 are effective the day following final enactment.472.5ARTICLE 12472.6HUMAN SERVICES APPROPRIATIONS

472.7Section 1. SUMMARY OF APPROPRIATIONS.

472.8    The amounts shown in this section summarize direct appropriations, by fund, made 472.9in this article.

472.1020082009Total472.11General$4,836,759,000$5,194,751,000$10,031,510,000472.12472.13State Government Special Revenue55,737,00056,428,000112,165,000472.14Health Care Access436,050,000549,573,000985,623,000472.15Federal TANF266,864,000277,866,000544,730,000472.16Environment Fund300,000300,000600,000472.17Lottery Prize Fund2,184,0001,787,0003,971,000472.18Total$5,597,894,000$6,080,705,000$11,678,599,000

472.19Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

472.20    The sums shown in the columns marked "Appropriations" are appropriated to the 472.21agencies and for the purposes specified in this article. The appropriations are from the 472.22general fund, or another named fund, and are available for the fiscal years indicated 472.23for each purpose. The figures "2008" and "2009" used in this article mean that the 472.24appropriations listed under them are available for the fiscal year ending June 30, 2008, or 472.25June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal 472.26year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal 472.27year ending June 30, 2007, are effective the day following final enactment.

472.28APPROPRIATIONS472.29Available for the Year472.30Ending June 30472.3120082009

472.32Sec. 3. HUMAN SERVICES

472.33Subdivision 1.Total Appropriation$5,356,970,000$5,848,682,000

473.1Appropriations by Fund473.220082009473.3General4,688,475,0005,050,169,000473.4473.5State Government Special Revenue545,000555,000473.6Health Care Access409,602,000529,655,000473.7Federal TANF255,514,000265,866,000473.8Lottery Prize Fund2,184,0001,787,000

473.9The amounts that may be spent for each 473.10purpose are specified in the following 473.11subdivisions.473.12Receipts for Systems Projects.473.13Appropriations and federal receipts for 473.14information system projects for MAXIS, 473.15PRISM, MMIS, and SSIS must be deposited 473.16in the state system account authorized in 473.17Minnesota Statutes, section 256.014. Money 473.18appropriated for computer projects approved 473.19by the Minnesota Office of Enterprise 473.20Technology, funded by the legislature, and 473.21approved by the commissioner of finance, 473.22may be transferred from one project to 473.23another and from development to operations 473.24as the commissioner of human services 473.25considers necessary. Any unexpended 473.26balance in the appropriation for these 473.27projects does not cancel but is available for 473.28ongoing development and operations.473.29Systems Continuity. In the event of 473.30disruption of technical systems or computer 473.31operations, the commissioner may use 473.32available grant appropriations to ensure 473.33continuity of payments for maintaining the 473.34health, safety, and well-being of clients 473.35served by programs administered by the 473.36Department of Human Services. Grant funds 474.1must be used in a manner consistent with the 474.2original intent of the appropriation.474.3Nonfederal Share Transfers. The 474.4nonfederal share of activities for which 474.5federal administrative reimbursement is 474.6appropriated to the commissioner may be 474.7transferred to the special revenue fund.474.8Gifts. Notwithstanding Minnesota 474.9Statutes, sections 16A.013 to 16A.016, the 474.10commissioner may accept, on behalf of the 474.11state, additional funding from sources other 474.12than state funds for the purpose of financing 474.13the cost of assistance program grants or 474.14nongrant administration. All additional 474.15funding is appropriated to the commissioner 474.16for use as designated by the grantor of 474.17funding.474.18TANF Funds Appropriated to Other 474.19Entities. Any expenditures from the TANF 474.20block grant shall be expended according 474.21to the requirements and limitations of part 474.22A of title IV of the Social Security Act, as 474.23amended, and any other applicable federal 474.24requirement or limitation. Prior to any 474.25expenditure of these funds, the commissioner 474.26shall ensure that funds are expended in 474.27compliance with the requirements and 474.28limitations of federal law and that any 474.29reporting requirements of federal law are 474.30met. It shall be the responsibility of any entity 474.31to which these funds are appropriated to 474.32implement a memorandum of understanding 474.33with the commissioner that provides the 474.34necessary assurance of compliance prior to 474.35any expenditure of funds. The commissioner 475.1shall receipt TANF funds appropriated 475.2to other state agencies and coordinate all 475.3related interagency accounting transactions 475.4necessary to implement these appropriations. 475.5Unexpended TANF funds appropriated to 475.6any state, local, or nonprofit entity cancel 475.7at the end of the state fiscal year unless 475.8appropriating or statutory language permits 475.9otherwise.475.10TANF Block Grant. Of this amount, 475.11$750,000 the first year and $750,000 the 475.12second year are onetime appropriations 475.13from the state's federal TANF block grant 475.14under Title I of Public Law 104-193. If the 475.15appropriation in either year is insufficient, the 475.16appropriation for the other year is available.475.17TANF Maintenance of Effort. (a) In 475.18order to meet the basic maintenance of 475.19effort (MOE) requirements of the TANF 475.20block grant specified under Code of Federal 475.21Regulations, title 45, section 263.1, the 475.22commissioner may only report nonfederal 475.23money expended for allowable activities 475.24listed in the following clauses as TANF/MOE 475.25expenditures:475.26(1) MFIP cash, diversionary work program, 475.27and food assistance benefits under Minnesota 475.28Statutes, chapter 256J;475.29(2) the child care assistance programs 475.30under Minnesota Statutes, sections 119B.03 475.31and 119B.05, and county child care 475.32administrative costs under Minnesota 475.33Statutes, section 119B.15;476.1(3) state and county MFIP administrative 476.2costs under Minnesota Statutes, chapters 476.3256J and 256K;476.4(4) state, county, and tribal MFIP 476.5employment services under Minnesota 476.6Statutes, chapters 256J and 256K;476.7(5) expenditures made on behalf of 476.8noncitizen MFIP recipients who qualify 476.9for the medical assistance without federal 476.10financial participation program under 476.11Minnesota Statutes, section 256B.06, 476.12subdivision 4, paragraphs (d), (e), and (j); 476.13and476.14(6) qualifying working family credit 476.15expenditures under Minnesota Statutes, 476.16section 290.0671.476.17(b) The commissioner shall ensure that 476.18sufficient qualified nonfederal expenditures 476.19are made each year to meet the state's 476.20TANF/MOE requirements. For the activities 476.21listed in paragraph (a), clauses (2) to 476.22(6), the commissioner may only report 476.23expenditures that are excluded from the 476.24definition of assistance under Code of 476.25Federal Regulations, title 45, section 260.31.476.26(c) The commissioner shall ensure that 476.27the maintenance of effort used by the 476.28commissioner of finance for the February 476.29and November forecasts required under 476.30Minnesota Statutes, section 16A.103, 476.31contains expenditures under paragraph (a), 476.32clause (1), equal to at least 25 percent of 476.33the total required under Code of Federal 476.34Regulations, title 45, section 263.1.477.1(d) Minnesota Statutes, section 256.011, 477.2subdivision 3, which requires that federal 477.3grants or aids secured or obtained under that 477.4subdivision be used to reduce any direct 477.5appropriations provided by law, does not 477.6apply if the grants or aids are federal TANF 477.7funds.477.8(e) Notwithstanding section 13, this rider 477.9expires June 30, 2011.477.10Working Family Credit Expenditures 477.11as TANF/MOE. The commissioner may 477.12claim as TANF maintenance of effort up 477.13to $6,707,000 per year for fiscal year 2008 477.14through fiscal year 2011. Notwithstanding 477.15section 13, this rider expires June 30, 2011.477.16Additional Working Family Credit 477.17Expenditures to be Claimed for 477.18TANF/MOE. In addition to the amounts 477.19provided in this section, the commissioner 477.20may count the following amounts of working 477.21family credit expenditure as TANF/MOE:477.22(1) fiscal year 2008, $4,269,000; and477.23(2) fiscal year 2009, $4,889,000.477.24Notwithstanding section 13, this rider expires 477.25June 30, 2011.477.26Capitation Rate Increase. Of the health care 477.27access fund appropriations to the University 477.28of Minnesota in the higher education 477.29omnibus appropriation bill, $2,157,000 in 477.30fiscal year 2008 and $2,157,000 in fiscal year 477.312009 are to be used to increase the capitation 477.32payments under Minnesota Statutes, section 477.33256B.69. 478.1Health Care Access Fund Transfer.478.2Notwithstanding Minnesota Statutes, section 478.3295.581, in addition to the transfers in 478.4Minnesota Statutes, section 16A.724, 478.5subdivision 2, the commissioner of finance 478.6shall transfer up to the following amounts 478.7from the health care access fund to the 478.8general fund on June 30 of each fiscal year:478.9(1) fiscal year 2008, $6,416,000;478.10(2) fiscal year 2009, $5,643,000;478.11(3) fiscal year 2010, $6,677,000; and478.12(4) fiscal year 2011, $7,866,000.478.13Notwithstanding section 13, this rider expires 478.14June 30, 2011.

478.15Subd. 2.Agency Management57,727,00058,161,000

478.16Appropriations by Fund478.17General48,413,00048,882,000478.18478.19State Government Special Revenue424,000432,000478.20Health Care Access8,018,0007,975,000478.21Federal TANF222,000222,000

478.22The amounts that may be spent from the 478.23appropriation for each purpose are as follows:

478.24(a) Financial Operations

478.25Appropriations by Fund478.26General7,102,0007,523,000478.27Health Care Access889,000880,000478.28Federal TANF122,000122,000

478.29(b) Legal and Regulation Operations

478.30Appropriations by Fund478.31General13,037,00013,138,000478.32478.33State Government Special Revenue424,000432,000478.34Health Care Access891,000908,000478.35Federal TANF100,000100,000

479.1Base Adjustment. The general fund base is 479.2decreased by $177,000 in fiscal year 2010 479.3and $353,000 in fiscal year 2011 for legal 479.4and regulatory.479.5Child Care Licensing. $697,000 is 479.6appropriated from the general fund to 479.7the commissioner of human services for 479.8the biennium beginning July 1, 2007, for 479.9purposes of completing background studies 479.10for family and group family child care 479.11providers under Minnesota Statutes, chapter 479.12245C. This appropriation will be $288,000 in 479.13fiscal year 2010 and $112,000 in fiscal year 479.142011.

479.15(c) Management Operations

479.16Appropriations by Fund479.17General4,390,0004,433,000479.18Health Care Access234,000238,000

479.19(d) Information Technology Operations

479.20Appropriations by Fund479.21General23,884,00023,788,000479.22Health Care Access6,004,0005,949,000

479.23479.24Subd. 3.Revenue and Pass-Through Expenditures66,842,00069,723,000

479.25Federal TANF 66,842,00069,723,000

479.26TANF Transfer to Federal Child Care 479.27and Development Fund. The following 479.28TANF fund amounts are appropriated to 479.29the commissioner for the purposes of MFIP 479.30transition year child care under MFIP, 479.31Minnesota Statutes, section 119B.05:479.32(1) fiscal year 2008, $10,333,000479.33(2) fiscal year 2009, $12,826,000479.34(3) fiscal year 2010, $4,104,000 and480.1(4) fiscal year 2011, $5,460,000.480.2The commissioner shall authorize transfer 480.3of sufficient TANF funds to the federal 480.4child care and development fund to meet 480.5this appropriation and shall ensure that all 480.6transferred funds are expended according 480.7the federal child care and development fund 480.8regulations.

480.9480.10Subd. 4.Children and Economic Assistance Grants749,318,000730,623,000

480.11Appropriations by Fund480.12General561,814,000535,898,000480.13Federal TANF187,254,000194,725,000480.14Health Care Access250,000-0-

480.15The amounts that may be spent from this 480.16appropriation for each purpose are as follows:

480.17(a) MFIP/DWP Grants

480.18Appropriations by Fund480.19General62,000,00061,911,000480.20Federal TANF82,532,00090,003,000

480.21(b) Support Services Grants

480.22Appropriations by Fund480.23General8,815,0009,465,000480.24Federal TANF103,382,000103,382,000

480.25TANF Prior Appropriation Cancellation.480.26Notwithstanding Laws 2001, First Special 480.27Session chapter 9, article 17, section 480.282, subdivision 11, paragraph (b), any 480.29unexpended TANF funds appropriated to the 480.30commissioner to contract with the Board of 480.31Trustees of Minnesota State Colleges and 480.32Universities, to provide tuition waivers to 480.33employees of health care and human service 480.34providers that are members of qualifying 480.35consortia operating under Minnesota 481.1Statutes, sections 116L.10 to 116L.15, must 481.2cancel at the end of fiscal year 2007.481.3MFIP Pilot Program. Of the general fund 481.4appropriation, $100,000 in fiscal year 2008 481.5and $750,000 in fiscal year 2009 are for a 481.6grant to the Stearns-Benton Employment and 481.7Training Council for the Workforce U pilot 481.8program.481.9Work Study. $750,000 in fiscal year 481.102008 and $750,000 in fiscal year 2009 are 481.11appropriated from the TANF reserve account 481.12to the Minnesota Office of Higher Education 481.13for work study grants under Minnesota 481.14Statutes, section 136A.233, specifically 481.15for low-income individuals who receive 481.16assistance under Minnesota Statutes, chapter 481.17256J.

481.18(c) MFIP Child Care Assistance Grants

481.19General74,797,00073,699,000

481.20481.21(d) Basic Sliding Fee Child Care Assistance Grants

481.22General43,012,00045,432,000

481.23Base Adjustment. The general fund base 481.24is increased by $1,262,000 in fiscal year 481.252010 and decreased by $951,000 in fiscal 481.26year 2011 for basic sliding fee child care 481.27assistance grants.

481.28(e) Child Care Development Grants

481.29General5,865,0005,865,000

481.30Child Care Services Grants. $5,000,000 481.31is appropriated from the general fund to 481.32the commissioner of human services for 481.33the biennium beginning July 1, 2007, for 481.34purposes of providing child care services 482.1grants under Minnesota Statutes, section 482.2119B.21, subdivision 5. This appropriation 482.3is for the 2008-2009 biennium only, and does 482.4not increase the base funding.482.5Early Childhood Professional 482.6Development System. $2,000,000 is 482.7appropriated from the general fund to 482.8the commissioner of human services for 482.9the biennium beginning July 1, 2007, for 482.10purposes of the early childhood professional 482.11development system, which increases the 482.12quality and continuum of professional 482.13development opportunities for child care 482.14practitioners. This appropriation is for the 482.152008-2009 biennium only, and does not 482.16increase the base funding.482.17Family, Friend, and Neighbor Grant 482.18Program. $750,000 in fiscal year 2008 and 482.19$750,000 in fiscal year 2009 are appropriated 482.20from the general fund to the commissioner 482.21of human services for the family, friend, 482.22and neighbor grant program in section 31. 482.23Any balance in the first year does not cancel 482.24but is available in the second year. This 482.25appropriation is for the 2008-2009 biennium 482.26only, and does not increase the base funding. 482.27(f) Increased Child Care Provider 482.28Connections. (1) $200,000 is appropriated 482.29from the general fund to the commissioner of 482.30human services for the biennium beginning 482.31July 1, 2007, for the following purposes: 482.32$100,000 each year is for a grant to Hennepin 482.33County, and  $100,000 each year is for a grant 482.34to Ramsey County. The two counties shall 482.35each contract with a nonprofit organization 483.1to work with the contracting county 483.2and county-based licensed family child 483.3care providers to facilitate county-based 483.4information regarding family and children's 483.5resources and to make training and peer 483.6support available to licensed family child 483.7care providers consistent with clause (2). 483.8These appropriations are available until 483.9June 30, 2009, and shall not become part 483.10of base-level funding for the biennium 483.11beginning July 1, 2009.483.12(2) Programs to improve child care provider 483.13connections to county services shall be 483.14established in Hennepin and Ramsey 483.15counties to:483.16(i) improve county contact activities 483.17with county-licensed family child care 483.18providers that facilitate utilization of county 483.19educational, social service, public health, 483.20and economic assistance services by eligible 483.21families, parents, and children using licensed 483.22family child care; and483.23(ii) support licensed family child care 483.24providers to qualify as quality-rated child 483.25care providers through peer support and 483.26coaching networks. 483.27Hennepin and Ramsey Counties shall 483.28contract with a nonprofit organization under 483.29clause (1) that utilizes licensed family child 483.30care providers as contacts for families using 483.31licensed family child care and to provide 483.32peer support to licensed family child care 483.33providers.483.34(3) Hennepin and Ramsey Counties must 483.35report back on successful strategies for 484.1increasing contact with county-based 484.2licensed family child care providers and 484.3report their findings to the appropriate 484.4legislative committees by February 15, 2010.484.5Base Adjustment. The general fund base 484.6is $1,515,000 for each of fiscal years 2010 484.7and 2011.

484.8(g) Child Support Enforcement Grants

484.9General9,038,0003,705,000

484.10Child Support Enforcement. $5,333,000 484.11for fiscal year 2008 is to make grants to 484.12counties for child support enforcement 484.13programs to make up for the loss under the 484.142006 federal Deficit Reduction Act of federal 484.15matching funds for federal incentive funds 484.16passed on to the counties by the state.484.17This appropriation is available until spent.

484.18(h) Children's Services Grants

484.19Appropriations by Fund484.20General62,745,00073,133,000484.21Health Care Access250,000-0-

484.22Base Adjustment. The general fund base 484.23is decreased by $673,000 in fiscal year 484.242010 and $670,000 in fiscal year 2011 for 484.25children's services grants.484.26Privatized Adoption Grants. Federal 484.27reimbursement for privatized adoption grant 484.28and foster care recruitment grant expenditures 484.29is appropriated to the commissioner for 484.30adoption grants and foster care and adoption 484.31administrative purposes.484.32Adoption Assistance Incentive Grants.484.33Federal funds available during fiscal year 484.342008 and fiscal year 2009 for the adoption 485.1incentive grants are appropriated to the 485.2commissioner for these purposes.485.3Adoption Assistance and Relative Custody 485.4Assistance. The commissioner may transfer 485.5unencumbered appropriation balances for 485.6adoption assistance and relative custody 485.7assistance between fiscal years and between 485.8programs.485.9Adoption Assistance and Relative 485.10Custody Assistance Subsidy Payment 485.11Increase. Notwithstanding Minnesota 485.12Rules, part 9560.0083, subparts 5 and 6, the 485.13commissioner shall increase the payment 485.14schedules for basic and supplemental 485.15maintenance needs subsidies by 3.95 percent 485.16effective July 1, 2007. The commissioner 485.17may make cost-neutral adjustments between 485.18schedules and between brackets within 485.19schedules to allow for whole-dollar bracket 485.20levels and account for differential cost 485.21increases in caring for children with special 485.22needs. Counties have until December 31, 485.232007, to implement the relative custody 485.24assistance payment increases and shall make 485.25payment adjustments retroactive to July 1, 485.262007.485.27Crisis Nurseries. $1,100,000 in fiscal year 485.282008 and $1,100,000 in fiscal year 2009 are 485.29appropriated from the general fund for the 485.30crisis nurseries program. Of this amount, 485.31$100,000 each year is to be made available 485.32for capacity development and technical 485.33support for crisis nurseries.485.34Respite Care. Of the general fund 485.35appropriation, $1,250,000 in fiscal year 486.12008 and $2,500,000 in fiscal year 2009 are 486.2to the commissioner of human services to 486.3fund respite care for children who have a 486.4diagnosis of emotional disturbance or severe 486.5emotional disturbance.486.6Childhood Trauma; Grants. Of the general 486.7fund appropriation, $125,000 in fiscal year 486.82008 and $250,000 in fiscal year 2009 are 486.9to the commissioner of human services to 486.10make grants for the purpose of maintaining 486.11and expanding evidence-based practices that 486.12support children and youth who have been 486.13exposed to violence or who are refugees.486.14Collaborative Services for High-Risk 486.15Children. Of the general fund appropriation, 486.16$2,632,000 in fiscal year 2008 and 486.17$6,150,000 in fiscal year 2009 are to the 486.18commissioner of human services to fund 486.19early intervention collaborative programs.486.20Evidence-Based Practice. Of the general 486.21fund appropriation, $2,175,000 in fiscal year 486.222008 and $4,350,000 in fiscal year 2009 486.23are to the commissioner of human services 486.24to develop and implement evidence-based 486.25practice in children's mental health care and 486.26treatment.486.27MFIP and Children's Mental Health Pilot 486.28Project. Of the general fund appropriation, 486.29$100,000 in fiscal year 2008 and $200,000 486.30in fiscal year 2009 are to the commissioner 486.31of human services to fund the MFIP and 486.32children's mental health pilot project.486.33Regional Children's Mental Health 486.34Initiative. $700,000 in fiscal year 2008 and 486.35$700,000 in fiscal year 2009 are appropriated 487.1to the commissioner of human services to 487.2fund the Regional Children's Mental Health 487.3Initiative pilot project. This is a onetime 487.4appropriation.487.5Child Safety Efforts. $1,000,000 in fiscal 487.6year 2008 and $1,000,000 in fiscal year 2009 487.7are appropriated to counties based on their 487.8population of residents under age 18. Funds 487.9are to be used to maintain and improve child 487.10safety services. By February 1, 2008, each 487.11county shall submit a report regarding current 487.12child safety efforts, child safety funding, and 487.13unmet needs including investments needed. 487.14The report shall also include methods and 487.15community partners available to ensure 487.16early identification of at-risk families. The 487.17Association of Minnesota Counties and 487.18county agencies shall develop a uniform 487.19report structure so that statewide data can 487.20be easily summarized. This is a onetime 487.21appropriation.487.22Fetal Alcohol Syndrome. Of the general 487.23fund appropriation, $75,000 in fiscal year 487.242008 and $75,000 in fiscal year 2009 are 487.25for three programs that provide services 487.26to reduce fetal alcohol syndrome under 487.27Minnesota Statutes, section 145.9266. The 487.28three program grantees are the University 487.29of Minnesota, the Meeker-McLeod-Sibley 487.30Community, and the American Indian Family 487.31Center. This appropriation shall become part 487.32of the base appropriation.487.33Base Adjustment. The general fund base is 487.34increased by $366,000 in fiscal year 2010 and 488.1$369,000 in fiscal year 2011 for children's 488.2services grants.

488.3(i) Children and Community Services Grants

488.4General110,802,00069,567,000

488.5Base Adjustment. The general fund base is 488.6increased by $99,000 in each of fiscal years 488.72010 and 2011 for children and community 488.8services grants.488.9Targeted Case Management Temporary 488.10Funding. Of the general fund appropriation, 488.11$40,000,000 in fiscal year 2008 is allocated to 488.12counties and tribes affected by reductions in 488.13targeted case management federal Medicaid 488.14revenue as a result of the provisions in 488.15the federal Deficit Reduction Act of 2005, 488.16Public Law 109-171. The commissioner 488.17shall distribute the funds proportionate 488.18to each affected county or tribe's targeted 488.19case management federal earnings for 488.20calendar year 2005. Prior to distribution 488.21of funds, the commissioner shall estimate 488.22and certify the amount by which the federal 488.23regulations will reduce case management 488.24revenue over the 2008-2009 biennium. The 488.25commissioner may provide grants up to the 488.26amount of the estimated reduction, not to 488.27exceed $40,000,000 for the biennium. The 488.28commissioner may determine the timing and 488.29frequency of payments to counties. These 488.30funds are available in either year of the 488.31biennium. Counties shall use these funds to 488.32pay for social service-related costs, but the 488.33funds are not subject to provisions of the 488.34Children and Community Services Act grant 488.35under Minnesota Statutes, chapter 256M.489.1Child Welfare Project. Of the general fund 489.2appropriation, $2,000,000 for the biennium 489.3beginning July 1, 2007, is for expanding 489.4the American Indian chid welfare project 489.5under Minnesota Statutes, section 256.01, 489.6subdivision 14b, to include the Red Lake 489.7Band of Chippewa Indians Tribe, provided 489.8the tribe meets the criteria in Minnesota 489.9Statutes, section 256.01, subdivision 14b.

489.10(j) General Assistance Grants

489.11General37,876,00038,253,000

489.12General Assistance Standard. The 489.13commissioner shall set the monthly standard 489.14of assistance for general assistance units 489.15consisting of an adult recipient who is 489.16childless and unmarried or living apart 489.17from parents or a legal guardian at $203. 489.18The commissioner may reduce this amount 489.19according to Laws 1997, chapter 85, article 489.203, section 54.489.21Emergency General Assistance. The 489.22amount appropriated for emergency general 489.23assistance funds is limited to no more 489.24than $7,889,812 in fiscal year 2008 and 489.25$7,889,812 in fiscal year 2009. Funds 489.26to counties must be allocated by the 489.27commissioner using the allocation method 489.28specified in Minnesota Statutes, section 489.29256D.06.

489.30(k) Minnesota Supplemental Aid Grants

489.31General30,798,00031,439,000

489.32Emergency Minnesota Supplemental 489.33Aid Funds. The amount appropriated for 489.34emergency Minnesota supplemental aid 490.1funds is limited to no more than $1,100,000 490.2in fiscal year 2008 and $1,100,000 in fiscal 490.3year 2009. Funds to counties must be 490.4allocated by the commissioner using the 490.5allocation method specified in Minnesota 490.6Statutes, section 256D.46.

490.7(l) Group Residential Housing Grants

490.8General91,441,00099,304,000

490.9Base Adjustment. The general fund base is 490.10increased by $6,665,000 in fiscal year 2010 490.11and $13,419,000 in fiscal year 2011.490.12People Incorporated. $460,000 in fiscal 490.13year 2008 and $460,000 in fiscal year 2009 490.14are appropriated from the general fund to the 490.15commissioner of human services to augment 490.16community support and mental health 490.17services provided to individuals residing in 490.18facilities under Minnesota Statutes, section 490.19256I.05, subdivision 1h.

490.20490.21(m) Other Children and Economic Assistance Grants

490.22General24,625,00024,125,000

490.23Federal TANF1,340,0001,340,000

490.24Base Adjustment. The general fund base 490.25shall be $20,447,000 in each of fiscal years 490.262010 and 2011.490.27New Chance. $140,000 in fiscal year 490.282008 and $140,000 in fiscal year 2009 are 490.29appropriated from federal TANF funds to the 490.30Hennepin County new chance program.490.31Mothers First. Of the TANF appropriation, 490.32$450,000 in fiscal year 2008 and $450,000 490.33in fiscal year 2009 are to fund the Ramsey 490.34County mothers first program. The 491.1appropriations are available until spent and 491.2are a onetime appropriation.491.3Homeless and Runaway Youth. $3,500,000 491.4in the first year and $3,500,000 in the second 491.5year are for the Runaway and Homeless 491.6Youth Act under Minnesota Statutes, section 491.7256K.45. Funds shall be spent in each area 491.8of the continuum of care to ensure that 491.9programs are meeting the greatest need. The 491.10base is decreased by $2,000,000 each year in 491.11fiscal year 2010 and fiscal year 2011. 491.12Transitional Housing and Emergency 491.13Services.491.14(1) $750,000 each year from the federal 491.15TANF fund is for transitional housing 491.16programs under Minnesota Statutes, section 491.17256E.33. The TANF appropriations 491.18are onetime. The general fund base for 491.19transitional housing is increased by $422,000 491.20each year for the fiscal 2010-2011 biennium. 491.21Up to ten percent of this appropriation may 491.22be used for housing and services which 491.23extend beyond 24 months. $300,000 in each 491.24year of this amount is for grants for safe 491.25housing pilot projects for battered women 491.26and families in Anoka County, Houston 491.27County, and Beltrami County; and491.28(2) $527,000 each year is added to the 491.29base for emergency services grants under 491.30Laws 1997, chapter 162, article 3, section 491.317. The base for emergency services grants 491.32is decreased each year by $300,000 in fiscal 491.33year 2010 and fiscal year 2011.491.34Foodshelf Programs. $575,000 each year 491.35is added to the base for foodshelf programs 492.1under Minnesota Statutes, section 256E.34. 492.2The base is decreased by $250,000 each year 492.3in fiscal year 2010 and fiscal year 2011.492.4Long-term Homeless Services. $2,440,000 492.5each year is added to the base for the 492.6long-term homeless services under 492.7Minnesota Statutes, section 256K.26. The 492.8base is decreased by $1,000,000 each year in 492.9fiscal year 2010 and fiscal year 2011.492.10Minnesota Community Action Grants.492.11$1,500,000 each year is added to the base for 492.12the purposes of Minnesota community action 492.13grants under Minnesota Statutes, sections 492.14256E.30 to 256E.32. The base is reduced by 492.15$500,000 each year in fiscal year 2010 and 492.16fiscal year 2011.492.17Tenant Hotline Services Program. $50,000 492.18each year is added to the base for a grant to 492.19HOME Line for the tenant hotline services 492.20program. This is a onetime appropriation.

492.21492.22Subd. 5.Children and Economic Assistance Management47,035,00046,884,000

492.23Appropriations by Fund492.24General45,492,00045,335,000492.25Health Care Access347,000354,000492.26Federal TANF1,196,0001,196,000

492.27The amounts that may be spent from the 492.28appropriation for each purpose are as follows:

492.29492.30(a) Children and Economic Assistance Administration

492.31Appropriations by Fund492.32General9,725,0009,612,000492.33Federal TANF1,196,0001,196,000

493.1Base Adjustment. The general fund base is 493.2$9,574,000 in each of fiscal years 2010 and 493.32011.

493.4493.5(b) Children and Economic Assistance Operations

493.6Appropriations by Fund493.7General35,767,00035,722,000493.8Health Care Access347,000354,000

493.9Spending Authority for Food Stamps 493.10Bonus Awards. In the event that Minnesota 493.11qualifies for the United States Department 493.12of Agriculture Food and Nutrition Services 493.13Food Stamp Program performance bonus 493.14awards, the funding is appropriated to the 493.15commissioner. The commissioner shall 493.16retain 25 percent of the funding, with the 493.17other 75 percent divided among the counties 493.18according to a formula that takes into account 493.19each county's impact on state performance in 493.20the applicable bonus categories.493.21Child Support Payment Center. Payments 493.22to the commissioner from other governmental 493.23units, private enterprises, and individuals 493.24for services performed by the child support 493.25payment center must be deposited in the state 493.26systems account authorized under Minnesota 493.27Statutes, section 256.014. These payments 493.28are appropriated to the commissioner for the 493.29operation of the child support payment center 493.30or system, according to Minnesota Statutes, 493.31section 256.014.493.32Financial Institution Data Match and 493.33Payment of Fees. The commissioner is 493.34authorized to allocate up to $310,000 each 493.35year in fiscal years 2008 and 2009 from the 493.36PRISM special revenue account to make 494.1payments to financial institutions in exchange 494.2for performing data matches between account 494.3information held by financial institutions 494.4and the public authority's database of child 494.5support obligors as authorized by Minnesota 494.6Statutes, section 13B.06, subdivision 7.494.7Base Adjustment. The general fund base is 494.8decreased by $22,000 in each of fiscal years 494.92010 and 2011.

494.10Subd. 6.Basic Health Care Grants2,397,260,0002,739,194,000

494.11Appropriations by Fund494.12General2,019,435,0002,246,743,000494.13Health Care Access377,825,000492,451,000

494.14The amounts that may be spent from the 494.15appropriation for each purpose are as follows:

494.16(a) MinnesotaCare Grants

494.17Health Care Access376,938,000459,891,000

494.18MinnesotaCare Federal Receipts. Receipts 494.19received as a result of federal participation 494.20in administering costs of the Minnesota 494.21health care reform waiver must be deposited 494.22as nondedicated revenue in the health care 494.23access fund. Receipts received as a result of 494.24federal participation in making grants must 494.25be deposited in the federal fund and must 494.26offset health care access funds for payments 494.27to providers.494.28MinnesotaCare Funding. The 494.29commissioner may expend money 494.30appropriated from the health care access fund 494.31for MinnesotaCare in either fiscal year of the 494.32biennium.494.33HealthMatch Delay. Of this appropriation, 494.34$2,560,000 in fiscal year 2008 and 495.1$29,647,000 in fiscal year 2009 are for 495.2MinnesotaCare program costs related to 495.3implementation of the HealthMatch program.

495.4495.5(b) MA Basic Health Care - Families and Children

495.6Appropriations by Fund495.7General758,212,000847,163,000495.8Health Care Access-0-31,661,000

495.9495.10(c) MA Basic Health Care - Elderly and Disabled

495.11General1,019,297,0001,145,789,000

495.12Provider-Directed Care Coordination. In 495.13addition to medical assistance reimbursement 495.14under Minnesota Statutes, sections 495.15256B.0625 and 256B.76, clinics participating 495.16in provider-directed care coordination under 495.17Minnesota Statutes, section 256B.0625, also 495.18receive a monthly payment per client when 495.19the clinic serves an eligible client. The 495.20payments across the program must average 495.21$50 per month per client.495.22Services for Developmentally Disabled.495.23The commissioner must serve: an additional 495.24200 persons in the MR/RC waiver program; 495.25an additional 200 persons in the family 495.26support grant program under Minnesota 495.27Statutes, section 252.32; and an additional 495.28200 persons in the semi-independent living 495.29services program under Minnesota Statutes, 495.30section 252.275.495.31County CADI allocation adjustment. (1) 495.32The commissioner shall adjust 2007 home 495.33and community-based allocations under 495.34section 256B.49 to qualifying counties 495.35that transferred persons to the community 496.1alternatives for disabled individuals 496.2(CADI) waiver program under Laws 2006, 496.3chapter 282, article 20, section 35. The 496.4adjustment shall reflect the amount that 496.5county-authorized funding for CADI waiver 496.6services exceeded the allowable amount 496.7as shown in the Medicaid Management 496.8Information System (MMIS) on March 1, 496.92007.496.10(2) A county that may qualify under 496.11paragraph (1) shall apply to the commissioner 496.12by June 10, 2007. Following a review of the 496.13county request and the MMIS documentation, 496.14the commissioner shall adjust the county 496.15allocation, as appropriate, by June 25, 2007.496.16(3) The amounts provided to a county under 496.17this section shall become part of the county's 496.18base level state allocation for the CADI 496.19waiver for the biennium beginning July 1, 496.202007.496.21(4) This rider is effective the day following 496.22final enactment.

496.23(d) General Assistance Medical Care Grants

496.24General238,887,000251,082,000

496.25(e) Other Health Care Grants

496.26General3,039,0002,709,000496.27Health Care Access887,000899,000

496.28Care Coordination. Of the general fund 496.29appropriation, $500,000 in fiscal year 2008 496.30and $1,000,000 in fiscal year 2009 are for 496.31the commissioner of human services for 496.32contracting for care coordination with the 496.33U special kids program under Minnesota 496.34Statutes, section 256B.0751.497.1Community-Based Health Care. Of the 497.2general fund appropriation, $1,050,000 497.3for the biennium beginning July 1, 2007, 497.4is to the commissioner of human services 497.5for the demonstration project grant 497.6described in Minnesota Statutes, section 497.762Q.80, subdivision 1a. This is a onetime 497.8appropriation and is available until June 30, 497.92012.497.10Health Care Payment Reform Pilot. Of 497.11the general fund appropriation, $1,018,000 497.12in fiscal year 2008 and $1,027,000 in fiscal 497.13year 2009 are for the health care payment 497.14reform pilot project. These are onetime 497.15appropriations.497.16Patient Incentive Programs. Of the general 497.17fund appropriation, $500,000 in fiscal year 497.182008 and $500,000 in fiscal year 2009 are 497.19for patient incentive programs.497.20State Health Policies Grant. Of the general 497.21fund appropriation, $300,000 in fiscal year 497.222008 is to provide a grant to a research center 497.23associated with a safety net hospital and 497.24county-affiliated health system to develop 497.25the capabilities necessary for evaluating the 497.26effects of changes in state health policies 497.27on low-income and uninsured individuals, 497.28including the impact on state health care 497.29program costs, health outcomes, cost-shifting 497.30to different units and levels of government, 497.31and utilization patterns including use of 497.32emergency room care and hospitalization 497.33rates.497.34Neighborhood Health Care Network. Of 497.35the general fund appropriation, $150,000 in 498.1fiscal year 2008 and $150,000 in fiscal year 498.22009 are for a grant to the Neighborhood 498.3Health Care Network to maintain and staff a 498.4toll-free health care access telephone number.

498.5Subd. 7.Health Care Management54,536,00058,696,000

498.6Appropriations by Fund498.7General32,416,00030,571,000498.8Health Care Access22,120,00028,125,000

498.9The amounts that may be spent from the 498.10appropriation for each purpose are as follows:

498.11(a) Health Care Policy Administration

498.12Appropriations by Fund498.13General10,236,0008,813,000498.14Health Care Access2,323,00010,074,000

498.15Minnesota Senior Health Options 498.16Reimbursement. Federal administrative 498.17reimbursement resulting from the Minnesota 498.18senior health options project is appropriated 498.19to the commissioner for this activity.498.20Utilization Review. Federal administrative 498.21reimbursement resulting from prior 498.22authorization and inpatient admission 498.23certification by a professional review 498.24organization is dedicated to the commissioner 498.25for these purposes. A portion of these funds 498.26must be used for activities to decrease 498.27unnecessary pharmaceutical costs in medical 498.28assistance.498.29Dental Access for Persons with Disabilities.498.30Of the general fund appropriation, $82,000 498.31in fiscal year 2008 is for a study on access to 498.32dental services for persons with disabilities.498.33Base Adjustment. The health care access 498.34fund base is $10,716,000 in fiscal year 2010 499.1and $8,870,000 in fiscal year 2011, for health 499.2care administration.

499.3(b) Health Care Operations

499.4Appropriations by Fund499.5General22,180,00021,758,000499.6Health Care Access19,797,00018,051,000

499.7Base Adjustment. The general fund base is 499.8decreased by $214,000 in fiscal year 2010 499.9for health care operations.

499.10Subd. 8.Continuing Care Grants1,697,359,0001,858,283,000

499.11Appropriations by Fund499.12General1,694,876,0001,855,900,000499.13Health Care Access750,000750,000499.14Lottery Prize1,733,0001,633,000

499.15The amounts that may be spent from the 499.16appropriation for each purpose are as follows: 

499.17(a) Aging and Adult Services Grants

499.18General15,986,00016,605,000

499.19Information and Assistance 499.20Reimbursement. Federal administrative 499.21reimbursement obtained from information 499.22and assistance services provided by the 499.23Senior LinkAge Line to people who are 499.24identified as eligible for medical assistance 499.25are appropriated to the commissioner for this 499.26activity.499.27Senior Companion Program. Of the 499.28general fund appropriation, $191,000 in 499.29fiscal year 2008 and $191,000 in fiscal year 499.302009 are for the senior companion program 499.31under Minnesota Statutes, section 256.977.499.32Volunteer Senior Citizens. Of the general 499.33fund appropriation, $192,000 in fiscal year 499.342008 and $192,000 in fiscal year 2009 are 500.1for the volunteer programs for retired senior 500.2citizens under Minnesota Statutes, section 500.3256.9753.500.4Foster Grandparent Program. Of the 500.5general fund appropriation, $192,000 in 500.6fiscal year 2008 and $192,000 in fiscal year 500.72009 are for the foster grandparent program 500.8in Minnesota Statutes, section 256.976.500.9Senior Nutrition. Of the general fund 500.10appropriation, $250,000 in fiscal year 500.112008 and $250,000 in fiscal year 2009 are 500.12for the senior nutrition programs under 500.13Minnesota Statutes, section 256.9752. 500.14The commissioner shall give priority to 500.15increase services to: (1) persons facing 500.16language or cultural barriers, (2) persons with 500.17special diets, (3) persons living in isolated 500.18rural areas, and (4) other hard-to-serve 500.19populations.500.20Living At Home/Block Nurse Program. Of 500.21the general fund appropriation, $580,000 in 500.22fiscal year 2008 and $655,000 in fiscal year 500.232009 are for the living at home/block nurse 500.24program. The purpose of the appropriation is 500.25to increase base funding levels to $25,000 500.26per program year, provide base funding for 500.27nine programs currently operating without 500.28base funding, provide base funding for five 500.29new programs beginning July 1, 2007, and 500.30provide base funding for six additional 500.31programs beginning July 1, 2008.500.32$76,000 in fiscal year 2008 and $62,000 in 500.33fiscal year 2009 are for increased staff for 500.34the ombudsman for older Minnesotans and 500.35related costs.501.1$150,000 in fiscal year 2008 and $150,000 in 501.2fiscal year 2009 are to increase the base of 501.3the Senior LinkAge line program.501.4Minnesota Kinship Caregivers 501.5Association. (1) Of the general fund 501.6appropriation, $175,000 in fiscal year 501.72008 and $175,000 in fiscal year 2009 501.8are transferred to a nonprofit organization 501.9experienced in kinship caregiver programs, 501.10with at least 50 percent of its board 501.11composed of kinship caregivers for purposes 501.12of providing support to grandparents or 501.13relatives who are raising kinship children. 501.14(2) The demonstration grant sites must 501.15include the Minnesota Kinship Caregivers 501.16Association central site in the metropolitan 501.17area and another site in the Bemidji region. 501.18The support must provide a one-stop services 501.19program. The services that may be provided 501.20include but are not limited to legal services, 501.21education, information, family activities, 501.22support groups, mental health access, 501.23advocacy, mentors, and information related 501.24to foster care licensing. The funds may also 501.25be used for a media campaign to inform 501.26kinship families about available information 501.27and services, support sites, and other program 501.28development. The general fund base for the 501.29program shall be $160,000 in fiscal year 501.302010 and $160,000 in fiscal year 2011.501.31Base Adjustment. The general fund base 501.32is increased by $72,000 in fiscal year 2010 501.33and $72,000 in fiscal year 2011 for aging and 501.34adult services grants.

501.35(b) Alternative Care Grants

502.1General50,063,00052,511,000

502.2Alternative Care Transfer. Any money 502.3allocated to the alternative care program that 502.4is not spent for the purposes indicated does 502.5not cancel but is transferred to the medical 502.6assistance account.502.7Base Adjustment. The general fund base is 502.8increased by $547,000 in fiscal year 2010 and 502.9$784,000 in fiscal year 2011 for alternative 502.10care grants.

502.11502.12(c) Medical Assistance Grants - Long-Term Care Facilities

502.13General499,278,000513,016,000

502.14New Nursing Facility Reimbursement 502.15System Delay. Notwithstanding Minnesota 502.16Statutes, section 256B.441, subdivision 1, 502.17paragraph (c), the commissioner shall begin 502.18to phase in the new reimbursement system 502.19for nursing facilities on or after October 1, 502.202009.502.21Long-Term Care Consultation Funding 502.22Increase. For the rate year beginning 502.23October 1, 2008, the county long-term 502.24care consultation allocations in Minnesota 502.25Statutes, section 256B.0911, subdivision 502.266, must be increased based on the number 502.27of transitional long-term care consultation 502.28visits projected by the commissioner in 502.29each county. For the rate year beginning 502.30October 1, 2009, final allocations must be 502.31determined based on the average between 502.32the actual number of transitional long-term 502.33care visits that were conducted in the prior 502.3412-month period and the projected number 503.1of consultations that will be provided in 503.2the rate year beginning October 1, 2009. 503.3Notwithstanding section 7, this rider expires 503.4June 30, 2010.503.5Life Safety Code Compliance. Of the 503.6general fund appropriation, $1,000,000 in 503.7fiscal year 2008 is for payments to nursing 503.8facilities for life safety code compliance 503.9under Minnesota Statutes, section 256B.434, 503.10subdivision 4, paragraph (e). This is a 503.11onetime appropriation and available until 503.12spent.

503.13503.14(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

503.15General966,623,0001,099,540,000

503.16(e) Mental Health Grants

503.17Appropriations by Fund503.18General57,522,00060,678,000503.19Health Care Access750,000750,000503.20Lottery Prize1,733,0001,633,000

503.21Dual Diagnosis; Demonstration Project.503.22Of the general fund appropriation, $800,000 503.23in fiscal year 2008 and $1,600,000 in fiscal 503.24year 2009 are to the commissioner of 503.25human services to fund the dual diagnosis 503.26demonstration project.503.27Mobile Mental Health Crisis Services. Of 503.28the general fund appropriation, $2,500,000 503.29in fiscal year 2008 and $3,625,000 in fiscal 503.30year 2009 are to the commissioner of human 503.31services for statewide funding of adult mobile 503.32mental health crisis services. Providers must 503.33utilize all available funding streams.503.34National Council on Problem Gambling.503.35(1) $225,000 in fiscal year 2008 and $225,000 504.1in fiscal year 2009 are appropriated from 504.2the lottery prize fund to the commissioner 504.3of human services for a grant to the state 504.4affiliate recognized by the National Council 504.5on Problem Gambling. The affiliate must 504.6provide services to increase public awareness 504.7of problem gambling, education, and training 504.8for individuals and organizations providing 504.9effective treatment services to problem 504.10gamblers and their families, and research 504.11relating to problem gambling. These 504.12services must be complementary to and not 504.13duplicative of the services provided through 504.14the problem gambling program administered 504.15by the commissioner of human services. This 504.16grant does not prevent the commissioner 504.17from regular monitoring and oversight of the 504.18grant or the ability to reallocate the funds to 504.19other services within the problem gambling 504.20program for nonperformance of duties by 504.21the grantee.504.22(2) Of this appropriation, $100,000 in 504.23fiscal year 2008 and $100,000 in fiscal year 504.242009 are contingent on the contribution 504.25of nonstate matching funds. Matching 504.26funds may be either cash or qualifying 504.27in-kind contributions. The commissioner of 504.28finance may disburse the state portion of the 504.29matching funds in increments of $25,000 504.30upon receipt of a commitment for an equal 504.31amount of matching nonstate funds. The 504.32general fund base shall be $100,000 in fiscal 504.33year 2010 and $100,000 in fiscal year 2011504.34(3) $100,000 in fiscal year 2008 is 504.35appropriated from the lottery prize fund to 504.36the commissioner of human services for a 505.1grant or grants to be awarded competitively 505.2to develop programs and services for 505.3problem gambling treatment, prevention, 505.4and education in immigrant communities. 505.5This appropriation is available until June 505.630, 2009, at which time the project must 505.7be completed and final products delivered, 505.8unless an earlier completion date is specified 505.9in the work program.505.10Compulsive Gambling. $300,000 in fiscal 505.11year 2008 and $100,000 in fiscal year 2009 505.12are appropriated from the lottery prize fund 505.13to the commissioner of human services for 505.14purposes of compulsive gambling education, 505.15assessment, and treatment under Minnesota 505.16Statutes, section 245.98.505.17Compulsive Gambling Study. $100,000 505.18in fiscal year 2008 is to continue the 505.19study currently being done on compulsive 505.20gambling treatment effectiveness and 505.21long-term effects of gambling.505.22Base Adjustment. The general fund base is 505.23increased by $266,000 in fiscal year 2010.

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

505.25General1,932,0002,380,000

505.26Hearing Loss Mentors. Of the general fund 505.27appropriation, $80,000 is to provide mentors 505.28who have a hearing loss to parents of newly 505.29identified infants and children with hearing 505.30loss.505.31Base Adjustment. The general fund base 505.32is increased by $7,000 in fiscal year 2010 505.33and $7,000 in fiscal year 2011 for deaf and 505.34hard-of-hearing grants.

506.1(g) Chemical Dependency Entitlement Grants

506.2General78,749,00089,946,000

506.3506.4(h) Chemical Dependency Nonentitlement Grants

506.5General1,055,0001,055,000

506.6(i) Other Continuing Care Grants

506.7Appropriations by Fund506.8General23,668,00020,169,000

506.9Native American Juvenile Treatment 506.10Center. Of the general fund appropriation, 506.11$50,000 is to conduct a feasibility study 506.12of and to predesign a Native American 506.13juvenile treatment center on or near the 506.14White Earth Reservation. The facility must 506.15house and treat Native American juveniles 506.16and provide culturally specific programming 506.17to juveniles placed in the treatment center. 506.18The commissioner of human services may 506.19contract with parties who have experience 506.20in the design and construction of juvenile 506.21treatment centers to assist in the feasibility 506.22study and predesign. On or before January 506.2315, 2008, the commissioner shall present 506.24the results of the feasibility study and the 506.25predesign of the facility to the chairs of house 506.26of representatives and senate committees 506.27having jurisdiction over human services 506.28finance, public safety finance, and capital 506.29investment.506.30Leech Lake Youth Treatment Center. Of 506.31the general fund appropriation, $75,000 in 506.32fiscal year 2008 and $75,000 in fiscal year 506.332009 are for a grant to the Leech Lake Youth 506.34Treatment Center project partners, in order 507.1to pay the salaries and other directly related 507.2costs associated with the development of this 507.3project.507.4Assistive Technology. Of the general fund 507.5appropriation, $300,000 in fiscal year 2008 is 507.6to the Minnesota State Council on Disability 507.7for the purposes of providing $100,000 507.8in financial support to the Minnesota 507.9Regions Assistive Technology Collaborative 507.10and $200,000 in fiscal year 2008 is for 507.11a local match required to access the 507.12federal Technology-Related Assistance for 507.13Individuals with Disabilities Act, alternate 507.14finance project.507.15Repayment. For the fiscal year ending June 507.1630, 2008, $5,287,000 is appropriated to the 507.17commissioner of human services to repay 507.18the amount of overspending in the waiver 507.19program for persons with developmental 507.20disabilities incurred by affected counties in 507.21calendar years 2004 and 2005.507.22Base Adjustment. The general fund base 507.23is $20,276,000 in fiscal year 2010 and 507.24$20,332,000 in fiscal year 2011 for other 507.25continuing care grants.

507.26Subd. 9.Continuing Care Management20,248,00019,400,000

507.27Appropriations by Fund507.28General19,384,00019,123,000507.29507.30State Government Special Revenue121,000123,000507.31Health Care Access292,000-0-507.32Lottery Prize451,000154,000

507.33Community Trainee and Consultation.507.34Of the general fund appropriation, $125,000 507.35in fiscal year 2008 is to the commissioner 508.1of human services to contract for training 508.2and consultation for clinical supervisors and 508.3staff of community mental health centers 508.4who provide services to children and adults. 508.5The purpose of the training and consultation 508.6is to improve clinical supervision of 508.7staff, strengthen compliance with federal 508.8and state rules and regulations, and to 508.9recommend strategies for standardization and 508.10simplification of administrative functions 508.11among community mental health centers.508.12Mental Health Tracking System. Of the 508.13general fund appropriation, $448,000 in fiscal 508.14year 2008 and $324,000 in fiscal year 2009 508.15are to the commissioner of human services 508.16to fund implementation of the mental health 508.17services outcomes and tracking system.508.18Quality Management; Assurance; and 508.19Improvement System for Minnesotans 508.20Receiving Disability Services. Of the 508.21general fund appropriation, up to $300,000 508.22for the biennium beginning July 1, 2007, 508.23may be used for the purposes of the quality 508.24management, assurance, and improvement 508.25system for Minnesotans receiving disability 508.26services. Federal Medicaid matching funds 508.27obtained for this purpose shall be dedicated 508.28to the commissioner for this purpose.508.29Base Adjustment. The health care access 508.30fund base is $0 in each of the fiscal years 2010 508.31and 2011 for continuing care management.508.32Disability Linkage Line. Of the general 508.33fund appropriation, $650,000 in fiscal year 508.342008 and $626,000 in fiscal year 2009 are to 509.1establish and maintain the disability linkage 509.2line.

509.3Subd. 10.State-Operated Services266,645,000267,718,000

509.4General266,645,000267,718,000

509.5Remembering With Dignity Project. (1) 509.6$200,000 is appropriated from the general 509.7fund to the commissioner of human services 509.8to be available until September 30, 2008, to 509.9make a grant to Advocating Change Together 509.10for the purposes of the Remembering With 509.11Dignity project in paragraph (2).509.12(2) As part of the Remembering With Dignity 509.13project, the grant recipient shall:509.14(i) conduct necessary research on persons 509.15buried in state cemeteries who were residents 509.16of state hospitals or regional treatment 509.17centers and buried in numbered or unmarked 509.18graves;509.19(ii) purchase and install headstones that are 509.20properly inscribed with their names on the 509.21graves of those persons; and509.22(iii) collaborate with community groups 509.23and state and local government agencies to 509.24build community involvement and public 509.25awareness, ensure public access to the 509.26graves, and ensure appropriate perpetual 509.27maintenance of state cemeteries.509.28(3) This rider is effective the day following 509.29final enactment.509.30Transfer Authority Related to 509.31State-Operated Services. Money 509.32appropriated to finance state-operated 509.33services programs and administrative 509.34services may be transferred between fiscal 510.1years of the biennium with the approval of 510.2the commissioner of finance.510.3The amounts that may be spent from the 510.4appropriation for each purpose are as follows:

510.5(a) Mental Health Services

510.6General116,270,000120,095,000

510.7Appropriation Limitation. No part of 510.8the appropriation in this article to the 510.9commissioner for mental health treatment 510.10services at the regional treatment centers 510.11shall be used for the Minnesota sex offender 510.12program.

510.13(b) Minnesota Sex Offender Services

510.14General67,719,00062,787,000

510.15510.16(c) Minnesota Security Hospital and METO Services

510.17General82,656,00084,836,000

510.18Minnesota Security Hospital. For the 510.19purposes of enhancing the safety of 510.20the public, improving supervision, and 510.21enhancing community-based mental health 510.22treatment, state-operated services may 510.23establish additional community capacity 510.24for providing treatment and supervision 510.25of clients who have been ordered into a 510.26less restrictive alternative care from the 510.27state-operated services transitional services 510.28program consistent with Minnesota Statutes, 510.29section 246.014.

510.30Sec. 4. COMMISSIONER OF HEALTH

510.31Subdivision 1.Total Appropriation$176,686,000$165,689,000

510.32Appropriations by Fund510.3320082009511.1General98,737,00092,829,000511.2511.3State Government Special Revenue39,851,00040,642,000511.4Health Care Access26,448,00019,918,000511.5Federal TANF11,350,00012,000,000511.6Environment300,000300,000

511.7511.8Subd. 2.Community and Family Health Promotion

511.9Appropriations by Fund511.10General59,881,00059,978,000511.11511.12State Government Special Revenue468,000471,000511.13Health Care Access3,539,0003,562,000511.14Federal TANF8,667,0009,002,000

511.15TANF Appropriations. (a) $3,579,000 of 511.16the TANF funds is appropriated in each year 511.17of the biennium to the commissioner for 511.18home visiting and nutritional services listed 511.19under Minnesota Statutes, section 145.882, 511.20subdivision 7, clauses (6) and (7). Funding 511.21shall be distributed to community health 511.22boards based on Minnesota Statutes, section 511.23145A.131, subdivision 1.511.24(b) $5,088,000 in the first year and $5,423,000 511.25in the second year are appropriated to the 511.26commissioner of health for the family home 511.27visiting grant program. The commissioner 511.28shall distribute funds to community health 511.29boards using a formula developed in 511.30conjunction with the state Community 511.31Health Services Advisory Committee. The 511.32commissioner may use five percent of the 511.33funds appropriated in each fiscal year to 511.34conduct the ongoing evaluations required 511.35under Minnesota Statutes, section 145A.17, 511.36subdivision 7, and may use ten percent of 511.37the funds appropriated each fiscal year to 512.1provide training and technical assistance as 512.2required under Minnesota Statutes, section 512.3145A.17, subdivisions 4 and 5.512.4TANF Carryforward. Any unexpended 512.5balance of the TANF appropriation in the 512.6first year of the biennium does not cancel but 512.7is available for the second year.512.8Loan Forgiveness. $605,000 the first year 512.9and $775,000 the second year and thereafter 512.10are for the loan forgiveness program under 512.11Minnesota Statutes, section 144.1501. This 512.12funding is in addition to the loan forgiveness 512.13program base.512.14MN ENABL. Base level funding for the MN 512.15ENABL program, under Minnesota Statutes, 512.16section 145.9255, is reduced by $220,000 512.17each year of the biennium beginning July 1, 512.182007.512.19Fetal Alcohol Spectrum Disorder. (a) 512.20$900,000 each year is added to the base for 512.21fetal alcohol spectrum disorder. On July 1 512.22each fiscal year, the portion of the general 512.23fund appropriation to the commissioner of 512.24health for fetal alcohol spectrum disorder 512.25administration and grants shall be transferred 512.26to a statewide organization that focuses 512.27solely on prevention of and intervention with 512.28fetal alcohol spectrum disorder as follows:512.29(1) on July 1, 2007, $2,090,000; and512.30(2) on July 2, 2008, and annually thereafter, 512.31$2,090,000.512.32(b) The money shall be used for prevention 512.33and intervention services and programs, 512.34including, but not limited to, community 513.1grants, professional education, public 513.2awareness, and diagnosis. The organization 513.3may retain $60,000 of the transferred money 513.4for administrative costs. The organization 513.5shall report to the commissioner annually 513.6by January 15 on the services and programs 513.7funded by the appropriation.513.8Deaf or Hearing Loss Support. $100,000 513.9for the first year and $100,000 for the second 513.10year is for the purpose of providing family 513.11support and assistance to families with 513.12children who are deaf or have a hearing 513.13loss. The family support provided must 513.14include direct parent-to-parent assistance and 513.15information on communication, educational, 513.16and medical options. The commissioner 513.17may contract with a nonprofit organization 513.18that has the ability to provide these services 513.19throughout the state.513.20Heart Disease and Stroke Prevention.513.21$200,000 is appropriated in the first year for 513.22the heart disease and stroke prevention unit 513.23of the Department of Health to fund data 513.24collection and other activities to improve 513.25cardiovascular health and reduce the burden 513.26of heart disease and stroke in Minnesota. 513.27This is a onetime appropriation.513.28Family Planning Grants. $1,000,000 each 513.29year is for family planning grants under 513.30Minnesota Statutes, section 145.925.513.31Bright Smiles Pilot Project. (a) $384,000 513.32in the first year and $50,000 in the second 513.33year is to fund a grant for the Bright Smiles 513.34pilot project.514.1(b) Of these amounts, $50,000 each year is to 514.2fund a dental health coordinator position at 514.3the Minnesota Department of Health.514.4(c) The commissioner of health shall 514.5establish a pilot project to fund a Bright 514.6Smiles program designed to increase access 514.7to oral health care for low-income and 514.8immigrant children, ages birth to five 514.9years, and their families and to build the 514.10knowledge and ability of parents to care 514.11for the oral health of their children. Under 514.12this pilot project, a Bright Smiles program 514.13shall serve the medically underserved areas 514.14in Minneapolis and the Bemidji area, as 514.15determined by the commissioner of health.514.16(d) A grant shall be used to fund costs related 514.17to improving oral health outreach, education, 514.18screening, and access to care for families 514.19with children, ages birth to five years.514.20(e) Grant applicants shall submit to 514.21the commissioner a written plan that 514.22demonstrates the ability to provide the 514.23following:514.24(1) new programs or continued expansion 514.25of current access programs that have 514.26demonstrated success in providing dental 514.27services in underserved areas of Minneapolis 514.28and the Bemidji area;514.29(2) programs for screening children entering 514.30the Minneapolis and the Bemidji area public 514.31school systems and facilitating access to care 514.32for their families;514.33(3) programs testing new models of care 514.34that are sensitive to cultural needs of the 514.35recipients;515.1(4) programs creating new educational 515.2campaigns that inform individuals of the 515.3importance of good oral health and the 515.4link between dental diseases, overall health 515.5status, and success in school; and515.6(5) programs testing new delivery models 515.7by creating partnerships between local early 515.8childhood and school-age education and 515.9community clinic dental providers.515.10(f) Qualified applicants are partnerships 515.11among early childhood experts, Minneapolis 515.12or Bemidji area public schools, and nonprofit 515.13clinics that are established to provide health 515.14services to low-income patients, provide 515.15preventive and dental care services, and 515.16utilize a sliding-scale fee or other method of 515.17providing charity care that ensures that no 515.18person is denied services because of inability 515.19to pay.515.20(g) Applicants shall submit to the 515.21commissioner an application and supporting 515.22documentation, in the form and manner 515.23specified by the commissioner. Applicants 515.24must be able to provide culturally appropriate 515.25outreach, screenings, and access to dental 515.26care for children, ages birth to five years, 515.27their parents, and pregnant women most at 515.28risk of poor oral health due to lack of access 515.29to dental care. Applicants must also meet the 515.30following criteria:515.31(1) have the potential to successfully increase 515.32access to families with children, ages birth 515.33to five years;515.34(2) incorporate quality program evaluation;515.35(3) maximize use of grant funds; and516.1(4) have experience in providing services to 516.2the target populations of this program.516.3(h) The commissioner shall evaluate the 516.4effectiveness of this pilot program on the 516.5oral health of children and their families and 516.6report to the house of representatives and 516.7senate committees with jurisdiction over 516.8public health policy and finance by January 516.91, 2009, with recommendations as to how to 516.10develop programs throughout Minnesota that 516.11provide education and access to oral health 516.12care for low-income and immigrant children.516.13Suicide prevention programs. $600,000 516.14each year is to fund the suicide prevention 516.15program. The base for fiscal years 2010 and 516.162011 is reduced by $300,000.516.17Hearing Aid Loan Bank. Of the general 516.18fund appropriation, $70,000 in fiscal year 516.192008 and $70,000 in fiscal year 2009 are 516.20for the purpose of providing a statewide 516.21hearing aid and instrument loan bank to 516.22families with children newly diagnosed with 516.23hearing loss from birth to the age of ten. This 516.24appropriation shall cover the administrative 516.25costs of the program.516.26Medical Home Learning Collaborative.516.27Of the general fund appropriation, $500,000 516.28in fiscal year 2008 and $500,000 in fiscal 516.29year 2009 are to expand the medical 516.30home learning collaborative initiative in 516.31collaboration with the commissioner of 516.32human services. Services provided under this 516.33funding must support a medical home model 516.34for children with special health care needs. 516.35The collaborative shall report back to the 517.1legislature on use of the funds by January 15, 517.22010. This appropriation shall not become 517.3part of the base funding for the 2010-2011 517.4biennium.517.5Community Collaboratives. Of the general 517.6fund appropriation, $330,000 in fiscal year 517.72008 and $850,000 in fiscal year 2009 are to 517.8provide grants to community collaboratives 517.9to cover the uninsured. These are onetime 517.10appropriations.517.11Base Adjustment. General fund base is 517.12$46,143,000 in each of fiscal years 2010 and 517.132011.

517.14Subd. 3.Policy, Quality, and Compliance51,209,00045,590,000

517.15Appropriations by Fund517.16General14,897,00015,737,000517.17517.18State Government Special Revenue13,403,00013,497,000517.19Health Care Access22,909,00016,356,000

517.20Health Care Access Survey. Of the 517.21health care access fund appropriation, 517.22$600,000 in fiscal year 2008 is appropriated 517.23to the commissioner to conduct a health 517.24insurance survey of Minnesota households, 517.25in partnership with the State Health Access 517.26Data Assistance Center at the University 517.27of Minnesota. The commissioner shall 517.28contract with the State Health Access Data 517.29Assistance Center to conduct a survey that 517.30provides information on the characteristics 517.31of the uninsured in Minnesota and the 517.32reasons for changing patterns of insurance 517.33coverage and access to health care services. 517.34This appropriation shall become part of the 517.35agency's base budget for even-numbered 517.36fiscal years.518.1MERC. Of the general fund appropriation, 518.2$8,000,000 each fiscal year is for distribution 518.3of MERC grants as follows:518.4(1) $5,000,000 according to Minnesota 518.5Statutes, section 62J.692, subdivision 4, 518.6paragraph (c);518.7(2) $900,000 according to Minnesota 518.8Statutes, section 62J.692, subdivision 4, 518.9paragraph (d);518.10(3) $100,000 according to Minnesota 518.11Statutes, section 62J.692, subdivision 4, 518.12paragraph (e); and518.13(4) $2,000,000 according to Minnesota 518.14Statutes, section 62J.692, subdivision 7a, 518.15paragraph (b).518.16Health Information Technology. Of 518.17the health care access fund appropriation, 518.18$6,750,000 each fiscal year is to implement 518.19Minnesota Statutes, section 144.3345. Up 518.20to $350,000 each fiscal year is available for 518.21grant administration and health information 518.22technology technical assistance and 518.23$6,400,000 each year is to be transferred 518.24to the commissioner of finance to establish 518.25and implement a revolving account under 518.26Minnesota Statutes, section 62J.496. This 518.27appropriation shall not be included in the 518.28agency's base budget for the fiscal year 518.29beginning July 1, 2009.518.30Health Insurance Exchange. Of the health 518.31care access fund appropriation, $6,000,000 518.32in fiscal year 2008 is appropriated to 518.33the commissioner to establish the health 518.34insurance exchange in Minnesota Statutes, 518.35section 62A.76. Up to $50,000 in fiscal year 519.12008 is available for administrative costs 519.2incurred by the Department of Health in 519.3establishing and providing grant funding to 519.4the legal entity responsible for implementing 519.5the health insurance exchange. This is a 519.6onetime appropriation.519.7Uncompensated Care Fund. Of the general 519.8fund appropriation, $65,000 in fiscal year 519.92008 is for the commissioner of health to 519.10study and present recommendations to the 519.11governor and the legislature by January 519.1215, 2008, on the design, operation, and 519.13funding of an uncompensated care fund to 519.14be used to provide subsidies to hospitals, 519.15community clinics, federally qualified health 519.16centers, community mental health centers, 519.17and other health care providers that serve 519.18a disproportionately large percentage of 519.19uninsured patients. An organization must not 519.20provide or perform abortion services under 519.21this program.519.22Community Collaboratives. Of the 519.23general fund appropriation, $300,000 for the 519.24biennium beginning July 1, 2007, is to the 519.25commissioner of health to provide grants 519.26to community collaboratives to cover the 519.27uninsured. This is a onetime appropriation.519.28Uniform Electronic Transactions. Of the 519.29general fund appropriation, $146,000 in fiscal 519.30year 2008 is for development of uniform 519.31electronic transactions and implementation 519.32guide standards under Minnesota Statutes, 519.33section 62J.536.519.34Federally Qualified Health Centers. Of the 519.35general fund appropriation, $3,000,000 in 520.1fiscal year 2008 and $3,900,000 in fiscal year 520.22009 are for subsidies to federally qualified 520.3health centers under Minnesota Statutes, 520.4section 145.9269.520.5Base Adjustment. The general fund base 520.6is reduced $500,000 in each of fiscal years 520.72010 and 2011. The health care access fund 520.8base is $3,456,000 in fiscal year 2010 and 520.9$2,856,000 in fiscal year 2011.

520.10Subd. 4.Health Protection

520.11Appropriations by Fund520.12General20,544,00013,900,000520.13520.14State Government Special Revenue25,980,00026,674,000520.15Environment300,000300,000

520.16Pandemic Influenza Preparedness. Of 520.17the general fund appropriation to the 520.18commissioner, $6,035,000 in fiscal year 2008 520.19is for preparation, planning, and response 520.20to a pandemic influenza outbreak. This 520.21appropriation is available until June 30, 2009.520.22Base funding for the 2010-2011 biennium is 520.23$0 each fiscal year.520.24Environmental Health Tracking and 520.25Biomonitoring. (a) $500,000 in the first 520.26year and $900,000 in the second year are 520.27for the environmental health tracking and 520.28biomonitoring program. The base for fiscal 520.29year 2010 and fiscal year 2011 is increased 520.30by $300,000 each year.520.31(b) $300,000 each year is from the 520.32environmental fund to the Pollution Control 520.33Agency for transfer to the Department 520.34of Health for the health tracking and 520.35biomonitoring program. The base for the 521.1environmental fund is $0 in fiscal year 2010 521.2and after.521.3AIDS Prevention Initiative Focusing 521.4on African-born Residents. $300,000 in 521.52008 is for an AIDS prevention initiative 521.6focusing on African-born residents. This 521.7appropriation is a onetime appropriation 521.8and shall not become part of the base-level 521.9funding for the 2010-2011 biennium.521.10The commissioner of health shall award 521.11grants in accordance with Minnesota Statutes, 521.12section 145.924, paragraph (b), for a public 521.13education and awareness campaign targeting 521.14communities of African-born Minnesota 521.15residents. The grants shall be designed to 521.16promote knowledge and understanding about 521.17HIV and to increase knowledge in order 521.18to eliminate and reduce the risk for HIV 521.19infection; to encourage screening and testing 521.20for HIV; and to link individuals to public 521.21health and health care resources. The grants 521.22must be awarded to collaborative efforts that 521.23bring together nonprofit community-based 521.24groups with demonstrated experience in 521.25addressing the public health, health care, 521.26and social service needs of African-born 521.27communities.521.28Arsenic Health Risk Standard. $920,000 in 521.29the first year and $461,000 in the second year 521.30is to fund the study relating to arsenic health 521.31risk standards, under Minnesota Statutes, 521.32section 144.967.521.33Lindane and Bisphenol-A Studies.521.34$114,000 in the first year is for the Lindane 521.35committee and the study of bisphenol-A, 522.1under Minnesota Statutes, section 145.958. 522.2This is a onetime appropriation.522.3Decabromodiphenyl Ether Study.522.4$118,000 in the first year is for transfer to the 522.5commissioner of the pollution control agency 522.6for the study of decabromodiphenyl ether 522.7under Minnesota Statutes, section 325E.387. 522.8This is a onetime appropriation.522.9Radiation Study. $45,000 in the first year 522.10from the general fund and $15,000 in the 522.11first year from the state government special 522.12revenue fund are for the radiation study in 522.13section 62. This is a onetime appropriation.522.14Lead Abatement. $925,000 in the first 522.15year and $950,000 in the second year are 522.16for changes in lead abatement requirements. 522.17Of this amount, $6,000 in the first year and 522.18$11,000 in the second year are for transfer 522.19to the commissioner of human services for 522.20increased medical assistance costs. A portion 522.21of this amount may be used to reimburse 522.22local governments for costs of implementing 522.23the new requirements.522.24Water Treatment. $40,000 in fiscal year 522.252008 is to augment any appropriation from the 522.26remediation fund to conduct an evaluation of 522.27point of use water treatment units at removing 522.28perfluorooctanoic acid, perfluorooctane 522.29sulfonate, and perfluorobutanoic acid from 522.30known concentrations of these compounds 522.31in drinking water. The evaluation shall be 522.32completed by December 31, 2007, and the 522.33commissioner may contract for services to 522.34complete the evaluation. This is a onetime 522.35appropriation.523.1Environmental Justice Mapping. $137,000 523.2in the first year and $53,000 in the second 523.3year is for environmental justice mapping.523.4HIV Information. $80,000 each year 523.5is to fund a community-based nonprofit 523.6organization with demonstrated capacity to 523.7operate a statewide HIV information and 523.8referral service using telephone, Internet, and 523.9other appropriate technologies.523.10Lead Hazard Reduction. $250,000 is 523.11appropriated each year of the biennium for a 523.12grant to a nonprofit organization operating 523.13the CLEARCorps to conduct a pilot project 523.14to determine the incidence of lead hazards in 523.15pre-1978 rental property. Any balance in the 523.16first year does not cancel but is available in 523.17the second year.523.18Minnesota Birth Defects Information 523.19System. $750,000 each year is to maintain 523.20the birth defects information system that was 523.21established by Minnesota Statutes, section 523.22144.2215.

523.23Subd. 5.Minority and Multicultural Health

523.24Appropriations by Fund523.25General5,042,0005,052,000523.26Federal TANF2,683,0002,998,000

523.27TANF Appropriations. (a) $2,421,000 of 523.28the TANF funds is appropriated in each year 523.29of the biennium to the commissioner for 523.30home visiting and nutritional services listed 523.31under Minnesota Statutes, section 145.882, 523.32subdivision 7, clauses (6) and (7). Funding 523.33shall be distributed to tribal governments 523.34based on Minnesota Statutes, section 523.35145A.14, subdivision 2a, paragraph (b).524.1(b) $262,000 in the first year and $577,000 524.2in the second year are appropriated 524.3to the commissioner of health for the 524.4family home visiting grant program. The 524.5commissioner shall distribute funds to tribal 524.6governments using a formula developed in 524.7conjunction with tribal governments. The 524.8commissioner may use five percent of the 524.9funds appropriated in each fiscal year to 524.10conduct the ongoing evaluations required 524.11under Minnesota Statutes, section 145A.17, 524.12subdivision 7, and may use ten percent of 524.13the funds appropriated each fiscal year to 524.14provide training and technical assistance as 524.15required under Minnesota Statutes, section 524.16145A.17, subdivisions 4 and 5.524.17TANF Carryforward. Any unexpended 524.18balance of the TANF appropriation in the 524.19first year of the biennium does not cancel but 524.20is available for the second year.

524.21Subd. 6.Administrative Support Services

524.22Appropriations by Fund524.23General 11,047,000 11,197,000

524.24Disease Surveillance. $2,000,000 each fiscal 524.25year is for redesigning and implementing 524.26coordinated and modern disease surveillance 524.27systems for the department, ensuring that 524.28occupational and residential histories are 524.29included in the database. Base level funding 524.30for the 2012-2013 biennium will be $600,000 524.31each fiscal year for maintaining and operating 524.32the systems.

524.33524.34Sec. 5. VETERANS NURSING HOMES BOARD$44,124,000$46,244,000

525.1Veterans Homes Special Revenue Account.525.2The general fund  appropriations made to 525.3the board may be transferred to a veterans 525.4homes special revenue account in the 525.5special revenue fund in the same manner 525.6as other receipts are deposited according to 525.7Minnesota Statutes, section 198.34, and are 525.8appropriated to the board for the operation of 525.9board facilities and programs.525.10Repair and Betterment. Of this 525.11appropriation, $4,000,000 in fiscal year 525.122008 and $4,000,000 in fiscal year 2009 525.13are to be used for repair, maintenance, 525.14rehabilitation, and betterment activities at 525.15facilities statewide.525.16Base Adjustment. The general fund base is 525.17decreased by $2,000,000 in fiscal year 2010 525.18and $2,000,000 in fiscal year 2011.

525.19Sec. 6. HEALTH-RELATED BOARDS

525.20525.21Subdivision 1.Total Appropriation; State Government Special Revenue Fund$14,654,000$14,527,000

525.22The commissioner of finance shall not permit 525.23the allotment, encumbrance, or expenditure 525.24of money appropriated in this section in 525.25excess of the anticipated biennial revenues 525.26or accumulated surplus revenues from fees 525.27collected by the boards.

525.28Subd. 2.Board of Chiropractic Examiners450,000447,000

525.29Subd. 3.Board of Dentistry987,0001,009,000

525.30525.31Subd. 4.Board of Dietetic and Nutrition Practice103,000119,000

525.32Base Adjustment. Of this appropriation in 525.33fiscal year 2009, $14,000 is onetime.

526.1526.2Subd. 5.Board of Marriage and Family Therapy134,000154,000

526.3Base Adjustment. Of this appropriation in 526.4fiscal year 2009, $17,000 is onetime.

526.5Subd. 6.Board of Medical Practice4,120,0003,674,000

526.6Subd. 7.Board of Nursing3,985,0004,146,000

526.7526.8Subd. 8.Board of Nursing Home Administrators633,000647,000

526.9Administrative Services Unit. Of this 526.10appropriation, $430,000 in fiscal year 526.112008 and $439,000 in fiscal year 2009 are 526.12for the administrative services unit. The 526.13administrative services unit may receive 526.14and expend reimbursements for services 526.15performed by other agencies.

526.16Subd. 9.Board of Optometry98,000114,000

526.17Base Adjustment. Of this appropriation in 526.18fiscal year 2009, $13,000 is onetime.

526.19Subd. 10.Board of Pharmacy1,375,0001,442,000

526.20Base Adjustment. Of this appropriation in 526.21fiscal year 2009, $29,000 is onetime.

526.22Subd. 11.Board of Physical Therapy306,000295,000

526.23Subd. 12.Board of Podiatry54,00063,000

526.24Base Adjustment. Of this appropriation in 526.25fiscal year 2009, $7,000 is onetime.

526.26Subd. 13.Board of Psychology788,000806,000

526.27Subd. 14.Board of Social Work997,0001,022,000

526.28Subd. 15.Board of Veterinary Medicine230,000195,000

526.29526.30Subd. 16.Board of Behavioral Health and Therapy394,000394,000

526.31526.32Sec. 7. EMERGENCY MEDICAL SERVICES BOARD$4,617,000$4,645,000

527.1Appropriations by Fund527.220082009527.3General3,023,0003,041,000527.4527.5State Government Special Revenue687,000704,000

527.6Regional Emergency Medical Services 527.7Programs. $400,000 each year is for 527.8regional emergency medical services 527.9programs, to be distributed equally to the 527.10eight emergency medical service regions. 527.11This amount shall be added to the base 527.12funding. Notwithstanding Minnesota 527.13Statutes, section 144E.50, 100 percent of 527.14the appropriation shall be passed on to the 527.15emergency medical service regions.527.16Health Professional Services Program.527.17$687,000 in fiscal year 2008 and $704,000 in 527.18fiscal year 2009 from the state government 527.19special revenue fund are for the health 527.20professional services program.

527.21Sec. 8. COUNCIL ON DISABILITY$582,000$590,000

527.22Options Too. (a) $75,000 for the first 527.23year and $75,000 for the second year are 527.24to continue the work of the Options Too 527.25disability services interagency work group 527.26established under Laws 2005, First Special 527.27Session chapter 4, article 7, section 57. 527.28Funds shall be used to monitor and assist the 527.29work group and the Options Too Steering 527.30Committee in the implementation of the 527.31recommendations in the Options Too report 527.32dated February 15, 2007.527.33(b) For purposes of this section, the Options 527.34Too Steering Committee shall consist of the 527.35following members:528.1(1) a representative from the Minnesota 528.2Housing Finance Agency;528.3(2) a representative from the Minnesota State 528.4Council on Disability; 528.5(3) a representative from the Department of 528.6Veterans Affairs;528.7(4) a representative from the Department of 528.8Transportation;528.9(5) a representative from the Department of 528.10Human Services; and528.11(6) representatives from interested 528.12stakeholders including counties, local 528.13public housing authorities, the Metropolitan 528.14Council, disability service providers, and 528.15disability advocacy organizations who are 528.16appointed by the Minnesota State Council on 528.17Disability for two-year terms.528.18(c) Notwithstanding Laws 2005, First Special 528.19Session chapter 4, article 7, section 57, the 528.20interagency work group shall be administered 528.21by the Minnesota Housing Finance Agency, 528.22the Minnesota State Council on Disability, 528.23Department of Human Services, and the 528.24Department of Transportation.528.25(d) The Options Too Steering Committee 528.26shall report to the chairs of the health 528.27and human services policy and finance 528.28committees of the senate and house of 528.29representatives by October 15, 2007, and 528.30October 15, 2008, on the continued progress 528.31of the work group towards implementing the 528.32recommendations in the Options Too report 528.33dated February 15, 2007.

529.1529.2529.3Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES$1,567,000$1,621,000

529.4Sec. 10. OMBUDSMAN FOR FAMILIES$251,000$257,000

529.5    Sec. 11. TRANSFERS.529.6    Subdivision 1.Grants.The commissioner of human services, with the approval 529.7of the commissioner of finance and after notifying the chairs of the senate and house 529.8committees with jurisdiction, may transfer unencumbered appropriation balances for the 529.9biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance; 529.10general assistance medical care; medical assistance; MFIP child care assistance under 529.11Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential 529.12housing programs; and the entitlement portion of the chemical dependency consolidated 529.13treatment fund and between fiscal years of the biennium.529.14    Subd. 2.Administration.Positions, salary money, and nonsalary administrative 529.15money may be transferred within the Departments of Human Services and Health and 529.16within the programs operated by the Veterans Nursing Homes Board as the commissioners 529.17and the board consider necessary, with the advance approval of the commissioner of 529.18finance. The commissioner or the board shall inform the chairs of the house and senate 529.19committees with jurisdiction quarterly about transfers made under this provision.529.20    Sec. 12. INDIRECT COSTS NOT TO FUND PROGRAMS.529.21    The commissioners of health and of human services shall not use indirect cost 529.22allocations to pay for the operational costs of any program for which they are responsible.529.23    Sec. 13. SUNSET OF UNCODIFIED LANGUAGE.529.24    All uncodified language contained in this article expires on June 30, 2009, unless a 529.25different expiration date is explicit.529.26    Sec. 14. EFFECTIVE DATE.529.27    The provisions in this article are effective July 1, 2007, unless a different effective 529.28date is specified.