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; regulating abortion procedures; 1.9establishing the Minnesota Health Insurance Exchange; requiring Section 1.10125 Plans; modifying health insurance provisions; regulating anatomical 1.11gifts; establishing family supportive services; providing rate increases for 1.12certain providers; changing health records information provisions; making 1.13technical changes; providing civil and criminal penalties; establishing task 1.14forces; requiring reports; making forecast adjustments; appropriating money for 1.15human services and health; appropriating money for various state boards and 1.16councils;amending Minnesota Statutes 2006, sections 13.3806, by adding a 1.17subdivision; 13.46, subdivision 2; 16A.10, by adding a subdivision; 16B.61, by 1.18adding a subdivision; 16D.13, subdivision 3; 43A.316; 62A.65, subdivision 3; 1.1962E.141; 62H.02; 62J.04, subdivision 3; 62J.17, subdivisions 2, 4a, 7; 62J.41, 1.20subdivision 1; 62J.495; 62J.52, subdivisions 1, 2; 62J.60, subdivisions 2, 3, by 1.21adding a subdivision; 62J.692, subdivisions 1, 4, 7a, 8, 10; 62J.81, subdivision 1.221; 62J.82; 62L.12, subdivisions 2, 4; 62Q.165, subdivisions 1, 2; 62Q.80, 1.23subdivisions 3, 4, 13, 14, by adding a subdivision; 103I.101, subdivision 6; 1.24103I.208, subdivisions 1, 2; 103I.235, subdivision 1; 119B.05, subdivision 1.251; 119B.09, subdivisions 1, 7, by adding subdivisions; 119B.12; 119B.125, 1.26subdivision 2; 119B.13, subdivisions 1, 3a, 6, 7; 119B.21, subdivision 5; 1.27144.05, by adding a subdivision; 144.123; 144.125; 144.2215, subdivision 1; 1.28144.3345; 144.565; 144.651, subdivisions 9, 10, 26; 144.672, subdivision 1; 1.29144.698, subdivision 1; 144.699, by adding a subdivision; 144.9502, subdivision 1.303; 144.9504, subdivision 2; 144.9507, by adding a subdivision; 144.9512; 1.31144A.071, subdivision 4c; 144D.03, subdivision 1; 144E.101, subdivision 6; 1.32144E.127; 144E.35, subdivision 1; 145.412, by adding a subdivision; 145A.17; 1.33145C.05; 145C.07, by adding a subdivision; 148.235, by adding a subdivision; 1.34148.6445, subdivisions 1, 2; 148B.53, subdivision 3; 149A.52, subdivision 3; 1.35149A.97, subdivision 7; 151.19, subdivision 2; 151.37, subdivision 2; 152.11, by 1.36adding a subdivision; 156.001, by adding a subdivision; 156.02, subdivisions 1.371, 2; 156.04; 156.072, subdivision 2; 156.073; 156.12, subdivisions 2, 4, 6; 1.38156.15, subdivision 2; 156.16, subdivisions 3, 10; 156.18, subdivisions 1, 2; 1.39156.19; 157.16, subdivision 1; 179A.03, subdivision 7; 198.075; 245.462, 2.1subdivision 20; 245.465, by adding a subdivision; 245.4874; 245.50, subdivision 2.25; 245.98, subdivisions 2, 5; 245A.035; 245A.10, subdivision 2; 245A.16, 2.3subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04, subdivision 1; 2.4245C.05, subdivisions 1, 4, 5, 7, by adding a subdivision; 245C.08, subdivisions 2.51, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12; 2.6245C.16, subdivision 1; 245C.17, by adding a subdivision; 245C.21, by adding a 2.7subdivision; 245C.23, subdivision 2; 245C.24, subdivision 2; 246.54, subdivision 2.81; 252.27, subdivision 2a; 252.32, subdivision 3; 252.46, by adding a subdivision; 2.9253B.185, subdivision 2; 254A.03, subdivision 3; 254A.16, subdivision 2; 2.10254B.02, subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06, subdivision 3; 2.11256.01, subdivisions 2, 2b, 4, 18, by adding subdivisions; 256.015, subdivision 2.127; 256.017, subdivisions 1, 9; 256.0471, subdivision 1; 256.476, subdivisions 1, 2.132, 3, 4, 5, 10; 256.482, subdivisions 1, 8; 256.969, subdivisions 3a, 9, by adding 2.14a subdivision; 256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3, 2.154, 6; 256.9744, subdivision 1; 256.975, subdivision 7; 256.984, subdivision 1; 2.16256.9862, subdivision 2; 256B.04, subdivision 14, by adding a subdivision; 2.17256B.055, subdivision 14; 256B.056, subdivisions 1a, 3, 5c, by adding a 2.18subdivision; 256B.057, subdivision 8; 256B.059, subdivision 5; 256B.0621, 2.19subdivision 11; 256B.0625, subdivisions 3f, 13c, 13d, 14, 17, 18a, 20, 23, 47, by 2.20adding subdivisions; 256B.0644; 256B.0911, subdivisions 3a, 3b, 4b, 4c, 6, 7, by 2.21adding subdivisions; 256B.0913, subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13, 14; 2.22256B.0915; 256B.0917, subdivision 8; 256B.0919, subdivision 3; 256B.0943, 2.23subdivisions 6, 9, 11, 12; 256B.0945, subdivision 4; 256B.095; 256B.0951, 2.24subdivision 1; 256B.199; 256B.431, subdivisions 1, 2e, 3f, 17e; 256B.434, 2.25subdivision 4, by adding subdivisions; 256B.437, by adding a subdivision; 2.26256B.438, subdivision 3; 256B.439, subdivision 1; 256B.441, subdivisions 2.271, 2, 5, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 2.28256B.49, subdivision 11, by adding a subdivision; 256B.5012, by adding a 2.29subdivision; 256B.69, subdivisions 5g, 5h, 23, 28; 256B.75; 256B.76; 256B.763; 2.30256D.03, subdivision 4; 256D.44, subdivisions 2, 5; 256E.35, subdivision 2; 2.31256I.04, subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding 2.32a subdivision; 256J.02, subdivisions 1, 4; 256J.021; 256J.08, subdivision 2.3365; 256J.21, subdivision 2; 256J.24, subdivision 10; 256J.39, by adding a 2.34subdivision; 256J.42, subdivision 1; 256J.425, subdivisions 3, 4; 256J.46, by 2.35adding a subdivision; 256J.49, subdivision 13; 256J.521, subdivisions 1, 2, by 2.36adding a subdivision; 256J.53, subdivision 2; 256J.55, subdivision 1; 256J.626, 2.37subdivisions 1, 2, 3, 4, 5, 6; 256J.751, subdivisions 2, 5; 256J.95, subdivisions 2.383, 13; 256K.45, by adding a subdivision; 256L.01, subdivision 4; 256L.03, 2.39subdivisions 1, 5; 256L.035; 256L.04, subdivisions 1, 12; 256L.11, subdivision 2.407; 256L.12, subdivision 9a; 259.20, subdivision 2; 259.24, subdivision 3; 259.29, 2.41subdivision 1; 259.41; 259.53, subdivisions 1, 2; 259.57, subdivisions 1, 2; 2.42259.67, subdivisions 4, 7; 259.75, subdivision 8; 260.012; 260.755, subdivisions 2.4312, 20; 260.761, subdivision 7; 260.765, subdivision 5; 260.771, subdivisions 2.441, 2; 260B.157, subdivision 1; 260C.152, subdivision 5; 260C.163, subdivision 2.451; 260C.201, subdivision 11; 260C.209; 260C.212, subdivisions 1, 2, 4, 9; 2.46260C.317, subdivision 3; 260C.331, subdivision 1; 270B.14, subdivision 1; 2.47609.115, subdivision 9; 626.556, subdivisions 2, 3, 10, 10a, 10c, 10f, by adding 2.48subdivisions; Laws 2000, chapter 340, section 19; Laws 2005, chapter 98, article 2.493, section 25; Laws 2005, First Special Session chapter 4, article 9, section 3, 2.50subdivision 2; Laws 2006, chapter 282, article 20, section 37; proposing coding 2.51for new law in Minnesota Statutes, chapters 16A; 62A; 62J; 62Q; 144; 145; 148; 2.52149A; 151; 152; 156; 245A; 245C; 254A; 256; 256B; 256C; 256D; 256F; 256J; 2.53260; 325E; proposing coding for new law as Minnesota Statutes, chapters 146B; 2.54256N; 525A; repealing Minnesota Statutes 2006, sections 62J.052, subdivision 2.551; 62J.17, subdivisions 1, 5a, 6a, 8; 119B.08, subdivision 4; 144.335; 252.21; 2.56252.22; 252.23; 252.24; 252.25; 252.261; 252.275, subdivision 5; 254A.02, 2.57subdivisions 7, 9, 12, 14, 15, 16; 254A.085; 254A.086; 254A.12; 254A.14; 2.58254A.15; 254A.16, subdivision 5; 254A.175; 254A.18; 256.969, subdivision 3.127; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, 5h; 256B.441, 3.2subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.29; 256J.37, subdivisions 3a, 3.33b; 256J.561, subdivision 1; 256J.62, subdivision 9; 256J.626, subdivisions 3.47, 9; 256J.65; 525.921; 525.9211; 525.9212; 525.9213; 525.9214; 525.9215; 3.5525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222; 525.9223; 3.6525.9224; Laws 1997, chapter 8, section 1; Laws 2004, chapter 288, article 6, 3.7section 27; Minnesota Rules, parts 4610.2800; 9503.0035, subpart 2; 9560.0102, 3.8subpart 2, item C; 9585.0030.3.9BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:3.10ARTICLE 13.11CHILDREN AND FAMILY3.12    Section 1. Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:3.13    Subd. 2. General. (a) Unless the data is summary data or a statute specifically 3.14provides a different classification, data on individuals collected, maintained, used, or 3.15disseminated by the welfare system is private data on individuals, and shall not be 3.16disclosed except:3.17    (1) according to section 
         13.05;3.18    (2) according to court order;3.19    (3) according to a statute specifically authorizing access to the private data;3.20    (4) to an agent of the welfare system, including a law enforcement person, attorney, 3.21or investigator acting for it in the investigation or prosecution of a criminal or civil 3.22proceeding relating to the administration of a program;3.23    (5) to personnel of the welfare system who require the data to verify an individual's 3.24identity; determine eligibility, amount of assistance, and the need to provide services to 3.25an individual or family across programs; evaluate the effectiveness of programs; and 3.26investigate suspected fraud;3.27    (6) to administer federal funds or programs;3.28    (7) between personnel of the welfare system working in the same program;3.29    (8) to the Department of Revenue to administer and evaluate tax refund or tax credit 3.30programs and to identify individuals who may benefit from these programs. The following 3.31information may be disclosed under this paragraph: an individual's and their dependent's 3.32names, dates of birth, Social Security numbers, income, addresses, and other data as 3.33required, upon request by the Department of Revenue. Disclosures by the commissioner 3.34of revenue to the commissioner of human services for the purposes described in this clause 3.35are governed by section 
         270B.14, subdivision 1. Tax refund or tax credit programs include, 3.36but are not limited to, the dependent care credit under section 
         290.067, the Minnesota 4.1working family credit under section 
         290.0671, the property tax refund and rental credit 4.2under section 
         290A.04, and the Minnesota education credit under section 
         290.0674;4.3    (9) between the Department of Human Services, the Department of Education, and 4.4the Department of Employment and Economic Development for the purpose of monitoring 4.5the eligibility of the data subject for unemployment benefits, for any employment or 4.6training program administered, supervised, or certified by that agency, for the purpose of 4.7administering any rehabilitation program or child care assistance program, whether alone 4.8or in conjunction with the welfare system, or to monitor and evaluate the Minnesota 4.9family investment program or the child care assistance program by exchanging data on 4.10recipients and former recipients of food support, cash assistance under chapter 256, 256D, 4.11256J, or 256K, child care assistance under chapter 119B, or medical programs under 4.12chapter 256B, 256D, or 256L;4.13    (10) to appropriate parties in connection with an emergency if knowledge of 4.14the information is necessary to protect the health or safety of the individual or other 4.15individuals or persons;4.16    (11) data maintained by residential programs as defined in section 
         245A.02 may 4.17be disclosed to the protection and advocacy system established in this state according 4.18to Part C of Public Law 98-527 to protect the legal and human rights of persons with 4.19developmental disabilities or other related conditions who live in residential facilities for 4.20these persons if the protection and advocacy system receives a complaint by or on behalf 4.21of that person and the person does not have a legal guardian or the state or a designee of 4.22the state is the legal guardian of the person;4.23    (12) to the county medical examiner or the county coroner for identifying or locating 4.24relatives or friends of a deceased person;4.25    (13) data on a child support obligor who makes payments to the public agency 4.26may be disclosed to the Minnesota Office of Higher Education to the extent necessary to 4.27determine eligibility under section 
         136A.121, subdivision 2, clause (5);4.28    (14) participant Social Security numbers and names collected by the telephone 4.29assistance program may be disclosed to the Department of Revenue to conduct an 4.30electronic data match with the property tax refund database to determine eligibility under 4.31section 
         237.70, subdivision 4a;4.32    (15) the current address of a Minnesota family investment program participant 4.33may be disclosed to law enforcement officers who provide the name of the participant 4.34and notify the agency that:4.35    (i) the participant:5.1    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 5.2conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 5.3jurisdiction from which the individual is fleeing; or5.4    (B) is violating a condition of probation or parole imposed under state or federal law;5.5    (ii) the location or apprehension of the felon is within the law enforcement officer's 5.6official duties; and5.7    (iii) the request is made in writing and in the proper exercise of those duties;5.8    (16) the current address of a recipient of general assistance or general assistance 5.9medical care may be disclosed to probation officers and corrections agents who are 5.10supervising the recipient and to law enforcement officers who are investigating the 5.11recipient in connection with a felony level offense;5.12    (17) information obtained from food support applicant or recipient households may 5.13be disclosed to local, state, or federal law enforcement officials, upon their written request, 5.14for the purpose of investigating an alleged violation of the Food Stamp Act, according 5.15to Code of Federal Regulations, title 7, section 272.1(c);5.16    (18) the address, Social Security number, and, if available, photograph of any 5.17member of a household receiving food support shall be made available, on request, to a 5.18local, state, or federal law enforcement officer if the officer furnishes the agency with the 5.19name of the member and notifies the agency that:5.20    (i) the member:5.21    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 5.22crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;5.23    (B) is violating a condition of probation or parole imposed under state or federal 5.24law; or5.25    (C) has information that is necessary for the officer to conduct an official duty related 5.26to conduct described in subitem (A) or (B);5.27    (ii) locating or apprehending the member is within the officer's official duties; and5.28    (iii) the request is made in writing and in the proper exercise of the officer's official 5.29duty;5.30    (19) the current address of a recipient of Minnesota family investment program, 5.31general assistance, general assistance medical care, or food support may be disclosed to 5.32law enforcement officers who, in writing, provide the name of the recipient and notify the 5.33agency that the recipient is a person required to register under section 
         243.166, but is not 5.34residing at the address at which the recipient is registered under section 
         243.166;5.35    (20) certain information regarding child support obligors who are in arrears may be 5.36made public according to section 
         518A.74;6.1    (21) data on child support payments made by a child support obligor and data on 6.2the distribution of those payments excluding identifying information on obligees may be 6.3disclosed to all obligees to whom the obligor owes support, and data on the enforcement 6.4actions undertaken by the public authority, the status of those actions, and data on the 6.5income of the obligor or obligee may be disclosed to the other party;6.6    (22) data in the work reporting system may be disclosed under section 
         256.998, 6.7subdivision 7
         ;6.8    (23) to the Department of Education for the purpose of matching Department of 6.9Education student data with public assistance data to determine students eligible for free 6.10and reduced price meals, meal supplements, and free milk according to United States 6.11Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and 6.12state funds that are distributed based on income of the student's family; and to verify 6.13receipt of energy assistance for the telephone assistance plan;6.14    (24) the current address and telephone number of program recipients and emergency 6.15contacts may be released to the commissioner of health or a local board of health as 6.16defined in section 
         145A.02, subdivision 2, when the commissioner or local board of health 6.17has reason to believe that a program recipient is a disease case, carrier, suspect case, or at 6.18risk of illness, and the data are necessary to locate the person;6.19    (25) to other state agencies, statewide systems, and political subdivisions of this 6.20state, including the attorney general, and agencies of other states, interstate information 6.21networks, federal agencies, and other entities as required by federal regulation or law for 6.22the administration of the child support enforcement program;6.23    (26) to personnel of public assistance programs as defined in section 
         256.741, for 6.24access to the child support system database for the purpose of administration, including 6.25monitoring and evaluation of those public assistance programs;6.26    (27) to monitor and evaluate the Minnesota family investment program by 6.27exchanging data between the Departments of Human Services and Education, on 6.28recipients and former recipients of food support, cash assistance under chapter 256, 256D, 6.29256J, or 256K, child care assistance under chapter 119B, or medical programs under 6.30chapter 256B, 256D, or 256L;6.31    (28) to evaluate child support program performance and to identify and prevent 6.32fraud in the child support program by exchanging data between the Department of Human 6.33Services, Department of Revenue under section 
         270B.14, subdivision 1, paragraphs (a) 6.34and (b), without regard to the limitation of use in paragraph (c), Department of Health, 6.35Department of Employment and Economic Development, and other state agencies as is 6.36reasonably necessary to perform these functions; or7.1    (29) counties operating child care assistance programs under chapter 119B may 7.2disseminate data on program participants, applicants, and providers to the commissioner 7.3of education.7.4    (b) Information on persons who have been treated for drug or alcohol abuse may 7.5only be disclosed according to the requirements of Code of Federal Regulations, title 7.642, sections 2.1 to 
         2.67.7.7    (c) Data provided to law enforcement agencies under paragraph (a), clause (15), 7.8(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected 7.9nonpublic while the investigation is active. The data are private after the investigation 7.10becomes inactive under section 
         13.82, subdivision 5, paragraph (a) or (b).7.11    (d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but is 7.12not subject to the access provisions of subdivision 10, paragraph (b).7.13    For the purposes of this subdivision, a request will be deemed to be made in writing 7.14if made through a computer interface system.7.15    Sec. 2. Minnesota Statutes 2006, section 16D.13, subdivision 3, is amended to read:7.16    Subd. 3. Exclusion. A state agency may not charge interest under this section on 7.17overpayments of assistance benefits under the programs formerly codified in sections 7.18256.031
          to 
         256.0361, 
         256.72 to 
         256.87, and under chapters 119B, 256D, and 256I, or the 7.19federal food stamp program. Notwithstanding this prohibition, any debts that have been 7.20reduced to judgment under these programs are subject to the interest charges provided 7.21under section 
         549.09.7.22    Sec. 3. Minnesota Statutes 2006, section 119B.05, subdivision 1, is amended to read:7.23    Subdivision 1. Eligible participants. Families eligible for child care assistance 7.24under the MFIP child care program are:7.25    (1) MFIP participants who are employed or in job search and meet the requirements 7.26of section 
         119B.10; 7.27    (2) persons who are members of transition year families under section 
         119B.011, 7.28subdivision 20
         , and meet the requirements of section 
         119B.10; 7.29    (3) families who are participating in employment orientation or job search, or 7.30other employment or training activities that are included in an approved employability 7.31development plan under section sections 256J.09 and256J.95; 7.32    (4) MFIP families who are participating in work job search, job support, 7.33employment, or training activities as required in their employment plan, or in appeals, 7.34hearings, assessments, or orientations according to chapter 256J;8.1    (5) MFIP families who are participating in social services activities under chapter 8.2256J as required in their employment plan approved according to chapter 256J;8.3    (6) families who are participating in programs as required in tribal contracts under 8.4section 
         119B.02, subdivision 2, or 
         256.01, subdivision 2; and 8.5    (7) families who are participating in the transition year extension under section 8.6119B.011, subdivision 20a
         . 8.7    Sec. 4. Minnesota Statutes 2006, section 119B.09, subdivision 1, is amended to read:8.8    Subdivision 1. General Eligibility requirements for all applicants for child 8.9care assistance. (a) Child care services must be available to families who need child 8.10care to find or keep employment or to obtain the training or education necessary to find 8.11employment and who:8.12    (1) have household income less than or equal to 250 percent of the federal poverty 8.13guidelines, adjusted for family size, and meet the requirements of section 
         119B.05; 8.14receive MFIP assistance; and are participating in employment and training services under 8.15chapter 256J or 256K; or8.16    (2) have household income less than or equal to 175 percent of the federal poverty 8.17guidelines, adjusted for family size, at program entry and less than 250 percent of the 8.18federal poverty guidelines, adjusted for family size, at program exit.; or8.19    (3) have household income less than or equal to 250 percent of the federal poverty 8.20guidelines, adjusted for family size, and were a family whose child care assistance was 8.21terminated due to insufficient funds under Minnesota Rules, part 3400.0183.8.22    (b) Child care services must be made available as in-kind services.8.23    (c) All applicants for child care assistance and families currently receiving child care 8.24assistance must be assisted and required to cooperate in establishment of paternity and 8.25enforcement of child support obligations for all children in the family as a condition 8.26of program eligibility. For purposes of this section, a family is considered to meet the 8.27requirement for cooperation when the family complies with the requirements of section 8.28256.741
         .8.29EFFECTIVE DATE.This section is effective July 1, 2008.8.30    Sec. 5. Minnesota Statutes 2006, section 119B.09, subdivision 7, is amended to read:8.31    Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child 8.32care assistance under this chapter is the later of the date the application was signed; the 8.33beginning date of employment, education, or training; the date the infant is born for 8.34applicants to the at-home infant care program; or the date a determination has been made 9.1that the applicant is a participant in employment and training services under Minnesota 9.2Rules, part 3400.0080, subpart 2a, or chapter 256J.9.3    (b) Payment ceases for a family under the at-home infant child care program when a 9.4family has used a total of 12 months of assistance as specified under section 
         119B.035. 9.5Payment of child care assistance for employed persons on MFIP is effective the date of 9.6employment or the date of MFIP eligibility, whichever is later. Payment of child care 9.7assistance for MFIP or DWP participants in employment and training services is effective 9.8the date of commencement of the services or the date of MFIP or DWP eligibility, 9.9whichever is later. Payment of child care assistance for transition year child care must be 9.10made retroactive to the date of eligibility for transition year child care. 9.11    (c) Notwithstanding paragraph (b), payment of child care assistance for participants 9.12eligible under section 119B.05, may only be made retroactively for a maximum of six 9.13months from the date of application for child care assistance.9.14EFFECTIVE DATE.This section is effective July 1, 2008.9.15    Sec. 6. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision 9.16to read:9.17    Subd. 11.Payment of other child care expenses.Payment by a source other 9.18than the family, of part or all of a family's child care expenses not payable under this 9.19chapter, does not affect the family's eligibility for child care assistance, and the amount 9.20paid is excluded from the family's income, if the funds are paid directly to the family's 9.21child care provider on behalf of the family. Child care providers who accept third-party 9.22payments must maintain family-specific documentation of payment source, amount, type 9.23of expenses, and time period covered by the payment.9.24    Sec. 7. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision 9.25to read:9.26    Subd. 12.Sliding fee.Child care services to families must be made available on 9.27a sliding fee basis.9.28    The commissioner shall convert eligibility requirements in section 119B.09 and 9.29parent fee schedules in 119B.12 to state median income, based on a family size of three, 9.30adjusted for family size, by July 1, 2008. The commissioner shall report to the 2008 9.31legislature with the necessary statutory changes to codify this conversion to state median 9.32income. 10.1    Sec. 8. Minnesota Statutes 2006, section 119B.12, is amended to read:10.2119B.12 SLIDING FEE SCALE.10.3    Subdivision 1. Fee schedule. In setting the sliding fee schedule, the commissioner 10.4shall exclude from the amount of income used to determine eligibility an amount for 10.5federal and state income and Social Security taxes attributable to that income level 10.6according to federal and state standardized tax tables. The commissioner shall base the 10.7parent fee on the ability of the family to pay for child care. The fee schedule must be 10.8designed to use any available tax credits.10.9    PARENT FEE SCHEDULE.   The parent fee schedule is as follows: 

10.1010.11Income Range (as a percent of the federal poverty guidelines)Co-payment (as a percentage of adjusted gross income)10.12 0-74.99%$0/month10.1375.00-99.99%$5/month10.14100.00-104.99%2.61%10.15105.00-109.99%2.61%10.16110.00-114.99%2.61%10.17115.00-119.99%2.61%10.18120.00-124.99%2.91%10.19125.00-129.99%2.91%10.20130.00-134.99%2.91%10.21135.00-139.99%2.91%10.22140.00-144.99%3.21%10.23145.00-149.99%3.21%10.24150.00-154.99%3.21%10.25155.00-159.99%3.84%10.26160.00-164.99%3.84%10.27165.00-169.99%4.46%10.28170.00-174.99%4.76%10.29175.00-179.99%5.05%10.30180.00-184.99%5.65%10.31185.00-189.99%5.95%10.32190.00-194.99%6.24%10.33195.00-199.99%6.84%10.34200.00-204.99%7.58%10.35205.00-209.99%8.33%10.36210.00-214.99%9.20%10.37215.00-219.99%10.07%10.38220.00-224.99%10.94%10.39225.00-229.99%11.55%10.40230.00-234.99%12.16%10.41235.00-239.99%12.77%10.42240.00-244.99%13.38%11.1245.00-249.99%14.00%11.2250%ineligible

11.3    A family's monthly co-payment fee is the fixed percentage established for the 11.4income range multiplied by the highest possible income within that income range.11.5    Subd. 2. Parent fee. A family must be assessed a parent fee for each service period. 11.6A family's parent fee must be a fixed percentage of its annual gross income. Parent fees 11.7must apply to families eligible for child care assistance under sections 
         119B.03 and 11.8119B.05
         . Income must be as defined in section 
         119B.011, subdivision 15. The fixed 11.9percent is based on the relationship of the family's annual gross income to 100 percent 11.10of the annual federal poverty guidelines. Parent fees must begin at 75 percent of the 11.11poverty level. The minimum parent fees for families between 75 percent and 100 percent 11.12of poverty level must be $10 $5 per month. Parent fees must provide for graduated 11.13movement to full payment. Payment of part or all of a family's parent fee directly to the 11.14family's child care provider on behalf of the family by a source other than the family shall 11.15not affect the family's eligibility for child care assistance, and the amount paid shall be 11.16excluded from the family's income. Child care providers who accept third-party payments 11.17must maintain family specific documentation of payment source, amount, and time period 11.18covered by the payment.11.19EFFECTIVE DATE.(a) This section is effective July 1, 2007. 11.20    (b) Effective July 1, 2008, the parent fee scale for families with incomes greater than 11.21or equal to 100 percent of FPG shall be converted to state median income for a family size 11.22of three, adjusted for family size, as directed in section 119B.09, subdivision 12. 11.23    Sec. 9. Minnesota Statutes 2006, section 119B.125, subdivision 2, is amended to read:11.24    Subd. 2. Persons who cannot be authorized. (a) A person who meets any of the 11.25conditions under paragraphs (b) to (n) must not be authorized as a legal nonlicensed 11.26family child care provider. To determine whether any of the listed conditions exist, 11.27the county must request information about the provider from the Bureau of Criminal 11.28Apprehension, the juvenile courts, and social service agencies. When one of the listed 11.29entities does not maintain information on a statewide basis, the county must contact the 11.30entity in the county where the provider resides and any other county in which the provider 11.31previously resided in the past year. For purposes of this subdivision, a finding that a 11.32delinquency petition is proven in juvenile court must be considered a conviction in state 11.33district court. If a county has determined that a provider is able to be authorized in that 11.34county, and a family in another county later selects that provider, the provider is able to 12.1be authorized in the second county without undergoing a new background investigation 12.2unless one of the following conditions exists:12.3    (1) two years have passed since the first authorization;12.4    (2) another person age 13 or older has joined the provider's household since the 12.5last authorization;12.6    (3) a current household member has turned 13 since the last authorization; or12.7    (4) there is reason to believe that a household member has a factor that prevents 12.8authorization.12.9    (b) The person has been convicted of one of the following offenses or has admitted to 12.10committing or a preponderance of the evidence indicates that the person has committed an 12.11act that meets the definition of one of the following offenses: sections 
         609.185 to 
         609.195, 12.12murder in the first, second, or third degree; 
         609.2661 to 
         609.2663, murder of an unborn 12.13child in the first, second, or third degree; 
         609.322, solicitation, inducement, promotion 12.14of prostitution, or receiving profit from prostitution; 
         609.342 to 
         609.345, criminal sexual 12.15conduct in the first, second, third, or fourth degree; 
         609.352, solicitation of children to 12.16engage in sexual conduct; 
         609.365, incest; 
         609.377, felony malicious punishment of a 12.17child; 
         617.246, use of minors in sexual performance; 
         617.247, possession of pictorial 12.18representation of a minor; 
         609.2242 to 
         609.2243, felony domestic assault; a felony offense 12.19of spousal abuse; a felony offense of child abuse or neglect; a felony offense of a crime 12.20against children; or an attempt or conspiracy to commit any of these offenses as defined in 12.21Minnesota Statutes; or an offense in any other state or country where the elements are 12.22substantially similar to any of the offenses listed in this paragraph.12.23    (c) Less than 15 years have passed since the discharge of the sentence imposed for 12.24the offense and the person has received a felony conviction for one of the following 12.25offenses, or the person has admitted to committing or a preponderance of the evidence 12.26indicates that the person has committed an act that meets the definition of a felony 12.27conviction for one of the following offenses: sections 
         609.20 to 
         609.205, manslaughter in 12.28the first or second degree; 
         609.21, criminal vehicular homicide; 
         609.215, aiding suicide 12.29or aiding attempted suicide; 
         609.221 to 
         609.2231, assault in the first, second, third, or 12.30fourth degree; 
         609.224, repeat offenses of fifth degree assault; 
         609.228, great bodily 12.31harm caused by distribution of drugs; 
         609.2325, criminal abuse of a vulnerable adult; 12.32609.2335
         , financial exploitation of a vulnerable adult; 
         609.235, use of drugs to injure or 12.33facilitate a crime; 
         609.24, simple robbery; 
         617.241, repeat offenses of obscene materials 12.34and performances; 
         609.245, aggravated robbery; 
         609.25, kidnapping; 
         609.255, false 12.35imprisonment; 
         609.2664 to 
         609.2665, manslaughter of an unborn child in the first or 12.36second degree; 
         609.267 to 
         609.2672, assault of an unborn child in the first, second, or third 13.1degree; 
         609.268, injury or death of an unborn child in the commission of a crime; 
         609.27, 13.2coercion; 
         609.275, attempt to coerce; 
         609.324, subdivision 1, other prohibited acts, minor 13.3engaged in prostitution; 
         609.3451, repeat offenses of criminal sexual conduct in the fifth 13.4degree; 
         609.378, neglect or endangerment of a child; 
         609.52, theft; 
         609.521, possession of 13.5shoplifting gear; 
         609.561 to 
         609.563, arson in the first, second, or third degree; 
         609.582, 13.6burglary in the first, second, third, or fourth degree; 
         609.625, aggravated forgery; 
         609.63, 13.7forgery; 
         609.631, check forgery, offering a forged check; 
         609.635, obtaining signature 13.8by false pretenses; 
         609.66, dangerous weapon; 
         609.665, setting a spring gun; 
         609.67, 13.9unlawfully owning, possessing, or operating a machine gun; 
         609.687, adulteration; 
         609.71, 13.10riot; 
         609.713, terrorist threats; 
         609.749, harassment, stalking; 
         260C.301, termination of 13.11parental rights; 
         152.021 to 
         152.022 and 
         152.0262, controlled substance crime in the first 13.12or second degree; 
         152.023, subdivision 1, clause (3) or (4), or 
         152.023, subdivision 2, 13.13clause (4), controlled substance crime in third degree; 
         152.024, subdivision 1, clause 13.14(2), (3), or (4), controlled substance crime in fourth degree; 
         617.23, repeat offenses of 13.15indecent exposure; an attempt or conspiracy to commit any of these offenses as defined in 13.16Minnesota Statutes; or an offense in any other state or country where the elements are 13.17substantially similar to any of the offenses listed in this paragraph.13.18    (d) Less than ten years have passed since the discharge of the sentence imposed for 13.19the offense and the person has received a gross misdemeanor conviction for one of the 13.20following offenses or the person has admitted to committing or a preponderance of the 13.21evidence indicates that the person has committed an act that meets the definition of a gross 13.22misdemeanor conviction for one of the following offenses: sections 
         609.224, fifth degree 13.23assault; 
         609.2242 to 
         609.2243, domestic assault; 
         518B.01, subdivision 14, violation of 13.24an order for protection; 
         609.3451, fifth degree criminal sexual conduct; 
         609.746, repeat 13.25offenses of interference with privacy; 
         617.23, repeat offenses of indecent exposure; 13.26617.241
         , obscene materials and performances; 
         617.243, indecent literature, distribution; 13.27617.293
         , disseminating or displaying harmful material to minors; 
         609.71, riot; 
         609.66, 13.28dangerous weapons; 
         609.749, harassment, stalking; 
         609.224, subdivision 2, paragraph 13.29(c), fifth degree assault against a vulnerable adult by a caregiver; 
         609.23, mistreatment 13.30of persons confined; 
         609.231, mistreatment of residents or patients; 
         609.2325, criminal 13.31abuse of a vulnerable adult; 
         609.2335, financial exploitation of a vulnerable adult; 13.32609.233
         , criminal neglect of a vulnerable adult; 
         609.234, failure to report maltreatment of 13.33a vulnerable adult; 
         609.72, subdivision 3, disorderly conduct against a vulnerable adult; 13.34609.265
         , abduction; 
         609.378, neglect or endangerment of a child; 
         609.377, malicious 13.35punishment of a child; 
         609.324, subdivision 1a, other prohibited acts, minor engaged 13.36in prostitution; 
         609.33, disorderly house; 
         609.52, theft; 
         609.582, burglary in the first, 14.1second, third, or fourth degree; 
         609.631, check forgery, offering a forged check; 
         609.275, 14.2attempt to coerce; an attempt or conspiracy to commit any of these offenses as defined in 14.3Minnesota Statutes; or an offense in any other state or country where the elements are 14.4substantially similar to any of the offenses listed in this paragraph.14.5    (e) Less than seven years have passed since the discharge of the sentence imposed 14.6for the offense and the person has received a misdemeanor conviction for one of the 14.7following offenses or the person has admitted to committing or a preponderance of 14.8the evidence indicates that the person has committed an act that meets the definition 14.9of a misdemeanor conviction for one of the following offenses: sections 
         609.224, fifth 14.10degree assault; 
         609.2242, domestic assault; 
         518B.01, violation of an order for protection; 14.11609.3232
         , violation of an order for protection; 
         609.746, interference with privacy; 
         609.79, 14.12obscene or harassing telephone calls; 
         609.795, letter, telegram, or package opening, 14.13harassment; 
         617.23, indecent exposure; 
         609.2672, assault of an unborn child, third degree; 14.14617.293
         , dissemination and display of harmful materials to minors; 
         609.66, dangerous 14.15weapons; 
         609.665, spring guns; an attempt or conspiracy to commit any of these offenses 14.16as defined in Minnesota Statutes; or an offense in any other state or country where the 14.17elements are substantially similar to any of the offenses listed in this paragraph.14.18    (f) The person has been identified by the child protection agency in the county where 14.19the provider resides or a county where the provider has resided or by the statewide child 14.20protection database as a person found by a preponderance of evidence under section 14.21626.556
          to be responsible for physical or sexual abuse of a child within the last seven years.14.22    (g) The person has been identified by the adult protection agency in the county 14.23where the provider resides or a county where the provider has resided or by the statewide 14.24adult protection database as the person responsible for abuse or neglect of a vulnerable 14.25adult within the last seven years.14.26    (h) The person has refused to give written consent for disclosure of criminal history 14.27records.14.28    (i) The person has been denied a family child care license or has received a fine or a 14.29sanction as a licensed child care provider that has not been reversed on appeal.14.30    (j) The person has a family child care licensing disqualification that has not been 14.31set aside.14.32    (k) The person has admitted or a county has found that there is a preponderance of 14.33evidence that fraudulent information was given to the county for child care assistance 14.34application purposes or was used in submitting child care assistance bills for payment.14.35    (l) The person has been convicted of the crime of theft by wrongfully obtaining 14.36public assistance or has been found guilty of wrongfully obtaining public assistance by a 15.1federal court, state court, or an administrative hearing determination or waiver, through a 15.2disqualification consent agreement, as part of an approved diversion plan under section 15.3401.065, or a court-ordered stay with probationary or other conditions.15.4    (m) The person has a household member age 13 or older who has access to children 15.5during the hours that care is provided and who meets one of the conditions listed in 15.6paragraphs (b) to (l).15.7    (n) The person has a household member ages ten to 12 who has access to children 15.8during the hours that care is provided; information or circumstances exist which provide 15.9the county with articulable suspicion that further pertinent information may exist showing 15.10the household member meets one of the conditions listed in paragraphs (b) to (l); and the 15.11household member actually meets one of the conditions listed in paragraphs (b) to (l).15.12    Sec. 10. Minnesota Statutes 2006, section 119B.13, subdivision 1, is amended to read:15.13    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006 2007, the 15.14maximum rate paid for child care assistance in any county or multicounty region under the 15.15child care fund shall be the  rate for like-care arrangements in the county effective January15.16July 1, 2006, increased by six two percent.15.17    (b) Rate changes shall be implemented for services provided in September 200615.182007 unless a participant eligibility redetermination or a new provider agreement is 15.19completed between July 1, 2006 2007, and August 31, 2006 2007.15.20    As necessary, appropriate notice of adverse action must be made according to 15.21Minnesota Rules, part 
         3400.0185, subparts 3 and 4.15.22    New cases approved on or after  July 1, 2006 2007, shall have the maximum rates 15.23under paragraph (a), implemented immediately.15.24    (c) Not less than once every two years year, the commissioner shall survey rates 15.25charged by child care providers in Minnesota to determine the 75th percentile for 15.26like-care arrangements in counties. When the commissioner determines that, using the 15.27commissioner's established protocol, the number of providers responding to the survey is 15.28too small to determine the 75th percentile rate for like-care arrangements in a county or 15.29multicounty region, the commissioner may establish the 75th percentile maximum rate 15.30based on like-care arrangements in a county, region, or category that the commissioner 15.31deems to be similar.15.32    (d) A rate which includes a special needs rate paid under subdivision 3 or under 15.33a school readiness service agreement paid under section 95 may be in excess of the 15.34maximum rate allowed under this subdivision.16.1    (e) The department shall monitor the effect of this paragraph on provider rates. The 16.2county shall pay the provider's full charges for every child in care up to the maximum 16.3established. The commissioner shall determine the maximum rate for each type of care 16.4on an hourly, full-day, and weekly basis, including special needs and disability care. The 16.5half-day rates are effective beginning July 1, 2008.16.6    (f) When the provider charge is greater than the maximum provider rate allowed, 16.7the parent is responsible for payment of the difference in the rates in addition to any 16.8family co-payment fee.16.9    (g) All maximum provider rate changes shall be implemented on the Monday 16.10following the effective date of the maximum provider rate.16.11    Sec. 11. Minnesota Statutes 2006, section 119B.13, subdivision 3a, is amended to read:16.12    Subd. 3a. Provider rate differential for accreditation. A family child care 16.13provider or child care center shall be paid a 15 percent differential above the maximum 16.14rate established in subdivision 1, up to the actual provider rate, if the provider or center 16.15holds a current early childhood development credential or is accredited.  For a family 16.16child care provider, early childhood development credential and accreditation includes 16.17an individual who has earned a child development associate degree, a child development 16.18associate credential, a diploma in child development from a Minnesota state technical 16.19college, or a bachelor's or post baccalaureate degree in early childhood education from 16.20an accredited college or university, or who is accredited by the National Association for 16.21Family Child Care or the Competency Based Training and Assessment Program.  For a 16.22child care center, accreditation includes accreditation by the National Association for the 16.23Education of Young Children, the Council on Accreditation, the National Early Childhood 16.24Program Accreditation, the National School-Age Care Association, or the National Head 16.25Start Association Program of Excellence.  For Montessori programs, accreditation includes 16.26the American Montessori Society, Association of Montessori International-USA, or the 16.27National Center for Montessori Education.16.28    Sec. 12. Minnesota Statutes 2006, section 119B.13, subdivision 6, is amended to read:16.29    Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments 16.30to the child care provider or pay the parent directly for eligible child care expenses.16.31    (b) If payments for child care assistance are made to providers, the provider shall 16.32bill the county for services provided within ten days of the end of the service period. If 16.33bills are submitted within ten days of the end of the service period, a county or the state 16.34shall issue payment to the provider of child care under the child care fund within 30 days 17.1of receiving a bill from the provider. Counties or the state may establish policies that 17.2make payments on a more frequent basis.17.3    (c) All billsIf a provider has received an authorization of care and has been issued a 17.4billing form for an eligible family, the bill must be submitted within 60 days of the last 17.5date of service on the bill. A county may pay a bill submitted more than 60 days after 17.6the last date of service if the provider shows good cause why the bill was not submitted 17.7within 60 days. Good cause must be defined in the county's child care fund plan under 17.8section 
         119B.08, subdivision 3, and the definition of good cause must include county 17.9error. A county may not pay any bill submitted more than a year after the last date of 17.10service on the bill. 17.11    (d) If a provider provided care for a time period without receiving an authorization 17.12of care and a billing form for an eligible family, payment of child care assistance may only 17.13be made retroactively for a maximum of six months from the date the provider is issued an 17.14authorization of care and a billing form.17.15    (d)(e) A county may stop payment issued to a provider or may refuse to pay a 17.16bill submitted by a provider if:17.17    (1) the provider admits to intentionally giving the county materially false information 17.18on the provider's billing forms; or17.19    (2) a county finds by a preponderance of the evidence that the provider intentionally 17.20gave the county materially false information on the provider's billing forms.17.21    (e)(f) A county's payment policies must be included in the county's child care plan 17.22under section 
         119B.08, subdivision 3. If payments are made by the state, in addition to 17.23being in compliance with this subdivision, the payments must be made in compliance 17.24with section 
         16A.124. 17.25    Sec. 13. Minnesota Statutes 2006, section 119B.13, subdivision 7, is amended to read:17.26    Subd. 7. Absent days. (a) Child care providers may not be reimbursed for more 17.27than 25 full-day absent days per child, excluding holidays, in a fiscal year, or for more 17.28than ten consecutive full-day absent days, unless the child has a documented medical 17.29condition that causes more frequent absences. Absences due to a documented medical 17.30condition of a parent or sibling who lives in the same residence as the child receiving 17.31child care assistance do not count against the 25-day absent day limit in a fiscal year. 17.32Documentation of medical conditions must be on the forms and submitted according to 17.33the timelines established by the commissioner. A public health nurse or school nurse 17.34may verify the illness in lieu of a medical practitioner. If a provider sends a child home 17.35early due to a medical reason including, but not limited to, fever or contagious illness, 18.1the child care center director or lead teacher may verify the illness in lieu of a medical 18.2practitioner. If a child attends for part of the time authorized to be in care in a day, but is 18.3absent for part of the time authorized to be in care in that same day, the absent time will be 18.4reimbursed but the time will not count toward the ten consecutive or 25 cumulative absent 18.5day limits. Children in families where at least one parent is under the age of 21, does not 18.6have a high school or general education development (GED) diploma, and is a student in a 18.7school district or another similar program that provides or arranges for child care, as well 18.8as parenting, social services, career and employment supports, and academic support to 18.9achieve high school graduation, may be exempt from the absent day limits upon request 18.10of the program and approval of the county. If a child attends part of an authorized day, 18.11payment to the provider must be for the full amount of care authorized for that day. Child 18.12care providers may only be reimbursed for absent days if the provider has a written policy 18.13for child absences and charges all other families in care for similar absences. 18.14    (b) Child care providers must be reimbursed for up to ten federal or state holidays 18.15or designated holidays per year when the provider charges all families for these days 18.16and the holiday or designated holiday falls on a day when the child is authorized to be 18.17in attendance. Parents may substitute other cultural or religious holidays for the ten 18.18recognized state and federal holidays. Holidays do not count toward the ten consecutive or 18.1925 cumulative absent day limits. 18.20    (c) A family or child care provider may not be assessed an overpayment for an 18.21absent day payment unless (1) there was an error in the amount of care authorized for the 18.22family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 18.23the family or provider did not timely report a change as required under law.18.24    (d) The provider and family must receive notification of the number of absent days 18.25used upon initial provider authorization for a family and when the family has used 15 18.26cumulative absent days. Upon statewide implementation of the Minnesota Electronic 18.27Child Care System, the provider and family authorization for a family and ongoing 18.28notification of the number of absent days used as of the date of the notification.18.29    (e) A county may pay for more absent days than the statewide absent day policy 18.30established under this subdivision, if current market practice in the county justifies 18.31payment for those additional days. County policies for payment of absent days in excess 18.32of the statewide absent day policy and justification for these county policies must be 18.33included in the county's child care fund plan under section 119B.08, subdivision 3. This 18.34paragraph may be implemented by counties on or after July 1, 2008.18.35    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. Minnesota Statutes 2006, section 256.9862, subdivision 2, is amended to read:33.2    Subd. 2. Transaction fee. The commissioner may must charge transaction fees 33.3in accordance with this subdivision up to a maximum of $10 in transaction fees per 33.4cardholder per month. In a given month, the first four cash withdrawals made by an 33.5individual cardholder are free. For subsequent cash withdrawals, $1 may be charged. No 33.6transaction fee can be charged if the card is used to purchase goods or services on a point 33.7of sale basis to cardholders. A transaction fee subsequently set by the federal government 33.8may supersede a fee established under this subdivision. The fees shall be appropriated to 33.9the commissioner and used for electronic benefit purposes.33.10    Sec. 25. [256D.0516] EXPIRATION OF FOOD SUPPORT BENEFITS AND 33.11REPORTING REQUIREMENTS.33.12    Subdivision 1.Expiration of food support benefits.Food support benefits shall 33.13not be stored off line or expunged from a recipient's account unless the benefits have not 33.14been accessed for 12 months after the month they were issued.33.15    Subd. 2.Food support reporting requirements.The Department of Human 33.16Services shall implement simplified reporting as permitted under the Food Stamp Act of 33.171977, as amended, and the food stamp regulations in Code of Federal Regulations, title 33.187, part 273. Food support recipient households required to report periodically shall not 33.19be required to report more often than one time every six months. This provision shall 33.20not apply to households receiving food benefits under the Minnesota family investment 33.21program waiver.33.22EFFECTIVE DATE.Subdivision 1 is effective February 1, 2008, and subdivision 33.232 is effective May 1, 2008.33.24    Sec. 26. [256F.15] GRANT PROGRAM FOR CRISIS NURSERIES.33.25    Subdivision 1.Crisis nurseries.The commissioner of human services shall 33.26establish a grant program to assist private and public agencies and organizations to 33.27provide crisis nurseries to offer services and temporary care to families experiencing crisis 33.28situations including children who are at high risk of abuse and neglect, children who have 33.29been abused and neglected, and children who are in families receiving child protective 33.30services. This service shall be provided without a fee for a maximum of 30 days in any 33.31year. Crisis nurseries shall provide short-term case management, family support services, 33.32parent education, crisis intervention, referrals, and resources, as needed.33.33    (a) The crisis nurseries must provide a spectrum of services that may include, but 33.34are not limited to:34.1    (1) being available 24 hours a day, seven days a week;34.2    (2) providing services for children up to 72 hours at any one time;34.3    (3) providing short-term case management to bridge the gap between crisis and 34.4successful living;34.5    (4) making referrals for parents to counseling services and other community 34.6resources to help alleviate the underlying cause of the precipitating stress or crisis;34.7    (5) providing services without a fee for a maximum of 30 days in any year;34.8    (6) providing services to families with children from birth through 12 years of age, 34.9as services are available;34.10    (7) providing an immediate response to family needs and strengths with an initial 34.11assessment and intake interview, making referrals to appropriate agencies or programs, 34.12and providing temporary care of children, as needed;34.13    (8) maintaining the clients' confidentiality to the extent required by law, and also 34.14complying with statutory reporting requirements which may mandate a report to child 34.15protective services;34.16    (9) providing a volunteer component and support for volunteers;34.17    (10) providing preservice training and ongoing training to providers and volunteers;34.18    (11) evaluating the services provided by documenting use of services, the result of 34.19family referrals made to community resources, and how the services reduced the risk of 34.20maltreatment;34.21    (12) providing developmental assessments;34.22    (13) providing medical assessments as determined by using a risk screening tool;34.23    (14) providing parent education classes or programs that include parent-child 34.24interaction either on site or in collaboration with other community agencies; and34.25    (15) having a multidisciplinary advisory board which may include one or more 34.26parents who have used the crisis nursery services.34.27    (b) The crisis nurseries are encouraged to provide opportunities for parents to 34.28volunteer, if appropriate.34.29    (c) Parents shall retain custody of their children during placement in a crisis facility.34.30    Subd. 2.Fund distribution.In distributing funds, the commissioner shall give 34.31priority consideration to agencies and organizations with experience in working with 34.32abused or neglected children and their families, and with children at high risk of abuse and 34.33neglect and their families, and serve communities which demonstrate the greatest need 34.34for these services. Funds shall be distributed to crisis nurseries according to a formula 34.35developed by the commissioner in consultation with the Minnesota Crisis Nursery 34.36Association. The formula shall include funding for all existing crisis nursery programs 35.1that have been previously funded through the Department of Human Services and that 35.2meet program requirements as specified in subdivision 1, paragraph (a), and consideration 35.3of factors reflecting the need for services in each service area, including but not limited to 35.4the number of children 18 years of age and under living in the service area, the percent 35.5of children 18 years of age and under living in poverty in the service area, and factors 35.6reflecting the cost of providing services, including but not limited to the number of hours 35.7of service provided in the previous year.35.8    Sec. 27. Minnesota Statutes 2006, section 256J.01, is amended by adding a subdivision 35.9to read:35.10    Subd. 6.Legislative approval to move programs or activities.The commissioner 35.11shall not move programs or activities funded with MFIP or TANF maintenance of effort 35.12funds to other funding sources without legislative approval.35.13    Sec. 28. Minnesota Statutes 2006, section 256J.02, subdivision 1, is amended to read:35.14    Subdivision 1. Commissioner's authority to administer block grant funds. The 35.15commissioner of human services is authorized to receive, administer, and expend funds 35.16available under the TANF block grant authorized under title I of Public Law 104-193, the 35.17Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and under 35.18Public Law 109-171, the Deficit Reduction Act of 2005.35.19    Sec. 29. Minnesota Statutes 2006, section 256J.02, subdivision 4, is amended to read:35.20    Subd. 4. Authority to transfer. Subject to limitations of title I of Public Law 35.21104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 35.22as amended, and under Public Law 109-171, the Deficit Reduction Act of 2005, the 35.23legislature may transfer money from the TANF block grant to the child care fund under 35.24chapter 119B, or the Title XX block grant.35.25    Sec. 30. Minnesota Statutes 2006, section 256J.021, is amended to read:35.26256J.021 SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.35.27    Families receiving assistance under this section must comply with all applicable 35.28requirements in this chapter.35.29    (a) Until October 1,  2006, the commissioner of human services must treat MFIP 35.30expenditures made to or on behalf of any minor child under section 256J.02, subdivision 35.312, clause (1), who is a resident of this state under section 256J.12, and who is part of a 35.32two-parent eligible household as expenditures under a separately funded state program 36.1and report those expenditures to the federal Department of Health and Human Services 36.2as separate state program expenditures under Code of Federal Regulations, title 45, 36.3section 263.5.36.4    (b) Beginning October 1, 2006, and each year thereafter, the commissioner of human 36.5services must treat MFIP expenditures made to or on behalf of any minor child under 36.6section 
         256J.02, subdivision 2, clause (1), who is a resident of this state under section 36.7256J.12, and who is part of a two-parent eligible household, as expenditures under a 36.8separately funded state program. These expenditures shall not count toward the state's 36.9maintenance of effort (MOE) requirements under the federal Temporary Assistance to 36.10Needy Families (TANF) program except if counting certain families would allow the 36.11commissioner to avoid a federal penalty. Families receiving assistance under this section 36.12must comply with all applicable requirements in this chapter.36.13    Sec. 31. Minnesota Statutes 2006, section 256J.08, subdivision 65, is amended to read:36.14    Subd. 65. Participant.(a) "Participant" means includes any of the following:36.15    (1) a person who is currently receiving cash assistance or the food portion available 36.16through MFIP. A person who fails to withdraw or access electronically any portion of the 36.17person's cash and food assistance payment by the end of the payment month, who makes a 36.18written request for closure before the first of a payment month and repays cash and food 36.19assistance electronically issued for that payment month within that payment month, or 36.20who returns any uncashed assistance check and food coupons and withdraws from the 36.21program is not a participant.;36.22    (2) a person who withdraws a cash or food assistance payment by electronic transfer 36.23or receives and cashes an MFIP assistance check or food coupons and is subsequently 36.24determined to be ineligible for assistance for that period of time is a participant, regardless 36.25whether that assistance is repaid. The term "participant" includes;36.26    (3) the caregiver relative and the minor child whose needs are included in the 36.27assistance payment.;36.28    (4) a person in an assistance unit who does not receive a cash and food assistance 36.29payment because the case has been suspended from MFIP is a participant.;36.30    (5) a person who receives cash payments under the diversionary work program 36.31under section 
         256J.95 is a participant.; and36.32    (6) a person who receives cash payments under the family stabilization services 36.33program under section 256J.575.36.34    (b) "Participant" does not include a person who fails to withdraw or access 36.35electronically any portion of the person's cash and food assistance payment by the end of 37.1the payment month, who makes a written request for closure before the first of a payment 37.2month and repays cash and food assistance electronically issued for that payment month 37.3within that payment month, or who returns any uncashed assistance check and food 37.4coupons and withdraws from the program.37.5EFFECTIVE DATE.This section is effective the day following final enactment.37.6    Sec. 32. Minnesota Statutes 2006, section 256J.21, subdivision 2, is amended to read:37.7    Subd. 2. Income exclusions. The following must be excluded in determining a 37.8family's available income:37.9    (1) payments for basic care, difficulty of care, and clothing allowances received for 37.10providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 37.11to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used 37.12for care and maintenance of a third-party beneficiary who is not a household member;37.13    (2) reimbursements for employment training received through the Workforce 37.14Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;37.15    (3) reimbursement for out-of-pocket expenses incurred while performing volunteer 37.16services, jury duty, employment, or informal carpooling arrangements directly related to 37.17employment;37.18    (4) all educational assistance, except the county agency must count graduate student 37.19teaching assistantships, fellowships, and other similar paid work as earned income and, 37.20after allowing deductions for any unmet and necessary educational expenses, shall 37.21count scholarships or grants awarded to graduate students that do not require teaching 37.22or research as unearned income;37.23    (5) loans, regardless of purpose, from public or private lending institutions, 37.24governmental lending institutions, or governmental agencies;37.25    (6) loans from private individuals, regardless of purpose, provided an applicant or 37.26participant documents that the lender expects repayment;37.27    (7)(i) state income tax refunds; and37.28    (ii) federal income tax refunds;37.29    (8)(i) federal earned income credits;37.30    (ii) Minnesota working family credits;37.31    (iii) state homeowners and renters credits under chapter 290A; and37.32    (iv) federal or state tax rebates;37.33    (9) funds received for reimbursement, replacement, or rebate of personal or real 37.34property when these payments are made by public agencies, awarded by a court, solicited 38.1through public appeal, or made as a grant by a federal agency, state or local government, 38.2or disaster assistance organizations, subsequent to a presidential declaration of disaster;38.3    (10) the portion of an insurance settlement that is used to pay medical, funeral, and 38.4burial expenses, or to repair or replace insured property;38.5    (11) reimbursements for medical expenses that cannot be paid by medical assistance;38.6    (12) payments by a vocational rehabilitation program administered by the state 38.7under chapter 268A, except those payments that are for current living expenses;38.8    (13) in-kind income, including any payments directly made by a third party to a 38.9provider of goods and services;38.10    (14) assistance payments to correct underpayments, but only for the month in which 38.11the payment is received;38.12    (15) payments for short-term emergency needs under section 
         256J.626, subdivision 38.132
         ;38.14    (16) funeral and cemetery payments as provided by section 
         256.935;38.15    (17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in 38.16a calendar month;38.17    (18) any form of energy assistance payment made through Public Law 97-35, 38.18Low-Income Home Energy Assistance Act of 1981, payments made directly to energy 38.19providers by other public and private agencies, and any form of credit or rebate payment 38.20issued by energy providers;38.21    (19) Supplemental Security Income (SSI), including retroactive SSI payments and 38.22other income of an SSI recipient, except as described in section 
         256J.37, subdivision 3b;38.23    (20) Minnesota supplemental aid, including retroactive payments;38.24    (21) proceeds from the sale of real or personal property;38.25    (22) state adoption assistance payments under section 
         259.67, and up to an equal 38.26amount of county adoption assistance payments;38.27    (23) state-funded family subsidy program payments made under section 
         252.3238.28to help families care for children with developmental disabilities, consumer support 38.29grant funds under section 
         256.476, and resources and services for a disabled household 38.30member under one of the home and community-based waiver services programs under 38.31chapter 256B;38.32    (24) interest payments and dividends from property that is not excluded from and 38.33that does not exceed the asset limit;38.34    (25) rent rebates;39.1    (26) income earned by a minor caregiver, minor child through age 6, or a minor 39.2child who is at least a half-time student in an approved elementary or secondary education 39.3program;39.4    (27) income earned by a caregiver under age 20 who is at least a half-time student in 39.5an approved elementary or secondary education program;39.6    (28) MFIP child care payments under section 
         119B.05;39.7    (29) all other payments made through MFIP to support a caregiver's pursuit of 39.8greater economic stability;39.9    (30) income a participant receives related to shared living expenses;39.10    (31) reverse mortgages;39.11    (32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 39.1242, chapter 13A, sections 1771 to 1790;39.13    (33) benefits provided by the women, infants, and children (WIC) nutrition program, 39.14United States Code, title 42, chapter 13A, section 1786;39.15    (34) benefits from the National School Lunch Act, United States Code, title 42, 39.16chapter 13, sections 1751 to 1769e;39.17    (35) relocation assistance for displaced persons under the Uniform Relocation 39.18Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title 39.1942, chapter 61, subchapter II, section 4636, or the National Housing Act, United States 39.20Code, title 12, chapter 13, sections 1701 to 1750jj;39.21    (36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 39.2212, part 2, sections 2271 to 2322;39.23    (37) war reparations payments to Japanese Americans and Aleuts under United 39.24States Code, title 50, sections 1989 to 1989d;39.25    (38) payments to veterans or their dependents as a result of legal settlements 39.26regarding Agent Orange or other chemical exposure under Public Law 101-239, section 39.2710405, paragraph (a)(2)(E);39.28    (39) income that is otherwise specifically excluded from MFIP consideration in 39.29federal law, state law, or federal regulation;39.30    (40) security and utility deposit refunds;39.31    (41) American Indian tribal land settlements excluded under Public Laws 98-123, 39.3298-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech 39.33Lake, and Mille Lacs reservations and payments to members of the White Earth Band, 39.34under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;40.1    (42) all income of the minor parent's parents and stepparents when determining the 40.2grant for the minor parent in households that include a minor parent living with parents or 40.3stepparents on MFIP with other children;40.4    (43) income of the minor parent's parents and stepparents equal to 200 percent of the 40.5federal poverty guideline for a family size not including the minor parent and the minor 40.6parent's child in households that include a minor parent living with parents or stepparents 40.7not on MFIP when determining the grant for the minor parent. The remainder of income is 40.8deemed as specified in section 
         256J.37, subdivision 1b;40.9    (44) payments made to children eligible for relative custody assistance under section 40.10257.85
         ;40.11    (45) vendor payments for goods and services made on behalf of a client unless the 40.12client has the option of receiving the payment in cash; and40.13    (46) the principal portion of a contract for deed payment.; and40.14    (47) cash payments to individuals enrolled for full-time service as a volunteer under 40.15AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps 40.16National, and AmeriCorps NCCC.40.17    Sec. 33. Minnesota Statutes 2006, section 256J.24, subdivision 10, is amended to read:40.18    Subd. 10. MFIP exit level. The commissioner shall adjust the MFIP earned income 40.19disregard to ensure that most participants do not lose eligibility for MFIP until their 40.20income reaches at least 115 140 percent of the federal poverty guidelines in effect in 40.21October of each fiscal year. The adjustment to the disregard shall be based on a household 40.22size of three, and the resulting earned income disregard percentage must be applied to all 40.23household sizes. The adjustment under this subdivision must be implemented at the same 40.24time as the October food stamp or food support cost-of-living adjustment is reflected in 40.25the food portion of MFIP transitional standard as required under subdivision 5a.40.26    Sec. 34. Minnesota Statutes 2006, section 256J.39, is amended by adding a subdivision 40.27to read:40.28    Subd. 1a.Prohibited purchases.MFIP recipients are prohibited from using MFIP 40.29monthly cash assistance payments issued in the form of an electronic benefits transfer 40.30to purchase tobacco products or alcohol.40.31    Sec. 35. Minnesota Statutes 2006, section 256J.42, subdivision 1, is amended to read:40.32    Subdivision 1. Time limit. (a) Except as otherwise provided for in this section, an 40.33assistance unit in which any adult caregiver has received 60 months of cash assistance 41.1funded in whole or in part by the TANF block grant in this or any other state or 41.2United States territory, or from a tribal TANF program, MFIP, the AFDC program 41.3formerly codified in sections 
         256.72 to 
         256.87, or the family general assistance program 41.4formerly codified in sections 
         256D.01 to 
         256D.23, funded in whole or in part by state 41.5appropriations, is ineligible to receive MFIP. Any cash assistance funded with TANF 41.6dollars in this or any other state or United States territory, or from a tribal TANF program, 41.7or MFIP assistance funded in whole or in part by state appropriations, that was received 41.8by the unit on or after the date TANF was implemented, including any assistance received 41.9in states or United States territories of prior residence, counts toward the 60-month 41.10limitation. Months during which any cash assistance is received by an assistance unit 41.11with a mandatory member who is disqualified for wrongfully obtaining public assistance 41.12under section 256.98, subdivision 8, counts toward the time limit for the disqualified 41.13member. The 60-month limit applies to a minor caregiver except under subdivision 5. The 41.1460-month time period does not need to be consecutive months for this provision to apply. 41.15    (b) The months before July 1998 in which individuals received assistance as part of 41.16the field trials as an MFIP, MFIP-R, or MFIP or MFIP-R comparison group family are 41.17not included in the 60-month time limit.41.18EFFECTIVE DATE.This section is effective October 1, 2007.41.19    Sec. 36. Minnesota Statutes 2006, section 256J.425, subdivision 3, is amended to read:41.20    Subd. 3. Hard-to-employ participants. An assistance unit subject to the time 41.21limit in section 
         256J.42, subdivision 1, is eligible to receive months of assistance under 41.22a hardship extension if the participant who reached the time limit belongs to any of the 41.23following groups: 41.24    (1) a person who is diagnosed by a licensed physician, psychological practitioner, 41.25or other qualified professional, as developmentally disabled or mentally ill, and that 41.26condition prevents the person from obtaining or retaining unsubsidized employment;41.27    (2) a person who:41.28    (i) has been assessed by a vocational specialist or the county agency to be 41.29unemployable for purposes of this subdivision; or41.30    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 41.31agency to be employable, but not at a level that makes the participant eligible for an 41.32extension under subdivision 4. The determination of IQ level must be made by a qualified 41.33professional. In the case of a non-English-speaking person: (A) the determination must 41.34be made by a qualified professional with experience conducting culturally appropriate 41.35assessments, whenever possible; (B) the county may accept reports that identify an 42.1IQ range as opposed to a specific score; (C) these reports must include a statement of 42.2confidence in the results;42.3    (3) a person who is determined by a qualified professional to be learning disabled, 42.4and the disability severely limits the person's ability to obtain, perform, or maintain 42.5suitable employment. For purposes of the initial approval of a learning disability 42.6extension, the determination must have been made or confirmed within the previous 12 42.7months. In the case of a non-English-speaking person: (i) the determination must be made 42.8by a qualified professional with experience conducting culturally appropriate assessments, 42.9whenever possible; and (ii) these reports must include a statement of confidence in the 42.10results. If a rehabilitation plan for a participant extended as learning disabled is developed 42.11or approved by the county agency, the plan must be incorporated into the employment 42.12plan. However, a rehabilitation plan does not replace the requirement to develop and 42.13comply with an employment plan under section 
         256J.521; or42.14    (4) a person who has been granted a family violence waiver, and who is complying 42.15with an employment plan under section 
         256J.521, subdivision 3; or42.16    (5) a participant under section 256J.561, subdivision 2, paragraph (d), who is 42.17complying with an employment plan tailored to recognize the special circumstances of 42.18the caregivers and family, including limitations due to illness or disability, and caregiving 42.19needs.42.20    Sec. 37. Minnesota Statutes 2006, section 256J.425, subdivision 4, is amended to read:42.21    Subd. 4. Employed participants. (a) An assistance unit subject to the time limit 42.22under section 
         256J.42, subdivision 1, is eligible to receive assistance under a hardship 42.23extension if the participant who reached the time limit belongs to: 42.24    (1) a one-parent assistance unit in which the participant is participating in work 42.25activities for at least 30 hours per week, of which an average of at least 25 hours per week 42.26every month are spent participating in employment;42.27    (2) a two-parent assistance unit in which the participants are participating in work 42.28activities for at least 55 hours per week, of which an average of at least 45 hours per week 42.29every month are spent participating in employment; or42.30    (3) an assistance unit in which a participant is participating in employment for fewer 42.31hours than those specified in clause (1) or (2), and the participant submits verification from 42.32a qualified professional, in a form acceptable to the commissioner, stating that the number 42.33of hours the participant may work is limited due to illness or disability, as long as the 42.34participant is participating in employment for at least the number of hours specified by the 42.35qualified professional. The participant must be following the treatment recommendations 43.1of the qualified professional providing the verification. The commissioner shall develop a 43.2form to be completed and signed by the qualified professional, documenting the diagnosis 43.3and any additional information necessary to document the functional limitations of the 43.4participant that limit work hours. If the participant is part of a two-parent assistance unit, 43.5the other parent must be treated as a one-parent assistance unit for purposes of meeting the 43.6work requirements under this subdivision.43.7    (b) For purposes of this section, employment means:43.8    (1) unsubsidized employment under section 256J.49, subdivision 13, clause (1); 43.9    (2) subsidized employment under section 256J.49, subdivision 13, clause (2); 43.10    (3) on-the-job training under section 256J.49, subdivision 13, clause (2); 43.11    (4) an apprenticeship under section 256J.49, subdivision 13, clause (1); 43.12    (5) supported work under section 256J.49, subdivision 13, clause (2); 43.13    (6) a combination of clauses (1) to (5); or43.14    (7) child care under section 256J.49, subdivision 13, clause (7), if it is in combination 43.15with paid employment.43.16    (c) If a participant is complying with a child protection plan under chapter 260C, 43.17the number of hours required under the child protection plan count toward the number 43.18of hours required under this subdivision.43.19    (d)(c) The county shall provide the opportunity for subsidized employment to 43.20participants needing that type of employment within available appropriations.43.21    (e)(d) To be eligible for a hardship extension for employed participants under this 43.22subdivision, a participant must be in compliance for at least ten out of the 12 months 43.23the participant received MFIP immediately preceding the participant's 61st month on 43.24assistance. If ten or fewer months of eligibility for TANF assistance remain at the time the 43.25participant from another state applies for assistance, the participant must be in compliance 43.26every month.43.27    (f)(e) The employment plan developed under section 
         256J.521, subdivision 2, for 43.28participants under this subdivision must contain at least the minimum number of hours 43.29specified in paragraph (a) for the purpose of meeting the requirements for an extension 43.30under this subdivision. The job counselor and the participant must sign the employment 43.31plan to indicate agreement between the job counselor and the participant on the contents 43.32of the plan. 43.33    (g)(f) Participants who fail to meet the requirements in paragraph (a), without 43.34good cause under section 
         256J.57, shall be sanctioned or permanently disqualified under 43.35subdivision 6. Good cause may only be granted for that portion of the month for which 44.1the good cause reason applies. Participants must meet all remaining requirements in the 44.2approved employment plan or be subject to sanction or permanent disqualification. 44.3    (h)(g) If the noncompliance with an employment plan is due to the involuntary loss 44.4of employment, the participant is exempt from the hourly employment requirement under 44.5this subdivision for one month. Participants must meet all remaining requirements in the 44.6approved employment plan or be subject to sanction or permanent disqualification. This 44.7exemption is available to each participant two times in a 12-month period.44.8    Sec. 38. Minnesota Statutes 2006, section 256J.46, is amended by adding a subdivision 44.9to read:44.10    Subd. 3.Restrictions on sanctions.A participant shall not be sanctioned for failure 44.11to meet the agreed upon hours in a participant's employment plan under section 256J.521, 44.12subdivision 2, when the participant:44.13    (1) fails to meet the agreed upon hours of participation in paid employment because 44.14the participant is not eligible for holiday pay and the participant's place of employment is 44.15closed for a holiday; or44.16    (2) is otherwise meeting or exceeding the federal TANF work participation rate 44.17hourly requirements.44.18    Sec. 39. Minnesota Statutes 2006, section 256J.49, subdivision 13, is amended to read:44.19    Subd. 13. Work activity. "Work activity" means any activity in a participant's 44.20approved employment plan that leads to employment. For purposes of the MFIP program, 44.21this includes activities that meet the definition of work activity under the participation 44.22requirements of TANF. Work activity includes:44.23    (1) unsubsidized employment, including work study and paid apprenticeships or 44.24internships;44.25    (2) subsidized private sector or public sector employment, including grant diversion 44.26as specified in section 
         256J.69, on-the-job training as specified in section 
         256J.66, 44.27the self-employment investment demonstration program (SEID) as specified in section 44.28256J.65
         , paid work experience, and supported work when a wage subsidy is provided; 44.29    (3) unpaid work experience, including community service, volunteer work, 44.30the community work experience program as specified in section 
         256J.67, unpaid 44.31apprenticeships or internships, and supported work when a wage subsidy is not provided. 44.32Unpaid work performed in return for cash assistance is prohibited and does not count 44.33as a work activity, unless the participant voluntarily agrees, in writing, to engage in 45.1unpaid work in return for cash assistance. The participant may terminate the unpaid 45.2work arrangement, in writing, at any time;45.3    (4) job search including job readiness assistance, job clubs, job placement, 45.4job-related counseling, and job retention services;45.5    (5) job readiness education, including English as a second language (ESL) or 45.6functional work literacy classes as limited by the provisions of section 
         256J.531, 45.7subdivision 2
         , general educational development (GED) course work, high school 45.8completion, and adult basic education as limited by the provisions of section 
         256J.531, 45.9subdivision 1
         ; 45.10    (6) job skills training directly related to employment, including education and 45.11training that can reasonably be expected to lead to employment, as limited by the 45.12provisions of section 
         256J.53; 45.13    (7) providing child care services to a participant who is working in a community 45.14service program;45.15    (8) activities included in the employment plan that is developed under section 45.16256J.521, subdivision 3
         ; and 45.17    (9) preemployment activities including chemical and mental health assessments, 45.18treatment, and services; learning disabilities services; child protective services; family 45.19stabilization services; or other programs designed to enhance employability.45.20    Sec. 40. Minnesota Statutes 2006, section 256J.521, subdivision 1, is amended to read:45.21    Subdivision 1. Assessments. (a) For purposes of MFIP employment services, 45.22assessment is a continuing process of gathering information related to employability 45.23for the purpose of identifying both participant's strengths and strategies for coping with 45.24issues that interfere with employment. The job counselor must use information from the 45.25assessment process to develop and update the employment plan under subdivision 2 or 3, 45.26as appropriate, and to determine whether the participant qualifies for a family violence 45.27waiver including an employment plan under subdivision 3, and to determine whether the 45.28participant should be referred to the family stabilization services program under section 45.29256J.575.45.30    (b) The scope of assessment must cover at least the following areas:45.31    (1) basic information about the participant's ability to obtain and retain employment, 45.32including: a review of the participant's education level; interests, skills, and abilities; prior 45.33employment or work experience; transferable work skills; child care and transportation 45.34needs;46.1    (2) identification of personal and family circumstances that impact the participant's 46.2ability to obtain and retain employment, including: any special needs of the children, the 46.3level of English proficiency, family violence issues, and any involvement with social 46.4services or the legal system;46.5    (3) the results of a mental and chemical health screening tool designed by the 46.6commissioner and results of the brief screening tool for special learning needs. Screening 46.7tools for mental and chemical health and special learning needs must be approved by the 46.8commissioner and may only be administered by job counselors or county staff trained in 46.9using such screening tools. The commissioner shall work with county agencies to develop 46.10protocols for referrals and follow-up actions after screens are administered to participants, 46.11including guidance on how employment plans may be modified based upon outcomes 46.12of certain screens. Participants must be told of the purpose of the screens and how the 46.13information will be used to assist the participant in identifying and overcoming barriers to 46.14employment. Screening for mental and chemical health and special learning needs must 46.15be completed by participants who are unable to find suitable employment after six weeks 46.16of job search under subdivision 2, paragraph (b), and participants who are determined to 46.17have barriers to employment under subdivision 2, paragraph (d). Failure to complete the 46.18screens will result in sanction under section 
         256J.46; and 46.19    (4) a comprehensive review of participation and progress for participants who have 46.20received MFIP assistance and have not worked in unsubsidized employment during the 46.21past 12 months. The purpose of the review is to determine the need for additional services 46.22and supports, including placement in subsidized employment or unpaid work experience 46.23under section 
         256J.49, subdivision 13, or referral to the family stabilization services 46.24program under section 256J.575. 46.25    (c) Information gathered during a caregiver's participation in the diversionary work 46.26program under section 
         256J.95 must be incorporated into the assessment process. 46.27    (d) The job counselor may require the participant to complete a professional chemical 46.28use assessment to be performed according to the rules adopted under section 
         254A.03, 46.29subdivision 3
         , including provisions in the administrative rules which recognize the cultural 46.30background of the participant, or a professional psychological assessment as a component 46.31of the assessment process, when the job counselor has a reasonable belief, based on 46.32objective evidence, that a participant's ability to obtain and retain suitable employment 46.33is impaired by a medical condition. The job counselor may assist the participant with 46.34arranging services, including child care assistance and transportation, necessary to meet 46.35needs identified by the assessment. Data gathered as part of a professional assessment 46.36must be classified and disclosed according to the provisions in section 
         13.46.47.1    Sec. 41. Minnesota Statutes 2006, section 256J.521, subdivision 2, is amended to read:47.2    Subd. 2. Employment plan; contents. (a) Based on the assessment under 47.3subdivision 1, the job counselor and the participant must develop an employment plan 47.4that includes participation in activities and hours that meet the requirements of section 47.5256J.55, subdivision 1
         . The purpose of the employment plan is to identify for each 47.6participant the most direct path to unsubsidized employment and any subsequent steps that 47.7support long-term economic stability. The employment plan should be developed using 47.8the highest level of activity appropriate for the participant. Activities must be chosen from 47.9clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of 47.10preference for activities, priority must be given for activities related to a family violence 47.11waiver when developing the employment plan. The employment plan must also list the 47.12specific steps the participant will take to obtain employment, including steps necessary 47.13for the participant to progress from one level of activity to another, and a timetable for 47.14completion of each step. Levels of activity include:47.15    (1) unsubsidized employment;47.16    (2) job search;47.17    (3) subsidized employment or unpaid work experience;47.18    (4) unsubsidized employment and job readiness education or job skills training;47.19    (5) unsubsidized employment or unpaid work experience and activities related to 47.20a family violence waiver or preemployment needs; and47.21    (6) activities related to a family violence waiver or preemployment needs.47.22    (b) Participants who are determined to possess sufficient skills such that the 47.23participant is likely to succeed in obtaining unsubsidized employment must job search at 47.24least 30 hours per week for up to six weeks and accept any offer of suitable employment. 47.25The remaining hours necessary to meet the requirements of section 
         256J.55, subdivision 47.261
         , may be met through participation in other work activities under section 
         256J.49, 47.27subdivision 13
         . The participant's employment plan must specify, at a minimum: (1) 47.28whether the job search is supervised or unsupervised; (2) support services that will 47.29be provided; and (3) how frequently the participant must report to the job counselor. 47.30Participants who are unable to find suitable employment after six weeks must meet 47.31with the job counselor to determine whether other activities in paragraph (a) should be 47.32incorporated into the employment plan. Job search activities which are continued after six 47.33weeks must be structured and supervised. 47.34    (c) Beginning July 1, 2004, activities and hourly requirements in the employment 47.35plan may be adjusted as necessary to accommodate the personal and family circumstances 47.36of participants identified under section 
         256J.561, subdivision 2, paragraph (d). Participants 48.1who no longer meet the provisions of section 
         256J.561, subdivision 2, paragraph (d), 48.2must meet with the job counselor within ten days of the determination to revise the 48.3employment plan. 48.4    (d) Participants who are determined to have barriers to obtaining or retaining 48.5employment that will not be overcome during six weeks of job search under paragraph (b) 48.6must work with the job counselor to develop an employment plan that addresses those 48.7barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6). 48.8The employment plan must include enough hours to meet the participation requirements 48.9in section 
         256J.55, subdivision 1, unless a compelling reason to require fewer hours 48.10is noted in the participant's file. 48.11    (e) The job counselor and the participant must sign the employment plan to indicate 48.12agreement on the contents.48.13    (f) Except as provided under paragraphs (g) and (h), failure to develop or comply 48.14with activities in the plan, or voluntarily quitting suitable employment without good 48.15cause, will result in the imposition of a sanction under section 
         256J.46. The job counselor 48.16is encouraged to allow participants who are participating in at least 20 hours of work 48.17activities to also participate in employment and training activities in order to meet the 48.18federal hourly participation rates.48.19    (g) When a participant fails to meet the agreed upon hours of participation in paid 48.20employment because the participant is not eligible for holiday pay and the participant's 48.21place of employment is closed for a holiday, the job counselor shall not impose a sanction 48.22or increase the hours of participation in any other activity, including paid employment, to 48.23offset the hours that were missed due to the holiday.48.24    (h) The job counselor shall not impose a sanction for failure to meet the agreed upon 48.25hours in a participant's employment plan under this subdivision when the participant 48.26is otherwise meeting or exceeding the federal TANF work participation rate hourly 48.27requirements.48.28    (f) (i) Employment plans must be reviewed at least every three months to determine 48.29whether activities and hourly requirements should be revised.48.30    Sec. 42. Minnesota Statutes 2006, section 256J.521, is amended by adding a 48.31subdivision to read:48.32    Subd. 7.Employment plan; nonmaintenance of effort; single caregivers.(a) 48.33When a single caregiver is moved to the nonmaintenance of effort state-funded program 48.34under section 256J.021, paragraphs (a) and (b), the single caregiver shall develop or revise 48.35the employment plan as specified in this subdivision with a job counselor or county. The 49.1plan must address issues interfering with employment, including physical and mental 49.2health, substance use, and social service issues of the caregiver and the caregiver's family. 49.3Job search and employment must also be included in the plan to the extent possible.49.4    (b) Counties must coordinate services by ensuring that all workers involved with 49.5the family communicate on a regular basis, and that expectations for the family across 49.6service areas lead to common goals.49.7    (c) Activities and hourly requirements in the employment plan may be adjusted as 49.8necessary to accommodate the personal and family circumstances of the participant. 49.9Participants who no longer meet the criteria for the nonmaintenance of effort state-funded 49.10program shall meet with the job counselor or county within ten days of the determination 49.11to revise the employment plan.49.12    Sec. 43. Minnesota Statutes 2006, section 256J.53, subdivision 2, is amended to read:49.13    Subd. 2. Approval of postsecondary education or training. (a) In order for a 49.14postsecondary education or training program to be an approved activity in an employment 49.15plan, the participant must be working in unsubsidized employment at least 20 hours per 49.16week.49.17    (b) Participants seeking approval of a postsecondary education or training plan 49.18must provide documentation that:49.19    (1) the employment goal can only be met with the additional education or training;49.20    (2) there are suitable employment opportunities that require the specific education or 49.21training in the area in which the participant resides or is willing to reside;49.22    (3) the education or training will result in significantly higher wages for the 49.23participant than the participant could earn without the education or training;49.24    (4) the participant can meet the requirements for admission into the program; and49.25    (5) there is a reasonable expectation that the participant will complete the training 49.26program based on such factors as the participant's MFIP assessment, previous education, 49.27training, and work history; current motivation; and changes in previous circumstances.49.28    (c) The hourly unsubsidized employment requirement does not apply for intensive 49.29education or training programs lasting 12 weeks or less when full-time attendance is 49.30required.49.31    (d)(b) Participants with an approved employment plan in place on July 1, 2003, 49.32which includes more than 12 months of postsecondary education or training shall be 49.33allowed to complete that plan provided that hourly requirements in section 
         256J.55, 49.34subdivision 1
         , and conditions specified in paragraph (b) (a), and subdivisions 3 and 5 are 49.35met. A participant whose case is subsequently closed for three months or less for reasons 50.1other than noncompliance with program requirements and who returns to MFIP shall 50.2be allowed to complete that plan provided that hourly requirements in section 
         256J.55, 50.3subdivision 1
         , and conditions specified in paragraph (b) (a) and subdivisions 3 and 5 are 50.4met.50.5    Sec. 44. Minnesota Statutes 2006, section 256J.55, subdivision 1, is amended to read:50.6    Subdivision 1. Participation requirements. (a) All caregivers must participate 50.7in employment services under sections 
         256J.515 to 
         256J.57 concurrent with receipt of 50.8MFIP assistance. 50.9    (b) Until July 1, 2004, participants who meet the requirements of section 
         256J.56 are 50.10exempt from participation requirements.50.11    (c) Participants under paragraph (a) must develop and comply with an employment 50.12plan under section 
         256J.521 or section 
         256J.54 in the case of a participant under the age of 50.1320 who has not obtained a high school diploma or its equivalent.50.14    (d) With the exception of participants under the age of 20 who must meet the 50.15education requirements of section 
         256J.54, all participants must meet the hourly 50.16participation requirements of TANF or the hourly requirements listed in clauses (1) to 50.17(3), whichever is higher.50.18    (1) In single-parent families with no children under six years of age, the job 50.19counselor and the caregiver must develop an employment plan that includes 30 to 35 hours 50.20per week of work activities 130 hours per month of work activities.50.21    (2) In single-parent families with a child under six years of age, the job counselor 50.22and the caregiver must develop an employment plan that includes 20 to 35 hours per week 50.23of work activities 87 hours per month of work activities.50.24    (3) In two-parent families, the job counselor and the caregivers must develop 50.25employment plans which result in a combined total of at least 55 hours per week of work 50.26activities.50.27    (e) Failure to participate in employment services, including the requirement to 50.28develop and comply with an employment plan, including hourly requirements, without 50.29good cause under section 
         256J.57, shall result in the imposition of a sanction under section 50.30256J.46
         .50.31    Sec. 45. [256J.575] FAMILY STABILIZATION SERVICES.50.32    Subdivision 1.Purpose.(a) The family stabilization services serve families who are 50.33not making significant progress within the Minnesota family investment program (MFIP) 50.34due to a variety of barriers to employment.51.1    (b) The goal of the services is to stabilize and improve the lives of families at risk 51.2of long-term welfare dependency or family instability due to employment barriers such 51.3as physical disability, mental disability, age, or providing care for a disabled household 51.4member. These services promote and support families to achieve the greatest possible 51.5degree of self-sufficiency.51.6    Subd. 2.Definitions.The terms used in this section have the meanings given them 51.7in paragraphs (a) to (d).51.8    (a) "Case management" means the services provided by or through the county 51.9agency or through the employment services agency to participating families, including 51.10assessment, information, referrals, and assistance in the preparation and implementation 51.11of a family stabilization plan under subdivision 5.51.12    (b) "Family stabilization plan" means a plan developed by a case manager and 51.13the participant, which identifies the participant's most appropriate path to unsubsidized 51.14employment, family stability, and barrier reduction, taking into account the family's 51.15circumstances.51.16    (c) "Family stabilization services" means programs, activities, and services in this 51.17section that provide participants and their family members with assistance regarding, 51.18but not limited to:51.19    (1) obtaining and retaining unsubsidized employment;51.20    (2) family stability;51.21    (3) economic stability; and51.22    (4) barrier reduction.51.23    The goal of the services is to achieve the greatest degree of economic self-sufficiency 51.24and family well-being possible for the family under the circumstances.51.25    (d) "Case manager" means the county-designated staff person or employment 51.26services counselor.51.27    Subd. 3.Eligibility.(a) The following MFIP or diversionary work program (DWP) 51.28participants are eligible for the services under this section:51.29    (1) a participant identified under section 256J.561, subdivision 2, paragraph (d), who 51.30has or is eligible for an employment plan developed under section 256J.521, subdivision 51.312, paragraph (c);51.32    (2) a participant identified under section 256J.95, subdivision 12, paragraph (b), as 51.33unlikely to benefit from the DWP;51.34    (3) a participant who meets the requirements for or has been granted a hardship 51.35extension under section 256J.425, subdivision 2 or 3;52.1    (4) a participant who is applying for supplemental security income or Social Security 52.2disability insurance; 52.3    (5) a participant who is a noncitizen who has been in the United States for 12 or 52.4fewer months; and52.5    (6) a new MFIP participant, for the first 30 days the participant receives assistance or 52.6when the participant's employment plan is completed, whichever is sooner.52.7    (b) Families must meet all other eligibility requirements for MFIP established in 52.8this chapter. Families are eligible for financial assistance to the same extent as if they 52.9were participating in MFIP.52.10    (c) A participant under paragraph (a), clause (5), must be provided with English as a 52.11second language opportunities and skills training for up to 12 months. After 12 months, 52.12the case manager and participant must determine whether the participant should continue 52.13with English as a second language classes or skills training, or both, or if the participant 52.14should become an MFIP participant.52.15    Subd. 4.Universal participation.All caregivers must participate in family 52.16stabilization services as defined in subdivision 2.52.17    Subd. 5.Case management; family stabilization plans; coordinated services.(a) 52.18The county agency shall provide family stabilization services to families through a case 52.19management model. A case manager shall be assigned to each participating family within 52.2030 days after the family begins to receive financial assistance as a participant of the family 52.21stabilization services. The case manager, with the full involvement of the participant, shall 52.22recommend, and the county agency shall establish and modify as necessary, a family 52.23stabilization plan for each participating family. If a participant is already assigned to a 52.24county case manager or a county-designated case manager in social services, disability 52.25services, or housing services that case manager already assigned may be the case manager 52.26for purposes of these services.52.27    (b) The family stabilization plan must include:52.28    (1) each participant's plan for long-term self-sufficiency, including an employment 52.29goal where applicable;52.30    (2) an assessment of each participant's strengths and barriers, and any special 52.31circumstances of the participant's family that impact, or are likely to impact, the 52.32participant's progress towards the goals in the plan; and52.33    (3) an identification of the services, supports, education, training, and 52.34accommodations needed to reduce or overcome any barriers to enable the family to 52.35achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.53.1    (c) The case manager and the participant shall meet within 30 days of the family's 53.2referral to the case manager. The initial family stabilization plan must be completed within 53.330 days of the first meeting with the case manager. The case manager shall establish a 53.4schedule for periodic review of the family stabilization plan that includes personal contact 53.5with the participant at least once per month. In addition, the case manager shall review 53.6and, if necessary, modify the plan under the following circumstances:53.7    (1) there is a lack of satisfactory progress in achieving the goals of the plan;53.8    (2) the participant has lost unsubsidized or subsidized employment;53.9    (3) a family member has failed or is unable to comply with a family stabilization 53.10plan requirement;53.11    (4) services, supports, or other activities required by the plan are unavailable;53.12    (5) changes to the plan are needed to promote the well-being of the children; or53.13    (6) the participant and case manager determine that the plan is no longer appropriate 53.14for any other reason.53.15    Subd. 6.Cooperation with services requirements.(a) To be eligible, a participant 53.16shall comply with paragraphs (b) to (e).53.17    (b) Participants shall engage in family stabilization plan services for the appropriate 53.18number of hours per week that the activities are scheduled and available, unless good 53.19cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate 53.20number of hours must be based on the participant's plan.53.21    (c) The case manager shall review the participant's progress toward the goals in the 53.22family stabilization plan every six months to determine whether conditions have changed, 53.23including whether revisions to the plan are needed.53.24    (d) When the participant has increased participation in work-related activities 53.25sufficient to meet the federal participation requirements of TANF, the county agency shall 53.26refer the participant to the MFIP program and assign the participant to a job counselor. 53.27The participant and the job counselor shall meet within 15 days of referral to the MFIP 53.28program to develop an employment plan under section 256J.521. No reapplication is 53.29necessary and financial assistance continues without interruption.53.30    (e) A participant's requirement to comply with any or all family stabilization plan 53.31requirements under this subdivision is excused when the case management services, 53.32training and educational services, and family support services identified in the participant's 53.33family stabilization plan are unavailable for reasons beyond the control of the participant, 53.34including when money appropriated is not sufficient to provide the services.53.35    Subd. 7.Sanctions.(a) The financial assistance grant of a participating family is 53.36reduced according to section 256J.46, if a participating adult fails without good cause to 54.1comply or continue to comply with the family stabilization plan requirements in this 54.2subdivision, unless compliance has been excused under subdivision 6, paragraph (e).54.3    (b) Given the purpose of the family stabilization services in this section and the 54.4nature of the underlying family circumstances that act as barriers to both employment and 54.5full compliance with program requirements, sanctions are appropriate only when it is clear 54.6that there is both the ability to comply and willful noncompliance by the participant, as 54.7confirmed by a behavioral health or medical professional.54.8    (c) Prior to the imposition of a sanction, the county agency shall review the 54.9participant's case to determine if the family stabilization plan is still appropriate and 54.10meet with the participant face-to-face. The participant may bring an advocate to the 54.11face-to-face meeting. 54.12    During the face-to-face meeting, the county agency must:54.13    (1) determine whether the continued noncompliance can be explained and mitigated 54.14by providing a needed family stabilization service, as defined in subdivision 2, paragraph 54.15(d);54.16    (2) determine whether the participant qualifies for a good cause exemption under 54.17section 256J.57, or if the sanction is for noncooperation with child support requirements, 54.18determine if the participant qualifies for a good cause exemption under section 256.741, 54.19subdivision 10;54.20    (3) determine whether activities in the family stabilization plan are appropriate 54.21based on the family's circumstances;54.22    (4) explain the consequences of continuing noncompliance;54.23    (5) identify other resources that may be available to the participant to meet the 54.24needs of the family; and54.25    (6) inform the participant of the right to appeal under section 256J.40.54.26    If the lack of an identified activity or service can explain the noncompliance, the 54.27county shall work with the participant to provide the identified activity.54.28    (d) If the participant fails to come to the face-to-face meeting, the case manager or a 54.29designee shall attempt at least one home visit. If a face-to-face meeting is not conducted, 54.30the county agency shall send the participant a written notice that includes the information 54.31under paragraph (c).54.32    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition 54.33of a sanction, the county agency shall provide a notice of intent to sanction under section 54.34256J.57, subdivision 2, and, when applicable, a notice of adverse action under section 54.35256J.31.55.1    (f) Section 256J.57 applies to this section except to the extent that it is modified 55.2by this subdivision.55.3    Subd. 8.Funding.(a) The commissioner of human services must treat MFIP 55.4expenditures made to or on behalf of any minor child under this section, who is part of a 55.5household that meets criteria in subdivision 3, as expenditures under a separately funded 55.6state program. These expenditures shall not count toward the state's maintenance of effort 55.7requirements under the federal TANF program.55.8    (b) A family is no longer part of a separately funded program under this section, if 55.9the caregiver no longer meets the criteria for family stabilization services in subdivision 55.103 or if it is determined at recertification that the caregiver is meeting the federal work 55.11participation rate, whichever occurs sooner.55.12    Sec. 46. Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:55.13    Subdivision 1. Consolidated fund. The consolidated fund is established to support 55.14counties and tribes in meeting their duties under this chapter. Counties and tribes must use 55.15funds from the consolidated fund to develop programs and services that are designed to 55.16improve participant outcomes as measured in section 
         256J.751, subdivision 2. Counties 55.17may use the funds for any allowable expenditures under subdivision 2, and to provide case 55.18management services to participants of the family stabilization services program. Tribes 55.19may use the funds for any allowable expenditures under subdivision 2, except those in 55.20subdivision 2, paragraph (a), clauses (1) and (6). 55.21    Sec. 47. Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:55.22    Subd. 2. Allowable expenditures. (a) The commissioner must restrict expenditures 55.23under the consolidated fund to benefits and services allowed under title IV-A of the federal 55.24Social Security Act. Allowable expenditures under the consolidated fund may include, but 55.25are not limited to:55.26    (1) short-term, nonrecurring shelter and utility needs that are excluded from the 55.27definition of assistance under Code of Federal Regulations, title 45, section 
         260.31, for 55.28families who meet the residency requirement in section 
         256J.12, subdivisions 1 and 1a. 55.29Payments under this subdivision are not considered TANF cash assistance and are not 55.30counted towards the 60-month time limit; 55.31    (2) transportation needed to obtain or retain employment or to participate in other 55.32approved work activities or activities under a family stabilization plan;55.33    (3) direct and administrative costs of staff to deliver employment services for 55.34MFIP or,  the diversionary work program, or the family stabilization services program; 56.1 to administer financial assistance,;  and to provide specialized services intended to assist 56.2hard-to-employ participants to transition to work or transition from the family stabilization 56.3services program to MFIP;56.4    (4) costs of education and training including functional work literacy and English as 56.5a second language;56.6    (5) cost of work supports including tools, clothing, boots, telephone service, and 56.7other work-related expenses;56.8    (6) county administrative expenses as defined in Code of Federal Regulations, title 56.945, section 260(b);56.10    (7) services to parenting and pregnant teens;56.11    (8) supported work;56.12    (9) wage subsidies;56.13    (10) child care needed for MFIP or, the  diversionary work program, or the family 56.14stabilization services program  participants to participate in social services;56.15    (11) child care to ensure that families leaving MFIP or diversionary work program 56.16will continue to receive child care assistance from the time the family no longer qualifies 56.17for transition year child care until an opening occurs under the basic sliding fee child 56.18care program; and56.19    (12) services to help noncustodial parents who live in Minnesota and have minor 56.20children receiving MFIP or DWP assistance, but do not live in the same household as the 56.21child, obtain or retain employment; and56.22    (13) services to help families participating in the family stabilization services 56.23program achieve the greatest possible degree of self-sufficiency.56.24    (b) Administrative costs that are not matched with county funds as provided in 56.25subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation 56.26under this section. The commissioner shall define administrative costs for purposes of 56.27this subdivision.56.28    (c) The commissioner may waive the cap on administrative costs for a county or tribe 56.29that elects to provide an approved supported employment, unpaid work, or community 56.30work experience program for a major segment of the county's or tribe's MFIP population. 56.31The county or tribe must apply for the waiver on forms provided by the commissioner. In 56.32no case shall total administrative costs exceed the TANF limits.56.33    Sec. 48. Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:56.34    Subd. 3. Eligibility for services. Families with a minor child, a pregnant woman, 56.35or a noncustodial parent of a minor child receiving assistance, with incomes below 200 57.1percent of the federal poverty guideline for a family of the applicable size, are eligible 57.2for services funded under the consolidated fund. Counties and tribes must give priority 57.3to families currently receiving MFIP or, the  diversionary work program, or the family 57.4stabilization services program, and families at risk of receiving MFIP or diversionary 57.5work program.57.6    Sec. 49. Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:57.7    Subd. 4. County and tribal biennial service agreements. (a) Effective January 1, 57.82004, and each two-year period thereafter, each county and tribe must have in place an 57.9approved biennial service agreement related to the services and programs in this chapter. 57.10In counties with a city of the first class with a population over 300,000, the county must 57.11consider a service agreement that includes a jointly developed plan for the delivery of 57.12employment services with the city. Counties may collaborate to develop multicounty, 57.13multitribal, or regional service agreements.57.14    (b) The service agreements will be completed in a form prescribed by the 57.15commissioner. The agreement must include:57.16    (1) a statement of the needs of the service population and strengths and resources 57.17in the community;57.18    (2) numerical goals for participant outcomes measures to be accomplished during 57.19the biennial period. The commissioner may identify outcomes from section 
         256J.751, 57.20subdivision 2
         , as core outcomes for all counties and tribes; 57.21    (3) strategies the county or tribe will pursue to achieve the outcome targets. 57.22Strategies must include specification of how funds under this section will be used and may 57.23include community partnerships that will be established or strengthened; and57.24    (4) strategies the county or tribe will pursue under the family stabilization services 57.25program; and 57.26    (5) other items prescribed by the commissioner in consultation with counties and 57.27tribes.57.28    (c) The commissioner shall provide each county and tribe with information needed 57.29to complete an agreement, including: (1) information on MFIP cases in the county or 57.30tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome 57.31measures; and (4) promising program practices.57.32    (d) The service agreement must be submitted to the commissioner by October 15, 57.332003, and October 15 of each second year thereafter. The county or tribe must allow 57.34a period of not less than 30 days prior to the submission of the agreement to solicit 57.35comments from the public on the contents of the agreement.58.1    (e) The commissioner must, within 60 days of receiving each county or tribal service 58.2agreement, inform the county or tribe if the service agreement is approved. If the service 58.3agreement is not approved, the commissioner must inform the county or tribe of any 58.4revisions needed prior to approval.58.5    (f) The service agreement in this subdivision supersedes the plan requirements 58.6of section 
         116L.88. 58.7    Sec. 50. Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:58.8    Subd. 5. Innovation projects. Beginning January 1, 2005, no more than $3,000,000 58.9of the funds annually appropriated to the commissioner for use in the consolidated 58.10fund shall be available to the commissioner for projects testing innovative approaches 58.11to improving outcomes for MFIP participants, family stabilization services program 58.12participants, and persons at risk of receiving MFIP as detailed in subdivision 3, and 58.13for providing incentives to counties and tribes that exceed performance. Projects shall 58.14be targeted to geographic areas with poor outcomes as specified in section 
         256J.751, 58.15subdivision 5
         , or to subgroups within the MFIP case load who are experiencing poor 58.16outcomes. For purposes of an incentive, a county or tribe exceeds performance if the 58.17county or tribe is above the top of the county's or tribe's annualized range of expected 58.18performance on the three-year self-support index under section 256J.751, subdivision 2, 58.19clause (7), and achieves a 50 percent TANF participation rate under section 256J.751, 58.20subdivision 2, clause (7), as averaged across the four quarterly measurements for the most 58.21recent year for which the measurements are available.58.22    Sec. 51. Minnesota Statutes 2006, section 256J.626, subdivision 6, is amended to read:58.23    Subd. 6. Base allocation to counties and tribes; definitions. (a) For purposes of 58.24this section, the following terms have the meanings given.58.25    (1) "2002 historic spending base" means the commissioner's determination of 58.26the sum of the reimbursement related to fiscal year 2002 of county or tribal agency 58.27expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings 58.28related to calendar year 2002 in the base program listed in clause (6), item (v), and the 58.29amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi), 58.30issued to or on behalf of persons residing in the county or tribal service delivery area.58.31    (2) "Adjusted caseload factor" means a factor weighted:58.32    (i) 47 percent on the MFIP cases in each county at four points in time in the most 58.33recent 12-month period for which data is available multiplied by the county's caseload 58.34difficulty factor; and59.1    (ii) 53 percent on the count of adults on MFIP in each county and tribe at four points 59.2in time in the most recent 12-month period for which data is available multiplied by the 59.3county or tribe's caseload difficulty factor.59.4    (3) "Caseload difficulty factor" means a factor determined by the commissioner for 59.5each county and tribe based upon the self-support index described in section 
         256J.751, 59.6subdivision 2
         , clause (7).59.7    (4) "Initial allocation" means the amount potentially available to each county or tribe 59.8based on the formula in paragraphs (b) through (h).59.9    (5) "Final allocation" means the amount available to each county or tribe based on 59.10the formula in paragraphs (b) through (h), after adjustment by subdivision 7.59.11    (6) "Base programs" means the:59.12    (i) MFIP employment and training services under Minnesota Statutes 2002, section 59.13256J.62, subdivision 1
         , in effect June 30, 2002;59.14    (ii) bilingual employment and training services to refugees under Minnesota Statutes 59.152002, section 
         256J.62, subdivision 6, in effect June 30, 2002;59.16    (iii) work literacy language programs under Minnesota Statutes 2002, section 59.17256J.62, subdivision 7
         , in effect June 30, 2002;59.18    (iv) supported work program authorized in Laws 2001, First Special Session chapter 59.199, article 17, section 2, in effect June 30, 2002;59.20    (v) administrative aid program under section 
         256J.76 in effect December 31, 2002; 59.21and59.22    (vi) emergency assistance program under Minnesota Statutes 2002, section 
         256J.48, 59.23in effect June 30, 2002.59.24    (b) The commissioner shall:59.25    (1) beginning July 1, 2003, determine the initial allocation of funds available under 59.26this section according to clause (2);59.27    (2) allocate all of the funds available for the period beginning July 1, 2003, and 59.28ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's 59.29share of the statewide 2002 historic spending base;59.30    (3) determine for calendar year 2005 the initial allocation of funds to be made 59.31available under this section in proportion to the county or tribe's initial allocation for the 59.32period of July 1, 2003, to December 31, 2004;59.33    (4) determine for calendar year 2006 the initial allocation of funds to be made 59.34available under this section based 90 percent on the proportion of the county or tribe's 59.35share of the statewide 2002 historic spending base and ten percent on the proportion of 59.36the county or tribe's share of the adjusted caseload factor;60.1    (5) determine for calendar year 2007 the initial allocation of funds to be made 60.2available under this section based 70 percent on the proportion of the county or tribe's 60.3share of the statewide 2002 historic spending base and 30 percent on the proportion of the 60.4county or tribe's share of the adjusted caseload factor; and60.5    (6) determine for calendar year 2008 and subsequent years the initial allocation of 60.6funds to be made available under this section based 50 percent on the proportion of the 60.7county or tribe's share of the statewide 2002 historic spending base and 50 percent on the 60.8proportion of the county or tribe's share of the adjusted caseload factor.60.9    (c) With the commencement of a new or expanded tribal TANF program or an 60.10agreement under section 
         256.01, subdivision 2, paragraph (g), in which some or all of 60.11the responsibilities of particular counties under this section are transferred to a tribe, 60.12the commissioner shall:60.13    (1) in the case where all responsibilities under this section are transferred to a tribal 60.14program, determine the percentage of the county's current caseload that is transferring to a 60.15tribal program and adjust the affected county's allocation accordingly; and60.16    (2) in the case where a portion of the responsibilities under this section are 60.17transferred to a tribal program, the commissioner shall consult with the affected county or 60.18counties to determine an appropriate adjustment to the allocation.60.19    (d) Effective January 1, 2005, counties and tribes will have their final allocations 60.20adjusted based on the performance provisions of subdivision 7.60.21    Sec. 52. Minnesota Statutes 2006, section 256J.751, subdivision 2, is amended to read:60.22    Subd. 2. Quarterly comparison report. The commissioner shall report quarterly to 60.23all counties on each county's performance on the following measures:60.24    (1) percent of MFIP caseload working in paid employment;60.25    (2) percent of MFIP caseload receiving only the food portion of assistance;60.26    (3) number of MFIP cases that have left assistance;60.27    (4) median placement wage rate;60.28    (5) caseload by months of TANF assistance;60.29    (6) percent of MFIP and diversionary work program (DWP) cases off cash assistance 60.30or working 30 or more hours per week at one-year, two-year, and three-year follow-up 60.31points from a baseline quarter. This measure is called the self-support index. The 60.32commissioner shall report quarterly an expected range of performance for each county, 60.33county grouping, and tribe on the self-support index. The expected range shall be derived 60.34by a statistical methodology developed by the commissioner in consultation with the 61.1counties and tribes. The statistical methodology shall control differences across counties 61.2in economic conditions and demographics of the MFIP and DWP case load; and61.3    (7) the MFIP TANF work participation rate, defined as the participation requirements 61.4specified in title 1 of Public Law 104-193 applied to all MFIP cases except child only 61.5cases under Public Law 109-171, the Deficit Reduction Act of 2005.61.6    Sec. 53. Minnesota Statutes 2006, section 256J.751, subdivision 5, is amended to read:61.7    Subd. 5. Failure to meet federal performance standards. (a) If sanctions occur 61.8for failure to meet the performance standards specified in title 1 of Public Law 104-193 61.9of the Personal Responsibility and Work Opportunity Act of 1996, and under Public 61.10Law 109-171, the Deficit Reduction Act of 2005, the state shall pay 88 percent of the 61.11sanction. The remaining 12 percent of the sanction will be paid by the counties. The 61.12county portion of the sanction will be distributed across all counties in proportion to each 61.13county's percentage of the MFIP average monthly caseload during the period for which 61.14the sanction was applied.61.15    (b) If a county fails to meet the performance standards specified in title 1 of Public 61.16Law 104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and 61.17Public Law 109-171, the Deficit Reduction Act of 2005, for any year, the commissioner 61.18shall work with counties to organize a joint state-county technical assistance team to work 61.19with the county. The commissioner shall coordinate any technical assistance with other 61.20departments and agencies including the Departments of Employment and Economic 61.21Development and Education as necessary to achieve the purpose of this paragraph.61.22    (c) For state performance measures, a low-performing county is one that:61.23    (1) performs below the bottom of their expected range for the measure in subdivision 61.242, clause (7) (6), in an annualized measurement reported in October of each year; or61.25    (2) performs below 40 percent for the measure in subdivision 2, clause (8) (7), as 61.26averaged across the four quarterly measurements for the year, or the ten counties with the 61.27lowest rates if more than ten are below 40 percent.61.28    (d) Low-performing counties under paragraph (c) must engage in corrective action 61.29planning as defined by the commissioner. The commissioner may coordinate technical 61.30assistance as specified in paragraph (b) for low-performing counties under paragraph (c).61.31    Sec. 54. Minnesota Statutes 2006, section 256J.95, subdivision 3, is amended to read:61.32    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories 61.33of family units listed below, all family units who apply for cash benefits and who 61.34meet MFIP eligibility as required in sections 
         256J.11 to 
         256J.15 are eligible and must 62.1participate in the diversionary work program. Family units that are not eligible for the 62.2diversionary work program include:62.3    (1) child only cases;62.4    (2) a single-parent family unit that includes a child under 12 weeks of age. A parent 62.5is eligible for this exception once in a parent's lifetime and is not eligible if the parent 62.6has already used the previously allowed child under age one exemption from MFIP 62.7employment services;62.8    (3) a minor parent without a high school diploma or its equivalent;62.9    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent 62.10who chooses to have an employment plan with an education option;62.11    (5) a caregiver age 60 or over;62.12    (6) family units with a caregiver who received DWP benefits in the 12 months prior 62.13to the month the family applied for DWP, except as provided in paragraph (c);62.14    (7) family units with a caregiver who received MFIP within the 12 months prior to 62.15the month the family unit applied for DWP;62.16    (8) a family unit with a caregiver who received 60 or more months of TANF 62.17assistance; and62.18    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to 62.19fraud.; and62.20    (10) refugees as defined in Code of Federal Regulations, title 45, chapter IV, section 62.21444.43, who arrived in the United States in the 12 months prior to the date of application 62.22for family cash assistance.62.23    (b) A two-parent family must participate in DWP unless both caregivers meet the 62.24criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit 62.25includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), or (9).62.26    (c) Once DWP eligibility is determined, the four months run consecutively. If a 62.27participant leaves the program for any reason and reapplies during the four-month period, 62.28the county must redetermine eligibility for DWP.62.29EFFECTIVE DATE.This section is effective the day following final enactment.62.30    Sec. 55. Minnesota Statutes 2006, section 256J.95, subdivision 13, is amended to read:62.31    Subd. 13. Immediate referral to employment services. Within one working day of 62.32determination that the applicant is eligible for the diversionary work program, but before 62.33benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to 62.34employment services. The referral to the DWP employment services must be in writing 62.35and must contain the following information:63.1    (1) notification that, as part of the application process, applicants are required to 63.2develop an employment plan or the DWP application will be denied;63.3    (2) the employment services provider name and phone number;63.4    (3) the date, time, and location of the scheduled employment services interview;63.5    (4) (3) the immediate availability of supportive services, including, but not limited 63.6to, child care, transportation, and other work-related aid; and63.7    (5) (4) the rights, responsibilities, and obligations of participants in the program, 63.8including, but not limited to, the grounds for good cause, the consequences of refusing or 63.9failing to participate fully with program requirements, and the appeal process.63.10    Sec. 56. Minnesota Statutes 2006, section 256K.45, is amended by adding a 63.11subdivision to read:63.12    Subd. 6.Funding.Any funds appropriated for this section may be expended 63.13on programs described under subdivisions 3 to 5, technical assistance, and capacity 63.14building. In addition, up to five percent of funds appropriated may be used for program 63.15administration and up to eight percent of funds appropriated may be used for the purpose 63.16of monitoring and evaluating runaway and homeless youth programs receiving funding 63.17under this section. Funding shall be directed to meet the greatest need, with a significant 63.18share of the funding focused on homeless youth providers in greater Minnesota.63.19    Sec. 57. Minnesota Statutes 2006, section 259.24, subdivision 3, is amended to read:63.20    Subd. 3. Child. When the child to be adopted is over 14 years of age, the child's 63.21written consent to adoption by a particular person is also shall be necessary. A child 63.22of any age who is under the guardianship of the commissioner and is legally available 63.23for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to 63.24recruit, identify, and place the child in an adoptive home required under section 260C.317, 63.25subdivision 3, paragraph (b), or sign a document relieving county social services agencies 63.26of all recruitment efforts on the child's behalf.63.27    Sec. 58. Minnesota Statutes 2006, section 259.53, subdivision 1, is amended to read:63.28    Subdivision 1. Notice to commissioner; referral for postplacement assessment.63.29    (a) Upon the filing of a petition for adoption of a child who is:63.30    (1) under the guardianship of the commissioner or a licensed child-placing agency 63.31according to section 260C.201, subdivision 11, or 260C.317;64.1    (2) placed by the commissioner, commissioner's agent, or licensed child-placing 64.2agency after a consent to adopt according to section 259.24 or under an agreement 64.3conferring authority to place for adoption according to section 259.25; or64.4    (3) placed by preadoptive custody order for a direct adoptive placement ordered 64.5by the district court under section 259.47,64.6the court administrator shall immediately transmit a copy of the petition to the 64.7commissioner of human services.64.8    (b) The court shall immediately refer the petition to the agency specified below for 64.9completion of a postplacement assessment and report as required by subdivision 2.64.10    (1) If the child to be adopted has been committed to the guardianship of the 64.11commissioner or an agency under section 
         260C.317 or an agency has been given authority 64.12to place the child under section 
         259.25, the court shall refer the petition to that agency, 64.13unless another agency is supervising the placement, in which case the court shall refer the 64.14petition to the supervising agency. 64.15    (2) If the child to be adopted has been placed in the petitioner's home by a direct 64.16adoptive placement, the court shall refer the petition to the agency supervising the 64.17placement under section 
         259.47, subdivision 3, paragraph (a), clause (6). 64.18    (3) If the child is to be adopted by an individual who is related to the child as defined 64.19by section 
         245A.02, subdivision 13, and in all other instances not described in clause (1) 64.20or (2), the court shall refer the petition to the local social services agency of the county in 64.21which the prospective adoptive parent lives. 64.22    Sec. 59. Minnesota Statutes 2006, section 259.57, subdivision 1, is amended to read:64.23    Subdivision 1. Findings; orders. Upon the hearing,64.24    (a) if the court finds that it is in the best interests of the child that the petition 64.25be granted, a decree of adoption shall be made and recorded in the office of the court 64.26administrator, ordering that henceforth the child shall be the child of the petitioner. In the 64.27decree the court may change the name of the child if desired. After the decree is granted64.28for a child who is:64.29    (1) under the guardianship of the commissioner or a licensed child-placing agency 64.30according to section 260C.201, subdivision 11, or 260C.317;64.31    (2) placed by the commissioner, commissioner's agent, or licensed child-placing 64.32agency after a consent to adopt according to section 259.24 or under an agreement 64.33conferring authority to place for adoption according to section 259.25; or64.34    (3) adopted after a direct adoptive placement ordered by the district court under 64.35section 259.47,65.1the court administrator shall immediately mail a copy of the recorded decree to the 65.2commissioner of human services;65.3    (b) if the court is not satisfied that the proposed adoption is in the best interests 65.4of the child, the court shall deny the petition, and shall order the child returned to the 65.5custody of the person or agency legally vested with permanent custody or certify the 65.6case for appropriate action and disposition to the court having jurisdiction to determine 65.7the custody and guardianship of the child.65.8    Sec. 60. Minnesota Statutes 2006, section 259.67, subdivision 4, is amended to read:65.9    Subd. 4. Eligibility conditions. (a) The placing agency shall use the AFDC 65.10requirements as specified in federal law as of July 16, 1996, when determining the child's 65.11eligibility for adoption assistance under title IV-E of the Social Security Act. If the child 65.12does not qualify, the placing agency shall certify a child as eligible for state funded 65.13adoption assistance only if the following criteria are met:65.14    (1) Due to the child's characteristics or circumstances it would be difficult to provide 65.15the child an adoptive home without adoption assistance.65.16    (2)(i) A placement agency has made reasonable efforts to place the child for adoption 65.17without adoption assistance, but has been unsuccessful; or65.18    (ii) the child's licensed foster parents desire to adopt the child and it is determined by 65.19the placing agency that the adoption is in the best interest of the child.65.20    (3)(i) The child has been a ward of the commissioner, a Minnesota-licensed 65.21child-placing agency, or a tribal social service agency of Minnesota recognized by the 65.22Secretary of the Interior; or (ii) the child will be adopted according to tribal law without a 65.23termination of parental rights or relinquishment, provided that the tribe has documented 65.24the valid reason why the child cannot or should not be returned to the home of the child's 65.25parent. The placing agency shall not certify a child who remains under the jurisdiction 65.26of the sending agency pursuant to section 
         260.851, article 5, for state-funded adoption 65.27assistance when Minnesota is the receiving state.65.28    (b) For purposes of this subdivision, the characteristics or circumstances that may 65.29be considered in determining whether a child is a child with special needs under United 65.30States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of 65.31paragraph (a), clause (1), are the following:65.32    (1) The child is a member of a sibling group to be placed as one unit in which at 65.33least one sibling is older than 15 months of age or is described in clause (2) or (3).65.34    (2) The child has documented physical, mental, emotional, or behavioral disabilities.66.1    (3) The child has a high risk of developing physical, mental, emotional, or behavioral 66.2disabilities.66.3    (4) The child is adopted according to tribal law without a termination of parental 66.4rights or relinquishment, provided that the tribe has documented the valid reason why the 66.5child cannot or should not be returned to the home of the child's parent.66.6    (4) The child is five years of age or older.66.7    (c) When a child's eligibility for adoption assistance is based upon the high risk of 66.8developing physical, mental, emotional, or behavioral disabilities, payments shall not be 66.9made under the adoption assistance agreement unless and until the potential disability 66.10manifests itself as documented by an appropriate health care professional.66.11    Sec. 61. Minnesota Statutes 2006, section 259.67, subdivision 7, is amended to read:66.12    Subd. 7. Reimbursement of costs. (a) Subject to rules of the commissioner, and 66.13the provisions of this subdivision a child-placing agency licensed in Minnesota or any 66.14other state, or local or tribal social services agency shall receive a reimbursement from the 66.15commissioner equal to 100 percent of the reasonable and appropriate cost of providing 66.16adoption services for a child certified as eligible for adoption assistance under subdivision 66.174. Such assistance. Adoption services under this subdivision may include adoptive family 66.18recruitment, counseling, and special training when needed. 66.19    (b) An eligible child must have a goal of adoption, which may include an adoption 66.20in accordance with tribal law, and meet one of the following criteria: 66.21    (1) is a ward of the commissioner of human services or a ward of tribal court 66.22pursuant to section 260.755, subdivision 20, who meets one of the criteria in subdivision 66.234, paragraph (b), clause (1), (2), or (3); or 66.24    (2) is under the guardianship of a Minnesota-licensed child-placing agency who 66.25meets one of the criteria in subdivision 4, paragraph (b), clause (1) or (2).66.26    (c) A child-placing agency licensed in Minnesota or any other state shall receive 66.27reimbursement for adoption services it purchases for or directly provides to an eligible 66.28child. Tribal social services shall receive reimbursement for adoption services it purchases 66.29for or directly provides to an eligible child. A local or tribal social services agency shall 66.30receive such reimbursement only for adoption services it purchases for an eligible child.66.31    (b) A child-placing agency licensed in Minnesota or any other state or local or tribal 66.32social services agency seeking reimbursement under this subdivision shall enter into66.33Before providing adoption services for which reimbursement will be sought under this 66.34subdivision, a reimbursement agreement, on the designated format, must be entered into66.35with the commissioner before providing adoption services for which reimbursement 67.1is sought. No reimbursement under this subdivision shall be made to an agency for 67.2services provided prior to entering a reimbursement agreement. Separate reimbursement 67.3agreements shall be made for each child and separate records shall be kept on each child 67.4for whom a reimbursement agreement is made. The commissioner of human services shall 67.5agree that the reimbursement costs are reasonable and appropriate. The commissioner 67.6may spend up to $16,000 for each purchase of service agreement. Only one agreement per 67.7child is allowed, unless an exception is granted by the commissioner. Funds encumbered 67.8and obligated under such an agreement for the child remain available until the terms of 67.9the agreement are fulfilled or the agreement is terminated.67.10    (c) When a local or tribal social services agency uses a purchase of service agreement 67.11to provide services reimbursable under a reimbursement agreement, The commissioner 67.12may shall make reimbursement payments directly to the agency providing the service if 67.13direct reimbursement is specified by the purchase of service agreement, and if the request 67.14for reimbursement is submitted by the local or tribal social services agency along with a 67.15verification that the service was provided.67.16    Sec. 62. Minnesota Statutes 2006, section 259.75, subdivision 8, is amended to read:67.17    Subd. 8. Reasons for deferral. Deferral of the listing of a child with the state 67.18adoption exchange shall be only for one or more of the following reasons:67.19    (a) the child is in an adoptive placement but is not legally adopted;67.20    (b) the child's foster parents or other individuals are now considering adoption;67.21    (c) diagnostic study or testing is required to clarify the child's problem and provide 67.22an adequate description; or67.23    (d) the child is currently in a hospital and continuing need for daily professional care 67.24will not permit placement in a family setting; or.67.25    (e) the child is 14 years of age or older and will not consent to an adoption plan.67.26Approval of a request to defer listing for any of the reasons specified in paragraph (b) or 67.27(c) shall be valid for a period not to exceed 90 days, with no subsequent deferrals for 67.28those reasons.67.29    Sec. 63. Minnesota Statutes 2006, section 260.012, is amended to read:67.30260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY 67.31REUNIFICATION; REASONABLE EFFORTS.67.32    (a) Once a child alleged to be in need of protection or services is under the court's 67.33jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate 67.34services, by the social services agency are made to prevent placement or to eliminate the 68.1need for removal and to reunite the child with the child's family at the earliest possible 68.2time, and when a child cannot be reunified with the parent or guardian from whom the68.3child was removed, the court must ensure that the responsible social services agency 68.4makes reasonable efforts to finalize an alternative permanent plan for the child as provided 68.5in paragraph (e). In determining reasonable efforts to be made with respect to a child and 68.6in making those reasonable efforts, the child's best interests, health, and safety must be of 68.7paramount concern. Reasonable efforts to prevent placement and for rehabilitation and 68.8reunification are always required except upon a determination by the court that a petition 68.9has been filed stating a prima facie case that:68.10    (1) the parent has subjected a child to egregious harm as defined in section 68.11260C.007, subdivision 14
         ;68.12    (2) the parental rights of the parent to another child have been terminated 68.13involuntarily;68.14    (3) the child is an abandoned infant under section 
         260C.301, subdivision 2, 68.15paragraph (a), clause (2);68.16    (4) the parent's custodial rights to another child have been involuntarily transferred 68.17to a relative under section 
         260C.201, subdivision 11, paragraph (e), clause (1), or a similar 68.18law of another jurisdiction; or68.19    (5) the provision of services or further services for the purpose of reunification is 68.20futile and therefore unreasonable under the circumstances.68.21    (b) When the court makes one of the prima facie determinations under paragraph (a), 68.22either permanency pleadings under section 
         260C.201, subdivision 11, or a termination 68.23of parental rights petition under sections 
         260C.141 and 
         260C.301 must be filed. A 68.24permanency hearing under section 
         260C.201, subdivision 11, must be held within 30 68.25days of this determination.68.26    (c) In the case of an Indian child, in proceedings under sections 
         260B.178 or 68.27260C.178
         , 
         260C.201, and 
         260C.301 the juvenile court must make findings and conclusions 68.28consistent with the Indian Child Welfare Act of 1978, United States Code, title 25, section 68.291901 et seq., as to the provision of active efforts. In cases governed by the Indian Child 68.30Welfare Act of 1978, United States Code, title 25, section 1901, the responsible social 68.31services agency must provide active efforts as required under United States Code, title 68.3225, section 1911(d).68.33    (d) "Reasonable efforts to prevent placement" means:68.34    (1) the agency has made reasonable efforts to prevent the placement of the child in 68.35foster care; or69.1    (2) given the particular circumstances of the child and family at the time of the 69.2child's removal, there are no services or efforts available which could allow the child to 69.3safely remain in the home.69.4    (e) "Reasonable efforts to finalize a permanent plan for the child" means due 69.5diligence by the responsible social services agency to:69.6    (1) reunify the child with the parent or guardian from whom the child was removed;69.7    (2) assess a noncustodial parent's ability to provide day-to-day care for the child and, 69.8where appropriate, provide services necessary to enable the noncustodial parent to safely 69.9provide the care, as required by section 
         260C.212, subdivision 4;69.10    (3) conduct a relative search as required under section 
         260C.212, subdivision 5; and69.11    (4) when the child cannot return to the parent or guardian from whom the child was 69.12removed, to plan for and finalize a safe and legally permanent alternative home for the 69.13child, and considers permanent alternative homes for the child inside or outside of the 69.14state, preferably through adoption or transfer of permanent legal and physical custody of 69.15the child.69.16    (f) Reasonable efforts are made upon the exercise of due diligence by the responsible 69.17social services agency to use culturally appropriate and available services to meet the 69.18needs of the child and the child's family. Services may include those provided by the 69.19responsible social services agency and other culturally appropriate services available in 69.20the community. At each stage of the proceedings where the court is required to review 69.21the appropriateness of the responsible social services agency's reasonable efforts as 69.22described in paragraphs (a), (d), and (e), the social services agency has the burden of 69.23demonstrating that:69.24    (1) it has made reasonable efforts to prevent placement of the child in foster care;69.25    (2) it has made reasonable efforts to eliminate the need for removal of the child from 69.26the child's home and to reunify the child with the child's family at the earliest possible time;69.27    (3) it has made reasonable efforts to finalize an alternative permanent home for 69.28the child, and considers permanent alternative homes for the child inside or outside of 69.29the state; or69.30    (4) reasonable efforts to prevent placement and to reunify the child with the parent 69.31or guardian are not required. The agency may meet this burden by stating facts in a sworn 69.32petition filed under section 
         260C.141, by filing an affidavit summarizing the agency's 69.33reasonable efforts or facts the agency believes demonstrate there is no need for reasonable 69.34efforts to reunify the parent and child, or through testimony or a certified report required 69.35under juvenile court rules.70.1    (g) Once the court determines that reasonable efforts for reunification are not 70.2required because the court has made one of the prima facie determinations under paragraph 70.3(a), the court may only require reasonable efforts for reunification after a hearing according 70.4to section 
         260C.163, where the court finds there is not clear and convincing evidence of 70.5the facts upon which the court based its prima facie determination. In this case when there 70.6is clear and convincing evidence that the child is in need of protection or services, the 70.7court may find the child in need of protection or services and order any of the dispositions 70.8available under section 
         260C.201, subdivision 1. Reunification of a surviving child with a 70.9parent is not required if the parent has been convicted of:70.10    (1) a violation of, or an attempt or conspiracy to commit a violation of, sections 70.11609.185
          to 
         609.20; 
         609.222, subdivision 2; or 
         609.223 in regard to another child of the 70.12parent;70.13    (2) a violation of section 
         609.222, subdivision 2; or 
         609.223, in regard to the 70.14surviving child; or70.15    (3) a violation of, or an attempt or conspiracy to commit a violation of, United States 70.16Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent.70.17    (h) The juvenile court, in proceedings under sections 
         260B.178 or 
         260C.178, 70.18260C.201
         , and 
         260C.301 shall make findings and conclusions as to the provision of 70.19reasonable efforts. When determining whether reasonable efforts have been made, the 70.20court shall consider whether services to the child and family were:70.21    (1) relevant to the safety and protection of the child;70.22    (2) adequate to meet the needs of the child and family;70.23    (3) culturally appropriate;70.24    (4) available and accessible;70.25    (5) consistent and timely; and70.26    (6) realistic under the circumstances.70.27    In the alternative, the court may determine that provision of services or further 70.28services for the purpose of rehabilitation is futile and therefore unreasonable under the 70.29circumstances or that reasonable efforts are not required as provided in paragraph (a).70.30    (i) This section does not prevent out-of-home placement for treatment of a child with 70.31a mental disability when the child's diagnostic assessment or individual treatment plan 70.32indicates that appropriate and necessary treatment cannot be effectively provided outside 70.33of a residential or inpatient treatment program.70.34    (j) If continuation of reasonable efforts to prevent placement or reunify the child 70.35with the parent or guardian from whom the child was removed is determined by the court 70.36to be inconsistent with the permanent plan for the child or upon the court making one of 71.1the prima facie determinations under paragraph (a), reasonable efforts must be made to 71.2place the child in a timely manner in a safe and permanent home and to complete whatever 71.3steps are necessary to legally finalize the permanent placement of the child.71.4    (k) Reasonable efforts to place a child for adoption or in another permanent 71.5placement may be made concurrently with reasonable efforts to prevent placement or to 71.6reunify the child with the parent or guardian from whom the child was removed. When 71.7the responsible social services agency decides to concurrently make reasonable efforts for 71.8both reunification and permanent placement away from the parent under paragraph (a), the 71.9agency shall disclose its decision and both plans for concurrent reasonable efforts to all 71.10parties and the court. When the agency discloses its decision to proceed on both plans for 71.11reunification and permanent placement away from the parent, the court's review of the 71.12agency's reasonable efforts shall include the agency's efforts under both plans.71.13    Sec. 64. Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:71.14    Subd. 12. Indian tribe. "Indian tribe" means an Indian tribe, band, nation, or 71.15other organized group or community of Indians recognized as eligible for the services 71.16provided to Indians by the secretary because of their status as Indians, including any band71.17Native group under the Alaska Native Claims Settlement Act, United States Code, title 43, 71.18section 1602, and exercising tribal governmental powers.71.19    Sec. 65. Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:71.20    Subd. 20. Tribal court. "Tribal court" means a court with federally recognized71.21jurisdiction over child custody proceedings and which is either a court of Indian offenses, 71.22or a court established and operated under the code or custom of an Indian tribe, or the71.23any other administrative body of a tribe which is vested with authority over child custody 71.24proceedings. Except as provided in section 
         260.771, subdivision 5, nothing in this chapter 71.25shall be construed as conferring jurisdiction on an Indian tribe. 71.26    Sec. 66. Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:71.27    Subd. 7. Identification of extended family members. Any agency considering 71.28placement of an Indian child shall make reasonable active efforts to identify and locate 71.29extended family members.71.30    Sec. 67. Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:72.1    Subd. 5. Identification of extended family members. Any agency considering 72.2placement of an Indian child shall make reasonable active efforts to identify and locate 72.3extended family members.72.4    Sec. 68. Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:72.5    Subdivision 1. Indian tribe jurisdiction. An Indian tribe with a tribal court has 72.6exclusive jurisdiction over a child placement proceeding involving an Indian child who 72.7resides or is domiciled within the reservation of such the tribe at the commencement of 72.8the proceedings, except where jurisdiction is otherwise vested in the state by existing 72.9federal law. When an Indian child is in the legal custody of a person or agency pursuant 72.10to an order of a ward of the tribal court, the Indian tribe retains exclusive jurisdiction, 72.11notwithstanding the residence or domicile of the child.72.12    Sec. 69. Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:72.13    Subd. 2. Court determination of tribal affiliation of child. In any child placement 72.14proceeding, the court shall establish whether an Indian child is involved and the identity 72.15of the Indian child's tribe. This chapter and the federal Indian Child Welfare Act are 72.16applicable without exception in any child custody proceeding, as defined in the federal act, 72.17involving an Indian child. This chapter applies to child custody proceedings involving 72.18an Indian child whether the child is in the physical or legal custody of an Indian parent, 72.19Indian custodian, Indian extended family member, or other person at the commencement 72.20of the proceedings. A court shall not determine the applicability of this chapter or the 72.21federal Indian Child Welfare Act to a child custody proceeding based upon whether an 72.22Indian child is part of an existing Indian family or based upon the level of contact a child 72.23has with the child's Indian tribe, reservation, society, or off-reservation community.72.24    Sec. 70. [260.852] PLACEMENT PROCEDURES.72.25    Subdivision 1.Home study.The state must have procedures for the orderly and 72.26timely interstate placement of children that are implemented in accordance with an 72.27interstate compact and that, within 60 days after the state receives from another state a 72.28request to conduct a study of a home environment for purposes of assessing the safety 72.29and suitability of placing a child in the home, the state shall, directly or by contract, 72.30conduct and complete a home study and return to the other state a report on the results of 72.31the study, which shall address the extent to which placement in the home would meet the 72.32needs of the child; except in the case of a home study begun before October 1, 2008, if the 72.33state fails to comply with conducting and completing the home study within the 60-day 73.1period and this is as a result of circumstances beyond the control of the state, the state has 73.275 days to comply if the state documents the circumstances involved and certifies that 73.3completing the home study is in the best interests of the child. 73.4    This subdivision does not require the completion within the applicable period of 73.5the parts of the home study involving the education and training of the prospective foster 73.6or adoptive parents.73.7    Subd. 2.Effect of received report.The state shall treat any report described in 73.8subdivision 1 that is received from another state, an Indian tribe, or a private agency 73.9under contract with another state or Indian tribe as meeting any requirements imposed by 73.10the state for the completion of a home study before placing a child in the home, unless, 73.11within 14 days after receipt of the report, the state determines, based on grounds that 73.12are specific to the content of the report, that making a decision in reliance on the report 73.13would be contrary to the welfare of the child.73.14    Subd. 3.Resources.The state shall make effective use of cross-jurisdictional 73.15resources, including through contract for the purchase of services, and shall eliminate 73.16legal barriers to facilitate timely adoptive or permanent placements for waiting children. 73.17The state shall not impose any restriction on the use of private agencies for the purpose of 73.18conducting a home study to meet the 60-day requirement.73.19    Subd. 4.Incentive eligibility.Minnesota is an incentive-eligible state and must:73.20    (1) have an approved plan as required by the United States Secretary of Health 73.21and Human Services;73.22    (2) be in compliance with the data requirements of the United States Department of 73.23Health and Human Services; and73.24    (3) have data that verify that a home study is completed within 30 days.73.25    Subd. 5.Data requirements.The state shall provide to the United States Secretary 73.26of Health and Human Services a written report, covering the preceding fiscal year, that 73.27specifies:73.28    (1) the total number of interstate home studies requested by the state with respect 73.29to children in foster care under the responsibility of the state, and with respect to each 73.30study, the identity of the other state involved;73.31    (2) the total number of timely interstate home studies completed by the state with 73.32respect to children in foster care under the responsibility of other states and, with respect 73.33to each study, the identity of the other state involved; and73.34    (3) other information the United States Secretary of Health and Human Services 73.35requires in order to determine whether Minnesota is a home study incentive-eligible state.73.36    Subd. 6.Definitions.(a) The definitions in this subdivision apply to this section.74.1    (b) "Home study" means an evaluation of a home environment conducted in 74.2accordance with applicable requirements of the state in which the home is located, to 74.3determine whether a proposed placement of a child would meet the individual needs of the 74.4child, including the child's safety; permanency; health; well-being; and mental, emotional, 74.5and physical development.74.6    (c) "Interstate home study" means a home study conducted by a state at the request 74.7of another state to facilitate an adoptive or foster placement in the state of a child in foster 74.8care under the responsibility of the state.74.9    (d) "Timely interstate home study" means an interstate home study completed by a 74.10state if the state provides to the state that requested the study, within 30 days after receipt 74.11of the request, a report on the results of the study, except that there is no requirement 74.12for completion within the 30-day period of the parts of the home study involving the 74.13education and training of the prospective foster or adoptive parents.74.14    Subd. 7.Background study requirements for adoption and foster care.(a) 74.15Background study requirements for an adoption home study must be completed consistent 74.16with section 259.41, subdivisions 1, 2, and 3.74.17    (b) Background study requirements for a foster care license must be completed 74.18consistent with section 245C.08.74.19    Subd. 8.Home visits.If a child has been placed in foster care outside the state in 74.20which the home of the parents of the child is located, periodically, but at least every six 74.21months, a caseworker on the staff of the agency of the state in which the home of the 74.22parents of the child is located or the state in which the child has been placed, or a private 74.23agency under contract with either state, must visit the child in the home or institution and 74.24submit a report on each visit to the agency of the state in which the home of the parents of 74.25the child is located.74.26    Sec. 71. Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:74.27    Subdivision 1. Investigation. Upon request of the court the local social services 74.28agency or probation officer shall investigate the personal and family history and 74.29environment of any minor coming within the jurisdiction of the court under section 74.30260B.101
          and shall report its findings to the court. The court may order any minor coming 74.31within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or 74.32psychologist appointed by the court. 74.33    The court shall have order a chemical use assessment conducted when a child is 74.34(1) found to be delinquent for violating a provision of chapter 152, or for committing a 74.35felony-level violation of a provision of chapter 609 if the probation officer determines 75.1that alcohol or drug use was a contributing factor in the commission of the offense, or 75.2(2) alleged to be delinquent for violating a provision of chapter 152, if the child is being 75.3held in custody under a detention order. The assessor's qualifications and the assessment 75.4criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under 75.5chapter 254B are to be used to pay for the recommended treatment, the assessment and 75.6placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to 75.79530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall 75.8reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.75.9    The court shall have order a children's mental health screening conducted when 75.10a child is found to be delinquent. The screening shall be conducted with a screening 75.11instrument approved by the commissioner of human services and shall be conducted by a 75.12mental health practitioner as defined in section 
         245.4871, subdivision 26, or a probation 75.13officer who is trained in the use of the screening instrument. If the screening indicates 75.14a need for assessment, the local social services agency, in consultation with the child's 75.15family, shall have a diagnostic assessment conducted, including a functional assessment, 75.16as defined in section 
         245.4871. 75.17    With the consent of the commissioner of corrections and agreement of the county to 75.18pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction 75.19in an institution maintained by the commissioner for the detention, diagnosis, custody and 75.20treatment of persons adjudicated to be delinquent, in order that the condition of the minor 75.21be given due consideration in the disposition of the case. Any funds received under the 75.22provisions of this subdivision shall not cancel until the end of the fiscal year immediately 75.23following the fiscal year in which the funds were received. The funds are available for 75.24use by the commissioner of corrections during that period and are hereby appropriated 75.25annually to the commissioner of corrections as reimbursement of the costs of providing 75.26these services to the juvenile courts.75.27    Sec. 72. Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:75.28    Subd. 5. Notice to foster parents and preadoptive parents and relatives. The 75.29foster parents, if any, of a child and any preadoptive parent or relative providing care 75.30for the child must be provided notice of and an opportunity a right to be heard in any 75.31review or hearing to be held with respect to the child. Any other relative may also request, 75.32and must be granted, a notice and the opportunity to be heard under this section. This 75.33subdivision does not require that a foster parent, preadoptive parent, or relative providing 75.34care for the child be made a party to a review or hearing solely on the basis of the notice 75.35and opportunity right to be heard.76.1    Sec. 73. Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:76.2    Subdivision 1. General. (a) Except for hearings arising under section 
         260C.425, 76.3hearings on any matter shall be without a jury and may be conducted in an informal 76.4manner. In all adjudicatory proceedings involving a child alleged to be in need of 76.5protection or services, the court shall admit only evidence that would be admissible in a 76.6civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of 76.7protection or services must be proved by clear and convincing evidence. 76.8    (b) Except for proceedings involving a child alleged to be in need of protection or 76.9services and petitions for the termination of parental rights, hearings may be continued or 76.10adjourned from time to time. In proceedings involving a child alleged to be in need of 76.11protection or services and petitions for the termination of parental rights, hearings may not 76.12be continued or adjourned for more than one week unless the court makes specific findings 76.13that the continuance or adjournment is in the best interests of the child. If a hearing is held 76.14on a petition involving physical or sexual abuse of a child who is alleged to be in need of 76.15protection or services or neglected and in foster care, the court shall file the decision with 76.16the court administrator as soon as possible but no later than 15 days after the matter is 76.17submitted to the court. When a continuance or adjournment is ordered in any proceeding, 76.18the court may make any interim orders as it deems in the best interests of the minor in 76.19accordance with the provisions of sections 
         260C.001 to 
         260C.421. 76.20    (c) Except as otherwise provided in this paragraph, the court shall exclude the 76.21general public from hearings under this chapter and shall admit only those persons who, in 76.22the discretion of the court, have a direct interest in the case or in the work of the court.76.23    (d) Adoption hearings shall be conducted in accordance with the provisions of 76.24laws relating to adoptions.76.25    (e) In any permanency hearing, including the transition of a child from foster care 76.26to independent living, the court shall ensure that any consult with the child is in an 76.27age-appropriate manner.76.28    Sec. 74. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to 76.29read:76.30    Subd. 11. Review of court-ordered placements; permanent placement 76.31determination. (a) This subdivision and subdivision 11a do not apply in cases where 76.32the child is in placement due solely to the child's developmental disability or emotional 76.33disturbance, where legal custody has not been transferred to the responsible social services 76.34agency, and where the court finds compelling reasons under section 
         260C.007, subdivision 76.358
         , to continue the child in foster care past the time periods specified in this subdivision. 77.1Foster care placements of children due solely to their disability are governed by section 77.2260C.141, subdivision 2a
         . In all other cases where the child is in foster care or in the care 77.3of a noncustodial parent under subdivision 1, the court shall commence proceedings 77.4to determine the permanent status of a child not later than 12 months after the child is 77.5placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing 77.6commencing such proceedings, the court shall determine whether there is a prima facie 77.7basis for finding that the agency made reasonable efforts, or in the case of an Indian 77.8child active efforts, required under section 
         260.012 and proceed according to the rules of 77.9juvenile court.77.10    For purposes of this subdivision, the date of the child's placement in foster care is 77.11the earlier of the first court-ordered placement or 60 days after the date on which the 77.12child has been voluntarily placed in foster care by the child's parent or guardian. For 77.13purposes of this subdivision, time spent by a child under the protective supervision of 77.14the responsible social services agency in the home of a noncustodial parent pursuant to 77.15an order under subdivision 1 counts towards the requirement of a permanency hearing 77.16under this subdivision or subdivision 11a. Time spent on a trial home visit does not count77.17counts towards the requirement of a permanency hearing under this subdivision orand a 77.18permanency review for a child under eight years of age under subdivision 11a.77.19    For purposes of this subdivision, 12 months is calculated as follows:77.20    (1) during the pendency of a petition alleging that a child is in need of protection 77.21or services, all time periods when a child is placed in foster care or in the home of a 77.22noncustodial parent are cumulated;77.23    (2) if a child has been placed in foster care within the previous five years under one 77.24or more previous petitions, the lengths of all prior time periods when the child was placed 77.25in foster care within the previous five years are cumulated. If a child under this clause 77.26has been in foster care for 12 months or more, the court, if it is in the best interests of the 77.27child and for compelling reasons, may extend the total time the child may continue out 77.28of the home under the current petition up to an additional six months before making a 77.29permanency determination.77.30    (b) Unless the responsible social services agency recommends return of the child 77.31to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing 77.32required under paragraph (a) and the rules of juvenile court, the responsible social services 77.33agency shall file pleadings in juvenile court to establish the basis for the juvenile court to 77.34order permanent placement of the child, including a termination of parental rights petition, 77.35according to paragraph (d). Notice of the hearing and copies of the pleadings must be 77.36provided pursuant to section 
         260C.152.78.1    (c) The permanency proceedings shall be conducted in a timely fashion including 78.2that any trial required under section 
         260C.163 shall be commenced within 60 days of the 78.3admit-deny hearing required under paragraph (a). At the conclusion of the permanency 78.4proceedings, the court shall:78.5    (1) order the child returned to the care of the parent or guardian from whom the 78.6child was removed; or78.7    (2) order a permanent placement or termination of parental rights if permanent 78.8placement or termination of parental rights is in the child's best interests. The "best 78.9interests of the child" means all relevant factors to be considered and evaluated. Transfer 78.10of permanent legal and physical custody, termination of parental rights, or guardianship 78.11and legal custody to the commissioner through a consent to adopt are preferred 78.12permanency options for a child who cannot return home.78.13    (d) If the child is not returned to the home, the court must order one of the following 78.14dispositions:78.15    (1) permanent legal and physical custody to a relative in the best interests of the 78.16child according to the following conditions:78.17    (i) an order for transfer of permanent legal and physical custody to a relative shall 78.18only be made after the court has reviewed the suitability of the prospective legal and 78.19physical custodian;78.20    (ii) in transferring permanent legal and physical custody to a relative, the juvenile 78.21court shall follow the standards applicable under this chapter and chapter 260, and the 78.22procedures set out in the juvenile court rules;78.23    (iii) an order establishing permanent legal and physical custody under this 78.24subdivision must be filed with the family court;78.25    (iv) a transfer of legal and physical custody includes responsibility for the protection, 78.26education, care, and control of the child and decision making on behalf of the child;78.27    (v) the social services agency may bring a petition or motion naming a fit and 78.28willing relative as a proposed permanent legal and physical custodian. The commissioner 78.29of human services shall annually prepare for counties information that must be given to 78.30proposed custodians about their legal rights and obligations as custodians together with 78.31information on financial and medical benefits for which the child is eligible; and78.32    (vi) the juvenile court may maintain jurisdiction over the responsible social services 78.33agency, the parents or guardian of the child, the child, and the permanent legal and 78.34physical custodian for purposes of ensuring appropriate services are delivered to the child 78.35and permanent legal custodian or for the purpose of ensuring conditions ordered by the 78.36court related to the care and custody of the child are met;79.1    (2) termination of parental rights when the requirements of sections 
         260C.301 to 79.2260C.328
          are met or according to the following conditions:79.3    (i) order the social services agency to file a petition for termination of parental 79.4rights in which case all the requirements of sections 
         260C.301 to 
         260C.328 remain 79.5applicable; and79.6    (ii) an adoption completed subsequent to a determination under this subdivision may 79.7include an agreement for communication or contact under section 
         259.58;79.8    (3) long-term foster care according to the following conditions:79.9    (i) the court may order a child into long-term foster care only if it approves the 79.10responsible social service agency's compelling reasons that neither an award of permanent 79.11legal and physical custody to a relative, nor termination of parental rights is in the child's 79.12best interests;79.13    (ii) further, the court may only order long-term foster care for the child under this 79.14section if it finds the following:79.15    (A) the child has reached age 12 and the responsible social services agency has made 79.16reasonable efforts to locate and place the child with an adoptive family or with a fit and 79.17willing relative who will agree to a transfer of permanent legal and physical custody of 79.18the child, but such efforts have not proven successful; or79.19    (B) the child is a sibling of a child described in subitem (A) and the siblings have 79.20a significant positive relationship and are ordered into the same long-term foster care 79.21home; and79.22    (iii) at least annually, the responsible social services agency reconsiders its provision 79.23of services to the child and the child's placement in long-term foster care to ensure that:79.24    (A) long-term foster care continues to be the most appropriate legal arrangement 79.25for meeting the child's need for permanency and stability, including whether there is 79.26another permanent placement option under this chapter that would better serve the child's 79.27needs and best interests;79.28    (B) whenever possible, there is an identified long-term foster care family that is 79.29committed to being the foster family for the child as long as the child is a minor or under 79.30the jurisdiction of the court;79.31    (C) the child is receiving appropriate services or assistance to maintain or build 79.32connections with the child's family and community;79.33    (D) the child's physical and mental health needs are being appropriately provided 79.34for; and79.35    (E) the child's educational needs are being met;79.36    (4) foster care for a specified period of time according to the following conditions:80.1    (i) foster care for a specified period of time may be ordered only if:80.2    (A) the sole basis for an adjudication that the child is in need of protection or 80.3services is the child's behavior;80.4    (B) the court finds that foster care for a specified period of time is in the best 80.5interests of the child; and80.6    (C) the court approves the responsible social services agency's compelling reasons 80.7that neither an award of permanent legal and physical custody to a relative, nor termination 80.8of parental rights is in the child's best interests;80.9    (ii) the order does not specify that the child continue in foster care for any period 80.10exceeding one year; or80.11    (5) guardianship and legal custody to the commissioner of human services under 80.12the following procedures and conditions:80.13    (i) there is an identified prospective adoptive home agreed to by the responsible 80.14social services agency having legal custody of the child pursuant to court order under this 80.15section that has agreed to adopt the child and the court accepts the parent's voluntary 80.16consent to adopt under section 
         259.24, except that such consent executed by a parent under 80.17this item, following proper notice that consent given under this provision is irrevocable 80.18upon acceptance by the court, shall be irrevocable unless fraud is established and an order 80.19issues permitting revocation as stated in item (vii);80.20    (ii) if the court accepts a consent to adopt in lieu of ordering one of the other 80.21enumerated permanency dispositions, the court must review the matter at least every 90 80.22days. The review will address the reasonable efforts of the agency to achieve a finalized 80.23adoption;80.24    (iii) a consent to adopt under this clause vests all legal authority regarding the child, 80.25including guardianship and legal custody of the child, with the commissioner of human 80.26services as if the child were a state ward after termination of parental rights;80.27    (iv) the court must forward a copy of the consent to adopt, together with a certified 80.28copy of the order transferring guardianship and legal custody to the commissioner, to 80.29the commissioner;80.30    (v) if an adoption is not finalized by the identified prospective adoptive parent within 80.3112 months of the execution of the consent to adopt under this clause, the commissioner of 80.32human services or the commissioner's delegate shall pursue adoptive placement in another 80.33home unless the commissioner certifies that the failure to finalize is not due to either an 80.34action or a failure to act by the prospective adoptive parent;80.35    (vi) notwithstanding item (v), the commissioner of human services or the 80.36commissioner's designee must pursue adoptive placement in another home as soon as the 81.1commissioner or commissioner's designee determines that finalization of the adoption with 81.2the identified prospective adoptive parent is not possible, that the identified prospective 81.3adoptive parent is not willing to adopt the child, that the identified prospective adoptive 81.4parent is not cooperative in completing the steps necessary to finalize the adoption, or 81.5upon the commissioner's determination to withhold consent to the adoption.81.6    (vii) unless otherwise required by the Indian Child Welfare Act, United States Code, 81.7title 25, section 1913, a consent to adopt executed under this section, following proper 81.8notice that consent given under this provision is irrevocable upon acceptance by the court, 81.9shall be irrevocable upon acceptance by the court except upon order permitting revocation 81.10issued by the same court after written findings that consent was obtained by fraud.81.11    (e) In ordering a permanent placement of a child, the court must be governed by the 81.12best interests of the child, including a review of the relationship between the child and 81.13relatives and the child and other important persons with whom the child has resided or 81.14had significant contact. When the court has determined that permanent placement of the 81.15child away from the parent is necessary, the court shall consider permanent alternative 81.16homes that are available both inside and outside the state.81.17    (f) Once a permanent placement determination has been made and permanent 81.18placement has been established, further court reviews are necessary if:81.19    (1) the placement is long-term foster care or foster care for a specified period of time;81.20    (2) the court orders further hearings because it has retained jurisdiction of a transfer 81.21of permanent legal and physical custody matter;81.22    (3) an adoption has not yet been finalized; or81.23    (4) there is a disruption of the permanent or long-term placement.81.24    (g) Court reviews of an order for long-term foster care, whether under this section 81.25or section 
         260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and 81.26must review the child's out-of-home placement plan and the reasonable efforts of the 81.27agency to finalize the permanent plan for the child including the agency's efforts to:81.28    (1) ensure that long-term foster care continues to be the most appropriate legal 81.29arrangement for meeting the child's need for permanency and stability or, if not, to identify 81.30and attempt to finalize another permanent placement option under this chapter that would 81.31better serve the child's needs and best interests;81.32    (2) identify a specific long-term foster home for the child, if one has not already 81.33been identified;81.34    (3) support continued placement of the child in the identified home, if one has been 81.35identified;82.1    (4) ensure appropriate services are provided to address the physical health, mental 82.2health, and educational needs of the child during the period of long-term foster care and 82.3also ensure appropriate services or assistance to maintain relationships with appropriate 82.4family members and the child's community; and82.5    (5) plan for the child's independence upon the child's leaving long-term foster care 82.6living as required under section 
         260C.212, subdivision 1.82.7    (h) In the event it is necessary for a child that has been ordered into foster care for a 82.8specified period of time to be in foster care longer than one year after the permanency 82.9hearing held under this section, not later than 12 months after the time the child was 82.10ordered into foster care for a specified period of time, the matter must be returned to 82.11court for a review of the appropriateness of continuing the child in foster care and of the 82.12responsible social services agency's reasonable efforts to finalize a permanent plan for 82.13the child; if it is in the child's best interests to continue the order for foster care for a 82.14specified period of time past a total of 12 months, the court shall set objectives for the 82.15child's continuation in foster care, specify any further amount of time the child may be in 82.16foster care, and review the plan for the safe return of the child to the parent.82.17    (i) An order permanently placing a child out of the home of the parent or guardian 82.18must include the following detailed findings:82.19    (1) how the child's best interests are served by the order;82.20    (2) the nature and extent of the responsible social service agency's reasonable efforts, 82.21or, in the case of an Indian child, active efforts to reunify the child with the parent or 82.22guardian where reasonable efforts are required;82.23    (3) the parent's or parents' efforts and ability to use services to correct the conditions 82.24which led to the out-of-home placement; and82.25    (4) that the conditions which led to the out-of-home placement have not been 82.26corrected so that the child can safely return home.82.27    (j) An order for permanent legal and physical custody of a child may be modified 82.28under sections 
         518.18 and 
         518.185. The social services agency is a party to the proceeding 82.29and must receive notice. A parent may only seek modification of an order for long-term 82.30foster care upon motion and a showing by the parent of a substantial change in the parent's 82.31circumstances such that the parent could provide appropriate care for the child and that 82.32removal of the child from the child's permanent placement and the return to the parent's 82.33care would be in the best interest of the child. The responsible social services agency may 82.34ask the court to vacate an order for long-term foster care upon a prima facie showing 82.35that there is a factual basis for the court to order another permanency option under this 82.36chapter and that such an option is in the child's best interests. Upon a hearing where 83.1the court determines that there is a factual basis for vacating the order for long-term 83.2foster care and that another permanent order regarding the placement of the child is in 83.3the child's best interests, the court may vacate the order for long-term foster care and 83.4enter a different order for permanent placement that is in the child's best interests. The 83.5court shall not require further reasonable efforts to reunify the child with the parent or 83.6guardian as a basis for vacating the order for long-term foster care and ordering a different 83.7permanent placement in the child's best interests. The county attorney must file pleadings 83.8and give notice as required under the rules of juvenile court in order to modify an order for 83.9long-term foster care under this paragraph.83.10    (k) The court shall issue an order required under this section within 15 days of the 83.11close of the proceedings. The court may extend issuing the order an additional 15 days 83.12when necessary in the interests of justice and the best interests of the child.83.13    (l) This paragraph applies to proceedings required under this subdivision when 83.14the child is on a trial home visit:83.15    (1) if the child is on a trial home visit 12 months after the child was placed in 83.16foster care or in the care of a noncustodial parent as calculated in this subdivision, the 83.17responsible social services agency may file a report with the court regarding the child's and 83.18parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe 83.19and permanent return to the care of the parent in lieu of filing the pleadings required under 83.20paragraph (b). The court shall make findings regarding reasonableness of the responsible 83.21social services efforts to finalize the child's return home as the permanent order in the best 83.22interests of the child. The court may continue the trial home visit to a total time not to 83.23exceed six months as provided in subdivision 1. If the court finds the responsible social 83.24services agency has not made reasonable efforts to finalize the child's return home as the 83.25permanent order in the best interests of the child, the court may order other or additional 83.26efforts to support the child remaining in the care of the parent; and83.27    (2) if a trial home visit ordered or continued at proceedings under this subdivision 83.28terminates, the court shall re-commence proceedings under this subdivision to determine 83.29the permanent status of the child not later than 30 days after the child is returned to foster 83.30care.83.31    Sec. 75. Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:83.32    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan 83.33shall be prepared within 30 days after any child is placed in a residential facility by court 83.34order or by the voluntary release of the child by the parent or parents.84.1    For purposes of this section, a residential facility means any group home, family 84.2foster home or other publicly supported out-of-home residential facility, including any 84.3out-of-home residential facility under contract with the state, county or other political 84.4subdivision, or any agency thereof, to provide those services or foster care as defined in 84.5section 
         260C.007, subdivision 18.84.6    (b) An out-of-home placement plan means a written document which is prepared by 84.7the responsible social services agency jointly with the parent or parents or guardian of the 84.8child and in consultation with the child's guardian ad litem, the child's tribe, if the child is 84.9an Indian child, the child's foster parent or representative of the residential facility, and, 84.10where appropriate, the child. For a child in placement due solely or in part to the child's 84.11emotional disturbance, preparation of the out-of-home placement plan shall additionally 84.12include the child's mental health treatment provider. As appropriate, the plan shall be:84.13    (1) submitted to the court for approval under section 
         260C.178, subdivision 7;84.14    (2) ordered by the court, either as presented or modified after hearing, under section 84.15260C.178, subdivision 7
         , or 
         260C.201, subdivision 6; and84.16    (3) signed by the parent or parents or guardian of the child, the child's guardian ad 84.17litem, a representative of the child's tribe, the responsible social services agency, and, if 84.18possible, the child.84.19    (c) The out-of-home placement plan shall be explained to all persons involved in its 84.20implementation, including the child who has signed the plan, and shall set forth:84.21    (1) a description of the residential facility including how the out-of-home placement 84.22plan is designed to achieve a safe placement for the child in the least restrictive, most 84.23family-like, setting available which is in close proximity to the home of the parent or 84.24parents or guardian of the child when the case plan goal is reunification, and how the 84.25placement is consistent with the best interests and special needs of the child according to 84.26the factors under subdivision 2, paragraph (b);84.27    (2) the specific reasons for the placement of the child in a residential facility, and 84.28when reunification is the plan, a description of the problems or conditions in the home of 84.29the parent or parents which necessitated removal of the child from home and the changes 84.30the parent or parents must make in order for the child to safely return home;84.31    (3) a description of the services offered and provided to prevent removal of the child 84.32from the home and to reunify the family including:84.33    (i) the specific actions to be taken by the parent or parents of the child to eliminate 84.34or correct the problems or conditions identified in clause (2), and the time period during 84.35which the actions are to be taken; and85.1    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made 85.2to achieve a safe and stable home for the child including social and other supportive 85.3services to be provided or offered to the parent or parents or guardian of the child, the 85.4child, and the residential facility during the period the child is in the residential facility;85.5    (4) a description of any services or resources that were requested by the child or the 85.6child's parent, guardian, foster parent, or custodian since the date of the child's placement 85.7in the residential facility, and whether those services or resources were provided and if 85.8not, the basis for the denial of the services or resources;85.9    (5) the visitation plan for the parent or parents or guardian, other relatives as defined 85.10in section 
         260C.007, subdivision 27, and siblings of the child if the siblings are not placed 85.11together in the residential facility, and whether visitation is consistent with the best interest 85.12of the child, during the period the child is in the residential facility;85.13    (6) documentation of steps to finalize the adoption or legal guardianship of the child 85.14if the court has issued an order terminating the rights of both parents of the child or of 85.15the only known, living parent of the child, and. At a minimum, the documentation must 85.16include child-specific recruitment efforts such as relative search and the use of state, 85.17regional, and national adoption exchanges to facilitate orderly and timely placements in 85.18and outside of the state. A copy of this documentation shall be provided to the court in the 85.19review required under section 
         260C.317, subdivision 3, paragraph (b);85.20    (7) to the extent available and accessible, the health and educational records of the 85.21child including the most recent information available regarding:85.22    (i) the names and addresses of the child's health and educational providers;85.23    (ii) the child's grade level performance;85.24    (iii) the child's school record;85.25    (iv) assurances that the child's placement in foster care takes into account proximity 85.26to the school in which the child is enrolled at the time of placement;85.27    (v) a record of the child's immunizations;85.28    (vi) the child's known medical problems, including any known communicable 85.29diseases, as defined in section 
         144.4172, subdivision 2;85.30    (vii) the child's medications; and85.31    (viii) any other relevant health and education information;85.32    (8) an independent living plan for a child age 16 or older who is in placement as 85.33a result of a permanency disposition. The plan should include, but not be limited to, 85.34the following objectives:85.35    (i) educational, vocational, or employment planning;85.36    (ii) health care planning and medical coverage;86.1    (iii) transportation including, where appropriate, assisting the child in obtaining a 86.2driver's license;86.3    (iv) money management;86.4    (v) planning for housing;86.5    (vi) social and recreational skills; and86.6    (vii) establishing and maintaining connections with the child's family and 86.7community; and86.8    (9) for a child in placement due solely or in part to the child's emotional disturbance, 86.9diagnostic and assessment information, specific services relating to meeting the mental 86.10health care needs of the child, and treatment outcomes.86.11    (d) The parent or parents or guardian and the child each shall have the right to legal 86.12counsel in the preparation of the case plan and shall be informed of the right at the time 86.13of placement of the child. The child shall also have the right to a guardian ad litem. 86.14If unable to employ counsel from their own resources, the court shall appoint counsel 86.15upon the request of the parent or parents or the child or the child's legal guardian. The 86.16parent or parents may also receive assistance from any person or social services agency 86.17in preparation of the case plan.86.18    After the plan has been agreed upon by the parties involved or approved or ordered 86.19by the court, the foster parents shall be fully informed of the provisions of the case plan 86.20and shall be provided a copy of the plan.86.21    Upon discharge from foster care, the parent, adoptive parent, or permanent legal and 86.22physical custodian, as appropriate, and the child, if appropriate, must be provided with 86.23a current copy of the child's health and education record.86.24    Sec. 76. Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:86.25    Subd. 4. Responsible social service agency's duties for children in placement. (a) 86.26When a child is in placement, the responsible social services agency shall make diligent 86.27efforts to identify, locate, and, where appropriate, offer services to both parents of the child.86.28    (1) The responsible social services agency shall assess whether a noncustodial or 86.29nonadjudicated parent is willing and capable of providing for the day-to-day care of the 86.30child temporarily or permanently. An assessment under this clause may include, but 86.31is not limited to, obtaining information under section 
         260C.209. If after assessment, 86.32the responsible social services agency determines that a noncustodial or nonadjudicated 86.33parent is willing and capable of providing day-to-day care of the child, the responsible 86.34social services agency may seek authority from the custodial parent or the court to have 86.35that parent assume day-to-day care of the child. If a parent is not an adjudicated parent, 87.1the responsible social services agency shall require the nonadjudicated parent to cooperate 87.2with paternity establishment procedures as part of the case plan.87.3    (2) If, after assessment, the responsible social services agency determines that the 87.4child cannot be in the day-to-day care of either parent, the agency shall:87.5    (i) prepare an out-of-home placement plan addressing the conditions that each parent 87.6must meet before the child can be in that parent's day-to-day care; and87.7    (ii) provide a parent who is the subject of a background study under section 87.8260C.209
          15 days' notice that it intends to use the study to recommend against putting the 87.9child with that parent, as well as the notice provided in section 
         260C.209, subdivision 4, 87.10and the court shall afford the parent an opportunity to be heard concerning the study.87.11    The results of a background study of a noncustodial parent shall not be used by the 87.12agency to determine that the parent is incapable of providing day-to-day care of the child 87.13unless the agency reasonably believes that placement of the child into the home of that 87.14parent would endanger the child's health, safety, or welfare.87.15    (3) If, after the provision of services following an out-of-home placement plan under 87.16this section, the child cannot return to the care of the parent from whom the child was 87.17removed or who had legal custody at the time the child was placed in foster care, the 87.18agency may petition on behalf of a noncustodial parent to establish legal custody with 87.19that parent under section 
         260C.201, subdivision 11. If paternity has not already been 87.20established, it may be established in the same proceeding in the manner provided for 87.21under chapter 257.87.22    (4) The responsible social services agency may be relieved of the requirement to 87.23locate and offer services to both parents by the juvenile court upon a finding of good cause 87.24after the filing of a petition under section 
         260C.141.87.25    (b) The responsible social services agency shall give notice to the parent or parents 87.26or guardian of each child in a residential facility, other than a child in placement due 87.27solely to that child's developmental disability or emotional disturbance, of the following 87.28information:87.29    (1) that residential care of the child may result in termination of parental rights or an 87.30order permanently placing the child out of the custody of the parent, but only after notice 87.31and a hearing as required under chapter 260C and the juvenile court rules;87.32    (2) time limits on the length of placement and of reunification services, including 87.33the date on which the child is expected to be returned to and safely maintained in the 87.34home of the parent or parents or placed for adoption or otherwise permanently removed 87.35from the care of the parent by court order;87.36    (3) the nature of the services available to the parent;88.1    (4) the consequences to the parent and the child if the parent fails or is unable to use 88.2services to correct the circumstances that led to the child's placement;88.3    (5) the first consideration for placement with relatives;88.4    (6) the benefit to the child in getting the child out of residential care as soon as 88.5possible, preferably by returning the child home, but if that is not possible, through a 88.6permanent legal placement of the child away from the parent;88.7    (7) when safe for the child, the benefits to the child and the parent of maintaining 88.8visitation with the child as soon as possible in the course of the case and, in any event, 88.9according to the visitation plan under this section; and88.10    (8) the financial responsibilities and obligations, if any, of the parent or parents for 88.11the support of the child during the period the child is in the residential facility.88.12    (c) The responsible social services agency shall inform a parent considering 88.13voluntary placement of a child who is not developmentally disabled or emotionally 88.14disturbed of the following information:88.15    (1) the parent and the child each has a right to separate legal counsel before signing a 88.16voluntary placement agreement, but not to counsel appointed at public expense;88.17    (2) the parent is not required to agree to the voluntary placement, and a parent 88.18who enters a voluntary placement agreement may at any time request that the agency 88.19return the child. If the parent so requests, the child must be returned within 24 hours of 88.20the receipt of the request;88.21    (3) evidence gathered during the time the child is voluntarily placed may be used 88.22at a later time as the basis for a petition alleging that the child is in need of protection 88.23or services or as the basis for a petition seeking termination of parental rights or other 88.24permanent placement of the child away from the parent;88.25    (4) if the responsible social services agency files a petition alleging that the child is 88.26in need of protection or services or a petition seeking the termination of parental rights 88.27or other permanent placement of the child away from the parent, the parent would have 88.28the right to appointment of separate legal counsel and the child would have a right to the 88.29appointment of counsel and a guardian ad litem as provided by law, and that counsel will 88.30be appointed at public expense if they are unable to afford counsel; and88.31    (5) the timelines and procedures for review of voluntary placements under 88.32subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a 88.33permanent placement determination hearing under section 
         260C.201, subdivision 11.88.34    (d) When an agency accepts a child for placement, the agency shall determine 88.35whether the child has had a physical examination by or under the direction of a licensed 88.36physician within the 12 months immediately preceding the date when the child came into 89.1the agency's care. If there is documentation that the child has had an examination within 89.2the last 12 months, the agency is responsible for seeing that the child has another physical 89.3examination within one year of the documented examination and annually in subsequent 89.4years. If the agency determines that the child has not had a physical examination within 89.5the 12 months immediately preceding placement, the agency shall ensure that the child 89.6has an examination within 30 days of coming into the agency's care and once a year 89.7in subsequent years.89.8    (e) If a child leaves foster care by reason of having attained the age of majority 89.9under state law, the child must be given at no cost a copy of the child's health and 89.10education report.89.11    Sec. 77. Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:89.12    Subd. 9. Review of certain child placements. (a) When a developmentally 89.13disabled child or emotionally disturbed child needs placement in a residential facility for 89.14the sole reason of accessing services or a level of skilled care that cannot be provided in 89.15the parent's home, the child must be placed pursuant to a voluntary placement agreement 89.16between the responsible social services agency and the child's parent. The voluntary 89.17placement agreement must give the responsible social services agency legal responsibility 89.18for the child's physical care, custody, and control, but must not transfer legal custody of 89.19the child to the agency. The voluntary placement agreement must be executed in a form 89.20developed and promulgated by the commissioner of human services. The responsible 89.21social services agency shall report to the commissioner the number of children who are the 89.22subject of a voluntary placement agreement under this subdivision and other information 89.23regarding these children as the commissioner may require.89.24    (b) If a developmentally disabled child or a child diagnosed as emotionally disturbed 89.25has been placed in a residential facility pursuant to a voluntary release by the child's parent 89.26or parents because of the child's disabling conditions or need for long-term residential 89.27treatment or supervision, the social services agency responsible for the placement shall 89.28report to the court and bring a petition for review of the child's foster care status as 89.29required in section 
         260C.141, subdivision 2a. 89.30    (b)(c) If a child is in placement due solely to the child's developmental disability or 89.31emotional disturbance, and the court finds compelling reasons not to proceed under section 89.32260C.201, subdivision 11
         , and custody of the child is not transferred to the responsible 89.33social services agency under section 
         260C.201, subdivision 1, paragraph (a), clause (2), 89.34and no petition is required by section 
         260C.201, subdivision 11. 90.1    (c)(d) Whenever a petition for review is brought pursuant to this subdivision, a 90.2guardian ad litem shall be appointed for the child.90.3    Sec. 78. Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:90.4    Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and 90.5the order terminating parental rights, and a summary of the court's information concerning 90.6the child shall be furnished by the court to the commissioner or the agency to which 90.7guardianship is transferred. The orders shall be on a document separate from the findings. 90.8The court shall furnish the individual to whom guardianship is transferred a copy of the 90.9order terminating parental rights.90.10    (b) The court shall retain jurisdiction in a case where adoption is the intended 90.11permanent placement disposition until the child's adoption is finalized, the child is 18 years 90.12of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The 90.13guardian ad litem and counsel for the child shall continue on the case until an adoption 90.14decree is entered. A hearing must be held every 90 days following termination of parental 90.15rights for the court to review progress toward an adoptive placement and the specific 90.16recruitment efforts the agency has taken to find an adoptive family or other placement 90.17living arrangement for the child and to finalize the adoption or other permanency plan.90.18    (c) The responsible social services agency may make a determination of compelling 90.19reasons for a child to be in long-term foster care when the agency has made exhaustive 90.20efforts to recruit, identify, and place the child in an adoptive home, and the child continues 90.21in foster care for at least 24 months after the court has issued the order terminating 90.22parental rights. A child of any age who is under the guardianship of the commissioner of 90.23the Department of Human Services and is legally available for adoption may not refuse 90.24or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the 90.25child in an adoptive home required under paragraph (b) or sign a document relieving 90.26county social services agencies of all recruitment efforts on the child's behalf. Upon 90.27approving the agency's determination of compelling reasons, the court may order the 90.28child placed in long-term foster care. At least every 12 months thereafter as long as the 90.29child continues in out-of-home placement, the court shall conduct a permanency review 90.30hearing to determine the future status of the child using the review requirements of section 90.31260C.201, subdivision 11
         , paragraph (g).90.32    (d) The court shall retain jurisdiction through the child's minority in a case where 90.33long-term foster care is the permanent disposition whether under paragraph (c) or section 90.34260C.201, subdivision 11
         .91.1    Sec. 79. Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:91.2    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights 91.3are terminated,91.4    (1) whenever legal custody of a child is transferred by the court to a responsible 91.5social services agency,91.6    (2) whenever legal custody is transferred to a person other than the responsible social 91.7services agency, but under the supervision of the responsible social services agency, or91.8    (3) whenever a child is given physical or mental examinations or treatment under 91.9order of the court, and no provision is otherwise made by law for payment for the care, 91.10examination, or treatment of the child, these costs are a charge upon the welfare funds of 91.11the county in which proceedings are held upon certification of the judge of juvenile court.91.12    (b) The court shall order, and the responsible social services agency shall require, 91.13the parents or custodian of a child, while the child is under the age of 18, to use the 91.14total income and resources attributable to the child for the period of care, examination, 91.15or treatment, except for clothing and personal needs allowance as provided in section 91.16256B.35
         , to reimburse the county for the cost of care, examination, or treatment. Income 91.17and resources attributable to the child include, but are not limited to, Social Security 91.18benefits, supplemental security income (SSI), veterans benefits, railroad retirement 91.19benefits and child support. When the child is over the age of 18, and continues to receive 91.20care, examination, or treatment, the court shall order, and the responsible social services 91.21agency shall require, reimbursement from the child for the cost of care, examination, or 91.22treatment from the income and resources attributable to the child less the clothing and 91.23personal needs allowance. Income does not include earnings from a child over the age of 91.2418 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c), 91.25clause (8), to transition from foster care.91.26    (c) If the income and resources attributable to the child are not enough to reimburse 91.27the county for the full cost of the care, examination, or treatment, the court shall inquire 91.28into the ability of the parents to support the child and, after giving the parents a reasonable 91.29opportunity to be heard, the court shall order, and the responsible social services agency 91.30shall require, the parents to contribute to the cost of care, examination, or treatment of 91.31the child. When determining the amount to be contributed by the parents, the court shall 91.32use a fee schedule based upon ability to pay that is established by the responsible social 91.33services agency and approved by the commissioner of human services. The income of 91.34a stepparent who has not adopted a child shall be excluded in calculating the parental 91.35contribution under this section.92.1    (d) The court shall order the amount of reimbursement attributable to the parents 92.2or custodian, or attributable to the child, or attributable to both sources, withheld under 92.3chapter 518A from the income of the parents or the custodian of the child. A parent or 92.4custodian who fails to pay without good reason may be proceeded against for contempt, or 92.5the court may inform the county attorney, who shall proceed to collect the unpaid sums, 92.6or both procedures may be used.92.7    (e) If the court orders a physical or mental examination for a child, the examination 92.8is a medically necessary service for purposes of determining whether the service is 92.9covered by a health insurance policy, health maintenance contract, or other health 92.10coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan 92.11requirements for medical necessity. Nothing in this paragraph changes or eliminates 92.12benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions, 92.13or other requirements in the policy, contract, or plan that relate to coverage of other 92.14medically necessary services.92.15    Sec. 80. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:92.16    Subdivision 1. Disclosure to commissioner of human services. (a) On the request 92.17of the commissioner of human services, the commissioner shall disclose return information 92.18regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to 92.19the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).92.20    (b) Data that may be disclosed are limited to data relating to the identity, 92.21whereabouts, employment, income, and property of a person owing or alleged to be owing 92.22an obligation of child support.92.23    (c) The commissioner of human services may request data only for the purposes of 92.24carrying out the child support enforcement program and to assist in the location of parents 92.25who have, or appear to have, deserted their children. Data received may be used only 92.26as set forth in section 
         256.978. 92.27    (d) The commissioner shall provide the records and information necessary to 92.28administer the supplemental housing allowance to the commissioner of human services.92.29    (e) At the request of the commissioner of human services, the commissioner of 92.30revenue shall electronically match the Social Security numbers and names of participants 92.31in the telephone assistance plan operated under sections 
         237.69 to 
         237.711, with those of 92.32property tax refund filers, and determine whether each participant's household income is 92.33within the eligibility standards for the telephone assistance plan. 92.34    (f) The commissioner may provide records and information collected under sections 92.35295.50
          to 
         295.59 to the commissioner of human services for purposes of the Medicaid 93.1Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law 93.2102-234. Upon the written agreement by the United States Department of Health and 93.3Human Services to maintain the confidentiality of the data, the commissioner may provide 93.4records and information collected under sections 
         295.50 to 
         295.59 to the Centers for 93.5Medicare and Medicaid Services section of the United States Department of Health and 93.6Human Services for purposes of meeting federal reporting requirements. 93.7    (g) The commissioner may provide records and information to the commissioner of 93.8human services as necessary to administer the early refund of refundable tax credits.93.9    (h) The commissioner may disclose information to the commissioner of human 93.10services necessary to verify income for eligibility and premium payment under the 93.11MinnesotaCare program, under section 
         256L.05, subdivision 2. 93.12    (i) The commissioner may disclose information to the commissioner of human 93.13services necessary to verify whether applicants or recipients for the Minnesota family 93.14investment program, general assistance, food support, and Minnesota supplemental aid 93.15program, and child care assistance have claimed refundable tax credits under chapter 290 93.16and the property tax refund under chapter 290A, and the amounts of the credits.93.17    Sec. 81. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:93.18    Subd. 2. Definitions. As used in this section, the following terms have the meanings 93.19given them unless the specific content indicates otherwise:93.20    (a) "Family assessment" means a comprehensive assessment of child safety, risk 93.21of subsequent child maltreatment, and family strengths and needs that is applied to a 93.22child maltreatment report that does not allege substantial child endangerment. Family 93.23assessment does not include a determination as to whether child maltreatment occurred 93.24but does determine the need for services to address the safety of family members and the 93.25risk of subsequent maltreatment.93.26    (b) "Investigation" means fact gathering related to the current safety of a child 93.27and the risk of subsequent maltreatment that determines whether child maltreatment 93.28occurred and whether child protective services are needed. An investigation must be used 93.29when reports involve substantial child endangerment, and for reports of maltreatment in 93.30facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to 93.31144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 93.3213, and 124D.10; or in a nonlicensed personal care provider association as defined in 93.33sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.93.34    (c) "Substantial child endangerment" means a person responsible for a child's care, 93.35and in the case of sexual abuse includes a person who has a significant relationship to the 94.1child as defined in section 609.341, or a person in a position of authority as defined in 94.2section 609.341, who by act or omission commits or attempts to commit an act against a 94.3child under their care that constitutes any of the following:94.4    (1) egregious harm as defined in section 260C.007, subdivision 14;94.5    (2) sexual abuse as defined in paragraph (d);94.6    (3) abandonment under section 260C.301, subdivision 2;94.7    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the 94.8child's physical or mental health, including a growth delay, which may be referred to as 94.9failure to thrive, that has been diagnosed by a physician and is due to parental neglect;94.10    (5) murder in the first, second, or third degree under section 609.185, 609.19, or 94.11609.195;94.12    (6) manslaughter in the first or second degree under section 609.20 or 609.205;94.13    (7) assault in the first, second, or third degree under section 609.221, 609.222, or 94.14609.223;94.15    (8) solicitation, inducement, and promotion of prostitution under section 609.322;94.16    (9) criminal sexual conduct under sections 609.342 to 609.3451;94.17    (10) solicitation of children to engage in sexual conduct under section 609.352;94.18    (11) malicious punishment or neglect or endangerment of a child under section 94.19609.377 or 609.378;94.20    (12) use of a minor in sexual performance under section 617.246; or94.21    (13) parental behavior, status, or condition which mandates that the county attorney 94.22file a termination of parental rights petition under section 260C.301, subdivision 3, 94.23paragraph (a).94.24    (d) "Sexual abuse" means the subjection of a child by a person responsible for the 94.25child's care, by a person who has a significant relationship to the child, as defined in 94.26section 609.341, or by a person in a position of authority, as defined in section 609.341, 94.27subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual 94.28conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 94.29609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct 94.30in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual 94.31abuse also includes any act which involves a minor which constitutes a violation of 94.32prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes 94.33threatened sexual abuse.94.34    (e) "Person responsible for the child's care" means (1) an individual functioning 94.35within the family unit and having responsibilities for the care of the child such as a 94.36parent, guardian, or other person having similar care responsibilities, or (2) an individual 95.1functioning outside the family unit and having responsibilities for the care of the child 95.2such as a teacher, school administrator, other school employees or agents, or other lawful 95.3custodian of a child having either full-time or short-term care responsibilities including, 95.4but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, 95.5and coaching.95.6    (f) "Neglect" means:95.7    (1) failure by a person responsible for a child's care to supply a child with necessary 95.8food, clothing, shelter, health, medical, or other care required for the child's physical or 95.9mental health when reasonably able to do so;95.10    (2) failure to protect a child from conditions or actions that seriously endanger the 95.11child's physical or mental health when reasonably able to do so, including a growth delay, 95.12which may be referred to as a failure to thrive, that has been diagnosed by a physician and 95.13is due to parental neglect;95.14    (3) failure to provide for necessary supervision or child care arrangements 95.15appropriate for a child after considering factors as the child's age, mental ability, physical 95.16condition, length of absence, or environment, when the child is unable to care for the 95.17child's own basic needs or safety, or the basic needs or safety of another child in their care;95.18    (4) failure to ensure that the child is educated as defined in sections 120A.22 and 95.19260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 95.20child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;95.21    (5) nothing in this section shall be construed to mean that a child is neglected solely 95.22because the child's parent, guardian, or other person responsible for the child's care in 95.23good faith selects and depends upon spiritual means or prayer for treatment or care of 95.24disease or remedial care of the child in lieu of medical care; except that a parent, guardian, 95.25or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report 95.26if a lack of medical care may cause serious danger to the child's health. This section does 95.27not impose upon persons, not otherwise legally responsible for providing a child with 95.28necessary food, clothing, shelter, education, or medical care, a duty to provide that care;95.29    (6) prenatal exposure to a controlled substance, as defined in section 253B.02, 95.30subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal 95.31symptoms in the child at birth, results of a toxicology test performed on the mother at 95.32delivery or the child at birth, or medical effects or developmental delays during the child's 95.33first year of life that medically indicate prenatal exposure to a controlled substance;95.34    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);96.1    (8) chronic and severe use of alcohol or a controlled substance by a parent or 96.2person responsible for the care of the child that adversely affects the child's basic needs 96.3and safety; or96.4    (9) emotional harm from a pattern of behavior which contributes to impaired 96.5emotional functioning of the child which may be demonstrated by a substantial and 96.6observable effect in the child's behavior, emotional response, or cognition that is not 96.7within the normal range for the child's age and stage of development, with due regard to 96.8the child's culture.96.9    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury, 96.10inflicted by a person responsible for the child's care on a child other than by accidental 96.11means, or any physical or mental injury that cannot reasonably be explained by the child's 96.12history of injuries, or any aversive or deprivation procedures, or regulated interventions, 96.13that have not been authorized under section 121A.67 or 245.825. Abuse does not include 96.14reasonable and moderate physical discipline of a child administered by a parent or legal 96.15guardian which does not result in an injury. Abuse does not include the use of reasonable 96.16force by a teacher, principal, or school employee as allowed by section 121A.582. Actions 96.17which are not reasonable and moderate include, but are not limited to, any of the following 96.18that are done in anger or without regard to the safety of the child:96.19    (1) throwing, kicking, burning, biting, or cutting a child;96.20    (2) striking a child with a closed fist;96.21    (3) shaking a child under age three;96.22    (4) striking or other actions which result in any nonaccidental injury to a child 96.23under 18 months of age;96.24    (5) unreasonable interference with a child's breathing;96.25    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;96.26    (7) striking a child under age one on the face or head;96.27    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 96.28substances which were not prescribed for the child by a practitioner, in order to control or 96.29punish the child; or other substances that substantially affect the child's behavior, motor 96.30coordination, or judgment or that results in sickness or internal injury, or subjects the 96.31child to medical procedures that would be unnecessary if the child were not exposed 96.32to the substances;96.33    (9) unreasonable physical confinement or restraint not permitted under section 96.34609.379, including but not limited to tying, caging, or chaining; or96.35    (10) in a school facility or school zone, an act by a person responsible for the child's 96.36care that is a violation under section 121A.58.97.1    (h) "Report" means any report received by the local welfare agency, police 97.2department, county sheriff, or agency responsible for assessing or investigating 97.3maltreatment pursuant to this section.97.4    (i) "Facility" means: 97.5    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 97.6sanitarium, or other facility or institution required to be licensed under sections 144.50 to 97.7144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B; 97.8    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 97.9124D.10; or 97.10    (3) a nonlicensed personal care provider organization as defined in sections 256B.04, 97.11subdivision 16, and 256B.0625, subdivision 19a.97.12    (j) "Operator" means an operator or agency as defined in section 245A.02.97.13    (k) "Commissioner" means the commissioner of human services.97.14    (l) "Practice of social services," for the purposes of subdivision 3, includes but is 97.15not limited to employee assistance counseling and the provision of guardian ad litem and 97.16parenting time expeditor services.97.17    (m) "Mental injury" means an injury to the psychological capacity or emotional 97.18stability of a child as evidenced by an observable or substantial impairment in the child's 97.19ability to function within a normal range of performance and behavior with due regard to 97.20the child's culture.97.21    (n) "Threatened injury" means a statement, overt act, condition, or status that 97.22represents a substantial risk of physical or sexual abuse or mental injury. Threatened 97.23injury includes, but is not limited to, exposing a child to a person responsible for the 97.24child's care, as defined in paragraph (e), clause (1), who has:97.25    (1) subjected a child to, or failed to protect a child from, an overt act or condition 97.26that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a 97.27similar law of another jurisdiction;97.28    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause 97.29(4), or a similar law of another jurisdiction;97.30    (3) committed an act that has resulted in an involuntary termination of parental rights 97.31under section 260C.301, or a similar law of another jurisdiction; or97.32    (4) committed an act that has resulted in the involuntary transfer of permanent legal 97.33and physical custody of a child to a relative under section 260C.201, subdivision 11, 97.34paragraph (d), clause (1), or a similar law of another jurisdiction.97.35    (o) Persons who conduct assessments or investigations under this section shall take 97.36into account accepted child-rearing practices of the culture in which a child participates 98.1and accepted teacher discipline practices, which are not injurious to the child's health, 98.2welfare, and safety.98.3    Sec. 82. Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:98.4    Subd. 3. Persons mandated to report. (a) A person who knows or has reason 98.5to believe a child is being neglected or physically or sexually abused, as defined in 98.6subdivision 2, or has been neglected or physically or sexually abused within the preceding 98.7three years, shall immediately report the information to the local welfare agency, agency 98.8responsible for assessing or investigating the report, police department, or the county 98.9sheriff if the person is:98.10    (1) a professional or professional's delegate who is engaged in the practice of 98.11the healing arts, social services, hospital administration, psychological or psychiatric 98.12treatment, child care, education, correctional supervision, probation and correctional 98.13services, or law enforcement; or98.14    (2) employed as a member of the clergy and received the information while 98.15engaged in ministerial duties, provided that a member of the clergy is not required by 98.16this subdivision to report information that is otherwise privileged under section 
         595.02, 98.17subdivision 1
         , paragraph (c).98.18    The police department or the county sheriff, upon receiving a report, shall 98.19immediately notify the local welfare agency or agency responsible for assessing or 98.20investigating the report, orally and in writing. The local welfare agency, or agency 98.21responsible for assessing or investigating the report, upon receiving a report, shall 98.22immediately notify the local police department or the county sheriff orally and in writing. 98.23The county sheriff and the head of every local welfare agency, agency responsible 98.24for assessing or investigating reports, and police department shall each designate a 98.25person within their agency, department, or office who is responsible for ensuring that 98.26the notification duties of this paragraph and paragraph (b) are carried out. Nothing in 98.27this subdivision shall be construed to require more than one report from any institution, 98.28facility, school, or agency.98.29    (b) Any person may voluntarily report to the local welfare agency, agency 98.30responsible for assessing or investigating the report, police department, or the county 98.31sheriff if the person knows, has reason to believe, or suspects a child is being or has been 98.32neglected or subjected to physical or sexual abuse. The police department or the county 98.33sheriff, upon receiving a report, shall immediately notify the local welfare agency or 98.34agency responsible for assessing or investigating the report, orally and in writing. The 98.35local welfare agency or agency responsible for assessing or investigating the report, upon 99.1receiving a report, shall immediately notify the local police department or the county 99.2sheriff orally and in writing.99.3    (c) A person mandated to report physical or sexual child abuse or neglect occurring 99.4within a licensed facility shall report the information to the agency responsible for 99.5licensing the facility under sections 
         144.50 to 
         144.58; 
         241.021; 
         245A.01 to 
         245A.16; or 99.6chapter 245B; or a nonlicensed personal care provider organization as defined in sections 99.7256B.04, subdivision 16
         ; and 
         256B.0625, subdivision 19. A health or corrections agency 99.8receiving a report may request the local welfare agency to provide assistance pursuant 99.9to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work 99.10within a school facility, upon receiving a complaint of alleged maltreatment, shall provide 99.11information about the circumstances of the alleged maltreatment to the commissioner of 99.12education. Section 
         13.03, subdivision 4, applies to data received by the commissioner of 99.13education from a licensing entity.99.14    (d) Any person mandated to report shall receive a summary of the disposition of 99.15any report made by that reporter, including whether the case has been opened for child 99.16protection or other services, or if a referral has been made to a community organization, 99.17unless release would be detrimental to the best interests of the child. Any person who is 99.18not mandated to report shall, upon request to the local welfare agency, receive a concise 99.19summary of the disposition of any report made by that reporter, unless release would be 99.20detrimental to the best interests of the child.99.21    (e) For purposes of this subdivision section, "immediately" means as soon as 99.22possible but in no event longer than 24 hours.99.23    Sec. 83. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision 99.24to read:99.25    Subd. 3e.Agency responsibility for assessing or investigating reports of sexual 99.26abuse.The local welfare agency is the agency responsible for investigating allegations 99.27of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual 99.28functioning within the family unit as a person responsible for the child's care, or a person 99.29with a significant relationship to the child if that person resides in the child's household.99.30    Sec. 84. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision 99.31to read:99.32    Subd. 3f.Law enforcement agency responsibility for investigating 99.33maltreatment.The local law enforcement agency has responsibility for investigating any 99.34report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement 100.1and the responsible agency must coordinate their investigations or assessments as required 100.2under subdivision 10.100.3    Sec. 85. Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:100.4    Subd. 10. Duties of local welfare agency and local law enforcement agency upon 100.5receipt of a report. (a) Upon receipt of a report, the local welfare agency shall determine 100.6whether to conduct a family assessment or an investigation as appropriate to prevent or 100.7provide a remedy for child maltreatment. The local welfare agency:100.8    (1) shall conduct an investigation on reports involving substantial child 100.9endangerment;100.10    (2) shall begin an immediate investigation if, at any time when it is using a family 100.11assessment response, it determines that there is reason to believe that substantial child 100.12endangerment or a serious threat to the child's safety exists;100.13    (3) may conduct a family assessment for reports that do not allege substantial child 100.14endangerment. In determining that a family assessment is appropriate, the local welfare 100.15agency may consider issues of child safety, parental cooperation, and the need for an 100.16immediate response; and100.17    (4) may conduct a family assessment on a report that was initially screened and 100.18assigned for an investigation. In determining that a complete investigation is not required, 100.19the local welfare agency must document the reason for terminating the investigation and 100.20notify the local law enforcement agency if the local law enforcement agency is conducting 100.21a joint investigation.100.22    If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, 100.23or individual functioning within the family unit as a person responsible for the child's 100.24care, or sexual abuse by a person with a significant relationship to the child when that 100.25person resides in the child's household or by a sibling, the local welfare agency shall 100.26immediately conduct a family assessment or investigation as identified in clauses (1) to 100.27(4). In conducting a family assessment or investigation, the local welfare agency shall 100.28gather information on the existence of substance abuse and domestic violence and offer 100.29services for purposes of preventing future child maltreatment, safeguarding and enhancing 100.30the welfare of the abused or neglected minor, and supporting and preserving family 100.31life whenever possible. If the report alleges a violation of a criminal statute involving 100.32sexual abuse, physical abuse, or neglect or endangerment, under section 
         609.378, the 100.33local law enforcement agency and local welfare agency shall coordinate the planning and 100.34execution of their respective investigation and assessment efforts to avoid a duplication of 100.35fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of 101.1the results of its investigation. In cases of alleged child maltreatment resulting in death, 101.2the local agency may rely on the fact-finding efforts of a law enforcement investigation 101.3to make a determination of whether or not maltreatment occurred. When necessary the 101.4local welfare agency shall seek authority to remove the child from the custody of a parent, 101.5guardian, or adult with whom the child is living. In performing any of these duties, the 101.6local welfare agency shall maintain appropriate records.101.7    If the family assessment or investigation indicates there is a potential for abuse of 101.8alcohol or other drugs by the parent, guardian, or person responsible for the child's care, 101.9the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota 101.10Rules, part 9530.6615. The local welfare agency shall report the determination of the 101.11chemical use assessment, and the recommendations and referrals for alcohol and other 101.12drug treatment services to the state authority on alcohol and drug abuse.101.13    (b) When a local agency receives a report or otherwise has information indicating 101.14that a child who is a client, as defined in section 
         245.91, has been the subject of physical 101.15abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section 101.16245.91
         , it shall, in addition to its other duties under this section, immediately inform the 101.17ombudsman established under sections 
         245.91 to 
         245.97. The commissioner of education 101.18shall inform the ombudsman established under sections 
         245.91 to 
         245.97 of reports 101.19regarding a child defined as a client in section 
         245.91 that maltreatment occurred at a 101.20school as defined in sections 
         120A.05, subdivisions 9, 11, and 13, and 
         124D.10.101.21    (c) Authority of the local welfare agency responsible for assessing or investigating 101.22the child abuse or neglect report, the agency responsible for assessing or investigating 101.23the report, and of the local law enforcement agency for investigating the alleged abuse or 101.24neglect includes, but is not limited to, authority to interview, without parental consent, 101.25the alleged victim and any other minors who currently reside with or who have resided 101.26with the alleged offender. The interview may take place at school or at any facility or 101.27other place where the alleged victim or other minors might be found or the child may be 101.28transported to, and the interview conducted at, a place appropriate for the interview of a 101.29child designated by the local welfare agency or law enforcement agency. The interview 101.30may take place outside the presence of the alleged offender or parent, legal custodian, 101.31guardian, or school official. For family assessments, it is the preferred practice to request 101.32a parent or guardian's permission to interview the child prior to conducting the child 101.33interview, unless doing so would compromise the safety assessment. Except as provided in 101.34this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible 101.35local welfare or law enforcement agency no later than the conclusion of the investigation 101.36or assessment that this interview has occurred. Notwithstanding rule 
         49.02 32 of the 102.1Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on 102.2an ex parte motion by the local welfare agency, order that, where reasonable cause exists, 102.3the agency withhold notification of this interview from the parent, legal custodian, or 102.4guardian. If the interview took place or is to take place on school property, the order shall 102.5specify that school officials may not disclose to the parent, legal custodian, or guardian the 102.6contents of the notification of intent to interview the child on school property, as provided 102.7under this paragraph, and any other related information regarding the interview that may 102.8be a part of the child's school record. A copy of the order shall be sent by the local welfare 102.9or law enforcement agency to the appropriate school official.102.10    (d) When the local welfare, local law enforcement agency, or the agency responsible 102.11for assessing or investigating a report of maltreatment determines that an interview should 102.12take place on school property, written notification of intent to interview the child on school 102.13property must be received by school officials prior to the interview. The notification 102.14shall include the name of the child to be interviewed, the purpose of the interview, and 102.15a reference to the statutory authority to conduct an interview on school property. For 102.16interviews conducted by the local welfare agency, the notification shall be signed by the 102.17chair of the local social services agency or the chair's designee. The notification shall be 102.18private data on individuals subject to the provisions of this paragraph. School officials 102.19may not disclose to the parent, legal custodian, or guardian the contents of the notification 102.20or any other related information regarding the interview until notified in writing by the 102.21local welfare or law enforcement agency that the investigation or assessment has been 102.22concluded, unless a school employee or agent is alleged to have maltreated the child. 102.23Until that time, the local welfare or law enforcement agency or the agency responsible 102.24for assessing or investigating a report of maltreatment shall be solely responsible for any 102.25disclosures regarding the nature of the assessment or investigation.102.26    Except where the alleged offender is believed to be a school official or employee, 102.27the time and place, and manner of the interview on school premises shall be within the 102.28discretion of school officials, but the local welfare or law enforcement agency shall have 102.29the exclusive authority to determine who may attend the interview. The conditions as to 102.30time, place, and manner of the interview set by the school officials shall be reasonable and 102.31the interview shall be conducted not more than 24 hours after the receipt of the notification 102.32unless another time is considered necessary by agreement between the school officials and 102.33the local welfare or law enforcement agency. Where the school fails to comply with the 102.34provisions of this paragraph, the juvenile court may order the school to comply. Every 102.35effort must be made to reduce the disruption of the educational program of the child, other 102.36students, or school staff when an interview is conducted on school premises.103.1    (e) Where the alleged offender or a person responsible for the care of the alleged 103.2victim or other minor prevents access to the victim or other minor by the local welfare 103.3agency, the juvenile court may order the parents, legal custodian, or guardian to produce 103.4the alleged victim or other minor for questioning by the local welfare agency or the local 103.5law enforcement agency outside the presence of the alleged offender or any person 103.6responsible for the child's care at reasonable places and times as specified by court order.103.7    (f) Before making an order under paragraph (e), the court shall issue an order to 103.8show cause, either upon its own motion or upon a verified petition, specifying the basis for 103.9the requested interviews and fixing the time and place of the hearing. The order to show 103.10cause shall be served personally and shall be heard in the same manner as provided in 103.11other cases in the juvenile court. The court shall consider the need for appointment of a 103.12guardian ad litem to protect the best interests of the child. If appointed, the guardian ad 103.13litem shall be present at the hearing on the order to show cause.103.14    (g) The commissioner of human services, the ombudsman for mental health and 103.15developmental disabilities, the local welfare agencies responsible for investigating reports, 103.16the commissioner of education, and the local law enforcement agencies have the right to 103.17enter facilities as defined in subdivision 2 and to inspect and copy the facility's records, 103.18including medical records, as part of the investigation. Notwithstanding the provisions of 103.19chapter 13, they also have the right to inform the facility under investigation that they are 103.20conducting an investigation, to disclose to the facility the names of the individuals under 103.21investigation for abusing or neglecting a child, and to provide the facility with a copy of 103.22the report and the investigative findings.103.23    (h) The local welfare agency responsible for conducting a family assessment or 103.24investigation shall collect available and relevant information to determine child safety, 103.25risk of subsequent child maltreatment, and family strengths and needs and share not public 103.26information with an Indian's tribal social services agency without violating any law of the 103.27state that may otherwise impose duties of confidentiality on the local welfare agency in 103.28order to implement the tribal state agreement. The local welfare agency or the agency 103.29responsible for investigating the report shall collect available and relevant information 103.30to ascertain whether maltreatment occurred and whether protective services are needed. 103.31Information collected includes, when relevant, information with regard to the person 103.32reporting the alleged maltreatment, including the nature of the reporter's relationship to the 103.33child and to the alleged offender, and the basis of the reporter's knowledge for the report; 103.34the child allegedly being maltreated; the alleged offender; the child's caretaker; and other 103.35collateral sources having relevant information related to the alleged maltreatment. The 103.36local welfare agency or the agency responsible for assessing or investigating the report 104.1may make a determination of no maltreatment early in an assessment, and close the case 104.2and retain immunity, if the collected information shows no basis for a full assessment or 104.3investigation.104.4    Information relevant to the assessment or investigation must be asked for, and 104.5may include:104.6    (1) the child's sex and age, prior reports of maltreatment, information relating 104.7to developmental functioning, credibility of the child's statement, and whether the 104.8information provided under this clause is consistent with other information collected 104.9during the course of the assessment or investigation;104.10    (2) the alleged offender's age, a record check for prior reports of maltreatment, and 104.11criminal charges and convictions. The local welfare agency or the agency responsible for 104.12assessing or investigating the report must provide the alleged offender with an opportunity 104.13to make a statement. The alleged offender may submit supporting documentation relevant 104.14to the assessment or investigation;104.15    (3) collateral source information regarding the alleged maltreatment and care of the 104.16child. Collateral information includes, when relevant: (i) a medical examination of the 104.17child; (ii) prior medical records relating to the alleged maltreatment or the care of the 104.18child maintained by any facility, clinic, or health care professional and an interview with 104.19the treating professionals; and (iii) interviews with the child's caretakers, including the 104.20child's parent, guardian, foster parent, child care provider, teachers, counselors, family 104.21members, relatives, and other persons who may have knowledge regarding the alleged 104.22maltreatment and the care of the child; and104.23    (4) information on the existence of domestic abuse and violence in the home of 104.24the child, and substance abuse.104.25    Nothing in this paragraph precludes the local welfare agency, the local law 104.26enforcement agency, or the agency responsible for assessing or investigating the report 104.27from collecting other relevant information necessary to conduct the assessment or 104.28investigation. Notwithstanding section 
         13.384 or 
         144.335, the local welfare agency has 104.29access to medical data and records for purposes of clause (3). Notwithstanding the data's 104.30classification in the possession of any other agency, data acquired by the local welfare 104.31agency or the agency responsible for assessing or investigating the report during the course 104.32of the assessment or investigation are private data on individuals and must be maintained 104.33in accordance with subdivision 11. Data of the commissioner of education collected 104.34or maintained during and for the purpose of an investigation of alleged maltreatment 104.35in a school are governed by this section, notwithstanding the data's classification as 104.36educational, licensing, or personnel data under chapter 13.105.1    In conducting an assessment or investigation involving a school facility as defined 105.2in subdivision 2, paragraph (i), the commissioner of education shall collect investigative 105.3reports and data that are relevant to a report of maltreatment and are from local law 105.4enforcement and the school facility.105.5    (i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face 105.6contact with the child reported to be maltreated and with the child's primary caregiver 105.7sufficient to complete a safety assessment and ensure the immediate safety of the child. 105.8The face-to-face contact with the child and primary caregiver shall occur immediately 105.9if substantial child endangerment is alleged and within five calendar days for all other 105.10reports. If the alleged offender was not already interviewed as the primary caregiver, the 105.11local welfare agency shall also conduct a face-to-face interview with the alleged offender 105.12in the early stages of the assessment or investigation. At the initial contact, the local child 105.13welfare agency or the agency responsible for assessing or investigating the report must 105.14inform the alleged offender of the complaints or allegations made against the individual in 105.15a manner consistent with laws protecting the rights of the person who made the report. 105.16The interview with the alleged offender may be postponed if it would jeopardize an active 105.17law enforcement investigation.105.18    (j) When conducting an investigation, the local welfare agency shall use a question 105.19and answer interviewing format with questioning as nondirective as possible to elicit 105.20spontaneous responses. For investigations only, the following interviewing methods and 105.21procedures must be used whenever possible when collecting information:105.22    (1) audio recordings of all interviews with witnesses and collateral sources; and105.23    (2) in cases of alleged sexual abuse, audio-video recordings of each interview with 105.24the alleged victim and child witnesses.105.25    (k) In conducting an assessment or investigation involving a school facility as 105.26defined in subdivision 2, paragraph (i), the commissioner of education shall collect 105.27available and relevant information and use the procedures in paragraphs (i), (k), and 105.28subdivision 3d, except that the requirement for face-to-face observation of the child 105.29and face-to-face interview of the alleged offender is to occur in the initial stages of the 105.30assessment or investigation provided that the commissioner may also base the assessment 105.31or investigation on investigative reports and data received from the school facility and 105.32local law enforcement, to the extent those investigations satisfy the requirements of 105.33paragraphs (i) and (k), and subdivision 3d.105.34    Sec. 86. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to 105.35read:106.1    Subd. 10a. Abuse outside family unit Law enforcement agency responsibility 106.2for investigation; welfare agency reliance on law enforcement fact-finding; welfare 106.3agency offer of services.(a) If the report alleges neglect, physical abuse, or sexual abuse 106.4by a person who is not a parent, guardian, sibling, person responsible for the child's care 106.5functioning outside within the family unit, or a person who lives in the child's household 106.6and who has a significant relationship to the child, in a setting other than a facility as 106.7defined in subdivision 2, the local welfare agency shall immediately notify the appropriate 106.8law enforcement agency, which shall conduct an investigation of the alleged abuse or 106.9neglect if a violation of a criminal statute is alleged. 106.10    (b) The local agency may rely on the fact-finding efforts of the law enforcement 106.11investigation conducted under this subdivision to make a determination whether or not 106.12threatened harm or other maltreatment has occurred under subdivision 2 if an alleged 106.13offender has minor children or lives with minors.106.14    (c) The local welfare agency shall offer appropriate social services for the purpose of 106.15safeguarding and enhancing the welfare of the abused or neglected minor.106.16    Sec. 87. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to 106.17read:106.18    Subd. 10c. Duties of local social service agency upon receipt of a report of 106.19medical neglect. If the report alleges medical neglect as defined in section 
         260C.007, 106.20subdivision 4 6, clause (5), the local welfare agency shall, in addition to its other duties 106.21under this section, immediately consult with designated hospital staff and with the parents 106.22of the infant to verify that appropriate nutrition, hydration, and medication are being 106.23provided; and shall immediately secure an independent medical review of the infant's 106.24medical charts and records and, if necessary, seek a court order for an independent medical 106.25examination of the infant. If the review or examination leads to a conclusion of medical 106.26neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings 106.27under section 
         260C.141 and by filing an expedited motion to prevent the withholding 106.28of medically indicated treatment. 106.29    Sec. 88. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:106.30    Subd. 10f. Notice of determinations. Within ten working days of the conclusion 106.31of a family assessment, the local welfare agency shall notify the parent or guardian of 106.32the child of the need for services to address child safety concerns or significant risk of 106.33subsequent child maltreatment. The local welfare agency and the family may also jointly 106.34agree that family support and family preservation services are needed. Within ten working 107.1days of the conclusion of an investigation, the local welfare agency or agency responsible 107.2for assessing or investigating the report shall notify the parent or guardian of the child, the 107.3person determined to be maltreating the child, and if applicable, the director of the facility, 107.4of the determination and a summary of the specific reasons for the determination. The 107.5notice must also include a certification that the information collection procedures under 107.6subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a 107.7data subject to obtain access to other private data on the subject collected, created, or 107.8maintained under this section. In addition, the notice shall include the length of time that 107.9the records will be kept under subdivision 11c. The investigating agency shall notify the 107.10parent or guardian of the child who is the subject of the report, and any person or facility 107.11determined to have maltreated a child, of their appeal or review rights under this section 107.12or section 
         256.022. The notice must also state that a finding of maltreatment may result 107.13in denial of a license application or background study disqualification under chapter 107.14245C related to employment or services that are licensed by the Department of Human 107.15Services under chapter 245A, the Department of Health under chapter 144 or 144A, the 107.16Department of Corrections under section 241.021, and from providing services related to 107.17an unlicensed personal care provider organization under chapter 256B.107.18    Sec. 89. KINSHIP NAVIGATOR PROGRAM; DEMONSTRATION GRANT.107.19    (a) The commissioner of human services shall fund a two-year demonstration grant 107.20to be transferred to a nonprofit organization experienced in kinship advocacy and policy 107.21that has:107.22    (1) experience working with grandparents and relatives who are raising kinship 107.23children;107.24    (2) an established statewide outreach network;107.25    (3) established kinship support groups;107.26    (4) an intergenerational approach to programming; and107.27    (5) a board of directors consisting of 50 percent grandparents and relatives raising 107.28kinship children.107.29    (b) The purpose of the grant is to provide support to grandparents or relatives raising 107.30kinship children. One site must be in the metropolitan area, and the other in the Bemidji 107.31region. One-stop services may include, but are not limited to, legal services, education, 107.32information, family activities, support groups, mental health access, advocacy, mentors, 107.33and information related to foster care licensing. Funds may also be used for a media 107.34campaign to inform kinship families about available information and services, support 107.35sites, and other program development.108.1    Sec. 90. MFIP PILOT PROGRAM; WORKFORCE U.108.2    Subdivision 1.Establishment.A pilot program is established in Stearns and 108.3Benton Counties to expand the Workforce U program administered by the Stearns-Benton 108.4Employment and Training Council.108.5    Subd. 2.Evaluation.The Workforce U pilot program must be evaluated by a 108.6research and evaluation organization with experience evaluating welfare programs. The 108.7evaluation must include information on the total number of persons served, percentage 108.8of participants exiting the program, percentage of former participants reentering the 108.9program, average wages of program participants, and recommendations to the legislature 108.10for possible statewide implementation of the program. The evaluation must be presented 108.11to the legislature by February 15, 2011.108.12    Subd. 3.Expiration.The Workforce U pilot program expires on June 30, 2011.108.13    Sec. 91. LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.108.14    (a) The commissioner of human services shall provide a planning grant to address 108.15the unmet need for local, effective, culturally relevant alcohol and drug treatment for 108.16American Indian youth, and develop a plan for a family-based youth treatment center in 108.17the Leech Lake area. The planning grant must be provided to a volunteer board consisting 108.18of at least four members appointed by the commissioner, to include at least the following:108.19    (1) two members of the Leech Lake Tribal Council or their designees;108.20    (2) one member appointed by the Cass County Social Services administrator; and108.21    (3) one member appointed by the Cass Lake-Bena Public School superintendent.108.22    (b) The plan must include:108.23    (1) an interest, feasibility, and suitability of location study;108.24    (2) defining scope of programs and services to be offered;108.25    (3) defining site use limitations and restrictions, including physical and capacity;108.26    (4) defining facilities required for programs and services offered;108.27    (5) identifying partners, partnership roles, and partner resources;108.28    (6) developing proposed operating and maintenance budgets;108.29    (7) identifying funding sources;108.30    (8) developing a long-term funding plan; and108.31    (9) developing a formal steering committee, structure, and bylaws.108.32    (c) The plan is due to the legislative committees having jurisdiction over chemical 108.33health issues no later than September 2008 in order to provide the 12 months necessary to 108.34complete the plan.109.1    Sec. 92. MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED 109.2APPLICATION.109.3    The Department of Human Services shall create a simplified application for the 109.4Minnesota food support program for persons over the age of 60 and persons with 109.5disabilities. The application must be no longer than three pages in length.109.6EFFECTIVE DATE.This section is effective January 1, 2008.109.7    Sec. 93. INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.109.8    The commissioner of human services, in consultation with the commissioners of 109.9health and education and the counties, shall develop and present recommendations to 109.10the legislature in January 2008 in order for each legally unlicensed child care provider 109.11receiving child care assistance funds to receive a onetime home visit to receive information 109.12on health and safety, and school readiness.109.13    Sec. 94. COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY 109.14CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT 109.15TRAINING.109.16    Subdivision 1.Development and implementation of an early childhood and 109.17school-age professional development system.(a) The commissioner of human services, 109.18in cooperation with the commissioners of education and health, shall develop and phase-in 109.19the implementation of a professional development system for practitioners serving 109.20children in early childhood and school-age programs. The system shall provide training 109.21options and supports for practitioners to voluntarily choose, as they complete or exceed 109.22existing licensing requirements.109.23    The system must, at a minimum, include the following features:109.24    (1) a continuum of training content based on the early childhood and school-age 109.25care practitioner core competencies that translates knowledge into improved practice to 109.26support children's school success;109.27    (2) training strategies that provide direct feedback about practice to practitioners 109.28through ongoing consultation, mentoring, or coaching with special emphasis on early 109.29literacy and early mathematics;109.30    (3) an approval process for trainers;109.31    (4) a professional development registry for early childhood and school-age care 109.32practitioners that will provide tracking and recognition of practitioner training/career 109.33development progress;110.1    (5) a career lattice that includes a range of professional development and educational 110.2opportunities that provide appropriate coursework and degree pathways;110.3    (6) development of a plan with public higher education institutions for an articulated 110.4system of education, training, and professional development that includes credit for prior 110.5learning and development of equivalences to two- and four-year degrees;110.6    (7) incentives and supports for early childhood and school-age care practitioners 110.7to seek additional training and education, including TEACH, other scholarships, and 110.8career guidance; and110.9    (8) coordinated and accessible delivery of training to early childhood and school-age 110.10care practitioners.110.11    (b) By January 1, 2008, the commissioner, in consultation with the organizations 110.12named in subdivision 2 shall develop additional opportunities in order to qualify more 110.13licensed family child care providers under section 119B.13, subdivision 3a.110.14    (c) The commissioner of human services must evaluate the professional development 110.15system and make continuous improvements.110.16    (d) Beginning July 1, 2007, as appropriations permit, the commissioner shall 110.17phase-in the professional development system.110.18    Subd. 2.Two-hour early childhood training.By January 15, 2008, the 110.19commissioner of human services, with input from the Minnesota Licensed Family Child 110.20Care Association and the Minnesota Professional Development Council, shall identify 110.21trainings that qualify for the two-hour early childhood development training requirement 110.22for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision 110.239a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also 110.24seek the input of labor unions that serve licensed family child care providers, if the union 110.25has been recognized by a county to serve licensed family child care providers.110.26    Sec. 95. SCHOOL READINESS SERVICE AGREEMENTS.110.27    Subdivision 1.Overview.(a) Effective July 1, 2007, funds must be made available 110.28to allow the commissioner to pay higher rates to up to 50 child care providers who are 110.29deemed by the commissioner to meet the requirements of a school readiness service 110.30agreement (SRSA) provider and perform services that support school readiness for 110.31children and economic stability for parents.110.32    (b) A provider may be paid a rate above that currently allowed under Minnesota 110.33Statutes, section 119B.13, if:110.34    (1) the provider has entered into an SRSA with the commissioner; 111.1    (2) a family using that provider receives child care assistance under any provision in 111.2Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035; 111.3    (3) the family using that provider meets the criteria in this section; and 111.4    (4) funding is available under this section.111.5    Subd. 2.Provider eligibility.(a) To be considered for an SRSA, a provider shall 111.6apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:111.7    (1) be eligible for child care assistance payments under Minnesota Statutes, chapter 111.8119B;111.9    (2) have at least 25 percent of the children enrolled with the provider subsidized 111.10through the child care assistance program;111.11    (3) provide full-time, full-year child care services; and 111.12    (4) serve at least one child who is subsidized through the child care assistance 111.13program and who is expected to enter kindergarten within the following 30 months.111.14    (b) The commissioner may waive the 25 percent requirement in paragraph (a), clause 111.15(2), if necessary to achieve geographic distribution of SRSA providers and diversity of 111.16types of care provided by SRSA providers.111.17    (c) An eligible provider who would like to enter into an SRSA with the commissioner 111.18shall submit an SRSA application. To determine whether to enter into an SRSA with a 111.19provider, the commissioner shall evaluate the following factors:111.20    (1) the qualifications of the provider and the provider's staff;111.21    (2) the provider's staff-child ratios;111.22    (3) the provider's curriculum;111.23    (4) the provider's current or planned parent education activities;111.24    (5) the provider's current or planned social service and employment linkages;111.25    (6) the provider's child development assessment plan;111.26    (7) the geographic distribution needed for SRSA providers;111.27    (8) the inclusion of a variety of child care delivery models; and 111.28    (9) other related factors determined by the commissioner.111.29    Subd. 3.Family and child eligibility.(a) A family eligible to choose an SRSA 111.30provider for their children shall:111.31    (1) be eligible to receive child care assistance under any provision in Minnesota 111.32Statutes, chapter 119B, except Minnesota Statutes, section 119B.035; 111.33    (2) be in an authorized activity for an average of at least 35 hours per week when 111.34initial eligibility is determined; and 111.35    (3) include a child who has not yet entered kindergarten.112.1    (b) A family who is determined to be eligible to choose an SRSA provider remains 112.2eligible to be paid at a higher rate through the SRSA provider when the following 112.3conditions exist:112.4    (1) the child attends child care with the SRSA provider a minimum of 25 hours per 112.5week, on average;112.6    (2) the family has a child who has not yet entered kindergarten; and 112.7    (3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except 112.8Minnesota Statutes, section 119B.035.112.9    (c) For the 12 months after initial eligibility has been determined, a decrease in 112.10the family's authorized activities to an average of less than 35 hours per week does not 112.11result in ineligibility for the SRSA rate.112.12    (d) A family that moves between counties but continues to use the same SRSA 112.13provider shall continue to receive SRSA funding for the increased payments.112.14    Subd. 4.Requirements of providers.An SRSA must include assessment, 112.15evaluation, and reporting requirements that promote the goals of improved school 112.16readiness and movement toward appropriate child development milestones. A provider 112.17who enters into an SRSA shall comply with the assessment, evaluation, and reporting 112.18requirements in the SRSA.112.19    Subd. 5.Relationship to current law.(a) The following provisions in Minnesota 112.20Statutes, chapter 119B, must be waived or modified for families receiving services under 112.21this section.112.22    (b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a, 112.23maximum weekly rates under this section are 125 percent of the existing maximum 112.24weekly rate for like-care. Providers eligible for a differential rate under Minnesota 112.25Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the 112.26rate identified in this section. Only care for children who have not yet entered kindergarten 112.27may be paid at the maximum rate under this section. The provider's charge for service 112.28provided through an SRSA may not exceed the rate that the provider charges a private-pay 112.29family for like-care arrangements.112.30    (c) A family or child care provider may not be assessed an overpayment for care 112.31provided through an SRSA unless: 112.32    (1) there was an error in the amount of care authorized for the family; or 112.33    (2) the family or provider did not timely report a change as required under the law.112.34    (d) Care provided through an SRSA is authorized on a weekly basis.112.35    (e) Funds appropriated under this section to serve families eligible under Minnesota 112.36Statutes, section 119B.03, are not allocated through the basic sliding fee formula under 113.1Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to 113.2offset increased costs when payments are made under SRSA's.113.3    (f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the 113.4maximum amount of child care assistance that may be authorized for a child receiving 113.5care through an SRSA in a two-week period is 160 hours per child.113.6    Subd. 6.Establishment of service agreements.(a) The commissioner shall 113.7approve SRSA's for up to 50 providers that represent diverse parts of the state and a 113.8variety of child care delivery models. Entering into a service agreement does not guarantee 113.9that a provider will receive payment at a higher rate for families receiving child care 113.10assistance. A family eligible under this section shall choose a provider participating in an 113.11SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by 113.12the availability of SRSA funds.113.13    (b) Nothing in this section shall be construed to limit parent choice as defined in 113.14Minnesota Statutes, section 119B.09, subdivision 5.113.15    (c) The commissioner may allow for startup time for some providers if failing to 113.16do so would limit geographic diversity of SRSA providers or a variety of child care 113.17delivery models.113.18    Sec. 96. FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.113.19    Subdivision 1.Establishment.A family, friend, and neighbor (FFN) grant program 113.20is established to promote children's early literacy, healthy development, and school 113.21readiness, and to foster community partnerships to promote children's school readiness. 113.22The commissioner shall attempt to ensure that grants are made in all areas of the state. The 113.23commissioner of human services shall make grants available to fund: community-based 113.24organizations, nonprofit organizations, and Indian tribes working with FFN caregivers 113.25under subdivision 2, paragraph (a); and community-based partnerships to implement early 113.26literacy programs under subdivision 2, paragraph (b).113.27    Subd. 2.Program components.(a)(1) Grants that the commissioner awards under 113.28this section must be used by community-based organizations, nonprofit organizations, and 113.29Indian tribes working with FFN caregivers in local communities, cultural communities, 113.30and Indian tribes to:113.31    (i) provide training, support, and resources to FFN caregivers in order to improve 113.32and promote children's health, safety, nutrition, and school readiness;113.33    (ii) connect FFN caregivers and children's families with appropriate community 113.34resources that support the families' health, mental health, economic, and developmental 113.35needs;114.1    (iii) connect FFN caregivers and children's families to early childhood screening 114.2programs and facilitate referrals where appropriate;114.3    (iv) provide FFN caregivers and children's families with information about early 114.4learning guidelines from the Departments of Human Services and Education;114.5    (v) provide FFN caregivers and children's families with information about becoming 114.6a licensed family child care provider; and114.7    (vi) provide FFN caregivers and children's families with information about early 114.8learning allowances and enrollment opportunities in high quality community-based 114.9child-care and preschool programs.114.10    (2) Grants that the commissioner awards under this paragraph also may be used for:114.11    (i) health and safety and early learning kits for FFN caregivers;114.12    (ii) play-and-learn groups with FFN caregivers;114.13    (iii) culturally appropriate early childhood training for FFN caregivers;114.14    (iv) transportation for FFN caregivers and children's families to school readiness and 114.15other early childhood training activities;114.16    (v) other activities that promote school readiness;114.17    (vi) data collection and evaluation;114.18    (vii) staff outreach and outreach activities;114.19    (viii) translation needs; or114.20    (ix) administrative costs that equal up to 12 percent of the recipient's grant award.114.21    (b) Grants that the commissioner awards under this section also must be used to fund 114.22partnerships among Minnesota public and regional library systems, community-based 114.23organizations, nonprofit organizations, and Indian tribes to implement early literacy 114.24programs in low-income communities, including tribal communities, to:114.25    (1) purchase and equip early childhood read-mobiles that provide FFN caregivers 114.26and children's families with books, training, and early literacy activities;114.27    (2) provide FFN caregivers and children's families with translations of early 114.28childhood books, training, and early literacy activities in native languages; or114.29    (3) provide FFN caregivers and children's families with early literacy activities in 114.30local libraries.114.31    Subd. 3.Grant awards.Interested entities eligible to receive a grant under 114.32this section may apply to the commissioner in the form and manner the commissioner 114.33determines. The commissioner shall awards grants to eligible entities consistent with 114.34the requirements of this section.114.35    Subd. 4.Evaluation.The commissioner, in consultation with early childhood 114.36care and education experts at the University of Minnesota, must evaluate the impact of 115.1the grants under subdivision 2 on children's school readiness and submit a written report 115.2to the human services and education finance and policy committees of the legislature by 115.3February 15, 2010.115.4EFFECTIVE DATE.This section is effective the day following final enactment.115.5    Sec. 97. CHILD CARE PROVIDER STUDY.115.6    The commissioner of human services is directed to study the implications of 115.7restricting the use of state subsidies in center-based child care to centers meeting state 115.8quality standards under Minnesota Statutes, section 124D.175, paragraph (c), and to 115.9publish the results no later than January 1, 2010. The study must include:115.10    (1) the likelihood of there being sufficient child care providers meeting the standards;115.11    (2) the cost to bring providers up to the standards and how this cost would be funded;115.12    (3) how the standards and the ratings would be communicated to both parents and 115.13the general public; and115.14    (4) a determination whether a similar system could be implemented for 115.15non-center-based care.115.16    Sec. 98. DIRECTION TO COMMISSIONER.115.17    (a) The commissioner of human services shall offer a request for proposals to 115.18identify a research and evaluation firm with experience working with:115.19    (1) homeless youth providers;115.20    (2) data; and115.21    (3) the topics of housing, homelessness, and a continuum of care for youth.115.22    (b) The research and evaluation firm identified under paragraph (a) shall monitor and 115.23evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.115.24    Sec. 99. REVISOR'S INSTRUCTION.115.25    (a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d, 115.26as Minnesota Statutes, section 626.556, subdivision 3g.115.27    (b) The revisor shall change references to Minnesota Statutes, section 260.851, 115.28to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to 115.29section 260.853, article 4, wherever those references appear in Minnesota Statutes and 115.30Minnesota Rules.115.31    Sec. 100.  REPEALER.116.1(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.29; 256J.37, 116.2subdivisions 3a and 3b; and 256J.626, subdivisions 7 and 9, are repealed.116.3(b) Laws 1997, chapter 8, section 1, is repealed.116.4(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed.116.5ARTICLE 2116.6LICENSING116.7    Section 1. Minnesota Statutes 2006, section 245A.035, is amended to read:116.8245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY 116.9LICENSE RELATIVE PLACEMENT.116.10    Subdivision 1. Grant of Emergency license placement. Notwithstanding section 116.11245A.03, subdivision 2a
         , or 
         245C.13, subdivision 2, a county agency may place a child 116.12for foster care with a relative who is not licensed to provide foster care, provided the 116.13requirements of subdivision 2 this section are met. As used in this section, the term 116.14"relative" has the meaning given it under section 
         260C.007, subdivision 27.116.15    Subd. 2. Cooperation with emergency licensing placement process. (a) A county 116.16agency that places a child with a relative who is not licensed to provide foster care must 116.17begin the process of securing an emergency license for the relative as soon as possible 116.18and must conduct the initial inspection required by subdivision 3, clause (1), whenever 116.19possible, prior to placing the child in the relative's home, but no later than three working 116.20days after placing the child in the home. A child placed in the home of a relative who is 116.21not licensed to provide foster care must be removed from that home if the relative fails 116.22to cooperate with the county agency in securing an emergency foster care license. The 116.23commissioner may issue an emergency foster care license to a relative with whom the 116.24county agency wishes to place or has placed a child for foster care, or to a relative with 116.25whom a child has been placed by court order.116.26    (b) If a child is to be placed in the home of a relative not licensed to provide foster 116.27care, either the placing agency or the county agency in the county in which the relative 116.28lives shall conduct the emergency licensing placement process as required in this section.116.29    Subd. 3. Requirements for emergency license placement. Before an emergency 116.30license placement may be issued made, the following requirements must be met:116.31    (1) the county agency must conduct an initial inspection of the premises where 116.32the foster care placement is to be provided made to ensure the health and safety of any 116.33child placed in the home. The county agency shall conduct the inspection using a form 116.34developed by the commissioner;117.1    (2) at the time of the inspection or placement, whichever is earlier, the county 117.2agency must provide the relative being considered for an emergency license shall receive117.3placement an application form for a child foster care license;117.4    (3) whenever possible, prior to placing the child in the relative's home, the relative 117.5being considered for an emergency license placement shall provide the information 117.6required by section 
         245C.05; and 117.7    (4) if the county determines, prior to the issuance of an emergency license117.8placement, that anyone requiring a background study may be prior to licensure of the 117.9home is disqualified under section 245C.14 and chapter 245C, and the disqualification 117.10is one which the commissioner cannot set aside, an emergency license shall placement 117.11must not be issued made.117.12    Subd. 4. Applicant study. When the county agency has received the information 117.13required by section 
         245C.05, the county agency shall begin an applicant study according to 117.14the procedures in chapter 245C. The commissioner may issue an emergency license upon 117.15recommendation of the county agency once the initial inspection has been successfully 117.16completed and the information necessary to begin the applicant background study has been 117.17provided. If the county agency does not recommend that the emergency license be granted, 117.18the agency shall notify the relative in writing that the agency is recommending denial to the 117.19commissioner; shall remove any child who has been placed in the home prior to licensure; 117.20and shall inform the relative in writing of the procedure to request review pursuant to 117.21subdivision 6. An emergency license shall be effective until a child foster care license is 117.22granted or denied, but shall in no case remain in effect more than 120 days from the date 117.23of placement submit the information to the commissioner according to section 245C.05.117.24    Subd. 5. Child foster care license application. (a) The relatives with whom the117.25emergency license holder placement has been made shall complete the child foster care 117.26license application and necessary paperwork within ten days of the placement. The county 117.27agency shall assist the emergency license holder applicant to complete the application. 117.28The granting of a child foster care license to a relative shall be under the procedures in this 117.29chapter and according to the standards set forth by foster care rule in Minnesota Rules, 117.30chapter 2960. In licensing a relative, the commissioner shall consider the importance of 117.31maintaining the child's relationship with relatives as an additional significant factor in 117.32determining whether to a background study disqualification should be set aside a licensing 117.33disqualifier under section 
         245C.22, or to grant a variance of licensing requirements should 117.34be granted under sections 245C.21 to 245C.27 section 245C.30.117.35    (b) When the county or private child-placing agency is processing an application 117.36for child foster care licensure of a relative as defined in section 
         260B.007, subdivision 118.112
         , or 
         260C.007, subdivision 27, the county agency or child-placing agency must explain 118.2the licensing process to the prospective licensee, including the background study process 118.3and the procedure for reconsideration of an initial disqualification for licensure. The 118.4county or private child-placing agency must also provide the prospective relative licensee 118.5with information regarding appropriate options for legal representation in the pertinent 118.6geographic area. If a relative is initially disqualified under section 
         245C.14, the county 118.7or child-placing agency commissioner must provide written notice of the reasons for the 118.8disqualification and the right to request a reconsideration by the commissioner as required 118.9under section 
         245C.17.118.10    (c) The commissioner shall maintain licensing data so that activities related to 118.11applications and licensing actions for relative foster care providers may be distinguished 118.12from other child foster care settings.118.13    Subd. 6.Denial of emergency license.If the commissioner denies an application 118.14for an emergency foster care license under this section, that denial must be in writing and 118.15must include reasons for the denial. Denial of an emergency license is not subject to 118.16appeal under chapter 14. The relative may request a review of the denial by submitting 118.17to the commissioner a written statement of the reasons an emergency license should be 118.18granted. The commissioner shall evaluate the request for review and determine whether 118.19to grant the emergency license. The commissioner's review shall be based on a review 118.20of the records submitted by the county agency and the relative. Within 15 working 118.21days of the receipt of the request for review, the commissioner shall notify the relative 118.22requesting review in written form whether the emergency license will be granted. The 118.23commissioner's review shall be based on a review of the records submitted by the county 118.24agency and the relative. A child shall not be placed or remain placed in the relative's home 118.25while the request for review is pending. Denial of an emergency license shall not preclude 118.26an individual from reapplying for an emergency license or from applying for a child foster 118.27care license. The decision of the commissioner is the final administrative agency action.118.28    Sec. 2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:118.29    Subd. 2. County fees for background studies and licensing inspections. (a) For 118.30purposes of family and group family child care licensing under this chapter, a county 118.31agency may charge a fee to an applicant or license holder to recover the actual cost of 118.32background studies, but in any case not to exceed $100 annually. A county agency may 118.33also charge alicense fee to an applicant or license holder to recover the actual cost of 118.34licensing inspections, but in any case not to exceed $150 annually$50 for a one-year 118.35license or $100 for a two-year license.119.1    (b) A county agency may charge a fee to a legal nonlicensed child care provider or 119.2applicant for authorization to recover the actual cost of background studies completed 119.3under section  
         119B.125, but in any case not to exceed $100 annually. 119.4    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):119.5    (1) in cases of financial hardship;119.6    (2)  if the county has a shortage of providers in the county's area;119.7    (3) for new providers; or119.8    (4) for providers who have attained at least 16 hours of training before seeking 119.9initial licensure.119.10    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on 119.11an installment basis for up to one year. If the provider is receiving child care assistance 119.12payments from the state, the provider may have the fees under paragraph (a) or (b) 119.13deducted from the child care assistance payments for up to one year and the state shall 119.14reimburse the county for the county fees collected in this manner.119.15EFFECTIVE DATE.This section is effective the day following final enactment.119.16    Sec. 3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:119.17    Subdivision 1. Delegation of authority to agencies. (a) County agencies and 119.18private agencies that have been designated or licensed by the commissioner to perform 119.19licensing functions and activities under section 
         245A.04andbackground studies for adult 119.20foster care, family adult day services, and until December 31, 2007, family child care, 119.21under chapter 245C,; to recommend denial of applicants under section 
         245A.05,; to issue 119.22correction orders, to issue variances, and recommend a conditional license under section 119.23245A.06
         , or to recommend suspending or revoking a license or issuing a fine under section 119.24245A.07
         , shall comply with rules and directives of the commissioner governing those 119.25functions and with this section. The following variances are excluded from the delegation 119.26of variance authority and may be issued only by the commissioner:119.27    (1) dual licensure of family child care and child foster care, dual licensure of child 119.28and adult foster care, and adult foster care and family child care;119.29    (2) adult foster care maximum capacity;119.30    (3) adult foster care minimum age requirement;119.31    (4) child foster care maximum age requirement;119.32    (5) variances regarding disqualified individuals except that county agencies may 119.33issue variances under section 
         245C.30 regarding disqualified individuals when the county 119.34is responsible for conducting a consolidated reconsideration according to sections 
         245C.25120.1and 
         245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 120.2and a disqualification based on serious or recurring maltreatment; and120.3    (6) the required presence of a caregiver in the adult foster care residence during 120.4normal sleeping hours.120.5    (b) County agencies must report:120.6    (1) information about disqualification reconsiderations under sections 
         245C.25 and 120.7245C.27, subdivision 2
         , clauses paragraphs (a) and (b), and variances granted under 120.8paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by 120.9the commissioner; and.120.10    (2) for relative child foster care applicants and license holders, the number of 120.11relatives, as defined in section 260C.007, subdivision 27, and household members of 120.12relatives who are disqualified under section 245C.14; the disqualifying characteristics 120.13under section 245C.15; the number of these individuals who requested reconsideration 120.14under section 245C.21; the number of set-asides under section 245C.22; and variances 120.15under section 245C.30 issued. This information shall be reported to the commissioner 120.16annually by January 15 of each year in a format prescribed by the commissioner.120.17    (c) For family day care programs, the commissioner may authorize licensing reviews 120.18every two years after a licensee has had at least one annual review.120.19    (d) For family adult day services programs, the commissioner may authorize 120.20licensing reviews every two years after a licensee has had at least one annual review.120.21    (e) A license issued under this section may be issued for up to two years.120.22    Sec. 4. Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:120.23    Subd. 3. Recommendations to the commissioner. The county or private agency 120.24shall not make recommendations to the commissioner regarding licensure without 120.25first conducting an inspection, and for adult foster care, family adult day services, and 120.26until December 31, 2007, family child care, a background study of the applicant, and 120.27evaluation pursuant to under chapter 245C. The county or private agency must forward its 120.28recommendation to the commissioner regarding the appropriate licensing action within 20 120.29working days of receipt of a completed application.120.30EFFECTIVE DATE.This section is effective January 1, 2008.120.31    Sec. 5. Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision 120.32to read:120.33    Subd. 14a.Private agency."Private agency" has the meaning given in section 120.34245A.02, subdivision 12.121.1    Sec. 6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:121.2    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a 121.3background study of an individual required to be studied under section 
         245C.03, 121.4subdivision 1
         , at least upon application for initial license for all license types. 121.5    (b) The commissioner shall conduct a background study of an individual required 121.6to be studied under section 
         245C.03, subdivision 1, at reapplication for a license for 121.7family child care, child foster care, and adult foster care, family adult day services, and 121.8until January 1, 2008, family child care. 121.9    (c) The commissioner is not required to conduct a study of an individual at the time 121.10of reapplication for a license if the individual's background study was completed by the 121.11commissioner of human services for an adult foster care license holder that is also:121.12    (1) registered under chapter 144D; or121.13    (2) licensed to provide home and community-based services to people with 121.14disabilities at the foster care location and the license holder does not reside in the foster 121.15care residence; and121.16    (3) the following conditions are met:121.17    (i) a study of the individual was conducted either at the time of initial licensure or 121.18when the individual became affiliated with the license holder;121.19    (ii) the individual has been continuously affiliated with the license holder since 121.20the last study was conducted; and121.21    (iii) the last study of the individual was conducted on or after October 1, 1995.121.22    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services 121.23shall conduct a study of an individual required to be studied under section 245C.03, at 121.24the time of reapplication for a child foster care license. The county or private agency 121.25shall collect and forward to the commissioner the information required under section 121.26245C.05, subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The 121.27background study conducted by the commissioner of human services under this paragraph 121.28must include a review of the information required under section 245C.08, subdivisions 121.291, paragraph (a), clauses (1) to (4), and 3.121.30    (e) From January 1, 2008, to December 31, 2009, the commissioner shall conduct 121.31a study of an individual required to be studied under section 245C.03, at the time of 121.32reapplication for a family child care license. The county shall collect and forward to the 121.33commissioner the information required under section 245C.05, subdivisions 1 and 5. The 121.34background study conducted by the commissioner under this paragraph must include a 121.35review of the information required under section 245C.08, subdivisions 1, paragraph 121.36(a), and 3.122.1    (f) The commissioner of human services shall conduct a background study of an 122.2individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) 122.3to (6), who is newly affiliated with a child foster care license holder. The county or 122.4private agency shall collect and forward to the commissioner the information required 122.5under section 245C.05, subdivisions 1 and 5. The background study conducted by the 122.6commissioner of human services under this paragraph must include a review of the 122.7information required under section 245C.08, subdivisions 1, paragraph (a), and 3.122.8    (g) Applicants for licensure, license holders, and other entities as provided in this 122.9chapter must submit completed background study forms to the commissioner before 122.10individuals specified in section 
         245C.03, subdivision 1, begin positions allowing direct 122.11contact in any licensed program. 122.12    (e) (h) For purposes of this section, a physician licensed under chapter 147 is 122.13considered to be continuously affiliated upon the license holder's receipt from the 122.14commissioner of health or human services of the physician's background study results.122.15    Sec. 7. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:122.16    Subdivision 1. Individual studied. (a) The individual who is the subject of the 122.17background study must provide the applicant, license holder, or other entity under section 122.18245C.04
          with sufficient information to ensure an accurate study, including: 122.19    (1) the individual's first, middle, and last name and all other names by which the 122.20individual has been known;122.21    (2) home address, city, and state of residence;122.22    (3) zip code;122.23    (4) sex;122.24    (5) date of birth; and122.25    (6) Minnesota driver's license number or state identification number.122.26    (b) Every subject of a background study conducted or initiated by counties or private 122.27agencies under this chapter must also provide the home address, city, county, and state of 122.28residence for the past five years.122.29    (c) Every subject of a background study related to child foster care licensed through 122.30a private agency shall also provide the commissioner a signed consent for the release of 122.31any information received from national crime information databases to the private agency 122.32that initiated the background study.122.33    (d) The subject of a background study shall provide fingerprints as required in 122.34subdivision 5, paragraph (c).123.1    Sec. 8. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision 123.2to read:123.3    Subd. 2a.County or private agency.For background studies related to child 123.4foster care, and beginning January 1, 2008, for studies related to family child care, county 123.5and private agencies must collect the information under subdivision 1 and forward it to 123.6the commissioner.123.7    Sec. 9. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:123.8    Subd. 4. Electronic transmission. For background studies conducted by the 123.9Department of Human Services, the commissioner shall implement a system for the 123.10electronic transmission of:123.11    (1) background study information to the commissioner; and123.12    (2) background study results to the license holder; and123.13    (3) background study results to county and private agencies for background studies 123.14conducted by the commissioner for child foster care, and beginning January 1, 2008, 123.15also for family child care.123.16EFFECTIVE DATE.This section is effective January 1, 2008.123.17    Sec. 10. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:123.18    Subd. 5. Fingerprints. (a) Except as provided in paragraph (c), for any background 123.19study completed under this chapter, when the commissioner has reasonable cause to 123.20believe that further pertinent information may exist on the subject of the background 123.21study, the subject shall provide the commissioner with a set of classifiable fingerprints 123.22obtained from an authorized law enforcement agency.123.23    (b) For purposes of requiring fingerprints, the commissioner has reasonable cause 123.24when, but not limited to, the:123.25    (1) information from the Bureau of Criminal Apprehension indicates that the subject 123.26is a multistate offender;123.27    (2) information from the Bureau of Criminal Apprehension indicates that multistate 123.28offender status is undetermined; or123.29    (3) commissioner has received a report from the subject or a third party indicating 123.30that the subject has a criminal history in a jurisdiction other than Minnesota.123.31    (c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for 123.32background studies conducted by the commissioner for child foster care, the subject of the 123.33background study shall provide the commissioner with a set of classifiable fingerprints 123.34obtained from an authorized agency.124.1    Sec. 11. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:124.2    Subd. 7. Probation officer and corrections agent. (a) A probation officer or 124.3corrections agent shall notify the commissioner of an individual's conviction if the 124.4individual is:124.5    (1) affiliated with a program or facility regulated by the Department of Human 124.6Services or Department of Health, a facility serving children or youth licensed by the 124.7Department of Corrections, or any type of home care agency or provider of personal care 124.8assistance services; and124.9    (2) convicted of a crime constituting a disqualification under section 
         245C.14. 124.10    (b) For the purpose of this subdivision, "conviction" has the meaning given it 124.11in section 
         609.02, subdivision 5. 124.12    (c) The commissioner, in consultation with the commissioner of corrections, shall 124.13develop forms and information necessary to implement this subdivision and shall provide 124.14the forms and information to the commissioner of corrections for distribution to local 124.15probation officers and corrections agents.124.16    (d) The commissioner shall inform individuals subject to a background study that 124.17criminal convictions for disqualifying crimes will be reported to the commissioner by the 124.18corrections system.124.19    (e) A probation officer, corrections agent, or corrections agency is not civilly or 124.20criminally liable for disclosing or failing to disclose the information required by this 124.21subdivision.124.22    (f) Upon receipt of disqualifying information, the commissioner shall provide the 124.23notice required under section 
         245C.17, as appropriate, to agencies on record as having 124.24initiated a background study or making a request for documentation of the background 124.25study status of the individual. 124.26    (g) This subdivision does not apply to family child care and child foster care124.27programs until January 1, 2008.124.28    Sec. 12. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:124.29    Subdivision 1. Background studies conducted by commissioner of human 124.30services. (a) For a background study conducted by the commissioner, the commissioner 124.31shall review:124.32    (1) information related to names of substantiated perpetrators of maltreatment of 124.33vulnerable adults that has been received by the commissioner as required under section 124.34626.557, subdivision 9c
         , paragraph (i);125.1    (2) the commissioner's records relating to the maltreatment of minors in licensed 125.2programs, and from county agency findings of maltreatment of minors as indicated 125.3through the social service information system;125.4    (3) information from juvenile courts as required in subdivision 4 for individuals 125.5listed in section 
         245C.03, subdivision 1, clauses (2), (5), and (6); and125.6    (4) information from the Bureau of Criminal Apprehension.; 125.7    (5) except as provided in clause (6), information from the national crime information 125.8system when the commissioner has reasonable cause as defined under section 245C.05, 125.9subdivision 5; and125.10    (6) for a background study related to a child foster care application for licensure, the 125.11commissioner shall also review:125.12    (i) information from the child abuse and neglect registry for any state in which the 125.13background study subject has resided in for the past five years; and125.14    (ii) information from national crime information databases.125.15    (b) Notwithstanding expungement by a court, the commissioner may consider 125.16information obtained under paragraph (a), clauses (3) and (4), unless the commissioner 125.17received notice of the petition for expungement and the court order for expungement is 125.18directed specifically to the commissioner.125.19    Sec. 13. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:125.20    Subd. 2. Background studies conducted by a county or private agency. (a) For 125.21a background study conducted by a county or private agency for child foster care, adult 125.22foster care, family adult day services, and until January 1, 2008, family child care homes125.23services, the commissioner shall review:125.24    (1) information from the county agency's record of substantiated maltreatment 125.25of adults and the maltreatment of minors;125.26    (2) information from juvenile courts as required in subdivision 4 for individuals 125.27listed in section 
         245C.03, subdivision 1, clauses (2), (5), and (6);125.28    (3) information from the Bureau of Criminal Apprehension; and125.29    (4) arrest and investigative records maintained by the Bureau of Criminal 125.30Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the 125.31National Criminal Records Repository, and criminal records from other states.125.32    (b) If the individual has resided in the county for less than five years, the study shall 125.33include the records specified under paragraph (a) for the previous county or counties of 125.34residence for the past five years.126.1    (c) Notwithstanding expungement by a court, the county or private agency may 126.2consider information obtained under paragraph (a), clauses (3) and (4), unless the 126.3commissioner received notice of the petition for expungement and the court order for 126.4expungement is directed specifically to the commissioner.126.5    Sec. 14. Minnesota Statutes 2006, section 245C.10, is amended by adding a 126.6subdivision to read:126.7    Subd. 4.Temporary personnel agencies, educational programs, and professional 126.8services agencies.The commissioner shall recover the cost of the background studies 126.9initiated by temporary personnel agencies, educational programs, and professional 126.10services agencies that initiate background studies under section 245C.03, subdivision 4, 126.11through a fee of no more than $20 per study charged to the agency. In fiscal years 2008 126.12and 2009, the fees collected under this subdivision are appropriated to the commissioner 126.13for the purpose of conducting background studies.126.14    Sec. 15. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:126.15    Subdivision 1. Adult foster care; criminal conviction data. For individuals who 126.16are required to have background studies under section 
         245C.03, subdivisions 1 and 2, and 126.17who have been continuously affiliated with a an adult foster care provider that is licensed 126.18in more than one county, criminal conviction data may be shared among those counties in 126.19which the adult foster care programs are licensed. A county agency's receipt of criminal 126.20conviction data from another county agency shall meet the criminal data background 126.21study requirements of this chapter. 126.22    Sec. 16. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:126.23    Subd. 2. Jointly licensed programs. A county agency may accept a background 126.24study completed by the commissioner under this chapter in place of the background study 126.25required under section 
         245A.16, subdivision 3, in programs with joint licensure as home 126.26and community-based services and adult foster care for people with developmental 126.27disabilities when the license holder does not reside in the adult foster care residence and 126.28the subject of the study has been continuously affiliated with the license holder since the 126.29date of the commissioner's study. 126.30    Sec. 17. Minnesota Statutes 2006, section 245C.12, is amended to read:126.31245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.127.1    (a) For the purposes of background studies completed by tribal organizations 127.2performing licensing activities otherwise required of the commissioner under this chapter, 127.3after obtaining consent from the background study subject, tribal licensing agencies shall 127.4have access to criminal history data in the same manner as county licensing agencies and 127.5private licensing agencies under this chapter.127.6    (b) Tribal organizations may contract with the commissioner to obtain background 127.7study data on individuals under tribal jurisdiction related to adoptions according to 127.8section 245C.34. Tribal organizations may also contract with the commissioner to obtain 127.9background study data on individuals under tribal jurisdiction related to child foster care 127.10according to section 245C.34.127.11    Sec. 18. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:127.12    Subdivision 1. Determining immediate risk of harm. (a) If the commissioner 127.13determines that the individual studied has a disqualifying characteristic, the commissioner 127.14shall review the information immediately available and make a determination as to the 127.15subject's immediate risk of harm to persons served by the program where the individual 127.16studied will have direct contact.127.17    (b) The commissioner shall consider all relevant information available, including the 127.18following factors in determining the immediate risk of harm:127.19    (1) the recency of the disqualifying characteristic;127.20    (2) the recency of discharge from probation for the crimes;127.21    (3) the number of disqualifying characteristics;127.22    (4) the intrusiveness or violence of the disqualifying characteristic;127.23    (5) the vulnerability of the victim involved in the disqualifying characteristic;127.24    (6) the similarity of the victim to the persons served by the program where the 127.25individual studied will have direct contact; and127.26    (7) whether the individual has a disqualification from a previous background study 127.27that has not been set aside.127.28    (c) This section does not apply when the subject of a background study is regulated 127.29by a health-related licensing board as defined in chapter 214, and the subject is determined 127.30to be responsible for substantiated maltreatment under section 
         626.556 or 
         626.557. 127.31    (d) This section does not apply to a background study related to an initial application 127.32for a child foster care license.127.33    (e) If the commissioner has reason to believe, based on arrest information or an 127.34active maltreatment investigation, that an individual poses an imminent risk of harm to 127.35persons receiving services, the commissioner may order that the person be continuously 128.1supervised or immediately removed pending the conclusion of the maltreatment 128.2investigation or criminal proceedings.128.3    Sec. 19. Minnesota Statutes 2006, section 245C.17, is amended by adding a 128.4subdivision to read:128.5    Subd. 5.Notice to county or private agency.For studies on individuals related 128.6to a license to provide child foster care, and beginning January 1, 2008, for family child 128.7care, the commissioner shall also provide a notice of the background study results to the 128.8county or private agency that initiated the background study.128.9    Sec. 20. Minnesota Statutes 2006, section 245C.21, is amended by adding a 128.10subdivision to read:128.11    Subd. 1a.Submission of reconsideration request to county or private agency.128.12    (a) For disqualifications related to studies conducted by county agencies, and for 128.13disqualifications related to studies conducted by the commissioner for child foster care, and 128.14beginning January 1, 2008, for family child care, the individual shall submit the request 128.15for reconsideration to the county or private agency that initiated the background study.128.16    (b) A reconsideration request shall be submitted within the time frames specified in 128.17subdivision 2.128.18    (c) The county or private agency shall forward the individual's request for 128.19reconsideration and provide the commissioner with a recommendation whether to set aside 128.20the individual's disqualification.128.21    Sec. 21. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:128.22    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The 128.23commissioner shall notify the license holder of the disqualification and order the license 128.24holder to immediately remove the individual from any position allowing direct contact 128.25with persons receiving services from the license holder if:128.26    (1) the individual studied does not submit a timely request for reconsideration 128.27under section 
         245C.21;128.28    (2) the individual submits a timely request for reconsideration, but the commissioner 128.29does not set aside the disqualification for that license holder under section 
         245C.22;128.30    (3) an individual who has a right to request a hearing under sections 
         245C.27 and 128.31256.045
         , or 
         245C.28 and chapter 14 for a disqualification that has not been set aside, does 128.32not request a hearing within the specified time; or129.1    (4) an individual submitted a timely request for a hearing under sections 
         245C.27129.2and 
         256.045, or 
         245C.28 and chapter 14, but the commissioner does not set aside the 129.3disqualification under section 
         245A.08, subdivision 5, or 
         256.045.129.4    (b) If the commissioner does not set aside the disqualification under section 
         245C.22, 129.5and the license holder was previously ordered under section 
         245C.17 to immediately 129.6remove the disqualified individual from direct contact with persons receiving services or 129.7to ensure that the individual is under continuous, direct supervision when providing direct 129.8contact services, the order remains in effect pending the outcome of a hearing under 129.9sections 
         245C.27 and 
         256.045, or 
         245C.28 and chapter 14.129.10    (c) For background studies related to child foster care, and beginning January 129.111, 2008, for family child care, the commissioner shall also notify the county or private 129.12agency that initiated the study of the results of the reconsideration.129.13    Sec. 22. Minnesota Statutes 2006, section 245C.24, subdivision 2, is amended to read:129.14    Subd. 2. Permanent bar to set aside a disqualification. (a) Except as provided in 129.15paragraph (b), the commissioner may not set aside the disqualification of any individual 129.16disqualified pursuant to this chapter, in connection with a license to provide family child 129.17care for children, foster care for children in the provider's home, or foster care or day care 129.18services for adults in the provider's home regardless of how much time has passed, if the 129.19individual was disqualified for a crime or conduct listed in section 
         245C.15, subdivision 1.129.20    (b) For an individual in the chemical dependency field who was disqualified for a 129.21crime or conduct listed under section 
         245C.15, subdivision 1, and whose disqualification 129.22was set aside prior to July 1, 2005, the commissioner must consider granting a variance 129.23pursuant to section 
         245C.30 for the license holder for a program dealing primarily with 129.24adults. A request for reconsideration evaluated under this paragraph must include a 129.25letter of recommendation from the license holder that was subject to the prior set-aside 129.26decision addressing the individual's quality of care to children or vulnerable adults and the 129.27circumstances of the individual's departure from that service.129.28    Sec. 23. [245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.129.29    Subdivision 1.Background studies conducted by commissioner.Before 129.30placement of a child for purposes of adoption, the commissioner shall conduct a 129.31background study on individuals listed in section 259.41, subdivision 3, for county 129.32agencies and private agencies licensed to place children for adoption.130.1    Subd. 2.Information and data provided to county or private agency.The 130.2subject of the background study shall provide the following information to the county 130.3or private agency:130.4    (1) the information specified in section 245C.05;130.5    (2) a set of classifiable fingerprints obtained from an authorized agency; and130.6    (3) for studies initiated by a private agency, a signed consent for the release of 130.7information received from national crime information databases to the private agency.130.8    Subd. 3.Information and data provided to commissioner.The county or private 130.9agency shall forward the data collected under subdivision 2 to the commissioner.130.10    Subd. 4.Information commissioner reviews.(a) The commissioner shall review 130.11the following information regarding the background study subject:130.12    (1) the information under section 245C.08, subdivisions 1, 3, and 4;130.13    (2) information from the child abuse and neglect registry for any state in which the 130.14subject has resided for the past five years; and130.15    (3) information from national crime information databases.130.16    (b) The commissioner shall provide any information collected under this subdivision 130.17to the county or private agency that initiated the background study. The commissioner 130.18shall indicate if the information collected shows that the subject of the background study 130.19has a conviction listed in United States Code, title 42, section 671(a)(20)(A).130.20    Sec. 24. [245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND 130.21STUDIES; TRIBAL ORGANIZATIONS.130.22    Subdivision 1.Background studies may be conducted by commissioner.(a) 130.23Tribal organizations may contract with the commissioner under section 245C.12 to obtain 130.24background study data on individuals under tribal jurisdiction related to adoptions.130.25    (b) Tribal organizations may contract with the commissioner under section 245C.12 130.26to obtain background study data on individuals under tribal jurisdiction related to child 130.27foster care.130.28    (c) Background studies initiated by tribal organizations under paragraphs (a) and (b) 130.29must be conducted as provided in subdivisions 2 and 3.130.30    Subd. 2.Information and data provided to tribal organization.The background 130.31study subject must provide the following information to the tribal organization:130.32    (1) for background studies related to adoptions, the information under section 130.33245C.05;130.34    (2) for background studies related to child foster care, the information under section 130.35245C.05;131.1    (3) a set of classifiable fingerprints obtained from an authorized agency; and131.2    (4) a signed consent for the release of information received from national crime 131.3information databases to the tribal organization.131.4    Subd. 3.Information and data provided to commissioner.The tribal organization 131.5shall forward the data collected under subdivision 2 to the commissioner.131.6    Subd. 4.Information commissioner reviews.(a) The commissioner shall review 131.7the following information regarding the background study subject:131.8    (1) the information under section 245C.08, subdivisions 1, 3, and 4;131.9    (2) information from the child abuse and neglect registry for any state in which the 131.10subject has resided for the past five years; and131.11    (3) information from national crime information databases.131.12    (b) The commissioner shall provide any information collected under this subdivision 131.13to the tribal organization that initiated the background study. The commissioner shall 131.14indicate if the information collected shows that the subject of the background study has a 131.15conviction listed in United States Code, title 42, section 671(a)(20)(A).131.16    Sec. 25. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:131.17    Subd. 2. Other applicable law.(a) Portions of chapters 245A, 245C, 257, 260, and 131.18317A may also affect the adoption of a particular child. 131.19    (b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter 131.2021, sections 1901-1923, may also apply in the adoption of an Indian child, and may 131.21preempt specific provisions of this chapter.131.22    (c) Consistent with section 245C.33 and Public Law 109-248, a completed 131.23background study is required before the approval of any foster or adoptive placement in 131.24a related or an unrelated home.131.25    Sec. 26. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:131.26    Subdivision 1. Best interests of the child. (a) The policy of the state of Minnesota 131.27is to ensure that the best interests of the child are met by requiring individualized 131.28determination of the needs of the child and of how the adoptive placement will serve the 131.29needs of the child.131.30    (b) Among the factors the agency shall consider in determining the needs of the child 131.31are those specified under section 
         260C.193, subdivision 3, paragraph (b).131.32    (c) Except for emergency placements provided for in section 245A.035, a completed 131.33background study is required under section 245C.33 before the approval of an adoptive 131.34placement in a home.132.1    Sec. 27. Minnesota Statutes 2006, section 259.41, is amended to read:132.2259.41 ADOPTION STUDY.132.3    Subdivision 1. Study required before placement; certain relatives excepted. (a) 132.4An approved adoption study; completed background study, as required under section 132.5245C.33; and written report must be completed before the child is placed in a prospective 132.6adoptive home under this chapter, except as allowed by section 
         259.47, subdivision 6. 132.7In an agency placement, the report must be filed with the court at the time the adoption 132.8petition is filed. In a direct adoptive placement, the report must be filed with the court in 132.9support of a motion for temporary preadoptive custody under section 
         259.47, subdivision 132.103
         , or, if the study and report are complete, in support of an emergency order under section 132.11259.47, subdivision 6
         . The study and report shall be completed by a licensed child-placing 132.12agency and must be thorough and comprehensive. The study and report shall be paid for 132.13by the prospective adoptive parent, except as otherwise required under section 
         259.67132.14or 
         259.73. 132.15    (b) A placement for adoption with an individual who is related to the child, as 132.16defined by section 
         245A.02, subdivision 13, is not subject to this section except as required 132.17by section sections 245C.33 and259.53, subdivision 2, paragraph (c). 132.18    (c) In the case of a licensed foster parent seeking to adopt a child who is in the foster 132.19parent's care, any portions of the foster care licensing process that duplicate requirements 132.20of the home study may be submitted in satisfaction of the relevant requirements of this 132.21section.132.22    Subd. 2. Form of study. (a) The adoption study must include at least one in-home 132.23visit with the prospective adoptive parent. At a minimum, the study must include132.24document the following information about the prospective adoptive parent:132.25    (1) a background check study as required by subdivision 3 and section 245C.33, 132.26and including:132.27    (i) an evaluation assessment of the data and information provided by section 132.28245C.33, subdivision 4, to determine if the prospective adoptive parent and any other 132.29person over the age of 13 living in the home has a felony conviction consistent with 132.30subdivision 3 and section 471(a)(2) of the Social Security Act; and132.31    (ii) an assessment of the effect of a any conviction or finding of substantiated 132.32maltreatment on the ability to capacity of the prospective adoptive parent to safely care 132.33for and parent a child;132.34    (2) a medical and social history and assessment of current health;132.35    (3) an assessment of potential parenting skills;132.36    (4) an assessment of ability to provide adequate financial support for a child; and133.1    (5) an assessment of the level of knowledge and awareness of adoption issues 133.2including, where appropriate, matters relating to interracial, cross-cultural, and special 133.3needs adoptions.133.4    (b) The adoption study is the basis for completion of a written report. The report 133.5must be in a format specified by the commissioner and must contain recommendations 133.6regarding the suitability of the subject of the study to be an adoptive parent.133.7    Subd. 3. Background check; affidavit of history study. (a) At the time an adoption 133.8study is commenced, each prospective adoptive parent must:133.9    (1) authorize access by the agency to any private data needed to complete the study;133.10    (2) provide all addresses at which the prospective adoptive parent and anyone in the 133.11household over the age of 13 has resided in the previous five years; and133.12    (3) disclose any names used previously other than the name used at the time of 133.13the study.133.14    (b) When the requirements of paragraph (a) have been met, the agency shall 133.15immediately begin initiate a background check, study under section 245C.33 to be 133.16completed by the commissioner on each person over the age of 13 living in the home, 133.17consisting, at a minimum, of the following:. As required under section 245C.33 and Public 133.18Law 109-248, a completed background study is required before the approval of any foster 133.19or adoptive placement in a related or an unrelated home. The required background study 133.20must be completed as part of the home study.133.21    (1) a check of criminal conviction data with the Bureau of Criminal Apprehension 133.22and local law enforcement authorities;133.23    (2) a check for data on substantiated maltreatment of a child or vulnerable adult 133.24and domestic violence data with local law enforcement and social services agencies and 133.25district courts; and133.26    (3) for those persons under the age of 25, a check of juvenile court records.133.27    Notwithstanding the provisions of section 260B.171 or 260C.171, the Bureau of 133.28Criminal Apprehension, local law enforcement and social services agencies, district courts, 133.29and juvenile courts shall release the requested information to the agency completing 133.30the adoption study.133.31    (c) When paragraph (b) requires checking the data or records of local law 133.32enforcement and social services agencies and district and juvenile courts, the agency 133.33shall check with the law enforcement and social services agencies and courts whose 133.34jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the 133.35agency is unable to complete any of the record checks required by paragraph (b), the 133.36agency shall document the fact and the agency's efforts to obtain the information.134.1    (d) For a study completed under this section, when the agency has reasonable 134.2cause to believe that further information may exist on the prospective adoptive parent or 134.3household member over the age of 13 that may relate to the health, safety, or welfare of 134.4the child, the prospective adoptive parent or household member over the age of 13 shall 134.5provide the agency with a set of classifiable fingerprints obtained from an authorized law 134.6enforcement agency and the agency may obtain criminal history data from the National 134.7Criminal Records Repository by submitting fingerprints to the Bureau of Criminal 134.8Apprehension. The agency has reasonable cause when, but not limited to, the:134.9    (1) information from the Bureau of Criminal Apprehension indicates that the 134.10prospective adoptive parent or household member over the age of 13 is a multistate 134.11offender;134.12    (2) information from the Bureau of Criminal Apprehension indicates that multistate 134.13offender status is undetermined;134.14    (3) the agency has received a report from the prospective adoptive parent or 134.15household member over the age of 13 or a third party indicating that the prospective 134.16adoptive parent or household member over the age of 13 has a criminal history in a 134.17jurisdiction other than Minnesota; or134.18    (4) the prospective adoptive parent or household member over the age of 13 is or has 134.19been a resident of a state other than Minnesota in the prior five years.134.20    (e) At any time prior to completion of the background check required under 134.21paragraph (b), a prospective adoptive parent may submit to the agency conducting the 134.22study a sworn affidavit stating whether they or any person residing in the household have 134.23been convicted of a crime. The affidavit shall also state whether the adoptive parent or any 134.24other person residing in the household is the subject of an open investigation of, or have 134.25been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment 134.26within the past ten years. A complete description of the crime, open investigation, or 134.27substantiated abuse, and a complete description of any sentence, treatment, or disposition 134.28must be included. The affidavit must contain an acknowledgment that if, at any time 134.29before the adoption is final, a court receives evidence leading to a conclusion that a 134.30prospective adoptive parent knowingly gave false information in the affidavit, it shall be 134.31determined that the adoption of the child by the prospective adoptive parent is not in the 134.32best interests of the child.134.33    (f) For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an 134.34adoption study is complete for placement, even though the background checks required by 134.35paragraph (b) have not been completed, if each prospective adoptive parent has completed 134.36the affidavit allowed by paragraph (e) and the other requirements of this section have been 135.1met. The background checks required by paragraph (b) must be completed before an 135.2adoption petition is filed. If an adoption study has been submitted to the court under section 135.3259.47, subdivision 3 or 6, before the background checks required by paragraph (b) were 135.4complete, an updated adoption study report which includes the results of the background 135.5check must be filed with the adoption petition. In the event that an agency is unable to 135.6complete any of the records checks required by paragraph (b), the agency shall submit with 135.7the petition to adopt an affidavit documenting the agency's efforts to complete the checks.135.8    (c) A home study under paragraph (b) used to consider placement of any child 135.9on whose behalf Title IV-E adoption assistance payments are to be made must not be 135.10approved if a background study reveals a felony conviction at any time for:135.11    (1) child abuse or neglect;135.12    (2) spousal abuse;135.13    (3) a crime against children, including child pornography; or135.14    (4) a crime involving violence, including rape, sexual assault, or homicide, but not 135.15including other physical assault or battery.135.16    (d) A home study under paragraph (b) used to consider placement of any child 135.17on whose behalf Title IV-E adoption assistance payments are to be made must not be 135.18approved if a background study reveals a felony conviction within the past five years for:135.19    (1) physical assault or battery; or135.20    (2) a drug-related offense.135.21    Subd. 4. Updates to adoption study; period of validity. An agency may update 135.22an adoption study and report as needed, regardless of when the original study and report 135.23or most recent update was completed. An update must be in a format specified by the 135.24commissioner and must verify the continuing accuracy of the elements of the original 135.25report and document any changes to elements of the original report. An update to a study 135.26and report not originally completed under this section must ensure that the study and 135.27report, as updated, meet the requirements of this section. An adoption study is valid if the 135.28report has been completed or updated within the previous 12 months.135.29    Sec. 28. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:135.30    Subd. 2. Adoption agencies; postplacement assessment and report. (a) The 135.31agency to which the petition has been referred under subdivision 1 shall conduct a 135.32postplacement assessment and file a report with the court within 90 days of receipt 135.33of a copy of the adoption petition. The agency shall send a copy of the report to the 135.34commissioner at the time it files the report with the court. The assessment and report 135.35must evaluate the environment and antecedents of the child to be adopted, the home of 136.1the petitioners, whether placement with the petitioners meets the needs of the child as 136.2described in section 
         259.57, subdivision 2. The report must include a recommendation to 136.3the court as to whether the petition should or should not be granted. 136.4    In making evaluations and recommendations, the postplacement assessment and 136.5report must, at a minimum, address the following:136.6    (1) the level of adaptation by the prospective adoptive parents to parenting the child;136.7    (2) the health and well-being of the child in the prospective adoptive parents' home;136.8    (3) the level of incorporation by the child into the prospective adoptive parents' 136.9home, extended family, and community; and136.10    (4) the level of inclusion of the child's previous history into the prospective adoptive 136.11home, such as cultural or ethnic practices, or contact with former foster parents or 136.12biological relatives.136.13    (b) A postplacement adoption report is valid for 12 months following its date 136.14of completion.136.15    (c) If the petitioner is an individual who is related to the child, as defined by section 136.16245A.02, subdivision 13, the agency, as part of its postplacement assessment and report 136.17under paragraph (a), shall conduct a background check meeting the requirements of 136.18section 259.41, subdivision 3, paragraph (b). The prospective adoptive parent shall 136.19cooperate in the completion of the background check by supplying the information and 136.20authorizations described in section 259.41, subdivision 3, paragraph (a).136.21    (d) (c) If the report recommends that the court not grant the petition to adopt the 136.22child, the provisions of this paragraph apply. Unless the assessment and report were 136.23completed by the local social services agency, the agency completing the report, at the 136.24time it files the report with the court under paragraph (a), must provide a copy of the report 136.25to the local social services agency in the county where the prospective adoptive parent 136.26lives. The agency or local social services agency may recommend that the court dismiss 136.27the petition. If the local social services agency determines that continued placement in the 136.28home endangers the child's physical or emotional health, the agency shall seek a court 136.29order to remove the child from the home.136.30    (e) (d) If, through no fault of the petitioner, the agency to whom the petition was 136.31referred under subdivision 1, paragraph (b), fails to complete the assessment and file the 136.32report within 90 days of the date it received a copy of the adoption petition, the court may 136.33hear the petition upon giving the agency and the local social services agency, if different, 136.34five days' notice by mail of the time and place of the hearing.136.35    Sec. 29. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:137.1    Subd. 2. Protection of child's best interests. (a) The policy of the state of 137.2Minnesota is to ensure that the best interests of children are met by requiring an 137.3individualized determination of the needs of the child and how the adoptive placement 137.4will serve the needs of the child.137.5    (b) Among the factors the court shall consider in determining the needs of the child 137.6are those specified under section 
         260C.193, subdivision 3, paragraph (b). Consistent with 137.7section 245C.33 and Public Law 109-248, a complete background study is required before 137.8the approval of an adoptive placement in a home. 137.9    (c) In reviewing adoptive placement and in determining appropriate adoption, 137.10the court shall consider placement, consistent with the child's best interests and in the 137.11following order, with (1) a relative or relatives of the child, or (2) an important friend with 137.12whom the child has resided or had significant contact. Placement of a child cannot be 137.13delayed or denied based on race, color, or national origin of the adoptive parent or the 137.14child. Whenever possible, siblings should be placed together unless it is determined 137.15not to be in the best interests of a sibling.137.16    (d) If the child's birth parent or parents explicitly request that relatives and important 137.17friends not be considered, the court shall honor that request consistent with the best 137.18interests of the child.137.19    If the child's birth parent or parents express a preference for placing the child in an 137.20adoptive home of the same or a similar religious background to that of the birth parent 137.21or parents, the court shall place the child with a family that also meets the birth parent's 137.22religious preference. Only if no family is available as described in clause (a) or (b) 137.23may the court give preference to a family described in clause (c) that meets the parent's 137.24religious preference.137.25    (e) This subdivision does not affect the Indian Child Welfare Act, United States 137.26Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation 137.27Act, sections 
         260.751 to 
         260.835.137.28    Sec. 30. Minnesota Statutes 2006, section 260C.209, is amended to read:137.29260C.209 BACKGROUND CHECKS.137.30    Subdivision 1. Subjects. The responsible social services agency must conduct137.31initiate a background check study to be completed by the commissioner under this section 137.32of chapter 245C on the following individuals:137.33    (1) a noncustodial parent or nonadjudicated parent who is being assessed for 137.34purposes of providing day-to-day care of a child temporarily or permanently under section 137.35260C.212, subdivision 4
         , and any member of the parent's household who is over the age of 138.113 when there is a reasonable cause to believe that the parent or household member over 138.2age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult 138.3which would endanger the child's health, safety, or welfare;138.4    (2) an individual whose suitability for relative placement under section 
         260C.212, 138.5subdivision 5
         , is being determined and any member of the relative's household who is 138.6over the age of 13 when:138.7    (i) the relative must be licensed for foster care; or138.8    (ii) the agency must conduct a background study is required under section 
         259.53, 138.9subdivision 2
         ; or138.10    (iii) the agency or the commissioner has reasonable cause to believe the relative 138.11or household member over the age of 13 has a criminal history which would not make 138.12transfer of permanent legal and physical custody to the relative under section 
         260C.201, 138.13subdivision 11
         , in the child's best interest; and138.14    (3) a parent, following an out-of-home placement, when the responsible social 138.15services agency has reasonable cause to believe that the parent has been convicted of a 138.16crime directly related to the parent's capacity to maintain the child's health, safety, or 138.17welfare or the parent is the subject of an open investigation of, or has been the subject 138.18of a substantiated allegation of, child or vulnerable-adult maltreatment within the past 138.19ten years.138.20"Reasonable cause" means that the agency has received information or a report from the 138.21subject or a third person that creates an articulable suspicion that the individual has a 138.22history that may pose a risk to the health, safety, or welfare of the child. The information 138.23or report must be specific to the potential subject of the background check and shall not 138.24be based on the race, religion, ethnic background, age, class, or lifestyle of the potential 138.25subject.138.26    Subd. 2. General procedures. (a) When conducting initiating a background check 138.27under subdivision 1, the agency may shall require the individual being assessed to provide 138.28sufficient information to ensure an accurate assessment under this section, including:138.29    (1) the individual's first, middle, and last name and all other names by which the 138.30individual has been known;138.31    (2) home address, zip code, city, county, and state of residence for the past ten five138.32years;138.33    (3) sex;138.34    (4) date of birth; and138.35    (5) driver's license number or state identification number.139.1    (b) When notified by the commissioner or the responsible social services agency that 139.2it is conducting an assessment under this section, the Bureau of Criminal Apprehension, 139.3commissioners of health and human services, law enforcement, and county agencies must 139.4provide the commissioner or the responsible social services agency or county attorney 139.5with the following information on the individual being assessed: criminal history data, 139.6reports about the maltreatment of adults substantiated under section 
         626.557, and reports 139.7of maltreatment of minors substantiated under section 
         626.556.139.8    Subd. 3. Multistate information.(a) For any assessment every background study139.9completed under this section, if the responsible social services agency has reasonable 139.10cause to believe that the individual is a multistate offender, the individual must the subject 139.11of the background study shall provide the responsible social services agency or the 139.12county attorney with a set of classifiable fingerprints obtained from an authorized law 139.13enforcement agency. The responsible social services agency or county attorney may shall 139.14provide the fingerprints to the commissioner, and the commissioner shall obtain criminal 139.15history data from the National Criminal Records Repository by submitting the fingerprints 139.16to the Bureau of Criminal Apprehension.139.17    (b) For purposes of this subdivision, the responsible social services agency has 139.18reasonable cause when, but not limited to:139.19    (1) information from the Bureau of Criminal Apprehension indicates that the 139.20individual is a multistate offender;139.21    (2) information from the Bureau of Criminal Apprehension indicates that multistate 139.22offender status is undetermined;139.23    (3) the social services agency has received a report from the individual or a third 139.24party indicating that the individual has a criminal history in a jurisdiction other than 139.25Minnesota; or139.26    (4) the individual is or has been a resident of a state other than Minnesota at any 139.27time during the prior ten years.139.28    Subd. 4. Notice upon receipt. The responsible social services agency commissioner139.29must provide the subject of the background study with the results of the study as required139.30under this section within 15 business days of receipt or at least 15 days prior to the hearing 139.31at which the results will be presented, whichever comes first. The subject may provide 139.32written information to the agency that the results are incorrect and may provide additional 139.33or clarifying information to the agency and to the court through a party to the proceeding. 139.34This provision does not apply to any background study conducted under chapters 245A 139.35and chapter 245C.140.1    Sec. 31. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:140.2    Subd. 2. Placement decisions based on best interest of the child. (a) The policy 140.3of the state of Minnesota is to ensure that the child's best interests are met by requiring an 140.4individualized determination of the needs of the child and of how the selected placement 140.5will serve the needs of the child being placed. The authorized child-placing agency shall 140.6place a child, released by court order or by voluntary release by the parent or parents, in 140.7a family foster home selected by considering placement with relatives and important 140.8friends in the following order:140.9    (1) with an individual who is related to the child by blood, marriage, or adoption; or140.10    (2) with an individual who is an important friend with whom the child has resided or 140.11had significant contact.140.12    (b) Among the factors the agency shall consider in determining the needs of the 140.13child are the following:140.14    (1) the child's current functioning and behaviors;140.15    (2) the medical, educational, and developmental needs of the child;140.16    (3) the child's history and past experience;140.17    (4) the child's religious and cultural needs;140.18    (5) the child's connection with a community, school, and church;140.19    (6) the child's interests and talents;140.20    (7) the child's relationship to current caretakers, parents, siblings, and relatives; and140.21    (8) the reasonable preference of the child, if the court, or the child-placing agency 140.22in the case of a voluntary placement, deems the child to be of sufficient age to express 140.23preferences.140.24    (c) Placement of a child cannot be delayed or denied based on race, color, or national 140.25origin of the foster parent or the child.140.26    (d) Siblings should be placed together for foster care and adoption at the earliest 140.27possible time unless it is determined not to be in the best interests of a sibling or unless it 140.28is not possible after appropriate efforts by the responsible social services agency.140.29    (e) Except for emergency placement as provided for in section 245A.035, a 140.30completed background study is required under section 245C.08 before the approval of a 140.31foster placement in a related or unrelated home.140.32    Sec. 32. LICENSING MORATORIUM.140.33    A program operated by a nonpublic school for children 33 months or older is 140.34exempt from the human services licensing requirements in Minnesota Statutes, chapter 140.35245A, until July 1, 2009. Nothing in this section prohibits an already licensed nonpublic 141.1school program from continuing its licensure or a nonpublic school program from seeking 141.2licensure.141.3EFFECTIVE DATE.This moratorium is effective the day following final 141.4enactment.141.5    Sec. 33. ANNUAL LICENSE REVIEW.141.6    The commissioner of human services shall work with counties to determine the cost 141.7and propose an ongoing funding allocation from the general fund to cover the cost to 141.8counties to implement an annual license review for licensed family child care providers. 141.9The commissioner shall solicit input from counties to determine the outcome. The 141.10commissioner shall report to the house and senate committees having jurisdiction over 141.11early childhood programs by January 15, 2008, as to the costs and the funding allocation 141.12recommended for future use.141.13EFFECTIVE DATE.This section is effective the day following final enactment.141.14    Sec. 34. EFFECTIVE DATE.141.15Changes made to sections in this article related to family child care are effective 141.16January 1, 2008.141.17ARTICLE 3141.18HEALTH CARE141.19    Section 1. Minnesota Statutes 2006, section 256.482, subdivision 1, is amended to read:141.20    Subdivision 1. Establishment; members. There is hereby established the Council 141.21on Disability which shall consist of 21 members appointed by the governor. Members 141.22shall be appointed from the general public and from organizations which provide services 141.23for persons who have a disability. A majority of council members shall be persons with a 141.24disability or parents or guardians of persons with a disability. There shall be at least 141.25one member of the council appointed from each of the state development regions. The 141.26commissioners of the Departments of Education, Human Services, Health, and Human 141.27Rights and the directors of the Rehabilitation Services and State Services for the Blind in 141.28the Department of Employment and Economic Development or their designees shall serve 141.29as ex officio members of the council without vote. In addition, the council may appoint ex 141.30officio members from other bureaus, divisions, or sections of state departments which are 141.31directly concerned with the provision of services to persons with a disability.142.1    Notwithstanding the provisions of section 
         15.059, each member of the council 142.2appointed by the governor shall serve a three-year term and until a successor is appointed 142.3and qualified. The compensation and removal of all members shall be as provided in 142.4section 
         15.059. The council performs functions that are not purely advisory, therefore the 142.5expiration dates provided in section 15.059 do not apply. The governor shall appoint a 142.6chair of the council from among the members appointed from the general public or who 142.7are persons with a disability or their parents or guardians. Vacancies shall be filled by the 142.8authority for the remainder of the unexpired term. 142.9EFFECTIVE DATE.This section is effective the day following final enactment.142.10    Sec. 2. Minnesota Statutes 2006, section 256.482, subdivision 8, is amended to read:142.11    Subd. 8.Sunset.Notwithstanding section 15.059, subdivision 5, the Council on 142.12Disability shall not sunset until June 30, 2007.142.13EFFECTIVE DATE.This section is effective the day following final enactment.142.14    Sec. 3. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to read:142.15    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 142.16assistance program must not be submitted until the recipient is discharged. However, 142.17the commissioner shall establish monthly interim payments for inpatient hospitals that 142.18have individual patient lengths of stay over 30 days regardless of diagnostic category. 142.19Except as provided in section 
         256.9693, medical assistance reimbursement for treatment 142.20of mental illness shall be reimbursed based on diagnostic classifications. Individual 142.21hospital payments established under this section and sections 
         256.9685, 
         256.9686, and 142.22256.9695
         , in addition to third party and recipient liability, for discharges occurring during 142.23the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 142.24inpatient services paid for the same period of time to the hospital. This payment limitation 142.25shall be calculated separately for medical assistance and general assistance medical 142.26care services. The limitation on general assistance medical care shall be effective for 142.27admissions occurring on or after July 1, 1991. Services that have rates established under 142.28subdivision 11 or 12, must be limited separately from other services. After consulting with 142.29the affected hospitals, the commissioner may consider related hospitals one entity and 142.30may merge the payment rates while maintaining separate provider numbers. The operating 142.31and property base rates per admission or per day shall be derived from the best Medicare 142.32and claims data available when rates are established. The commissioner shall determine 142.33the best Medicare and claims data, taking into consideration variables of recency of the 143.1data, audit disposition, settlement status, and the ability to set rates in a timely manner. 143.2The commissioner shall notify hospitals of payment rates by December 1 of the year 143.3preceding the rate year. The rate setting data must reflect the admissions data used to 143.4establish relative values. Base year changes from 1981 to the base year established for the 143.5rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 143.6to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 143.71. The commissioner may adjust base year cost, relative value, and case mix index data 143.8to exclude the costs of services that have been discontinued by the October 1 of the year 143.9preceding the rate year or that are paid separately from inpatient services. Inpatient stays 143.10that encompass portions of two or more rate years shall have payments established based 143.11on payment rates in effect at the time of admission unless the date of admission preceded 143.12the rate year in effect by six months or more. In this case, operating payment rates for 143.13services rendered during the rate year in effect and established based on the date of 143.14admission shall be adjusted to the rate year in effect by the hospital cost index.143.15    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 143.16payment, before third-party liability and spenddown, made to hospitals for inpatient 143.17services is reduced by .5 percent from the current statutory rates.143.18    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 143.19admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 143.20before third-party liability and spenddown, is reduced five percent from the current 143.21statutory rates. Mental health services within diagnosis related groups 424 to 432, and143.22facilities defined under subdivision 16, and, effective for admissions occurring on or after 143.23July 1, 2007, a long-term hospital as designated by the Medicare program that is located in 143.24a city of the first class as defined in section 410.01, are excluded from this paragraph.143.25    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 143.26fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 143.27inpatient services before third-party liability and spenddown, is reduced 6.0 percent from 143.28the current statutory rates. Mental health services within diagnosis related groups 424 to 143.29432 and, facilities defined under subdivision 16, and, effective for admissions occurring 143.30on or after July 1, 2007, a long-term hospital as designated by the Medicare program 143.31that is located in a city of the first class as defined in section 410.01, are excluded from 143.32this paragraph. Notwithstanding section 
         256.9686, subdivision 7, for purposes of this 143.33paragraph, medical assistance does not include general assistance medical care. Payments 143.34made to managed care plans shall be reduced for services provided on or after January 143.351, 2006, to reflect this reduction.144.1    Sec. 4. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:144.2    Subd. 9. Disproportionate numbers of low-income patients served. (a) For 144.3admissions occurring on or after October 1, 1992, through December 31, 1992, the 144.4medical assistance disproportionate population adjustment shall comply with federal law 144.5and shall be paid to a hospital, excluding regional treatment centers and facilities of the 144.6federal Indian Health Service, with a medical assistance inpatient utilization rate in excess 144.7of the arithmetic mean. The adjustment must be determined as follows:144.8    (1) for a hospital with a medical assistance inpatient utilization rate above the 144.9arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 144.10federal Indian Health Service but less than or equal to one standard deviation above the 144.11mean, the adjustment must be determined by multiplying the total of the operating and 144.12property payment rates by the difference between the hospital's actual medical assistance 144.13inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 144.14treatment centers and facilities of the federal Indian Health Service; and144.15    (2) for a hospital with a medical assistance inpatient utilization rate above one 144.16standard deviation above the mean, the adjustment must be determined by multiplying 144.17the adjustment that would be determined under clause (1) for that hospital by 1.1. If 144.18federal matching funds are not available for all adjustments under this subdivision, the 144.19commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for 144.20federal match. The commissioner may establish a separate disproportionate population 144.21operating payment rate adjustment under the general assistance medical care program. 144.22For purposes of this subdivision medical assistance does not include general assistance 144.23medical care. The commissioner shall report annually on the number of hospitals likely to 144.24receive the adjustment authorized by this paragraph. The commissioner shall specifically 144.25report on the adjustments received by public hospitals and public hospital corporations 144.26located in cities of the first class.144.27    (b) For admissions occurring on or after July 1, 1993, the medical assistance 144.28disproportionate population adjustment shall comply with federal law and shall be paid to 144.29a hospital, excluding regional treatment centers and facilities of the federal Indian Health 144.30Service, with a medical assistance inpatient utilization rate in excess of the arithmetic 144.31mean. The adjustment must be determined as follows:144.32    (1) for a hospital with a medical assistance inpatient utilization rate above the 144.33arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 144.34federal Indian Health Service but less than or equal to one standard deviation above the 144.35mean, the adjustment must be determined by multiplying the total of the operating and 144.36property payment rates by the difference between the hospital's actual medical assistance 145.1inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 145.2treatment centers and facilities of the federal Indian Health Service;145.3    (2) for a hospital with a medical assistance inpatient utilization rate above one 145.4standard deviation above the mean, the adjustment must be determined by multiplying 145.5the adjustment that would be determined under clause (1) for that hospital by 1.1. The 145.6commissioner may establish a separate disproportionate population operating payment 145.7rate adjustment under the general assistance medical care program. For purposes of this 145.8subdivision, medical assistance does not include general assistance medical care. The 145.9commissioner shall report annually on the number of hospitals likely to receive the 145.10adjustment authorized by this paragraph. The commissioner shall specifically report on 145.11the adjustments received by public hospitals and public hospital corporations located 145.12in cities of the first class;145.13    (3) for a hospital that had medical assistance fee-for-service payment volume during 145.14calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service 145.15payment volume, a medical assistance disproportionate population adjustment shall be 145.16paid in addition to any other disproportionate payment due under this subdivision as 145.17follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. 145.18For a hospital that had medical assistance fee-for-service payment volume during calendar 145.19year 1991 in excess of eight percent of total medical assistance fee-for-service payment 145.20volume and was the primary hospital affiliated with the University of Minnesota, a 145.21medical assistance disproportionate population adjustment shall be paid in addition to any 145.22other disproportionate payment due under this subdivision as follows: $505,000 due on 145.23the 15th of each month after noon, beginning July 15, 1995; and145.24    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be 145.25reduced to zero.145.26    (c) The commissioner shall adjust rates paid to a health maintenance organization 145.27under contract with the commissioner to reflect rate increases provided in paragraph (b), 145.28clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those 145.29rates to reflect payments provided in clause (3).145.30    (d) If federal matching funds are not available for all adjustments under paragraph 145.31(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a 145.32pro rata basis so that all adjustments under paragraph (b) qualify for federal match.145.33    (e) For purposes of this subdivision, medical assistance does not include general 145.34assistance medical care.145.35    (f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, general 145.36assistance medical care expenditures for fee-for-service inpatient and outpatient hospital 146.1services made by the department and by prepaid health plans participating in general 146.2assistance medical careeffective July 1, 2007, payments under section 256B.199 shall be 146.3considered Medicaid disproportionate share hospital payments, except as limited below:146.4by clauses (1) to (5);146.5    (1) only the portion of Minnesota's disproportionate share hospital allotment under 146.6section 1923(f) of the Social Security Act that is not spent on the disproportionate 146.7population adjustments in paragraph (b), clauses (1) and (2), may be used for general 146.8assistance medical care expenditures;146.9    (2) only those general assistance medical care expenditures made to hospitals that 146.10qualify for disproportionate share payments under section 1923 of the Social Security Act 146.11and the Medicaid state plan may be considered disproportionate share hospital payments;146.12    (3) only those general assistance medical care expenditures made to an individual 146.13hospital that would not cause the hospital to exceed its individual hospital limits under 146.14section 1923 of the Social Security Act may be considered; and146.15    (4) general assistance medical care expenditures may be considered only to the 146.16extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.146.17All hospitals and prepaid health plans participating in general assistance medical care 146.18must provide any necessary expenditure, cost, and revenue information required by 146.19the commissioner as necessary for purposes of obtaining federal Medicaid matching 146.20funds for general assistance medical care expenditures. Medicaid disproportionate share 146.21payments; and146.22    (5) expenditures under general assistance medical care shall be used to the fullest 146.23extent before payments under section 256B.199.146.24    (g) Upon federal approval of the related state plan amendment, paragraph (f) is 146.25effective retroactively from July 1, 2005, or the earliest effective date approved by the 146.26Centers for Medicare and Medicaid Services.146.27    Sec. 5. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision 146.28to read:146.29    Subd. 28.Long-term hospital payment adjustment.For admissions occurring on 146.30or after July 1, 2009, the commissioner shall increase the medical assistance payments 146.31to a long-term hospital with a medical assistance inpatient utilization rate of 17.95 146.32percent of total patient days as of the base year in effect on July 1, 2005, by an amount 146.33equal to 13 percent of the total of the operating and property payment rates. Payments 146.34made to managed care plans shall not reflect this payment increase. For purposes of 146.35this subdivision, medical assistance does not include general assistance medical care. 147.1Payments to a hospital under this subdivision shall be reduced by the amount of any 147.2payments made under subdivision 27.147.3    Sec. 6. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:147.4    Subd. 14. Competitive bidding. (a) When determined to be effective, economical, 147.5and feasible, the commissioner may utilize volume purchase through competitive bidding 147.6and negotiation under the provisions of chapter 16C, to provide items under the medical 147.7assistance program including but not limited to the following:147.8    (1) eyeglasses;147.9    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency 147.10situation on a short-term basis, until the vendor can obtain the necessary supply from 147.11the contract dealer;147.12    (3) hearing aids and supplies; and147.13    (4) durable medical equipment, including but not limited to:147.14    (i) hospital beds;147.15    (ii) commodes;147.16    (iii) glide-about chairs;147.17    (iv) patient lift apparatus;147.18    (v) wheelchairs and accessories;147.19    (vi) oxygen administration equipment;147.20    (vii) respiratory therapy equipment;147.21    (viii) electronic diagnostic, therapeutic and life support systems;147.22    (5) specialnonemergency transportation services level of need determinations, 147.23disbursement of public transportation passes and tokens, and volunteer and recipient 147.24mileage and parking reimbursements; and147.25    (6) drugs.147.26    (b) Rate changes under this chapter and chapters 256D and 256L do not affect 147.27contract payments under this subdivision unless specifically identified.147.28    Sec. 7. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision 147.29to read:147.30    Subd. 14a.Level of need determination.Nonemergency medical transportation 147.31level of need determinations must be performed by a physician, a registered nurse working 147.32under direct supervision of a physician, a physician's assistant, a nurse practitioner, a 147.33licensed practical nurse, or a discharge planner. Nonemergency medical transportation 147.34level of need determinations must not be performed more than semiannually on any 148.1individual, unless the individual's circumstances have sufficiently changed so as to 148.2require a new level of need determination. Individuals residing in licensed nursing 148.3facilities and individuals requiring stretcher transportation are exempt from a level of need 148.4determination and are eligible for special transportation services until the individual no 148.5longer resides in a licensed nursing facility or no longer requires stretcher transportation.148.6    Sec. 8. Minnesota Statutes 2006, section 256B.055, subdivision 14, is amended to read:148.7    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an 148.8inmate of a correctional facility who is conditionally released as authorized under section 148.9241.26
         , 
         244.065, or 
         631.425, if the individual does not require the security of a public 148.10detention facility and is housed in a halfway house or community correction center, or 148.11under house arrest and monitored by electronic surveillance in a residence approved 148.12by the commissioner of corrections, and if the individual meets the other eligibility 148.13requirements of this chapter.148.14    (b) An individual who is enrolled in medical assistance, and who is charged with a 148.15crime and incarcerated in a local jail, workhouse, or juvenile correctional facility for less 148.16than 12 months shall be suspended from eligibility at the time of incarceration until the 148.17individual is released. Upon release, medical assistance eligibility is reinstated without 148.18reapplication, if the individual is otherwise eligible.148.19    (c) An individual, regardless of age, who is considered an inmate of a public 148.20institution as defined in Code of Federal Regulations, title 42, section 
         435.1009, is not 148.21eligible for medical assistance.148.22    Sec. 9. Minnesota Statutes 2006, section 256B.056, is amended by adding a 148.23subdivision to read:148.24    Subd. 1d.Treatment of certain monetary gifts.The commissioner shall disregard 148.25as income any portion of a monetary gift received by an applicant or enrollee that is 148.26designated to purchase a prosthetic device not covered by insurance, other third-party 148.27payers, or medical assistance.148.28    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to 148.29read:148.30    Subd. 3f. Circumcision for newborns.Newborn Circumcision is not covered, 148.31unless the procedure is medically necessary or required because of a well-established 148.32religious practice.149.1    Sec. 11. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 149.2subdivision to read:149.3    Subd. 8d.Chiropractic services.Medical assistance covers the following 149.4medically necessary chiropractic services: one initial or progress exam per year, manual 149.5manipulation of the spine, and x-rays.149.6EFFECTIVE DATE.This section is effective July 1, 2007.149.7    Sec. 12. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to 149.8read:149.9    Subd. 13c. Formulary committee. The commissioner, after receiving 149.10recommendations from professional medical associations and professional pharmacy 149.11associations, and consumer groups shall designate a Formulary Committee to carry 149.12out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be 149.13comprised of four licensed physicians actively engaged in the practice of medicine in 149.14Minnesota one of whom must be actively engaged in the treatment of persons with mental 149.15illness; at least three licensed pharmacists actively engaged in the practice of pharmacy 149.16in Minnesota; and one consumer representative; the remainder to be made up of health 149.17care professionals who are licensed in their field and have recognized knowledge in the 149.18clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs. 149.19Members of the Formulary Committee shall not be employed by the Department of 149.20Human Services, but the committee shall be staffed by an employee of the department 149.21who shall serve as an ex officio, nonvoting member of the board committee. The 149.22department's medical director shall also serve as an ex officio, nonvoting member for the 149.23committee. Committee members shall serve three-year terms and may be reappointed 149.24by the commissioner. The Formulary Committee shall meet at least quarterly. The 149.25commissioner may require more frequent Formulary Committee meetings as needed. An 149.26honorarium of $100 per meeting and reimbursement for mileage shall be paid to each 149.27committee member in attendance.149.28    Sec. 13. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to 149.29read:149.30    Subd. 13d. Drug formulary.(a) The commissioner shall establish a drug 149.31formulary. Its establishment and publication shall not be subject to the requirements of the 149.32Administrative Procedure Act, but the Formulary Committee shall review and comment 149.33on the formulary contents.149.34    (b) The formulary shall not include:150.1    (1) drugs or products for which there is no federal funding;150.2    (2) over-the-counter drugs, except as provided in subdivision 13;150.3    (3) drugs used for weight loss, except that medically necessary lipase inhibitors may 150.4be covered for a recipient with type II diabetes;150.5    (4) drugs when used for the treatment of impotence or erectile dysfunction;150.6    (5) drugs for which medical value has not been established; and150.7    (6) drugs from manufacturers who have not signed a rebate agreement with the 150.8Department of Health and Human Services pursuant to section 1927 of title XIX of the 150.9Social Security Act.150.10    (c) If a single-source drug used by at least two percent of the fee-for-service 150.11medical assistance recipients is removed from the formulary due to the failure of the 150.12manufacturer to sign a rebate agreement with the Department of Health and Human 150.13Services, the commissioner shall notify prescribing practitioners within 30 days of 150.14receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a 150.15rebate agreement was not signed.150.16EFFECTIVE DATE.This section is effective the day following final enactment.150.17    Sec. 14. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 150.18subdivision to read:150.19    Subd. 13i.Medicare Part D.Notwithstanding subdivision 13, paragraph (d), for 150.20recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare 150.21Advantage special needs plan, medical assistance covers co-payments which the recipient 150.22is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage 150.23special needs plan, once the recipient has paid $12 per month in prescription drug 150.24co-payments, and according to the requirements of the plan.150.25    Sec. 15. Minnesota Statutes 2006, section 256B.0625, subdivision 17, is amended to 150.26read:150.27    Subd. 17. Transportation costs. (a) Medical assistance covers transportation costs 150.28incurred solely for obtaining emergency medical care or transportation costs incurred 150.29by eligible persons in obtaining emergency or nonemergency medical care when paid 150.30directly to an ambulance company, common carrier, or other recognized providers of 150.31transportation services.150.32    (b) Medical assistance covers special transportation, as defined in Minnesota Rules, 150.33part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 151.1would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 151.2transportation, or private automobile.151.3The commissioner may use an order by the recipient's attending physician to certify that 151.4the recipient requires special transportation services. Special transportation includes 151.5driver-assisted service to eligible individuals. Driver-assisted service includes passenger 151.6pickup at and return to the individual's residence or place of business, assistance with 151.7admittance of the individual to the medical facility, and assistance in passenger securement 151.8or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers 151.9must obtain written documentation from the health care service provider who is serving 151.10the recipient being transported, identifying the time that the recipient arrived. Special 151.11transportation providers may not bill for separate base rates for the continuation of a trip 151.12beyond the original destination. Special transportation providers must take recipients 151.13to the nearest appropriate health care provider, using the most direct quickest route 151.14available as determined by a commercially available mileage software program approved 151.15by the commissioner. The maximum medical assistance reimbursement rates for special 151.16transportation services are:151.17    (1) $17 for the base rate and $1.35 $1.43 per mile for services to eligible persons 151.18who need a wheelchair-accessible van;151.19    (2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who 151.20do not need a wheelchair-accessible van; and151.21    (3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 151.22services to eligible persons who need a stretcher-accessible vehicle.151.23    Sec. 16. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 151.24read:151.25    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 151.26meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 151.27$6.50 for lunch, or $8 for dinner.151.28    (b) Medical assistance reimbursement for lodging for persons traveling to receive 151.29medical care may not exceed $50 per day unless prior authorized by the local agency.151.30    (c) Medical assistance direct mileage reimbursement to thean eligible person or the151.31an eligible person's driver may not exceed 20 cents per mile friend, neighbor, or relative 151.32that is providing direct transportation to a covered service shall be at 15 cents below the 151.33current Internal Revenue Service mileage reimbursement for business purposes.152.1    (d) Medical assistance covers oral language interpreter services when provided by 152.2an enrolled health care provider during the course of providing a direct, person-to-person 152.3covered health care service to an enrolled recipient with limited English proficiency.152.4    Sec. 17. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 152.5subdivision to read:152.6    Subd. 49.Community health worker.(a) Medical assistance covers the care 152.7coordination and patient education services provided by a community health worker if 152.8the community health worker has: 152.9    (1) received a certificate from the Minnesota State Colleges and Universities System 152.10approved community health worker curriculum; or152.11    (2) at least five years of supervised experience with an enrolled physician or 152.12advanced practice registered nurse.152.13Community health workers eligible for payment under clause (2) must complete the 152.14certification program by January 1, 2010, to continue to be eligible for payment.152.15    (b) Community health workers must work under the supervision of a medical 152.16assistance enrolled physician or advanced practice registered nurse.152.17    Sec. 18. Minnesota Statutes 2006, section 256B.0644, is amended to read:152.18256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 152.19PROGRAMS.152.20    (a) A vendor of medical care, as defined in section 
         256B.02, subdivision 7, and a 152.21health maintenance organization, as defined in chapter 62D, must participate as a provider 152.22or contractor in the medical assistance program, general assistance medical care program, 152.23and MinnesotaCare as a condition of participating as a provider in health insurance plans 152.24and programs or contractor for state employees established under section 
         43A.18, the 152.25public employees insurance program under section 
         43A.316, for health insurance plans 152.26offered to local statutory or home rule charter city, county, and school district employees, 152.27the workers' compensation system under section 
         176.135, and insurance plans provided 152.28through the Minnesota Comprehensive Health Association under sections 
         62E.01 to 152.2962E.19
         . The limitations on insurance plans offered to local government employees shall 152.30not be applicable in geographic areas where provider participation is limited by managed 152.31care contracts with the Department of Human Services. 152.32    (b) For providers other than health maintenance organizations, participation in the 152.33medical assistance program means that:153.1     (1) the provider accepts new medical assistance, general assistance medical care, 153.2and MinnesotaCare patients or;153.3    (2) for providers other than dental service providers, at least 20 percent of the 153.4provider's patients are covered by medical assistance, general assistance medical care, and 153.5MinnesotaCare as their primary source of coverage, or; or153.6    (3) for dental service providers, at least ten percent of the provider's patients are 153.7covered by medical assistance, general assistance medical care, and MinnesotaCare as 153.8their primary source of coverage, or the provider accepts new medical assistance and 153.9MinnesotaCare patients who are children with special health care needs. For purposes 153.10of this section, "children with special health care needs" means children up to age 18 153.11who: (i) require health and related services beyond that required by children generally; 153.12and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 153.13condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 153.14cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 153.15neurological diseases; visual impairment or deafness; Down syndrome and other genetic 153.16disorders; autism; fetal alcohol syndrome; and other conditions designated by the 153.17commissioner after consultation with representatives of pediatric dental providers and 153.18consumers. 153.19    (c) Patients seen on a volunteer basis by the provider at a location other than the 153.20provider's usual place of practice may be considered in meeting this the participation 153.21requirement in this section. The commissioner shall establish participation requirements 153.22for health maintenance organizations. The commissioner shall provide lists of 153.23participating medical assistance providers on a quarterly basis to the commissioner of 153.24employee relations, the commissioner of labor and industry, and the commissioner of 153.25commerce. Each of the commissioners shall develop and implement procedures to exclude 153.26as participating providers in the program or programs under their jurisdiction those 153.27providers who do not participate in the medical assistance program. The commissioner 153.28of employee relations shall implement this section through contracts with participating 153.29health and dental carriers. 153.30    Sec. 19. [256B.0751] CARE COORDINATION FOR CHILDREN WITH 153.31HIGH-COST MEDICAL 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 153.35high-cost medical conditions, and to perform the other duties specified in this section.154.1    (b) For purposes of this section, "care coordination" means collaboration with 154.2primary care physicians and specialists to manage care, development of medical 154.3management plans for recurrent acute illnesses, oversight and coordination of all aspects 154.4of care in partnership with families, organization of medical information into a summary 154.5of critical information, coordination and appropriate sequencing of tests and multiple 154.6appointments, information and assistance with accessing resources, and telephone triage 154.7for acute illnesses or problems.154.8    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer 154.9children to the U special kids program for care coordination. Beginning October 1, 2007, 154.10and subject to the limits on total program enrollment specified in subdivision 3, the 154.11commissioner shall refer to the U special kids program children who:154.12    (1) incur medical expenses that exceed the qualifying level specified in subdivision 3;154.13    (2) have medical conditions that involve four or more major systems; require 154.14multiple specialists; require use of technology such as G-tube, trach, central line, or 154.15oxygen; and require multiple medications;154.16    (3) do not have a medical case manager for cancer, organ transplantation, epilepsy, 154.17or bone marrow replacement; and154.18    (4) voluntarily agree to participate in the program.154.19    Subd. 3.Qualifying level of medical expenses.(a) For the period October 1, 2007, 154.20through September 30, 2008, the commissioner shall refer children for care coordination 154.21under this section if they incurred medical expenses of $500,000 or more during the 154.22fiscal year ending June 30, 2007.154.23    (b) For the period October 1, 2008, through September 30, 2009, the commissioner 154.24shall refer children for care coordination under this section if they incurred medical 154.25expenses of $400,000 or more during the fiscal year ending June 30, 2008.154.26    (c) For the period October 1, 2009, through September 30, 2010, the commissioner 154.27shall refer children for care coordination under this section if they incurred medical 154.28expenses of $300,000 or more during the fiscal year ending June 30, 2009.154.29    (d) Beginning October 1, 2010, the commissioner shall refer children for care 154.30coordination under this section if they incurred medical expenses of $250,000 or more 154.31during the previous fiscal year.154.32    (e) The commissioner shall limit referrals to the extent necessary to ensure that 154.33total enrollment in the U special kids program does not exceed 100 children for the 154.34period October 1, 2007, through September 30, 2008, and does not exceed 150 children 154.35beginning October 1, 2008.155.1    Subd. 4.Case management.Beginning October 1, 2007, the U special kids 155.2program shall coordinate all nonmedical case management services provided to children 155.3who are required to receive care coordination under this section. The program may 155.4require all nonmedical case managers, including, but not limited to, county case managers 155.5and case managers for children served under a home and community-based waiver, 155.6to submit care plans for approval, and to document client compliance with the care 155.7plans. The U special kids program, beginning October 1, 2008, may employ or contract 155.8with nonmedical case managers to provide all nonmedical case management services to 155.9children required to receive care coordination under this section. The commissioner shall 155.10reimburse the U special kids program for case management services through the medical 155.11assistance program.155.12    Subd. 5.Statewide availability of care coordination.The U special kids program 155.13may contract with other entities to provide care coordination services as defined in 155.14subdivision 1, in order to ensure the availability of these services in all regions of the state.155.15    Subd. 6.Advance practice nurse telephone triage system.The U special kids 155.16program shall establish and operate an advance practice nurse telephone triage system that 155.17is available statewide, 24 hours a day, seven days per week. The system must provide 155.18advance practice nurses with access to a Web-based information system to appropriately 155.19triage medical problems, manage care, and reduce unnecessary hospitalizations.155.20    Subd. 7.Monitoring and evaluation.The commissioner shall monitor program 155.21outcomes and evaluate the extent to which referrals to the U special kids program have 155.22improved the quality and coordination of care and provided financial savings to the 155.23medical assistance program. The U special kids program shall submit to the commissioner, 155.24in the form and manner specified by the commissioner, all data and information necessary 155.25to monitor program outcomes and evaluate the program. The commissioner shall present a 155.26preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 155.27legislature by January 15, 2010.155.28EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 155.29approval, whichever is later.155.30    Sec. 20. [256B.0752] CARE COORDINATION FOR CHILDREN WITH 155.31HIGH-COST MENTAL HEALTH CONDITIONS.155.32    Subdivision 1.Care coordination required.(a) The commissioner of human 155.33services shall contract with the U special kids program to provide care coordination, 155.34beginning October 1, 2007, for medical assistance enrollees who are children with 156.1high-cost mental health conditions and behavioral problems, and to perform the other 156.2duties specified in this section.156.3    (b) For purposes of this section, "care coordination" means: collaboration with 156.4primary care physicians and specialists to manage care; development of mental health 156.5management plans for recurrent mental health issues; oversight and coordination of all 156.6aspects of care in partnership with families; organization of medical, treatment, and 156.7therapy information into a summary of critical information; coordination and appropriate 156.8sequencing of evaluations and multiple appointments; information and assistance with 156.9accessing resources; and telephone triage for behavior or other problems.156.10    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer children 156.11to the program for care coordination. Beginning October 1, 2007, and subject to the limits 156.12on total program enrollment specified in subdivision 3, the commissioner shall refer to 156.13the U special kids program children who:156.14    (1) incur mental health expenses that exceed the qualifying level specified in 156.15subdivision 3;156.16    (2) are currently receiving or at risk of needing inpatient mental health treatment, 156.17foster home care, or both; and156.18    (3) voluntarily agree to participate in the program.156.19    Subd. 3.Qualifying level of medical expenses.(a) Beginning October 1, 2007, the 156.20commissioner shall refer children for care coordination under this section if they incurred 156.21medical and mental health expenses of $250,000 or more in the previous fiscal year.156.22    (b) The commissioner shall limit referrals to the extent necessary to ensure that total 156.23enrollment in the U special kids program does not exceed 25 children for the period 156.24October 1, 2007, through September 30, 2008; does not exceed 75 children for the 156.25period October 1, 2008, through September 30, 2009; and does not exceed 125 children 156.26beginning October 1, 2009.156.27    Subd. 4.Case management.The U special kids program, beginning October 1, 156.282007, shall coordinate all nonmedical case management services provided to children who 156.29are required to receive care coordination under this section. The program may require all 156.30nonmedical case managers, including but not limited to county case managers and case 156.31managers for children served under a home and community-based waiver, to submit care 156.32plans for approval, and to document client compliance with the care plans. The U special 156.33kids program, beginning October 1, 2008, may employ or contract with nonmedical case 156.34managers to provide all nonmedical case management services to children required to 156.35receive care coordination under this section. The commissioner shall reimburse the 157.1U special kids program for case management services through the medical assistance 157.2program.157.3    Subd. 5.Statewide availability of care coordination.The program may contract 157.4with other entities to provide care coordination services as defined in subdivision 1, in 157.5order to ensure the availability of these services in all regions of the state.157.6    Subd. 6.Monitoring and evaluation.The commissioner shall monitor program 157.7outcomes and shall evaluate the extent to which referrals to the U special kids program 157.8have improved the quality and coordination of care and provided financial savings to the 157.9medical assistance program. The U special kids program shall submit to the commissioner, 157.10in the form and manner specified by the commissioner, all data and information necessary 157.11to monitor program outcomes and evaluate the program. The commissioner shall present a 157.12preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 157.13legislature by January 15, 2010.157.14EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 157.15approval, whichever is later. The commissioner shall notify the Office of the Revisor of 157.16Statutes when federal approval is obtained.157.17    Sec. 21. [256B.194] FEDERAL PAYMENTS.157.18    Subdivision 1.Payments at actual cost.If the Centers for Medicare & Medicaid 157.19Services (CMS) promulgates a final rule consistent with its stated intent in the proposed 157.20rule published at 72 Federal Register, No. 11, January 18, 2007, regarding limiting 157.21payments to units of government, and notwithstanding Minnesota Statutes or Minnesota 157.22Rules to the contrary, for providers that are units of government, the commissioner may 157.23limit medical assistance and MinnesotaCare payments to a provider's actual cost of 157.24providing services, in accordance with the CMS final rule. If a final rule is promulgated, 157.25the commissioner may also require medical assistance and MinnesotaCare providers to 157.26provide any information necessary to determine Medicaid-related costs, and require the 157.27cooperation of providers in any audit or review necessary to ensure payments are limited 157.28to cost. This section does not apply to providers who are exempt from the provisions of 157.29the CMS final rule.157.30    Subd. 2.Loss of federal financial participation.For all transfers, certified 157.31expenditures, and medical assistance payments listed below, if the commissioner 157.32determines that federal financial participation is no longer available for the medical 157.33assistance payments listed, then related obligations for the nonfederal share of payments 157.34and the medical assistance payments shall terminate. The commissioner shall notify all 157.35affected parties of the loss of federal financial participation, and the resulting payments 158.1and obligations that are terminated. If the commissioner determines that federal financial 158.2participation is no longer available for any medical assistance payments or contributions 158.3to the nonfederal share of medical assistance payments that have already been made, the 158.4commissioner may collect the medical assistance payments from providers and return 158.5contributions of the nonfederal share to its source. The transfers, certified expenditures, 158.6and medical assistance payments subject to this section are those specified in: sections 158.762J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d; 158.8256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses 158.9(2), (3), and (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws 158.102005, First Special Session chapter 4, article 9, section 2, subdivision 1.158.11    Sec. 22. Minnesota Statutes 2006, section 256B.199, is amended to read:158.12256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.158.13    (a) Hennepin County,and Hennepin County Medical Center, Ramsey County, 158.14Regions Hospital, the University of Minnesota, and Fairview-University Medical Center158.15shall report quarterly to the commissioner beginning June 1, 2007, payments made during 158.16the second previous quarter that may qualify for reimbursement under federal law.158.17    (b) Based on these reports, the commissioner shall apply for federal matching funds. 158.18These funds are appropriated to the commissioner for the payments under section 256.969, 158.19subdivision 27 to Hennepin County Medical Center.158.20    (c) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform 158.21the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 158.22hospital payment money expected to be available in the current federal fiscal year.158.23    (d) This section sunsets on June 30, 2009. The commissioner shall report to 158.24the legislature by December 15, 2008, with recommendations for maximizing federal 158.25disproportionate share hospital payments after June 30, 2009.158.26    Sec. 23. Minnesota Statutes 2006, section 256B.75, is amended to read:158.27256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.158.28    (a) For outpatient hospital facility fee payments for services rendered on or after 158.29October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted 158.30charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those 158.31services for which there is a federal maximum allowable payment. Effective for services 158.32rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital 158.33facility fees and emergency room facility fees shall be increased by eight percent over the 158.34rates in effect on December 31, 1999, except for those services for which there is a federal 159.1maximum allowable payment. Services for which there is a federal maximum allowable 159.2payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum 159.3allowable payment. Total aggregate payment for outpatient hospital facility fee services 159.4shall not exceed the Medicare upper limit. If it is determined that a provision of this 159.5section conflicts with existing or future requirements of the United States government with 159.6respect to federal financial participation in medical assistance, the federal requirements 159.7prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to 159.8avoid reduced federal financial participation resulting from rates that are in excess of 159.9the Medicare upper limitations.159.10    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and 159.11ambulatory surgery hospital facility fee services for critical access hospitals designated 159.12under section 
         144.1483, clause (10), shall be paid on a cost-based payment system that 159.13is based on the cost-finding methods and allowable costs of the Medicare program. All 159.14hospital outpatient services provided by any hospital exclusively devoted to the care of 159.15pediatric patients under age 21 that is located in a Minnesota metropolitan statistical area 159.16must be paid for using the methodology established for critical access hospitals at a rate 159.17equal to fee-for-service rates plus 46 percent, as limited by allowable costs.159.18    (c) Effective for services provided on or after July 1, 2003, rates that are based 159.19on the Medicare outpatient prospective payment system shall be replaced by a budget 159.20neutral prospective payment system that is derived using medical assistance data. The 159.21commissioner shall provide a proposal to the 2003 legislature to define and implement 159.22this provision.159.23    (d) For fee-for-service services provided on or after July 1, 2002, the total payment, 159.24before third-party liability and spenddown, made to hospitals for outpatient hospital 159.25facility services is reduced by .5 percent from the current statutory rate.159.26    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 159.27services provided on or after July 1, 2003, made to hospitals for outpatient hospital 159.28facility services before third-party liability and spenddown, is reduced five percent from 159.29the current statutory rates. Facilities defined under section 
         256.969, subdivision 16, are 159.30excluded from this paragraph.159.31EFFECTIVE DATE.This section is effective July 1, 2007, and applies to services 159.32provided on or after that date.159.33    Sec. 24. Minnesota Statutes 2006, section 256B.76, is amended to read:159.34256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.160.1    (a) Effective for services rendered on or after October 1, 1992, the commissioner 160.2shall make payments for physician services as follows:160.3    (1) payment for level one Centers for Medicare and Medicaid Services' common 160.4procedural coding system codes titled "office and other outpatient services," "preventive 160.5medicine new and established patient," "delivery, antepartum, and postpartum care," 160.6"critical care," cesarean delivery and pharmacologic management provided to psychiatric 160.7patients, and level three codes for enhanced services for prenatal high risk, shall be paid 160.8at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 160.930, 1992. If the rate on any procedure code within these categories is different than the 160.10rate that would have been paid under the methodology in section 
         256B.74, subdivision 2, 160.11then the larger rate shall be paid; 160.12    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 160.13or (ii) 15.4 percent above the rate in effect on June 30, 1992;160.14    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 160.15percentile of 1989, less the percent in aggregate necessary to equal the above increases 160.16except that payment rates for home health agency services shall be the rates in effect 160.17on September 30, 1992;160.18    (4) effective for services rendered on or after January 1, 2000, payment rates for 160.19physician and professional services shall be increased by three percent over the rates in 160.20effect on December 31, 1999, except for home health agency and family planning agency 160.21services; and160.22    (5) the increases in clause (4) shall be implemented January 1, 2000, for managed 160.23care.160.24    (b) Effective for services rendered on or after October 1, 1992, the commissioner 160.25shall make payments for dental services as follows:160.26    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 160.27percent above the rate in effect on June 30, 1992;160.28    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 160.29percentile of 1989, less the percent in aggregate necessary to equal the above increases;160.30    (3) effective for services rendered on or after January 1, 2000, payment rates for 160.31dental services shall be increased by three percent over the rates in effect on December 160.3231, 1999;160.33    (4) the commissioner shall award grants to community clinics or other nonprofit 160.34community organizations, political subdivisions, professional associations, or other 160.35organizations that demonstrate the ability to provide dental services effectively to public 160.36program recipients. Grants may be used to fund the costs related to coordinating access for 161.1recipients, developing and implementing patient care criteria, upgrading or establishing 161.2new facilities, acquiring furnishings or equipment, recruiting new providers, or other 161.3development costs that will improve access to dental care in a region. In awarding grants, 161.4the commissioner shall give priority to applicants that plan to serve areas of the state in 161.5which the number of dental providers is not currently sufficient to meet the needs of 161.6recipients of public programs or uninsured individuals. The commissioner shall consider 161.7the following in awarding the grants:161.8    (i) potential to successfully increase access to an underserved population;161.9    (ii) the ability to raise matching funds;161.10    (iii) the long-term viability of the project to improve access beyond the period 161.11of initial funding;161.12    (iv) the efficiency in the use of the funding; and161.13    (v) the experience of the proposers in providing services to the target population.161.14    The commissioner shall monitor the grants and may terminate a grant if the grantee 161.15does not increase dental access for public program recipients. The commissioner shall 161.16consider grants for the following:161.17    (i) implementation of new programs or continued expansion of current access 161.18programs that have demonstrated success in providing dental services in underserved 161.19areas;161.20    (ii) a pilot program for utilizing hygienists outside of a traditional dental office to 161.21provide dental hygiene services; and161.22    (iii) a program that organizes a network of volunteer dentists, establishes a system to 161.23refer eligible individuals to volunteer dentists, and through that network provides donated 161.24dental care services to public program recipients or uninsured individuals;161.25    (5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 161.26shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;161.27    (6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, 161.28for managed care; and161.29    (7) effective for services provided on or after January 1, 2002, payment for 161.30diagnostic examinations and dental x-rays provided to children under age 21 shall be the 161.31lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.161.32    (c) Effective for dental services rendered on or after January 1, 2002, the 161.33commissioner may, within the limits of available appropriation, increase reimbursements 161.34to dentists and dental clinics deemed by the commissioner to be critical access dental 161.35providers. Reimbursement to a critical access dental provider may be increased by not 161.36more than 50 percent above the reimbursement rate that would otherwise be paid to the 162.1provider. Payments toFor dental services rendered after June 30, 2007, the commissioner 162.2shall increase reimbursement by 33 percent above the reimbursement rate that would 162.3otherwise be paid to the provider. The commissioner shall pay the health plan companies 162.4shall be adjustedin amounts sufficient to reflect increased reimbursements to critical 162.5access dental providers as approved by the commissioner. In determining which dentists 162.6and dental clinics shall be deemed critical access dental providers, the commissioner 162.7shall review:162.8    (1) the utilization rate in the service area in which the dentist or dental clinic operates 162.9for dental services to patients covered by medical assistance, general assistance medical 162.10care, or MinnesotaCare as their primary source of coverage;162.11    (2) the level of services provided by the dentist or dental clinic to patients covered 162.12by medical assistance, general assistance medical care, or MinnesotaCare as their primary 162.13source of coverage; and162.14    (3) whether the level of services provided by the dentist or dental clinic is critical to 162.15maintaining adequate levels of patient access within the service area.162.16In the absence of a critical access dental provider in a service area, the commissioner may 162.17designate a dentist or dental clinic as a critical access dental provider if the dentist or 162.18dental clinic is willing to provide care to patients covered by medical assistance, general 162.19assistance medical care, or MinnesotaCare at a level which significantly increases access 162.20to dental care in the service area.162.21    The commissioner shall annually establish a reimbursement schedule for critical 162.22access dental providers and provider-specific limits on total reimbursement received 162.23under the reimbursement schedule, and shall notify each critical access dental provider 162.24of the schedule and limit.162.25    (d) An entity that operates both a Medicare certified comprehensive outpatient 162.26rehabilitation facility and a facility which was certified prior to January 1, 1993, that is 162.27licensed under Minnesota Rules, parts 
         9570.2000 to 
         9570.3600, and for whom at least 33 162.28percent of the clients receiving rehabilitation services in the most recent calendar year are 162.29medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation 162.30services at rates that are 38 percent greater than the maximum reimbursement rate 162.31allowed under paragraph (a), clause (2), when those services are (1) provided within the 162.32comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing 162.33facilities owned by the entity.162.34    (e) Effective for services rendered on or after January 1, 2007, the commissioner 162.35shall make payments for physician and professional services based on the Medicare 163.1relative value units (RVU's). This change shall be budget neutral and the cost of 163.2implementing RVU's will be incorporated in the established conversion factor.163.3    Sec. 25. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:163.4    Subd. 4. General assistance medical care; services. (a)(i) For a person who is 163.5eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 163.6care covers, except as provided in paragraph (c):163.7    (1) inpatient hospital services;163.8    (2) outpatient hospital services;163.9    (3) services provided by Medicare certified rehabilitation agencies;163.10    (4) prescription drugs and other products recommended through the process 163.11established in section 
         256B.0625, subdivision 13;163.12    (5) equipment necessary to administer insulin and diagnostic supplies and equipment 163.13for diabetics to monitor blood sugar level;163.14    (6) eyeglasses and eye examinations provided by a physician or optometrist;163.15    (7) hearing aids;163.16    (8) prosthetic devices;163.17    (9) laboratory and X-ray services;163.18    (10) physician's services;163.19    (11) medical transportation except special transportation;163.20    (12) chiropractic services as covered under the medical assistance program;163.21    (13) podiatric services;163.22    (14) dental services as covered under the medical assistance program;163.23    (15) outpatient services provided by a mental health center or clinic that is under 163.24contract with the county board and is established under section 
         245.62;163.25    (16) day treatment services for mental illness provided under contract with the 163.26county board;163.27    (17) prescribed medications for persons who have been diagnosed as mentally ill as 163.28necessary to prevent more restrictive institutionalization;163.29    (18) psychological services, medical supplies and equipment, and Medicare 163.30premiums, coinsurance and deductible payments;163.31    (19) medical equipment not specifically listed in this paragraph when the use of 163.32the equipment will prevent the need for costlier services that are reimbursable under 163.33this subdivision;163.34    (20) services performed by a certified pediatric nurse practitioner, a certified family 163.35nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 164.1nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 164.2practitioner in independent practice, if (1) the service is otherwise covered under this 164.3chapter as a physician service, (2) the service provided on an inpatient basis is not included 164.4as part of the cost for inpatient services included in the operating payment rate, and (3) the 164.5service is within the scope of practice of the nurse practitioner's license as a registered 164.6nurse, as defined in section 
         148.171;164.7    (21) services of a certified public health nurse or a registered nurse practicing in 164.8a public health nursing clinic that is a department of, or that operates under the direct 164.9authority of, a unit of government, if the service is within the scope of practice of the 164.10public health nurse's license as a registered nurse, as defined in section 
         148.171;164.11    (22) telemedicine consultations, to the extent they are covered under section 164.12256B.0625, subdivision 3b
         ; and164.13    (23) mental health telemedicine and psychiatric consultation as covered under 164.14section 
         256B.0625, subdivisions 46 and 48.;164.15    (24) care coordination and patient education services provided by a community 164.16health worker according to section 256B.0625, subdivision 49; and164.17    (25) regardless of the number of employees that an enrolled health care provider 164.18may have, sign language interpreter services when provided by an enrolled health care 164.19provider during the course of providing a direct, person-to-person covered health care 164.20service to an enrolled recipient who has a hearing loss and uses interpreting services.164.21    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 164.22paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 164.23to inpatient hospital services, including physician services provided during the inpatient 164.24hospital stay. A $1,000 deductible is required for each inpatient hospitalization.164.25    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this 164.26subdivision.164.27    (c) In order to contain costs, the commissioner of human services shall select 164.28vendors of medical care who can provide the most economical care consistent with high 164.29medical standards and shall where possible contract with organizations on a prepaid 164.30capitation basis to provide these services. The commissioner shall consider proposals by 164.31counties and vendors for prepaid health plans, competitive bidding programs, block grants, 164.32or other vendor payment mechanisms designed to provide services in an economical 164.33manner or to control utilization, with safeguards to ensure that necessary services are 164.34provided. Before implementing prepaid programs in counties with a county operated or 164.35affiliated public teaching hospital or a hospital or clinic operated by the University of 164.36Minnesota, the commissioner shall consider the risks the prepaid program creates for the 165.1hospital and allow the county or hospital the opportunity to participate in the program in a 165.2manner that reflects the risk of adverse selection and the nature of the patients served by 165.3the hospital, provided the terms of participation in the program are competitive with the 165.4terms of other participants considering the nature of the population served. Payment for 165.5services provided pursuant to this subdivision shall be as provided to medical assistance 165.6vendors of these services under sections 
         256B.02, subdivision 8, and 
         256B.0625. For 165.7payments made during fiscal year 1990 and later years, the commissioner shall consult 165.8with an independent actuary in establishing prepayment rates, but shall retain final control 165.9over the rate methodology.165.10    (d) Effective January 1, 2008, drug coverage under general assistance medical care 165.11is limited to prescription drugs that:165.12    (i) are covered under the medical assistance program as described in section 165.13256B.0625, subdivisions 13 and 13d; and165.14    (ii) are provided by manufacturers that have fully executed general assistance 165.15medical care rebate agreements with the commissioner and comply with the agreements. 165.16Prescription drug coverage under general assistance medical care must conform to 165.17coverage under the medical assistance program according to section 256B.0625, 165.18subdivisions 13 to 13g.165.19    (d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 165.20co-payments for services provided on or after October 1, 2003:165.21    (1) $25 for eyeglasses;165.22    (2) $25 for nonemergency visits to a hospital-based emergency room;165.23    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, 165.24subject to a $12 per month maximum for prescription drug co-payments. No co-payments 165.25shall apply to antipsychotic drugs when used for the treatment of mental illness; and165.26    (4) 50 percent coinsurance on restorative dental services.165.27    (e) (f) Co-payments shall be limited to one per day per provider for nonpreventive 165.28visits, eyeglasses, and nonemergency visits to a hospital-based emergency room. 165.29Recipients of general assistance medical care are responsible for all co-payments in this 165.30subdivision. The general assistance medical care reimbursement to the provider shall be 165.31reduced by the amount of the co-payment, except that reimbursement for prescription 165.32drugs shall not be reduced once a recipient has reached the $12 per month maximum for 165.33prescription drug co-payments. The provider collects the co-payment from the recipient. 165.34Providers may not deny services to recipients who are unable to pay the co-payment, 165.35except as provided in paragraph (f).166.1    (f) (g) If it is the routine business practice of a provider to refuse service to an 166.2individual with uncollected debt, the provider may include uncollected co-payments 166.3under this section. A provider must give advance notice to a recipient with uncollected 166.4debt before services can be denied.166.5    (g) (h) Any county may, from its own resources, provide medical payments for 166.6which state payments are not made.166.7    (h) (i) Chemical dependency services that are reimbursed under chapter 254B must 166.8not be reimbursed under general assistance medical care.166.9    (i) (j) The maximum payment for new vendors enrolled in the general assistance 166.10medical care program after the base year shall be determined from the average usual and 166.11customary charge of the same vendor type enrolled in the base year.166.12    (j) (k) The conditions of payment for services under this subdivision are the same 166.13as the conditions specified in rules adopted under chapter 256B governing the medical 166.14assistance program, unless otherwise provided by statute or rule.166.15    (k) (l) Inpatient and outpatient payments shall be reduced by five percent, effective 166.16July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 166.172003, and incorporated by reference in paragraph (i).166.18    (l) (m) Payments for all other health services except inpatient, outpatient, and 166.19pharmacy services shall be reduced by five percent, effective July 1, 2003.166.20    (m) (n) Payments to managed care plans shall be reduced by five percent for services 166.21provided on or after October 1, 2003.166.22    (n) (o) A hospital receiving a reduced payment as a result of this section may apply 166.23the unpaid balance toward satisfaction of the hospital's bad debts.166.24    (o) (p) Fee-for-service payments for nonpreventive visits shall be reduced by $3 166.25for services provided on or after January 1, 2006. For purposes of this subdivision, a 166.26visit means an episode of service which is required because of a recipient's symptoms, 166.27diagnosis, or established illness, and which is delivered in an ambulatory setting by 166.28a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 166.29audiologist, optician, or optometrist.166.30    (p) (q) Payments to managed care plans shall not be increased as a result of the 166.31removal of the $3 nonpreventive visit co-payment effective January 1, 2006.166.32    Sec. 26. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:166.33    Subd. 4. Gross individual or gross family income. (a) "Gross individual or gross 166.34family income" for nonfarm self-employed means income calculated for the six-month 166.35period of eligibility using the net profit or loss reported on the applicant's federal income 167.1tax form for the previous year and using the medical assistance families with children 167.2methodology for determining allowable and nonallowable self-employment expenses and 167.3countable income.167.4    (b) "Gross individual or gross family income" for farm self-employed means income 167.5calculated for the six-month period of eligibility using as the baseline the adjusted gross 167.6income reported on the applicant's federal income tax form for the previous year and 167.7adding back in reported depreciation amounts that apply to the business in which the 167.8family is currently engaged.167.9    (c) "Gross individual or gross family income" means the total income for all family 167.10members, calculated for the six-month period of eligibility.167.11EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal 167.12approval, whichever is later.167.13    Sec. 27. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:167.14    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 167.15and (c), the MinnesotaCare benefit plan shall include the following co-payments and 167.16coinsurance requirements for all enrollees:167.17    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 167.18subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 167.19$3,000 per family;167.20    (2) $3 per prescription for adult enrollees;167.21    (3) $25 for eyeglasses for adult enrollees;167.22    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 167.23episode of service which is required because of a recipient's symptoms, diagnosis, or 167.24established illness, and which is delivered in an ambulatory setting by a physician or 167.25physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 167.26audiologist, optician, or optometrist; and167.27    (5) $6 for nonemergency visits to a hospital-based emergency room.167.28    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 167.29children under the age of 21 in households with family income equal to or less than 175 167.30percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 167.31parents and relative caretakers of children under the age of 21 in households with family 167.32income greater than 175 percent of the federal poverty guidelines for inpatient hospital 167.33admissions occurring on or after January 1, 2001.167.34    (c) Paragraph (a), clauses (1) to (4), dodoes not apply to pregnant women and 167.35children under the age of 21.168.1    (d) Adult enrollees with family gross income that exceeds 175 percent of the 168.2federal poverty guidelines and who are not pregnant shall be financially responsible for 168.3the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 168.4hospital benefit limit.168.5    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 168.6or changes from one prepaid health plan to another during a calendar year, any charges 168.7submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 168.8expenses incurred by the enrollee for inpatient services, that were submitted or incurred 168.9prior to enrollment, or prior to the change in health plans, shall be disregarded.168.10    Sec. 28. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:168.11    Subdivision 1. Families with children. (a) Families with children with family 168.12income equal to or less than 275 percent of the federal poverty guidelines for the 168.13applicable family size shall be eligible for MinnesotaCare according to this section. All 168.14other provisions of sections 
         256L.01 to 
         256L.18, including the insurance-related barriers 168.15to enrollment under section 
         256L.07, shall apply unless otherwise specified. 168.16    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, 168.17if the children are eligible. Children may be enrolled separately without enrollment by 168.18parents. However, if one parent in the household enrolls, both parents must enroll, unless 168.19other insurance is available. If one child from a family is enrolled, all children must 168.20be enrolled, unless other insurance is available. If one spouse in a household enrolls, 168.21the other spouse in the household must also enroll, unless other insurance is available. 168.22Families cannot choose to enroll only certain uninsured members.168.23    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies 168.24to the MinnesotaCare program. These persons are no longer counted in the parental 168.25household and may apply as a separate household.168.26    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents 168.27are not eligible for MinnesotaCare if their gross income exceeds $50,000 $25,000 for the 168.28six-month period of eligibility.168.29    Sec. 29. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:168.30    Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing 168.31in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee 168.32residing in a correctional or detention facility is not eligible at renewal of eligibility under 168.33section 
         256L.05, subdivision 3b 3a.169.1    Sec. 30. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:169.2    Subd. 7. Critical access dental providers. Effective for dental services provided 169.3to MinnesotaCare enrollees on or afterbetween January 1, 2007, and June 30, 2007, the 169.4commissioner shall increase payment rates to dentists and dental clinics deemed by the 169.5commissioner to be critical access providers under section 
         256B.76, paragraph (c), by 50 169.6percent above the payment rate that would otherwise be paid to the provider. Effective 169.7for dental services provided to MinnesotaCare enrollees on or after July 1, 2007, the 169.8commissioner shall increase payment rates to dentists and dental clinics deemed by the 169.9commissioner to be critical access providers under section 256B.76, paragraph (c), by 169.1033 percent above the payment rate that would otherwise be paid to the provider. The 169.11commissioner shall adjust the rates paid on or after January 1, 2007, topay the prepaid 169.12health plans under contract with the commissioner amounts sufficient to reflect this rate 169.13increase. The prepaid health plan must pass this rate increase to providers who have 169.14been identified by the commissioner as critical access dental providers under section 169.15256B.76
         , paragraph (c).169.16    Sec. 31. HENNEPIN COUNTY PILOT PROJECT.169.17    The commissioner of human services shall support a pilot project in Hennepin 169.18County to demonstrate the effectiveness of alternative strategies to redetermine eligibility 169.19for certain recipient populations in the medical assistance program. The target populations 169.20for the demonstration are persons who are eligible based upon disability or age, who have 169.21chronic medical conditions, and who are expected to experience minimal change in income 169.22or assets from month to month. The commissioner and the county shall analyze the issues 169.23and strategies employed and the outcomes to determine reasonable efforts to streamline 169.24eligibility statewide. The duration of the pilot project shall be no more than two years. 169.25The commissioner shall apply for any federal waivers needed to implement this section.169.26    Sec. 32. COUNTY-BASED PURCHASING STUDY.169.27    The commissioner of health shall study county-based purchasing initiatives 169.28established under Minnesota Statutes, section 256B.692, and compare these initiatives 169.29to managed care plans serving medical assistance, general assistance medical care, and 169.30MinnesotaCare enrollees. The study must:169.31    (1) provide a history and description of county-based purchasing initiatives, 169.32including state and federal requirements and any federal waivers Minnesota counties have 169.33applied for or received;170.1    (2) provide a history and description of managed care plan participation in the 170.2prepaid medical assistance, prepaid general assistance medical care, and prepaid 170.3Minnesota programs, and the provision by managed care plans of third-party administrator 170.4services for county-based purchasing initiatives;170.5    (3) provide relevant data, including limitations on data, data that was requested but 170.6not received, and explanations for why requested data was not received;170.7    (4) provide recommendations for further data collection and research;170.8    (5) summarize successes and challenges of the two service delivery methods;170.9    (6) provide recommendations for possible expansion of county-based purchasing 170.10in rural and urban settings; and170.11    (7) identify and describe features of county-based purchasing and managed care 170.12plans serving medical assistance, general assistance medical care, and MinnesotaCare 170.13enrollees, to provide a comparison of cost, quality, access, and community health 170.14improvement that includes, but is not limited to:170.15    (i) descriptions of how health care and social services are integrated and coordinated 170.16for persons with complex care needs, including persons with high-risk pregnancies, 170.17adolescents, persons who are disabled, persons who are elderly, and persons with chronic 170.18health care and social needs;170.19    (ii) use of monetary grants and surpluses to:170.20    (A) increase provider reimbursement, including dental care reimbursement, in order 170.21to improve health care access; and170.22    (B) improve community health beyond the requirements of the public health care 170.23programs, such as the funding of public education, research, and community initiatives to 170.24enhance utilization of preventive services, social services, or mental health care;170.25    (iii) administrative costs, including billing and collection of unpaid fees, co-pays or 170.26other charges, and top five management salaries;170.27    (iv) reporting requirements of contracts with the Department of Human Services;170.28    (v) public access to all information about management and administration, including 170.29but not limited to provider contracts and reimbursement, models of care management and 170.30coordination, utilization review, contracts with consultants and other vendors, handling of 170.31monetary grants and surpluses, and health outcomes data;170.32    (vi) provider reimbursement by clinical practice area;170.33    (vii) populations served, described by age, disability, income, race, language, 170.34occupation, and other demographic characteristics;170.35    (viii) utilization of community-based prevention interventions, including but not 170.36limited to public health nursing visits to new parents, use of nurse-managed interventions 171.1to reduce cardiac hospitalizations, and the use of medical homes for chronic disease 171.2management;171.3    (ix) utilization of cancer screening;171.4    (x) utilization of interpreter services;171.5    (xi) immunization rates for children age five and under;171.6    (xii) hospitalization rates for conditions related to diabetes, asthma, or cardiac 171.7illnesses;171.8    (xiii) rates of rehospitalization within a month of hospital discharge;171.9    (xiv) coordination with county agencies to increase enrollment;171.10    (xv) number of new program enrollees and the rate of enrollment, including the 171.11percentage of eligible persons who become enrollees;171.12    (xvi) enrollee satisfaction with their care; and171.13    (xvii) number of enrollees who do not receive care.171.14    Managed care plans, county-based purchasing initiatives, health care providers, 171.15counties, and the commissioner of human services shall, upon request, provide data to 171.16the commissioner of health that is necessary to complete the study. The commissioner of 171.17health shall submit the study to the legislature by December 31, 2007.171.18    Sec. 33. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.171.19    The commissioner of human services shall award a grant to the Neighborhood 171.20Health Care Network to pay the costs of maintaining and staffing a toll-free telephone 171.21number to provide callers with information on health coverage options, eligibility for 171.22MinnesotaCare and other health care programs, and health care providers that offer free or 171.23reduced-cost health care services.171.24    Sec. 34. IMPLEMENTATION OF PHARMACY DISPENSING FEE INCREASE.171.25    The commissioner of human services, after consulting with the Pharmacy Payment 171.26Reform Advisory Committee established under Laws 2006, chapter 282, article 16, section 171.2715, may proportionally increase or decrease the dispensing fee for multiple-source generic 171.28drugs under Minnesota Statutes, section 256B.0625, subdivision 13e, paragraph (a), to 171.29reflect the actual amount of reductions in program cost for ingredient reimbursement 171.30savings obtained. The commissioner of human services shall seek federal matching funds 171.31to further increase the dispensing fee to cover the cost of dispensing, up to a maximum 171.32dispensing fee of $12.92.172.1EFFECTIVE DATE.This section is effective upon implementation of changes to 172.2the federal upper reimbursement limit under title VI, chapter IV of the federal Deficit 172.3Reduction Act of 2005, United States Code, title 42, section 1396r-8(e)(5).172.4    Sec. 35. PHARMACY STUDIES.172.5    Subdivision 1.Fiscal impact of deficit reduction act.The commissioner of 172.6human services shall report to the legislature by January 1, 2008, on the fiscal impact of 172.7Deficit Reduction Act reforms on the Minnesota Medicaid pharmacy program, including 172.8but not limited to:172.9    (1) overall cost reductions to the Minnesota Medicaid pharmacy program as a result 172.10of the Deficit Reduction Act of 2005;172.11    (2) the impact of reforms on the federal upper limit on pharmacy reimbursement, 172.12and the amount that the dispensing fee for multiple-source generic drugs would have to 172.13be adjusted to offset any reductions resulting from federal upper limits implemented as a 172.14result of the Deficit Reduction Act of 2005;172.15    (3) the cost of reduced federal rebates received from pharmaceutical manufacturers 172.16as a result of Deficit Reduction Act reforms, and strategies that could be employed in 172.17administering the Medicaid drug formulary to compensate for lost manufacturer rebates; 172.18and172.19    (4) a detailed comparison of the federal upper limits and state maximum allowable 172.20cost (MAC) prices prior to and following implementation of the Deficit Reduction Act 172.21reforms.172.22    Subd. 2.Pharmacy payment reform advisory committee.(a) The Pharmacy 172.23Payment Reform Advisory Committee established under Laws of Minnesota 2006, 172.24chapter 282, article 16, section 15, shall present findings and recommendations to the 172.25commissioner of human services on:172.26    (1) whether pharmacy reimbursement for multiple-source generic prescriptions 172.27following implementation of Deficit Reduction Act reforms allows for payment sufficient 172.28to cover the actual pharmacy costs for acquiring the drug product and dispensing the 172.29prescription;172.30    (2) the impact of the reforms on pharmacies with more than ten percent of annual 172.31prescription volume from Medicaid, and on pharmacies in rural areas or areas with a 172.32significant Medicaid population;172.33    (3) the impact of changes in pharmacy reimbursement for multiple-source drugs on 172.34patient access to pharmacy services; and173.1    (4) the impact of changes in pharmacy reimbursement for multiple-source drugs on 173.2generic dispensing rates.173.3    (b) The Pharmacy Payment Reform Advisory Committee shall also review the 173.4current method of reimbursement for single-source drugs, and present recommendations 173.5to the commissioner of human services on the creation of a transparent reimbursement 173.6model for single-source drugs that would adequately reimburse pharmacies for drug 173.7product costs and pharmacy dispensing services.173.8    (c) The commissioner of human services shall present the advisory committee's 173.9findings and recommendations on the topics specified in paragraphs (a) and (b) to the 173.10legislature by January 1, 2008.173.11EFFECTIVE DATE.This section is effective the day following final enactment.173.12    Sec. 36. REPEALER.173.13Minnesota Statutes 2006, section 256.969, subdivision 27, is repealed effective 173.14July 1, 2007.173.15ARTICLE 4173.16CONTINUING CARE173.17    Section 1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to 173.18read:173.19    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The 173.20commissioner of health, in coordination with the commissioner of human services, may 173.21approve the renovation, replacement, upgrading, or relocation of a nursing home or 173.22boarding care home, under the following conditions:173.23    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be 173.24constructed on the site of a new city-owned hospital to replace an existing 85-bed facility 173.25attached to a hospital that is also being replaced. The threshold allowed for this project 173.26under section 
         144A.073 shall be the maximum amount available to pay the additional 173.27medical assistance costs of the new facility; 173.28    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St. 173.29Louis County, provided that the 29 beds must be transferred from active or layaway status 173.30at an existing facility in St. Louis County that had 235 beds on April 1, 2003.173.31The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment 173.32rate at that facility shall not be adjusted as a result of this transfer. The operating payment 173.33rate of the facility adding beds after completion of this project shall be the same as it was 174.1on the day prior to the day the beds are licensed and certified. This project shall not 174.2proceed unless it is approved and financed under the provisions of section 
         144A.073;  174.3    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of 174.4the new beds are transferred from a 45-bed facility in Austin under common ownership 174.5that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea 174.6under common ownership; (ii) the commissioner of human services is authorized by the 174.72004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) 174.8money is available from planned closures of facilities under common ownership to make 174.9implementation of this clause budget-neutral to the state. The bed capacity of the Albert 174.10Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the 174.11new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's 174.12disease or related dementias; and174.13    (4) to license and certify up to 80 beds transferred from an existing state-owned 174.14nursing facility in Cass County to a new facility located on the grounds of the 174.15Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be 174.16determined based on the interim and settle-up payment provisions of Minnesota Rules, 174.17part 
         9549.0057, and the reimbursement provisions of section 
         256B.431. The property 174.18payment rate for the first three years of operation shall be $35 per day. For subsequent 174.19years, the property payment rate of $35 per day shall be adjusted for inflation as provided 174.20in section 
         256B.434, subdivision 4, paragraph (c), as long as the facility has a contract 174.21under section 
         256B.434.; and174.22    (5) to license and certify 180 beds transferred from an existing facility in 174.23Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred from a 174.24219-bed facility under common ownership that shall be closed following the transfer. The 174.25operating payment rate of the new facility after completion of this project shall be adjusted 174.26upward by $35 per day and the property payment rate shall be $34.049 per day.174.27    (b) Projects approved under this subdivision shall be treated in a manner equivalent 174.28to projects approved under subdivision 4a.174.29EFFECTIVE DATE.This section is effective the day following final enactment.174.30    Sec. 2. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:174.31    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 174.32child, including a child determined eligible for medical assistance without consideration of 174.33parental income, must contribute to the cost of services used by making monthly payments 174.34on a sliding scale based on income, unless the child is married or has been married, 174.35parental rights have been terminated, or the child's adoption is subsidized according to 175.1section 
         259.67 or through title IV-E of the Social Security Act. The parental contribution 175.2is a partial or full payment for medical services provided for diagnostic, therapeutic, 175.3curing, treating, mitigating, rehabilitation, and maintenance and personal care services as 175.4defined in United States Code, title 26, section 213, needed by the child with a chronic 175.5illness or disability.175.6    (b) For households with adjusted gross income equal to or greater than 100 percent 175.7of federal poverty guidelines, the parental contribution shall be computed by applying the 175.8following schedule of rates to the adjusted gross income of the natural or adoptive parents:175.9    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 175.10poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 175.11contribution is $4 per month;175.12    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 175.13poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 175.14the parental contribution shall be determined using a sliding fee scale established by the 175.15commissioner of human services which begins at one percent of adjusted gross income 175.16at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 175.17gross income for those with adjusted gross income up to 545 percent of federal poverty 175.18guidelines;175.19    (3) if the adjusted gross income is greater than 545 percent of federal poverty 175.20guidelines and less than 675 percent of federal poverty guidelines, the parental 175.21contribution shall be 7.5 percent of adjusted gross income;175.22    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 175.23poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 175.24contribution shall be determined using a sliding fee scale established by the commissioner 175.25of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 175.26federal poverty guidelines and increases to ten percent of adjusted gross income for those 175.27with adjusted gross income up to 975 percent of federal poverty guidelines; and175.28    (5) if the adjusted gross income is equal to or greater than 975 percent of federal 175.29poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 175.30income.175.31    If the child lives with the parent, the annual adjusted gross income parental 175.32contribution is reduced by $2,400 prior to calculating the parental contribution$100 175.33per month. If the child resides in an institution specified in section 
         256B.35, the parent 175.34is responsible for the personal needs allowance specified under that section in addition 175.35to the parental contribution determined under this section. The parental contribution is 176.1reduced by any amount required to be paid directly to the child pursuant to a court order, 176.2but only if actually paid.176.3    (c) The household size to be used in determining the amount of contribution under 176.4paragraph (b) includes natural and adoptive parents and their dependents, including the 176.5child receiving services. Adjustments in the contribution amount due to annual changes 176.6in the federal poverty guidelines shall be implemented on the first day of July following 176.7publication of the changes.176.8    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 176.9natural or adoptive parents determined according to the previous year's federal tax form, 176.10except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 176.11have been used to purchase a home shall not be counted as income.176.12    (e) The contribution shall be explained in writing to the parents at the time eligibility 176.13for services is being determined. The contribution shall be made on a monthly basis 176.14effective with the first month in which the child receives services. Annually upon 176.15redetermination or at termination of eligibility, if the contribution exceeded the cost of 176.16services provided, the local agency or the state shall reimburse that excess amount to 176.17the parents, either by direct reimbursement if the parent is no longer required to pay 176.18a contribution, or by a reduction in or waiver of parental fees until the excess amount 176.19is exhausted.176.20    (f) The monthly contribution amount must be reviewed at least every 12 months; 176.21when there is a change in household size; and when there is a loss of or gain in income 176.22from one month to another in excess of ten percent. The local agency shall mail a written 176.23notice 30 days in advance of the effective date of a change in the contribution amount. 176.24A decrease in the contribution amount is effective in the month that the parent verifies a 176.25reduction in income or change in household size.176.26    (g) Parents of a minor child who do not live with each other shall each pay the 176.27contribution required under paragraph (a). An amount equal to the annual court-ordered 176.28child support payment actually paid on behalf of the child receiving services shall be 176.29deducted from the adjusted gross income of the parent making the payment prior to 176.30calculating the parental contribution under paragraph (b).176.31    (h) The contribution under paragraph (b) shall be increased by an additional five 176.32percent if the local agency determines that insurance coverage is available but not 176.33obtained for the child. For purposes of this section, "available" means the insurance is a 176.34benefit of employment for a family member at an annual cost of no more than five percent 176.35of the family's annual income. For purposes of this section, "insurance" means health 177.1and accident insurance coverage, enrollment in a nonprofit health service plan, health 177.2maintenance organization, self-insured plan, or preferred provider organization.177.3    Parents who have more than one child receiving services shall not be required 177.4to pay more than the amount for the child with the highest expenditures. There shall 177.5be no resource contribution from the parents. The parent shall not be required to pay 177.6a contribution in excess of the cost of the services provided to the child, not counting 177.7payments made to school districts for education-related services. Notice of an increase in 177.8fee payment must be given at least 30 days before the increased fee is due.177.9    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 177.10in the 12 months prior to July 1:177.11    (1) the parent applied for insurance for the child;177.12    (2) the insurer denied insurance;177.13    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 177.14a complaint or appeal, in writing, to the commissioner of health or the commissioner of 177.15commerce, or litigated the complaint or appeal; and177.16    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.177.17    For purposes of this section, "insurance" has the meaning given in paragraph (h).177.18    A parent who has requested a reduction in the contribution amount under this 177.19paragraph shall submit proof in the form and manner prescribed by the commissioner or 177.20county agency, including, but not limited to, the insurer's denial of insurance, the written 177.21letter or complaint of the parents, court documents, and the written response of the insurer 177.22approving insurance. The determinations of the commissioner or county agency under this 177.23paragraph are not rules subject to chapter 14.177.24    Sec. 3. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:177.25    Subd. 3. Amount of support grant; use. Support grant amounts shall be 177.26determined by the county social service agency. Services and items purchased with a 177.27support grant must:177.28    (1) be over and above the normal costs of caring for the dependent if the dependent 177.29did not have a disability;177.30    (2) be directly attributable to the dependent's disabling condition; and177.31    (3) enable the family to delay or prevent the out-of-home placement of the dependent.177.32    The design and delivery of services and items purchased under this section must 177.33suit the dependent's chronological age and be provided in the least restrictive environment 177.34possible, consistent with the needs identified in the individual service plan.178.1    Items and services purchased with support grants must be those for which there 178.2are no other public or private funds available to the family. Fees assessed to parents 178.3for health or human services that are funded by federal, state, or county dollars are not 178.4reimbursable through this program.178.5    In approving or denying applications, the county shall consider the following factors:178.6    (1) the extent and areas of the functional limitations of the disabled child;178.7    (2) the degree of need in the home environment for additional support; and178.8    (3) the potential effectiveness of the grant to maintain and support the person in 178.9the family environment.178.10    The maximum monthly grant amount shall be $250 per eligible dependent, or 178.11$3,000 per eligible dependent per state fiscal year, within the limits of available funds and 178.12as adjusted by any legislatively authorized cost of living adjustment. The county social 178.13service agency may consider the dependent's supplemental security income in determining 178.14the amount of the support grant.178.15    Any adjustments to their monthly grant amount must be based on the needs of the 178.16family and funding availability.178.17    Sec. 4. Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision 178.18to read:178.19    Subd. 22.Provider rate increase; St. Louis County.A day training and 178.20habilitation provider in St. Louis County licensed to provide services to up to 80 178.21individuals shall receive a per diem rate increase that does not exceed 95 percent of the 178.22greater of 125 percent of the current statewide median or 125 percent of the regional 178.23average per diem rate, whichever is higher.178.24    Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 178.25to read:178.26    Subd. 24.Disability linkage line.The commissioner shall establish the disability 178.27linkage line, a statewide consumer information, referral, and assistance system for people 178.28with disabilities and chronic illnesses that: 178.29    (1) provides information about state and federal eligibility requirements, benefits, 178.30and service options; 178.31    (2) makes referrals to appropriate support entities; 178.32    (3) delivers information and assistance based on national and state standards; 178.33    (4) assists people to make well-informed decisions; and 178.34    (5) supports the timely resolution of service access and benefit issues.179.1    Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:179.2    Subdivision 1. Purpose and goals. The commissioner of human services shall 179.3establish a consumer support grant program for individuals with functional limitations and 179.4their families who wish to purchase and secure their own supports. The commissioner and 179.5local agencies shall jointly develop an implementation plan which must include a way to 179.6resolve the issues related to county liability. The program shall:179.7    (1) make support grants available to individuals or families as an effective alternative 179.8to the developmental disability family support program, personal care attendant services, 179.9home health aide services, and private duty nursing services;179.10    (2) provide consumers more control, flexibility, and responsibility over their services 179.11and supports;179.12    (3) promote local program management and decision making; and179.13    (4) encourage the use of informal and typical community supports.179.14    Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:179.15    Subd. 2. Definitions. For purposes of this section, the following terms have the 179.16meanings given them:179.17    (a) "County board" means the county board of commissioners for the county of 179.18financial responsibility as defined in section 
         256G.02, subdivision 4, or its designated 179.19representative. When a human services board has been established under sections 
         402.01179.20to 
         402.10, it shall be considered the county board for the purposes of this section. 179.21    (b) "Family" means the person's birth parents, adoptive parents or stepparents, 179.22siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece, 179.23nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is 179.24at least 18 years of age.179.25    (c) "Functional limitations" means the long-term inability to perform an activity or 179.26task in one or more areas of major life activity, including self-care, understanding and use 179.27of language, learning, mobility, self-direction, and capacity for independent living. For the 179.28purpose of this section, the inability to perform an activity or task results from a mental, 179.29emotional, psychological, sensory, or physical disability, condition, or illness.179.30    (d) "Informed choice" means a voluntary decision made by the person or,179.31the person's legal representative, or other authorized representative after becoming 179.32familiarized with the alternatives to:179.33    (1) select a preferred alternative from a number of feasible alternatives;179.34    (2) select an alternative which may be developed in the future; and179.35    (3) refuse any or all alternatives.180.1    (e) "Local agency" means the local agency authorized by the county board or, 180.2for counties not participating in the consumer grant program by July 1, 2002, the 180.3commissioner, to carry out the provisions of this section.180.4    (f) "Person" or "persons" means a person or persons meeting the eligibility criteria in 180.5subdivision 3.180.6    (g) "Authorized representative" means an individual designated by the person or 180.7their legal representative to act on their behalf. This individual may be a family member, 180.8guardian, representative payee, or other individual designated by the person or their legal 180.9representative, if any, to assist in purchasing and arranging for supports. For the purposes 180.10of this section, an authorized representative is at least 18 years of age.180.11    (h) "Screening" means the screening of a person's service needs under sections 180.12256B.0911
          and 
         256B.092. 180.13    (i) "Supports" means services, care, aids, environmental modifications, or assistance 180.14purchased by the person or the person's family, the person's legal representative, or other 180.15authorized representative. Examples of supports include respite care, assistance with daily 180.16living, and assistive technology. For the purpose of this section, notwithstanding the 180.17provisions of section 
         144A.43, supports purchased under the consumer support program 180.18are not considered home care services. 180.19    (j) "Program of origination" means the program the individual transferred from 180.20when approved for the consumer support grant program.180.21    Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:180.22    Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a 180.23consumer support grant if the person meets all of the following criteria:180.24    (1) the person is eligible for and has been approved to receive services under 180.25medical assistance as determined under sections 
         256B.055 and 
         256B.056 or the person 180.26has been approved to receive a grant under the developmental disability family support 180.27program under section 
         252.32; 180.28    (2) the person is able to direct and purchase the person's own care and supports, or 180.29the person has a family member, legal representative, or other authorized representative 180.30who can purchase and arrange supports on the person's behalf;180.31    (3) the person has functional limitations, requires ongoing supports to live in the 180.32community, and is at risk of or would continue institutionalization without such supports; 180.33and181.1    (4) the person will live in a home. For the purpose of this section, "home" means the 181.2person's own home or home of a person's family member. These homes are natural home 181.3settings and are not licensed by the Department of Health or Human Services.181.4    (b) Persons may not concurrently receive a consumer support grant if they are:181.5    (1) receiving personal care attendant and home health aide services, or private duty 181.6nursing under section 
         256B.0625; a developmental disability family support grant; or 181.7alternative care services under section 
         256B.0913; or 181.8    (2) residing in an institutional or congregate care setting.181.9    (c) A person or person's family receiving a consumer support grant shall not be 181.10charged a fee or premium by a local agency for participating in the program.181.11    (d) Individuals receiving home and community-based waivers under United States 181.12Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except 181.13for individuals receiving consumer support grants before July 1, 2003, as long as other 181.14eligibility criteria are met.181.15    (e) The commissioner shall establish a budgeted appropriation each fiscal year 181.16for the consumer support grant program. The number of individuals participating in 181.17the program will be adjusted so the total amount allocated to counties does not exceed 181.18the amount of the budgeted appropriation. The budgeted appropriation will be adjusted 181.19annually to accommodate changes in demand for the consumer support grants.181.20    Sec. 9. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:181.21    Subd. 4. Support grants; criteria and limitations. (a) A county board may 181.22choose to participate in the consumer support grant program. If a county has not chosen 181.23to participate by July 1, 2002, the commissioner shall contract with another county or 181.24other entity to provide access to residents of the nonparticipating county who choose 181.25the consumer support grant option. The commissioner shall notify the county board 181.26in a county that has declined to participate of the commissioner's intent to enter into 181.27a contract with another county or other entity at least 30 days in advance of entering 181.28into the contract. The local agency shall establish written procedures and criteria to 181.29determine the amount and use of support grants. These procedures must include, at least, 181.30the availability of respite care, assistance with daily living, and adaptive aids. The local 181.31agency may establish monthly or annual maximum amounts for grants and procedures 181.32where exceptional resources may be required to meet the health and safety needs of the 181.33person on a time-limited basis, however, the total amount awarded to each individual may 181.34not exceed the limits established in subdivision 11.182.1    (b) Support grants to a person or a person's family, a person's legal representative, 182.2or other authorized representative will be provided through a monthly subsidy payment 182.3and be in the form of cash, voucher, or direct county payment to vendor. Support grant 182.4amounts must be determined by the local agency. Each service and item purchased with a 182.5support grant must meet all of the following criteria:182.6    (1) it must be over and above the normal cost of caring for the person if the person 182.7did not have functional limitations;182.8    (2) it must be directly attributable to the person's functional limitations;182.9    (3) it must enable the person or the person's family, a person's legal representative, 182.10or other authorized representative to delay or prevent out-of-home placement of the 182.11person; and182.12    (4) it must be consistent with the needs identified in the service agreement, when 182.13applicable.182.14    (c) Items and services purchased with support grants must be those for which there 182.15are no other public or private funds available to the person or the person's family, a person's 182.16legal representative, or other authorized representative. Fees assessed to the person or the 182.17person's family for health and human services are not reimbursable through the grant.182.18    (d) In approving or denying applications, the local agency shall consider the 182.19following factors:182.20    (1) the extent and areas of the person's functional limitations;182.21    (2) the degree of need in the home environment for additional support; and182.22    (3) the potential effectiveness of the grant to maintain and support the person in the 182.23family environment or the person's own home.182.24    (e) At the time of application to the program or screening for other services, 182.25the person or the person's family, a person's legal representative, or other authorized 182.26representative shall be provided sufficient information to ensure an informed choice 182.27of alternatives by the person, the person's legal representative, or other authorized 182.28representative, if any, or the person's family. The application shall be made to the local 182.29agency and shall specify the needs of the person and family, the form and amount of 182.30grant requested, the items and services to be reimbursed, and evidence of eligibility for 182.31medical assistance.182.32    (f) Upon approval of an application by the local agency and agreement on a support 182.33plan for the person or person's family, the local agency shall make grants to the person or 182.34the person's family. The grant shall be in an amount for the direct costs of the services or 182.35supports outlined in the service agreement.183.1    (g) Reimbursable costs shall not include costs for resources already available, such as 183.2special education classes, day training and habilitation, case management, other services to 183.3which the person is entitled, medical costs covered by insurance or other health programs, 183.4or other resources usually available at no cost to the person or the person's family.183.5    (h) The state of Minnesota, the county boards participating in the consumer 183.6support grant program, or the agencies acting on behalf of the county boards in the 183.7implementation and administration of the consumer support grant program shall not be 183.8liable for damages, injuries, or liabilities sustained through the purchase of support by 183.9the individual, the individual's family, or the authorized representative under this section 183.10with funds received through the consumer support grant program. Liabilities include but 183.11are not limited to: workers' compensation liability, the Federal Insurance Contributions 183.12Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, 183.13participating county boards and agencies acting on behalf of county boards are exempt 183.14from the provisions of section 
         268.04.183.15    Sec. 10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:183.16    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of 183.17transferring persons to the consumer support grant program from the developmental 183.18disability family support program and personal care assistant services, home health 183.19aide services, or private duty nursing services, the amount of funds transferred by the 183.20commissioner between the developmental disability family support program account, the 183.21medical assistance account, or the consumer support grant account shall be based on each 183.22county's participation in transferring persons to the consumer support grant program 183.23from those programs and services.183.24    (b) At the beginning of each fiscal year, county allocations for consumer support 183.25grants shall be based on:183.26    (1) the number of persons to whom the county board expects to provide consumer 183.27supports grants;183.28    (2) their eligibility for current program and services;183.29    (3) the amount of nonfederal dollars allowed under subdivision 11; and183.30    (4) projected dates when persons will start receiving grants. County allocations shall 183.31be adjusted periodically by the commissioner based on the actual transfer of persons or 183.32service openings, and the nonfederal dollars associated with those persons or service 183.33openings, to the consumer support grant program.184.1    (c) The amount of funds transferred by the commissioner from the medical 184.2assistance account for an individual may be changed if it is determined by the county or its 184.3agent that the individual's need for support has changed.184.4    (d) The authority to utilize funds transferred to the consumer support grant account 184.5for the purposes of implementing and administering the consumer support grant program 184.6will not be limited or constrained by the spending authority provided to the program 184.7of origination.184.8    (e) The commissioner may use up to five percent of each county's allocation, as 184.9adjusted, for payments for administrative expenses, to be paid as a proportionate addition 184.10to reported direct service expenditures.184.11    (f) The county allocation for each individual or individual's family cannot exceed 184.12the amount allowed under subdivision 11.184.13    (g) The commissioner may recover, suspend, or withhold payments if the county 184.14board, local agency, or grantee does not comply with the requirements of this section.184.15    (h) Grant funds unexpended by consumers shall return to the state once a year. The 184.16annual return of unexpended grant funds shall occur in the quarter following the end of 184.17the state fiscal year.184.18    Sec. 11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:184.19    Subd. 10. Consumer responsibilities. Persons receiving grants under this section 184.20shall:184.21    (1) spend the grant money in a manner consistent with their agreement with the 184.22local agency;184.23    (2) notify the local agency of any necessary changes in the grant or the items on 184.24which it is spent;184.25    (3) notify the local agency of any decision made by the person, the a person's legal 184.26representative, or the person's family or other authorized representative that would change 184.27their eligibility for consumer support grants;184.28    (4) arrange and pay for supports; and184.29    (5) inform the local agency of areas where they have experienced difficulty securing 184.30or maintaining supports.184.31    Sec. 12. Minnesota Statutes 2006, section 256.974, is amended to read:184.32256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS184.33LONG-TERM CARE; LOCAL PROGRAMS.185.1    The ombudsman for older Minnesotans long-term care serves in the classified service 185.2under section 
         256.01, subdivision 7, in an office within the Minnesota Board on Aging that 185.3incorporates the long-term care ombudsman program required by the Older Americans 185.4Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12)185.5(9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota 185.6Board on Aging may make grants to and designate local programs for the provision of 185.7ombudsman services to clients in county or multicounty areas. The local program may not 185.8be an agency engaged in the provision of nursing home care, hospital care, or home care 185.9services either directly or by contract, or have the responsibility for planning, coordinating, 185.10funding, or administering nursing home care, hospital care, or home care services.185.11    Sec. 13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:185.12    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing 185.13home licensed under sections 
         144A.02 to 
         144A.10or; a boarding care home licensed 185.14under sections 
         144.50 to 
         144.56; or a licensed or registered residential setting which 185.15provides or arranges for the provision of home care services. 185.16    Sec. 14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:185.17    Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a 185.18request is made for, ombudsman services and is (a) a resident of a long-term care facility 185.19or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or 185.20denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or 185.21requesting a home care service.185.22    Sec. 15. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:185.23    Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a 185.24conspicuous place the address and telephone number of the office. A home care service 185.25provider shall provide all recipients, including those in elderly housing with services 185.26under chapter 144D, with the address and telephone number of the office. Counties shall 185.27provide clients receiving a consumer support grant or a service allowancelong-term care 185.28consultation services under section 256B.0911 or home and community-based services 185.29through a state or federally funded program with the name, address, and telephone number 185.30of the office. The posting or notice is subject to approval by the ombudsman.185.31    Sec. 16. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:186.1    Subd. 4. Access to long-term care and acute care facilities and clients. The 186.2ombudsman or designee may:186.3    (1) enter any long-term care facility without notice at any time;186.4    (2) enter any acute care facility without notice during normal business hours;186.5    (3) enter any acute care facility without notice at any time to interview a patient or 186.6observe services being provided to the patient as part of an investigation of a matter that is 186.7within the scope of the ombudsman's authority, but only if the ombudsman's or designee's 186.8presence does not intrude upon the privacy of another patient or interfere with routine 186.9hospital services provided to any patient in the facility;186.10    (4) communicate privately and without restriction with any client in accordance 186.11with section 144.651, as long as the ombudsman has the client's consent for such 186.12communication; 186.13    (5) inspect records of a long-term care facility, home care service provider, or acute 186.14care facility that pertain to the care of the client according to sectionssection 144.335and 186.15144.651; and 186.16    (6) with the consent of a client or client's legal guardian, the ombudsman or 186.17designated staff shall have access to review records pertaining to the care of the client 186.18according to sectionssection 144.335and 144.651. If a client cannot consent and has no 186.19legal guardian, access to the records is authorized by this section. 186.20    A person who denies access to the ombudsman or designee in violation of this 186.21subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a 186.22misdemeanor.186.23    Sec. 17. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:186.24    Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take 186.25discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a 186.26patient, resident, or guardian or family member of a patient, resident, or guardian for filing 186.27in good faith a complaint with or providing information to the ombudsman or designee 186.28including volunteers. A person who violates this subdivision or who aids, abets, invites, 186.29compels, or coerces another to do so is guilty of a misdemeanor.186.30    (b) There shall be a rebuttable presumption that any adverse action, as defined below, 186.31within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose 186.32of this clause, the term "adverse action" refers to action taken by the entity involved in a 186.33report against the person making the report or the person with respect to whom the report 186.34was made because of the report, and includes, but is not limited to:186.35    (1) discharge or transfer from a facility;187.1    (2) termination of service;187.2    (3) restriction or prohibition of access to the facility or its residents;187.3    (4) discharge from or termination of employment;187.4    (5) demotion or reduction in remuneration for services; and187.5    (6) any restriction of rights set forth in section 
         144.651or,144A.44, or 144A.751. 187.6    Sec. 18. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:187.7    Subdivision 1. Classification. Except as provided in this section, data maintained 187.8by the office under sections 
         256.974 to 
         256.9744 are private data on individuals or 187.9nonpublic data as defined in section 
         13.02, subdivision 9 or 12, and must be maintained 187.10in accordance with the requirements of Public Law 100-75 the Older Americans Act, as 187.11amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).187.12    Sec. 19. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:187.13    Subd. 7. Consumer information and assistance; senior linkage. (a) The 187.14Minnesota Board on Aging shall operate a statewide information and assistance service 187.15to aid older Minnesotans and their families in making informed choices about long-term 187.16care options and health care benefits. Language services to persons with limited English 187.17language skills may be made available. The service, known as Senior LinkAge Line, must 187.18be available during business hours through a statewide toll-free number and must also 187.19be available through the Internet.187.20    (b) The service must assist older adults, caregivers, and providers in accessing 187.21information about choices in long-term care services that are purchased through private 187.22providers or available through public options. The service must:187.23    (1) develop a comprehensive database that includes detailed listings in both 187.24consumer- and provider-oriented formats;187.25    (2) make the database accessible on the Internet and through other telecommunication 187.26and media-related tools;187.27    (3) link callers to interactive long-term care screening tools and make these tools 187.28available through the Internet by integrating the tools with the database;187.29    (4) develop community education materials with a focus on planning for long-term 187.30care and evaluating independent living, housing, and service options;187.31    (5) conduct an outreach campaign to assist older adults and their caregivers in 187.32finding information on the Internet and through other means of communication;187.33    (6) implement a messaging system for overflow callers and respond to these callers 187.34by the next business day;188.1    (7) link callers with county human services and other providers to receive more 188.2in-depth assistance and consultation related to long-term care options; and188.3    (8) link callers with quality profiles for nursing facilities and other providers 188.4developed by the commissioner of health.; and188.5    (9) incorporate information about housing with services and consumer rights 188.6within the MinnesotaHelp.info network long-term care database to facilitate consumer 188.7comparison of services and costs among housing with services establishments and with 188.8other in-home services and to support financial self-sufficiency as long as possible. 188.9Housing with services establishments and their arranged home care providers shall provide 188.10information to the commissioner of human services that is consistent with information 188.11required by the commissioner of health under section 144G.06, the Uniform Consumer 188.12Information Guide. The commissioner of human services shall provide the data to the 188.13Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term 188.14care database.188.15    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 188.16of the statewide information and assistance, and submit this evaluation to the legislature 188.17by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 188.18in service delivery, continuity in information between the service and identified linkages, 188.19and potential use of private funding to enhance the service.188.20EFFECTIVE DATE.This section is effective the day following final enactment.188.21    Sec. 20. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to 188.22read:188.23    Subd. 1a. Income and assets generally. Unless specifically required by state law or 188.24rule or federal law or regulation, the methodologies used in counting income and assets 188.25to determine eligibility for medical assistance for persons whose eligibility category is 188.26based on blindness, disability, or age of 65 or more years, the methodologies for the 188.27supplemental security income program shall be used, except as provided under subdivision 188.283, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be 188.29counted as income for purposes of this subdivision until July 1 of each year. Effective 188.30upon federal approval, for children eligible under section 
         256B.055, subdivision 12, or 188.31for home and community-based waiver services whose eligibility for medical assistance 188.32is determined without regard to parental income, child support payments, including any 188.33payments made by an obligor in satisfaction of or in addition to a temporary or permanent 188.34order for child support, and Social Security payments are not counted as income. For 188.35families and children, which includes all other eligibility categories, the methodologies 189.1under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal 189.2Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public 189.3Law 104-193, shall be used, except that effective October 1, 2003, the earned income 189.4disregards and deductions are limited to those in subdivision 1c. For these purposes, a 189.5"methodology" does not include an asset or income standard, or accounting method, 189.6or method of determining effective dates.189.7    Sec. 21. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:189.8    Subd. 3. Asset limitations for aged, blind, or disabled individuals and families.189.9    To be eligible for medical assistance, a person whose eligibility is based on blindness, 189.10disability, or age of 65 or more years must not individually own more than $3,000 $6,000189.11in assets, or if a member of a household with two family members, husband and wife, or 189.12parent and child, the household must not own more than $6,000 $12,000 in assets, plus 189.13$200 $400 for each additional legal dependent. In addition to these maximum amounts, 189.14an eligible individual or family may accrue interest on these amounts, but they must be 189.15reduced to the maximum at the time of an eligibility redetermination. The accumulation 189.16of the clothing and personal needs allowance according to section 
         256B.35 must also be 189.17reduced to the maximum at the time of the eligibility redetermination. The value of assets 189.18that are not considered in determining eligibility for medical assistance is the value of 189.19those assets excluded under the supplemental security income program for aged, blind, 189.20and disabled persons, with the following exceptions: 189.21    (a) Household goods and personal effects are not considered.189.22    (b) Capital and operating assets of a trade or business that the local agency 189.23determines are necessary to the person's ability to earn an income are not considered.189.24    (c) Motor vehicles are excluded to the same extent excluded by the supplemental 189.25security income program.189.26    (d) Assets designated as burial expenses are excluded to the same extent excluded by 189.27the supplemental security income program. Burial expenses funded by annuity contracts 189.28or life insurance policies must irrevocably designate the individual's estate as contingent 189.29beneficiary to the extent proceeds are not used for payment of selected burial expenses.189.30    (e) Effective upon federal approval, for a person who no longer qualifies as an 189.31employed person with a disability due to loss of earnings, assets allowed while eligible 189.32for medical assistance under section 
         256B.057, subdivision 9, are not considered for 12 189.33months, beginning with the first month of ineligibility as an employed person with a 189.34disability, to the extent that the person's total assets remain within the allowed limits of 189.35section 
         256B.057, subdivision 9, paragraph (b). 190.1    (f) When a person enrolled in medical assistance under section 256B.057, 190.2subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive 190.3months before the person's 65th birthday, the assets owned by the person and the person's 190.4spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph 190.5(b), when determining eligibility for medical assistance under section 256B.055, 190.6subdivision 7. The income of a spouse of a person enrolled in medical assistance under 190.7section 256B.057, subdivision 9, during each of the 24 consecutive months before the 190.8person's 65th birthday must be disregarded when determining eligibility for medical 190.9assistance under section 256B.055, subdivision 7, when the person reaches age 65. This 190.10paragraph does not apply at the time the person or the person's spouse requests medical 190.11assistance payment for long-term care services.190.12EFFECTIVE DATE.This section is effective July 1, 2007, except that the increase 190.13in the asset standard for persons whose eligibility for medical assistance is based on 190.14blindness, disability, or age of 65 or more years is effective July 1, 2008.190.15    Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 5c, is amended to 190.16read:190.17    Subd. 5c. Excess income standard. (a) The excess income standard for families 190.18with children is the standard specified in subdivision 4.190.19    (b) The excess income standard for a person whose eligibility is based on blindness, 190.20disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the 190.21family size. Effective July 1, 2002, the excess income standard for this paragraph shall 190.22equal 75 percent of the federal poverty guidelines. Effective July 1, 2007, the excess 190.23income standard for this paragraph shall equal 85 percent of the federal poverty guidelines. 190.24The excess income standard for this paragraph shall be increased by five percentage points 190.25on July 1 of each of the next three years, so that the excess income standard shall equal 190.26100 percent of the federal poverty guidelines effective July 1, 2010.190.27EFFECTIVE DATE.This section is effective July 1, 2007.190.28    Sec. 23. Minnesota Statutes 2006, section 256B.059, subdivision 5, is amended to read:190.29    Subd. 5. Asset availability. (a) At the time of initial determination of eligibility for 190.30medical assistance benefits following the first continuous period of institutionalization on 190.31or after October 1, 1989, assets considered available to the institutionalized spouse shall 190.32be the total value of all assets in which either spouse has an ownership interest, reduced by 190.33the following amount for the community spouse:191.1    (1) prior to July 1, 1994, the greater of:191.2    (i) $14,148;191.3    (ii) the lesser of the spousal share or $70,740; or191.4    (iii) the amount required by court order to be paid to the community spouse;191.5    (2) for persons whose date of initial determination of eligibility for medical 191.6assistance following their first continuous period of institutionalization occurs on or after 191.7July 1, 1994, the greater of:191.8    (i) $20,000;191.9    (ii) the lesser of the spousal share or $70,740; or191.10    (iii) the amount required by court order to be paid to the community spouse.191.11The value of assets transferred for the sole benefit of the community spouse under section 191.12256B.0595, subdivision 4
         , in combination with other assets available to the community 191.13spouse under this section, cannot exceed the limit for the community spouse asset 191.14allowance determined under subdivision 3 or 4. Assets that exceed this allowance shall be 191.15considered available to the institutionalized spouse, as provided by federal law,  whether or 191.16not converted to income. If the community spouse asset allowance has been increased 191.17under subdivision 4, then the assets considered available to the institutionalized spouse 191.18under this subdivision shall be further reduced by the value of additional amounts allowed 191.19under subdivision 4. 191.20    (b) An institutionalized spouse may be found eligible for medical assistance even 191.21though assets in excess of the allowable amount are found to be available under paragraph 191.22(a) if the assets are owned jointly or individually by the community spouse, and the 191.23institutionalized spouse cannot use those assets to pay for the cost of care without the 191.24consent of the community spouse, and if: (i) the institutionalized spouse assigns to the 191.25commissioner the right to support from the community spouse under section 
         256B.14, 191.26subdivision 3
         ; (ii) the institutionalized spouse lacks the ability to execute an assignment 191.27due to a physical or mental impairment; or (iii) the denial of eligibility would cause an 191.28imminent threat to the institutionalized spouse's health and well-being. 191.29    (c) After the month in which the institutionalized spouse is determined eligible for 191.30medical assistance, during the continuous period of institutionalization, no assets of the 191.31community spouse are considered available to the institutionalized spouse, unless the 191.32institutionalized spouse has been found eligible under paragraph (b).191.33    (d) Assets determined to be available to the institutionalized spouse under this 191.34section must be used for the health care or personal needs of the institutionalized spouse.191.35    (e) For purposes of this section, assets do not include assets excluded under the 191.36supplemental security income program.192.1    Sec. 24. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to 192.2read:192.3    Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner 192.4shall execute a data use agreement with the Centers for Medicare and Medicaid Services 192.5to obtain the long-term care minimum data set data to assist residents of nursing facilities 192.6who have establish a process with the Centers for Independent Living that allows a person 192.7residing in a Minnesota nursing facility to receive needed information, consultation, and 192.8assistance from one of the centers about the available community support options that may 192.9enable the person to relocate to the community, if the person: (1) is under the age of 65, 192.10(2) has indicated a desire to live in the community. The commissioner shall in turn enter 192.11into agreements with the Centers for Independent Living to provide information about 192.12assistance for persons who want to move to the community. The commissioner shall work 192.13with the Centers for Independent Living on both the content of the information to be 192.14provided and privacy protections for the individual residents, and (3) has signed a release 192.15of information authorized by the person or the person's appointed legal representative. 192.16The process established under this subdivision shall be coordinated with the long-term 192.17care consultation service activities established in section 256B.0911.192.18    Sec. 25. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 192.19read:192.20    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 192.21meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 192.22$6.50 for lunch, or $8 for dinner.192.23    (b) Medical assistance reimbursement for lodging for persons traveling to receive 192.24medical care may not exceed $50 per day unless prior authorized by the local agency.192.25    (c) Medical assistance direct mileage reimbursement to the eligible person or the 192.26eligible person's driver may not exceed 20 cents per mile.192.27    (d) Regardless of the number of employees that an enrolled health care provider 192.28may have, medical assistance covers sign and oral language interpreter services when 192.29provided by an enrolled health care provider during the course of providing a direct, 192.30person-to-person covered health care service to an enrolled recipient with limited English 192.31proficiency or who has a hearing loss and uses interpreting services.192.32    Sec. 26. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 192.33subdivision to read:193.1    Subd. 49.Self-directed supports option.Upon federal approval, medical 193.2assistance covers the self-directed supports option as defined under section 256B.0657 and 193.3section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.193.4EFFECTIVE DATE.This section is effective upon federal approval of the state 193.5Medicaid plan amendment. The commissioner of human services shall inform the Office 193.6of the Revisor of Statutes when approval is obtained.193.7    Sec. 27. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.193.8    Subdivision 1.Definition."Self-directed supports option" means personal 193.9assistance, supports, items, and related services purchased under an approved budget 193.10plan and budget by a recipient.193.11    Subd. 2.Eligibility.(a) The self-directed supports option is available to a person 193.12who:193.13    (1) is a recipient of medical assistance as determined under sections 256B.055, 193.14256B.056, and 256B.057, subdivision 9;193.15    (2) is eligible for personal care assistant services under section 256B.0655;193.16    (3) lives in the person's own apartment or home, which is not owned, operated, or 193.17controlled by a provider of services not related by blood or marriage;193.18    (4) has the ability to hire, fire, supervise, establish staff compensation for, and 193.19manage the individuals providing services, and to choose and obtain items, related 193.20services, and supports as described in the participant's plan. If the recipient is not able to 193.21carry out these functions but has a legal guardian or parent to carry them out, the guardian 193.22or parent may fulfill these functions on behalf of the recipient; and193.23    (5) has not been excluded or disenrolled by the commissioner.193.24    (b) The commissioner may disenroll or exclude recipients, including guardians and 193.25parents, under the following circumstances:193.26    (1) recipients who have been restricted by the Primary Care Utilization Review 193.27Committee may be excluded for a specified time period; and 193.28    (2) recipients who exit the self-directed supports option during the recipient's 193.29service plan year shall not access the self-directed supports option for the remainder 193.30of that service plan year.193.31    Subd. 3.Eligibility for other services.Selection of the self-directed supports 193.32option by a recipient shall not restrict access to other medically necessary care and 193.33services furnished under the state plan medical assistance benefit, including home care 193.34targeted case management, except that a person receiving home and community-based 194.1waiver services, a family support grant or a consumer support grant is not eligible for 194.2funding under the self-directed supports option.194.3    Subd. 4.Assessment requirements.(a) The self-directed supports option 194.4assessment must meet the following requirements:194.5    (1) it shall be conducted by the county public health nurse or a certified public 194.6health nurse under contract with the county;194.7    (2) it shall be conducted face-to-face in the recipient's home initially, and at least 194.8annually thereafter; when there is a significant change in the recipient's condition; and 194.9when there is a change in the need for personal care assistant services. A recipient who is 194.10residing in a facility may be assessed for the self-directed support option for the purpose 194.11of returning to the community using this option; and 194.12    (3) it shall be completed using the format established by the commissioner.194.13    (b) The results of the assessment and recommendations shall be communicated to 194.14the commissioner and the recipient by the county public health nurse or certified public 194.15health nurse under contract with the county.194.16    Subd. 5.Self-directed supports option plan requirements.(a) The plan for the 194.17self-directed supports option must meet the following requirements:194.18    (1) the plan must be completed using a person-centered process that:194.19    (i) builds upon the recipient's capacity to engage in activities that promote 194.20community life;194.21    (ii) respects the recipient's preferences, choices, and abilities;194.22    (iii) involves families, friends, and professionals in the planning or delivery of 194.23services or supports as desired or required by the recipient; and 194.24    (iv) addresses the need for personal care assistant services identified in the recipient's 194.25self-directed supports option assessment;194.26    (2) the plan shall be developed by the recipient or by the guardian of an adult 194.27recipient or by a parent or guardian of a minor child, with the assistance of an enrolled 194.28medical assistance home care targeted case manager provider who meets the requirements 194.29established for using a person-centered planning process and shall be reviewed at least 194.30annually upon reassessment or when there is a significant change in the recipient's 194.31condition; and 194.32    (3) the plan must include the total budget amount available divided into monthly 194.33amounts that cover the number of months of personal care assistant services authorization 194.34included in the budget. The amount used each month may vary, but additional funds shall 194.35not be provided above the annual personal care assistant services authorized amount 194.36unless a change in condition is documented.195.1    (b) The commissioner shall:195.2    (1) establish the format and criteria for the plan as well as the requirements for 195.3providers who assist with plan development;195.4    (2) review the assessment and plan and, within 30 days after receiving the 195.5assessment and plan, make a decision on approval of the plan;195.6    (3) notify the recipient, parent, or guardian of approval or denial of the plan and 195.7provide notice of the right to appeal under section 256.045; and 195.8    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.195.9    Subd. 6.Services covered.(a) Services covered under the self-directed supports 195.10option include:195.11    (1) personal care assistant services under section 256B.0655; and 195.12    (2) items, related services, and supports, including assistive technology, that increase 195.13independence or substitute for human assistance to the extent expenditures would 195.14otherwise be used for human assistance.195.15    (b) Items, supports, and related services purchased under this option shall not be 195.16considered home care services for the purposes of section 144A.43.195.17    Subd. 7.Noncovered services.Services or supports that are not eligible for 195.18payment under the self-directed supports option include:195.19    (1) services, goods, or supports that do not benefit the recipient;195.20    (2) any fees incurred by the recipient, such as Minnesota health care program fees 195.21and co-pays, legal fees, or costs related to advocate agencies;195.22    (3) insurance, except for insurance costs related to employee coverage or fiscal 195.23support entity payments;195.24    (4) room and board and personal items that are not related to the disability, except 195.25that medically prescribed specialized diet items may be covered if they reduce the need for 195.26human assistance;195.27    (5) home modifications that add square footage;195.28    (6) home modifications for a residence other than the primary residence of the 195.29recipient, or in the event of a minor with parents not living together, the primary residences 195.30of the parents;195.31    (7) expenses for travel, lodging, or meals related to training the recipient, the parent 195.32or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or 195.33unpaid caregivers that exceed $500 in a 12-month period;195.34    (8) experimental treatment;196.1    (9) any service or item covered by other medical assistance state plan services, 196.2including prescription and over-the-counter medications, compounds, and solutions and 196.3related fees, including premiums and co-payments;196.4    (10) membership dues or costs, except when the service is necessary and appropriate 196.5to treat a physical condition or to improve or maintain the recipient's physical condition. 196.6The condition must be identified in the recipient's plan of care and monitored by a 196.7Minnesota health care program enrolled physician;196.8    (11) vacation expenses other than the cost of direct services;196.9    (12) vehicle maintenance or modifications not related to the disability;196.10    (13) tickets and related costs to attend sporting or other recreational events; and196.11    (14) costs related to Internet access, except when necessary for operation of assistive 196.12technology, to increase independence, or to substitute for human assistance.196.13    Subd. 8.Self-directed budget requirements.The budget for the provision of the 196.14self-directed service option shall be equal to the greater of either:196.15    (1) the annual amount of personal care assistant services under section 256B.0655 196.16that the recipient has used in the most recent 12-month period; or 196.17    (2) the amount determined using the consumer support grant methodology under 196.18section 256.476, subdivision 11, except that the budget amount shall include the federal 196.19and nonfederal share of the average service costs.196.20    Subd. 9.Quality assurance and risk management.(a) The commissioner 196.21shall establish quality assurance and risk management measures for use in developing 196.22and implementing self-directed plans and budgets that (1) recognize the roles and 196.23responsibilities involved in obtaining services in a self-directed manner, and (2) assure 196.24the appropriateness of such plans and budgets based upon a recipient's resources and 196.25capabilities. These measures must include (i) background studies, and (ii) backup and 196.26emergency plans, including disaster planning.196.27    (b) The commissioner shall provide ongoing technical assistance and resource and 196.28educational materials for families and recipients selecting the self-directed option.196.29    (c) Performance assessments measures, such as of a recipient's satisfaction with the 196.30services and supports, and ongoing monitoring of health and well-being shall be identified 196.31in consultation with the stakeholder group.196.32    Subd. 10.Fiscal support entity.(a) Each recipient shall choose a fiscal support 196.33entity provider certified by the commissioner to make payments for services, items, 196.34supports, and administrative costs related to managing a self-directed service plan 196.35authorized for payment in the approved plan and budget. Recipients shall also choose 197.1the payroll, agency with choice, or the fiscal conduit model of financial and service 197.2management.197.3    (b) The fiscal support entity:197.4    (1) may not limit or restrict the recipient's choice of service or support providers, 197.5including use of the payroll, agency with choice, or fiscal conduit model of financial 197.6and service management; 197.7    (2) must have a written agreement with the recipient or the recipient's representative 197.8that identifies the duties and responsibilities to be performed and the specific related 197.9charges; 197.10    (3) must provide the recipient and the home care targeted case manager with a 197.11monthly written summary of the self-directed supports option services that were billed, 197.12including charges from the fiscal support entity;197.13    (4) must be knowledgeable of and comply with Internal Revenue Service 197.14requirements necessary to process employer and employee deductions, provide appropriate 197.15and timely submission of employer tax liabilities, and maintain documentation to support 197.16medical assistance claims; 197.17    (5) must have current and adequate liability insurance and bonding and sufficient 197.18cash flow and have on staff or under contract a certified public accountant or an individual 197.19with a baccalaureate degree in accounting; and 197.20    (6) must maintain records to track all self-directed supports option services 197.21expenditures, including time records of persons paid to provide supports and receipts for 197.22any goods purchased. The records must be maintained for a minimum of five years from 197.23the claim date and be available for audit or review upon request. Claims submitted by 197.24the fiscal support entity must correspond with services, amounts, and time periods as 197.25authorized in the recipient's self-directed supports option plan.197.26    (c) The commissioner shall have authority to:197.27    (1) set or negotiate rates with fiscal support entities;197.28    (2) limit the number of fiscal support entities;197.29    (3) identify a process to certify and recertify fiscal support entities and assure fiscal 197.30support entities are available to recipients throughout the state; and 197.31    (4) establish a uniform format and protocol to be used by eligible fiscal support 197.32entities.197.33    Subd. 11.Stakeholder consultation.The commissioner shall consult with a 197.34statewide consumer-directed services stakeholder group, including representatives of 197.35all types of consumer-directed service users, advocacy organizations, counties, and 198.1consumer-directed service providers. The commissioner shall seek recommendations 198.2from this stakeholder group in developing:198.3    (1) the self-directed plan format;198.4    (2) requirements and guidelines for the person-centered plan assessment and 198.5planning process;198.6    (3) implementation of the option and the quality assurance and risk management 198.7techniques; and 198.8    (4) standards and requirements, including rates for the personal support plan 198.9development provider and the fiscal support entity; policies; training; and implementation. 198.10The stakeholder group shall provide recommendations on the repeal of the personal care 198.11assistant choice option, transition issues, and whether the consumer support grant program 198.12under section 256.476 should be modified. The stakeholder group shall meet at least 198.13three times each year to provide advice on policy, implementation, and other aspects of 198.14consumer and self-directed services.198.15EFFECTIVE DATE.Subdivisions 1 to 10 are effective upon federal approval of 198.16the state Medicaid plan amendment. The commissioner of human services shall inform 198.17the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11 198.18is effective July 1, 2007.198.19    Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to 198.20read:198.21    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 198.22services planning, or other assistance intended to support community-based living, 198.23including persons who need assessment in order to determine waiver or alternative care 198.24program eligibility, must be visited by a long-term care consultation team within ten 198.25working days after the date on which an assessment was requested or recommended. 198.26Assessments must be conducted according to paragraphs (b) to (g) (i).198.27    (b) The county may utilize a team of either the social worker or public health nurse, 198.28or both, to conduct the assessment in a face-to-face interview. The consultation team 198.29members must confer regarding the most appropriate care for each individual screened or 198.30assessed.198.31    (c) The long-term care consultation team must assess the health and social needs of 198.32the person, using an assessment form provided by the commissioner.198.33    (d) The team must conduct the assessment in a face-to-face interview with the 198.34person being assessed and the person's legal representative, if applicable.199.1    (e) The team must provide the person, or the person's legal representative, with 199.2written recommendations for facility- or community-based services. The team must 199.3document that the most cost-effective alternatives available were offered to the individual. 199.4For purposes of this requirement, "cost-effective alternatives" means community services 199.5and living arrangements that cost the same as or less than nursing facility care.199.6    (f) If the person chooses to use community-based services, the team must provide 199.7the person or the person's legal representative with a written community support plan, 199.8regardless of whether the individual is eligible for Minnesota health care programs. 199.9The person may request assistance in developing a community support plan without 199.10participating in a complete assessment.199.11    (g) The person has the right to make the final decision between nursing facility 199.12placement and community placement after the screening team's recommendation, except 199.13as provided in subdivision 4a, paragraph (c).199.14    (h) The team must give the person receiving assessment or support planning, or 199.15the person's legal representative, materials, and forms supplied by the commissioner 199.16containing the following information:199.17    (1) the need for and purpose of preadmission screening and assessment if the person 199.18selects nursing facility placement;199.19    (2) the role of the long-term care consultation assessment and support planning in 199.20waiver and alternative care program eligibility determination;199.21    (2) (3) information about Minnesota health care programs;199.22    (3) (4) the person's freedom to accept or reject the recommendations of the team;199.23    (4) (5) the person's right to confidentiality under the Minnesota Government Data 199.24Practices Act, chapter 13; and199.25    (6) the long-term care consultant's decision regarding the person's need for nursing 199.26facility level of care;199.27    (5) (7) the person's right to appeal the decision regarding the need for nursing facility 199.28level of care or the county's final decisions regarding public programs eligibility according 199.29to section 
         256.045, subdivision 3. 199.30    (i) Face-to-face assessment completed as part of eligibility determination for 199.31the alternative care, elderly waiver, community alternatives for disabled individuals, 199.32community alternative care, and traumatic brain injury waiver programs under sections 199.33256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 199.34than 60 calendar days after the date of assessment. The effective eligibility start date 199.35for these programs can never be prior to the date of assessment. If an assessment was 199.36completed more than 60 days before the effective waiver or alternative care program 200.1eligibility start date, assessment and support plan information must be updated in a 200.2face-to-face visit and documented in the department's Medicaid Management Information 200.3System (MMIS). The effective date of program eligibility in this case cannot be prior to 200.4the date the updated assessment is completed.200.5    Sec. 29. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to 200.6read:200.7    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall 200.8provide assistance to persons residing in a nursing facility, hospital, regional treatment 200.9center, or intermediate care facility for persons with developmental disabilities who 200.10request or are referred for assistance. Transition assistance must include assessment, 200.11community support plan development, referrals to Minnesota health care programs, 200.12and referrals to programs that provide assistance with housing. Transition assistance 200.13must also include information about the Centers for Independent Living and about other 200.14organizations that can provide assistance with relocation efforts, and information about 200.15contacting these organizations to obtain their assistance and support. 200.16    (b) The county shall develop transition processes with institutional social workers 200.17and discharge planners to ensure that:200.18    (1) persons admitted to facilities receive information about transition assistance 200.19that is available;200.20    (2) the assessment is completed for persons within ten working days of the date of 200.21request or recommendation for assessment; and200.22    (3) there is a plan for transition and follow-up for the individual's return to the 200.23community. The plan must require notification of other local agencies when a person 200.24who may require assistance is screened by one county for admission to a facility located 200.25in another county.200.26    (c) If a person who is eligible for a Minnesota health care program is admitted to a 200.27nursing facility, the nursing facility must include a consultation team member or the case 200.28manager in the discharge planning process.200.29    Sec. 30. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 200.30subdivision to read:200.31    Subd. 3c.Transition to housing with services.(a) Transitional consultation shall 200.32be offered to all prospective residents 65 years of age or older regardless of income, assets, 200.33or funding sources before housing with services establishments offering or providing 200.34assisted living execute a lease or contract with the prospective resident. The purpose of 201.1transitional long-term care consultation is to support persons with current or anticipated 201.2long-term care needs in making informed choices among options that include the most 201.3cost-effective and least restrictive settings, and to delay spenddown to eligibility for 201.4publicly funded programs by connecting people to alternative services in their homes 201.5before transition to housing with services.201.6    (b) Transitional consultation services are provided as determined by the 201.7commissioner of human services in partnership with county long-term care consultation 201.8units, and the Area Agencies on Aging, and are a combination of telephone-based 201.9and in-person assistance provided under models developed by the commissioner. The 201.10consultation is to be performed in a manner which provides objective and complete 201.11information. Transitional consultation must be provided within five working days of the 201.12request of the prospective resident as follows:201.13    (1) the consultation must be provided by a qualified professional as determined by 201.14the commissioner;201.15    (2) the consultation must include a review of the prospective resident's reasons for 201.16considering assisted living, the prospective resident's personal goals, a discussion of the 201.17prospective resident's immediate and projected long-term care needs, and alternative 201.18community services or assisted living settings that may meet the prospective resident's 201.19needs; and201.20    (3) the prospective resident will be informed of the availability of long-term care 201.21consultation services described in subdivision 3a that are available at no charge to the 201.22prospective resident to assist the prospective resident in assessment and planning to 201.23meet the prospective resident's long-term care needs. Regardless of the consultation, 201.24prospective residents maintain the right to choose housing with services or assisted living, 201.25if that is their choice.201.26EFFECTIVE DATE.This section is effective October 1, 2008.201.27    Sec. 31. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to 201.28read:201.29    Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the 201.30federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are 201.31limited to:201.32    (1) a person who, having entered an acute care facility from a certified nursing 201.33facility, is returning to a certified nursing facility;201.34    (2) a person transferring from one certified nursing facility in Minnesota to another 201.35certified nursing facility in Minnesota; and202.1    (3) a person, 21 years of age or older, who satisfies the following criteria, as specified 202.2in Code of Federal Regulations, title 42, section 483.106(b)(2):202.3    (i) the person is admitted to a nursing facility directly from a hospital after receiving 202.4acute inpatient care at the hospital;202.5    (ii) the person requires nursing facility services for the same condition for which 202.6care was provided in the hospital; and202.7    (iii) the attending physician has certified before the nursing facility admission that 202.8the person is likely to receive less than 30 days of nursing facility services.202.9    (b) Persons who are exempt from preadmission screening for purposes of level of 202.10care determination include:202.11    (1) persons described in paragraph (a);202.12    (2) an individual who has a contractual right to have nursing facility care paid for 202.13indefinitely by the veterans' administration;202.14    (3) an individual enrolled in a demonstration project under section 
         256B.69, 202.15subdivision 8
         , at the time of application to a nursing facility; and202.16    (4) an individual currently being served under the alternative care program or under 202.17a home and community-based services waiver authorized under section 1915(c) of the 202.18federal Social Security Act; and.202.19    (5) individuals admitted to a certified nursing facility for a short-term stay, which 202.20is expected to be 14 days or less in duration based upon a physician's certification, and 202.21who have been assessed and approved for nursing facility admission within the previous 202.22six months. This exemption applies only if the consultation team member determines at 202.23the time of the initial assessment of the six-month period that it is appropriate to use the 202.24nursing facility for short-term stays and that there is an adequate plan of care for return to 202.25the home or community-based setting. If a stay exceeds 14 days, the individual must be 202.26referred no later than the first county working day following the 14th resident day for a 202.27screening, which must be completed within five working days of the referral. The payment 202.28limitations in subdivision 7 apply to an individual found at screening to not meet the level 202.29of care criteria for admission to a certified nursing facility.202.30    (c) Persons admitted to a Medicaid-certified nursing facility from the community 202.31on an emergency basis as described in paragraph (d) or from an acute care facility on a 202.32nonworking day must be screened the first working day after admission.202.33    (d) Emergency admission to a nursing facility prior to screening is permitted when 202.34all of the following conditions are met:202.35    (1) a person is admitted from the community to a certified nursing or certified 202.36boarding care facility during county nonworking hours;203.1    (2) a physician has determined that delaying admission until preadmission screening 203.2is completed would adversely affect the person's health and safety;203.3    (3) there is a recent precipitating event that precludes the client from living safely in 203.4the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's 203.5inability to continue to provide care;203.6    (4) the attending physician has authorized the emergency placement and has 203.7documented the reason that the emergency placement is recommended; and203.8    (5) the county is contacted on the first working day following the emergency 203.9admission.203.10Transfer of a patient from an acute care hospital to a nursing facility is not considered 203.11an emergency except for a person who has received hospital services in the following 203.12situations: hospital admission for observation, care in an emergency room without hospital 203.13admission, or following hospital 24-hour bed care.203.14    (e) A nursing facility must provide a written notice to persons who satisfy the criteria 203.15in paragraph (a), clause (3),information to all persons admitted regarding the person's 203.16right to request and receive long-term care consultation services as defined in subdivision 203.171a. The noticeinformation must be provided prior to the person's discharge from the 203.18facility and in a format specified by the commissioner.203.19    Sec. 32. Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to 203.20read:203.21    Subd. 4c. Screening requirements. (a) A person may be screened for nursing 203.22facility admission by telephone or in a face-to-face screening interview. Consultation team 203.23members shall identify each individual's needs using the following categories:203.24    (1) the person needs no face-to-face screening interview to determine the need 203.25for nursing facility level of care based on information obtained from other health care 203.26professionals;203.27    (2) the person needs an immediate face-to-face screening interview to determine the 203.28need for nursing facility level of care and complete activities required under subdivision 203.294a; or203.30    (3) the person may be exempt from screening requirements as outlined in subdivision 203.314b, but will need transitional assistance after admission or in-person follow-along after 203.32a return home.203.33    (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing 203.34facility must be screened prior to admission.204.1    (c) The long-term care consultation team shall recommend a case mix classification 204.2for persons admitted to a certified nursing facility when sufficient information is received 204.3to make that classification. The nursing facility is authorized to conduct all case mix 204.4assessments for persons who have been screened prior to admission for whom the county 204.5did not recommend a case mix classification. The nursing facility is authorized to conduct 204.6all case mix assessments for persons admitted to the facility prior to a preadmission 204.7screening. The county retains the responsibility of distributing appropriate case mix 204.8forms to the nursing facility.204.9    (d) (c) The county screening or intake activity must include processes to identify 204.10persons who may require transition assistance as described in subdivision 3b.204.11    Sec. 33. Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to 204.12read:204.13    Subd. 6. Payment for long-term care consultation services. (a) The total payment 204.14for each county must be paid monthly by certified nursing facilities in the county. The 204.15monthly amount to be paid by each nursing facility for each fiscal year must be determined 204.16by dividing the county's annual allocation for long-term care consultation services by 12 204.17to determine the monthly payment and allocating the monthly payment to each nursing 204.18facility based on the number of licensed beds in the nursing facility. Payments to counties 204.19in which there is no certified nursing facility must be made by increasing the payment 204.20rate of the two facilities located nearest to the county seat.204.21    (b) The commissioner shall include the total annual payment determined under 204.22paragraph (a) for each nursing facility reimbursed under section 
         256B.431 or 
         256B.434204.23according to section 
         256B.431, subdivision 2b, paragraph (g), or 256B.435.204.24    (c) In the event of the layaway, delicensure and decertification, or removal from 204.25layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 204.26the per diem payment amount in paragraph (b) and may adjust the monthly payment 204.27amount in paragraph (a). The effective date of an adjustment made under this paragraph 204.28shall be on or after the first day of the month following the effective date of the layaway, 204.29delicensure and decertification, or removal from layaway.204.30    (d) Payments for long-term care consultation services are available to the county 204.31or counties to cover staff salaries and expenses to provide the services described in 204.32subdivision 1a. The county shall employ, or contract with other agencies to employ, within 204.33the limits of available funding, sufficient personnel to provide long-term care consultation 204.34services while meeting the state's long-term care outcomes and objectives as defined in 204.35section 
         256B.0917, subdivision 1. The county shall be accountable for meeting local 205.1objectives as approved by the commissioner in the biennial home and community-based 205.2services quality assurance plan on a form provided by the commissioner.205.3    (e) Notwithstanding section 
         256B.0641, overpayments attributable to payment of the 205.4screening costs under the medical assistance program may not be recovered from a facility.205.5    (f) The commissioner of human services shall amend the Minnesota medical 205.6assistance plan to include reimbursement for the local consultation teams.205.7    (g) The county may bill, as case management services, assessments, support 205.8planning, and follow-along provided to persons determined to be eligible for case 205.9management under Minnesota health care programs. No individual or family member 205.10shall be charged for an initial assessment or initial support plan development provided 205.11under subdivision 3a or 3b.205.12    Sec. 34. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 205.13subdivision to read:205.14    Subd. 6a.Withholding.If any provider obligated to pay the long-term care 205.15consultation amount as described in subdivision 6 is more than two months delinquent in 205.16the timely payment of the monthly installment, the commissioner may withhold payments, 205.17penalties, and interest in accordance with the methods outlined in section 256.9657, 205.18subdivision 7a. Any amount withheld under this provision must be returned to the county 205.19to whom the delinquent payments were due.205.20    Sec. 35. Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to 205.21read:205.22    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance 205.23reimbursement for nursing facilities shall be authorized for a medical assistance recipient 205.24only if a preadmission screening has been conducted prior to admission or the county has 205.25authorized an exemption. Medical assistance reimbursement for nursing facilities shall 205.26not be provided for any recipient who the local screener has determined does not meet the 205.27level of care criteria for nursing facility placement or, if indicated, has not had a level II 205.28OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 205.291987 completed unless an admission for a recipient with mental illness is approved by the 205.30local mental health authority or an admission for a recipient with developmental disability 205.31is approved by the state developmental disability authority.205.32    (b) The nursing facility must not bill a person who is not a medical assistance 205.33recipient for resident days that preceded the date of completion of screening activities as 206.1required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 206.2resident days in the nursing facility resident day totals reported to the commissioner.206.3    (c) The commissioner shall make a request to the Centers for Medicare and Medicaid 206.4Services for a waiver allowing team approval of Medicaid payments for certified nursing 206.5facility care. An individual has a choice and makes the final decision between nursing 206.6facility placement and community placement after the screening team's recommendation, 206.7except as provided in subdivision 4a, paragraph (c).206.8    Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to 206.9read:206.10    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.206.11    (a) Funding for services under the alternative care program is available to persons who 206.12meet the following criteria:206.13    (1) the person has been determined by a community assessment under section 206.14256B.0911
          to be a person who would require the level of care provided in a nursing 206.15facility, but for the provision of services under the alternative care program;206.16    (2) the person is age 65 or older;206.17    (3) the person would be eligible for medical assistance within 135 days of admission 206.18to a nursing facility;206.19    (4) the person is not ineligible for the payment of long-term care services by the206.20medical assistance program due to an asset transfer penalty under section 256B.0595 or 206.21equity interest in the home exceeding $500,000 as stated in section 256B.056;206.22    (5) the person needs long-term care services that are not funded through other state 206.23or federal funding;206.24    (6) the monthly cost of the alternative care services funded by the program for 206.25this person does not exceed 75 percent of the monthly limit described under section 206.26256B.0915, subdivision 3a
         . This monthly limit does not prohibit the alternative care client 206.27from payment for additional services, but in no case may the cost of additional services 206.28purchased under this section exceed the difference between the client's monthly service 206.29limit defined under section 
         256B.0915, subdivision 3, and the alternative care program 206.30monthly service limit defined in this paragraph. If medical care-related supplies and 206.31equipment or environmental modifications and adaptations are or will be purchased for 206.32an alternative care services recipient, the costs may be prorated on a monthly basis for 206.33up to 12 consecutive months beginning with the month of purchase. If the monthly cost 206.34of a recipient's other alternative care services exceeds the monthly limit established in 206.35this paragraph, the annual cost of the alternative care services shall be determined. In this 207.1event, the annual cost of alternative care services shall not exceed 12 times the monthly 207.2limit described in this paragraph; and207.3    (7) the person is making timely payments of the assessed monthly fee.207.4A person is ineligible if payment of the fee is over 60 days past due, unless the person 207.5agrees to:207.6    (i) the appointment of a representative payee;207.7    (ii) automatic payment from a financial account;207.8    (iii) the establishment of greater family involvement in the financial management of 207.9payments; or207.10    (iv) another method acceptable to the county lead agency to ensure prompt fee 207.11payments.207.12    The county shall lead agency may extend the client's eligibility as necessary while 207.13making arrangements to facilitate payment of past-due amounts and future premium 207.14payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall 207.15not be reinstated for a period of 30 days.207.16    (b) Alternative care funding under this subdivision is not available for a person 207.17who is a medical assistance recipient or who would be eligible for medical assistance 207.18without a spenddown or waiver obligation. A person whose initial application for medical 207.19assistance and the elderly waiver program is being processed may be served under the 207.20alternative care program for a period up to 60 days. If the individual is found to be eligible 207.21for medical assistance, medical assistance must be billed for services payable under the 207.22federally approved elderly waiver plan and delivered from the date the individual was 207.23found eligible for the federally approved elderly waiver plan. Notwithstanding this 207.24provision, alternative care funds may not be used to pay for any service the cost of which: 207.25(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 207.26or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 207.27to participate in the federally approved elderly waiver program under the special income 207.28standard provision.207.29    (c) Alternative care funding is not available for a person who resides in a licensed 207.30nursing home, certified boarding care home, hospital, or intermediate care facility, except 207.31for case management services which are provided in support of the discharge planning 207.32process for a nursing home resident or certified boarding care home resident to assist with 207.33a relocation process to a community-based setting.207.34    (d) Alternative care funding is not available for a person whose income is greater 207.35than the maintenance needs allowance under section 
         256B.0915, subdivision 1d, but equal 207.36to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal208.1year for which alternative care eligibility is determined, who would be eligible for the 208.2elderly waiver with a waiver obligation.208.3    Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to 208.4read:208.5    Subd. 5. Services covered under alternative care. Alternative care funding may 208.6be used for payment of costs of:208.7    (1) adult day care;208.8    (2) home health aide;208.9    (3) homemaker services;208.10    (4) personal care;208.11    (5) case management;208.12    (6) respite care;208.13    (7) care-related supplies and equipment;208.14    (8) meals delivered to the home;208.15    (9) nonmedical transportation;208.16    (10) nursing services;208.17    (11) chore services;208.18    (12) companion services;208.19    (13) nutrition services;208.20    (14) training for direct informal caregivers;208.21    (15) telehome care to provide services in their own homes in conjunction with 208.22in-home visits;208.23    (16) discretionary services, for which counties may make payment from their 208.24alternative care program allocation or services not otherwise defined in this section 208.25or section 256B.0625, following approval by the commissioner consumer-directed 208.26community services under the alternative care programs which are available statewide and 208.27limited to the average monthly expenditures representative of all alternative care program 208.28participants for the same case mix resident class assigned in the most recent fiscal year for 208.29which complete expenditure data is available;208.30    (17) environmental modifications and adaptations; and208.31    (18) direct cash payments for which counties may make payment from their 208.32alternative care program allocation to clients for the purpose of purchasing services, 208.33following approval by the commissioner, and subject to the provisions of subdivision 5h, 208.34until approval and implementation of consumer-directed services through the federally 208.35approved elderly waiver plan. Upon implementation, consumer-directed services under 209.1the alternative care program are available statewide and limited to the average monthly 209.2expenditures representative of all alternative care program participants for the same case 209.3mix resident class assigned in the most recent fiscal year for which complete expenditure 209.4data is available discretionary services, for which lead agencies may make payment from 209.5their alternative care program allocation for services not otherwise defined in this section 209.6or section 256B.0625, following approval by the commissioner.209.7    Total annual payments for discretionary services and direct cash payments, until 209.8the federally approved consumer-directed service option is implemented statewide, for 209.9all clients within a county may served by a lead agency must not exceed 25 percent of 209.10that county's lead agency's annual alternative care program base allocation. Thereafter, 209.11discretionary services are limited to 25 percent of the county's annual alternative care 209.12program base allocation.209.13    Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to 209.14read:209.15    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in 209.16statute, the services, service definitions, and standards for alternative care services shall 209.17be the same as the services, service definitions, and standards specified in the federally 209.18approved elderly waiver plan, except foralternative care does not cover transitional 209.19support services, assisted living services, adult foster care services, and residential care 209.20services and benefits defined under section 256B.0625 that meet primary and acute 209.21health care needs.209.22    (b) The county lead agency must ensure that the funds are not used to supplant 209.23or supplement services available through other public assistance or services programs., 209.24including supplementation of client co-pays, deductibles, premiums, or other cost-sharing 209.25arrangements for health-related benefits and services or entitlement programs and services 209.26that are available to the person, but in which they have elected not to enroll. For a provider 209.27of supplies and equipment when the monthly cost of the supplies and equipment is less 209.28than $250, persons or agencies must be employed by or under a contract with the county209.29lead agency or the public health nursing agency of the local board of health in order to 209.30receive funding under the alternative care program. Supplies and equipment may be 209.31purchased from a vendor not certified to participate in the Medicaid program if the cost for 209.32the item is less than that of a Medicaid vendor.209.33    (c) Personal care services must meet the service standards defined in the federally 209.34approved elderly waiver plan, except that a county lead agency may contract with a 209.35client's relative who meets the relative hardship waiver requirements or a relative who 210.1meets the criteria and is also the responsible party under an individual service plan that 210.2ensures the client's health and safety and supervision of the personal care services by a 210.3qualified professional as defined in section 
         256B.0625, subdivision 19c. Relative hardship 210.4is established by the county lead agency when the client's care causes a relative caregiver 210.5to do any of the following: resign from a paying job, reduce work hours resulting in lost 210.6wages, obtain a leave of absence resulting in lost wages, incur substantial client-related 210.7expenses, provide services to address authorized, unstaffed direct care time, or meet 210.8special needs of the client unmet in the formal service plan.210.9    Sec. 39. Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to 210.10read:210.11    Subd. 8. Requirements for individual care plan. (a) The case manager shall 210.12implement the plan of care for each alternative care client and ensure that a client's 210.13service needs and eligibility are reassessed at least every 12 months. The plan shall 210.14include any services prescribed by the individual's attending physician as necessary to 210.15allow the individual to remain in a community setting. In developing the individual's care 210.16plan, the case manager should include the use of volunteers from families and neighbors, 210.17religious organizations, social clubs, and civic and service organizations to support the 210.18formal home care services. The county lead agency shall be held harmless for damages or 210.19injuries sustained through the use of volunteers under this subdivision including workers' 210.20compensation liability. The county of service case manager shall provide documentation 210.21in each individual's plan of care and, if requested, to the commissioner that the most 210.22cost-effective alternatives available have been offered to the individual and that the 210.23individual was free to choose among available qualified providers, both public and private, 210.24including qualified case management or service coordination providers other than those 210.25employed by any county; however, the county or tribe maintains responsibility for prior 210.26authorizing services in accordance with statutory and administrative requirements. The 210.27case manager must give the individual a ten-day written notice of any denial, termination, 210.28or reduction of alternative care services.210.29    (b) The county of service or tribe must provide access to and arrange for case 210.30management services, including assuring implementation of the plan. "County of service" 210.31has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The county of 210.32service must notify the county of financial responsibility of the approved care plan and 210.33the amount of encumbered funds.211.1    Sec. 40. Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to 211.2read:211.3    Subd. 9. Contracting provisions for providers. Alternative care funds paid to 211.4service providers are subject to audit by the commissioner for fiscal and utilization control.211.5    The lead agency must select providers for contracts or agreements using the 211.6following criteria and other criteria established by the county lead agency:211.7    (1) the need for the particular services offered by the provider;211.8    (2) the population to be served, including the number of clients, the length of time 211.9services will be provided, and the medical condition of clients;211.10    (3) the geographic area to be served;211.11    (4) quality assurance methods, including appropriate licensure, certification, or 211.12standards, and supervision of employees when needed;211.13    (5) rates for each service and unit of service exclusive of county lead agency211.14administrative costs;211.15    (6) evaluation of services previously delivered by the provider; and211.16    (7) contract or agreement conditions, including billing requirements, cancellation, 211.17and indemnification.211.18    The county lead agency must evaluate its own agency services under the criteria 211.19established for other providers.211.20    Sec. 41. Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to 211.21read:211.22    Subd. 10. Allocation formula. (a) The alternative care appropriation for fiscal 211.23years 1992 and beyond shall cover only alternative care eligible clients. By July 1 15 of 211.24each year, the commissioner shall allocate to county agencies the state funds available for 211.25alternative care for persons eligible under subdivision 2.211.26    (b) The adjusted base for each county lead agency is the county's lead agency's211.27current fiscal year base allocation plus any targeted funds approved during the current 211.28fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each 211.29county lead agency, the determination of alternative care program expenditures shall be 211.30based on payments for services rendered from April 1 through March 31 in the base year, 211.31to the extent that claims have been submitted and paid by June 1 of that year.211.32    (c) If the alternative care program expenditures as defined in paragraph (b) are 95 211.33percent or more of the county's lead agency's adjusted base allocation, the allocation for 211.34the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that 211.35inflation is included in the state budget.212.1    (d) If the alternative care program expenditures as defined in paragraph (b) are less 212.2than 95 percent of the county's lead agency's adjusted base allocation, the allocation 212.3for the next fiscal year is the adjusted base allocation less the amount of unspent funds 212.4below the 95 percent level.212.5    (e) If the annual legislative appropriation for the alternative care program is 212.6inadequate to fund the combined county lead agency allocations for a biennium, the 212.7commissioner shall distribute to each county lead agency the entire annual appropriation 212.8as that county's lead agency's percentage of the computed base as calculated in paragraphs 212.9(c) and (d).212.10    (f) On agreement between the commissioner and the lead agency, the commissioner 212.11may have discretion to reallocate alternative care base allocations distributed to lead 212.12agencies in which the base amount exceeds program expenditures.212.13    Sec. 42. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to 212.14read:212.15    Subd. 11. Targeted funding. (a) The purpose of targeted funding is to make 212.16additional money available to counties lead agencies with the greatest need. Targeted 212.17funds are not intended to be distributed equitably among all counties lead agencies, but 212.18rather, allocated to those with long-term care strategies that meet state goals.212.19    (b) The funds available for targeted funding shall be the total appropriation for each 212.20fiscal year minus county lead agency allocations determined under subdivision 10 as 212.21adjusted for any inflation increases provided in appropriations for the biennium.212.22    (c) The commissioner shall allocate targeted funds to counties lead agencies that 212.23demonstrate to the satisfaction of the commissioner that they have developed feasible 212.24plans to increase alternative care spending. In making targeted funding allocations, the 212.25commissioner shall use the following priorities:212.26    (1) counties lead agencies that received a lower allocation in fiscal year 1991 than in 212.27fiscal year 1990. Counties remain in this priority until they have been restored to their 212.28fiscal year 1990 level plus inflation;212.29    (2) counties lead agencies that sustain a base allocation reduction for failure to spend 212.3095 percent of the allocation if they demonstrate that the base reduction should be restored;212.31    (3) counties lead agencies that propose projects to divert community residents from 212.32nursing home placement or convert nursing home residents to community living; and212.33    (4) counties lead agencies that can otherwise justify program growth by 212.34demonstrating the existence of waiting lists, demographically justified needs, or other 212.35unmet needs.213.1    (d) Counties Lead agencies that would receive targeted funds according to 213.2paragraph (c) must demonstrate to the commissioner's satisfaction that the funds 213.3would be appropriately spent by showing how the funds would be used to further the 213.4state's alternative care goals as described in subdivision 1, and that the county has the 213.5administrative and service delivery capability to use them.213.6    (e) The commissioner shall request applications make applications available for 213.7targeted funds by November 1 of each year. The counties lead agencies selected for 213.8targeted funds shall be notified of the amount of their additional funding. Targeted funds 213.9allocated to a county lead agency in one year shall be treated as part of the county's lead 213.10agency's base allocation for that year in determining allocations for subsequent years. No 213.11reallocations between counties lead agencies shall be made.213.12    Sec. 43. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to 213.13read:213.14    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients 213.15to help pay for the cost of participating in the program. The amount of the fee for the 213.16alternative care client shall be determined as follows:213.17    (1) when the alternative care client's income less recurring and predictable medical 213.18expenses is less than 100 percent of the federal poverty guideline effective on July 1 of 213.19the state fiscal year in which the fee is being computed, and total assets are less than 213.20$10,000, the fee is zero;213.21    (2) when the alternative care client's income less recurring and predictable medical 213.22expenses is equal to or greater than 100 percent but less than 150 percent of the federal 213.23poverty guideline effective on July 1 of the state fiscal year in which the fee is being 213.24computed, and total assets are less than $10,000, the fee is five percent of the cost of 213.25alternative care services;213.26    (3) when the alternative care client's income less recurring and predictable medical 213.27expenses is equal to or greater than 150 percent but less than 200 percent of the federal 213.28poverty guidelines effective on July 1 of the state fiscal year in which the fee is being 213.29computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative 213.30care services;213.31    (4) when the alternative care client's income less recurring and predictable medical 213.32expenses is equal to or greater than 200 percent of the federal poverty guidelines effective 213.33on July 1 of the state fiscal year in which the fee is being computed and assets are less than 213.34$10,000, the fee is 30 percent of the cost of alternative care services; and214.1    (5) when the alternative care client's assets are equal to or greater than $10,000, the 214.2fee is 30 percent of the cost of alternative care services.214.3    For married persons, total assets are defined as the total marital assets less the 214.4estimated community spouse asset allowance, under section 
         256B.059, if applicable. For 214.5married persons, total income is defined as the client's income less the monthly spousal 214.6allotment, under section 
         256B.058. 214.7    All alternative care services shall be included in the estimated costs for the purpose 214.8of determining the fee.214.9    Fees are due and payable each month alternative care services are received unless the 214.10actual cost of the services is less than the fee, in which case the fee is the lesser amount.214.11    (b) The fee shall be waived by the commissioner when:214.12    (1) a person who is residing in a nursing facility is receiving case management only;214.13    (2) a married couple is requesting an asset assessment under the spousal 214.14impoverishment provisions;214.15    (3) a person is found eligible for alternative care, but is not yet receiving alternative 214.16care services including case management services; or214.17    (4) a person has chosen to participate in a consumer-directed service plan for which 214.18the cost is no greater than the total cost of the person's alternative care service plan less 214.19the monthly fee amount that would otherwise be assessed.214.20    (c) The county agency must record in the state's receivable system the client's 214.21assessed fee amount or the reason the fee has been waived. The commissioner will bill 214.22and collect the fee from the client. Money collected must be deposited in the general fund 214.23and is appropriated to the commissioner for the alternative care program. The client must 214.24supply the county lead agency with the client's Social Security number at the time of 214.25application. The county lead agency shall supply the commissioner with the client's Social 214.26Security number and other information the commissioner requires to collect the fee from 214.27the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in 214.28chapter 270A and other methods available to the commissioner. The commissioner may 214.29require counties lead agencies to inform clients of the collection procedures that may be 214.30used by the state if a fee is not paid. This paragraph does not apply to alternative care 214.31pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 214.32133, if a county operating under the pilot project reports the following dollar amounts 214.33to the commissioner quarterly:214.34    (1) total fees billed to clients;214.35    (2) total collections of fees billed; and214.36    (3) balance of fees owed by clients.215.1If a county lead agency does not adhere to these reporting requirements, the commissioner 215.2may terminate the billing, collecting, and remitting portions of the pilot project and require 215.3the county lead agency involved to operate under the procedures set forth in this paragraph.215.4    Sec. 44. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to 215.5read:215.6    Subd. 13. County Lead agency biennial plan. The county lead agency biennial 215.7plan for long-term care consultation services under section 
         256B.0911, the alternative 215.8care program under this section, and waivers for the elderly under section 
         256B.0915, 215.9shall be submitted by the lead agency as the home and community-based services quality 215.10assurance plan on a form provided by the commissioner.215.11    Sec. 45. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to 215.12read:215.13    Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless 215.14otherwise specified in statute, providers must be enrolled as Minnesota health care 215.15program providers and abide by the requirements for provider participation according to 215.16Minnesota Rules, part 9505.0195.215.17    (b) Payment for provided alternative care services as approved by the client's 215.18case manager shall occur through the invoice processing procedures of the department's 215.19Medicaid Management Information System (MMIS). To receive payment, the county lead 215.20agency or vendor must submit invoices within 12 months following the date of service. 215.21The county lead agency and its vendors under contract shall not be reimbursed for services 215.22which exceed the county allocation.215.23    (c) The county lead agency shall negotiate individual rates with vendors and may 215.24authorize service payment for actual costs up to the county's current approved rate. 215.25Notwithstanding any other rule or statutory provision to the contrary, the commissioner 215.26shall not be authorized to increase rates by an annual inflation factor, unless so authorized 215.27by the legislature. To improve access to community services and eliminate payment 215.28disparities between the alternative care program and the elderly waiver program, the 215.29commissioner shall establish statewide maximum service rate limits and eliminate 215.30county-specific service rate limits.215.31    (1) Effective July 1, 2001, for service rate limits, except those in subdivision 5, 215.32paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative 215.33care statewide maximum rate or the elderly waiver statewide maximum rate.216.1    (2) Counties Lead agencies may negotiate individual service rates with vendors for 216.2actual costs up to the statewide maximum service rate limit.216.3    Sec. 46. Minnesota Statutes 2006, section 256B.0915, is amended to read:216.4256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.216.5    Subdivision 1. Authority. The commissioner is authorized to apply for a home 216.6and community-based services waiver for the elderly, authorized under section 1915(c) 216.7of the Social Security Act, in order to obtain federal financial participation to expand 216.8the availability of services for persons who are eligible for medical assistance. The 216.9commissioner may apply for additional waivers or pursue other federal financial 216.10participation which is advantageous to the state for funding home care services for the 216.11frail elderly who are eligible for medical assistance. The provision of waivered services 216.12to elderly and disabled medical assistance recipients must comply with the criteria for 216.13service definitions and provider standards approved in the waiver.216.14    Subd. 1a. Elderly waiver case management services. (a) Elderly case management 216.15services under the home and community-based services waiver for elderly individuals are 216.16available from providers meeting qualification requirements and the standards specified 216.17in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case 216.18management services.216.19    Case management services assist individuals who receive waiver services in gaining 216.20access to needed waiver and other state plan services, as well as needed medical, social, 216.21educational, and other services regardless of the funding source for the services to which 216.22access is gained.216.23    A case aide shall provide assistance to the case manager in carrying out 216.24administrative activities of the case management function. The case aide may not assume 216.25responsibilities that require professional judgment including assessments, reassessments, 216.26and care plan development. The case manager is responsible for providing oversight of 216.27the case aide.216.28    Case managers shall be responsible for ongoing monitoring of the provision of 216.29services included in the individual's plan of care. Case managers shall initiate and oversee 216.30the process of assessment and reassessment of the individual's care and review plan of 216.31care at intervals specified in the federally approved waiver plan.216.32    (b) The county of service or tribe must provide access to and arrange for case 216.33management services. County of service has the meaning given it in Minnesota Rules, 216.34part 9505.0015, subpart 11.217.1    Subd. 1b. Provider qualifications and standards. The commissioner must 217.2enroll qualified providers of elderly case management services under the home 217.3and community-based waiver for the elderly under section 1915(c) of the Social 217.4Security Act. The enrollment process shall ensure the provider's ability to meet the 217.5qualification requirements and standards in this subdivision and other federal and state 217.6requirements of this service. An elderly case management provider is an enrolled medical 217.7assistance provider who is determined by the commissioner to have all of the following 217.8characteristics:217.9    (1) the demonstrated capacity and experience to provide the components of 217.10case management to coordinate and link community resources needed by the eligible 217.11population;217.12    (2) administrative capacity and experience in serving the target population for 217.13whom it will provide services and in ensuring quality of services under state and federal 217.14requirements;217.15    (3) a financial management system that provides accurate documentation of services 217.16and costs under state and federal requirements;217.17    (4) the capacity to document and maintain individual case records under state and 217.18federal requirements; and217.19    (5) the countylead agency may allow a case manager employed by the countylead 217.20agency to delegate certain aspects of the case management activity to another individual 217.21employed by the countylead agency provided there is oversight of the individual by 217.22the case manager. The case manager may not delegate those aspects which require 217.23professional judgment including assessments, reassessments, and care plan development.217.24Lead agencies include counties, health plans, and federally recognized tribes who 217.25authorize services under this section.217.26    Subd. 1c.Case management activities under the state plan.The commissioner 217.27shall seek an amendment to the home and community-based services waiver for the 217.28elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner 217.29is unable to secure the approval of the secretary of health and human services for the 217.30requested waiver amendment by December 31, 1993, the commissioner shall amend 217.31the medical assistance state plan to provide that case management provided under the 217.32home and community-based services waiver for the elderly is performed by counties 217.33as an administrative function for the proper and effective administration of the state 217.34medical assistance plan. The state shall reimburse counties for the nonfederal share of 217.35costs for case management performed as an administrative function under the home and 217.36community-based services waiver for the elderly.218.1    Subd. 1d. Posteligibility treatment of income and resources for elderly waiver.218.2    Notwithstanding the provisions of section 
         256B.056, the commissioner shall make the 218.3following amendment to the medical assistance elderly waiver program effective July 1, 218.41999, or upon federal approval, whichever is later. 218.5    A recipient's maintenance needs will be an amount equal to the Minnesota 218.6supplemental aid equivalent rate as defined in section 
         256I.03, subdivision 5, plus the 218.7medical assistance personal needs allowance as defined in section 
         256B.35, subdivision 218.81
         , paragraph (a), when applying posteligibility treatment of income rules to the gross 218.9income of elderly waiver recipients, except for individuals whose income is in excess of 218.10the special income standard according to Code of Federal Regulations, title 42, section 218.11435.236
         . Recipient maintenance needs shall be adjusted under this provision each July 1. 218.12    Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend 218.13the federal waiver and the medical assistance state plan to allowapply:218.14    (1) the spousal impoverishment criteria as authorized under United States Code, title 218.1542, section 1396r-5, and as implemented in sections 
         256B.0575, 
         256B.058, and 
         256B.059, 218.16except that the amendment shall seek to add to;218.17    (2)  the personal needs allowance permitted in section 
         256B.0575,; and218.18    (3) an amount equivalent to the group residential housing rate as set by section 218.19256I.03, subdivision 5
         , and according to the approved federal waiver and medical 218.20assistance state plan. 218.21    Subd. 3. Limits of cases. The number of medical assistance waiver recipients that 218.22a countylead agency may serve must be allocated according to the number of medical 218.23assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be 218.24served with the approval of the commissioner.218.25    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered 218.26services to an individual elderly waiver client shall be the weighted average monthly 218.27nursing facility rate of the case mix resident class to which the elderly waiver client would 218.28be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's 218.29maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first 218.30day of the state fiscal year in which the resident assessment system as described in section 218.31256B.437
          for nursing home rate determination is implemented. Effective on the first day 218.32of the state fiscal year in which the resident assessment system as described in section 218.33256B.437
          for nursing home rate determination is implemented and the first day of each 218.34subsequent state fiscal year, the monthly limit for the cost of waivered services to an 218.35individual elderly waiver client shall be the rate of the case mix resident class to which the 218.36waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 219.1in effect on the last day of the previous state fiscal year, adjusted by the greater of any 219.2legislatively adopted home and community-based services percentage rate increase or the 219.3average statewide percentage increase in nursing facility payment rates. 219.4    (b) If extended medical supplies and equipment or environmental modifications are 219.5or will be purchased for an elderly waiver client, the costs may be prorated for up to 219.612 consecutive months beginning with the month of purchase. If the monthly cost of a 219.7recipient's waivered services exceeds the monthly limit established in paragraph (a), the 219.8annual cost of all waivered services shall be determined. In this event, the annual cost of 219.9all waivered services shall not exceed 12 times the monthly limit of waivered services as 219.10described in paragraph (a).219.11    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing 219.12facility. (a) For a person who is a nursing facility resident at the time of requesting a 219.13determination of eligibility for elderly waivered services, a monthly conversion limit for 219.14the cost of elderly waivered services may be requested. The monthly conversion limit for 219.15the cost of elderly waiver services shall be the resident class assigned under Minnesota 219.16Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where 219.17the resident currently resides until July 1 of the state fiscal year in which the resident 219.18assessment system as described in section 
         256B.437 for nursing home rate determination 219.19is implemented. Effective on July 1 of the state fiscal year in which the resident 219.20assessment system as described in section 
         256B.437 for nursing home rate determination 219.21is implemented, the monthly conversion limit for the cost of elderly waiver services 219.22shall be the per diem nursing facility rate as determined by the resident assessment 219.23system as described in section 
         256B.437 for that resident in the nursing facility where 219.24the resident currently resides multiplied by 365 and divided by 12, less the recipient's 219.25maintenance needs allowance as described in subdivision 1d. The initially approved 219.26conversion rate may be adjusted by the greater of any subsequent legislatively adopted 219.27home and community-based services percentage rate increase or the average statewide 219.28percentage increase in nursing facility payment rates. The limit under this subdivision 219.29only applies to persons discharged from a nursing facility after a minimum 30-day stay 219.30and found eligible for waivered services on or after July 1, 1997. For conversions from the 219.31nursing home to the elderly waiver with consumer directed community support services, 219.32the conversion rate limit is equal to the nursing facility rate reduced by a percentage equal 219.33to the percentage difference between the consumer directed services budget limit that 219.34would be assigned according to the federally approved waiver plan and the corresponding 219.35community case mix cap, but not to exceed 50 percent.220.1    (b) The following costs must be included in determining the total monthly costs 220.2for the waiver client:220.3    (1) cost of all waivered services, including extended medical supplies and equipment 220.4and environmental modifications and adaptations; and220.5    (2) cost of skilled nursing, home health aide, and personal care services reimbursable 220.6by medical assistance.220.7    Subd. 3c. Service approval and contracting provisions. (a) Medical assistance 220.8funding for skilled nursing services, private duty nursing, home health aide, and personal 220.9care services for waiver recipients must be approved by the case manager and included in 220.10the individual care plan.220.11    (b) A countylead agency is not required to contract with a provider of supplies and 220.12equipment if the monthly cost of the supplies and equipment is less than $250.220.13    Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered 220.14a difficulty of care payment and shall not include room and board. The adult foster 220.15care service rate shall be negotiated between the countylead agency and the foster care 220.16provider. The elderly waiver payment for the foster care service in combination with 220.17the payment for all other elderly waiver services, including case management, must not 220.18exceed the limit specified in subdivision 3a, paragraph (a).220.19    Subd. 3e. Assisted livingCustomized living service rate. (a) Payment for assisted 220.20living servicecustomize living services shall be a monthly rate negotiated and authorized 220.21by the county agency based on an individualized service plan for each resident and may 220.22not cover direct rent or food costs. lead agency within the parameters established by 220.23the commissioner. The payment agreement must delineate the services that have been 220.24customized for each recipient and specify the amount of each service to be provided. The 220.25lead agency shall ensure that there is a documented need for all services authorized. 220.26Customized living services must not include rent or raw food costs. The negotiated 220.27payment rate must be based on services to be provided. Negotiated rates must not exceed 220.28payment rates for comparable elderly waiver or medical assistance services and must 220.29reflect economies of scale.220.30    (b) The individualized monthly negotiated payment for assisted livingcustomized 220.31living services as described in section 256B.0913, subdivisions 5d to 5f, and residential 220.32care services as described in section 256B.0913, subdivision 5c, shall not exceed the 220.33nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit 220.34is being calculated, of the greater of either the statewide or any of the geographic 220.35groups' weighted average monthly nursing facility rate of the case mix resident class 220.36to which the elderly waiver eligible client would be assigned under Minnesota Rules, 221.1parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in 221.2subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident 221.3assessment system as described in section 
         256B.437 for nursing home rate determination 221.4is implemented. Effective on July 1 of the state fiscal year in which the resident 221.5assessment system as described in section 
         256B.437 for nursing home rate determination 221.6is implemented and July 1 of each subsequent state fiscal year, the individualized monthly 221.7negotiated payment for the services described in this clause shall not exceed the limit 221.8described in this clause which was in effect on June 30 of the previous state fiscal year 221.9and which has been adjusted by the greater of any legislatively adopted home and 221.10community-based services cost-of-living percentage increase or any legislatively adopted 221.11statewide percent rate increase for nursing facilities. 221.12    (c) The individualized monthly negotiated payment for assisted Customized living 221.13services described in section 144A.4605 and are delivered by a provider licensed by the 221.14Department of Health as a class A or class F home care provider or an assisted living 221.15home care provider and provided in a building that is registered as a housing with services 221.16establishment under chapter 144D and that provides 24-hour supervision in combination 221.17with the payment for other elderly waiver services, including case management, must not 221.18exceed the limit specified in subdivision 3a. 221.19    Subd. 3f. Individual service rates; expenditure forecasts. (a) The countylead 221.20agency shall negotiate individual service rates with vendors and may authorize payment 221.21for actual costs up to the county'slead agency's current approved rate. Persons or agencies 221.22must be employed by or under a contract with the countylead agency or the public health 221.23nursing agency of the local board of health in order to receive funding under the elderly 221.24waiver program, except as a provider of supplies and equipment when the monthly cost of 221.25the supplies and equipment is less than $250.221.26    (b) Reimbursement for the medical assistance recipients under the approved waiver 221.27shall be made from the medical assistance account through the invoice processing 221.28procedures of the department's Medicaid Management Information System (MMIS), 221.29only with the approval of the client's case manager. The budget for the state share of the 221.30Medicaid expenditures shall be forecasted with the medical assistance budget, and shall 221.31be consistent with the approved waiver.221.32    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access 221.33to community services and eliminate payment disparities between the alternative care 221.34program and the elderly waiver, the commissioner shall establish statewide maximum 221.35service rate limits and eliminate county-specificlead agency-specific service rate limits.222.1    (b) Effective July 1, 2001, for service rate limits, except those described or defined in 222.2subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative 222.3care statewide maximum rate or the elderly waiver statewide maximum rate.222.4    (c) CountiesLead agencies may negotiate individual service rates with vendors for 222.5actual costs up to the statewide maximum service rate limit.222.6    Subd. 3h.Service rate limits; 24-hour customized living services.The payment 222.7rates for 24-hour customized living services is a monthly rate negotiated and authorized by 222.8the lead agency within the parameters established by the commissioner of human services. 222.9The payment agreement must delineate the services that have been customized for each 222.10recipient and specify the amount of each service to be provided. The lead agency shall 222.11ensure that there is a documented need for all services authorized. The lead agency shall 222.12not authorize 24-hour customized living services unless there is a documented need for 222.1324-hour supervision. For purposes of this section, "24-hour supervision" means that the 222.14recipient requires assistance due to needs related to one or more of the following:222.15    (1) intermittent assistance with toileting or transferring;222.16    (2) cognitive or behavioral issues;222.17    (3) a medical condition that requires clinical monitoring; or222.18    (4) other conditions or needs as defined by the commissioner of human services. 222.19The lead agency shall ensure that the frequency and mode of supervision of the recipient 222.20and the qualifications of staff providing supervision are described and meet the needs 222.21of the recipient. Customized living services must not include rent or raw food costs. 222.22The negotiated payment rate for 24-hour customized living services must be based on 222.23services to be provided. Negotiated rates must not exceed payment rates for comparable 222.24elderly waiver or medical assistance services and must reflect economies of scale. The 222.25individually negotiated 24-hour customized living payments, in combination with the 222.26payment for other elderly waiver services, including case management, must not exceed 222.27the recipient's community budget cap specified in subdivision 3a.222.28    Subd. 4. Termination notice. The case manager must give the individual a ten-day 222.29written notice of any denial, reduction, or termination of waivered services.222.30    Subd. 5. Assessments and reassessments for waiver clients. Each client shall 222.31receive an initial assessment of strengths, informal supports, and need for services in 222.32accordance with section 
         256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 222.33client served under the elderly waiver must be conducted at least every 12 months and 222.34at other times when the case manager determines that there has been significant change 222.35in the client's functioning. This may include instances where the client is discharged 222.36from the hospital. 223.1    Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided 223.2a copy of a written care plan that meets the requirements outlined in section 
         256B.0913, 223.3subdivision 8
         . The care plan must be implemented by the county administering waivered 223.4servicesof service when it is different than the county of financial responsibility. The 223.5county of service administering waivered services must notify the county of financial 223.6responsibility of the approved care plan.223.7    Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health 223.8plan is liable for nursing home services or elderly waiver services according to section 223.9256B.69, subdivision 6a
         , is not eligible to also receive county-administered elderly waiver 223.10services under this section. 223.11    Subd. 8. Services and supports. (a) Services and supports shall meet the 223.12requirements set out in United States Code, title 42, section 1396n.223.13    (b) Services and supports shall promote consumer choice and be arranged and 223.14provided consistent with individualized, written care plans.223.15    (c) The state of Minnesota, county, managed care organization, or tribal government 223.16under contract to administer the elderly waiver shall not be liable for damages, injuries, 223.17or liabilities sustained through the purchase of direct supports or goods by the person, 223.18the person's family, or the authorized representatives with funds received through 223.19consumer-directed community support services under the federally approved waiver plan. 223.20Liabilities include, but are not limited to, workers' compensation liability, the Federal 223.21Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).223.22    Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary 223.23provisions of this section, or those in other state laws or rules, the commissioner may 223.24develop a model for tribal management of the elderly waiver program and implement this 223.25model through a contract between the state and any of the state's federally recognized tribal 223.26governments. The model shall include the provision of tribal waiver case management, 223.27assessment for personal care assistance, and administrative requirements otherwise carried 223.28out by countieslead agencies but shall not include tribal financial eligibility determination 223.29for medical assistance.223.30EFFECTIVE DATE.Subdivision 3h is effective the day following final enactment.223.31    Sec. 47. Minnesota Statutes 2006, section 256B.0917, subdivision 8, is amended to 223.32read:223.33    Subd. 8. Living-at-home/block nurse program grant. (a) The organization 223.34awarded the contract under subdivision 7, shall develop and administer a grant program 223.35to establish or expand up to 3351 community-based organizations that will implement 224.1living-at-home/block nurse programs that are designed to enable senior citizens to live as 224.2independently as possible in their homes and in their communities. At least one-half of 224.3the programs must be in counties outside the seven-county metropolitan area. Nonprofit 224.4organizations and units of local government are eligible to apply for grants to establish 224.5the community organizations that will implement living-at-home/block nurse programs. 224.6In awarding grants, the organization awarded the contract under subdivision 7 shall give 224.7preference to nonprofit organizations and units of local government from communities 224.8that:224.9    (1) have high nursing home occupancy rates;224.10    (2) have a shortage of health care professionals;224.11    (3) are located in counties adjacent to, or are located in, counties with existing 224.12living-at-home/block nurse programs; and224.13    (4) meet other criteria established by LAH/BN, Inc., in consultation with the 224.14commissioner.224.15    (b) Grant applicants must also meet the following criteria:224.16    (1) the local community demonstrates a readiness to establish a community model 224.17of care, including the formation of a board of directors, advisory committee, or similar 224.18group, of which at least two-thirds is comprised of community citizens interested in 224.19community-based care for older persons;224.20    (2) the program has sponsorship by a credible, representative organization within 224.21the community;224.22    (3) the program has defined specific geographic boundaries and defined its 224.23organization, staffing and coordination/delivery of services;224.24    (4) the program demonstrates a team approach to coordination and care, ensuring 224.25that the older adult participants, their families, the formal and informal providers are all 224.26part of the effort to plan and provide services; and224.27    (5) the program provides assurances that all community resources and funding will 224.28be coordinated and that other funding sources will be maximized, including a person's 224.29own resources.224.30    (c) Grant applicants must provide a minimum of five percent of total estimated 224.31development costs from local community funding. Grants shall be awarded for four-year 224.32periods, and the base amount shall not exceed $80,000 $100,000 per applicant for the grant 224.33period. The organization under contract may increase the grant amount for applicants from 224.34communities that have socioeconomic characteristics that indicate a higher level of need 224.35for assistance. Subject to the availability of funding, grants and grant renewals awarded or 224.36entered into on or after July 1, 1997, shall be renewed by LAH/BN, Inc. every four years, 225.1unless LAH/BN, Inc. determines that the grant recipient has not satisfactorily operated the 225.2living-at-home/block nurse program in compliance with the requirements of paragraphs 225.3(b) and (d). Grants provided to living-at-home/block nurse programs under this paragraph 225.4may be used for both program development and the delivery of services.225.5    (d) Each living-at-home/block nurse program shall be designed by representatives of 225.6the communities being served to ensure that the program addresses the specific needs of 225.7the community residents. The programs must be designed to:225.8    (1) incorporate the basic community, organizational, and service delivery principles 225.9of the living-at-home/block nurse program model;225.10    (2) provide senior citizens with registered nurse directed assessment, provision and 225.11coordination of health and personal care services on a sliding fee basis as an alternative 225.12to expensive nursing home care;225.13    (3) provide information, support services, homemaking services, counseling, and 225.14training for the client and family caregivers;225.15    (4) encourage the development and use of respite care, caregiver support, and 225.16in-home support programs, such as adult foster care and in-home adult day care;225.17    (5) encourage neighborhood residents and local organizations to collaborate in 225.18meeting the needs of senior citizens in their communities;225.19    (6) recruit, train, and direct the use of volunteers to provide informal services and 225.20other appropriate support to senior citizens and their caregivers; and225.21    (7) provide coordination and management of formal and informal services to senior 225.22citizens and their families using less expensive alternatives.225.23    Sec. 48. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to 225.24read:225.25    Subd. 3. County certification of persons providing adult foster care to related 225.26persons. A person exempt from licensure under section 
         245A.03, subdivision 2, who 225.27provides adult foster care to a related individual age 65 and older, and who meets the 225.28requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the 225.29county to provide adult foster care. A person certified by the county to provide adult foster 225.30care may be reimbursed for services provided and eligible for funding under sections 225.31256B.0913 and section256B.0915, if the relative would suffer a financial hardship as 225.32a result of providing care. For purposes of this subdivision, financial hardship refers 225.33to a situation in which a relative incurs a substantial reduction in income as a result of 225.34resigning from a full-time job or taking a leave of absence without pay from a full-time 225.35job to care for the client. 226.1    Sec. 49. Minnesota Statutes 2006, section 256B.095, is amended to read:226.2256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.226.3    (a) Effective July 1, 1998, a quality assurance system for persons with developmental 226.4disabilities, which includes an alternative quality assurance licensing system for programs, 226.5is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, 226.6Steele, Wabasha, and Winona Counties for the purpose of improving the quality of 226.7services provided to persons with developmental disabilities. A county, at its option, may 226.8choose to have all programs for persons with developmental disabilities located within 226.9the county licensed under chapter 245A using standards determined under the alternative 226.10quality assurance licensing system or may continue regulation of these programs under 226.11the licensing system operated by the commissioner. The project expires on June 30, 226.1220092014.226.13    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to 226.14participate in the quality assurance system established under paragraph (a). The 226.15commission established under section 
         256B.0951 may, at its option, allow additional 226.16counties to participate in the system.226.17    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) 226.18may establish a quality assurance system under this section. A new system established 226.19under this section shall have the same rights and duties as the system established 226.20under paragraph (a). A new system shall be governed by a commission under section 226.21256B.0951
         . The commissioner shall appoint the initial commission members based 226.22on recommendations from advocates, families, service providers, and counties in the 226.23geographic area included in the new system. Counties that choose to participate in a 226.24new system shall have the duties assigned under section 
         256B.0952. The new system 226.25shall establish a quality assurance process under section 
         256B.0953. The provisions of 226.26section 
         256B.0954 shall apply to a new system established under this paragraph. The 226.27commissioner shall delegate authority to a new system established under this paragraph 226.28according to section 
         256B.0955.226.29    (d) Effective July 1, 2007, the quality assurance system may be expanded to include 226.30programs for persons with disabilities and older adults.226.31    Sec. 50. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to 226.32read:226.33    Subdivision 1. Membership. The Quality Assurance Commission is established. 226.34The commission consists of at least 14 but not more than 21 members as follows: at 226.35least three but not more than five members representing advocacy organizations; at 227.1least three but not more than five members representing consumers, families, and their 227.2legal representatives; at least three but not more than five members representing service 227.3providers; at least three but not more than five members representing counties; and the 227.4commissioner of human services or the commissioner's designee. The first commission 227.5shall establish membership guidelines for the transition and recruitment of membership for 227.6the commission's ongoing existence. Members of the commission who do not receive a 227.7salary or wages from an employer for time spent on commission duties may receive a per 227.8diem payment when performing commission duties and functions. All members may be 227.9reimbursed for expenses related to commission activities. Notwithstanding the provisions 227.10of section 
         15.059, subdivision 5, the commission expires on June 30, 20092014.227.11    Sec. 51. [256B.096] QUALITY MANAGEMENT; ASSURANCE; AND 227.12IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY 227.13SERVICES.227.14    Subdivision 1.Scope.In order to improve the quality of services provided to 227.15Minnesotans with disabilities and to meet the requirements of the federally approved home 227.16and community-based waivers under section 1915c of the Social Security Act, a statewide 227.17quality assurance and improvement system for Minnesotans receiving disability services 227.18shall be developed. The disability services included are the home and community-based 227.19services waiver programs for persons with developmental disabilities under section 227.20256B.092, subdivision 4, and persons with disabilities under section 256B.49.227.21    Subd. 2.Stakeholder advisory group.The commissioner shall consult with a 227.22stakeholder advisory group on the development and implementation of the state quality 227.23management, assurance, and improvement system, including representatives from: 227.24disability service recipients, disability service providers, disability advocacy groups, 227.25county human service agencies, and state agency staff from the Departments of Human 227.26Services and Health and ombudsman for mental health and developmental disabilities on 227.27the development of a statewide quality assurance and improvement system.227.28    Subd. 3.Annual survey of service recipients.The commissioner, in consultation 227.29with the stakeholder advisory group, shall develop and conduct an annual independent 227.30random statewide survey of between five and ten percent of service recipients to determine 227.31the effectiveness and quality of disability services. The survey shall be consistent with 227.32the system performance expectations of the Centers for Medicare and Medicaid Services 227.33quality management requirements and framework. The survey shall analyze whether 227.34desired outcomes have been achieved for persons with different demographic, diagnostic, 227.35health, and functional needs and receiving different types of services, in different settings, 228.1with different costs. The survey shall be field tested during 2008 and implemented by 228.2February 1, 2009. Annual statewide and regional reports of the results shall be published 228.3for use by regions, counties, and providers to plan and measure the impact of quality 228.4improvement activities.228.5    Subd. 4.Improvements for incident reporting, investigation, analysis, and 228.6follow-up.In consultation with the stakeholder advisory group, the commissioner shall 228.7identify the information, data sources, and technology needed to improve the system 228.8of incident reporting, including:228.9    (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and228.10    (2) investigation, analysis, and follow-up for disability services.228.11    The commissioner must ensure that the federal home and community-based waiver 228.12requirements are met and that incidents that may have jeopardized safety; health; or 228.13violated service-related assurances, civil and human rights, and other protections designed 228.14to prevent abuse, neglect, and exploitation are reviewed, investigated, and acted upon 228.15in a timely manner.228.16    Subd. 5.Biennial report.The commissioner shall provide a biennial report to the 228.17chairs of the legislative committees with jurisdiction over health and human services 228.18policy and funding beginning January 15, 2009, on the development and activities of the 228.19quality management, assurance, and improvement system designed to meet the federal 228.20requirements under the home and community-based services waiver programs for persons 228.21with disabilities. By January 15, 2008, the commissioner shall provide a preliminary 228.22report on the priorities for meeting the federal requirements, progress on the annual 228.23survey, recommendations for improvements in the incident reporting system, and a plan 228.24for incorporating the quality assurance efforts under section 256B.095 and other regional 228.25efforts into the statewide system.228.26    Sec. 52. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:228.27    Subdivision 1. In general. The commissioner shall determine prospective 228.28payment rates for resident care costs. For rates established on or after July 1, 1985, the 228.29commissioner shall develop procedures for determining operating cost payment rates that 228.30take into account the mix of resident needs, geographic location, and other factors as 228.31determined by the commissioner. The commissioner shall consider whether the fact that a 228.32facility is attached to a hospital or has an average length of stay of 180 days or less should 228.33be taken into account in determining rates. The commissioner shall consider the use of the 228.34standard metropolitan statistical areas when developing groups by geographic location. 228.35The commissioner shall provide notice to each nursing facility on or before May 1 August 229.115 of the rates effective for the following rate year except that if legislation is pending on 229.2May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the 229.3rates after the legislation is enacted and provide notice to each facility as soon as possible.229.4    Compensation for top management personnel shall continue to be categorized as a 229.5general and administrative cost and is subject to any limits imposed on that cost category.229.6    Sec. 53. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to 229.7read:229.8    Subd. 2e. Contracts for services for ventilator-dependent persons.(a) 229.9The commissioner may negotiate with a nursing facility eligible to receive medical 229.10assistance payments to provide services to a ventilator-dependent person identified by the 229.11commissioner according to criteria developed by the commissioner, including:229.12    (1) nursing facility care has been recommended for the person by a preadmission 229.13screening team;229.14    (2) the person has been hospitalized and no longer requires inpatient acute care 229.15hospital services; and229.16    (3) the commissioner has determined that necessary services for the person cannot 229.17be provided under existing nursing facility rates.229.18    The commissioner may negotiate an adjustment to the operating cost payment 229.19rate for a nursing facility with a resident who is ventilator-dependent, for that resident. 229.20The negotiated adjustment must reflect only the actual additional cost of meeting the 229.21specialized care needs of a ventilator-dependent person identified by the commissioner 229.22for whom necessary services cannot be provided under existing nursing facility rates and 229.23which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or 229.249505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before 229.25July 1, 2001, and have their payment rate under this subdivision negotiated after July 1, 229.262001, the negotiated payment rate must not exceed 200 percent of the highest multiple 229.27bedroom payment rate for the facility, as initially established by the commissioner for the 229.28rate year for case mix classification K; or, upon implementation of the RUG's-based case 229.29mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a 229.30nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300 229.31percent of the facility's multiple bedroom payment rate for case mix classification K; or, 229.32upon implementation of the RUG's-based case mix system, 300 percent of the highest 229.33RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private 229.34paying residents under the provisions of section   
         256B.48, subdivision 1. 230.1    (b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to 230.2care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever 230.3is later, the operating payment rates for residents determined eligible under paragraph (a) 230.4of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds 230.5and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300 230.6percent of the facility's highest RUG rate.230.7    Sec. 54. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to 230.8read:230.9    Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the 230.10rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571 230.11per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom. 230.12For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a 230.13single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060, 230.14subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per 230.15bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060, 230.16subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per 230.17bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060, 230.18subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the 230.19Census: Composite fixed-weighted price index as published in the C30 Report, Value 230.20of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed 230.21Investments in Structures; Special Care. 230.22    (b)  Rental factor. For the rate year beginning July 1, 1988, the commissioner shall 230.23increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8, 230.24item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing 230.25nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation 230.26services used by the state's contracted appraisers. For rate years beginning on or after July 230.271, 1989, the rental factor is the amount determined under this paragraph for the rate year 230.28beginning July 1, 1988. 230.29    (c)  Occupancy factor. For rate years beginning on or after July 1, 1988, in order 230.30to determine property-related payment rates under Minnesota Rules, part 9549.0060, 230.31for all nursing facilities except those whose average length of stay in a skilled level of 230.32care within a nursing facility is 180 days or less, the commissioner shall use 95 percent 230.33of capacity days. For a nursing facility whose average length of stay in a skilled level of 230.34care within a nursing facility is 180 days or less, the commissioner shall use the greater of 231.1resident days or 80 percent of capacity days but in no event shall the divisor exceed 95 231.2percent of capacity days. 231.3    (d)  Equipment allowance. For rate years beginning on July 1, 1988, and July 1, 231.41989, the commissioner shall add ten cents per resident per day to each nursing facility's 231.5property-related payment rate. The ten-cent property-related payment rate increase is not 231.6cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the 231.7commissioner shall increase each nursing facility's equipment allowance as established 231.8in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For 231.9rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be 231.10adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E. 231.11For the rate period beginning October 1, 1992, the equipment allowance for each nursing 231.12facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the 231.13allowance must be adjusted annually for inflation. 231.14    (e)  Post chapter 199 related-organization debts and interest expense. For rate 231.15years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item 231.16E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983, 231.17provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010 231.18to 9510.0480, the debt is subject to repayment through annual principal payments, and 231.19the nursing facility demonstrates to the commissioner's satisfaction that the interest rate 231.20on the debt was less than market interest rates for similar arm's-length transactions at 231.21the time the debt was incurred. If the debt was incurred due to a sale between family 231.22members, the nursing facility must also demonstrate that the seller no longer participates 231.23in the management or operation of the nursing facility. Debts meeting the conditions of 231.24this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010 231.25to 9549.0080. 231.26    (f)  Building capital allowance for nursing facilities with operating leases. For 231.27rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs 231.28incurred for the nursing facility's buildings shall receive its building capital allowance 231.29computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating 231.30lease provides that the lessee's rent is adjusted to recognize improvements made by the 231.31lessor and related debt, the costs for capital improvements and related debt shall be allowed 231.32in the computation of the lessee's building capital allowance, provided that reimbursement 231.33for these costs under an operating lease shall not exceed the rate otherwise paid. 231.34    Sec. 55. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to 231.35read:232.1    Subd. 17e. Replacement-costs-new per bed limit effective July 1, 2001.232.2    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), 232.3for a total replacement, as defined in paragraph (f) subdivision 17d, authorized under 232.4section   
         144A.071 or   
         144A.073 after July 1, 1999, or any building project that is a 232.5relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, the 232.6replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed 232.7rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating 232.8the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 232.99549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be 232.10adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000. 232.11    Sec. 56. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:232.12    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which 232.13have their payment rates determined under this section rather than section 
         256B.431, the 232.14commissioner shall establish a rate under this subdivision. The nursing facility must enter 232.15into a written contract with the commissioner.232.16    (b) A nursing facility's case mix payment rate for the first rate year of a facility's 232.17contract under this section is the payment rate the facility would have received under 232.18section 
         256B.431.232.19    (c) A nursing facility's case mix payment rates for the second and subsequent years 232.20of a facility's contract under this section are the previous rate year's contract payment 232.21rates plus an inflation adjustment and, for facilities reimbursed under this section or 232.22section 
         256B.431, an adjustment to include the cost of any increase in Health Department 232.23licensing fees for the facility taking effect on or after July 1, 2001. The index for the 232.24inflation adjustment must be based on the change in the Consumer Price Index-all items 232.25(United States City average) (CPI-U) forecasted by the commissioner of finance's national 232.26economic consultant, as forecasted in the fourth quarter of the calendar year preceding 232.27the rate year. The inflation adjustment must be based on the 12-month period from the 232.28midpoint of the previous rate year to the midpoint of the rate year for which the rate is 232.29being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, 232.30July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, and July 232.311, 2008,  this paragraph shall apply only to the property-related payment rate, except 232.32that adjustments to include the cost of any increase in Health Department licensing fees 232.33taking effect on or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to 232.34the property payment rate under this section and section 
         256B.431 shall be effective on 232.35October 1. In determining the amount of the property-related payment rate adjustment 233.1under this paragraph, the commissioner shall determine the proportion of the facility's 233.2rates that are property-related based on the facility's most recent cost report. 233.3    (d) The commissioner shall develop additional incentive-based payments of up to 233.4five percent above a facility's operating payment rate for achieving outcomes specified 233.5in a contract. The commissioner may solicit contract amendments and implement those 233.6which, on a competitive basis, best meet the state's policy objectives. The commissioner 233.7shall limit the amount of any incentive payment and the number of contract amendments 233.8under this paragraph to operate the incentive payments within funds appropriated for this 233.9purpose. The contract amendments may specify various levels of payment for various 233.10levels of performance. Incentive payments to facilities under this paragraph may be in the 233.11form of time-limited rate adjustments or onetime supplemental payments. In establishing 233.12the specified outcomes and related criteria, the commissioner shall consider the following 233.13state policy objectives:233.14    (1) successful diversion or discharge of residents to the residents' prior home or other 233.15community-based alternatives;233.16    (2) adoption of new technology to improve quality or efficiency; 233.17    (3) improved quality as measured in the Nursing Home Report Card; 233.18    (4) reduced acute care costs; and233.19    (5) any additional outcomes proposed by a nursing facility that the commissioner 233.20finds desirable.233.21    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 233.22take action to come into compliance with existing or pending requirements of the life 233.23safety code provisions or other federal regulations governing sprinkler systems shall 233.24receive reimbursement for the costs associated with compliance if all of the following 233.25conditions are met:233.26    (1) the expenses associated with compliance occurred on or after January 1, 2005, 233.27and before December 31, 2008;233.28    (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073, 233.29or 256B.434, subdivision 4f; and233.30    (3) the total allowable costs reported under this paragraph are less than the minimum 233.31threshold established under section 256B.431, subdivisions 15, paragraph (e), and 16.233.32The commissioner shall use funds appropriated for this purpose to provide to qualifying 233.33nursing facilities a rate adjustment beginning October 1, 2007, and ending September 233.3430, 2008. Nursing facilities that have expended funds or anticipate the need to expend 233.35funds to satisfy the most recent life safety code requirements by (1) installing a sprinkler 233.36system or (2) replacing all or portions of an existing sprinkler system may submit to the 234.1commissioner by June 30, 2007, on a form provided by the commissioner the actual 234.2costs of a completed project or the estimated costs, based on a project bid, of a planned 234.3project. The commissioner shall calculate a rate adjustment equal to the allowable 234.4costs of the project divided by the resident days reported for the report year ending 234.5September 30, 2006. If the costs from all projects exceed the appropriation for this 234.6purpose, the commissioner shall allocate the funds appropriated on a pro rata basis to the 234.7qualifying facilities by reducing the rate adjustment determined for each facility by an 234.8equal percentage. If the rate adjustments under this subdivision are reduced to fit the 234.9appropriation, facilities may include the portion of the costs that are not reimbursed by 234.10the rate adjustment as part of a project that meets the requirements of subdivision 4f. 234.11If the commissioner determines that there are any unexpended funds for the purposes 234.12of this paragraph, the commissioner may allocate the remainder of the funds to the 234.13qualifying facilities on a pro rata basis for other physical plant changes required by the 234.14nursing facility in order to meet the most recent life safety code compliance standards. 234.15Facilities that used estimated costs when requesting the rate adjustment shall report to 234.16the commissioner by January 31, 2009, on the use of these funds on a form provided by 234.17the commissioner. If the nursing facility fails to provide the report, the commissioner 234.18shall recoup the funds appropriated to the facility for this purpose. If the facility reports 234.19expenditures allowable under this subdivision that are less than the amount received in the 234.20facility's annualized rate adjustment, the commissioner shall recoup the difference.234.21    Sec. 57. Minnesota Statutes 2006, section 256B.434, is amended by adding a 234.22subdivision to read:234.23    Subd. 4i.Nursing facility rate increase effective October 1, 2007; Hennepin 234.24County.For the rate year beginning October 1, 2007, the commissioner shall provide to 234.25a nursing facility in Hennepin County licensed for 268 beds as of February 1, 2007, an 234.26increase in the property payment rate of $6.52 per resident per day. The increase under 234.27this subdivision must be added following the determination under this chapter of the 234.28payment rate for the rate year beginning October 1, 2007, and must be included in the 234.29facility's total payment rate for purposes of determining future rates under this section or 234.30any other section.234.31    Sec. 58. Minnesota Statutes 2006, section 256B.434, is amended by adding a 234.32subdivision to read:234.33    Subd. 4j.Rate increase for facilities in Chisago County.Effective October 234.341, 2007, operating payment rates of all nursing facilities in Chisago County that are 235.1reimbursed under this section or section 256B.441 shall be increased to be equal, for 235.2a RUG's rate with a weight of 1.00, to the geographic group III median rate for the 235.3same RUG's weight. The percentage of the operating payment rate for each facility to 235.4be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that 235.5facility's September 30, 2007, operating payment rate. This subdivision applies only if it 235.6results in a rate increase. Increases provided by this subdivision shall be added to the rate 235.7determined under any new reimbursement system established under section 256B.441.235.8    Sec. 59. Minnesota Statutes 2006, section 256B.434, is amended by adding a 235.9subdivision to read:235.10    Subd. 4k.Nursing facility rate increase effective January 1, 2008; Hennepin 235.11County.Effective January 1, 2008, a nursing facility in Hennepin County licensed for 235.12137 beds as of February 1, 2007, shall receive an increase of $2.81 in each case mix 235.13payment rate to offset property tax payments due as a result of the facility's conversion 235.14from nonprofit to for-profit status. The increase under this subdivision must be added 235.15following the determination under this chapter of the payment rate for the rate year 235.16beginning October 1, 2007, and must be included in the facility's total payment rate for the 235.17purposes of determining future rates under this section or any other section.235.18    Sec. 60. Minnesota Statutes 2006, section 256B.434, is amended by adding a 235.19subdivision to read:235.20    Subd. 4l.Property rate adjustment; Kanabec County.The commissioner 235.21shall allow a property rate adjustment for a facility located in Kanabec County that 235.22was approved for a moratorium exception project in 2001, but experienced a delay and 235.23additional costs associated with the project, and completed the project in 2005. The 235.24property payment rate for the rate years beginning October 1, 2007, and ending September 235.2530, 2009, must be $22.73 per resident day. For subsequent years, the property rate of 235.26$22.73 per resident day shall be adjusted as provided in subdivision 4, paragraph (c), as 235.27long as the facility has a contract under this section.235.28    Sec. 61. Minnesota Statutes 2006, section 256B.434, is amended by adding a 235.29subdivision to read:235.30    Subd. 4m.Rate increase for facilities in Rice County.Effective July 1, 2007, 235.31operating payment rates of nursing facilities in Rice County located within two miles 235.32of Scott County or Dakota County that are reimbursed under this section or section 235.33256B.441 must be increased to be equal, for a RUG's rate with a weight of 1.00, to the 236.1geographic group III median rate for the same RUG's weight. The percentage of the 236.2operating payment rate for each facility to be case-mix adjusted must be equal to the 236.3percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment 236.4rate. This subdivision applies only if it results in a rate increase.236.5    Sec. 62. Minnesota Statutes 2006, section 256B.434, is amended by adding a 236.6subdivision to read:236.7    Subd. 4n.Facility rate increase.For the rate year beginning October 1, 2007, a 236.8nursing facility in Faribault County licensed for 50 beds as of April 19, 2006, shall receive 236.9a rate increase of $2.64 in each case mix payment rate to offset property tax payments 236.10due as a result of the facility's conversion from nonprofit to for-profit status. The increase 236.11under this subdivision shall be added to the payment rates in effect for the facility on 236.12September 30, 2007, and shall be included in the facility's total payment rates for the 236.13purposes of determining future rates under this section or any other section.236.14    Sec. 63. Minnesota Statutes 2006, section 256B.434, is amended by adding a 236.15subdivision to read:236.16    Subd. 19.Nursing facility rate increases beginning October 1, 2007, and 236.17October 1, 2008.(a) For the rate year beginning October 1, 2007, the commissioner 236.18shall make available to each nursing facility reimbursed under this section operating 236.19payment rate adjustments equal to three percent of the operating payment rates in effect 236.20on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner 236.21shall make available to each nursing facility reimbursed under this section operating 236.22payment rate adjustments equal to three percent of the operating payment rates in effect 236.23on September 30, 2008.236.24    (b) Seventy-five percent of the money resulting from the rate adjustments under 236.25paragraph (a) must be used for increases in compensation-related costs of eligible 236.26employees. 236.27    (c) For purposes of this subdivision, eligible employees includes all persons directly 236.28employed by the nursing facility on or after the effective date of the rate adjustments, 236.29except:236.30    (1) persons employed in the central office of a corporation that has an ownership 236.31interest in the nursing facility or exercises control over the nursing facility; and 236.32    (2) persons paid by the nursing facility under a management contract.236.33    (d) The commissioner shall allow as compensation-related costs all costs for:236.34    (1) wages and salaries;237.1    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 237.2compensation;237.3    (3) the employer's share of health and dental insurance, life insurance, disability 237.4insurance, long-term care insurance, uniform allowance, and pensions; and237.5    (4) other benefits provided, subject to the approval of the commissioner.237.6    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the 237.7requirements in paragraph (b) shall be provided to nursing facilities effective October 237.81 of each year.237.9    (f) Nursing facilities may apply for the portion of the rate adjustments under 237.10paragraph (a) that is subject to the requirements in paragraph (b). The application 237.11must be submitted to the commissioner within six months of the effective date of the 237.12rate adjustments, and the nursing facility must provide additional information required 237.13by the commissioner within nine months of the effective date of the rate adjustments. 237.14The commissioner must respond to all applications within three weeks of receipt. 237.15The commissioner may waive the deadlines in this paragraph under extraordinary 237.16circumstances, to be determined at the sole discretion of the commissioner. The 237.17application must contain:237.18    (1) an estimate of the amounts of money that must be used as specified in paragraph 237.19(b);237.20    (2) a detailed distribution plan specifying the allowable compensation-related 237.21increases the nursing facility will implement to use the funds available in clause (1);237.22    (3) a description of how the nursing facility will notify eligible employees of 237.23the contents of the approved application, which must provide for giving each eligible 237.24employee a copy of the approved application, excluding the information required in clause 237.25(1), or posting a copy of the approved application, excluding the information required in 237.26clause (1), for a period of at least six weeks in an area of the nursing facility to which all 237.27eligible employees have access; and237.28    (4) instructions for employees who believe they have not received the 237.29compensation-related increases specified in clause (2), as approved by the commissioner, 237.30and which must include a mailing address, e-mail address, and the telephone number 237.31that may be used by the employee to contact the commissioner or the commissioner's 237.32representative.237.33    (g) The commissioner shall ensure that cost increases in distribution plans under 237.34paragraph (f), clause (2), that may be included in approved applications, comply with 237.35requirements in clauses (1) to (4):238.1    (1) costs to be incurred during the applicable rate year resulting from wage and 238.2salary increases implemented prior to the first day of the nursing facility's payroll period 238.3that includes October 1 of each year shall be allowed if they were not used in a prior 238.4year's application;238.5    (2) a portion of the costs resulting from tenure-related wage or salary increases may 238.6be considered to be allowable compensation-related increases, in accordance with existing 238.7formulas that the commissioner shall provide;238.8    (3) the annualized amount of increases in costs for the employer's share of health 238.9and dental insurance, life insurance, disability insurance, and workers' compensation shall 238.10be allowable compensation-related increases if they are effective on or after April 1 of 238.11the year in which the rate adjustments are effective and prior to April 1 of the following 238.12year; and 238.13    (4) for nursing facilities in which employees are represented by an exclusive 238.14bargaining representative, an agreement negotiated and agreed to by the employer and 238.15the exclusive bargaining representative constitutes the plan. The commissioner shall not 238.16review and shall not require changes to the portions of the plan covered by collective 238.17bargaining agreements. A negotiated agreement may constitute the plan only if the 238.18agreement is finalized after the date of enactment of all increases for the rate year and 238.19signed by both parties prior to submission to the commissioner.238.20    (h) The commissioner shall review applications received under paragraph (f) and 238.21shall provide the portion of the rate adjustments under paragraph (b) if the requirements of 238.22this subdivision have been met. The rate adjustments shall be effective October 1 of each 238.23year. Notwithstanding paragraph (a), if the approved application distributes less money 238.24than is available, the amount of the rate adjustment shall be reduced so that the amount of 238.25money made available is equal to the amount to be distributed.238.26    Sec. 64. Minnesota Statutes 2006, section 256B.434, is amended by adding a 238.27subdivision to read:238.28    Subd. 20.Payment of Public Employees Retirement Association costs.Nursing 238.29facilities that participate in the Public Employees Retirement Association (PERA) shall 238.30have the component of their payment rate associated with the costs of PERA determined 238.31for each rate year. Effective for rate years beginning on and after October 1, 2007, the 238.32commissioner shall determine the portion of the payment rate in effect on September 30 238.33each year and shall subtract that amount from the payment rate to be effective on the 238.34following October 1. The portion that shall be deemed to be included in the September 30, 238.352007, rate that is associated with PERA costs shall be the allowed costs in the facility's 239.1base for determining rates under this section, divided by the resident days reported for that 239.2year. The commissioner shall add to the payment rate to be effective on October 1 each 239.3year an amount equal to the reported costs associated with PERA, for the year ended on 239.4the most recent September 30 for which data is available, divided by total resident days 239.5for that year, as reported by the facility and audited under section 256B.441.239.6    Sec. 65. Minnesota Statutes 2006, section 256B.437, is amended by adding a 239.7subdivision to read:239.8    Subd. 11.Big Stone County rate adjustment. Notwithstanding the time period 239.9specified in subdivision 3, the commissioner shall approve a planned closure rate 239.10adjustment in Big Stone County for an eight-bed facility in Clinton for reassignment to a 239.1150-bed facility in Graceville. The adjustment shall be calculated according to subdivisions 239.123 and 6.239.13    Sec. 66. Minnesota Statutes 2006, section 256B.438, subdivision 3, is amended to read:239.14    Subd. 3. Case mix indices. (a) The commissioner of human services shall assign a 239.15case mix index to each resident class based on the Centers for Medicare and Medicaid 239.16Services staff time measurement study and adjusted for Minnesota-specific wage indices. 239.17The case mix indices assigned to each resident class shall be published in the Minnesota 239.18State Register at least 120 days prior to the implementation of the 34 group, RUG-III 239.19resident classification system.239.20    (b) An index maximization approach shall be used to classify residents.239.21    (c) After implementation of the revised case mix system, the commissioner of 239.22human services may annually rebase case mix indices and base rates using more current 239.23data on average wage rates and staff time measurement studies. This rebasing shall be 239.24calculated under subdivision 7, paragraph (b). The commissioner shall publish in the 239.25Minnesota State Register adjusted case mix indices at least 45 days prior to the effective 239.26date of the adjusted case mix indices.239.27    Sec. 67. Minnesota Statutes 2006, section 256B.439, subdivision 1, is amended to read:239.28    Subdivision 1. Development and implementation of quality profiles. (a) The 239.29commissioner of human services, in cooperation with the commissioner of health, shall 239.30develop and implement a quality profile system for nursing facilities and, beginning not 239.31later than July 1, 2004, other providers of long-term care services, except when the quality 239.32profile system would duplicate requirements under section 
         256B.5011, 
         256B.5012, or 239.33256B.5013
         . Beginning July 1, 2008, the commissioners shall include quality profiles of 240.1nursing homes that are not medical assistance certified in the Minnesota Nursing Home 240.2Report Card. The nonmedical assistance certified nursing homes may provide to the 240.3commissioners information necessary to conduct consumer satisfaction surveys and to 240.4determine other quality measures. The system must be developed and implemented to the 240.5extent possible without the collection of significant amounts of new data. To the extent 240.6possible, the system must incorporate or be coordinated with information on quality 240.7maintained by area agencies on aging, long-term care trade associations, and other entities. 240.8The system must be designed to provide information on quality to: 240.9    (1) consumers and their families to facilitate informed choices of service providers;240.10    (2) providers to enable them to measure the results of their quality improvement 240.11efforts and compare quality achievements with other service providers; and240.12    (3) public and private purchasers of long-term care services to enable them to 240.13purchase high-quality care.240.14    (b) The system must be developed in consultation with the long-term care task force, 240.15area agencies on aging, and representatives of consumers, providers, and labor unions. 240.16Within the limits of available appropriations, the commissioners may employ consultants 240.17to assist with this project.240.18    Sec. 68. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:240.19    Subdivision 1. Rate determination Rebasing of nursing facility operating cost 240.20payment rates. (a) The commissioner shall establish a value-based nursing facility 240.21reimbursement system which will provide facility-specific, prospective rates for nursing 240.22facilities participating in the medical assistance program. The rates shall be determined 240.23using an annual statistical and cost report filed by each nursing facility. The total payment 240.24rate shall be composed of four rate components: direct care services, support services, 240.25external fixed, and property-related rate components. The payment rate shall be derived 240.26from statistical measures of actual costs incurred in facility operation of nursing facilities. 240.27From this cost basis, the components of the total payment rate shall be adjusted for quality 240.28of services provided, recognition of staffing levels, geographic variation in labor costs, and 240.29resident acuity. The commissioner shall rebase nursing facility operating cost payment 240.30rates to align payments to facilities with the cost of providing care. The rebased operating 240.31cost payment rates shall be calculated using the statistical and cost report filed by each 240.32nursing facility for the report period ending one year prior to the rate year.240.33    (b) Rates shall be rebased annually. The new operating cost payment rates based on 240.34this section shall take effect beginning with the rate year beginning October 1, 2009, and 240.35shall be phased in over two rate years through October 1, 2010.241.1    (c) Operating cost payment rates shall be rebased on October 1, 2011, and every 241.2two years after that date.241.3    (d) Operating cost payment rates for rate years in which rebasing does not occur 241.4shall be increased by the Global Insight SNF Market Basket inflation factor from the 241.5midpoint of the previous rate year to the midpoint of the next rate year.241.6    (e) Each cost reporting year shall begin on October 1 and end on the following 241.7September 30. Beginning in 2006, a statistical and cost report shall be filed by each 241.8nursing facility by January 15. Notice of rates shall be distributed by August 15 and the 241.9rates shall go into effect on October 1 for one year.241.10    (c) The commissioner shall begin to phase in the new reimbursement system 241.11beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.241.12    Sec. 69. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:241.13    Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to 241.1442 42a  have the meanings given unless otherwise provided for in this section.241.15    Sec. 70. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:241.16    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for 241.17administering the overall activities of the nursing home. These costs include salaries and 241.18wages of the administrator, assistant administrator, business office employees, security 241.19guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases 241.20related to business office functions, licenses, and permits except as provided in the 241.21external fixed costs category, employee recognition, travel including meals and lodging, 241.22training, voice and data communication or transmission, office supplies, liability insurance 241.23and other forms of insurance not designated to other areas, personnel recruitment, legal 241.24services, accounting services, management or business consultants, data processing, 241.25information technology, Web site, central or home office costs, business meetings and 241.26seminars, postage, fees for professional organizations, subscriptions, security services, 241.27advertising, board of director's fees, working capital interest expense, and bad debts and 241.28bad debt collection fees.241.29    Sec. 71. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:241.30    Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the facility 241.31which are necessary for the operation of the facility and the care of residents and which 241.32are reviewed by the department for accuracy, reasonableness, and compliance with this 242.1section and generally accepted accounting principles. All references to costs in this section 242.2shall be assumed to refer to allowed costs.242.3    Sec. 72. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to 242.4read:242.5    Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages 242.6of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees 242.7assigned to the kitchen and dining room, and associated fringe benefits and payroll 242.8taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs 242.9of raw food (both normal and special diet food), dietary supplies, and food preparation 242.10and serving. Also included are special dietary supplements used for tube feeding or oral 242.11feeding, such as elemental high nitrogen diet, even if written as a prescription item by a 242.12physician.242.13    Sec. 73. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to 242.14read:242.15    Subd. 11. Direct care costs category."Direct care costs category" "Direct care 242.16costs" means costs for nursing services, activities, and social services the wages of nursing 242.17administration, staff education, direct care registered nurses, licensed practical nurses, 242.18certified nursing assistants, trained medication aides, and associated fringe benefits and 242.19payroll taxes; services from a supplemental nursing services agency; supplies that are 242.20stocked at nursing stations or on the floor and distributed or used individually, including, 242.21but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice 242.22bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas, 242.23enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products, 242.24thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic 242.25agents, drugs that are not paid for on a separate fee schedule by the medical assistance 242.26program or any other payer, and technology related to the provision of nursing care to 242.27residents, such as electronic charting systems.242.28    Sec. 74. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to 242.29read:242.30    Subd. 13. External fixed costs category."External fixed costs category" "External 242.31fixed costs"  means costs related to the nursing home surcharge under section 
         256.9657, 242.32subdivision 1
         ; licensure fees under section 
         144.122; long-term care consultation fees 242.33under section 
         256B.0911, subdivision 6; family advisory council fee under section 243.1 144A.33
         ; scholarships under section 
         256B.431, subdivision 36; planned closure rate 243.2adjustments under section 256B.436 or256B.437; or single bed room incentives under 243.3section 256B.431, subdivision 42; property taxes and property insurance; and PERA.243.4    Sec. 75. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to 243.5read:243.6    Subd. 14. Facility average case mix index. "Facility average case mix index" or 243.7"CMI" means a numerical value score that describes the relative resource use for all 243.8residents within the groups under the resource utilization group (RUG-III) classification 243.9system prescribed by the commissioner based on an assessment of each resident. The 243.10facility average CMI shall be computed as the standardized days divided by total days for 243.11all residents in the facility. The RUG's weights used in this section shall be as follows 243.12for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB 243.131.109; RAA 0.957; SSC 1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2 243.141.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676; 243.15BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023; 243.16PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1 243.170.651; and DDF 1.000243.18    Sec. 76. Minnesota Statutes 2006, section 256B.441, is amended by adding a 243.19subdivision to read:243.20    Subd. 14a.Facility type groups.Facilities shall be classified into two groups, 243.21called "facility type groups," which shall consist of:243.22    (1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota 243.23Rules, parts 9570.2000 to 9570.3400; and 243.24    (2) freestanding: all other facilities.243.25    Sec. 77. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to 243.26read:243.27    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group 243.28life, health, dental, workers' compensation, and other employee insurances and pension, 243.29profit-sharing, and retirement plans for which the employer pays all or a portion of the 243.30costs and that are available to at least all employees who work at least 20 hours per week.243.31    Sec. 78. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to 243.32read:244.1    Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the 244.2salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning 244.3employees and associated fringe benefits and payroll taxes. It also includes the cost of 244.4housekeeping supplies, including, but not limited to,  cleaning and lavatory supplies and 244.5contract services.244.6    Sec. 79. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to 244.7read:244.8    Subd. 24. Maintenance and plant operations costs. "Maintenance and plant 244.9operations costs" means the costs for the salaries and wages of the maintenance supervisor, 244.10engineers, heating-plant employees, and other maintenance employees and associated 244.11fringe benefits and payroll taxes. It also includes direct costs for maintenance and 244.12operation of the building and grounds, including, but not limited to,  fuel, electricity, 244.13medical waste and garbage removal, water, sewer, supplies, tools, and repairs.244.14    Sec. 80. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.15subdivision to read:244.16    Subd. 28a.Other direct care costs."Other direct care costs" means the costs 244.17for the salaries and wages and associated fringe benefits and payroll taxes of mental 244.18health workers, religious personnel, and other direct care employees not specified in 244.19the definition of direct care costs. 244.20    Sec. 81. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to 244.21read:244.22    Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer 244.23groups," which by county. The groups  shall consist of:244.24    (1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed 244.25per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000 244.26to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota, 244.27Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott, 244.28Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;244.29    (2) boarding care homes - facilities that have more than 50 percent of their beds 244.30licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth, 244.31Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, 244.32Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, 245.1Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, 245.2Watonwan, or Wilkin County; and245.3    (3) standard - all other facilities group three: facilities in all other counties.245.4    Sec. 82. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to 245.5read:245.6    Subd. 31. Prior rate-setting method system operating cost payment rate."Prior 245.7rate-setting method" "Prior system operating cost payment rate"  means the operating cost 245.8payment rate determination process in effect prior to October 1, 2006 on September 30, 245.92009, under Minnesota Rules and Minnesota Statutes, not including planned closure rate 245.10adjustments under section 256B.436 or 256B.437, or single bed room incentives under 245.11section 256B.431, subdivision 42.245.12    Sec. 83. Minnesota Statutes 2006, section 256B.441, is amended by adding a 245.13subdivision to read:245.14    Subd. 33a.Raw food costs."Raw food costs" means the cost of food provided to 245.15nursing facility residents. Also included are special dietary supplements used for tube 245.16feeding or oral feeding, such as elemental high nitrogen diet.245.17    Sec. 84. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to 245.18read:245.19    Subd. 34. Related organization. "Related organization" means a person that 245.20furnishes goods or services to a nursing facility and that is a close relative of a nursing 245.21facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility, 245.22or an affiliate of a close relative of an affiliate of a nursing facility. As used in this 245.23subdivision, paragraphs (a) to (d) apply:245.24    (a) "Affiliate" means a person that directly, or indirectly through one or more 245.25intermediaries, controls or is controlled by, or is under common control with another 245.26person.245.27    (b) "Person" means an individual, a corporation, a partnership, an association, a 245.28trust, an unincorporated organization, or a government or political subdivision.245.29    (c) "Close relative of an affiliate of a nursing facility" means an individual whose 245.30relationship by blood, marriage, or adoption to an individual who is an affiliate of a 245.31nursing facility is no more remote than first cousin.245.32    (d) "Control" including the terms "controlling," "controlled by," and "under common 245.33control with" means the possession, direct or indirect, of the power to direct or cause the 246.1direction of the management, operations, or policies of a person, whether through the 246.2ownership of voting securities, by contract, or otherwise, or to influence in any manner 246.3other than through an arms length, legal transaction.246.4    Sec. 85. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to 246.5read:246.6    Subd. 38. Social services costs. "Social services costs" means the costs for the 246.7salaries and wages of the supervisor and other social work employees, associated fringe 246.8benefits and payroll taxes, supplies, services, and consultants. This category includes the 246.9cost of those employees who manage and process admission to the nursing facility.246.10    Sec. 86. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.11subdivision to read:246.12    Subd. 42a.Therapy costs."Therapy costs" means any costs related to medical 246.13assistance therapy services provided to residents that are not billed separately from the 246.14daily operating rate.246.15    Sec. 87. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.16subdivision to read:246.17    Subd. 48.Calculation of operating per diems.The direct care per diem for 246.18each facility shall be the facility's direct care costs divided by its standardized days. 246.19The other care-related per diem shall be the sum of the facility's activities costs, other 246.20direct care costs, raw food costs, therapy costs, and social services costs, divided by the 246.21facility's resident days. The other operating per diem shall be the sum of the facility's 246.22administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance 246.23and plant operations costs divided by the facility's resident days.246.24    Sec. 88. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.25subdivision to read:246.26    Subd. 49.Determination of total care-related per diem.The total care-related 246.27per diem for each facility shall be the sum of the direct care per diem and the other 246.28care-related per diem.246.29    Sec. 89. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.30subdivision to read:247.1    Subd. 50.Determination of total care-related limit.The limit on the total 247.2care-related per diem shall be determined for each peer group and facility type group 247.3combination. A facility's total care-related per diems shall be limited to 120 percent of the 247.4median for the facility's peer and facility type group. The facility-specific direct care costs 247.5used in making this comparison and in the calculation of the median shall be based on a 247.6RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per 247.7diem reduced to the limit. If a reduction of the total care-related per diem is necessary 247.8because of this limit, the reduction shall be made proportionally to both the direct care per 247.9diem and the other care-related per diem.247.10    Sec. 90. Minnesota Statutes 2006, section 256B.441, is amended by adding a 247.11subdivision to read:247.12    Subd. 51.Determination of other operating limit.The limit on the other operating 247.13per diem shall be determined for each peer group. A facility's other operating per diem 247.14shall be limited to 105 percent of the median for its peer group. A facility that is above 247.15that limit shall have its other operating per diem reduced to the limit.247.16    Sec. 91. Minnesota Statutes 2006, section 256B.441, is amended by adding a 247.17subdivision to read:247.18    Subd. 52.Determination of efficiency incentive.Each facility shall be eligible 247.19for an efficiency incentive based on its other operating per diem. A facility with an other 247.20operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency 247.21incentive. All other facilities shall receive an incentive calculated as 50 percent times the 247.22difference between the facility's other operating per diem and its other operating per diem 247.23limit, up to a maximum incentive of $3.247.24    Sec. 92. Minnesota Statutes 2006, section 256B.441, is amended by adding a 247.25subdivision to read:247.26    Subd. 53.Calculation of payment rate for external fixed costs.The commissioner 247.27shall calculate a payment rate for external fixed costs.247.28    (a) For a facility licensed as a nursing home, the portion related to section 256.9657 247.29shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care 247.30home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the 247.31result of its number of nursing home beds divided by its total number of licensed beds.247.32    (b) The portion related to the licensure fee under section 144.122, paragraph (d), 247.33shall be the amount of the fee divided by actual resident days.248.1    (c) The portion related to scholarships shall be determined under section 256B.431, 248.2subdivision 36.248.3    (d) The portion related to long-term care consultation shall be determined according 248.4to section 256B.0911, subdivision 6.248.5    (e) The portion related to development and education of resident and family advisory 248.6councils under section 144A.33 shall be $5 divided by 365.248.7    (f) The portion related to planned closure rate adjustments shall be as determined 248.8under sections 256B.436 and 256B.437, subdivision 6.248.9    (g) The portions related to property insurance, real estate taxes, special assessments, 248.10and payments made in lieu of real estate taxes directly identified or allocated to the nursing 248.11facility shall be the actual amounts divided by actual resident days.248.12    (h) The portion related to the Public Employees Retirement Association shall be 248.13actual costs divided by resident days.248.14    (i) The single bed room incentives shall be as determined under section 256B.431, 248.15subdivision 42.248.16    (j) The payment rate for external fixed costs shall be the sum of the amounts in 248.17paragraphs (a) to (i).248.18    Sec. 93. Minnesota Statutes 2006, section 256B.441, is amended by adding a 248.19subdivision to read:248.20    Subd. 54.Adjustment of per diem for inflation.The total care-related per diem 248.21and other operating per diem calculated under this section shall be adjusted for inflation to 248.22adjust for the delay between the reporting year and the rate year. The total care-related 248.23payment rate and other operating payment rate shall be calculated as the per diem 248.24increased by the Global Insight Consumer Price Index urban inflation factor for the period 248.25from the midpoint of the reporting year to the midpoint of the rate year. 248.26    Sec. 94. Minnesota Statutes 2006, section 256B.441, is amended by adding a 248.27subdivision to read:248.28    Subd. 55.Determination of total payment rates.In rate years when rates are 248.29rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total 248.30care-related payment rate, other operating payment rate, efficiency incentive, external 248.31fixed cost rate, and the property rate determined under section 256B.434. To determine 248.32a total payment rate for each RUG's level, the total care-related payment rate shall be 248.33divided into the direct care payment rate and the other care-related payment rate, and the 249.1direct care payment rate multiplied by the RUG's weight for each RUG's level using the 249.2weights in subdivision 14.249.3    Sec. 95. Minnesota Statutes 2006, section 256B.441, is amended by adding a 249.4subdivision to read:249.5    Subd. 56.Rate increase; phase-in of rebased operating payment rates.(a) 249.6Effective October 1, 2009, operating payment rates of all nursing facilities shall be 249.7increased to be equal, for a RUG's rate with a weight of 1.00, to the median rate for the 249.8same RUG's weight of all nursing facilities in subdivision 31, paragraph 1. The percentage 249.9of the operating payment rate for each facility to be case-mix adjusted shall be equal to 249.10the percentage that is case-mix adjusted in that facility's September 30, 2009, operating 249.11payment rate. This paragraph shall apply only if it results in a rate increase.249.12    (b) For the rate years beginning October 1, 2009, and October 1, 2010, the operating 249.13cost payment rate calculated under this section shall be phased in by blending them 249.14with the operating cost payment rate determined under section 256B.434. For the rate 249.15year beginning October 1, 2009, the operating cost payment rate for each facility shall 249.16be 42 percent of the operating cost payment rate from this section, and 58 percent of the 249.17operating cost payment rate from section 256B.434. For the rate year beginning October 1, 249.182010, the operating cost payment rate for each facility shall be the operating cost payment 249.19rate determined under this section. The blending of operating cost payment rates under 249.20this subdivision shall be performed separately for each RUG's class.249.21    (c) All funds received under this subdivision that are in excess of operating cost 249.22payment rates that a facility would have received under section 256B.434 shall be subject 249.23to the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h).249.24    Sec. 96. Minnesota Statutes 2006, section 256B.441, is amended by adding a 249.25subdivision to read:249.26    Subd. 57.Adjustment for inflation during phase-in of rebased operating cost 249.27payment rates.During the phase-in of operating cost payment rates under subdivision 249.2856, both the operating costs per diem under this section and the operating cost payment 249.29rate under section 256B.434 shall be adjusted for inflation. The adjustment for each year 249.30for the operating cost per diems shall be the Global Insight Consumer Price Index urban 249.31inflation factor from the midpoint of the reporting year to the midpoint of the current rate 249.32year. The adjustment for each year for the operating cost payment rate under section 249.33256B.434 shall be the Global Insight Consumer Price Index urban inflation factor from the 249.34midpoint of the October 1, 2007, rate year to the midpoint of the current rate year.250.1    Sec. 97. Minnesota Statutes 2006, section 256B.441, is amended by adding a 250.2subdivision to read:250.3    Subd. 58.Hold harmless.For the rate years beginning October 1, 2009, October 1, 250.42010, and October 1, 2011, no nursing facility shall receive an operating cost payment 250.5rate less than its operating cost payment rate under section 256B.434. The comparison 250.6of operating cost payment rates under this section shall be made for each of the RUG's 250.7classes separately, and the operating cost payment rates under section 256B.434 used 250.8under this section shall not include the inflation increases described in subdivision 57.250.9    Sec. 98. Minnesota Statutes 2006, section 256B.441, is amended by adding a 250.10subdivision to read:250.11    Subd. 59.Appeals.Nursing facilities may appeal, as defined under section 256B.50, 250.12the determination of a payment rate established under this chapter.250.13    Sec. 99. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:250.14    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and 250.15community-based service waivers, as authorized under section 1915(c) of the Social 250.16Security Act to serve persons under the age of 65 who are determined to require the level 250.17of care provided in a nursing home and persons who require the level of care provided in a 250.18hospital. The commissioner shall apply for the home and community-based waivers in 250.19order to:250.20    (i) promote the support of persons with disabilities in the most integrated settings;250.21    (ii) expand the availability of services for persons who are eligible for medical 250.22assistance;250.23    (iii) promote cost-effective options to institutional care; and250.24    (iv) obtain federal financial participation.250.25    (b) The provision of waivered services to medical assistance recipients with 250.26disabilities shall comply with the requirements outlined in the federally approved 250.27applications for home and community-based services and subsequent amendments, 250.28including provision of services according to a service plan designed to meet the needs of 250.29the individual. For purposes of this section, the approved home and community-based 250.30application is considered the necessary federal requirement.250.31    (c) The commissioner shall provide interested persons serving on agency advisory 250.32committees and, task forces, the Centers for Independent Living, and others upon who250.33request, with to be on a list to receive, notice of, and an opportunity to comment on, 250.34at least 30 days before any effective dates, (1) any substantive changes to the state's 251.1disability services program manual, or (2) changes or amendments to the federally 251.2approved applications for home and community-based waivers, prior to their submission 251.3to the federal Centers for Medicare and Medicaid Services.251.4    (d) The commissioner shall seek approval, as authorized under section 1915(c) of 251.5the Social Security Act, to allow medical assistance eligibility under this section for 251.6children under age 21 without deeming of parental income or assets.251.7    (e) The commissioner shall seek approval, as authorized under section 1915(c) of 251.8the Social Act, to allow medical assistance eligibility under this section for individuals 251.9under age 65 without deeming the spouse's income or assets.251.10    Sec. 100. Minnesota Statutes 2006, section 256B.49, is amended by adding a 251.11subdivision to read:251.12    Subd. 16a.Medical assistance reimbursement.(a) The commissioner shall 251.13seek federal approval for medical assistance reimbursement of independent living skills 251.14services, foster care waiver service, supported employment, prevocational service, 251.15structured day service, and adult day care under the home and community-based waiver 251.16for persons with a traumatic brain injury, the community alternatives for disabled 251.17individuals waivers, and the community alternative care waivers.251.18    (b) Medical reimbursement shall be made only when the provider demonstrates 251.19evidence of its capacity to meet basic health, safety, and protection standards through 251.20one of the methods in paragraphs (c) to (e).251.21    (c) The provider is licensed to provide services under chapter 245B and agrees to 251.22apply these standards to services funded through the traumatic brain injury, community 251.23alternatives for disabled, or community alternative care home and community-based 251.24waivers.251.25    (d) The local agency contracting for the services certifies on a form provided by the 251.26commissioner that the provider has the capacity to meet the individual needs as identified 251.27in each person's individual service plan. When certifying that the service provider meets 251.28the necessary provider qualifications, the local agency shall verify that the provider has 251.29policies and procedures governing the following:251.30    (1) protection of the consumer's rights and privacy;251.31    (2) risk assessment and planning;251.32    (3) record keeping and reporting of incidents and emergencies with documentation 251.33of corrective action if needed;251.34    (4) service outcomes, regular reviews of progress, and periodic reports;251.35    (5) complaint and grievance procedures;252.1    (6) service termination or suspension;252.2    (7) necessary training and supervision of direct care staff that includes:252.3    (i) documentation in personnel files of 20 hours of orientation training in providing 252.4training related to service provision;252.5    (ii) training in recognizing the symptoms and effects of certain disabilities, health 252.6conditions, and positive behavioral supports and interventions; and 252.7    (iii) a minimum of five hours of related training annually; and 252.8    (8) when applicable, the local agency shall verify that the provider has policies and 252.9procedures in place governing the following:252.10    (i) safe medication administration;252.11    (ii) proper handling of consumer funds; and 252.12    (iii) behavioral interventions that are in compliance with prohibitions and standards 252.13developed by the commissioner to meet federal requirements regarding the use of 252.14restraints and restrictive interventions.252.15    (e) For foster care waiver services or independent living skills services, the local 252.16agency contracting for the services certifies on a form provided by the commissioner that 252.17the provider meets the following:252.18    (1) the provider of foster care waiver services is licensed to provide adult foster 252.19care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under 252.20Minnesota Rules, parts 2960.3000 to 2960.3230;252.21    (2) the provider of independent living skills services also provides licensed foster 252.22care services and agrees to apply the foster care standards under Minnesota Rules, parts 252.239555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225, subpart 252.248; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts 10 252.25and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of those 252.26services; and252.27    (3) the provider has policies and procedures applying to the provision of foster 252.28care waiver services or independent living skills services that govern (i) behavioral 252.29interventions that are in compliance with prohibitions and standards developed by the 252.30commissioner to meet federal requirements regarding the use of restraints and restrictive 252.31interventions and (ii) documentation of service needs and outcomes, regular reviews 252.32of progress, and periodic reports.252.33    (f) The local agency shall review each provider's continued compliance with 252.34the basic health, safety, and protection standards on a regular basis. For the review 252.35of paragraph (e), the local agency shall coordinate the review with the county review 252.36of foster care licensure.253.1EFFECTIVE DATE.This section is effective the day following final enactment.253.2    Sec. 101. Minnesota Statutes 2006, section 256B.5012, is amended by adding a 253.3subdivision to read:253.4    Subd. 7.ICF/MR rate increases October 1, 2007, and October 1, 2008.(a) For 253.5the rate periods beginning October 1, 2007, and October 1, 2008, the commissioner shall 253.6make available to each facility reimbursed under this section an adjustment to the total 253.7operating payment rate of three percent.253.8    (b) Seventy-five percent of the money resulting from the rate adjustment under 253.9paragraph (a) must be used to increase wages and benefits and pay associated costs for 253.10employees, except for administrative and central office employees. Seventy-five percent 253.11of the money received by a facility as a result of the rate adjustment provided in paragraph 253.12(a) must be used only for wage, benefit, and staff increases implemented on or after 253.13the effective date of the rate increase each year, and must not be used for increases 253.14implemented prior to that date. The wage adjustment eligible employees may receive may 253.15vary based on merit, seniority, or other factors determined by the provider.253.16    (c) For each facility, the commissioner shall make available an adjustment, based 253.17on occupied beds, using the percentage specified in paragraph (a) multiplied by the total 253.18payment rate, including variable rate but excluding the property-related payment rate, in 253.19effect on the preceding day. The total payment rate must include the adjustment provided 253.20in section 256B.501, subdivision 12.253.21    (d) A facility whose payment rates are governed by closure agreements, receivership 253.22agreements, or Minnesota Rules, part 9553.0075, is not eligible for an adjustment 253.23otherwise granted under this subdivision.253.24    (e) A facility may apply for the portion of the payment rate adjustment provided 253.25under paragraph (a) for employee wages and benefits and associated costs. The application 253.26must be made to the commissioner and contain a plan by which the facility will distribute 253.27the funds according to paragraph (b). For facilities in which the employees are represented 253.28by an exclusive bargaining representative, an agreement negotiated and agreed to by 253.29the employer and the exclusive bargaining representative constitutes the plan. The 253.30commissioner shall not review, and shall not require changes, to the portion or portions 253.31of the plan covered by collective bargaining agreements. A negotiated agreement may 253.32constitute the plan only if the agreement is finalized after the date of enactment of all rate 253.33increases for the rate year. The commissioner shall review the plan to ensure that the 253.34payment rate adjustment per diem is used as provided in this subdivision. To be eligible, a 253.35facility must submit its plan by March 31, 2008, and December 31, 2008, respectively. 254.1If a facility's plan is effective for its employees after the first day of the applicable rate 254.2period that the funds are available, the payment rate adjustment per diem is effective 254.3the same date as its plan.254.4    (f) A copy of the approved distribution plan must be made available to all employees 254.5by giving each employee a copy or by posting it in an area of the facility to which all 254.6employees have access. If an employee does not receive the wage and benefit adjustment 254.7described in the facility's approved plan and is unable to resolve the problem with the 254.8facility's management or through the employee's union representative, the employee 254.9may contact the commissioner at an address or telephone number provided by the 254.10commissioner and included in the approved plan.254.11    Sec. 102. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to 254.12read:254.13    Subd. 23. Alternative services; elderly and disabled persons. (a) The 254.14commissioner may implement demonstration projects to create alternative integrated 254.15delivery systems for acute and long-term care services to elderly persons and persons 254.16with disabilities as defined in section 
         256B.77, subdivision 7a, that provide increased 254.17coordination, improve access to quality services, and mitigate future cost increases. 254.18The commissioner may seek federal authority to combine Medicare and Medicaid 254.19capitation payments for the purpose of such demonstrations and may contract with 254.20Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 254.21services shall be administered according to the terms and conditions of the federal contract 254.22and demonstration provisions. For the purpose of administering medical assistance funds, 254.23demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 254.24of Minnesota Rules, parts 
         9500.1450 to 
         9500.1464, apply to these demonstrations, 254.25with the exceptions of parts 
         9500.1452, subpart 2, item B; and 
         9500.1457, subpart 1, 254.26items B and C, which do not apply to persons enrolling in demonstrations under this 254.27section. An initial open enrollment period may be provided. Persons who disenroll from 254.28demonstrations under this subdivision remain subject to Minnesota Rules, parts 
         9500.1450254.29to 
         9500.1464. When a person is enrolled in a health plan under these demonstrations and 254.30the health plan's participation is subsequently terminated for any reason, the person shall 254.31be provided an opportunity to select a new health plan and shall have the right to change 254.32health plans within the first 60 days of enrollment in the second health plan. Persons 254.33required to participate in health plans under this section who fail to make a choice of 254.34health plan shall not be randomly assigned to health plans under these demonstrations. 254.35Notwithstanding section 
         256L.12, subdivision 5, and Minnesota Rules, part 
         9505.5220, 255.1subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 255.2the commissioner may contract with managed care organizations, including counties, to 255.3serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 255.4disabled persons only. For persons with a primary diagnosis of developmental disability, 255.5serious and persistent mental illness, or serious emotional disturbance, the commissioner 255.6must ensure that the county authority has approved the demonstration and contracting 255.7design. Enrollment in these projects for persons with disabilities shall be voluntary. The 255.8commissioner shall not implement any demonstration project under this subdivision for 255.9persons with a primary diagnosis of developmental disabilities, serious and persistent 255.10mental illness, or serious emotional disturbance, without approval of the county board of 255.11the county in which the demonstration is being implemented.255.12    (b) Notwithstanding chapter 245B, sections 
         252.40 to 
         252.46, 
         256B.092, 
         256B.501255.13to 
         256B.5015, and Minnesota Rules, parts 
         9525.0004 to 
         9525.0036, 
         9525.1200 to 255.149525.1330
         , 
         9525.1580, and 
         9525.1800 to 
         9525.1930, the commissioner may implement 255.15under this section projects for persons with developmental disabilities. The commissioner 255.16may capitate payments for ICF/MR services, waivered services for developmental 255.17disabilities, including case management services, day training and habilitation and 255.18alternative active treatment services, and other services as approved by the state and by 255.19the federal government. Case management and active treatment must be individualized 255.20and developed in accordance with a person-centered plan. Costs under these projects may 255.21not exceed costs that would have been incurred under fee-for-service. Beginning July 1, 255.222003, and until twofour years after the pilot project implementation date, subcontractor 255.23participation in the long-term care developmental disability pilot is limited to a nonprofit 255.24long-term care system providing ICF/MR services, home and community-based waiver 255.25services, and in-home services to no more than 120 consumers with developmental 255.26disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the 255.27legislature prior to expansion of the developmental disability pilot project. This paragraph 255.28expires twofour years after the implementation date of the pilot project.255.29    (c) Before implementation of a demonstration project for disabled persons, the 255.30commissioner must provide information to appropriate committees of the house of 255.31representatives and senate and must involve representatives of affected disability groups 255.32in the design of the demonstration projects.255.33    (d) A nursing facility reimbursed under the alternative reimbursement methodology 255.34in section 
         256B.434 may, in collaboration with a hospital, clinic, or other health care entity 255.35provide services under paragraph (a). The commissioner shall amend the state plan and 255.36seek any federal waivers necessary to implement this paragraph.256.1    (e) The commissioner, in consultation with the commissioners of commerce and 256.2health, may approve and implement programs for all-inclusive care for the elderly (PACE) 256.3according to federal laws and regulations governing that program and state laws or rules 256.4applicable to participating providers. The process for approval of these programs shall 256.5begin only after the commissioner receives grant money in an amount sufficient to cover 256.6the state share of the administrative and actuarial costs to implement the programs during 256.7state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 256.8account in the special revenue fund and are appropriated to the commissioner to be used 256.9solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 256.10not required to be licensed or certified as a health plan company as defined in section 256.1162Q.01, subdivision 4
         . Persons age 55 and older who have been screened by the county 256.12and found to be eligible for services under the elderly waiver or community alternatives 256.13for disabled individuals or who are already eligible for Medicaid but meet level of 256.14care criteria for receipt of waiver services may choose to enroll in the PACE program. 256.15Medicare and Medicaid services will be provided according to this subdivision and 256.16federal Medicare and Medicaid requirements governing PACE providers and programs. 256.17PACE enrollees will receive Medicaid home and community-based services through the 256.18PACE provider as an alternative to services for which they would otherwise be eligible 256.19through home and community-based waiver programs and Medicaid State Plan Services. 256.20The commissioner shall establish Medicaid rates for PACE providers that do not exceed 256.21costs that would have been incurred under fee-for-service or other relevant managed care 256.22programs operated by the state.256.23    (f) The commissioner shall seek federal approval to expand the Minnesota disability 256.24health options (MnDHO) program established under this subdivision in stages, first to 256.25regional population centers outside the seven-county metro area and then to all areas 256.26of the state. Until January 1, 2008July 1, 2009, expansion for MnDHO projects that 256.27include home and community-based services is limited to the two projects and service 256.28areas in effect on March 1, 2006.  Enrollment in integrated MnDHO programs that 256.29include home and community-based services shall remain voluntary. Costs for home 256.30and community-based services included under MnDHO must not exceed costs that 256.31would have been incurred under the fee-for-service program. In developing program 256.32specifications for expansion of integrated programs, the commissioner shall involve and 256.33consult the state-level stakeholder group established in subdivision 28, paragraph (d), 256.34including consultation on whether and how to include home and community-based waiver 256.35programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 257.1of the house and senate committees with jurisdiction over health and human services 257.2policy and finance by February 1, 2007.257.3    (g) Notwithstanding section 
         256B.0261, health plans providing services under this 257.4section are responsible for home care targeted case management and relocation targeted 257.5case management. Services must be provided according to the terms of the waivers and 257.6contracts approved by the federal government.257.7    Sec. 103. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to 257.8read:257.9    Subd. 28. Medicare special needs plans; medical assistance basic health care.257.10    (a) The commissioner may contract with qualified Medicare-approved special needs 257.11plans to provide medical assistance basic health care services to persons with disabilities, 257.12including those with developmental disabilities. Basic health care services include:257.13    (1) those services covered by the medical assistance state plan except for ICF/MR 257.14services, home and community-based waiver services, case management for persons with 257.15developmental disabilities under section 
         256B.0625, subdivision 20a, and personal care 257.16and certain home care services defined by the commissioner in consultation with the 257.17stakeholder group established under paragraph (d); and257.18    (2) basic health care services may also include risk for up to 100 days of nursing 257.19facility services for persons who reside in a noninstitutional setting and home health 257.20services related to rehabilitation as defined by the commissioner after consultation with 257.21the stakeholder group.257.22    The commissioner may exclude other medical assistance services from the basic 257.23health care benefit set. Enrollees in these plans can access any excluded services on the 257.24same basis as other medical assistance recipients who have not enrolled.257.25    Unless a person is otherwise required to enroll in managed care, enrollment in these 257.26plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 257.27enrollment with an option to opt out is not voluntary enrollment. 257.28    (b) Beginning January 1, 2007, the commissioner may contract with qualified 257.29Medicare special needs plans to provide basic health care services under medical 257.30assistance to persons who are dually eligible for both Medicare and Medicaid and those 257.31Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 257.32The commissioner shall consult with the stakeholder group under paragraph (d) (e) in 257.33developing program specifications for these services. The commissioner shall report to 257.34the chairs of the house and senate committees with jurisdiction over health and human 257.35services policy and finance by February 1, 2007, on implementation of these programs and 258.1the need for increased funding for the ombudsman for managed care and other consumer 258.2assistance and protections needed due to enrollment in managed care of persons with 258.3disabilities. Payment for Medicaid services provided under this subdivision for the months 258.4of May and June will be made no earlier than July 1 of the same calendar year.258.5    (c) Beginning January 1, 2008, the commissioner may expand contracting under this 258.6subdivision to all persons with disabilities not otherwise required to enroll in managed 258.7care.258.8    (d) By February 1, 2009, the commissioner shall report to the chairs of the house and 258.9senate committees with jurisdiction over health and human services policy and finance on 258.10the initial results of implementation of contracts with qualified Medicare special needs 258.11plans to provide basic health care services under medical assistance to persons who are 258.12dually eligible for both Medicare and Medicaid. This report shall include an overall 258.13assessment of the impact on quality of care including actual costs and benefits.258.14    (e) The commissioner shall establish a state-level stakeholder group to provide 258.15advice on managed care programs for persons with disabilities, including both MnDHO 258.16and contracts with special needs plans that provide basic health care services as described 258.17in paragraphs (a) and (b). The stakeholder group shall include representatives of the 258.18counties and labor organizations representing county social service workers, members, 258.19consumer advocates, and providers, and provide advice on program expansions under this 258.20subdivision and subdivision 23, including:258.21    (1) implementation efforts; 258.22    (2) consumer protections; and258.23    (3) program specifications such as quality assurance measures, data collection and 258.24reporting, and evaluation of costs, quality, and results.; and258.25    (4) county safety net protections for persons with disabilities.258.26    (e) (f) Each plan under contract to provide medical assistance basic health care 258.27services shall establish a local or regional stakeholder group, including representatives 258.28of the counties covered by the plan and labor organizations representing county social 258.29service workers, members, consumer advocates, and current providers, for advice on 258.30issues that arise in the local or regional area.258.31    Sec. 104. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.258.32     (a) The commissioner of human services shall combine the existing biennial base 258.33level funding for deaf-blind services into a single grant program. At least 35 percent 258.34of the total funding is awarded for services and other supports to deaf-blind children 259.1and their families and at least 25 percent is awarded for services and other supports to 259.2deaf-blind adults.259.3    The commissioner shall award grants for the purposes of: 259.4    (1) providing services and supports to individuals who are deaf-blind; and 259.5    (2) developing and providing training to counties and the network of senior citizen 259.6service providers. The purpose of the training grants is to teach counties how to use 259.7existing programs that capture federal financial participation to meet the needs of eligible 259.8deaf-blind persons and to build capacity of senior service programs to meet the needs of 259.9seniors with a dual sensory hearing and vision loss.259.10    (b) The commissioner may make grants:259.11    (1) for services and training provided by organizations; and259.12    (2) to develop and administer consumer-directed services.259.13    (c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant 259.14under paragraph (a).259.15    (d) Deaf-blind service providers are not required to, but may, provide intervenor 259.16services as part of the service package provided with grant funds under this section.259.17    Sec. 105. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:259.18    Subd. 2. Standard of assistance for persons eligible for medical assistance 259.19waivers or at risk of placement in a group residential housing facility. The state 259.20standard of assistance for a person (1) who is eligible for a medical assistance home 259.21and community-based services waiver or a person, (2) who has been determined by the 259.22local agency to meet the plan requirements for placement in a group residential housing 259.23facility under section 
         256I.04, subdivision 1a, or (3) who is eligible for a shelter needy 259.24payment under subdivision 5, paragraph (f), is the standard established in subdivision 3, 259.25paragraph (a) or (b).259.26    Sec. 106. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:259.27    Subd. 5. Special needs. In addition to the state standards of assistance established in 259.28subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 259.29Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 259.30center, or a group residential housing facility.259.31    (a) The county agency shall pay a monthly allowance for medically prescribed 259.32diets if the cost of those additional dietary needs cannot be met through some other 259.33maintenance benefit. The need for special diets or dietary items must be prescribed by 259.34a licensed physician. Costs for special diets shall be determined as percentages of the 260.1allotment for a one-person household under the thrifty food plan as defined by the United 260.2States Department of Agriculture. The types of diets and the percentages of the thrifty 260.3food plan that are covered are as follows:260.4    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;260.5    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 260.6of thrifty food plan;260.7    (3) controlled protein diet, less than 40 grams and requires special products, 125 260.8percent of thrifty food plan;260.9    (4) low cholesterol diet, 25 percent of thrifty food plan;260.10    (5) high residue diet, 20 percent of thrifty food plan;260.11    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;260.12    (7) gluten-free diet, 25 percent of thrifty food plan;260.13    (8) lactose-free diet, 25 percent of thrifty food plan;260.14    (9) antidumping diet, 15 percent of thrifty food plan;260.15    (10) hypoglycemic diet, 15 percent of thrifty food plan; or260.16    (11) ketogenic diet, 25 percent of thrifty food plan.260.17    (b) Payment for nonrecurring special needs must be allowed for necessary home 260.18repairs or necessary repairs or replacement of household furniture and appliances using 260.19the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 260.20as long as other funding sources are not available.260.21    (c) A fee for guardian or conservator service is allowed at a reasonable rate 260.22negotiated by the county or approved by the court. This rate shall not exceed five percent 260.23of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 260.24guardian or conservator is a member of the county agency staff, no fee is allowed.260.25    (d) The county agency shall continue to pay a monthly allowance of $68 for 260.26restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 260.271990, and who eats two or more meals in a restaurant daily. The allowance must continue 260.28until the person has not received Minnesota supplemental aid for one full calendar month 260.29or until the person's living arrangement changes and the person no longer meets the criteria 260.30for the restaurant meal allowance, whichever occurs first.260.31    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 260.32is allowed for representative payee services provided by an agency that meets the 260.33requirements under SSI regulations to charge a fee for representative payee services. This 260.34special need is available to all recipients of Minnesota supplemental aid regardless of 260.35their living arrangement.261.1    (f) Notwithstanding the language in this subdivision, an amount equal to the 261.2maximum allotment authorized by the federal Food Stamp Program for a single individual 261.3which is in effect on the first day of January July of the previous each year will be added to 261.4the standards of assistance established in subdivisions 1 to 4 for individuals adults under 261.5the age of 65 who qualify as shelter needy and are: (1) relocating from an institution, or 261.6an adult mental health residential treatment program under section 
         256B.0622, and who 261.7are shelter needy; (2) self-directed supports option participants defined under section 261.8256B.0657 if enacted in the 2007 legislative session; or (3) home and community-based 261.9waiver recipients living in their own rented, leased, or owned apartment or home not 261.10owned, operated, or controlled by a provider of service not related by blood or marriage. 261.11Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy 261.12benefit under subdivision 5, paragraph (f), is considered a household of one. An eligible 261.13individual who receives this benefit prior to age 65 may continue to receive the benefit 261.14after the age of 65.261.15    (g)(1) Persons eligible for shelter needy funding under paragraph (f), who are not 261.16receiving medial assistance home and community-based waiver services, are eligible for 261.17a state-funded transitional supports allowance under section 256B.49, subdivision 16, 261.18paragraph (e), to establish their own residence not owned, operated, or controlled by a 261.19provider of service not related by blood or marriage.261.20    (2) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 261.21exceed 40 percent of the assistance unit's gross income before the application of this 261.22special needs standard. "Gross income" for the purposes of this section is the applicant's or 261.23recipient's income as defined in section 
         256D.35, subdivision 10, or the standard specified 261.24in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 261.25state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 261.26considered shelter needy for purposes of this paragraph.261.27    Sec. 107. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:261.28    Subd. 3. Moratorium on the development of group residential housing beds. (a) 261.29County agencies shall not enter into agreements for new group residential housing beds 261.30with total rates in excess of the MSA equivalent rate except: (1) for group residential 261.31housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 261.32provided the facility is needed to meet the census reduction targets for persons with 261.33developmental disabilities at regional treatment centers; (2) to ensure compliance with 261.34the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements 261.35for inappropriately placed persons with developmental disabilities or mental illness; 262.1(3) up to 80 beds in a single, specialized facility located in Hennepin County that will 262.2provide housing for chronic inebriates who are repetitive users of detoxification centers 262.3and are refused placement in emergency shelters because of their state of intoxication, 262.4and planning for the specialized facility must have been initiated before July 1, 1991, in 262.5anticipation of receiving a grant from the Housing Finance Agency under section 
         462A.05, 262.6subdivision 20a
         , paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for 262.7up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County 262.8for homeless adults with a mental illness, a history of substance abuse, or human 262.9immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this 262.10section, "homeless adult" means a person who is living on the street or in a shelter or 262.11discharged from a regional treatment center, community hospital, or residential treatment 262.12program and has no appropriate housing available and lacks the resources and support 262.13necessary to access appropriate housing. At least 70 percent of the supportive housing 262.14units must serve homeless adults with mental illness, substance abuse problems, or human 262.15immunodeficiency virus or acquired immunodeficiency syndrome who are about to be 262.16or, within the previous six months, has been discharged from a regional treatment center, 262.17or a state-contracted psychiatric bed in a community hospital, or a residential mental 262.18health or chemical dependency treatment program. If a person meets the requirements of 262.19subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group 262.20residential housing rate for that person is limited to the supplementary rate under section 262.21256I.05, subdivision 1a
         , and is determined by subtracting the amount of the person's 262.22countable income that exceeds the MSA equivalent rate from the group residential housing 262.23supplementary rate. A resident in a demonstration project site who no longer participates 262.24in the demonstration program shall retain eligibility for a group residential housing 262.25payment in an amount determined under section 
         256I.06, subdivision 8, using the MSA 262.26equivalent rate. Service funding under section 
         256I.05, subdivision 1a, will end June 30, 262.271997, if federal matching funds are available and the services can be provided through a 262.28managed care entity. If federal matching funds are not available, then service funding will 262.29continue under section 
         256I.05, subdivision 1a; or (6) (5) for group residential housing 262.30beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which 262.31are used exclusively for recipients receiving home and community-based waiver services 262.32under sections 
         256B.0915, 
         256B.092, subdivision 5, 
         256B.093, and 
         256B.49, and who 262.33resided in a nursing facility for the six months immediately prior to the month of entry 262.34into the group residential housing setting. The group residential housing rate for these 262.35beds must be set so that the monthly group residential housing payment for an individual 262.36occupying the bed when combined with the nonfederal share of services delivered under 263.1the waiver for that person does not exceed the nonfederal share of the monthly medical 263.2assistance payment made for the person to the nursing facility in which the person resided 263.3prior to entry into the group residential housing establishment. The rate may not exceed 263.4the MSA equivalent rate plus $426.37 for any case.; or (6) for an additional two beds, 263.5resulting in a total of 32 beds, for a facility located in Hennepin County providing services 263.6for recovering and chemically dependent men that has had a group residential housing 263.7contract with the county and has been licensed as a board and lodge facility with special 263.8services since 1980; (7) for a group residential housing provider located in Stearns County 263.9that operates a 40-bed facility, that received financing through the Minnesota Housing 263.10Finance Agency Ending Long-Term Homelessness Initiative and serves chemically 263.11dependent clientele, providing 24-hour-a-day supervision; (8) for a group residential 263.12housing provider located in Crow Wing County that serves a chemically dependent 263.13clientele, providing 24-hour-a-day supervision and limiting a resident's maximum length 263.14of stay to 13 months out of a consecutive 24-month period; (9) for a 60-bed facility in 263.15St. Louis County which opened in January 2006 that will serve chemically dependent 263.16persons operated by a group residential housing provider that currently operates a 304-bed 263.17facility in Minneapolis; and (10) for a group residential housing provider that operates two 263.18ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 263.19which provide community support and serve the mental health needs of individuals who 263.20have chronically lived unsheltered, providing 24-hour-a-day supervision.263.21    (b) A county agency may enter into a group residential housing agreement for beds 263.22with rates in excess of the MSA equivalent rate in addition to those currently covered 263.23under a group residential housing agreement if the additional beds are only a replacement 263.24of beds with rates in excess of the MSA equivalent rate which have been made available 263.25due to closure of a setting, a change of licensure or certification which removes the beds 263.26from group residential housing payment, or as a result of the downsizing of a group 263.27residential housing setting. The transfer of available beds from one county to another can 263.28only occur by the agreement of both counties.263.29    Sec. 108. Minnesota Statutes 2006, section 256I.05, is amended by adding a 263.30subdivision to read:263.31    Subd. 1h.Supplementary rate for certain facilities serving chemically 263.32dependent males.Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a 263.33county agency shall negotiate a supplementary rate in addition to the rate specified in 263.34subdivision 1, not to exceed $737.87 per month, including any legislatively authorized 263.35inflationary adjustments, for a group residential housing provider that:264.1    (1) is located in Ramsey County and has had a group residential housing contract 264.2with the county since 1982 and has been licensed as a board and lodge facility with special 264.3services since 1979; and264.4    (2) serves recovering and chemically dependent males, providing 24-hour-a-day 264.5supervision.264.6    Sec. 109. Minnesota Statutes 2006, section 256I.05, is amended by adding a 264.7subdivision to read:264.8    Subd. 1i.Supplementary rate for certain facilities; Hennepin County.264.9    Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate 264.10a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 264.11per month, including any legislatively authorized inflationary adjustments, for a facility 264.12located in Hennepin County with a capacity of up to 48 beds that has been licensed since 264.131978 as a board and lodging facility and that until August 1, 2007, operated as a licensed 264.14chemical dependency treatment program.264.15EFFECTIVE DATE.This section is effective the day following final enactment.264.16    Sec. 110. Minnesota Statutes 2006, section 256I.05, is amended by adding a 264.17subdivision to read:264.18    Subd. 1j.Supplementary rate for certain facilities; St. Louis County.(a) 264.19Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 264.20county agency shall negotiate a supplementary rate in addition to the rate specified in 264.21subdivision 1, not to exceed $700 per month, including any legislatively authorized 264.22inflationary adjustments, for a 60-bed facility in St. Louis County which opened in 264.23January 2006 that will serve chemically dependent persons operated by a group residential 264.24housing provider that currently operates a 304-bed facility in Minneapolis.264.25    (b) The supplementary rate in paragraph (a) applies to the 48 beds which do not 264.26already receive a supplementary rate.264.27    Sec. 111. Minnesota Statutes 2006, section 256I.05, is amended by adding a 264.28subdivision to read:264.29    Subd. 1k.Supplementary rate for certain facilities; Crow Wing County.264.30    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 264.31county agency shall negotiate a supplementary rate in addition to the rate specified in 264.32subdivision 1, not to exceed $700 per month, including any legislatively authorized 264.33inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve 265.1chemically dependent persons operated by a group residential housing provider that 265.2currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which 265.3opened in January of 2006.265.4    Sec. 112. Minnesota Statutes 2006, section 256I.05, is amended by adding a 265.5subdivision to read:265.6    Subd. 1l.Supplementary rate for certain facilities; Stearns County.265.7    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 265.8shall negotiate a supplementary service rate in addition to the rate specified in subdivision 265.91, not to exceed $700 per month, including any legislatively authorized inflationary 265.10adjustments, for a group residential housing provider located in Stearns County that 265.11operates a 40-bed facility, that received financing through the Minnesota Housing Finance 265.12Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 265.13clientele, providing 24-hour-a-day supervision.265.14    Sec. 113. Minnesota Statutes 2006, section 256I.05, is amended by adding a 265.15subdivision to read:265.16    Subd. 1m.Supplementary rate for certain facilities; St. Louis County.265.17    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 265.18shall negotiate a supplementary service rate in addition to the rate specified in subdivision 265.191, not to exceed $700 per month, including any legislatively authorized inflationary 265.20adjustments, for a group residential housing provider located in St. Louis County that 265.21operates a 30-bed facility, that received financing through the Minnesota Housing Finance 265.22Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 265.23clientele, providing 24-hour-a-day supervision. 265.24    Sec. 114. Minnesota Statutes 2006, section 256I.05, is amended by adding a 265.25subdivision to read:265.26    Subd. 1n.Supplemental rate for certain facilities; Hennepin and Ramsey 265.27Counties.Notwithstanding the provisions of this section, beginning July 1, 2007, a county 265.28agency shall negotiate a supplemental service rate in addition to the rate specified in 265.29subdivision 1, not to exceed $715.78 per month, including any legislatively authorized 265.30inflationary adjustments, for a group residential housing provider that operates two 265.31ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 265.32which provide community support and serve the mental health needs of individuals who 265.33have chronically lived unsheltered, providing 24-hour-a-day supervision.266.1    Sec. 115. Laws 2000, chapter 340, section 19, is amended to read:266.2    Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.266.3    (a) Expenditures for housing with services and adult foster care shall be excluded 266.4when determining average monthly expenditures per client for alternative care pilot 266.5projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.266.6    (b) Alternative care pilot projects shall not expire on June 30, 2001, but shall 266.7continue until June 30, 2005 2007.266.8EFFECTIVE DATE.This section is effective retroactively from June 29, 2005, for 266.9activities related to discontinuing pilot projects under this section.266.10    Sec. 116. Laws 2006, chapter 282, article 20, section 37, is amended to read:266.11    Sec. 37. REPAYMENT DELAY.266.12    A county that overspent its allowed amounts in calendar year 2004 or 2005 under 266.13the waivered services program for persons with developmental disabilities shall not be 266.14required to pay back the amount of overspending until May 31, 2007.266.15EFFECTIVE DATE.This section is effective the day following final enactment.266.16    Sec. 117. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.266.17    (a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the 266.18recommendation of a county agency, the commissioner of human services shall grant a 266.19license with any necessary variances to a nonresidential program for youth which provides 266.20services to youth with disabilities under age 21 during nonschool hours established 266.21to ensure health and safety, prevent out-of-home placement, and increase community 266.22inclusion of youth with disabilities. The nonresidential youth program is subject to the 266.23conditions of any variances granted and with consumer rights under Minnesota Statutes, 266.24section 245B.04, consumer protection standards under Minnesota Statutes, section 266.25245B.05, service standards under Minnesota Statutes, section 245B.06, management 266.26standards under Minnesota Statutes, section 245B.07, and fire marshal inspections under 266.27Minnesota Statutes, section 245A.151, until the commissioner develops other licensure 266.28requirements for this type of program.266.29    (b) By February 1, 2008, the commissioner shall recommend amendments to 266.30licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of 266.31appropriate services for school-age youth with disabilities under age 21 who need 266.32supervision and services to develop skills necessary to maintain personal safety and 266.33increase their independence, productivity, and participation in their communities during 267.1nonschool hours. As part of developing the recommendations, the commissioner shall 267.2survey county agencies to determine how the needs of youth with disabilities under age 21 267.3who require supervision and support services are being met and the funding sources used. 267.4The recommendations must be provided to the house and senate chairs of the committees 267.5with jurisdiction over licensing of programs for youth with disabilities.267.6    Sec. 118. INDEPENDENT LIVING.267.7    An individual who has lived in one of the facilities under Minnesota Statutes, 267.8section 256I.05, subdivision 1n, who is being transitioned to independent living as 267.9part of the program plan continues to be eligible for group residential housing and the 267.10supplemental service rate negotiated with the county under Minnesota Statutes, section 267.11256I.05, subdivision 1n.267.12    Sec. 119. ASSISTIVE TECHNOLOGY RECOMMENDATIONS.267.13    Subdivision 1.Review.(a) During the biennium ending June 30, 2009, the Council 267.14on Disability shall facilitate a statewide review of the assistive technology needs of people 267.15with disabling conditions, and seniors. The council shall identify community-based 267.16service providers, state agencies, and other entities involved in providing assistive 267.17technology supports.267.18    (b) The council shall provide oversight and direction to the Minnesota Regions 267.19Assistive Technology Collaborative during the biennium ending June 30, 2009.267.20    Subd. 2.Recommendations.The council shall present to the chairs of the house 267.21and senate committees having jurisdiction over human services, by January 1, 2009, 267.22recommendations, including proposed legislation creating a statewide comprehensive plan 267.23to meet the assistive technology needs of people with disabling conditions and seniors. 267.24The statewide plan must include steps to coordinate and streamline assistive technology 267.25services.267.26    Sec. 120. COMMUNITY SERVICES PROVIDER RATE INCREASES.267.27    (a) The commissioner of human services shall increase allocations, reimbursement 267.28rates, or rate limits, as applicable, by three percent for the rate period beginning October 1, 267.292007, and the rate period beginning October 1, 2008, effective for services rendered on 267.30or after those dates.267.31    (b) The three percent annual rate increase described in this section must be provided 267.32to:268.1    (1) home and community-based waivered services for persons with developmental 268.2disabilities or related conditions under Minnesota Statutes, section 256B.501;268.3    (2) home and community-based waivered services for the elderly under Minnesota 268.4Statutes, section 256B.0915;268.5    (3) waivered services under community alternatives for disabled individuals under 268.6Minnesota Statutes, section 256B.49;268.7    (4) community alternative care waivered services under Minnesota Statutes, section 268.8256B.49;268.9    (5) traumatic brain injury waivered services under Minnesota Statutes, section 268.10256B.49;268.11    (6) nursing services and home health services under Minnesota Statutes, section 268.12256B.0625, subdivision 6a;268.13    (7) personal care services and nursing supervision of personal care services under 268.14Minnesota Statutes, section 256B.0625, subdivision 19a;268.15    (8) private duty nursing services under Minnesota Statutes, section 256B.0625, 268.16subdivision 7;268.17    (9) day training and habilitation services for adults with developmental disabilities 268.18or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 268.19additional cost of rate adjustments on day training and habilitation service, provided as a 268.20social service under Minnesota Statutes, section 256M.60;268.21    (10) alternative care services under Minnesota Statutes, section 256B.0913;268.22    (11) adult residential program grants under Minnesota Statutes, section 245.73;268.23    (12) adult and children's mental health grants under Minnesota Rules, parts 268.249535.1700 to 9535.1760;268.25    (13) the group residential housing supplementary service rate under Minnesota 268.26Statutes, section 256I.05, subdivision 1a;268.27    (14) adult mental health integrated fund grants under Minnesota Statutes, section 268.28245.4661;268.29    (15) semi-independent living services (SILS) under Minnesota Statutes, section 268.30252.275, including SILS funding under county social services grants formerly funded 268.31under Minnesota Statutes, chapter 256I;268.32    (16) community support services for deaf and hard-of-hearing adults with mental 268.33illness who use or wish to use sign language as their primary means of communication 268.34under Minnesota Statutes, section 256.01, subdivision 2;268.35    (17) living skills training programs for persons with intractable epilepsy who need 268.36assistance in the transition to independent living under Laws 1988, chapter 689;269.1    (18) physical therapy services under Minnesota Statutes, sections 256B.0625, 269.2subdivision 8, and 256D.03, subdivision 4;269.3    (19) occupational therapy services under Minnesota Statutes, sections 256B.0625, 269.4subdivision 8a, and 256D.03, subdivision 4;269.5    (20) speech-language therapy services under Minnesota Statutes, section 256D.03, 269.6subdivision 4, and Minnesota Rules, part 9505.0390; 269.7    (21) respiratory therapy services under Minnesota Statutes, section 256D.03, 269.8subdivision 4, and Minnesota Rules, part 9505.0295;269.9    (22) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, 269.10and 256B.0928;269.11    (23) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233; 269.12256C.25; Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter 269.135, section 20;269.14    (24) children's therapeutic services and supports under Minnesota Statutes, section 269.15256B.0943;269.16    (25) tier I chemical health services under Minnesota Statutes, chapter 254B;269.17    (26) consumer support grants under Minnesota Statutes, section 256.476;269.18    (27) family support grants under Minnesota Statutes, section 252.32;269.19    (28) case management services to persons with HIV or AIDS under Minnesota 269.20Statutes, section 256.01, subdivision 19; and269.21    (29) adult rehabilitative mental health services under Minnesota Statutes, section 269.22256B.0623.269.23    (c) Providers that receive a rate increase under this section shall use 75 percent of 269.24the additional revenue to increase wages and benefits and pay associated costs for all 269.25employees, except for management fees, the administrator, and central office staff.269.26    (d) For public employees, the increase for wages and benefits for certain staff is 269.27available and pay rates must be increased only to the extent that they comply with laws 269.28governing public employees' collective bargaining. Money received by a provider for pay 269.29increases under this section may be used only for increases implemented on or after the 269.30first day of the rate period in which the increase is available and must not be used for 269.31increases implemented prior to that date.269.32    (e) A copy of the provider's plan for complying with paragraph (c) must be made 269.33available to all employees by giving each employee a copy or by posting a copy in an area 269.34of the provider's operation to which all employees have access. If an employee does not 269.35receive the adjustment, if any, described in the plan and is unable to resolve the problem 269.36with the provider, the employee may contact the employee's union representative. If the 270.1employee is not covered by a collective bargaining agreement, the employee may contact 270.2the commissioner at a telephone number provided by the commissioner and included in 270.3the provider's plan. 270.4    (f) The commissioner and each county agency shall take steps necessary to 270.5implement the increases required by this section on the dates specified, and the increases 270.6must be effective on the dates specified, regardless of the client's service authorization date 270.7and notwithstanding the terms of any provider contract, service agreement, or schedule 270.8that limits when a county may increase payment rates.270.9    Sec. 121. DENTAL ACCESS FOR PERSONS WITH DISABILITIES.270.10    The commissioner of human services shall study access to dental services for 270.11persons with disabilities, and shall present recommendations for improving access to 270.12dental services to the legislature by January 15, 2008. The study must examine physical 270.13and geographic access, the willingness of dentists to serve persons with disabilities 270.14enrolled in state health care programs, reimbursement rates for dental service providers, 270.15and other factors identified by the commissioner.270.16    Sec. 122. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.270.17    By October 1, 2007, the commissioner shall seek federal approval to allow persons 270.18who have been eligible for medical assistance for employed persons with disabilities 270.19(MA-EPD) under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24 270.20consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility 270.21rules as long as they qualify.270.22    Sec. 123. RECOMMENDATIONS FOR PAYMENT OF NURSING FACILITIES.270.23    The commissioner of human services shall provide recommendations to the 270.24legislature by February 15, 2008, on changes to the nursing facility payment system 270.25for specialized care, setting property payment rates and proper treatment of bed closure 270.26incentives.270.27    Sec. 124. RATE ADJUSTMENTS FOR FINANCIALLY STRESSED 270.28FACILITIES.270.29    The commissioner of human services may negotiate operations payment rate 270.30adjustments with nursing facilities in danger of financial failure. The commissioner 270.31shall publish a request for proposals by September 30, 2007. Facilities may apply to 271.1the commissioner to negotiate for funding under this provision based on submittal of 271.2the following information:271.3    (1) financial statements demonstrating financial losses and low net worth;271.4    (2) statement of support from county agency;271.5    (3) demonstrated potential for access problems for services if the facility closed; and271.6    (4) cost per bed required to preserve the nursing facilities ability to operate until 271.7October 1, 2009.271.8    Sec. 125. MINNESOTA RULES.271.9    The Department of Administration shall publish adopted rules in the State Register 271.10making the terminology changes specified in section 126 in Minnesota Rules. Upon 271.11publication in the State Register, the terminology changes for Minnesota Rules are 271.12adopted without further administrative action.271.13    Sec. 126. REVISOR'S INSTRUCTION.271.14    The revisor of statutes shall change the terms in column A to the terms in column B 271.15wherever they appear in Minnesota Statutes:

271.16Column AColumn B271.17271.18271.19271.20271.21"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans""Office of Ombudsman for Long-Term Care"271.22271.23"ombudsman for older Minnesotans""ombudsman for long-term care"

271.24    Sec. 127. REPEALER.271.25Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 271.26252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h; 271.27and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.271.28ARTICLE 5271.29MENTAL HEALTH271.30    Section 1. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to 271.31read:271.32    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the 271.33brain or a clinically significant disorder of thought, mood, perception, orientation, 271.34memory, or behavior that is listed in the clinical manual of the International Classification 272.1of Diseases (ICD-9-CM), current edition, code range 290.0 to 
         302.99 or 306.0 to 316.0 272.2or the corresponding code in the American Psychiatric Association's Diagnostic and 272.3Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and 272.4that seriously limits a person's capacity to function in primary aspects of daily living such 272.5as personal relations, living arrangements, work, and recreation. 272.6    (b) An "adult with acute mental illness" means an adult who has a mental illness that 272.7is serious enough to require prompt intervention.272.8    (c) For purposes of case management and community support services, a "person 272.9with serious and persistent mental illness" means an adult who has a mental illness and 272.10meets at least one of the following criteria:272.11    (1) the adult has undergone two or more episodes of inpatient care for a mental 272.12illness within the preceding 24 months;272.13    (2) the adult has experienced a continuous psychiatric hospitalization or residential 272.14treatment exceeding six months' duration within the preceding 12 months;272.15    (3) the adult has been treated by a crisis team two or more times within the preceding 272.1624 months;272.17    (4) the adult:272.18    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline 272.19personality disorder;272.20    (ii) indicates a significant impairment in functioning; and272.21    (iii) has a written opinion from a mental health professional, in the last three years, 272.22stating that the adult is reasonably likely to have future episodes requiring inpatient or 272.23residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 272.24management or community support services are provided;272.25    (4) (5) the adult has, in the last three years, been committed by a court as a person 272.26who is mentally ill under chapter 253B, or the adult's commitment has been stayed or 272.27continued; or272.28    (5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time 272.29period has expired or the adult was eligible as a child under section 
         245.4871, subdivision 272.306
         ; and (ii) has a written opinion from a mental health professional, in the last three years, 272.31stating that the adult is reasonably likely to have future episodes requiring inpatient or 272.32residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 272.33management or community support services are provided. 272.34    Sec. 2. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision 272.35to read:273.1    Subd. 3.Responsibility not duplicated.For individuals who have health care 273.2coverage, the county board is not responsible for providing mental health services which 273.3are within the limits of the individual's health care coverage.273.4    Sec. 3. Minnesota Statutes 2006, section 245.4874, is amended to read:273.5245.4874 DUTIES OF COUNTY BOARD.273.6    Subdivision 1.Duties of the county board. (a) The county board must:273.7    (1) develop a system of affordable and locally available children's mental health 273.8services according to sections 
         245.487 to 
         245.4887;273.9    (2) establish a mechanism providing for interagency coordination as specified in 273.10section 
         245.4875, subdivision 6;273.11    (3) consider the assessment of unmet needs in the county as reported by the local 273.12children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 273.13(b), clause (3). The county shall provide, upon request of the local children's mental health 273.14advisory council, readily available data to assist in the determination of unmet needs;273.15    (4) assure that parents and providers in the county receive information about how to 273.16gain access to services provided according to sections 
         245.487 to 
         245.4887;273.17    (5) coordinate the delivery of children's mental health services with services 273.18provided by social services, education, corrections, health, and vocational agencies to 273.19improve the availability of mental health services to children and the cost-effectiveness of 273.20their delivery;273.21    (6) assure that mental health services delivered according to sections 
         245.487273.22to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 273.23assessment and individual treatment plan;273.24    (7) provide the community with information about predictors and symptoms of 273.25emotional disturbances and how to access children's mental health services according to 273.26sections 
         245.4877 and 
         245.4878;273.27    (8) provide for case management services to each child with severe emotional 273.28disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 273.29subdivisions 1, 3, and 5
         ;273.30    (9) provide for screening of each child under section 
         245.4885 upon admission 273.31to a residential treatment facility, acute care hospital inpatient treatment, or informal 273.32admission to a regional treatment center;273.33    (10) prudently administer grants and purchase-of-service contracts that the county 273.34board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 273.35245.4887
         ;274.1    (11) assure that mental health professionals, mental health practitioners, and case 274.2managers employed by or under contract to the county to provide mental health services 274.3are qualified under section 
         245.4871;274.4    (12) assure that children's mental health services are coordinated with adult mental 274.5health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 274.6health services is available to serve persons with mental illness, regardless of the person's 274.7age;274.8    (13) assure that culturally informed mental health consultants are used as necessary 274.9to assist the county board in assessing and providing appropriate treatment for children of 274.10cultural or racial minority heritage; and274.11    (14) consistent with section 
         245.486, arrange for or provide a children's mental 274.12health screening to a child receiving child protective services or a child in out-of-home 274.13placement, a child for whom parental rights have been terminated, a child found to be 274.14delinquent, and a child found to have committed a juvenile petty offense for the third or 274.15subsequent time, unless a screening has been performed within the previous 180 days, or 274.16the child is currently under the care of a mental health professional. The court or county 274.17agency must notify a parent or guardian whose parental rights have not been terminated of 274.18the potential mental health screening and the option to prevent the screening by notifying 274.19the court or county agency in writing. The screening shall be conducted with a screening 274.20instrument approved by the commissioner of human services according to criteria that 274.21are updated and issued annually to ensure that approved screening instruments are valid 274.22and useful for child welfare and juvenile justice populations, and shall be conducted 274.23by a mental health practitioner as defined in section 
         245.4871, subdivision 26, or a 274.24probation officer or local social services agency staff person who is trained in the use of 274.25the screening instrument. Training in the use of the instrument shall include training in the 274.26administration of the instrument, the interpretation of its validity given the child's current 274.27circumstances, the state and federal data practices laws and confidentiality standards, the 274.28parental consent requirement, and providing respect for families and cultural values. 274.29If the screen indicates a need for assessment, the child's family, or if the family lacks 274.30mental health insurance, the local social services agency, in consultation with the child's 274.31family, shall have conducted a diagnostic assessment, including a functional assessment, 274.32as defined in section 
         245.4871. The administration of the screening shall safeguard the 274.33privacy of children receiving the screening and their families and shall comply with the 274.34Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance 274.35Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be 274.36considered private data and the commissioner shall not collect individual screening results.275.1    (b) When the county board refers clients to providers of children's therapeutic 275.2services and supports under section 
         256B.0943, the county board must clearly identify 275.3the desired services components not covered under section 
         256B.0943 and identify the 275.4reimbursement source for those requested services, the method of payment, and the 275.5payment rate to the provider.275.6    Subd. 2.Responsibility not duplicated.For individuals who have health care 275.7coverage, the county board is not responsible for providing mental health services which 275.8are within the limits of the individual's health care coverage.275.9    Sec. 4. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:275.10    Subd. 5. Special contracts; bordering states. (a) An individual who is detained, 275.11committed, or placed on an involuntary basis under chapter 253B may be confined or 275.12treated in a bordering state pursuant to a contract under this section. An individual who is 275.13detained, committed, or placed on an involuntary basis under the civil law of a bordering 275.14state may be confined or treated in Minnesota pursuant to a contract under this section. A 275.15peace or health officer who is acting under the authority of the sending state may transport 275.16an individual to a receiving agency that provides services pursuant to a contract under 275.17this section and may transport the individual back to the sending state under the laws 275.18of the sending state. Court orders valid under the law of the sending state are granted 275.19recognition and reciprocity in the receiving state for individuals covered by a contract 275.20under this section to the extent that the court orders relate to confinement for treatment 275.21or care of mental illness or chemical dependency. Such treatment or care may address 275.22other conditions that may be co-occurring with the mental illness or chemical dependency. 275.23These court orders are not subject to legal challenge in the courts of the receiving state. 275.24Individuals who are detained, committed, or placed under the law of a sending state and 275.25who are transferred to a receiving state under this section continue to be in the legal 275.26custody of the authority responsible for them under the law of the sending state. Except 275.27in emergencies, those individuals may not be transferred, removed, or furloughed from 275.28a receiving agency without the specific approval of the authority responsible for them 275.29under the law of the sending state.275.30    (b) While in the receiving state pursuant to a contract under this section, an 275.31individual shall be subject to the sending state's laws and rules relating to length of 275.32confinement, reexaminations, and extensions of confinement. No individual may be sent 275.33to another state pursuant to a contract under this section until the receiving state has 275.34enacted a law recognizing the validity and applicability of this section.276.1    (c) If an individual receiving services pursuant to a contract under this section leaves 276.2the receiving agency without permission and the individual is subject to involuntary 276.3confinement under the law of the sending state, the receiving agency shall use all 276.4reasonable means to return the individual to the receiving agency. The receiving agency 276.5shall immediately report the absence to the sending agency. The receiving state has the 276.6primary responsibility for, and the authority to direct, the return of these individuals 276.7within its borders and is liable for the cost of the action to the extent that it would be 276.8liable for costs of its own resident.276.9    (d) Responsibility for payment for the cost of care remains with the sending agency.276.10    (e) This subdivision also applies to county contracts under subdivision 2 which 276.11include emergency care and treatment provided to a county resident in a bordering state.276.12    (f) If a Minnesota resident is admitted to a facility in a bordering state under this 276.13chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or 276.14an advance practice registered nurse certified in mental health, who is licensed in the 276.15bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092, 276.16253B.12, and 253B.17 subject to the same requirements and limitations in section 276.17253B.02, subdivision 7.276.18    Sec. 5. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:276.19    Subd. 2. Program. The commissioner of human services shall establish a program 276.20for the treatment of compulsive gamblers. The commissioner may contract with an 276.21entity with expertise regarding the treatment of compulsive gambling to operate the 276.22program. The program may include the establishment of a statewide toll-free number, 276.23resource library, public education programs; regional in-service training programs and 276.24conferences for health care professionals, educators, treatment providers, employee 276.25assistance programs, and criminal justice representatives; and the establishment of 276.26certification standards for programs and service providers. The commissioner may enter 276.27into agreements with other entities and may employ or contract with consultants to 276.28facilitate the provision of these services or the training of individuals to qualify them to 276.29provide these services. The program may also include inpatient and outpatient treatment 276.30and rehabilitation services and for residents in a temporary or permanent residential 276.31setting for mental health or chemical dependency, and individuals in jails or correctional 276.32facilities. The program may also include research studies. The research studies must 276.33include baseline and prevalence studies for adolescents and adults to identify those at the 276.34highest risk. The program must be approved by the commissioner before it is established.277.1    Sec. 6. Minnesota Statutes 2006, section 245.98, subdivision 5, is amended to read:277.2    Subd. 5. Standards. The commissioner shall create standards for treatment and 277.3provider qualifications for the treatment component of the compulsive gambling program.277.4The commissioner, in coordination with the commissioner of corrections, shall create 277.5standards for the assessment and treatment of compulsive gamblers in programs operated 277.6by the commissioner of corrections.277.7    Sec. 7. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.277.8    Prior to placement of a child in a foster care home, the child foster care provider, if 277.9required to be licensed, must complete two hours of training that addresses the causes, 277.10symptoms, and key warning signs of mental health disorders; cultural considerations; and 277.11effective approaches for dealing with a child's behaviors. At least one hour of the annual 277.1212-hour training requirement for foster parents must be on children's mental health issues 277.13and treatment. Training curriculum shall be approved by the commissioner of human 277.14services.277.15    Sec. 8. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:277.16    Subdivision 1. County portion for cost of care. Except for chemical dependency 277.17services provided under sections 
         254B.01 to 
         254B.09, the client's county shall pay to the 277.18state of Minnesota a portion of the cost of care provided in a regional treatment center 277.19or a state nursing facility to a client legally settled in that county. A county's payment 277.20shall be made from the county's own sources of revenue and payments shall be paid as 277.21follows: payments to the state from the county shall equal 20 percent a percentage of the 277.22cost of care, as determined by the commissioner, for each day, or the portion thereof, that 277.23the client spends at a regional treatment center or a state nursing facility. according to 277.24the following schedule for each admission:277.25    (1) for the first 30 days: 20 percent until January 1, 2008, ten percent from January 277.261, 2008, to June 30, 2009, and zero percent thereafter;277.27    (2) 20 percent for days 31 to 60; and277.28    (3) for any days over 60: 20 percent until January 1, 2008, 30 percent from January 277.291, 2008, to June 30, 2009, 40 percent from July 1, 2009, to June 30, 2010, and 50 percent 277.30thereafter.277.31 If payments received by the state under sections 
         246.50 to 
         246.53 exceed 80 percent the 277.32noncounty portion of the cost of care, the county shall be responsible for paying the state 277.33only the remaining amount. The county shall not be entitled to reimbursement from 277.34the client, the client's estate, or from the client's relatives, except as provided in section 278.1246.53
         . No such payments shall be made for any client who was last committed prior to 278.2July 1, 1947.278.3    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to 278.4read:278.5    Subd. 20. Mental health case management. (a) To the extent authorized by rule 278.6of the state agency, medical assistance covers case management services to persons with 278.7serious and persistent mental illness and children with severe emotional disturbance. 278.8Services provided under this section must meet the relevant standards in sections 
         245.461278.9to 
         245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota 278.10Rules, parts 
         9520.0900 to 
         9520.0926, and 
         9505.0322, excluding subpart 10. 278.11    (b) Entities meeting program standards set out in rules governing family community 278.12support services as defined in section 
         245.4871, subdivision 17, are eligible for medical 278.13assistance reimbursement for case management services for children with severe 278.14emotional disturbance when these services meet the program standards in Minnesota 278.15Rules, parts 
         9520.0900 to 
         9520.0926 and 
         9505.0322, excluding subparts 6 and 10. 278.16    (c) Medical assistance and MinnesotaCare payment for mental health case 278.17management shall be made on a monthly basis. In order to receive payment for an eligible 278.18child, the provider must document at least a face-to-face contact with the child, the child's 278.19parents, or the child's legal representative. To receive payment for an eligible adult, the 278.20provider must document:278.21    (1) at least a face-to-face contact with the adult or the adult's legal representative; or278.22    (2) at least a telephone contact with the adult or the adult's legal representative and 278.23document a face-to-face contact with the adult or the adult's legal representative within 278.24the preceding two months.278.25    (d) Payment for mental health case management provided by county or state staff 278.26shall be based on the monthly rate methodology under section 
         256B.094, subdivision 6, 278.27paragraph (b), with separate rates calculated for child welfare and mental health, and 278.28within mental health, separate rates for children and adults. 278.29    (e) Payment for mental health case management provided by Indian health services 278.30or by agencies operated by Indian tribes may be made according to this section or other 278.31relevant federally approved rate setting methodology.278.32    (f) Payment for mental health case management provided by vendors who contract 278.33with a county or Indian tribe shall be based on a monthly rate negotiated by the host county 278.34or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 278.35service to other payers. If the service is provided by a team of contracted vendors, the 279.1county or tribe may negotiate a team rate with a vendor who is a member of the team. The 279.2team shall determine how to distribute the rate among its members. No reimbursement 279.3received by contracted vendors shall be returned to the county or tribe, except to reimburse 279.4the county or tribe for advance funding provided by the county or tribe to the vendor.279.5    (g) If the service is provided by a team which includes contracted vendors, tribal 279.6staff, and county or state staff, the costs for county or state staff participation in the team 279.7shall be included in the rate for county-provided services. In this case, the contracted 279.8vendor, the tribal agency, and the county may each receive separate payment for services 279.9provided by each entity in the same month. In order to prevent duplication of services, 279.10each entity must document, in the recipient's file, the need for team case management and 279.11a description of the roles of the team members.279.12    (h) The commissioner shall calculate the nonfederal share of actual medical 279.13assistance and general assistance medical care payments for each county, based on the 279.14higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999, 279.15and transfer one-half of the result from medical assistance and general assistance medical 279.16care to each county's mental health grants under section 
         256E.12 for calendar year 1999. 279.17The annualized minimum amount added to each county's mental health grant shall be 279.18$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce 279.19the statewide growth factor in order to fund these minimums. The annualized total amount 279.20transferred shall become part of the base for future mental health grants for each county. 279.21    (i) Notwithstanding section 
         256B.19, subdivision 1, the nonfederal share of costs 279.22for mental health case management shall be provided by the recipient's county of 279.23responsibility, as defined in sections 
         256G.01 to 
         256G.12, from sources other than federal 279.24funds or funds used to match other federal funds. If the service is provided by a tribal 279.25agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this 279.26service is paid by the state without a federal share through fee-for-service, 50 percent of 279.27the cost shall be provided by the recipient's county of responsibility.279.28    (j) Notwithstanding any administrative rule to the contrary, prepaid medical 279.29assistance, general assistance medical care, and MinnesotaCare include mental health case 279.30management. When the service is provided through prepaid capitation, the nonfederal 279.31share is paid by the state and the county pays no share.279.32    (j)(k) The commissioner may suspend, reduce, or terminate the reimbursement to a 279.33provider that does not meet the reporting or other requirements of this section. The county 279.34of responsibility, as defined in sections 
         256G.01 to 
         256G.12, or, if applicable, the tribal 279.35agency, is responsible for any federal disallowances. The county or tribe may share this 279.36responsibility with its contracted vendors. 280.1    (k)(l) The commissioner shall set aside a portion of the federal funds earned for 280.2county expenditures under this section to repay the special revenue maximization account 280.3under section 
         256.01, subdivision 2, clause (15). The repayment is limited to: 280.4    (1) the costs of developing and implementing this section; and280.5    (2) programming the information systems.280.6    (l)(m) Payments to counties and tribal agencies for case management expenditures 280.7under this section shall only be made from federal earnings from services provided 280.8under this section. When this service is paid by the state without a federal share through 280.9fee-for-service, 50 percent of the cost shall be provided by the state. Payments to 280.10county-contracted vendors shall include both the federal earnings, the state share, and the 280.11county share.280.12    (m)(n) Notwithstanding section 
         256B.041, county payments for the cost of mental 280.13health case management services provided by county or state staff shall not be made 280.14to the commissioner of finance. For the purposes of mental health case management 280.15services provided by county or state staff under this section, the centralized disbursement 280.16of payments to counties under section 
         256B.041 consists only of federal earnings from 280.17services provided under this section. 280.18    (n)(o) Case management services under this subdivision do not include therapy, 280.19treatment, legal, or outreach services.280.20    (o)(p) If the recipient is a resident of a nursing facility, intermediate care facility, 280.21or hospital, and the recipient's institutional care is paid by medical assistance, payment 280.22for case management services under this subdivision is limited to the last 180 days of 280.23the recipient's residency in that facility and may not exceed more than six months in a 280.24calendar year.280.25    (p)(q) Payment for case management services under this subdivision shall not 280.26duplicate payments made under other program authorities for the same purpose.280.27    (q)(r) By July 1, 2000, the commissioner shall evaluate the effectiveness of the 280.28changes required by this section, including changes in number of persons receiving 280.29mental health case management, changes in hours of service per person, and changes in 280.30caseload size.280.31    (r)(s) For each calendar year beginning with the calendar year 2001, the annualized 280.32amount of state funds for each county determined under paragraph (h) shall be adjusted by 280.33the county's percentage change in the average number of clients per month who received 280.34case management under this section during the fiscal year that ended six months prior to 280.35the calendar year in question, in comparison to the prior fiscal year.281.1    (s)(t) For counties receiving the minimum allocation of $3,000 or $5,000 described 281.2in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county 281.3receives the higher of the following amounts:281.4    (1) a continuation of the minimum allocation in paragraph (h); or281.5    (2) an amount based on that county's average number of clients per month who 281.6received case management under this section during the fiscal year that ended six months 281.7prior to the calendar year in question, times the average statewide grant per person per 281.8month for counties not receiving the minimum allocation.281.9    (t)(u) The adjustments in paragraphs (s) and (t) shall be calculated separately for 281.10children and adults.281.11EFFECTIVE DATE.This section is effective January 1, 2009, except the 281.12amendment to paragraph (i) is effective January 1, 2008.281.13    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to 281.14read:281.15    Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject 281.16to federal approval, medical assistance covers treatment foster care services according to 281.17section 
         256B.0946.281.18    Sec. 11. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to 281.19read:281.20    Subd. 4. Payment rates. (a) Notwithstanding sections 
         256B.19 and 
         256B.041, 281.21payments to counties for residential services provided by a residential facility shall only 281.22be made of federal earnings for services provided under this section, and the nonfederal 281.23share of costs for services provided under this section shall be paid by the county from 281.24sources other than federal funds or funds used to match other federal funds. Payment to 281.25counties for services provided according to this section shall be a proportion of the per 281.26day contract rate that relates to rehabilitative mental health services and shall not include 281.27payment for costs or services that are billed to the IV-E program as room and board. 281.28    (b) Per diem rates paid to providers under this section by prepaid plans shall be the 281.29proportion of the per-day contract rate that relates to rehabilitative mental health services 281.30and shall not include payment for group foster care costs or services that are billed to the 281.31county of financial responsibility.281.32    (c) The commissioner shall set aside a portion not to exceed five percent of the 281.33federal funds earned for county expenditures under this section to cover the state costs of 282.1administering this section. Any unexpended funds from the set-aside shall be distributed 282.2to the counties in proportion to their earnings under this section.282.3EFFECTIVE DATE.This section is effective January 1, 2009.282.4    Sec. 12. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:282.5    Subd. 5g. Payment for covered services. For services rendered on or after January 282.61, 2003, the total payment made to managed care plans for providing covered services 282.7under the medical assistance and general assistance medical care programs is reduced by 282.8.5 percent from their current statutory rates. This provision excludes payments for nursing 282.9home services, home and community-based waivers, and payments to demonstration 282.10projects for persons with disabilities, and mental health services added as covered benefits 282.11after December 31, 2007.282.12    Sec. 13. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:282.13    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g, 282.14the total payment made to managed care plans under the medical assistance program is 282.15reduced 1.0 percent for services provided on or after October 1, 2003, and an additional 282.161.0 percent for services provided on or after January 1, 2004. This provision excludes 282.17payments for nursing home services, home and community-based waivers, and payments 282.18to demonstration projects for persons with disabilities, and mental health services added as 282.19covered benefits after December 1, 2007.282.20    Sec. 14. Minnesota Statutes 2006, section 256B.763, is amended to read:282.21256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.282.22    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007, 282.23payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 282.242006, for:282.25    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;282.26    (2) community mental health centers under section 
         256B.0625, subdivision 5; and282.27    (3) mental health clinics and centers certified under Minnesota Rules, parts 282.289520.0750
          to 
         9520.0870, or hospital outpatient psychiatric departments that are designated 282.29as essential community providers under section 
         62Q.19.282.30    (b) This increase applies to group skills training when provided as a component of 282.31children's therapeutic services and support, psychotherapy, medication management, 282.32evaluation and management, diagnostic assessment, explanation of findings, psychological 283.1testing, neuropsychological services, direction of behavioral aides, and inpatient 283.2consultation.283.3    (c) This increase does not apply to rates that are governed by section 
         256B.0625, 283.4subdivision 30, or 
         256B.761, paragraph (b), other cost-based rates, rates that are 283.5negotiated with the county, rates that are established by the federal government, or rates 283.6that increased between January 1, 2004, and January 1, 2005.283.7    (d) The commissioner shall adjust rates paid to prepaid health plans under contract 283.8with the commissioner to reflect the rate increases provided in paragraph (a). The prepaid 283.9health plan must pass this rate increase to the providers identified in paragraph (a)283.10paragraphs (a), (e), and (f). The prepaid plan must pass this rate increase to the providers 283.11identified in paragraphs (a), (e), and (f).283.12    (e) For MinnesotaCare only, payment rates shall be increased by 23.7 percent over 283.13the rates in effect on December 31, 2007, for:283.14    (1) medication education services provided on or after January 1, 2008, by adult 283.15rehabilitative mental health services providers certified under section 256B.0623; and283.16    (2) mental health behavioral aide services provided on or after January 1, 2008, by 283.17children's therapeutic services and support providers certified under section 256B.0943.283.18    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by 283.19children's therapeutic services and support providers certified under section 256B.0943 283.20and not already included in paragraph (a), payment rates for MinnesotaCare shall be 283.21increased by 23.7 percent over the rates in effect on December 31, 2007.283.22    Sec. 15. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:283.23    Subdivision 1. Covered health services. For individuals under section 
         256L.04, 283.24subdivision 7
         , with income no greater than 75 percent of the federal poverty guidelines 283.25or for families with children under section 
         256L.04, subdivision 1, all subdivisions of 283.26this section apply. "Covered health services" means the health services reimbursed 283.27under chapter 256B, with the exception of inpatient hospital services, special education 283.28services, private duty nursing services, adult dental care services other than services 283.29covered under section 
         256B.0625, subdivision 9, orthodontic services, nonemergency 283.30medical transportation services, personal care assistant and case management services, 283.31nursing home or intermediate care facilities services, inpatient mental health services, 283.32and chemical dependency services. Outpatient mental health services covered under the 283.33MinnesotaCare program are limited to diagnostic assessments, psychological testing, 283.34explanation of findings, mental health telemedicine, psychiatric consultation, medication 284.1management by a physician, day treatment, partial hospitalization, and individual, family, 284.2and group psychotherapy.284.3    "Covered health services" also includes intensive mental health outpatient treatment 284.4for dialectical behavioral therapy for adults.284.5    No public funds shall be used for coverage of abortion under MinnesotaCare 284.6except where the life of the female would be endangered or substantial and irreversible 284.7impairment of a major bodily function would result if the fetus were carried to term; or 284.8where the pregnancy is the result of rape or incest.284.9    Covered health services shall be expanded as provided in this section.284.10EFFECTIVE DATE.This section is effective January 1, 2008, except coverage for 284.11mental health case management is effective January 1, 2009.284.12    Sec. 16. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:284.13    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 284.14and (c), the MinnesotaCare benefit plan shall include the following co-payments and 284.15coinsurance requirements for all enrollees:284.16    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 284.17subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 284.18$3,000 per family;284.19    (2) $3 per prescription for adult enrollees;284.20    (3) $25 for eyeglasses for adult enrollees;284.21    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 284.22episode of service which is required because of a recipient's symptoms, diagnosis, or 284.23established illness, and which is delivered in an ambulatory setting by a physician or 284.24physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 284.25audiologist, optician, or optometrist; and284.26    (5) $6 for nonemergency visits to a hospital-based emergency room.284.27    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 284.28children under the age of 21 in households with family income equal to or less than 175 284.29percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 284.30parents and relative caretakers of children under the age of 21 in households with family 284.31income greater than 175 percent of the federal poverty guidelines for inpatient hospital 284.32admissions occurring on or after January 1, 2001.284.33    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children 284.34under the age of 21.284.35    (d) Paragraph (a), clause (4), does not apply to mental health services.285.1    (e) Adult enrollees with family gross income that exceeds 175 percent of the 285.2federal poverty guidelines and who are not pregnant shall be financially responsible for 285.3the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 285.4hospital benefit limit.285.5    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 285.6or changes from one prepaid health plan to another during a calendar year, any charges 285.7submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 285.8expenses incurred by the enrollee for inpatient services, that were submitted or incurred 285.9prior to enrollment, or prior to the change in health plans, shall be disregarded.285.10    Sec. 17. Minnesota Statutes 2006, section 256L.035, is amended to read:285.11256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE 285.12ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.285.13    (a) "Covered health services" for individuals under section 
         256L.04, subdivision 285.147
         , with income above 75 percent, but not exceeding 175 percent, of the federal poverty 285.15guideline means:285.16    (1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and 285.17subject to an annual limitation of $10,000;285.18    (2) physician services provided during an inpatient stay; and285.19    (3) physician services not provided during an inpatient stay; outpatient hospital 285.20services; freestanding ambulatory surgical center services; chiropractic services; lab and 285.21diagnostic services; diabetic supplies and equipment; mental health services as covered 285.22under chapter 256B; and prescription drugs; subject to the following co-payments:285.23    (i) $50 co-pay per emergency room visit;285.24    (ii) $3 co-pay per prescription drug; and285.25    (iii) $5 co-pay per nonpreventive visit; except this co-pay does not apply to mental 285.26health services or community mental health services.285.27The services covered under this section may be provided by a physician, physician 285.28ancillary, chiropractor, psychologist, or licensed independent clinical social worker, or 285.29other mental health providers covered under chapter 256B if the services are within the 285.30scope of practice of that health care professional.285.31    For purposes of this section, "a visit" means an episode of service which is required 285.32because of a recipient's symptoms, diagnosis, or established illness, and which is delivered 285.33in an ambulatory setting by any health care provider identified in this paragraph.285.34    Enrollees are responsible for all co-payments in this section.286.1    (b) Reimbursement to the providers shall be reduced by the amount of the 286.2co-payment, except that reimbursement for prescription drugs shall not be reduced once a 286.3recipient has reached the $20 per month maximum for prescription drug co-payments. 286.4The provider collects the co-payment from the recipient. Providers may not deny services 286.5to recipients who are unable to pay the co-payment, except as provided in paragraph (c).286.6    (c) If it is the routine business practice of a provider to refuse service to an individual 286.7with uncollected debt, the provider may include uncollected co-payments under this 286.8section. A provider must give advance notice to a recipient with uncollected debt before 286.9services can be denied.286.10EFFECTIVE DATE.This section is effective January 1, 2008, except coverage 286.11for mental health case management under paragraph (a), clause (3), is effective January 286.121, 2009.286.13    Sec. 18. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:286.14    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after 286.15October 1, 2003, the total payment made to managed care plans under the MinnesotaCare 286.16program is reduced 1.0 percent. This provision excludes payments for mental health 286.17services added as covered benefits after December 31, 2007.286.18    Sec. 19. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:286.19    Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted 286.20of theft under section 
         609.52, embezzlement of public funds under section 
         609.54, or 286.21forgery under section 
         609.625, 
         609.63, or 
         609.631, the probation officer shall determine in 286.22the report prepared under subdivision 1 whether or not compulsive gambling contributed 286.23to the commission of the offense. If so, the report shall contain the results of a compulsive 286.24gambling assessment conducted in accordance with this subdivision. The probation officer 286.25shall make an appointment for the offender to undergo the assessment if so indicated. 286.26    (b) The compulsive gambling assessment report must include a recommended level 286.27of treatment for the offender if the assessor concludes that the offender is in need of 286.28compulsive gambling treatment. The assessment must be conducted by an assessor 286.29qualified under section 
         245.98, subdivision 2a, to perform these assessments or to 286.30provide compulsive gambling treatment. An assessor providing a compulsive gambling 286.31assessment may not have any direct or shared financial interest or referral relationship 286.32resulting in shared financial gain with a treatment provider. If an independent assessor is 286.33not available, the probation officer may use the services of an assessor with a financial 287.1interest or referral relationship as authorized under rules adopted by the commissioner 287.2of human services under section 
         245.98, subdivision 2a. 287.3    (c) The commissioner of human services shall reimburse the assessor for the 287.4costs associated with a compulsive gambling assessment at a rate established by the 287.5commissioner up to a maximum of $100 for each assessment. To the extent practicable, the 287.6commissioner shall standardize reimbursement rates for assessments. The commissioner 287.7shall reimburse these costs after receiving written verification from the probation officer 287.8that the assessment was performed and found acceptable.287.9    Sec. 20. REPORT.287.10    The commissioner shall make a report to the legislature by January 15, 2008, 287.11regarding the transfer of funds to counties for state registered nurses employed in 287.12community mental health pilot projects as part of the assertive community treatment 287.13teams under Minnesota Statutes, section 245.4661. The report shall address the impact 287.14of the nursing shortage on replacing these positions, continuity of patient care if these 287.15positions cannot be filled, and ways to maintain state registered nurses in these positions 287.16until the nurse retires or leaves employment. No funds for state registered nurse positions 287.17may be transferred before the report date.287.18    Sec. 21. CASE MANAGEMENT; BEST PRACTICES.287.19    The commissioner of human services, in consultation with consumers, families, 287.20counties, and other interested stakeholders, will develop recommendations for changes in 287.21the adult mental health act related to case management, consistent with evidence-based 287.22and best practices.287.23    Sec. 22. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.287.24    Subdivision 1.Pilot project authorized; purpose.A two-year Regional Children's 287.25Mental Health Initiative pilot project is established to improve children's mental health 287.26service coordination, communication, and processes in Blue Earth, Brown, Faribault, 287.27Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The 287.28purpose of the Regional Children's Mental Health Initiative will be to plan and develop 287.29new programs and services related to children's mental health in south central Minnesota.287.30    Subd. 2.Goals.To accomplish its purpose, the Regional Children's Mental Health 287.31Initiative shall have the following goals:287.32    (1) work to streamline delivery and regional access to services;287.33    (2) share strategies and resources for the management of out-of-home placements;288.1    (3) establish standard protocols and operating procedures for functions that are 288.2performed across all counties;288.3    (4) share information to improve resource allocation and service delivery across 288.4counties;288.5    (5) evaluate outcomes of various treatment alternatives;288.6    (6) create a network for and provide support to service delivery groups;288.7    (7) establish a regional process to match children in need of out-of-home placement 288.8with foster homes that can meet their needs; and288.9    (8) recruit and retain foster homes.288.10    Subd. 3.Director's Council.The Director's Council shall govern the operations of 288.11the Regional Children's Mental Health Initiative. Members of the Director's Council shall 288.12represent each of the 11 counties participating in the pilot project.288.13    Subd. 4.Regional Children's Mental Health Initiative Team.The members 288.14of the Regional Children's Mental Health Initiative Team shall conduct planning and 288.15development of new and modified children's mental health programs and services in the 288.16region. Members of the team shall reflect the cultural, demographic, and geographic 288.17diversity of the region and shall be composed of representatives from each of the 288.18following:288.19    (1) the medical community;288.20    (2) human services;288.21    (3) corrections;288.22    (4) education;288.23    (5) mental health providers and vendors;288.24    (6) advocacy organizations;288.25    (7) parents; and288.26    (8) children and youth.288.27    Subd. 5.Authority.The regional children's mental health initiative shall have the 288.28authority to develop and implement the following programs:288.29    (1) Flexible funding payments. This program will make funds available to respond to 288.30the unique and unpredictable needs of children with mental health issues such as the need 288.31for prescription drugs, transportation, clothing, and assessments not otherwise available.288.32    (2) Transition to self-sufficiency. This program will help youths between the ages of 288.3314 and 21 establish professional relationships, find jobs, build financial foundations, and 288.34learn to fulfill their roles as productive citizens.288.35    (3) Crisis response. This program will establish public and private partnerships 288.36to offer a range of options to meet the needs of children in crisis. Methods to meet 289.1these needs may include accessible local services, holistic assessments, urgent care and 289.2stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.289.3    (4) Integrated services for complex conditions. This program will design, develop, 289.4and implement packages of integrated services to meet the needs of children with specific, 289.5complex conditions.289.6    Subd. 6.Evaluation and report.The regional children's mental health initiative 289.7shall develop a method for evaluating the effectiveness of this pilot project focusing on 289.8identifiable goals and outcomes. An interim report on the pilot project's effectiveness 289.9shall be submitted to the house and senate finance committees having jurisdiction over 289.10mental health, the commissioner of human services, and the Minnesota Association of 289.11County Social Service Administrators no later than December 31, 2008. A final report 289.12is due no later than December 31, 2009.289.13    Sec. 23. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES TO 289.14CHILDREN.289.15    Organizations that are certified to provide children's therapeutic services and 289.16supports under Minnesota Statutes, section 256B.0943, are eligible to apply for a grant. 289.17Grants are to be used to provide trauma-focused evidence-based practices to children 289.18who are living in a battered women's shelter, homeless shelter, transitional housing, or 289.19supported housing. Children served must have been exposed to or witnessed domestic 289.20violence, have been exposed to or witnessed community violence, or be a refugee. Priority 289.21shall be given to organizations that demonstrate collaboration with battered women's 289.22shelters, homeless shelters, or providers of transitional housing or supported housing. The 289.23commissioner shall specify which constitutes evidence-based practice. Organizations shall 289.24use all available funding streams.289.25    Sec. 24. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.289.26    (a) The commissioner of human services shall fund demonstration projects for high 289.27risk adults with serious mental illness and co-occurring substance abuse problems. The 289.28projects must include, but not be limited to, the following:289.29    (1) housing services, including rent or housing subsidies, housing with clinical 289.30staff, or housing support;289.31    (2) assertive outreach services; and289.32    (3) intensive direct therapeutic, rehabilitative, and care management services 289.33oriented to harm reduction.290.1    (b) The commissioner shall work with providers to ensure proper licensure or 290.2certification to meet medical assistance or third-party payor reimbursement requirements.290.3    Sec. 25. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S 290.4MENTAL HEALTH PILOT PROJECT.290.5    Subdivision 1.Pilot project authorized.The commissioner of human services 290.6shall fund a three-year pilot project to measure the effect of children's identified mental 290.7health needs, including social and emotional needs, on Minnesota family investment 290.8program (MFIP) participants' ability to obtain and retain employment. The project shall 290.9also measure the effect on work activity of MFIP participants' needs to address their 290.10children's identified mental health needs.290.11    Subd. 2.Provider and agency proposals.(a) Interested MFIP providers and 290.12agencies shall: 290.13    (1) submit proposals defining how they will identify participants whose children 290.14have mental health needs that hinder the employment process; 290.15    (2) connect families with appropriate developmental, social, and emotional 290.16screenings and services; and 290.17    (3) incorporate those services into the participant's employment plan.290.18Each proposal under this paragraph must include an evaluation component.290.19    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP 290.20participants of the following: 290.21    (1) the availability of developmental, social, and emotional screening tools for 290.22children and youth; 290.23    (2) the purpose of the screenings; 290.24    (3) how the information will be used to assist the participants in identifying and 290.25addressing potential barriers to employment; and 290.26    (4) that their employment plan may be modified based on the screening results.290.27    Subd. 3.Program components.(a) MFIP providers shall obtain the participant's 290.28written consent for participation in the pilot project, including consent for developmental, 290.29social, and emotional screening.290.30    (b) MFIP providers shall coordinate with county social service agencies and health 290.31plans to assist recipients in arranging referrals indicated by the screening results.290.32    (c) Tools used for developmental, social, and emotional screenings shall be approved 290.33by the commissioner of human services.290.34    Subd. 4.Program evaluation.The commissioner of human services shall conduct 290.35an evaluation of the pilot project to determine:291.1    (1) the number of participants who took part in the screening;291.2    (2) the number of children who were screened and what screening tools were used;291.3    (3) the number of children who were identified in the screening who needed referral 291.4or follow-up services;291.5    (4) the number of children who received services, what agency provided the services, 291.6and what type of services were provided;291.7    (5) the number of employment plans that were adjusted to include the activities 291.8recommended in the screenings;291.9    (6) the changes in work participation rates;291.10    (7) the changes in earned income;291.11    (8) the changes in sanction rates; and291.12    (9) the participants' report of program effectiveness.291.13    Subd. 5.Work activity.Participant involvement in screenings and subsequent 291.14referral and follow-up services shall count as work activity under Minnesota Statutes, 291.15section 256J.49, subdivision 13.291.16    Sec. 26. SOCIAL AND ECONOMIC COSTS OF GAMBLING.291.17    Subdivision 1.Report.The commissioner of human services, in consultation with 291.18the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed 291.19vendors, shall prepare a report that provides a process and funding mechanism to study the 291.20issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate 291.21of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall 291.22include in the report potential financial commitments made by stakeholders and others in 291.23order to fund the study. The report is due to the legislative committees having jurisdiction 291.24over compulsive gambling issues by December 1, 2007. 291.25    Subd. 2.Issues to be addressed.The study must address:291.26    (1) state, local, and tribal government policies and practices in Minnesota to legalize 291.27or prohibit gambling;291.28    (2) the relationship between gambling and crime in Minnesota, including: (i) the 291.29relationship between gambling and overall crime rates; (ii) the relationship between 291.30gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child 291.31neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement 291.32and regulation practices that are intended to address the relationship between gambling 291.33and levels of crime;292.1    (3) the relationship between expanded gambling and increased rates of problem 292.2gambling in Minnesota, including the impact of pathological or problem gambling on 292.3individuals, families, businesses, social institutions, and the economy;292.4    (4) the social impact of gambling on individuals, families, businesses, and social 292.5institutions in Minnesota, including an analysis of the relationship between gambling and 292.6depression, abuse, divorce, homelessness, suicide, and bankruptcy;292.7    (5) the economic impact of gambling on state, local, and tribal economies in 292.8Minnesota; and292.9    (6) any other issues deemed necessary in assessing the social and economic impact 292.10of gambling in Minnesota.292.11    Subd. 3.Quantification of social and economic impact.The study shall quantify 292.12the social and economic impact on both (1) state, local, and tribal governments in 292.13Minnesota, and (2) Minnesota's communities and social institutions, including individuals, 292.14families, and businesses within those communities and institutions.292.15    Sec. 27.  REPEALER.292.16Minnesota Rules, part 9585.0030, is repealed.292.17ARTICLE 6292.18DEPARTMENT OF HEALTH292.19    Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:292.20    Subd. 2. Definitions. For purposes of this section, the terms defined in this 292.21subdivision have the meanings given.292.22    (a) "Access" means the financial, temporal, and geographic availability of health 292.23care to individuals who need it.292.24    (b)(a) "Capital expenditure" means an expenditure which, under generally accepted 292.25accounting principles, is not properly chargeable as an expense of operation and 292.26maintenance.292.27    (c) "Cost" means the amount paid by consumers or third party payers for health 292.28care services or products.292.29    (d) "Date of the major spending commitment" means the date the provider formally 292.30obligated itself to the major spending commitment. The obligation may be incurred 292.31by entering into a contract, making a down payment, issuing bonds or entering a loan 292.32agreement to provide financing for the major spending commitment, or taking some other 292.33formal, tangible action evidencing the provider's intention to make the major spending 292.34commitment.293.1    (e)(b) "Health care service" means:293.2    (1) a service or item that would be covered by the medical assistance program 293.3under chapter 256B if provided in accordance with medical assistance requirements to an 293.4eligible medical assistance recipient; and293.5    (2) a service or item that would be covered by medical assistance except that it is 293.6characterized as experimental, cosmetic, or voluntary.293.7    "Health care service" does not include retail, over-the-counter sales of 293.8nonprescription drugs and other retail sales of health-related products that are not generally 293.9paid for by medical assistance and other third-party coverage.293.10    (f)(c) "Major spending commitment" means an expenditure in excess of $1,000,000 293.11for:293.12    (1) acquisition of a unit of medical equipment;293.13    (2) a capital expenditure for a single project for the purposes of providing health 293.14care services, other than for the acquisition of medical equipment;293.15    (3) offering a new specialized service not offered before;293.16    (4) planning for an activity that would qualify as a major spending commitment 293.17under this paragraph; or293.18    (5) a project involving a combination of two or more of the activities in clauses 293.19(1) to (4).293.20    The cost of acquisition of medical equipment, and the amount of a capital 293.21expenditure, is the total cost to the provider regardless of whether the cost is distributed 293.22over time through a lease arrangement or other financing or payment mechanism.293.23    (g)(d) "Medical equipment" means fixed and movable equipment that is used by 293.24a provider in the provision of a health care service. "Medical equipment" includes, but 293.25is not limited to, the following:293.26    (1) an extracorporeal shock wave lithotripter;293.27    (2) a computerized axial tomography (CAT) scanner;293.28    (3) a magnetic resonance imaging (MRI) unit;293.29    (4) a positron emission tomography (PET) scanner; and293.30    (5) emergency and nonemergency medical transportation equipment and vehicles.293.31    (h)(e) "New specialized service" means a specialized health care procedure or 293.32treatment regimen offered by a provider that was not previously offered by the provider, 293.33including, but not limited to:293.34    (1) cardiac catheterization services involving high-risk patients as defined in the 293.35Guidelines for Coronary Angiography established by the American Heart Association 293.36and the American College of Cardiology;294.1    (2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or 294.2any other service for transplantation of any other organ;294.3    (3) megavoltage radiation therapy;294.4    (4) open heart surgery;294.5    (5) neonatal intensive care services; and294.6    (6) any new medical technology for which premarket approval has been granted by 294.7the United States Food and Drug Administration, excluding implantable and wearable 294.8devices.294.9    (f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic, 294.10obstetrics, mental health, chemical dependency, and emergency services.294.11    Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:294.12    Subd. 4a. Expenditure reporting.(a) A provider making a major spending 294.13commitment after April 1, 1992, shall submit notification of the expenditure to the 294.14commissioner and provide the commissioner with any relevant background information.294.15    (b) Notification must include a report, submitted within 60 days after the date of the 294.16major spending commitment, using terms conforming to the definitions in section 62J.03294.17and this section. Each report is subject to retrospective review and must contain: 294.18    (1) a detailed description of the major spending commitment, including the specific 294.19dollar amount of each expenditure, and its purpose;294.20    (2) the date of the major spending commitment;294.21    (3) a statement of the expected impact that the major spending commitment will 294.22have on charges by the provider to patients and third party payers;294.23    (4) a statement of the expected impact on the clinical effectiveness or quality of care 294.24received by the patients that the provider expects to serve;294.25    (5) a statement of the extent to which equivalent services or technology are already 294.26available to the provider's actual and potential patient population;294.27    (6) a statement of the distance from which the nearest equivalent services or 294.28technology are already available to the provider's actual and potential population;294.29    (7) a statement describing the pursuit of any lawful collaborative arrangements; and294.30    (8) a statement of assurance that the provider will not use, purchase, or perform 294.31health care technologies and procedures that are not clinically effective and cost-effective, 294.32unless the technology is used for experimental or research purposes to determine whether 294.33a technology or procedure is clinically effective and cost-effective.294.34    The provider may submit any additional information that it deems relevant.295.1    (c) The commissioner may request additional information from a provider for the 295.2purpose of review of a report submitted by that provider, and may consider relevant 295.3information from other sources. A provider shall provide any information requested by 295.4the commissioner within the time period stated in the request, or within 30 days after the 295.5date of the request if the request does not state a time.295.6    (d) If the provider fails to submit a complete and timely expenditure report, including 295.7any additional information requested by the commissioner, the commissioner may make 295.8the provider's subsequent major spending commitments subject to the procedures of 295.9prospective review and approval under subdivision 6a.295.10    Each hospital, outpatient surgical center, diagnostic imaging center, and physician 295.11clinic shall report annually to the commissioner on all major spending commitments, 295.12in the form and manner specified by the commissioner. The report shall include the 295.13following information:295.14    (a) a description of major spending commitments made during the previous year, 295.15including the total dollar amount of major spending commitments and purpose of the 295.16expenditures;295.17    (b) the cost of land acquisition, construction of new facilities, and renovation of 295.18existing facilities;295.19    (c) the cost of purchased or leased medical equipment, by type of equipment;295.20    (d) expenditures by type for specialty care and new specialized services;295.21    (e) information on the amount and types of added capacity for diagnostic imaging 295.22services, outpatient surgical services, and new specialized services; and295.23    (f) information on investments in electronic medical records systems.295.24For hospitals and outpatient surgical centers, this information shall be included in reports 295.25to the commissioner that are required under section 144.698. For diagnostic imaging 295.26centers, this information shall be included in reports to the commissioner that are required 295.27under section 144.565. For physician clinics, this information shall be included in reports 295.28to the commissioner that are required under section 62J.41. For all other health care 295.29providers that are subject to this reporting requirement, reports must be submitted to the 295.30commissioner by March 1 each year for the preceding calendar year.295.31    Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:295.32    Subd. 7. Exceptions. (a) The retrospective review process as described in 295.33subdivision 5a and the prospective review and approval process as described in subdivision 295.346a reporting requirement in subdivision 4adodoes not apply to:296.1    (1) a major spending commitment to replace existing equipment with comparable 296.2equipment used for direct patient care, upgrades of equipment beyond the current model, 296.3or comparable model must be reported;296.4    (2) (1) a major spending commitment made by a research and teaching institution 296.5for purposes of conducting medical education, medical research supported or sponsored 296.6by a medical school, or by a federal or foundation grant or clinical trials;296.7    (3) a major spending commitment to repair, remodel, or replace existing buildings or 296.8fixtures if, in the judgment of the commissioner, the project does not involve a substantial 296.9expansion of service capacity or a substantial change in the nature of health care services 296.10provided;296.11    (4) (2) a major spending commitment for building maintenance including heating, 296.12water, electricity, and other maintenance-related expenditures; and296.13    (5) (3) a major spending commitment for activities, not directly related to the 296.14delivery of patient care services, including food service, laundry, housekeeping, and 296.15other service-related activities; and.296.16    (6) a major spending commitment for computer equipment or data systems not 296.17directly related to the delivery of patient care services, including computer equipment or 296.18data systems related to medical record automation.296.19    (b) In addition to the exceptions listed in paragraph (a), the prospective review and 296.20approval process described in subdivision 6a reporting requirement in subdivision 4a does 296.21not apply to mergers, acquisitions, and other changes in ownership or control that, in the 296.22judgment of the commissioner, do not involve a substantial expansion of service capacity 296.23or a substantial change in the nature of health care services provided.296.24    Sec. 4. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:296.25    Subdivision 1. Cost containment data to be collected from providers. The 296.26commissioner shall require health care providers to collect and provide both patient 296.27specific information and descriptive and financial aggregate data on:296.28    (1) the total number of patients served;296.29    (2) the total number of patients served by state of residence and Minnesota county;296.30    (3) the site or sites where the health care provider provides services;296.31    (4) the number of individuals employed, by type of employee, by the health care 296.32provider;296.33    (5) the services and their costs for which no payment was received;296.34    (6) total revenue by type of payer or by groups of payers, including but not limited 296.35to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service 297.1plan corporations, commercial insurers, health maintenance organizations, and individual 297.2patients;297.3    (7) revenue from research activities;297.4    (8) revenue from educational activities;297.5    (9) revenue from out-of-pocket payments by patients;297.6    (10) revenue from donations; and297.7    (11) a report on health care capital expenditures during the previous year, as required 297.8by section 62J.17; and297.9    (11) (12) any other data required by the commissioner, including data in 297.10unaggregated form, for the purposes of developing spending estimates, setting spending 297.11limits, monitoring actual spending, and monitoring costs.297.12The commissioner may, by rule, modify the data submission categories listed above if the 297.13commissioner determines that this will reduce the reporting burden on providers without 297.14having a significant negative effect on necessary data collection efforts.297.15    Sec. 5. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:297.16    Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1, 297.171996, all institutional inpatient hospital services, ancillary services, institutionally owned 297.18or operated outpatient services rendered by providers in Minnesota, and institutional 297.19or noninstitutional home health services that are not being billed using an equivalent 297.20electronic billing format, must be billed using the uniform billing form CMS 1450, except 297.21as provided in subdivision 5.297.22    (b) The instructions and definitions for the use of the uniform billing form CMS 297.231450 shall be in accordance with the uniform billing form manual specified by the 297.24commissioner. In promulgating these instructions, the commissioner may utilize the 297.25manual developed by the National Uniform Billing Committee, as adopted and finalized 297.26by the Minnesota Uniform Billing Committee.297.27    (c) Services to be billed using the uniform billing form CMS 1450 include: 297.28institutional inpatient hospital services and distinct units in the hospital such as psychiatric 297.29unit services, physical therapy unit services, swing bed (SNF) services, inpatient state 297.30psychiatric hospital services, inpatient skilled nursing facility services, home health 297.31services (Medicare part A), and hospice services; ancillary services, where benefits are 297.32exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals, 297.33skilled nursing facilities, and home health (Medicare part B); institutional owned or 297.34operated outpatient services such as waivered services, hospital outpatient services, 297.35including ambulatory surgical center services, hospital referred laboratory services, 298.1hospital-based ambulance services, and other hospital outpatient services, skilled nursing 298.2facilities, home health, freestanding renal dialysis centers, comprehensive outpatient 298.3rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health 298.4clinics, and community mental health centers; home health services such as home health 298.5intravenous therapy providers, waivered services, personal care attendants, and hospice; 298.6and any other health care provider certified by the Medicare program to use this form.298.7    (d) On and after January 1, 1996, a mother and newborn child must be billed 298.8separately, and must not be combined on one claim form.298.9    (e) Services provided by Medicare Critical Access Hospitals electing Method 298.10II billing will be allowed an exception to this provision to allow the inclusion of the 298.11professional fees on the CMS 1450.298.12    Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:298.13    Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all 298.14noninstitutional health care services rendered by providers in Minnesota except dental 298.15or pharmacy providers, that are not currently being billed using an equivalent electronic 298.16billing format, must be billed using the health insurance claim form CMS 1500, except as 298.17provided in subdivision 5.298.18    (b) The instructions and definitions for the use of the uniform billing form CMS 298.191500 shall be in accordance with the manual developed by the Administrative Uniformity 298.20Committee entitled standards for the use of the CMS 1500 form, dated February 1994, 298.21as further defined by the commissioner.298.22    (c) Services to be billed using the uniform billing form CMS 1500 include physician 298.23services and supplies, durable medical equipment, noninstitutional ambulance services, 298.24independent ancillary services including occupational therapy, physical therapy, speech 298.25therapy and audiology, home infusion therapy, podiatry services, optometry services, 298.26mental health licensed professional services, substance abuse licensed professional 298.27services, nursing practitioner professional services, certified registered nurse anesthetists, 298.28chiropractors, physician assistants, laboratories, medical suppliers, and other health care 298.29providers such as day activity centers and freestanding ambulatory surgical centers.298.30    (d) Services provided by Medicare Critical Access Hospitals electing Method 298.31II billing will be allowed an exception to this provision to allow the inclusion of the 298.32professional fees on the CMS 1450.298.33    Sec. 7. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:299.1    Subd. 2. General characteristics. (a) The Minnesota uniform health care 299.2identification card must be a preprinted card constructed of plastic, paper, or any other 299.3medium that conforms with ANSI and ISO 7810 physical characteristics standards. The 299.4card dimensions must also conform to ANSI and ISO 7810 physical characteristics 299.5standard. The use of a signature panel is optional. The uniform prescription drug 299.6information contained on the card must conform with the format adopted by the NCPDP 299.7and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of 299.8the fields required to submit a claim in conformance with the most recent pharmacy 299.9identification card implementation guide produced by the NCPDP. All information 299.10required to submit a prescription drug claim, exclusive of information provided on a 299.11prescription that is required by law, must be included on the card in a clear, readable, and 299.12understandable manner. If a health benefit plan requires a conditional or situational field, 299.13as defined by the NCPDP, the conditional or situational field must conform to the most 299.14recent pharmacy information card implementation guide produced by the NCPDP.299.15    (b) The Minnesota uniform health care identification card must have an essential 299.16information window on the front side with the following data elements: card issuer name, 299.17electronic transaction routing information, card issuer identification number, cardholder 299.18(insured) identification number, and cardholder (insured) identification name. No optional 299.19data may be interspersed between these data elements. 299.20    (c) Standardized labels are required next to human readable data elements and 299.21must come before the human data elements.299.22    Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:299.23    Subd. 3. Human readable data elements. (a) The following are the minimum 299.24human readable data elements that must be present on the front side of the Minnesota 299.25uniform health care identification card:299.26    (1) card issuer name or logo, which is the name or logo that identifies the card issuer. 299.27The card issuer name or logo may be located at the top of the card. No standard label 299.28is required for this data element;299.29    (2) complete electronic transaction routing information including, at a minimum, 299.30the international identification number. The standardized label of this data element 299.31is "RxBIN." Processor control numbers and group numbers are required if needed to 299.32electronically process a prescription drug claim. The standardized label for the process 299.33control numbers data element is "RxPCN" and the standardized label for the group 299.34numbers data element is "RxGrp," except that if the group number data element is a 299.35universal element to be used by all health care providers, the standardized label may be 300.1"Grp." To conserve vertical space on the card, the international identification number and 300.2the processor control number may be printed on the same line;300.3     (3) cardholder (insured) identification number, which is the unique identification 300.4number of the individual card holder established and defined under this section. The 300.5standardized label for the data element is "ID";300.6    (4) cardholder (insured) identification name, which is the name of the individual 300.7card holder. The identification name must be formatted as follows: first name, space, 300.8optional middle initial, space, last name, optional space and name suffix. The standardized 300.9label for this data element is "Name";300.10    (5) care type, which is the description of the group purchaser's plan product under 300.11which the beneficiary is covered. The description shall include the health plan company 300.12name and the plan or product name. The standardized label for this data element is 300.13"Care Type";300.14    (6) service type, which is the description of coverage provided such as hospital, 300.15dental, vision, prescription, or mental health. The standard label for this data element 300.16is "Svc Type"; and300.17    (7) provider/clinic name, which is the name of the primary care clinic the card 300.18holder is assigned to by the health plan company. The standard label for this field is 300.19"PCP." This information is mandatory only if the health plan company assigns a specific 300.20primary care provider to the card holder.300.21    (b) The following human readable data elements shall be present on the back side 300.22of the Minnesota uniform health care identification card. These elements must be left 300.23justified, and no optional data elements may be interspersed between them:300.24    (1) claims submission names and addresses, which are the names and addresses of 300.25the entity or entities to which claims should be submitted. If different destinations are 300.26required for different types of claims, this must be labeled;300.27    (2) telephone numbers and names that pharmacies and other health care providers 300.28may call for assistance. These telephone numbers and names are required on the back 300.29side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies 300.30or other providers with assistance or with the telephone numbers and names of contacts 300.31for assistance; and300.32    (3) telephone numbers and names; which are the telephone numbers and names of the 300.33following contacts with a standardized label describing the service function as applicable:300.34    (i) eligibility and benefit information;300.35    (ii) utilization review;300.36    (iii) precertification; or301.1    (iv) customer services.301.2    (c) The following human readable data elements are mandatory on the back 301.3side of the Minnesota uniform health care identification card for health maintenance 301.4organizations:301.5    (1) emergency care authorization telephone number or instruction on how to receive 301.6authorization for emergency care. There is no standard label required for this information; 301.7and301.8    (2) one of the following:301.9    (i) telephone number to call to appeal to or file a complaint with the commissioner of 301.10health; or301.11    (ii) for persons enrolled under section 
         256B.69, 
         256D.03, or 
         256L.12, the telephone 301.12number to call to file a complaint with the ombudsperson designated by the commissioner 301.13of human services under section 
         256B.69 and the address to appeal to the commissioner of 301.14human services. There is no standard label required for this information. 301.15    (d) All human readable data elements not required under paragraphs (a) to (c) are 301.16optional and may be used at the issuer's discretion.301.17    Sec. 9. Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision 301.18to read:301.19    Subd. 1a.Demonstration project.The commissioner of health shall award a 301.20demonstration project grant to a community-based health care initiative to develop and 301.21operate a community-based health care coverage program to operate within Carlton, 301.22Cook, Lake, and St. Louis Counties. The demonstration project shall extend for five years 301.23and must comply with all the requirements of this section.301.24    Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:301.25    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 301.26coverage program, a community-based health initiative shall submit to the commissioner 301.27of health for approval the community-based health care coverage program developed by 301.28the initiative. The commissioner shall only approve a program that has been awarded 301.29a community access program grant from the United States Department of Health and 301.30Human Services. The commissioner shall ensure that the program meets the federal grant 301.31requirements and any requirements described in this section and is actuarially sound based 301.32on a review of appropriate records and methods utilized by the community-based health 301.33initiative in establishing premium rates for the community-based health care coverage 301.34program. 302.1    (b) Prior to approval, the commissioner shall also ensure that:302.2    (1) the benefits offered comply with subdivision 8 and that there are adequate 302.3numbers of health care providers participating in the community-based health network to 302.4deliver the benefits offered under the program;302.5    (2) the activities of the program are limited to activities that are exempt under this 302.6section or otherwise from regulation by the commissioner of commerce;302.7    (3) the complaint resolution process meets the requirements of subdivision 10; and 302.8    (4) the data privacy policies and procedures comply with state and federal law.302.9    Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:302.10    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 302.11by the commissioner of health a community-based health care coverage program. The 302.12operational structure established by the initiative shall include, but is not limited to: 302.13    (1) establishing a process for enrolling eligible individuals and their dependents; 302.14    (2) collecting and coordinating premiums from enrollees and employers of enrollees;302.15    (3) providing payment to participating providers; 302.16    (4) establishing a benefit set according to subdivision 8 and establishing premium 302.17rates and cost-sharing requirements; 302.18    (5) creating incentives to encourage primary care and wellness services; and 302.19    (6) initiating disease management services, as appropriate. 302.20    (b) The payments collected under paragraph (a), clause (2), may be used to capture 302.21available federal funds.302.22    Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:302.23    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 302.24commissioner of health on January 15, April 15, July 15, and October 15 of each year, 302.25with the first report due January 15, 2007 2008. The status report shall include:302.26    (1) the financial status of the program, including the premium rates, cost per member 302.27per month, claims paid out, premiums received, and administrative expenses; 302.28    (2) a description of the health care benefits offered and the services utilized; 302.29    (3) the number of employers participating, the number of employees and dependents 302.30covered under the program, and the number of health care providers participating; 302.31    (4) a description of the health outcomes to be achieved by the program and a status 302.32report on the performance measurements to be used and collected; and 302.33    (5) any other information requested by the commissioner of health or commerce or 302.34the legislature. 303.1    (b) The initiative shall contract with an independent entity to conduct an evaluation 303.2of the program to be submitted to the commissioners of health and commerce and the 303.3legislature by January 15, 2009 2010. The evaluation shall include:303.4    (1) an analysis of the health outcomes established by the initiative and the 303.5performance measurements to determine whether the outcomes are being achieved;303.6    (2) an analysis of the financial status of the program, including the claims to 303.7premiums loss ratio and utilization and cost experience; 303.8    (3) the demographics of the enrollees, including their age, gender, family income, 303.9and the number of dependents; 303.10    (4) the number of employers and employees who have been denied access to the 303.11program and the basis for the denial; 303.12    (5) specific analysis on enrollees who have aggregate medical claims totaling over 303.13$5,000 per year, including data on the enrollee's main diagnosis and whether all the 303.14medical claims were covered by the program; 303.15    (6) number of enrollees referred to state public assistance programs; 303.16    (7) a comparison of employer-subsidized health coverage provided in a comparable 303.17geographic area to the designated community-based geographic area served by the 303.18program, including, to the extent available: 303.19    (i) the difference in the number of employers with 50 or fewer employees offering 303.20employer-subsidized health coverage; 303.21    (ii) the difference in uncompensated care being provided in each area; and303.22    (iii) a comparison of health care outcomes and measurements established by the 303.23initiative; and 303.24    (8) any other information requested by the commissioner of health or commerce.303.25    Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:303.26    Subd. 14. Sunset. This section expires December 31, 2011 2012.303.27    Sec. 14. [144.291] MINNESOTA HEALTH RECORDS ACT.303.28    Subdivision 1.Short title.Sections 144.291 to 144.298 may be cited as the 303.29Minnesota Health Records Act.303.30    Subd. 2.Definitions.For the purposes of sections 144.291 to 144.298, the following 303.31terms have the meanings given.303.32    (a) Affiliate. "Affiliate" has the meaning given in section 144.6521, subdivision 3, 303.33paragraph (b).304.1    (b) Group purchaser. "Group purchaser" has the meaning given in section 62J.03, 304.2subdivision 6.304.3    (c) Health record. "Health record" means any information, whether oral or recorded 304.4in any form or medium, that relates to the past, present, or future physical or mental health 304.5or condition of a patient; the provision of health care to a patient; or the past, present, or 304.6future payment for the provision of health care to a patient.304.7    (d) Identifying information. "Identifying information" means the patient's name, 304.8address, date of birth, gender, parent's or guardian's name regardless of the age of the 304.9patient, and other nonclinical data which can be used to uniquely identify a patient.304.10    (e) Individually identifiable form. "Individually identifiable form" means a form in 304.11which the patient is or can be identified as the subject of the health records.304.12    (f) Medical emergency. "Medical emergency" means medically necessary care 304.13which is immediately needed to preserve life, prevent serious impairment to bodily 304.14functions, organs, or parts, or prevent placing the physical or mental health of the patient 304.15in serious jeopardy.304.16    (g) Patient. "Patient" means a natural person who has received health care services 304.17from a provider for treatment or examination of a medical, psychiatric, or mental 304.18condition, the surviving spouse and parents of a deceased patient, or a person the patient 304.19appoints in writing as a representative, including a health care agent acting according to 304.20chapter 145C, unless the authority of the agent has been limited by the principal in the 304.21principal's health care directive. Except for minors who have received health care services 304.22under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or 304.23guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.304.24    (h) Provider. "Provider" means: 304.25    (1) any person who furnishes health care services and is regulated to furnish the 304.26services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 304.27151, 153, or 153A; 304.28    (2) a home care provider licensed under section 144A.46; 304.29    (3) a health care facility licensed under this chapter or chapter 144A; 304.30    (4) a physician assistant registered under chapter 147A; and 304.31    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to 304.32148B.71.304.33    (i) Record locator service. "Record locator service" means an electronic index of 304.34patient identifying information that directs providers in a health information exchange to 304.35the location of patient health records held by providers and group purchasers.305.1    (j) Related health care entity. "Related health care entity" means an affiliate of 305.2the provider releasing the health records.305.3    Sec. 15. [144.292] PATIENT RIGHTS.305.4    Subdivision 1.Scope.Patients have the rights specified in this section regarding the 305.5treatment the patient receives and the patient's health record.305.6    Subd. 2.Patient access.Upon request, a provider shall supply to a patient complete 305.7and current information possessed by that provider concerning any diagnosis, treatment, 305.8and prognosis of the patient in terms and language the patient can reasonably be expected 305.9to understand.305.10    Subd. 3.Additional patient rights.A patient's right specified in this section and 305.11sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and 305.12144.652 and any other provision of law relating to the access of a patient to the patient's 305.13health records.305.14    Subd. 4.Notice of rights; information on release.A provider shall provide to 305.15patients, in a clear and conspicuous manner, a written notice concerning practices and 305.16rights with respect to access to health records. The notice must include an explanation of:305.17    (1) disclosures of health records that may be made without the written consent of the 305.18patient, including the type of records and to whom the records may be disclosed; and305.19    (2) the right of the patient to have access to and obtain copies of the patient's health 305.20records and other information about the patient that is maintained by the provider.305.21    The notice requirements of this subdivision are satisfied if the notice is included with 305.22the notice and copy of the patient and resident bill of rights under section 144.652 or if it 305.23is displayed prominently in the provider's place of business. The commissioner of health 305.24shall develop the notice required in this subdivision and publish it in the State Register.305.25    Subd. 5.Copies of health records to patients.Except as provided in section 305.26144.296, upon a patient's written request, a provider, at a reasonable cost to the patient, 305.27shall promptly furnish to the patient:305.28    (1) copies of the patient's health record, including but not limited to laboratory 305.29reports, x-rays, prescriptions, and other technical information used in assessing the 305.30patient's health conditions; or305.31    (2) the pertinent portion of the record relating to a condition specified by the patient.305.32    With the consent of the patient, the provider may instead furnish only a summary 305.33of the record. The provider may exclude from the health record written speculations 305.34about the patient's health condition, except that all information necessary for the patient's 305.35informed consent must be provided.306.1    Subd. 6.Cost.(a) When a patient requests a copy of the patient's record for 306.2purposes of reviewing current medical care, the provider must not charge a fee.306.3    (b) When a provider or its representative makes copies of patient records upon a 306.4patient's request under this section, the provider or its representative may charge the 306.5patient or the patient's representative no more than 75 cents per page, plus $10 for time 306.6spent retrieving and copying the records, unless other law or a rule or contract provide for 306.7a lower maximum charge. This limitation does not apply to x-rays. The provider may 306.8charge a patient no more than the actual cost of reproducing x-rays, plus no more than 306.9$10 for the time spent retrieving and copying the x-rays.306.10    (c) The respective maximum charges of 75 cents per page and $10 for time provided 306.11in this subdivision are in effect for calendar year 1992 and may be adjusted annually each 306.12calendar year as provided in this subdivision. The permissible maximum charges shall 306.13change each year by an amount that reflects the change, as compared to the previous year, 306.14in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 306.15published by the Department of Labor.306.16    (d) A provider or its representative must not charge a fee to provide copies of records 306.17requested by a patient or the patient's authorized representative if the request for copies 306.18of records is for purposes of appealing a denial of Social Security disability income or 306.19Social Security disability benefits under title II or title XVI of the Social Security Act. For 306.20the purpose of further appeals, a patient may receive no more than two medical record 306.21updates without charge, but only for medical record information previously not provided. 306.22For purposes of this paragraph, a patient's authorized representative does not include units 306.23of state government engaged in the adjudication of Social Security disability claims.306.24    Subd. 7.Withholding health records from patient.(a) If a provider reasonably 306.25determines that the information is detrimental to the physical or mental health of the 306.26patient, or is likely to cause the patient to inflict self harm, or to harm another, the provider 306.27may withhold the information from the patient and may supply the information to an 306.28appropriate third party or to another provider. The other provider or third party may 306.29release the information to the patient.306.30    (b) A provider shall release information upon written request unless, prior to the 306.31request, a provider has designated and described a specific basis for withholding the 306.32information as authorized by paragraph (a).306.33    Sec. 16. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.306.34    Subdivision 1.Release or disclosure of health records.Health records can be 306.35released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.307.1    Subd. 2.Patient consent to release of records.A provider, or a person who 307.2receives health records from a provider, may not release a patient's health records to a 307.3person without:307.4    (1) a signed and dated consent from the patient or the patient's legally authorized 307.5representative authorizing the release;307.6    (2) specific authorization in law; or307.7    (3) a representation from a provider that the provider holds a consent from the 307.8patient.307.9    Subd. 3.Release from one provider to another.A patient's health record, 307.10including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical 307.11information used in assessing the patient's condition, or the pertinent portion of the record 307.12relating to a specific condition, or a summary of the record, shall promptly be furnished to 307.13another provider upon the written request of the patient. The written request shall specify 307.14the name of the provider to whom the health record is to be furnished. The provider who 307.15furnishes the health record or summary may retain a copy of the materials furnished. The 307.16patient shall be responsible for the reasonable costs of furnishing the information.307.17    Subd. 4.Duration of consent.Except as provided in this section, a consent is 307.18valid for one year or for a lesser period specified in the consent or for a different period 307.19provided by law.307.20    Subd. 5.Exceptions to consent requirement.This section does not prohibit the 307.21release of health records:307.22    (1) for a medical emergency when the provider is unable to obtain the patient's 307.23consent due to the patient's condition or the nature of the medical emergency;307.24    (2) to other providers within related health care entities when necessary for the 307.25current treatment of the patient; or307.26    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same 307.27types of health care facilities licensed by this chapter and chapter 144A that are licensed 307.28in another state when a patient:307.29    (i) is returning to the health care facility and unable to provide consent; or307.30    (ii) who resides in the health care facility, has services provided by an outside 307.31resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable 307.32to provide consent.307.33    Subd. 6.Consent does not expire.Notwithstanding subdivision 4, if a patient 307.34explicitly gives informed consent to the release of health records for the purposes and 307.35restrictions in clauses (1) and (2), the consent does not expire after one year for:308.1    (1) the release of health records to a provider who is being advised or consulted with 308.2in connection with the releasing provider's current treatment of the patient;308.3    (2) the release of health records to an accident and health insurer, health service plan 308.4corporation, health maintenance organization, or third-party administrator for purposes of 308.5payment of claims, fraud investigation, or quality of care review and studies, provided that:308.6    (i) the use or release of the records complies with sections 72A.49 to 72A.505;308.7    (ii) further use or release of the records in individually identifiable form to a person 308.8other than the patient without the patient's consent is prohibited; and308.9    (iii) the recipient establishes adequate safeguards to protect the records from 308.10unauthorized disclosure, including a procedure for removal or destruction of information 308.11that identifies the patient.308.12    Subd. 7.Exception to consent.Subdivision 2 does not apply to the release of health 308.13records to the commissioner of health or the Health Data Institute under chapter 62J, 308.14provided that the commissioner encrypts the patient identifier upon receipt of the data.308.15    Subd. 8.Record locator service.(a) A provider or group purchaser may send 308.16patient identifying information and information about the location of the patient's health 308.17records to a record locator service without consent from the patient. Except in the case of 308.18a medical emergency, a provider participating in a health information exchange using a 308.19record locator service cannot access patient identifying information and information 308.20about the location of the patient's health records until the patient has provided consent. 308.21The Minnesota Department of Health may not access the record locator service or receive 308.22data from the record locator service. Only a provider may access patient identifying 308.23information in a record locator service. The consent does not expire and may be revoked 308.24by the patient at any time by providing written notice of the revocation to the provider.308.25    (b) A health information exchange maintaining a record locator service or an entity 308.26maintaining a record locator service for a health information exchange must maintain an 308.27audit log of providers accessing information in a record locator service that minimally 308.28contains information on: 308.29    (1) the identity of the provider accessing the information; 308.30    (2) the identity of the patient whose information was accessed by the provider; and 308.31    (3) the date the information was accessed. 308.32    (c) No group purchaser may in any way require a provider to participate in any 308.33record locator service as a condition of payment or participation.308.34    (d) A record locator service must provide a mechanism for patients to opt out of 308.35including their identifying information and information about the location of their health 308.36records in a record locator service. At a minimum, any consent form that permits a 309.1provider to access a record locator service must include a check-box option that allows a 309.2patient to completely opt out of the record locator service which shall be clearly displayed 309.3to the patient. A provider participating in a health information exchange with a record 309.4locator service who receives a patient's request to completely opt out of the record locator 309.5service or to not have a specific provider contact in the record locator service shall be 309.6responsible for removing the patient's information from the record locator service.309.7    Subd. 9.Documentation of release.(a) In cases where a provider releases health 309.8records without patient consent as authorized by law, the release must be documented in 309.9the patient's health record. In the case of a release under section 144.294, subdivision 2, the 309.10documentation must include the date and circumstances under which the release was made, 309.11the person or agency to whom the release was made, and the records that were released.309.12    (b) When a health record is released using a representation from a provider that 309.13holds a consent from the patient, the releasing provider shall document: 309.14    (1) the provider requesting the health records; 309.15    (2) the identity of the patient;309.16    (3) the health records requested; and 309.17    (4) the date the health records were requested.309.18    Sec. 17. [144.294] RECORDS RELATING TO MENTAL HEALTH.309.19    Subdivision 1.Provider inquiry.Upon the written request of a spouse, parent, 309.20child, or sibling of a patient being evaluated for or diagnosed with mental illness, a 309.21provider shall inquire of a patient whether the patient wishes to authorize a specific 309.22individual to receive information regarding the patient's current and proposed course of 309.23treatment. If the patient so authorizes, the provider shall communicate to the designated 309.24individual the patient's current and proposed course of treatment. Section 144.293, 309.25subdivisions 2 and 4, apply to consents given under this subdivision.309.26    Subd. 2.Disclosure to law enforcement agency.Notwithstanding section 144.293, 309.27subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental 309.28health to a law enforcement agency if the law enforcement agency provides the name 309.29of the patient and communicates that the:309.30    (1) patient is currently involved in an emergency interaction with the law 309.31enforcement agency; and309.32    (2) disclosure of the records is necessary to protect the health or safety of the patient 309.33or of another person. 309.34    The scope of disclosure under this subdivision is limited to the minimum necessary 309.35for law enforcement to respond to the emergency. A law enforcement agency that obtains 310.1health records under this subdivision shall maintain a record of the requestor, the provider 310.2of the information, and the patient's name. Health records obtained by a law enforcement 310.3agency under this subdivision are private data on individuals as defined in section 13.02, 310.4subdivision 12, and must not be used by law enforcement for any other purpose.310.5    Subd. 3.Records release for family and caretaker; mental health care.(a) 310.6Notwithstanding section 144.293, a provider providing mental health care and treatment 310.7may disclose health record information described in paragraph (b) about a patient to a 310.8family member of the patient or other person who requests the information if:310.9    (1) the request for information is in writing;310.10    (2) the family member or other person lives with, provides care for, or is directly 310.11involved in monitoring the treatment of the patient;310.12    (3) the involvement under clause (2) is verified by the patient's mental health care 310.13provider, the patient's attending physician, or a person other than the person requesting the 310.14information, and is documented in the patient's medical record;310.15    (4) before the disclosure, the patient is informed in writing of the request, the name 310.16of the person requesting the information, the reason for the request, and the specific 310.17information being requested;310.18    (5) the patient agrees to the disclosure, does not object to the disclosure, or is 310.19unable to consent or object, and the patient's decision or inability to make a decision is 310.20documented in the patient's medical record; and310.21    (6) the disclosure is necessary to assist in the provision of care or monitoring of the 310.22patient's treatment. 310.23    (b) The information disclosed under this paragraph is limited to diagnosis, admission 310.24to or discharge from treatment, the name and dosage of the medications prescribed, side 310.25effects of the medication, consequences of failure of the patient to take the prescribed 310.26medication, and a summary of the discharge plan. 310.27    (c) If a provider reasonably determines that providing information under this 310.28subdivision would be detrimental to the physical or mental health of the patient or is 310.29likely to cause the patient to inflict self harm or to harm another, the provider must not 310.30disclose the information. 310.31    (d) This subdivision does not apply to disclosures for a medical emergency or 310.32to family members as authorized or required under subdivision 1 or section 144.293, 310.33subdivision 5, clause (1).310.34    Sec. 18. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL 310.35RESEARCH.311.1    Subdivision 1.Methods of release.(a) Notwithstanding section 144.293, 311.2subdivisions 2 and 4, health records may be released to an external researcher solely for 311.3purposes of medical or scientific research only as follows:311.4    (1) health records generated before January 1, 1997, may be released if the patient 311.5has not objected or does not elect to object after that date;311.6    (2) for health records generated on or after January 1, 1997, the provider must:311.7    (i) disclose in writing to patients currently being treated by the provider that health 311.8records, regardless of when generated, may be released and that the patient may object, in 311.9which case the records will not be released; and311.10    (ii) use reasonable efforts to obtain the patient's written general authorization that 311.11describes the release of records in item (i), which does not expire but may be revoked or 311.12limited in writing at any time by the patient or the patient's authorized representative; 311.13    (3) the provider must advise the patient of the rights specified in clause (4); and311.14    (4) the provider must, at the request of the patient, provide information on how the 311.15patient may contact an external researcher to whom the health record was released and 311.16the date it was released.311.17    (b) Authorization may be established if an authorization is mailed at least two 311.18times to the patient's last known address with a postage prepaid return envelope and a 311.19conspicuous notice that the patient's medical records may be released if the patient does 311.20not object, and at least 60 days have expired since the second notice was sent.311.21    Subd. 2.Duties of researcher.In making a release for research purposes, the 311.22provider shall make a reasonable effort to determine that:311.23    (1) the use or disclosure does not violate any limitations under which the record 311.24was collected;311.25    (2) the use or disclosure in individually identifiable form is necessary to accomplish 311.26the research or statistical purpose for which the use or disclosure is to be made;311.27    (3) the recipient has established and maintains adequate safeguards to protect the 311.28records from unauthorized disclosure, including a procedure for removal or destruction of 311.29information that identifies the patient; and311.30    (4) further use or release of the records in individually identifiable form to a person 311.31other than the patient without the patient's consent is prohibited.311.32    Sec. 19. [144.296] COPIES OF VIDEOTAPES.311.33    A provider may not release a copy of a videotape of a child victim or alleged victim 311.34of physical or sexual abuse without a court order under section 13.03, subdivision 6, or 312.1as provided in section 611A.90. This section does not limit the right of a patient to view 312.2the videotape.312.3    Sec. 20. [144.297] INDEPENDENT MEDICAL EXAMINATION.312.4    This section applies to the subject and provider of an independent medical 312.5examination requested by or paid for by a third party. Notwithstanding section 144.293, a 312.6provider may release health records created as part of an independent medical examination 312.7to the third party who requested or paid for the examination.312.8    Sec. 21. [144.298] PENALTIES.312.9    Subdivision 1.Licensing action.A violation of sections 144.291 to 144.298 may 312.10be grounds for disciplinary action against a provider by the appropriate licensing board 312.11or agency.312.12    Subd. 2.Allocation of liability.In adjudicating a dispute involving the disclosure 312.13of patient health records, a court shall use the criteria in this subdivision in determining 312.14how liability will be allocated.312.15    (a) When requesting health records using consent, a person warrants that the consent:312.16    (1) contains no information known to the person to be false; and312.17    (2) accurately states the patient's desire to have health records disclosed or that there 312.18is specific authorization in law.312.19    (b) When requesting health records using consent or the representation authorized in 312.20section 144.293, subdivision 2, a provider warrants that the request:312.21    (1) contains no information known to the provider to be false;312.22    (2) accurately states the patient's desire to have health records disclosed or that 312.23there is specific authorization in law; and312.24    (3) does not exceed any limits imposed by the patient in the consent.312.25    (c) When disclosing health records, a person releasing health records warrants that 312.26the person:312.27    (1) has complied with the requirements of this section regarding disclosure of 312.28health records;312.29    (2) knows of no information related to the request that is false; and312.30    (3) has complied with the limits set by the patient in the consent or as described 312.31in the representation of consent.312.32    (d) A court of this state presumes that:312.33    (1) a request made by a person that complies with the provisions of this section is 312.34valid and represents the wishes of the patient;313.1    (2) the information listed in a consent or representation of consent is accurate;313.2    (3) the recipient of a consent or representation of consent has no knowledge or 313.3notice that the person making the request breached a duty to the patient or does not 313.4rightfully have a consent;313.5    (4) the signature on the consent or representation of consent is not forged;313.6    (5) the consent or representation of consent was not obtained under false pretenses; 313.7and313.8    (6) the consent or representation of consent was not altered without the patient's 313.9permission.313.10    (e) No person or provider may disclaim or contractually limit the application of this 313.11section, or obtain indemnity for its effects, if the disclaimer, limitation, or indemnity 313.12restricts liability for misrepresentation against persons reasonably relying on the consent, 313.13representation of consent, or disclosure.313.14    (f) A court of this state shall give effect to liability allocations between the parties 313.15provided by contract that does not allocate liability to the detriment of the patient and the 313.16allocation is consistent with the requirements of sections 144.291 to 144.298.313.17    (g) A patient is eligible to receive compensatory damages plus costs and reasonable 313.18attorney fees if there is a negligent or intentional violation of sections 144.293 to 144.295.313.19    Subd. 3.Liability for a record locator service.A patient is eligible to receive 313.20compensatory damages plus costs and reasonable attorney fees if a health information 313.21exchange maintaining a record locator service, or an entity maintaining a record locator 313.22service for a health information exchange, negligently or intentionally violates the 313.23provisions of section 144.293, subdivision 8.313.24    Sec. 22. Minnesota Statutes 2006, section 144.3345, is amended to read:313.25144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD 313.26GRANTS.313.27    Subdivision 1. Definitions. The following definitions are used for the purposes 313.28of this section.313.29    (a) "Eligible community e-health collaborative" means an existing or newly 313.30established collaborative to support the adoption and use of interoperable electronic 313.31health records. A collaborative must consist of at least three two or more eligible health 313.32care entities in at least two of the categories listed in paragraph (b) and have a focus on 313.33interconnecting the members of the collaborative for secure and interoperable exchange of 313.34health care information.313.35    (b) "Eligible health care entity" means one of the following:314.1    (1) community clinics, as defined under section 
         145.9268; 314.2    (2) hospitals eligible for rural hospital capital improvement grants, as defined 314.3in section 
         144.148;314.4    (3) physician clinics located in a community with a population of less than 50,000 314.5according to United States Census Bureau statistics and outside the seven-county 314.6metropolitan area; 314.7    (4) nursing facilities licensed under sections 
         144A.01 to 
         144A.27; 314.8    (5) community health boards or boards of health as established under chapter 145A; 314.9    (6) nonprofit entities with a purpose to provide health information exchange 314.10coordination governed by a representative, multi-stakeholder board of directors; and314.11    (7) other providers of health or health care services approved by the commissioner 314.12for which interoperable electronic health record capability would improve quality of 314.13care, patient safety, or community health.314.14    Subd. 2. Grants authorized. The commissioner of health shall award grants to:314.15    (a) eligible community e-health collaborative projects to improve the implementation 314.16and use of interoperable electronic health records including but not limited to the 314.17following projects:314.18    (1) collaborative efforts to host and support fully functional interoperable electronic 314.19health records in multiple care settings; 314.20    (2) electronic medication history and electronic patient registration medical history314.21information; 314.22    (3) electronic personal health records for persons with chronic diseases and for 314.23prevention services; 314.24    (4) rural and underserved community models for electronic prescribing; and314.25    (5) enabling modernize local public health information systems to rapidly and 314.26electronically exchange information needed to participate in community e-health 314.27collaboratives or for public health emergency preparedness and response.; and314.28    (6) implement regional or community-based health information exchange 314.29organizations;314.30    (b) community clinics, as defined under section 145.9268, to implement and use 314.31interoperable electronic health records, including but not limited to the following projects:314.32    (1) efforts to plan for and implement fully functional, standards-based interoperable 314.33electronic health records; and314.34    (2) purchases and implementation of computer hardware, software, and technology 314.35to fully implement interoperable electronic health records;315.1    (c) regional or community-based health information exchange organizations to 315.2connect and facilitate the exchange of health information between eligible health care 315.3entities, including but not limited to the development, testing, and implementation of:315.4    (1) data exchange standards, including data, vocabulary, and messaging standards, 315.5for the exchange of health information, provided that such standards are consistent with 315.6state and national standards;315.7    (2) security standards necessary to ensure the confidentiality and integrity of health 315.8records;315.9    (3) computer interfaces and mechanisms for standardizing health information 315.10exchanged between eligible health care entities;315.11    (4) a record locator service for identifying the location of patient health records; or315.12    (5) interfaces and mechanisms for implementing patient consent requirements; and315.13    (d) community health boards and boards of health as established under chapter 315.14145A to modernize local public health information systems to be standards-based and 315.15interoperable with other electronic health records and information systems, or for 315.16enhanced public health emergency preparedness and response.315.17    Grant funds may not be used for construction of health care or other buildings or 315.18facilities.315.19    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible 315.20community e-health collaborative, community clinic, regional or community-based health 315.21information exchange, or community health boards and boards of health must submit an 315.22application to the commissioner of health by the deadline established by the commissioner. 315.23A grant may be awarded upon the signing of a grant contract. In awarding grants, the 315.24commissioner shall give preference to projects benefiting providers located in rural and 315.25underserved areas of Minnesota which the commissioner has determined have an unmet 315.26need for the development and funding of electronic health records. Applicants may apply 315.27for and the commissioner may award grants for one-year, two-year, or three-year periods.315.28    (b) An application must be on a form and contain information as specified by the 315.29commissioner but at a minimum must contain:315.30    (1) a description of the purpose or project for which grant funds will be used; 315.31    (2) a description of the problem or problems the grant funds will be used to address, 315.32including an assessment of the likelihood of the project occurring absent grant funding; 315.33    (3) a description of achievable objectives, a workplan, budget, budget narrative, a 315.34project communications plan, a timeline for implementation and completion of processes 315.35or projects enabled by the grant, and an assessment of privacy and security issues and a 315.36proposed approach to address these issues;316.1    (4) a description of the health care entities and other groups participating in the 316.2project, including identification of the lead entity responsible for applying for and 316.3receiving grant funds; 316.4    (5) a plan for how patients and consumers will be involved in development of 316.5policies and procedures related to the access to and interchange of information; 316.6    (6) evidence of consensus and commitment among the health care entities and others 316.7who developed the proposal and are responsible for its implementation; and316.8    (7) a plan for documenting and evaluating results of the grant. ; and316.9    (8) a plan for use of data exchange standards, including data and vocabulary.316.10    (c) The commissioner shall review each application to determine whether the 316.11application is complete and whether the applicant and the project are eligible for a 316.12grant. In evaluating applications, the commissioner shall take into consideration factors, 316.13including but not limited to, the following:316.14    (1) the degree to which the proposal interconnects the various providers of care with 316.15other health care entities in the applicant's geographic community; 316.16    (2) the degree to which the project provides for the interoperability of electronic 316.17health records or related health information technology between the members of the 316.18collaborative, and presence and scope of a description of how the project intends to 316.19interconnect with other providers not part of the project into the future;316.20    (3) the degree to which the project addresses current unmet needs pertaining 316.21to interoperable electronic health records in a geographic area of Minnesota and the 316.22likelihood that the needs would not be met absent grant funds; 316.23    (4) the applicant's thoroughness and clarity in describing the project, how the project 316.24will improve patient safety, quality of care, and consumer empowerment, and the role of 316.25the various collaborative members;316.26    (5) the recommendations of the Health Information and Technology Infrastructure 316.27Advisory Committee; and316.28    (6) other factors that the commissioner deems relevant.316.29    (d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall 316.30be required to provide $1 in the form of cash or in-kind staff or services for each $3 316.31provided under the grant program.316.32    (e) Grants shall not exceed $900,000 per grant. The commissioner has discretion 316.33over the size and number of grants awarded.316.34    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the 316.35overall effectiveness of the grant program. The commissioner shall collect progress 317.1and expenditure reports to evaluate the grant program from the eligible community 317.2collaboratives receiving grants.317.3    Sec. 23. Minnesota Statutes 2006, section 144.565, is amended to read:317.4144.565 DIAGNOSTIC IMAGING FACILITIES.317.5    Subdivision 1. Utilization and services data; economic and financial interests.317.6    The commissioner shall require diagnostic imaging facilities and providers of diagnostic 317.7imaging services in Minnesota to annually report by March 1 each year for the preceding 317.8fiscal year to the commissioner, in the form and manner specified by the commissioner:317.9    (1) utilization data for each health plan company and each public program, 317.10including workers' compensation, as follows: of diagnostic imaging services as defined 317.11in subdivision 4, paragraph (b);317.12    (i) the number of computerized tomography (CT) procedures performed;317.13    (ii) the number of magnetic resonance imaging (MRI) procedures performed; and317.14    (iii) the number of positron emission tomography (PET) procedures performed; and317.15    (2) the names of all physicians with any financial or economic interest and all other 317.16individuals with a ten percent or greater financial or economic interest in the facility.;317.17    (3) the location where procedures were performed;317.18    (4) the number of units of each type of fixed, portable, and mobile scanner used at 317.19each location;317.20    (5) the average number of hours per month each mobile scanner was operated at 317.21each location;317.22    (6) the number of hours per month each scanner was leased, if applicable;317.23    (7) the total number of diagnostic imaging procedures billed for by the provider at 317.24each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph 317.25(b); and317.26    (8) a report on major health care capital expenditures during the previous year, as 317.27required by section 62J.17.317.28    Subd. 2. Commissioner's right to inspect records. If the report is not filed or 317.29the commissioner of health has reason to believe the report is incomplete or false, the 317.30commissioner shall have the right to inspect diagnostic imaging facility books, audits, 317.31and records.317.32    Subd. 3. Separate reports.For a diagnostic imaging facility that is not attached 317.33or not contiguous to a hospital or a hospital affiliate, the commissioner shall require 317.34the information in subdivision 1 be reported separately for each detached diagnostic 317.35imaging facility as part of the report required under section 144.702. If any entity owns 318.1more than one diagnostic imaging facility, that entity must report by individual facility. 318.2Reports must include only services that were billed by the provider of diagnostic imaging 318.3services submitting the report. If a diagnostic imaging facility leases capacity, technical 318.4services, or professional services to one or more other providers of diagnostic imaging 318.5services, each provider must submit a separate annual report to the commissioner for all 318.6diagnostic imaging services that it provided and billed. The owner of the leased capacity 318.7must provide a report listing the names and addresses of providers to whom the diagnostic 318.8imaging services and equipment were leased.318.9    Subd. 4. Definitions. For purposes of this section, the following terms have the 318.10meanings given:318.11    (a) "Diagnostic imaging facility" means a health care facility that providesis not 318.12a hospital or location licensed as a hospital which offers diagnostic imaging services 318.13through the use of ionizing radiation or other imaging technique including, but not limited 318.14to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a 318.15freestanding or mobile basis in Minnesota, regardless of whether the equipment used 318.16to provide the service is owned or leased. For the purposes of this section, diagnostic 318.17imaging facility includes, but is not limited to, facilities such as a physician's office, clinic, 318.18mobile transport vehicle, outpatient imaging center, or surgical center.318.19    (b) "Diagnostic imaging service" means the use of ionizing radiation or other 318.20imaging technique on a human patient including, but not limited to, magnetic resonance 318.21imaging (MRI) or computerized tomography (CT), positron emission tomography (PET), 318.22or single photon emission computerized tomography (SPECT) scans using fixed, portable, 318.23or mobile equipment.318.24    (b)(c) "Financial or economic interest" means a direct or indirect:318.25    (1) equity or debt security issued by an entity, including, but not limited to, shares of 318.26stock in a corporation, membership in a limited liability company, beneficial interest in 318.27a trust, units or other interests in a partnership, bonds, debentures, notes or other equity 318.28interests or debt instruments, or any contractual arrangements;318.29    (2) membership, proprietary interest, or co-ownership with an individual, group, or 318.30organization to which patients, clients, or customers are referred to; or318.31    (3) employer-employee or independent contractor relationship, including, but not 318.32limited to, those that may occur in a limited partnership, profit-sharing arrangement, or 318.33other similar arrangement with any facility to which patients are referred, including any 318.34compensation between a facility and a health care provider, the group practice of which 318.35the provider is a member or employee or a related party with respect to any of them.319.1    (c)(d) "Freestanding Fixed equipment" means a stationary diagnostic imaging 319.2facility that is not located within a: machine installed in a permanent location.319.3    (1) hospital;319.4    (2) location licensed as a hospital; or319.5    (3) physician's office or clinic where the professional practice of medicine by 319.6licensed physicians is the primary purpose and not the provision of ancillary services 319.7such as diagnostic imaging.319.8    (d)(e) "Mobile equipment" means a diagnostic imaging facility that is transported to 319.9various sites not including movement within a hospital or a physician's office or clinic319.10machine in a self-contained transport vehicle designed to be brought to a temporary offsite 319.11location to perform diagnostic imaging services.319.12    (f) "Portable equipment" means a diagnostic imaging machine designed to be 319.13temporarily transported within a permanent location to perform diagnostic imaging 319.14services.319.15    (g) "Provider of diagnostic imaging services" means a diagnostic imaging facility 319.16or an entity that offers and bills for diagnostic imaging services at a facility owned or 319.17leased by the entity.319.18    Subd. 5.Reports open to public inspection.All reports filed pursuant to this 319.19section shall be open to public inspection.319.20    Sec. 24. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS 319.21CONTROL PROGRAMS.319.22    In order to improve the prevention of hospital-associated bloodstream infections due 319.23to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall establish 319.24an MRSA control program that meets Minnesota Department of Health best practices 319.25standards as published January 15, 2008, including considerations of: 319.26    (1) identification of all MRSA-colonized patients in all intensive care units, and 319.27other at-risk patients identified by the hospital, through active surveillance testing; 319.28    (2) isolation of identified MRSA-colonized or MRSA-infected patients in an 319.29appropriate manner; 319.30    (3) monitoring and strict enforcement of hand hygiene requirements; and 319.31    (4) maintenance of records.319.32    Sec. 25. Minnesota Statutes 2006, section 144.651, subdivision 9, is amended to read:319.33    Subd. 9. Information about treatment. Patients and residents shall be given by 319.34their physicians complete and current information concerning their diagnosis, treatment, 320.1alternatives, risks, and prognosis as required by the physician's legal duty to disclose. This 320.2information shall be in terms and language the patients or residents can reasonably be 320.3expected to understand. Patients and residents may be accompanied by a family member 320.4or other chosen representative, or both. This information shall include the likely medical 320.5or major psychological results of the treatment and its alternatives. In cases where it is 320.6medically inadvisable, as documented by the attending physician in a patient's or resident's 320.7medical record, the information shall be given to the patient's or resident's guardian or 320.8other person designated by the patient or resident as a representative. Individuals have the 320.9right to refuse this information.320.10    Every patient or resident suffering from any form of breast cancer shall be fully 320.11informed, prior to or at the time of admission and during her stay, of all alternative 320.12effective methods of treatment of which the treating physician is knowledgeable, including 320.13surgical, radiological, or chemotherapeutic treatments or combinations of treatments and 320.14the risks associated with each of those methods.320.15    Sec. 26. Minnesota Statutes 2006, section 144.651, subdivision 10, is amended to read:320.16    Subd. 10. Participation in planning treatment; notification of family members.320.17    (a) Patients and residents shall have the right to participate in the planning of their 320.18health care. This right includes the opportunity to discuss treatment and alternatives 320.19with individual caregivers, the opportunity to request and participate in formal care 320.20conferences, and the right to include a family member or other chosen representative, or 320.21both. In the event that the patient or resident cannot be present, a family member or other 320.22representative chosen by the patient or resident may be included in such conferences. A 320.23chosen representative may include a doula of the patient's choice.320.24    (b) If a patient or resident who enters a facility is unconscious or comatose or is 320.25unable to communicate, the facility shall make reasonable efforts as required under 320.26paragraph (c) to notify either a family member or a person designated in writing by the 320.27patient as the person to contact in an emergency that the patient or resident has been 320.28admitted to the facility. The facility shall allow the family member to participate in 320.29treatment planning, unless the facility knows or has reason to believe the patient or 320.30resident has an effective advance directive to the contrary or knows the patient or resident 320.31has specified in writing that they do not want a family member included in treatment 320.32planning. After notifying a family member but prior to allowing a family member to 320.33participate in treatment planning, the facility must make reasonable efforts, consistent 320.34with reasonable medical practice, to determine if the patient or resident has executed an 321.1advance directive relative to the patient or resident's health care decisions. For purposes of 321.2this paragraph, "reasonable efforts" include:321.3    (1) examining the personal effects of the patient or resident;321.4    (2) examining the medical records of the patient or resident in the possession 321.5of the facility;321.6    (3) inquiring of any emergency contact or family member contacted under this 321.7section whether the patient or resident has executed an advance directive and whether the 321.8patient or resident has a physician to whom the patient or resident normally goes for 321.9care; and321.10    (4) inquiring of the physician to whom the patient or resident normally goes for care, 321.11if known, whether the patient or resident has executed an advance directive. If a facility 321.12notifies a family member or designated emergency contact or allows a family member 321.13to participate in treatment planning in accordance with this paragraph, the facility is not 321.14liable to the patient or resident for damages on the grounds that the notification of the 321.15family member or emergency contact or the participation of the family member was 321.16improper or violated the patient's privacy rights.321.17    (c) In making reasonable efforts to notify a family member or designated emergency 321.18contact, the facility shall attempt to identify family members or a designated emergency 321.19contact by examining the personal effects of the patient or resident and the medical records 321.20of the patient or resident in the possession of the facility. If the facility is unable to notify 321.21a family member or designated emergency contact within 24 hours after the admission, 321.22the facility shall notify the county social service agency or local law enforcement agency 321.23that the patient or resident has been admitted and the facility has been unable to notify a 321.24family member or designated emergency contact. The county social service agency and 321.25local law enforcement agency shall assist the facility in identifying and notifying a family 321.26member or designated emergency contact. A county social service agency or local law 321.27enforcement agency that assists a facility in implementing this subdivision is not liable 321.28to the patient or resident for damages on the grounds that the notification of the family 321.29member or emergency contact or the participation of the family member was improper or 321.30violated the patient's privacy rights.321.31    Sec. 27. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:321.32    Subd. 26. Right to associate.(a) Residents may meet with and receive visitors 321.33and participate in activities of commercial, religious, political, as defined in section 321.34203B.11
          and community groups without interference at their discretion if the activities 322.1do not infringe on the right to privacy of other residents or are not programmatically 322.2contraindicated. This includes:322.3    (1) the right to join with other individuals within and outside the facility to work for 322.4improvements in long-term care;322.5    (2) the right to visitation by an individual the patient has appointed as the patient's 322.6health care agent under chapter 145C;322.7    (3) the right to visitation and health care decision making by an individual designated 322.8by the patient under paragraph (c).322.9    (b) Upon admission to a facility where federal law prohibits unauthorized disclosure 322.10of patient or resident identifying information to callers and visitors, the patient or 322.11resident, or the legal guardian or conservator of the patient or resident, shall be given the 322.12opportunity to authorize disclosure of the patient's or resident's presence in the facility 322.13to callers and visitors who may seek to communicate with the patient or resident. To the 322.14extent possible, the legal guardian or conservator of a patient or resident shall consider the 322.15opinions of the patient or resident regarding the disclosure of the patient's or resident's 322.16presence in the facility. 322.17    (c) Upon admission to a facility, the patient or resident, or the legal guardian 322.18or conservator of the patient or resident, must be given the opportunity to designate 322.19a person who is not related who will have the status of the patient's next of kin with 322.20respect to visitation and making a health care decision. A designation must be included 322.21in the patient's health record. With respect to making a health care decision, a health 322.22care directive or appointment of a health care agent under chapter 145C prevails over a 322.23designation made under this paragraph. The unrelated person may also be identified as 322.24such by the patient or by the patient's family.322.25    Sec. 28. Minnesota Statutes 2006, section 144D.03, subdivision 1, is amended to read:322.26    Subdivision 1. Registration procedures. The commissioner shall establish forms 322.27and procedures for annual registration of housing with services establishments. The 322.28commissioner shall charge an annual registration fee of $35 $155. No fee shall be 322.29refunded. A registered establishment shall notify the commissioner within 30 days of the 322.30date it is no longer required to be registered under this chapter or of any change in the 322.31business name or address of the establishment, the name or mailing address of the owner 322.32or owners, or the name or mailing address of the managing agent. There shall be no 322.33fee for submission of the notice.323.1    Sec. 29. Minnesota Statutes 2006, section 145.412, is amended by adding a subdivision 323.2to read:323.3    Subd. 2a.Sex selection.It shall be unlawful to willfully perform an abortion, based 323.4on the sex of the unborn child, upon a woman known to be pregnant.323.5    Sec. 30. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.323.6    Subdivision 1.Definitions.For purposes of this section, "federally qualified health 323.7center" means an entity that is receiving a grant under United States Code, title 42, 323.8section 254b, or, based on the recommendation of the Health Resources and Services 323.9Administration within the Public Health Service, is determined by the secretary to meet 323.10the requirements for receiving such a grant.323.11    Subd. 2.Allocation of subsidies.The commissioner of health shall distribute 323.12subsidies to federally qualified health centers operating in Minnesota to continue, expand, 323.13and improve federally qualified health center services to low-income populations. The 323.14commissioner shall distribute the funds appropriated under this section to federally 323.15qualified health centers operating in Minnesota as of January 1, 2007. The amount of 323.16each subsidy shall be in proportion to each federally qualified health center's amount of 323.17discounts granted to patients during calendar year 2006 as reported on the federal Uniform 323.18Data System report in conformance with the Bureau of Primary Health Care Program 323.19Expectations Policy Information Notice 98-23, except that each eligible federally qualified 323.20health center shall receive at least two percent but no more than 30 percent of the total 323.21amount of money available under this section.323.22    Sec. 31. Minnesota Statutes 2006, section 145C.05, is amended to read:323.23145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.323.24    Subdivision 1. Content. A health care directive executed pursuant to this chapter 323.25may, but need not, be in the form contained in section 
         145C.16. 323.26    Subd. 2. Provisions that may be included. (a) A health care directive may include 323.27provisions consistent with this chapter, including, but not limited to:323.28    (1) the designation of one or more alternate health care agents to act if the named 323.29health care agent is not reasonably available to serve;323.30    (2) directions to joint health care agents regarding the process or standards by which 323.31the health care agents are to reach a health care decision for the principal, and a statement 323.32whether joint health care agents may act independently of one another;323.33    (3) limitations, if any, on the right of the health care agent or any alternate health 323.34care agents to receive, review, obtain copies of, and consent to the disclosure of the 324.1principal's medical records or to visit the principal when the principal is a patient in a 324.2health care facility;324.3    (4) limitations, if any, on the nomination of the health care agent as guardian for 324.4purposes of sections 
         524.5-202, 
         524.5-211, 
         524.5-302, and 
         524.5-303; 324.5    (5) a document of gift for the purpose of making an anatomical gift, as set forth in 324.6sections 
         525.921 to 
         525.9224, or an amendment to, revocation of, or refusal to make 324.7an anatomical gift; 324.8    (6) a declaration regarding intrusive mental health treatment under section 
         253B.03, 324.9subdivision 6d
         , or a statement that the health care agent is authorized to give consent for 324.10the principal under section 
         253B.04, subdivision 1a; 324.11    (7) a funeral directive as provided in section 
         149A.80, subdivision 2; 324.12    (8) limitations, if any, to the effect of dissolution or annulment of marriage or 324.13termination of domestic partnership on the appointment of a health care agent under 324.14section 
         145C.09, subdivision 2; 324.15    (9) specific reasons why a principal wants a health care provider or an employee 324.16of a health care provider attending the principal to be eligible to act as the principal's 324.17health care agent;324.18    (10) health care instructions by a woman of child bearing age regarding how she 324.19would like her pregnancy, if any, to affect health care decisions made on her behalf; and324.20    (11) health care instructions regarding artificially administered nutrition or hydration.324.21    (b) A health care directive may include a statement of the circumstances under 324.22which the directive becomes effective other than upon the judgment of the principal's 324.23attending physician in the following situations:324.24    (1) a principal who in good faith generally selects and depends upon spiritual means 324.25or prayer for the treatment or care of disease or remedial care and does not have an 324.26attending physician, may include a statement appointing an individual who may determine 324.27the principal's decision-making capacity; and324.28    (2) a principal who in good faith does not generally select a physician or a health 324.29care facility for the principal's health care needs may include a statement appointing an 324.30individual who may determine the principal's decision-making capacity, provided that if 324.31the need to determine the principal's capacity arises when the principal is receiving care 324.32under the direction of an attending physician in a health care facility, the determination 324.33must be made by an attending physician after consultation with the appointed individual.324.34    If a person appointed under clause (1) or (2) is not reasonably available and the 324.35principal is receiving care under the direction of an attending physician in a health care 324.36facility, an attending physician shall determine the principal's decision-making capacity.325.1    (c) A health care directive may authorize a health care agent to make health care 325.2decisions for a principal even though the principal retains decision-making capacity.325.3    Sec. 32. [146B.01] DEFINITIONS.325.4    Subdivision 1.Applicability.The definitions in this section apply to this chapter.325.5    Subd. 2.Certified doula."Certified doula" means an individual who has received 325.6a certification to perform doula services from the International Childbirth Education 325.7Association, the Doulas of North America (DONA), the Association of Labor Assistants 325.8and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional 325.9Association (CAPPA), or Childbirth International.325.10    Subd. 3.Commissioner."Commissioner" means the commissioner of health.325.11    Subd. 4.Doula services."Doula services" means emotional and physical support 325.12during pregnancy, labor, birth, and postpartum.325.13EFFECTIVE DATE.This section is effective July 1, 2007.325.14    Sec. 33. [146B.02] REGISTRY.325.15    Subdivision 1.Establishment.The commissioner of health shall maintain a registry 325.16of certified doulas who have met the requirements listed in subdivision 2.325.17    Subd. 2.Qualifications.The commissioner shall include on the registry any 325.18individual who:325.19    (1) submits an application on a form provided by the commissioner. The form must 325.20include the applicant's name, address, and contact information;325.21    (2) maintains a current certification from one of the organizations listed in section 325.22146B.01, subdivision 2;325.23    (3) completes a criminal background check; and325.24    (4) pays the fees required under section 146B.04.325.25    Subd. 3.Renewal.Inclusion on the registry maintained by the commissioner is 325.26valid for three years. At the end of the three-year period, the certified doula may submit a 325.27new application to remain on the doula registry by meeting the requirements described in 325.28subdivision 2.325.29EFFECTIVE DATE.This section is effective July 1, 2007.325.30    Sec. 34. [146B.03] COMMISSIONER DUTIES.325.31    The commissioner shall establish and maintain the doula registry and: 325.32    (1) provide registry application forms;326.1    (2) complete the criminal background checks on registry applicants; and326.2    (3) maintain public access to the registry by providing a link to the registry on the 326.3Department of Health's Web site.326.4EFFECTIVE DATE.This section is effective July 1, 2007.326.5    Sec. 35. [146B.04] FEES.326.6    The application fee is $142 every three years, which includes the cost of a criminal 326.7background check. This fee is nonrefundable.326.8EFFECTIVE DATE.This section is effective July 1, 2007.326.9    Sec. 36. Minnesota Statutes 2006, section 145C.07, is amended by adding a 326.10subdivision to read:326.11    Subd. 5.Visitation.A health care agent may visit the principal when the 326.12principal is a patient in a health care facility regardless of whether the principal retains 326.13decision-making capacity, unless:326.14    (1) the principal has otherwise specified in the health care directive;326.15    (2) a principal who retains decision-making capacity indicates otherwise; or326.16    (3) a health care provider reasonably determines that the principal must be isolated 326.17from all visitors or that the presence of the health care agent would endanger the health or 326.18safety of the principal, other patients, or the facility in which the care is being provided.326.19    Sec. 37. Minnesota Statutes 2006, section 148.6445, subdivision 1, is amended to read:326.20    Subdivision 1. Initial licensure fee. The initial licensure fee for occupational 326.21therapists is $180 $145. The initial licensure fee for occupational therapy assistants is 326.22$100 $80. The commissioner shall prorate fees based on the number of quarters remaining 326.23in the biennial licensure period.326.24    Sec. 38. Minnesota Statutes 2006, section 148.6445, subdivision 2, is amended to read:326.25    Subd. 2. Licensure renewal fee. The biennial licensure renewal fee for 326.26occupational therapists is $180 $145. The biennial licensure renewal fee for occupational 326.27therapy assistants is $100 $80.326.28    Sec. 39. [148.785] FEES.326.29    The fees charged by the board are fixed at the following rates:326.30    (1) application fee for physical therapists and physical therapist assistants, $100;327.1    (2) annual licensure for physical therapists and physical therapist assistants, $60;327.2    (3) licensure renewal late fee, $20;327.3    (4) temporary permit, $25;327.4    (5) duplicate license or registration, $20;327.5    (6) certification letter, $25;327.6    (7) education or training program approval, $100;327.7    (8) report creation and generation, $60 per hour billed in quarter-hour increments 327.8with a quarter-hour minimum; and327.9    (9) examination administration:327.10    (i) half day, $50; and327.11    (ii) full day, $80.327.12    Sec. 40. Minnesota Statutes 2006, section 148B.53, subdivision 3, is amended to read:327.13    Subd. 3. Fee. Nonrefundable fees are as follows:327.14    (1) initial license application fee for licensed professional counseling (LPC) - $250327.15$150;327.16    (2) initial license fee for LPC - $250;327.17    (3) annual active license renewal fee for LPC - $200 $250 or equivalent;327.18    (3) (4) annual inactive license renewal fee for LPC - $100 $125;327.19    (5) initial license application fee for licensed professional clinical counseling 327.20(LPCC) - $150;327.21    (6) initial license fee for LPCC - $250;327.22    (7) annual active license renewal fee for LPCC - $250 or equivalent;327.23    (8) annual inactive license renewal fee for LPCC - $125;327.24    (4) (9) license renewal late fee - $100 per month or portion thereof;327.25    (5) (10) copy of board order or stipulation - $10;327.26    (6) (11) certificate of good standing or license verification - $10 $25;327.27    (7) (12) duplicate certificate fee - $10 $25;327.28    (8) (13) professional firm renewal fee - $25;327.29    (9) (14) sponsor application for approval of a continuing education course - $60;327.30    (15) initial registration fee - $50; and327.31    (10) (16) annual registration renewal fee - $25; and327.32    (17) approved supervisor application processing fee - $30.327.33    Sec. 41. Minnesota Statutes 2006, section 149A.52, subdivision 3, is amended to read:328.1    Subd. 3. Application procedure; documentation; initial inspection. An applicant 328.2for a license to operate a crematory shall submit to the commissioner a completed 328.3application. A completed application includes:328.4    (1) a completed application form, as provided by the commissioner;328.5    (2) proof of business form and ownership; and328.6    (3) proof of liability insurance coverage or other financial documentation, as 328.7determined by the commissioner, that demonstrates the applicant's ability to respond in 328.8damages for liability arising from the ownership, maintenance, management, or operation 328.9of a crematory.328.10    Upon receipt of the application and appropriate fee, the commissioner shall review 328.11and verify all information. Upon completion of the verification process and resolution 328.12of any deficiencies in the application information, the commissioner shall conduct an 328.13initial inspection of the premises to be licensed. After the inspection and resolution of 328.14any deficiencies found and any reinspections as may be necessary, the commissioner shall 328.15make a determination, based on all the information available, to grant or deny licensure. If 328.16the commissioner's determination is to grant the license, the applicant shall be notified and 328.17the license shall issue and remain valid for a period prescribed on the license, but not to 328.18exceed one calendar year from the date of issuance of the license. If the commissioner's 328.19determination is to deny the license, the commissioner must notify the applicant, in 328.20writing, of the denial and provide the specific reason for denial.328.21    Sec. 42. [149A.65] FEES.328.22    Subdivision 1.Generally.This section establishes the fees for registrations, 328.23examinations, initial and renewal licenses, and late fees authorized under the provisions 328.24of this chapter.328.25    Subd. 2.Mortuary science fees.Fees for mortuary science are:328.26    (1) $50 for the initial and renewal registration of a mortuary science intern;328.27    (2) $100 for the mortuary science examination;328.28    (3) $125 for issuance of initial and renewal mortuary science licenses;328.29    (4) $25 late fee charge for a license renewal; and328.30    (5) $200 for issuing a mortuary science license by endorsement.328.31    Subd. 3.Funeral directors.The license renewal fee for funeral directors is $125. 328.32The late fee charge for a license renewal is $25.328.33    Subd. 4.Funeral establishments.The initial and renewal fee for funeral 328.34establishments is $300. The late fee charge for a license renewal is $25.329.1    Subd. 5.Crematories.The initial and renewal fee for a crematory is $300. The 329.2late fee charge for a license renewal is $25.329.3    Sec. 43. Minnesota Statutes 2006, section 149A.97, subdivision 7, is amended to read:329.4    Subd. 7. Reports to commissioner. Every funeral provider lawfully doing business 329.5in Minnesota that accepts funds under subdivision 2 must make a complete annual report 329.6to the commissioner. The reports may be on forms provided by the commissioner or 329.7substantially similar forms containing, at least, identification and the state of each trust 329.8account, including all transactions involving principal and accrued interest, and must be 329.9filed by March 31 of the calendar year following the reporting year along with a filing 329.10fee of $15 $25 for each report. Fees shall be paid to the commissioner of finance, state of 329.11Minnesota, for deposit in the state government special revenue fund in the state treasury. 329.12Reports must be signed by an authorized representative of the funeral provider and 329.13notarized under oath. All reports to the commissioner shall be reviewed for account 329.14inaccuracies or possible violations of this section. If the commissioner has a reasonable 329.15belief to suspect that there are account irregularities or possible violations of this section, 329.16the commissioner shall report that belief, in a timely manner, to the state auditor. The 329.17commissioner shall also file an annual letter with the state auditor disclosing whether or 329.18not any irregularities or possible violations were detected in review of the annual trust 329.19fund reports filed by the funeral providers. This letter shall be filed with the state auditor 329.20by May 31 of the calendar year following the reporting year.329.21    Sec. 44. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:329.22    Subdivision 1. License required annually. A license is required annually for every 329.23person, firm, or corporation engaged in the business of conducting a food and beverage 329.24service establishment, hotel, motel, lodging establishment, or resort. Any person wishing 329.25to operate a place of business licensed in this section shall first make application, pay the 329.26required fee specified in this section, and receive approval for operation, including plan 329.27review approval. Seasonal and temporary food stands and special event food stands are 329.28not required to submit plans. Nonprofit organizations operating a special event food 329.29stand with multiple locations at an annual one-day event shall be issued only one license. 329.30Application shall be made on forms provided by the commissioner and shall require 329.31the applicant to state the full name and address of the owner of the building, structure, 329.32or enclosure, the lessee and manager of the food and beverage service establishment, 329.33hotel, motel, lodging establishment, or resort; the name under which the business is to 330.1be conducted; and any other information as may be required by the commissioner to 330.2complete the application for license.330.3    Sec. 45. HEALTH PROMOTION PROGRAM.330.4    The State Community Health Services Advisory Committee established in 330.5Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to fund and 330.6implement an ongoing comprehensive health promotion program that can effect change 330.7more effectively and at lower cost at a community level rather than through individual 330.8counseling and change promotion. The program shall use proven public health strategies 330.9to promote healthy lifestyles and behaviors in order to establish a sustainable, long-term 330.10approach to reducing preventable disability, chronic health conditions, and disease. The 330.11focus shall be on community based initiatives that address childhood and adult obesity, 330.12tobacco and substance abuse, improved activity levels among senior citizens, and other 330.13lifestyle issues that impact health and healthcare costs. Because of its population health 330.14focus, funding shall be related to the size of the population to be served. The plan shall be 330.15completed by September 15, 2007, and shared with the Legislative Health Care Access 330.16Commission.330.17    Sec. 46. INJUNCTIVE RELIEF REPORT.330.18    The commissioner of health shall present to the 2008 legislature, by December 15, 330.192007, recommendations to fund the cost of bringing actions for injunctive relief under 330.20Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).330.21    Sec. 47. DIAGNOSTIC IMAGING SERVICES ADVISORY COMMITTEE; 330.22ESTABLISHMENT.330.23    (a) The commissioner of health shall establish a Diagnostic Imaging Services 330.24Advisory Committee to perform the following duties:330.25    (1) gather and analyze data to understand the factors driving utilization of diagnostic 330.26imaging services, including computed tomography (CT), magnetic resonance imaging 330.27(MRI), positron emission tomography (PET), magnetic resonance angiography (MRA), 330.28and nuclear cardiology, in the state relative to evidence-based guidelines; and330.29    (2) develop recommendations, based on the data collected, on how to improve 330.30the delivery of evidence-based diagnostic imaging services. In developing these 330.31recommendations, the advisory committee shall consider the impacts on patient care, 330.32premium costs, and administrative simplicity.331.1    (b) The members of the Diagnostic Imaging Services Advisory Committee shall 331.2include the commissioners of health and human services or the commissioners' designees 331.3and the following:331.4    (1) three physicians representing speciality and geographic diversity, appointed by 331.5the Minnesota Medical Association;331.6    (2) two hospital representatives, one from a metropolitan hospital and one from a 331.7rural hospital, appointed by the Minnesota Hospital Association;331.8    (3) three health plan company representatives appointed by the Minnesota Council 331.9of Health Plans;331.10    (4) two representatives appointed by the Institute for Clinical System Improvement; 331.11and331.12    (5) one clinic manager appointed by the Minnesota Medical Group Management 331.13Association.331.14    (c) The Diagnostic Imaging Services Advisory Committee shall convene no later 331.15than September 1, 2007. The commissioner shall report back to the legislature no later 331.16than January 15, 2008. The advisory committee is governed under Minnesota Statutes, 331.17section 15.059, except that members shall not receive a per diem and may only be 331.18reimbursed for expenses.331.19    (d) A strategy to improve the delivery of evidence-based diagnostic imaging services 331.20may be developed by health plans. The commissioner of health shall report the agreement 331.21to the chairs of the senate and house health care committees immediately.331.22EFFECTIVE DATE.This section is effective July 1, 2007.331.23    Sec. 48. HEARING AID DISPENSER FEES.331.24    Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section 331.25153A.17, may not be increased until after the Department of Health provides a report to 331.26the legislature regarding the need and reasons for fee increases.331.27    Sec. 49. REVISOR'S INSTRUCTION.331.28    In Minnesota Statutes and Minnesota Rules, the revisor shall change the references 331.29in column A with the references in column B.

331.30Column AColumn B331.31section 144.335sections 144.291 to 144.298331.32section 144.335, subdivision 1section 144.291, subdivision 2331.33331.34section 144.335, subdivision 1, paragraph (b)section 144.291, subdivision 2, paragraph (h)332.1332.2section 144.335, subdivision 2, paragraphs (a) and (b)section 144.292, subdivisions 2 and 5332.3section 144.335, subdivision 2section 144.292332.4section 144.335, subdivision 3asection 144.294, subdivision 2332.5332.6section 144.335, subdivision 3a, paragraph (d)section 144.295332.7332.8section 144.335, subdivision 3a, paragraph (f)section 144.294332.9section 144.335, subdivision 3bsection 144.293, subdivision 7

332.10    Sec. 50.  REPEALER.332.11(a) Minnesota Statutes 2006, section 144.335, is repealed.332.12(b) Minnesota Statutes 2006, section 62J.17, subdivisions 1, 5a, 6a, and 8, are 332.13repealed.332.14(c) Minnesota Rules, part 4610.2800, is repealed.332.15ARTICLE 7332.16MISCELLANEOUS332.17    Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a 332.18subdivision to read:332.19    Subd. 2a.Base budget detail.Within one week of the release of the budget forecasts 332.20required in section 16A.102 in November of an even-numbered year and February of an 332.21odd-numbered year, the commissioner, after consulting with the commissioners of human 332.22services and health, must provide to the legislature information at the program, budget 332.23activity and management activity level for the base level budget of the Department of 332.24Human Services and the Department of Health for the next biennium. The information 332.25must be organized in a manner that explains how base level budget appropriations are 332.26projected to be spent. Within one week of the release of the budget forecasts required in 332.27section 16A.102 in November of an even-numbered year, the commissioner must also 332.28provide the legislature with the information submitted by the commissioners of human 332.29services and health under subdivision 2, clauses (3) and (4).332.30    Sec. 2. Minnesota Statutes 2006, section 43A.316, is amended to read:332.3143A.316 PUBLIC EMPLOYEES INSURANCE PROGRAM.332.32    Subdivision 1. Intent. The legislature finds that the creation of a statewide program 332.33to provide public employees and other eligible persons with life insurance and hospital, 332.34medical, and dental benefit coverage through provider organizations would result in a 333.1greater utilization more efficient use of government resources and would advance the 333.2health and welfare of the citizens of the state.333.3    Subd. 2. Definitions. For the purpose of this section, the terms defined in this 333.4subdivision have the meaning given them.333.5    (a)  Commissioner. "Commissioner" means the commissioner of employee relations. 333.6    (b)  Employee. "Employee" means: 333.7    (1) a person who is a public employee within the definition of section 
         179A.03, 333.8subdivision 14
         , who is insurance eligible and is employed by an eligible employer; 333.9    (2) an elected public official of an eligible employer who is insurance eligible;333.10    (3) a person employed by a labor organization or employee association certified as 333.11an exclusive representative of employees of an eligible employer or by another public 333.12employer approved by the commissioner, so long as the plan meets the requirements of a 333.13governmental plan under United States Code, title 29, section 1002(32); or333.14    (4) a person employed by a county or municipal hospital.333.15    (c)  Eligible employer. "Eligible employer" means: 333.16    (1) a public employer within the definition of section 
         179A.03, subdivision 15, that 333.17is a town, county, city, school district as defined in section 
         120A.05, service cooperative 333.18as defined in section 
         123A.21, intermediate district as defined in section 
         136D.01, 333.19Cooperative Center for Vocational Education as defined in section 
         123A.22, regional 333.20management information center as defined in section 
         123A.23, or an education unit 333.21organized under the joint powers action, section 
         471.59; or 333.22    (2) an exclusive representative of employees, as defined in paragraph (b);333.23    (3) a county or municipal hospital; or333.24    (4) another public employer approved by the commissioner.333.25    (d)  Exclusive representative. "Exclusive representative" means an exclusive 333.26representative as defined in section 
         179A.03, subdivision 8. 333.27    (e)  Labor-Management Committee. "Labor-Management Committee" means the 333.28committee established by subdivision 4. 333.29    (f)  Program. "Program" means the statewide public employees insurance program 333.30created by subdivision 3. 333.31    Subd. 3. Public employee insurance program. The commissioner shall be the 333.32administrator of the public employee insurance program and may determine its funding 333.33arrangements. The commissioner may contract with a qualified entity to perform the 333.34administrative functions. The commissioner shall model the program after the plan 333.35established in section 
         43A.18, subdivision 2, but may modify adopt variations from that 334.1plan, in consultation with the Labor-Management Committee. The variations may include 334.2different deductibles, coinsurance, co-pays, or other enrollee cost-sharing provisions.334.3    Subd. 4. Labor-Management Committee. The Labor-Management Committee 334.4consists of ten members appointed by the commissioner. The Labor-Management 334.5Committee must comprise five members who represent employees, including at least 334.6one retired employee, and five members who represent eligible employers. Committee 334.7members are eligible for expense reimbursement in the same manner and amount as 334.8authorized by the commissioner's plan adopted under section 
         43A.18, subdivision 2. The 334.9commissioner shall consult with the labor-management committee in major decisions 334.10that affect the program. The committee shall study issues and make recommendations 334.11relating to the insurance program including, but not limited to, flexible benefits, utilization 334.12review, quality assessment, and cost efficiency. The committee continues to exist while 334.13the program remains in operation. 334.14    Subd. 5. Public employee participation. (a) Participation in the program is subject 334.15to the conditions in this subdivision.334.16    (b) Each exclusive representative for an eligible employer determines whether the 334.17employees it represents will participate in the program. The exclusive representative shall 334.18give the employer notice of intent to participate at least 30 60 days before the expiration 334.19date of the collective bargaining agreement preceding the collective bargaining agreement 334.20that covers the date of entry into the program. Either all or none of the employees 334.21represented by an exclusive representative must participate. The exclusive representative 334.22and the eligible employer shall give notice to the commissioner of the determination to 334.23participate in the program at least 30 60 days before entry into the program. Entry into the 334.24program is governed by a schedule established by the commissioner.334.25    (c) Employees not represented by exclusive representatives may become members 334.26of the program upon a determination of an eligible employer to include these employees 334.27in the program. Either all or none of the employer's unrepresented employees must 334.28participate. The eligible employer shall give at least 30 60 days' notice to the commissioner 334.29before entering the program. Entry into the program is governed by a schedule established 334.30by the commissioner.334.31    (d) Participation in the program is for a two-year three-year term. Participation is 334.32automatically renewed for an additional two-year three-year term unless the exclusive 334.33representative, or the employer for unrepresented employees, gives the commissioner 334.34notice of withdrawal at least 30 60 days before expiration of the participation period. A 334.35group that withdraws must wait two years before rejoining, except with the approval of 334.36the commissioner. An exclusive representative, or employer for unrepresented employees, 335.1may also withdraw if premiums increase 50 percent by more than 20 percent in excess of 335.2the Consumer Price Index for all urban consumers or more from one insurance year to 335.3the next.335.4    (e) The exclusive representative shall give the employer notice of intent to withdraw 335.5to the commissioner at least 30 60 days before the expiration date of a collective 335.6bargaining agreement that includes the date on which the term of participation expires.335.7    (f) Each participating eligible employer shall notify the commissioner of the names 335.8of individuals who will be participating within two weeks of after the commissioner 335.9receiving receives notice of the parties' intent to participate. The employer shall also 335.10submit other information as required by the commissioner for administration of the 335.11program.335.12    (g) An employer that withdraws from the program under circumstances that do not 335.13permit withdrawal under this subdivision is liable to the board for premiums payable by 335.14the employer until the time that the employer is eligible to withdraw, and the employer 335.15shall pay those premiums voluntarily and no later than their due date. If the premiums are 335.16not paid voluntarily, the board has authority to and shall collect these premiums under any 335.17method permitted by law for a governmental or nongovernmental creditor of the employer.335.18    Subd. 6. Coverage. (a) By January 1, 1989, The commissioner shall announce the 335.19benefits of the program. The program shall include employee hospital, medical, dental, 335.20and life insurance for employees and hospital and medical benefits for dependents. Health 335.21maintenance organization options and other delivery system options may be provided if 335.22they are available, cost-effective, and capable of servicing the number of people covered 335.23in the program. Participation in optional coverages may be provided by collective 335.24bargaining agreements. For employees not represented by an exclusive representative, the 335.25employer may offer the optional coverages to eligible employees and their dependents 335.26provided in the program. Health coverage must include at least the benefits required of a 335.27health plan company regulated under chapter 62A, 62C, or 62D.335.28    (b) The commissioner, with the assistance of the Labor-Management Committee, 335.29shall periodically assess whether it is financially feasible for the program to offer or to 335.30continue an individual retiree program that has competitive premium rates and benefits. 335.31If the commissioner determines it to be feasible to offer an individual retiree program, 335.32the commissioner shall announce the applicable benefits, premium rates, and terms of 335.33participation. Eligibility to participate in the individual retiree program is governed by 335.34subdivision 8, but applies to retirees of eligible employers that do not participate in the 335.35program and to those retirees' dependents and surviving spouses.336.1    Subd. 6a. Chiropractic services Choice of type of provider. All benefits provided 336.2by the program or a successor program relating to expenses incurred for medical treatment 336.3or services of a physician health care provider must also include chiropractic treatment 336.4and services of a chiropractor any other type of licensed, certified, or registered health care 336.5provider to the extent that the chiropractic services and treatment are within the scope of 336.6chiropractic licensure the provider's licensure, certification, or registration.336.7    This subdivision is intended to provide equal access to benefits for program members 336.8who choose to obtain treatment for illness or injury from a doctor of chiropractic, as long 336.9as the treatment falls within the chiropractor's scope of practice. This subdivision is not 336.10intended to change or add to the benefits provided for in the program.336.11    Subd. 7. Premiums.(a) The proportion of premium paid by the employer and 336.12employee is subject to collective bargaining or personnel policies. If, at the beginning of 336.13the coverage period, no collective bargaining agreement has been finalized, the increased 336.14dollar costs, if any, from the previous year is the sole responsibility of the individual 336.15participant until a collective bargaining agreement states otherwise. Premiums, including 336.16an administration fee, shall be established by the commissioner. The commissioner may 336.17decide to rate specific employers separately for premium purposes, if the commissioner 336.18determines that doing so is in the best interests of the program. Each employer shall pay 336.19monthly the amounts due for employee benefits including the amounts under subdivision 336.208 to the commissioner no later than the dates established by the commissioner. If an 336.21employer fails to make the payments as required, the commissioner may shall cancel 336.22program benefits and pursue other civil remedies, as provided in subdivision 5, paragraph 336.23(d).336.24    (b) The premium charged for an employer's first month in the program must be 336.25three times the regular monthly premium charged to that employer, to help establish 336.26and maintain the program's financial resources. The extra two months premium must 336.27be refunded to the employer if the employer leaves the program, if the refund would 336.28not reduce the program's reserves below the level determined to be appropriate by the 336.29commissioner.336.30    Subd. 8. Continuation of coverage. (a) A former employee of an employer 336.31participating in the program who is receiving a public pension disability benefit or an 336.32annuity or has met the age and service requirements necessary to receive an annuity under 336.33chapter 353, 353C, 354, 354A, 356, 422A, 423, 423A, or 424, and the former employee's 336.34dependents, are eligible to participate in the program. This participation is at the person's 336.35expense unless a collective bargaining agreement or personnel policy provides otherwise. 336.36Premiums for these participants must be established by the commissioner.337.1    The commissioner may provide policy exclusions for preexisting conditions 337.2only when there is a break in coverage between a participant's coverage under the 337.3employment-based group insurance program and the participant's coverage under this 337.4section. An employer shall notify an employee of the option to participate under this 337.5paragraph no later than the effective date of retirement. The retired employee or the 337.6employer of a participating group on behalf of a current or retired employee shall notify 337.7the commissioner within 30 days of the effective date of retirement of intent to participate 337.8in the program according to the rules established by the commissioner.337.9    (b) The spouse of a deceased employee or former employee may purchase the 337.10benefits provided at premiums established by the commissioner if the spouse was a 337.11dependent under the employee's or former employee's coverage under this section at the 337.12time of the death. The spouse remains eligible to participate in the program as long as 337.13the group that included the deceased employee or former employee participates in the 337.14program. Coverage under this clause must be coordinated with relevant insurance benefits 337.15provided through the federally sponsored Medicare program.337.16    (c) The program benefits must continue in the event of strike permitted by section 337.17179A.18
         , if the exclusive representative chooses to have coverage continue and the 337.18employee pays the total monthly premiums when due. 337.19    (d) A participant who discontinues coverage may not reenroll.337.20    (d) Persons participating under these paragraphs this subdivision shall make 337.21appropriate premium payments in the time and manner established by the commissioner.337.22They are not subject to the payment of the extra payments required under subdivision 7, 337.23paragraph (b).337.24    Subd. 9. Insurance trust fund. The insurance trust fund in the state treasury 337.25consists of deposits of the premiums received from employers participating in the 337.26program and transfers before July 1, 1994, from the excess contributions holding account 337.27established by section 
         353.65, subdivision 7. All money in the fund is appropriated to 337.28the commissioner to pay insurance premiums, approved claims, refunds, administrative 337.29costs, and other related service costs. Premiums paid by employers to the fund are exempt 337.30from the taxes imposed by chapter 297I. The commissioner shall reserve an amount of 337.31money to cover the estimated costs of claims incurred but unpaid. The State Board of 337.32Investment shall invest the money according to section 
         11A.24. Investment income and 337.33losses attributable to the fund must be credited to the fund. 337.34    Subd. 10. Exemption. The public employee insurance program and, where 337.35applicable, the employers participating in it are exempt from chapters 60A, 62A, 62C, 338.162D, 62E, and 62H, section 
         471.617, subdivisions 2 and 3, and the bidding requirements 338.2of section 
         471.6161, except as otherwise provided in subdivision 6, paragraph (a). 338.3    Subd. 11.Reinsurance.The commissioner may, on behalf of the program, 338.4participate in an insured or self-insured reinsurance pool.338.5    Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:338.662H.02 REQUIRED PROVISIONS.338.7    (a) A joint self-insurance plan must include aggregate excess stop-loss coverage and 338.8individual excess stop-loss coverage provided by an insurance company licensed by the 338.9state of Minnesota. 338.10    (b) Aggregate excess stop-loss coverage must include provisions to cover incurred, 338.11unpaid claim liability in the event of plan termination. In addition,338.12    (c) The plan of self-insurance must have participating employers fund an amount at 338.13least equal to the point at which the excess or stop-loss insurer has contracted to assume 338.14100 percent of additional liability. 338.15    (d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance 338.16contract to the commissioner of commerce at least 30 days prior to the proposed plan's 338.17effective date and at least 30 days subsequent to any renewal date. The commissioner shall 338.18review the contract to determine if they meet the standards established by sections 
         62H.01338.19to 
         62H.08 and respond within a 30-day period. 338.20    (e) Any excess or stop-loss insurance plan must contain a provision that the excess 338.21or stop-loss insurer will give the plan and the commissioner of commerce a minimum of 338.22180 days' notice of termination or nonrenewal. If the plan fails to secure replacement 338.23coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the 338.24commissioner shall issue an order providing for the orderly termination of the plan. 338.25    (f) The commissioner may waive the requirements of this section and of any rule 338.26relating to the requirements of this section, if the commissioner determines that a joint 338.27self-insurance plan has established alternative arrangements that fully fund the plan's 338.28liability or incurred but unpaid claims. The commissioner may not waive the requirement 338.29that a joint self-insurance plan have excess stop-loss coverage. 338.30EFFECTIVE DATE.This section is effective the day following final enactment.338.31    Sec. 4. [62Q.40] LANGUAGE INTERPRETER SERVICES.338.32    (a) A health plan must cover sign language interpreter services provided to deaf and 338.33hard-of-hearing enrollees and language interpreter services provided to enrollees with 339.1limited English proficiency in order to facilitate the provision of health care services by a 339.2provider. For purposes of this section, "provider" has the meaning given in section 62J.03, 339.3subdivision 8, and includes a health care provider facility; and "health plan" includes 339.4coverage excluded under section 62A.011, subdivision 3, clauses (6), (7), (9), and (10). 339.5Interpreter services may be provided in person, by telephone, facsimile, video or audio 339.6streaming, or by video conference. In accordance with paragraphs (b) and (c), a health 339.7plan company shall reimburse either the party providing interpreter services directly 339.8for the costs of language interpreter services provided to the enrollee or the provider 339.9arranging for the provision of interpreter services. Providers that employ or contract 339.10with interpreters may bill and shall be reimbursed directly by health plan companies for 339.11such services in accordance with paragraph (b). A health plan company shall provide to 339.12enrollees, upon request, the policies and procedures for addressing the needs of deaf and 339.13hard-of-hearing enrollees and enrollees with limited English proficiency. All parties 339.14providing interpreter services must disclose their methods for ensuring competency upon 339.15request of any health plan company, provider, or consumer.339.16    (b) A health plan company shall pay for interpreter services as required in paragraph 339.17(a) by establishing a network of interpreter service providers and requiring use of its own 339.18network of interpreter services providers. The health plan company shall consider, as part 339.19of its interpreter service provider network, entering into an agreement with a provider for 339.20use of an interpreter service provider employed by or under contract with the provider if:339.21    (1) the provider accepts as reimbursement for services rendered by the provider's 339.22employed or contracted interpreter service provider the lesser of either the health plan 339.23company's reimbursement rate for its in-network interpreter service providers or the 339.24provider's fee for services rendered by the provider's interpreter service provider; and339.25    (2) the interpreter service provider meets the published quality standards of the 339.26health plan company.339.27    (c) If a health plan company's or a provider's employed or contracted interpreter 339.28service provider is unavailable to provide interpreter services, the health plan company 339.29shall reimburse the interpreter service provider at the lesser of the health plan company's 339.30median reimbursement rate for its in-network interpreter service providers or the 339.31interpreter service provider's fee. An interpreter service provider not employed or under 339.32contract with a health plan company or provider who fails to meet the quality standards 339.33of a health plan company or as required by law, shall be ineligible for reimbursement 339.34under this section.339.35    (d) If the health plan company pays the interpreter service provider directly, it has no 339.36obligation to pay the provider under this section.340.1    (e) Nothing in this section requires a health plan company to establish a network 340.2of interpreter service providers.340.3EFFECTIVE DATE.This section is effective July 1, 2008, and applies to plans 340.4issued or renewed to provide coverage to Minnesota residents on or after that date unless 340.5the legislature enacts alternative funding sources based on the recommendations of the 340.6commissioner.340.7    Sec. 5. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision 340.8to read:340.9    Subd. 5.Base budget detail.The commissioner shall provide the commissioner 340.10of finance with the information necessary to provide base budget detail to the legislature 340.11under section 16A.10, subdivision 2a.340.12    Sec. 6. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision 340.13to read:340.14    Subd. 11.Dispensing by protocol.A registered nurse in a family planning agency 340.15as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives 340.16prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant 340.17to a dispensing protocol established by the agency's medical director or under the direction 340.18of a physician. The dispensing protocol must address the requirements of sections 151.01, 340.19subdivision 30, and 151.212, subdivision 1.340.20    Sec. 7. Minnesota Statutes 2006, section 151.19, subdivision 2, is amended to read:340.21    Subd. 2. Nonresident pharmacies. The board shall require and provide for an 340.22annual nonresident special pharmacy registration for all pharmacies located outside of this 340.23state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 340.24prescription medications into this state. Nonresident special pharmacy registration shall 340.25be granted by the board upon the disclosure and certification by a pharmacy:340.26    (1) that it is licensed in the state in which the dispensing facility is located and from 340.27which the drugs are dispensed;340.28    (2) the location, names, and titles of all principal corporate officers and all 340.29pharmacists who are dispensing drugs to residents of this state;340.30    (3) that it complies with all lawful directions and requests for information from 340.31the Board of Pharmacy of all states in which it is licensed or registered, except that it 340.32shall respond directly to all communications from the board concerning emergency 340.33circumstances arising from the dispensing of drugs to residents of this state;341.1    (4) that it maintains its records of drugs dispensed to residents of this state so that the 341.2records are readily retrievable from the records of other drugs dispensed;341.3    (5) that it cooperates with the board in providing information to the Board of 341.4Pharmacy of the state in which it is licensed concerning matters related to the dispensing 341.5of drugs to residents of this state; and341.6    (6) that during its regular hours of operation, but not less than six days per week, for 341.7a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 341.8communication between patients in this state and a pharmacist at the pharmacy who has 341.9access to the patients' records; the toll-free number must be disclosed on the label affixed 341.10to each container of drugs dispensed to residents of this state.; and341.11    (7) that, upon request of a resident of a long-term care facility located within the 341.12state of Minnesota or by an agent of the resident, the pharmacy will dispense medications 341.13prescribed for the resident in unit-dose packaging or, alternatively, comply with the 341.14provisions of section 151.415, subdivision 5.341.15    Sec. 8. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:341.16    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of 341.17professional practice only, may prescribe, administer, and dispense a legend drug, and may 341.18cause the same to be administered by a nurse, a physician assistant, or medical student or 341.19resident under the practitioner's direction and supervision, and may cause a person who 341.20is an appropriately certified, registered, or licensed health care professional to prescribe, 341.21dispense, and administer the same within the expressed legal scope of the person's practice 341.22as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, 341.23without reference to a specific patient, by directing a nurse, pursuant to section 
         148.235, 341.24subdivisions 8 and 9
         , physician assistant, or medical student or resident to adhere to 341.25a particular practice guideline or protocol when treating patients whose condition falls 341.26within such guideline or protocol, and when such guideline or protocol specifies the 341.27circumstances under which the legend drug is to be prescribed and administered. An 341.28individual who verbally, electronically, or otherwise transmits a written, oral, or electronic 341.29order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. 341.30This paragraph applies to a physician assistant only if the physician assistant meets the 341.31requirements of section 
         147A.18. 341.32    (b) A licensed practitioner that dispenses for profit a legend drug that is to be 341.33administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must 341.34file with the practitioner's licensing board a statement indicating that the practitioner 341.35dispenses legend drugs for profit, the general circumstances under which the practitioner 342.1dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to 342.2dispense legend drugs for profit after July 31, 1990, unless the statement has been filed 342.3with the appropriate licensing board. For purposes of this paragraph, "profit" means (1) 342.4any amount received by the practitioner in excess of the acquisition cost of a legend drug 342.5for legend drugs that are purchased in prepackaged form, or (2) any amount received 342.6by the practitioner in excess of the acquisition cost of a legend drug plus the cost of 342.7making the drug available if the legend drug requires compounding, packaging, or other 342.8treatment. The statement filed under this paragraph is public data under section 
         13.03. 342.9This paragraph does not apply to a licensed doctor of veterinary medicine or a registered 342.10pharmacist. Any person other than a licensed practitioner with the authority to prescribe, 342.11dispense, and administer a legend drug under paragraph (a) shall not dispense for profit. 342.12To dispense for profit does not include dispensing by a community health clinic when the 342.13profit from dispensing is used to meet operating expenses. 342.14    (c) A prescription or drug order for a legend drug is not valid unless it is issued 342.15for a legitimate medical purpose arising from a prescriber-patient relationship that 342.16includes a documented patient evaluation adequate to establish diagnoses and identify 342.17underlying conditions and contraindications to the treatment. Treatment, including issuing 342.18a prescription or drug order, based solely on an online questionnaire does not constitute a 342.19legitimate medical purpose.342.20    Sec. 9. [151.415] LONG-TERM CARE RESIDENT ACCESS TO 342.21PHARMACEUTICALS ACT.342.22    Subdivision 1.Title; citation.This section may be cited as the "Long-Term Care 342.23Resident Access to Pharmaceuticals Act."342.24    Subd. 2.Definitions.For the purposes of this section, the following terms have the 342.25meanings given them unless otherwise provided by text:342.26    (a) "Board" means the Board of Pharmacy.342.27    (b) "Contract pharmacy" means a pharmacy, licensed under this chapter, which is 342.28under contract to a long-term care facility.342.29    (c) "Long-term care facility" has the meaning given in section 256.9741, subdivision 342.301.342.31    (d) "Original dispensing pharmacy" shall mean a pharmacy, licensed in any state in 342.32the United States, which dispenses drugs in bulk prescription containers to a person who 342.33is a resident in a long-term care facility.342.34    Subd. 3.Authorization to administer and repackage drugs.(a) A contract 342.35pharmacist or pharmacy may repackage a resident's prescription drugs, which have been 343.1lawfully dispensed from bulk prescription containers by an original dispensing pharmacy, 343.2into a unit-dose system compatible with the system used by the long-term care facility.343.3    (b) A long-term care facility may administer drugs to residents of the facility that 343.4have been repackaged according to this subdivision.343.5    (c) Drugs may be dispensed for and administered to a resident of a long-term care 343.6facility according to this subdivision, provided that:343.7    (1) the drug is dispensed by the original dispensing pharmacy according to a current, 343.8valid prescription;343.9    (2) the original bulk prescription container for the resident is delivered by the 343.10original dispensing pharmacy directly to the contract pharmacist or pharmacy;343.11    (3) the contract pharmacist or pharmacy verifies the name and strength of the drug, 343.12the name of the manufacturer of the drug, the manufacturer's lot or control number, the 343.13manufacturer's expiration date for the drug, and the date the drug was dispensed by the 343.14original dispensing pharmacy;343.15    (4) the contract pharmacist or pharmacy verifies the validity and accuracy of the 343.16current prescription order;343.17    (5) the contract pharmacist or pharmacy repackages the drug in board-approved 343.18unit-dose packaging, with labeling that complies with Minnesota Rules, part 6800.6300, 343.19and that identifies that the drug has been repackaged according to this section;343.20    (6) the resident for whom the medication is repackaged obtains medications from or 343.21receives medications at a discounted rate from the original dispensing pharmacy under the 343.22resident's state or federal health assistance program or a private health insurance plan; and343.23    (7) the resident for whom the medication is to be repackaged, or the resident's 343.24authorized representative, has signed an informed consent form provided by the facility 343.25which includes an explanation of the repackaging process and which notifies the resident 343.26of the immunities from liability provided in this section.343.27    Subd. 4.Maintenance of records.For each drug repackaged by a contract 343.28pharmacy under this section, the contract pharmacy shall maintain a record for at least 343.29two years of the following information:343.30    (1) the name, manufacturer, manufacturer's lot number, manufacturer's expiration 343.31date, and quantity of the drug prescribed;343.32    (2) the name and address of the resident for whom the drug was repackaged;343.33    (3) the name and address or other identifier of the prescriber;343.34    (4) the date the prescription was issued and the date the drug was repackaged;343.35    (5) the date the repackaged drug was delivered to the long-term care facility;343.36    (6) the directions for use;344.1    (7) a copy of the label that was affixed to the repackaged drug;344.2    (8) the initials of the packager;344.3    (9) the initials of the supervising pharmacist; and344.4    (10) the name and business address of the original dispensing pharmacy.344.5    Subd. 5.Duties of the original dispensing pharmacy.Upon request of the 344.6resident, the resident's authorized representative, or a contract pharmacy or licensed 344.7health care facility acting on behalf of the resident, the original dispensing pharmacy 344.8is required to deliver medications dispensed for the resident directly to the contract 344.9pharmacist or pharmacy. The original dispensing pharmacy is further required to provide 344.10the contract pharmacist or pharmacy with the name and strength of the drug, the name of 344.11the manufacturer of the drug, the manufacturer's lot or control number, the manufacturer's 344.12expiration date for the drug, and the date the drug was dispensed.344.13    Subd. 6.Redispensing of returned drugs prohibited.Unused drugs repackaged 344.14according to this section that are returned to any pharmacy shall not be redispensed.344.15    Subd. 7.Immunity from civil liability.(a) A contract pharmacist or pharmacy 344.16and its employees or agents repackaging a drug acquired from an original dispensing 344.17pharmacy shall be immune from civil liability arising from harm caused by the drug due 344.18to acts or omissions of other persons outside of the contract pharmacist or pharmacy if the 344.19contract pharmacist or pharmacy properly repackages the drug according to this section.344.20    (b) A long-term care facility and the facility's employees or agents who properly 344.21administer a drug repackaged by a contract pharmacist or pharmacy under this section 344.22shall be immune from civil liability arising from harm caused by the drug due to acts or 344.23omissions of other persons outside the long-term care facility.344.24    Subd. 8.Handling fee.A contract pharmacist or pharmacy may charge a monthly 344.25fee of no more than 250 percent of the medical assistance program dispensing fee for 344.26each drug repackaged according to this section, but no more than $100 per month for 344.27each individual resident.344.28    Sec. 10. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision 344.29to read:344.30    Subd. 2d.Identification requirement for schedule II or III controlled substance.344.31    No person may dispense a controlled substance included in schedule II or III without 344.32requiring the person purchasing the controlled substance, who need not be the person for 344.33whom the controlled substance prescription is written, to present valid photographic 344.34identification, unless the person purchasing the controlled substance, or if applicable the 344.35person for whom the controlled substance prescription is written, is known to the dispenser.345.1    Sec. 11. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES 345.2PRESCRIPTION ELECTRONIC REPORTING SYSTEM.345.3    Subdivision 1.Definitions.For purposes of this section, the terms defined in this 345.4subdivision have the meanings given.345.5    (a) "Board" means the Minnesota State Board of Pharmacy established under 345.6chapter 151.345.7    (b) "Controlled substances" means those substances listed in section 152.02, 345.8subdivisions 3 and 4, and those substances defined by the board pursuant to section 345.9152.02, subdivisions 8 and 12.345.10    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 345.1130. Dispensing does not include the direct administering of a controlled substance to a 345.12patient by a licensed health care professional.345.13    (d) "Dispenser" means a person authorized by law to dispense a controlled substance, 345.14pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy 345.15that distributes controlled substances for inpatient hospital care.345.16    (e) "Prescriber" means a licensed health care professional who is authorized to 345.17prescribe a controlled substance under section 152.12, subdivision 1.345.18    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.345.19    Subd. 2.Prescription electronic reporting system.(a) By January 1, 2009, 345.20or upon enactment of legislation that implements the recommendations of the Board 345.21of Pharmacy under subdivision 3, paragraph (c), whichever is later, the board shall 345.22establish an electronic system for reporting the information required under subdivision 345.234 for all controlled substances dispensed within the state. Data for controlled substance 345.24prescriptions that are dispensed in a quantity small enough to provide treatment to a 345.25patient for a period of 48 hours or less need not be reported.345.26    (b) The board may contract with a vendor for the purpose of obtaining technical 345.27assistance in the design, implementation, and maintenance of the electronic reporting 345.28system. The vendor's role shall be limited to providing technical support to the board 345.29concerning the software, databases, and computer systems required to interface with the 345.30existing systems currently used by pharmacies to dispense prescriptions and transmit 345.31prescription data to other third parties.345.32    (c) The board may issue a waiver to a dispenser that is unable to submit dispensing 345.33information by electronic means. The waiver may permit the dispenser to submit 345.34dispensing information by paper form or other means, provided all information required 345.35by subdivision 4 is submitted in this alternative format.346.1    Subd. 3.Prescription Electronic Reporting Advisory Committee.(a) The 346.2board shall convene an advisory committee. The committee must include at least one 346.3representative of:346.4    (1) the Department of Health;346.5    (2) the Department of Human Services;346.6    (3) each health-related licensing board that licenses prescribers;346.7    (4) a professional medical association, which may include an association of pain 346.8management and chemical dependency specialists;346.9    (5) a professional pharmacy association; 346.10    (6) a consumer privacy or security advocate; and 346.11    (7) a consumer or patient rights organization.346.12    (b) The advisory committee shall advise the board on the development and operation 346.13of the electronic reporting system, including, but not limited to:346.14    (1) technical standards for electronic prescription drug reporting;346.15    (2) proper analysis and interpretation of prescription monitoring data; and346.16    (3) an evaluation process for the program.346.17    (c) The Board of Pharmacy, after consultation with the advisory committee, shall 346.18present recommendations and draft legislation on the issues addressed by the advisory 346.19committee under paragraph (b), to the legislature by December 15, 2007.346.20    Subd. 4.Reporting requirements and notice.(a) Each dispenser must submit the 346.21following data to the board or its designated vendor, subject to the notice required under 346.22paragraph (d):346.23    (1) prescriber DEA number;346.24    (2) dispenser DEA number;346.25    (3) name of the patient for whom the prescription was written;346.26    (4) date of birth of the patient for whom the prescription was written;346.27    (5) date the prescription was written;346.28    (6) date the prescription was filled;346.29    (7) NDC code for drug dispensed; and346.30    (8) quantity of controlled substance dispensed.346.31    (b) The dispenser must submit the required information according to the format and 346.32protocols specified in the "ASAP Telecommunications Format for Controlled Substances," 346.33May 1995 edition, published by the American Society for Automation in Pharmacy, which 346.34is hereby adopted by reference, by a procedure established by the board.346.35    (c) A dispenser is not required to submit this data for those controlled substance 346.36prescriptions dispensed for:347.1    (1) individuals residing in licensed skilled nursing or intermediate care facilities;347.2    (2) individuals receiving assisted living services under chapter 144G or through a 347.3medical assistance home and community-based waiver;347.4    (3) individuals receiving medication intravenously;347.5    (4) individuals receiving hospice and other palliative or end-of-life care; and347.6    (5) individuals receiving services from a home care provider regulated under chapter 347.7144A.347.8    (d) A dispenser must not submit data under this subdivision unless a conspicuous 347.9notice of the reporting requirements of this section is given to the patient for whom the 347.10prescription was written.347.11    Subd. 5.Use of data by board.(a) The board shall develop and maintain a database 347.12of the data reported under subdivision 4. The board shall maintain data that could identify 347.13an individual prescriber or dispenser in encrypted form. The database may be used by 347.14permissible users identified under subdivision 6 for the identification of:347.15    (1) individuals receiving prescriptions for controlled substances from prescribers 347.16who subsequently obtain controlled substances from dispensers in quantities or with a 347.17frequency inconsistent with generally recognized standards of dosage for those controlled 347.18substances; and 347.19    (2) individuals presenting forged or otherwise false or altered prescriptions for 347.20controlled substances to dispensers. 347.21    (b) No permissible user identified under subdivision 6 may access the database 347.22for the sole purpose of identifying prescribers of controlled substances for unusual or 347.23excessive prescribing patterns without a valid search warrant or court order.347.24    (c) No personnel of a state or federal occupational licensing board or agency may 347.25access the database for the purpose of obtaining information to be used to initiate or 347.26substantiate a disciplinary action against a prescriber.347.27    (d) Data reported under subdivision 4 shall be retained by the board in the database 347.28for a six-month period, and shall be removed from the database six months from the 347.29date the data was received.347.30    Subd. 6.Access to reporting system data.(a) Except as indicated in this 347.31subdivision, the data submitted to the board under subdivision 4 is private data on 347.32individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.347.33    (b) Except as specified in subdivision 5, the following persons shall be considered 347.34permissible users and may access the data submitted under subdivision 4 in the same or 347.35similar manner, and for the same or similar purposes, as those persons who are authorized 347.36to access similar private data on individuals under federal and state law:348.1    (1) a prescriber, to the extent the information relates specifically to a current patient 348.2of the prescriber, to whom the practitioner is prescribing or considering prescribing any 348.3controlled substance;348.4    (2) a dispenser to the extent the information relates specifically to a current patient to 348.5whom that dispenser is dispensing or considering dispensing any controlled substance;348.6    (3) an individual who is the recipient of a controlled substance prescription for 348.7which data was submitted under subdivision 4;348.8    (4) personnel of the board specifically assigned to conduct a bona fide investigation 348.9of a specific board licensee;348.10    (5) personnel of the board engaged in the collection of controlled substance 348.11prescription information as part of the assigned duties and responsibilities under this 348.12section;348.13    (6) authorized personnel of a vendor under contract with the board who are engaged 348.14in the design, implementation, and maintenance of the electronic reporting system as part 348.15of the assigned duties and responsibilities of their employment, provided that access to data 348.16is limited to the minimum amount necessary to test and maintain the system databases;348.17    (7) federal, state, and local law enforcement authorities engaged in a bona fide 348.18investigation of a specific person; and348.19    (8) personnel of the medical assistance program assigned to use the data collected 348.20under this section to identify recipients whose usage of controlled substances may warrant 348.21restriction to a single primary care physician, a single outpatient pharmacy, or a single 348.22hospital.348.23    (c) Any permissible user identified in paragraph (b), who directly accesses 348.24the data electronically, shall implement and maintain a comprehensive information 348.25security program that contains administrative, technical, and physical safeguards that 348.26are appropriate to the user's size and complexity, and the sensitivity of the personal 348.27information obtained. The permissible user shall identify reasonably foreseeable internal 348.28and external risks to the security, confidentiality, and integrity of personal information 348.29that could result in the unauthorized disclosure, misuse, or other compromise of the 348.30information and assess the sufficiency of any safeguards in place to control the risks.348.31    (d) The board shall not release data submitted under this section unless it is provided 348.32with evidence, satisfactory to the board, that the person requesting the information is 348.33entitled to receive the data. Access to the data by law enforcement authorities must be 348.34accompanied by a valid search warrant.348.35    (e) The board shall not release the name of a prescriber without the written consent 348.36of the prescriber or a valid search warrant or court order. The board shall provide a 349.1mechanism for a prescriber to submit to the board a signed consent authorizing the release 349.2of the prescriber's name when data containing the prescriber's name is requested.349.3    (f) The board shall maintain a log of all persons who access the data and shall ensure 349.4that any permissible user complies with paragraph (c) prior to attaining direct access to 349.5the data.349.6    Subd. 7.Disciplinary action.(a) A dispenser who knowingly fails to submit data to 349.7the board as required under this section is subject to disciplinary action by the appropriate 349.8health-related licensing board.349.9    (b) A prescriber or dispenser authorized to access the data who knowingly discloses 349.10the data in violation of state or federal laws relating to the privacy of health care data 349.11shall be subject to disciplinary action by the appropriate health-related licensing board, 349.12and appropriate civil penalties.349.13    Subd. 8.Evaluation and reporting.(a) The board shall evaluate the prescription 349.14electronic reporting system to determine if the system is cost-effective and whether it is 349.15negatively impacting appropriate prescribing practices of controlled substances. The 349.16board may contract with a vendor to design and conduct the evaluation.349.17    (b) The board shall submit the evaluation of the system to the legislature by January 349.1815, 2010.349.19    Subd. 9.Immunity from liability; no requirement to obtain information.(a) A 349.20pharmacist, prescriber, or other dispenser making a report to the program in good faith 349.21under this section is immune from any civil, criminal, or administrative liability, which 349.22might otherwise be incurred or imposed as a result of the report, or on the basis that the 349.23pharmacist or prescriber did or did not seek or obtain or use information from the program.349.24    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser 349.25to obtain information about a patient from the program, and the pharmacist, prescriber, 349.26or other dispenser, if acting in good faith, is immune from any civil, criminal, or 349.27administrative liability that might otherwise be incurred or imposed for requesting, 349.28receiving, or using information from the program.349.29EFFECTIVE DATE.This section is effective July 1, 2007, or upon receiving 349.30sufficient nonstate funds to implement the prescription electronic reporting program, 349.31whichever is later. In the event that nonstate funds are not secured by the Board of 349.32Pharmacy to adequately fund the implementation of the prescription electronic reporting 349.33program, the board is not required to implement this section without a subsequent 349.34appropriation from the legislature.349.35    Sec. 12. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:350.1    Subd. 7. Essential employee. "Essential employee" means firefighters, peace 350.2officers subject to licensure under sections 
         626.84 to 
         626.863, 911 system and police and 350.3fire department public safety dispatchers, guards at correctional facilities, confidential 350.4employees, supervisory employees, assistant county attorneys, assistant city attorneys, 350.5principals, and assistant principals. However, for state employees, "essential employee" 350.6means all employees, except for nonprofessional employees employed by the Department 350.7of Human Services in mental health facilities for the treatment of psychopathic 350.8personalities, sexual predators, and the criminally insane, in law enforcement, public 350.9safety radio communications operators, health care professionals, correctional guards, 350.10professional engineering, and supervisory collective bargaining units, irrespective of 350.11severance, and no other employees. For University of Minnesota employees, "essential 350.12employee" means all employees in law enforcement, nursing professional and supervisory 350.13units, irrespective of severance, and no other employees. "Firefighters" means salaried 350.14employees of a fire department whose duties include, directly or indirectly, controlling, 350.15extinguishing, preventing, detecting, or investigating fires. Employees for whom the state 350.16court administrator is the negotiating employer are not essential employees. For Hennepin 350.17Healthcare System, Inc. employees, "essential employees" means all employees.350.18EFFECTIVE DATE.This section is effective the day following final enactment.350.19    Sec. 13. Minnesota Statutes 2006, section 245.4874, is amended to read:350.20245.4874 DUTIES OF COUNTY BOARD.350.21    (a) The county board must:350.22    (1) develop a system of affordable and locally available children's mental health 350.23services according to sections 
         245.487 to 
         245.4887;350.24    (2) establish a mechanism providing for interagency coordination as specified in 350.25section 
         245.4875, subdivision 6;350.26    (3) consider the assessment of unmet needs in the county as reported by the local 350.27children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 350.28(b), clause (3). The county shall provide, upon request of the local children's mental health 350.29advisory council, readily available data to assist in the determination of unmet needs;350.30    (4) assure that parents and providers in the county receive information about how to 350.31gain access to services provided according to sections 
         245.487 to 
         245.4887;350.32    (5) coordinate the delivery of children's mental health services with services 350.33provided by social services, education, corrections, health, and vocational agencies to 351.1improve the availability of mental health services to children and the cost-effectiveness of 351.2their delivery;351.3    (6) assure that mental health services delivered according to sections 
         245.487351.4to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 351.5assessment and individual treatment plan;351.6    (7) provide the community with information about predictors and symptoms of 351.7emotional disturbances and how to access children's mental health services according to 351.8sections 
         245.4877 and 
         245.4878;351.9    (8) provide for case management services to each child with severe emotional 351.10disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 351.11subdivisions 1, 3, and 5
         ;351.12    (9) provide for screening of each child under section 
         245.4885 upon admission 351.13to a residential treatment facility, acute care hospital inpatient treatment, or informal 351.14admission to a regional treatment center;351.15    (10) prudently administer grants and purchase-of-service contracts that the county 351.16board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 351.17245.4887
         ;351.18    (11) assure that mental health professionals, mental health practitioners, and case 351.19managers employed by or under contract to the county to provide mental health services 351.20are qualified under section 
         245.4871;351.21    (12) assure that children's mental health services are coordinated with adult mental 351.22health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 351.23health services is available to serve persons with mental illness, regardless of the person's 351.24age;351.25    (13) assure that culturally informed mental health consultants are used as necessary 351.26to assist the county board in assessing and providing appropriate treatment for children of 351.27cultural or racial minority heritage; and351.28    (14) consistent with section 
         245.486, arrange for or provide a children's mental 351.29health screening to a child receiving child protective services or a child in out-of-home 351.30placement, a child for whom parental rights have been terminated, a child found to be 351.31delinquent, and a child found to have committed a juvenile petty offense for the third 351.32or subsequent time, unless a screening or diagnostic assessment has been performed 351.33within the previous 180 days, or the child is currently under the care of a mental health 351.34professional. The court or county agency must notify a parent or guardian whose 351.35parental rights have not been terminated of the potential mental health screening and the 351.36option to prevent the screening by notifying the court or county agency in writing. The 352.1screening shall be conducted with a screening instrument approved by the commissioner 352.2of human services according to criteria that are updated and issued annually to ensure 352.3that approved screening instruments are valid and useful for child welfare and juvenile 352.4justice populations, and shall be conducted by a mental health practitioner as defined in 352.5section 
         245.4871, subdivision 26, or a probation officer or local social services agency 352.6staff person who is trained in the use of the screening instrument. Training in the use of the 352.7instrument shall include training in the administration of the instrument, the interpretation 352.8of its validity given the child's current circumstances, the state and federal data practices 352.9laws and confidentiality standards, the parental consent requirement, and providing respect 352.10for families and cultural values. If the screen indicates a need for assessment, the child's 352.11family, or if the family lacks mental health insurance, the local social services agency, 352.12in consultation with the child's family, shall have conducted a diagnostic assessment, 352.13including a functional assessment, as defined in section 
         245.4871. The administration of 352.14the screening shall safeguard the privacy of children receiving the screening and their 352.15families and shall comply with the Minnesota Government Data Practices Act, chapter 352.1613, and the federal Health Insurance Portability and Accountability Act of 1996, Public 352.17Law 104-191. Screening results shall be considered private data and the commissioner 352.18shall not collect individual screening results.352.19    (b) When the county board refers clients to providers of children's therapeutic 352.20services and supports under section 
         256B.0943, the county board must clearly identify 352.21the desired services components not covered under section 
         256B.0943 and identify the 352.22reimbursement source for those requested services, the method of payment, and the 352.23payment rate to the provider.352.24    Sec. 14. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:352.25    Subd. 2. Transfer to correctional facility. (a) If a person has been committed 352.26under this section and later is committed to the custody of the commissioner of corrections 352.27for any reason, including but not limited to, being sentenced for a crime or revocation of 352.28the person's supervised release or conditional release under section 
         244.05, 609.108, 352.29subdivision 6, or 
         609.109, subdivision 7, the person shall be transferred to a facility 352.30designated by the commissioner of corrections without regard to the procedures provided 352.31in section 
         253B.18. 352.32    (b) If a person is committed under this section after a commitment to the 352.33commissioner of corrections, the person shall first serve the sentence in a facility 352.34designated by the commissioner of corrections. After the person has served the sentence, 353.1the person shall be transferred to a treatment program designated by the commissioner 353.2of human services.353.3    Sec. 15. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:353.4    Subd. 3. Rules for chemical dependency care. The commissioner of human 353.5services shall establish by rule criteria to be used in determining the appropriate level 353.6of chemical dependency care, whether outpatient, inpatient or short-term treatment 353.7programs, for each recipient of public assistance seeking treatment for alcohol or other 353.8drug dependency and abuse problems. The criteria shall address, at least, the family 353.9relationship, past treatment history, medical or physical problems, arrest record, and 353.10employment situation.353.11    Sec. 16. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:353.12    Subd. 2. Program and service guidelines. (a) The commissioner shall provide 353.13program and service guidelines and technical assistance to the county boards in carrying 353.14out services authorized under sections section254A.08, 254A.12, 254A.14, and their 353.15responsibilities under chapter 256E. 353.16    (b) The commissioner shall recommend to the governor means of improving 353.17the efficiency and effectiveness of comprehensive program services in the state and 353.18maximizing the use of nongovernmental funds for providing comprehensive programs.353.19    Sec. 17. [254A.20] CHEMICAL USE ASSESSMENTS; FINANCIAL CONFLICT 353.20OF INTEREST.353.21    (a) Except as provided in paragraph (b), an assessor conducting a chemical use 353.22assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any 353.23direct or shared financial interest or referral relationship resulting in shared financial 353.24interest or referral relationship resulting in shared financial gain with a treatment provider. 353.25    (b) A county may contract with an assessor having a conflict described in paragraph 353.26(a) if the county documents that: 353.27    (1) the assessor is employed by a culturally specific service provider or a service 353.28provider with a program designed to treat individuals of a specific age, sex, or sexual 353.29preference; 353.30    (2) the county does not employ a sufficient number of qualified assessors and the 353.31only qualified assessors available in the county have a direct or shared financial interest or 353.32a referral relationship resulting in shared financial gain with a treatment provider; or 354.1    (3) the county social service agency has an existing relationship with an assessor 354.2or service provider and elects to enter into a contract with that assessor to provide both 354.3assessment and treatment under circumstances specified in the county's contract, provided 354.4the county retains responsibility for making placement decisions.354.5EFFECTIVE DATE.This section is effective the day following final enactment.354.6    Sec. 18. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:354.7    Subdivision 1. Chemical dependency treatment allocation. The chemical 354.8dependency funds appropriated for allocation shall be placed in a special revenue account. 354.9The commissioner shall annually transfer funds from the chemical dependency fund to pay 354.10for operation of the drug and alcohol abuse normative evaluation system and to pay for all 354.11costs incurred by adding two positions for licensing of chemical dependency treatment 354.12and rehabilitation programs located in hospitals for which funds are not otherwise 354.13appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall 354.14allocate funds to the American Indian chemical dependency tribal account for treatment 354.15of American Indians by eligible vendors under section 254B.05, equal to the amount 354.16allocated in fiscal year 1997. Six percent of the remaining money must be reserved for 354.17tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall 354.18annually divide the money available in the chemical dependency fund that is not held 354.19in reserve by counties from a previous allocation, or allocated to the American Indian 354.20chemical dependency tribal account. Six percent of the remaining money must be 354.21reserved for the nonreservation American Indian chemical dependency allocation for 354.22treatment of American Indians by eligible vendors under section 
         254B.05, subdivision 354.231
         . The remainder of the money must be allocated among the counties according to the 354.24following formula, using state demographer data and other data sources determined by 354.25the commissioner: 354.26    (a) For purposes of this formula, American Indians and children under age 14 are 354.27subtracted from the population of each county to determine the restricted population.354.28    (b) The amount of chemical dependency fund expenditures for entitled persons for 354.29services not covered by prepaid plans governed by section 
         256B.69 in the previous year is 354.30divided by the amount of chemical dependency fund expenditures for entitled persons for 354.31all services to determine the proportion of exempt service expenditures for each county. 354.32    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 354.33service expenditures to determine the adjusted prepaid plan months of eligibility for 354.34each county.355.1    (d) The adjusted prepaid plan months of eligibility is added to the number of 355.2restricted population fee for service months of eligibility for the Minnesota family 355.3investment program, general assistance, and medical assistance and divided by the county 355.4restricted population to determine county per capita months of covered service eligibility.355.5    (e) The number of adjusted prepaid plan months of eligibility for the state is added 355.6to the number of fee for service months of eligibility for the Minnesota family investment 355.7program, general assistance, and medical assistance for the state restricted population and 355.8divided by the state restricted population to determine state per capita months of covered 355.9service eligibility.355.10    (f) The county per capita months of covered service eligibility is divided by the 355.11state per capita months of covered service eligibility to determine the county welfare 355.12caseload factor.355.13    (g) The median married couple income for the most recent three-year period 355.14available for the state is divided by the median married couple income for the same period 355.15for each county to determine the income factor for each county.355.16    (h) The county restricted population is multiplied by the sum of the county welfare 355.17caseload factor and the county income factor to determine the adjusted population.355.18    (i) $15,000 shall be allocated to each county.355.19    (j) The remaining funds shall be allocated proportional to the county adjusted 355.20population.355.21    Sec. 19. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:355.22    Subd. 5. Administrative adjustment. The commissioner may make payments to 355.23local agencies from money allocated under this section to support administrative activities 355.24under sections 
         254B.03 and 
         254B.04. The administrative payment must not exceed 355.25five percent of the first $50,000, four percent of the next $50,000, and three percent of 355.26the remaining payments for services from the allocation. Twenty-five percent of the 355.27administrative allowance shall be advanced at the beginning of each quarter, based on 355.28the payments for services made in the most recent quarter for which data is available. 355.29Adjustment of any overestimate or underestimate based on actual expenditures shall be 355.30made by the state agency by adjusting the administrative allowance for any succeeding 355.31quarter.355.32    Sec. 20. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:355.33    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical 355.34dependency services to persons residing within its jurisdiction who meet criteria 356.1established by the commissioner for placement in a chemical dependency residential or 356.2nonresidential treatment service. Chemical dependency money must be administered 356.3by the local agencies according to law and rules adopted by the commissioner under 356.4sections 
         14.001 to 
         14.69. 356.5    (b) In order to contain costs, the county board shall, with the approval of the 356.6commissioner of human services, select eligible vendors of chemical dependency services 356.7who can provide economical and appropriate treatment. Unless the local agency is a social 356.8services department directly administered by a county or human services board, the local 356.9agency shall not be an eligible vendor under section 
         254B.05. The commissioner may 356.10approve proposals from county boards to provide services in an economical manner or to 356.11control utilization, with safeguards to ensure that necessary services are provided. If a 356.12county implements a demonstration or experimental medical services funding plan, the 356.13commissioner shall transfer the money as appropriate. If a county selects a vendor located 356.14in another state, the county shall ensure that the vendor is in compliance with the rules 356.15governing licensure of programs located in the state. 356.16    (c) The calendar year 2002 rate for vendors may not increase more than three 356.17percent above the rate approved in effect on January 1, 2001. The calendar year 2003 356.18rate for vendors may not increase more than three percent above the rate in effect on 356.19January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in 356.20effect on January 1, 2003.356.21    (d) (c) A culturally specific vendor that provides assessments under a variance under 356.22Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 356.23persons not covered by the variance.356.24    Sec. 21. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:356.25    Subd. 3. Local agencies to pay state for county share.Local agencies shall submit 356.26invoices to the state on forms supplied by the commissioner and according to procedures 356.27established by the commissioner. Local agencies shall pay the state for the county share 356.28of the invoiced services authorized by the local agency. Payments shall be made at the 356.29beginning of each month for services provided in the previous month. The commissioner 356.30shall bill the county monthly for services, based on the most recent month for which 356.31expenditure information is available. Adjustment of any overestimate or underestimate 356.32based on actual expenditures shall be made by the state agency by adjusting the estimate 356.33for any succeeding month.356.34    Sec. 22. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:357.1    Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for 357.2placements made by local agencies under section 
         254B.03, subdivision 1, and placements 357.3by tribal designated agencies according to section 
         254B.09. The commissioner may 357.4reduce or deny payment of the state share when services are not provided according to the 357.5placement criteria established by the commissioner. The commissioner may pay for all or 357.6a portion of improper county chemical dependency placements and bill the county for the 357.7entire payment made when the placement did not comply with criteria established by the 357.8commissioner. The commissioner may make payments to vendors and charge the county 357.9100 percent of the payments if documentation of a county approved placement is received 357.10more than 30 working days, exclusive of weekends and holidays, after the date services 357.11began; or if the county approved invoice is received by the commissioner more than 120 357.12days after the last date of service provided. The commissioner shall not pay vendors until 357.13private insurance company claims have been settled. 357.14    Sec. 23. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 357.15to read:357.16    Subd. 25.Base budget detail.The commissioner shall provide the commissioner 357.17of finance with the information necessary to provide base budget detail to the legislature 357.18under section 16A.10, subdivision 2a.357.19    Sec. 24. [256.9675] PUBLIC BENEFITS; INELIGIBILITY.357.20    A person who moves into the state with a felony conviction is ineligible for 357.21public assistance, including but not limited to benefits under medical assistance, general 357.22assistance medical care, MinnesotaCare, and the Minnesota family investment program.357.23    Sec. 25. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to 357.24read:357.25    Subd. 23. Day treatment services. Medical assistance covers day treatment 357.26services as specified in sections 
         245.462, subdivision 8, and 
         245.4871, subdivision 10, that 357.27are provided under contract with the county board. Notwithstanding Minnesota Rules, 357.28part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day 357.29treatment for adults according to section 
         256B.0625, subdivision 25. Notwithstanding 357.30Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance 357.31covers day treatment services for children as specified under section 
         256B.0943. 358.1    Sec. 26. [256B.0636] PRESCRIBING OF CONTROLLED SUBSTANCES; 358.2ABUSE PREVENTION.358.3    The commissioner shall develop and implement a plan to:358.4    (1) monitor the prescribing of controlled substances listed in section 152.02, 358.5subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 358.6section 152.02, subdivisions 8 and 12, by enrolled providers and providers under contract 358.7with participating managed care plans;358.8    (2) require enrolled providers and providers under contract with participating 358.9managed care plans to report information related to potential patient abuse of the 358.10controlled substances to the commissioner, and the Board of Pharmacy; and358.11    (3) provide education to Minnesota health care program enrollees on the proper use 358.12of controlled substances.358.13    Sec. 27. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to 358.14read:358.15    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be 358.16an eligible provider entity under this section, a provider entity must have a clinical 358.17infrastructure that utilizes diagnostic assessment, an individualized treatment plan, 358.18service delivery, and individual treatment plan review that are culturally competent, 358.19child-centered, and family-driven to achieve maximum benefit for the client. The provider 358.20entity must review and update the clinical policies and procedures every three years and 358.21must distribute the policies and procedures to staff initially and upon each subsequent 358.22update.358.23    (b) The clinical infrastructure written policies and procedures must include policies 358.24and procedures for:358.25    (1) providing or obtaining a client's diagnostic assessment that identifies acute and 358.26chronic clinical disorders, co-occurring medical conditions, sources of psychological and 358.27environmental problems, and a functional assessment. The functional assessment must 358.28clearly summarize the client's individual strengths and needs;358.29    (2) developing an individual treatment plan that is:358.30    (i) based on the information in the client's diagnostic assessment;358.31    (ii) developed no later than the end of the first psychotherapy session after the 358.32completion of the client's diagnostic assessment by the mental health professional who 358.33provides the client's psychotherapy;358.34    (iii) developed through a child-centered, family-driven planning process that 358.35identifies service needs and individualized, planned, and culturally appropriate 359.1interventions that contain specific treatment goals and objectives for the client and the 359.2client's family or foster family;359.3    (iv) reviewed at least once every 90 days and revised, if necessary; and359.4    (v) signed by the client or, if appropriate, by the client's parent or other person 359.5authorized by statute to consent to mental health services for the client;359.6    (3) developing an individual behavior plan that documents services to be provided 359.7by the mental health behavioral aide. The individual behavior plan must include:359.8    (i) detailed instructions on the service to be provided;359.9    (ii) time allocated to each service;359.10    (iii) methods of documenting the child's behavior;359.11    (iv) methods of monitoring the child's progress in reaching objectives; and359.12    (v) goals to increase or decrease targeted behavior as identified in the individual 359.13treatment plan;359.14    (4) clinical supervision of the mental health practitioner and mental health behavioral 359.15aide. A mental health professional must document the clinical supervision the professional 359.16provides by cosigning individual treatment plans and making entries in the client's record 359.17on supervisory activities. Clinical supervision does not include the authority to make or 359.18terminate court-ordered placements of the child. A clinical supervisor must be available 359.19for urgent consultation as required by the individual client's needs or the situation. Clinical 359.20supervision may occur individually or in a small group to discuss treatment and review 359.21progress toward goals. The focus of clinical supervision must be the client's treatment 359.22needs and progress and the mental health practitioner's or behavioral aide's ability to 359.23provide services;359.24    (4a) CTSS certified provider entities providing day treatment programs must meet 359.25the conditions in items (i) to (iii):359.26    (i) the provider supervisor must be present and available on the premises more 359.27than 50 percent of the time in a five-working-day period during which the supervisee is 359.28providing a mental health service;359.29    (ii) the diagnosis and the client's individual treatment plan or a change in the 359.30diagnosis or individual treatment plan must be made by or reviewed, approved, and signed 359.31by the provider supervisor; and359.32    (iii) every 30 days, the supervisor must review and sign the record of the client's care 359.33for all activities in the preceding 30-day period;359.34    (4b) for all other services provided under CTSS, clinical supervision standards 359.35provided in items (i) to (iii) must be used:360.1    (i) medical assistance shall reimburse a mental health practitioner who maintains a 360.2consulting relationship with a mental health professional who accepts full professional 360.3responsibility and is present on site for at least one observation during the first 12 hours 360.4in which the mental health practitioner provides the individual, family, or group skills 360.5training to the child or the child's family;360.6    (ii) thereafter, the mental health professional is required to be present on site for 360.7observation as clinically appropriate when the mental health practitioner is providing 360.8individual, family, or group skills training to the child or the child's family; and360.9    (iii) the observation must be a minimum of one clinical unit. The on-site presence of 360.10the mental health professional must be documented in the child's record and signed by the 360.11mental health professional who accepts full professional responsibility;360.12    (5) providing direction to a mental health behavioral aide. For entities that employ 360.13mental health behavioral aides, the clinical supervisor must be employed by the provider 360.14entity or other certified children's therapeutic supports and services provider entity to 360.15ensure necessary and appropriate oversight for the client's treatment and continuity 360.16of care. The mental health professional or mental health practitioner giving direction 360.17must begin with the goals on the individualized treatment plan, and instruct the mental 360.18health behavioral aide on how to construct therapeutic activities and interventions that 360.19will lead to goal attainment. The professional or practitioner giving direction must also 360.20instruct the mental health behavioral aide about the client's diagnosis, functional status, 360.21and other characteristics that are likely to affect service delivery. Direction must also 360.22include determining that the mental health behavioral aide has the skills to interact with 360.23the client and the client's family in ways that convey personal and cultural respect and 360.24that the aide actively solicits information relevant to treatment from the family. The aide 360.25must be able to clearly explain the activities the aide is doing with the client and the 360.26activities' relationship to treatment goals. Direction is more didactic than is supervision 360.27and requires the professional or practitioner providing it to continuously evaluate the 360.28mental health behavioral aide's ability to carry out the activities of the individualized 360.29treatment plan and the individualized behavior plan. When providing direction, the 360.30professional or practitioner must:360.31    (i) review progress notes prepared by the mental health behavioral aide for accuracy 360.32and consistency with diagnostic assessment, treatment plan, and behavior goals and the 360.33professional or practitioner must approve and sign the progress notes;360.34    (ii) identify changes in treatment strategies, revise the individual behavior plan, 360.35and communicate treatment instructions and methodologies as appropriate to ensure 360.36that treatment is implemented correctly;361.1    (iii) demonstrate family-friendly behaviors that support healthy collaboration among 361.2the child, the child's family, and providers as treatment is planned and implemented;361.3    (iv) ensure that the mental health behavioral aide is able to effectively communicate 361.4with the child, the child's family, and the provider; and361.5    (v) record the results of any evaluation and corrective actions taken to modify the 361.6work of the mental health behavioral aide;361.7    (6) providing service delivery that implements the individual treatment plan and 361.8meets the requirements under subdivision 9; and361.9    (7) individual treatment plan review. The review must determine the extent to which 361.10the services have met the goals and objectives in the previous treatment plan. The review 361.11must assess the client's progress and ensure that services and treatment goals continue to 361.12be necessary and appropriate to the client and the client's family or foster family. Revision 361.13of the individual treatment plan does not require a new diagnostic assessment unless the 361.14client's mental health status has changed markedly. The updated treatment plan must be 361.15signed by the client, if appropriate, and by the client's parent or other person authorized by 361.16statute to give consent to the mental health services for the child.361.17    Sec. 28. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to 361.18read:361.19    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a 361.20certified provider entity must ensure that:361.21    (1) each individual provider's caseload size permits the provider to deliver services 361.22to both clients with severe, complex needs and clients with less intensive needs. The 361.23provider's caseload size should reasonably enable the provider to play an active role in 361.24service planning, monitoring, and delivering services to meet the client's and client's 361.25family's needs, as specified in each client's individual treatment plan;361.26    (2) site-based programs, including day treatment and preschool programs, provide 361.27staffing and facilities to ensure the client's health, safety, and protection of rights, and that 361.28the programs are able to implement each client's individual treatment plan;361.29    (3) a day treatment program is provided to a group of clients by a multidisciplinary 361.30team under the clinical supervision of a mental health professional. The day treatment 361.31program must be provided in and by: (i) an outpatient hospital accredited by the Joint 361.32Commission on Accreditation of Health Organizations and licensed under sections 361.33144.50
          to 
         144.55; (ii) a community mental health center under section 
         245.62; and (iii) 361.34an entity that is under contract with the county board to operate a program that meets 361.35the requirements of sections 
         245.4712, subdivision 2, and 
         245.4884, subdivision 2, 362.1and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must 362.2stabilize the client's mental health status while developing and improving the client's 362.3independent living and socialization skills. The goal of the day treatment program must be 362.4to reduce or relieve the effects of mental illness and provide training to enable the client 362.5to live in the community. The program must be available at least one day a week for a 362.6minimum three-hour time block. The three-hour time block must include at least one 362.7hour, but no more than two hours, of individual or group psychotherapy. The remainder 362.8of the three-hour time block may include recreation therapy, socialization therapy, or 362.9independent living skills therapy, but only if the therapies are included in the client's 362.10individual treatment plan. Day treatment programs are not part of inpatient or residential 362.11treatment services; and 362.12    (4) a preschool program is a structured treatment program offered to a child who 362.13is at least 33 months old, but who has not yet reached the first day of kindergarten, by a 362.14preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts 362.159503.0005 to 9503.0175. The program must be available at least one day a week for a 362.16minimum two-hour time block. The structured treatment program may include individual 362.17or group psychotherapy and recreation therapy, socialization therapy, or independent 362.18living skills therapy, if included in the client's individual treatment plan.362.19    (b) A provider entity must deliver the service components of children's therapeutic 362.20services and supports in compliance with the following requirements:362.21    (1) individual, family, and group psychotherapy must be delivered as specified in 362.22Minnesota Rules, part 9505.0323;362.23    (2) individual, family, or group skills training must be provided by a mental health 362.24professional or a mental health practitioner who has a consulting relationship with a 362.25mental health professional who accepts full professional responsibility for the training;362.26    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis 362.27through arrangements for direct intervention and support services to the child and the 362.28child's family. Crisis assistance must utilize resources designed to address abrupt or 362.29substantial changes in the functioning of the child or the child's family as evidenced by 362.30a sudden change in behavior with negative consequences for well being, a loss of usual 362.31coping mechanisms, or the presentation of danger to self or others;362.32    (4) medically necessary services that are provided by a mental health behavioral 362.33aide must be designed to improve the functioning of the child and support the family in 362.34activities of daily and community living. A mental health behavioral aide must document 362.35the delivery of services in written progress notes. The mental health behavioral aide 362.36must implement goals in the treatment plan for the child's emotional disturbance that 363.1allow the child to acquire developmentally and therapeutically appropriate daily living 363.2skills, social skills, and leisure and recreational skills through targeted activities. These 363.3activities may include:363.4    (i) assisting a child as needed with skills development in dressing, eating, and 363.5toileting;363.6    (ii) assisting, monitoring, and guiding the child to complete tasks, including 363.7facilitating the child's participation in medical appointments;363.8    (iii) observing the child and intervening to redirect the child's inappropriate behavior;363.9    (iv) assisting the child in using age-appropriate self-management skills as related 363.10to the child's emotional disorder or mental illness, including problem solving, decision 363.11making, communication, conflict resolution, anger management, social skills, and 363.12recreational skills;363.13    (v) implementing deescalation techniques as recommended by the mental health 363.14professional;363.15    (vi) implementing any other mental health service that the mental health professional 363.16has approved as being within the scope of the behavioral aide's duties; or363.17    (vii) assisting the parents to develop and use parenting skills that help the child 363.18achieve the goals outlined in the child's individual treatment plan or individual behavioral 363.19plan. Parenting skills must be directed exclusively to the child's treatment; and363.20    (5) direction of a mental health behavioral aide must include the following:363.21    (i) a total of one hour of on-site observation by a mental health professional during 363.22the first 12 hours of service provided to a child;363.23    (ii) ongoing on-site observation by a mental health professional or mental health 363.24practitioner for at least a total of one hour during every 40 hours of service provided 363.25to a child; and363.26    (iii) immediate accessibility of the mental health professional or mental health 363.27practitioner to the mental health behavioral aide during service provision.363.28    Sec. 29. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to 363.29read:363.30    Subd. 11. Documentation and billing. (a) A provider entity must document the 363.31services it provides under this section. The provider entity must ensure that the entity's 363.32documentation standards meet the requirements of federal and state laws. Services billed 363.33under this section that are not documented according to this subdivision shall be subject to 363.34monetary recovery by the commissioner. The provider entity may not bill for anything 363.35other than direct service time.364.1    (b) An individual mental health provider must promptly document the following 364.2in a client's record after providing services to the client:364.3    (1) each occurrence of the client's mental health service, including the date, type, 364.4length, and scope of the service;364.5    (2) the name of the person who gave the service;364.6    (3) contact made with other persons interested in the client, including representatives 364.7of the courts, corrections systems, or schools. The provider must document the name 364.8and date of each contact;364.9    (4) any contact made with the client's other mental health providers, case manager, 364.10family members, primary caregiver, legal representative, or the reason the provider did 364.11not contact the client's family members, primary caregiver, or legal representative, if 364.12applicable; and364.13    (5) required clinical supervision, as appropriate.364.14    Sec. 30. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to 364.15read:364.16    Subd. 12. Excluded services. The following services are not eligible for medical 364.17assistance payment as children's therapeutic services and supports:364.18    (1) service components of children's therapeutic services and supports 364.19simultaneously provided by more than one provider entity unless prior authorization is 364.20obtained;364.21    (2) children's therapeutic services and supports provided in violation of medical 364.22assistance policy in Minnesota Rules, part 9505.0220;364.23    (3) mental health behavioral aide services provided by a personal care assistant who 364.24is not qualified as a mental health behavioral aide and employed by a certified children's 364.25therapeutic services and supports provider entity;364.26    (4) service components of CTSS that are the responsibility of a residential or 364.27program license holder, including foster care providers under the terms of a service 364.28agreement or administrative rules governing licensure; and364.29    (5) adjunctive activities that may be offered by a provider entity but are not 364.30otherwise covered by medical assistance, including:364.31    (i) a service that is primarily recreation oriented or that is provided in a setting that 364.32is not medically supervised. This includes sports activities, exercise groups, activities 364.33such as craft hours, leisure time, social hours, meal or snack time, trips to community 364.34activities, and tours;365.1    (ii) a social or educational service that does not have or cannot reasonably be 365.2expected to have a therapeutic outcome related to the client's emotional disturbance;365.3    (iii) consultation with other providers or service agency staff about the care or 365.4progress of a client;365.5    (iv) prevention or education programs provided to the community; and365.6    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and365.7    (6) activities that are not direct service time.365.8    Sec. 31. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.365.9    Effective for services rendered on or after July 1, 2007, payment rates for family 365.10planning services shall be increased by 25 percent over the rates in effect July 30, 2007, 365.11when these services are provided by a community clinic as defined in section 145.9268, 365.12subdivision 1.365.13    Sec. 32. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:365.14    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.365.15    (b) "Family asset account" means a savings account opened by a household 365.16participating in the Minnesota family assets for independence initiative.365.17    (c) "Fiduciary organization" means:365.18    (1) a community action agency that has obtained recognition under section 
         268.53365.19256E.31;365.20    (2) a federal community development credit union serving the seven-county 365.21metropolitan area; or365.22    (3) a women-oriented economic development agency serving the seven-county 365.23metropolitan area.365.24    (d) "Financial institution" means a bank, bank and trust, savings bank, savings 365.25association, or credit union, the deposits of which are insured by the Federal Deposit 365.26Insurance Corporation or the National Credit Union Administration.365.27    (e) "Permissible use" means:365.28    (1) postsecondary educational expenses at an accredited public postsecondary 365.29institution including books, supplies, and equipment required for courses of instruction;365.30    (2) acquisition costs of acquiring, constructing, or reconstructing a residence, 365.31including any usual or reasonable settlement, financing, or other closing costs;365.32    (3) business capitalization expenses for expenditures on capital, plant, equipment, 365.33working capital, and inventory expenses of a legitimate business pursuant to a business 365.34plan approved by the fiduciary organization; and366.1    (4) acquisition costs of a principal residence within the meaning of section 1034 of 366.2the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area 366.3purchase price applicable to the residence determined according to section 143(e)(2) and 366.4(3) of the Internal Revenue Code of 1986.366.5    (f) "Household" means all individuals who share use of a dwelling unit as primary 366.6quarters for living and eating separate from other individuals.366.7    Sec. 33. [525A.01] SHORT TITLE.366.8    This chapter may be cited as the "Darlene Luther Revised Uniform Anatomical 366.9Gift Act."366.10    Sec. 34. [525A.02] DEFINITIONS.366.11    Subdivision 1.Scope.The definitions in this section apply to this chapter.366.12    Subd. 2.Adult."Adult" means an individual who is at least 18 years of age.366.13    Subd. 3.Agent."Agent" means an individual who is:366.14    (1) authorized to make health care decisions on the principal's behalf by a power of 366.15attorney for health care; or366.16    (2) expressly authorized to make an anatomical gift on the principal's behalf by 366.17any other record signed by the principal.366.18    Subd. 4.Anatomical gift."Anatomical gift" means a donation of all or part of 366.19a human body to take effect after the donor's death for the purpose of transplantation, 366.20therapy, research, or education.366.21    Subd. 5.Decedent."Decedent" means a deceased individual and includes a stillborn 366.22infant or an embryo or fetus that has died of natural causes in utero.366.23    Subd. 6.Disinterested witness."Disinterested witness" means a witness other than 366.24the spouse, child, parent, sibling, grandchild, grandparent, or guardian of the individual 366.25who makes, amends, revokes, or refuses to make an anatomical gift, or another adult who 366.26exhibited special care and concern for the individual. The term does not include a person 366.27to which an anatomical gift could pass under section 525A.11.366.28    Subd. 7.Document of gift."Document of gift" means a donor card or other record 366.29used to make an anatomical gift. The term includes a statement or symbol on a driver's 366.30license, identification card, or donor registry.366.31    Subd. 8.Donor."Donor" means an individual whose body or part is the subject of 366.32an anatomical gift.366.33    Subd. 9.Donor registry."Donor registry" means a database that contains records 366.34of anatomical gifts and amendments to or revocations of anatomical gifts.367.1    Subd. 10.Driver's license."Driver's license" means a license or permit issued 367.2under chapter 171 to operate a vehicle, whether or not conditions are attached to the 367.3license or permit.367.4    Subd. 11.Eye bank."Eye bank" means a person that is licensed, accredited, 367.5or regulated under federal or state law to engage in the recovery, screening, testing, 367.6processing, storage, or distribution of human eyes or portions of human eyes.367.7    Subd. 12.Guardian."Guardian" means a person appointed by a court to make 367.8decisions regarding the support, care, education, health, or welfare of an individual. The 367.9term does not include a guardian ad litem.367.10    Subd. 13.Hospital."Hospital" means a facility licensed as a hospital under the 367.11law of any state or a facility operated as a hospital by the United States, a state, or a 367.12subdivision of a state.367.13    Subd. 14.Identification card."Identification card" means a Minnesota 367.14identification card issued under chapter 171.367.15    Subd. 15.Know."Know" means to have actual knowledge.367.16    Subd. 16.Medical examiner."Medical examiner" includes coroner.367.17    Subd. 17.Minor."Minor" means an individual who is under 18 years of age.367.18    Subd. 18.Organ procurement organization."Organ procurement organization" 367.19means a person designated by the secretary of the United States Department of Health and 367.20Human Services as an organ procurement organization.367.21    Subd. 19.Parent."Parent" means a parent whose parental rights have not been 367.22terminated.367.23    Subd. 20.Part."Part" means an organ, an eye, or tissue of a human being. The term 367.24does not include the whole body.367.25    Subd. 21.Person."Person" means an individual, corporation, business trust, estate, 367.26trust, partnership, limited liability company, association, joint venture, public corporation, 367.27government or governmental subdivision, agency, or instrumentality, or any other legal or 367.28commercial entity.367.29    Subd. 22.Physician."Physician" means an individual authorized to practice 367.30medicine or osteopathy under the law of any state.367.31    Subd. 23.Procurement organization."Procurement organization" means an eye 367.32bank, organ procurement organization, or tissue bank.367.33    Subd. 24.Prospective donor."Prospective donor" means an individual who is dead 367.34or near death and has been determined by a procurement organization to have a part that 367.35could be medically suitable for transplantation, therapy, research, or education. The term 367.36does not include an individual who has made a refusal.368.1    Subd. 25.Reasonably available."Reasonably available" means able to be 368.2contacted by a procurement organization without undue effort and willing and able to act 368.3in a timely manner consistent with existing medical criteria necessary for the making of 368.4an anatomical gift.368.5    Subd. 26.Recipient."Recipient" means an individual into whose body a decedent's 368.6part has been or is intended to be transplanted.368.7    Subd. 27.Record."Record" means information that is inscribed on a tangible 368.8medium or that is stored in an electronic or other medium and is retrievable in perceivable 368.9form.368.10    Subd. 28.Refusal."Refusal" means a record created under section 525A.07 that 368.11expressly states an intent to bar other persons from making an anatomical gift of an 368.12individual's body or part.368.13    Subd. 29.Sign."Sign" means, with the present intent to authenticate or adopt 368.14a record:368.15    (1) to execute or adopt a tangible symbol; or368.16    (2) to attach to or logically associate with the record an electronic symbol, sound, 368.17or process.368.18    Subd. 30.State."State" means a state of the United States, the District of Columbia, 368.19Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject 368.20to the jurisdiction of the United States.368.21    Subd. 31.Technician."Technician" means an individual determined to be qualified 368.22to remove or process parts by an appropriate organization that is licensed, accredited, or 368.23regulated under federal or state law. The term includes an enucleator.368.24    Subd. 32.Tissue."Tissue" means a portion of the human body other than an organ 368.25or an eye. The term does not include blood unless the blood is donated for the purpose 368.26of research or education.368.27    Subd. 33.Tissue bank."Tissue bank" means a person that is licensed, accredited, 368.28or regulated under federal or state law to engage in the recovery, screening, testing, 368.29processing, storage, or distribution of tissue.368.30    Subd. 34.Transplant hospital."Transplant hospital" means a hospital that 368.31furnishes organ transplants and other medical and surgical specialty services required 368.32for the care of transplant patients.368.33    Sec. 35. [525A.03] APPLICABILITY.368.34    This chapter applies to an anatomical gift or amendment to, revocation of, or refusal 368.35to make an anatomical gift, whenever made.369.1    Sec. 36. [525A.04] WHO MAY MAKE ANATOMICAL GIFT BEFORE 369.2DONOR'S DEATH.369.3    Subject to section 525A.08, an anatomical gift of a donor's body or part may be 369.4made during the life of the donor for the purpose of transplantation, therapy, research, or 369.5education in the manner provided in section 525A.05 by:369.6    (1) the donor, if the donor is an adult or if the donor is a minor and is:369.7    (i) emancipated; or369.8    (ii) authorized under state law to apply for a driver's license because the donor is 369.9at least 16 years of age;369.10    (2) an agent of the donor, unless the power of attorney for health care or other record 369.11prohibits the agent from making an anatomical gift;369.12    (3) a parent of the donor, if the donor is an unemancipated minor; or369.13    (4) the donor's guardian.369.14    Sec. 37. [525A.05] MANNER OF MAKING ANATOMICAL GIFT BEFORE 369.15DONOR'S DEATH.369.16    (a) A donor may make an anatomical gift:369.17    (1) by authorizing a statement or symbol indicating that the donor has made an 369.18anatomical gift to be imprinted on the donor's driver's license or identification card;369.19    (2) in a will;369.20    (3) during a terminal illness or injury of the donor, by any form of communication 369.21addressed to at least two adults, at least one of whom is a disinterested witness; or369.22    (4) as provided in paragraph (b).369.23    (b) A donor or other person authorized to make an anatomical gift under section 369.24525A.04 may make a gift by a donor card or other record signed by the donor or other 369.25person making the gift or by authorizing that a statement or symbol indicating that the 369.26donor has made an anatomical gift be included on a donor registry. If the donor or 369.27other person is physically unable to sign a record, the record may be signed by another 369.28individual at the direction of the donor or other person and must:369.29    (1) be witnessed by at least two adults, at least one of whom is a disinterested 369.30witness, who have signed at the request of the donor or the other person; and369.31    (2) state that it has been signed and witnessed as provided in clause (1).369.32    (c) Revocation, suspension, expiration, or cancellation of a driver's license or 369.33identification card upon which an anatomical gift is indicated does not invalidate the gift.370.1    (d) An anatomical gift made by will takes effect upon the donor's death whether or 370.2not the will is probated. Invalidation of the will after the donor's death does not invalidate 370.3the gift.370.4    (e) The making of an anatomical gift shall not itself authorize or direct the denial 370.5of health care.370.6    Sec. 38. [525A.06] AMENDING OR REVOKING ANATOMICAL GIFT 370.7BEFORE DONOR'S DEATH.370.8    (a) Subject to section 525A.08, a donor or other person authorized to make an 370.9anatomical gift under section 525A.04 may amend or revoke an anatomical gift by:370.10    (1) a record signed by:370.11    (i) the donor;370.12    (ii) the other person; or370.13    (iii) subject to paragraph (b), another individual acting at the direction of the donor 370.14or the other person if the donor or other person is physically unable to sign; or370.15    (2) a later-executed document of gift that amends or revokes a previous anatomical 370.16gift or portion of an anatomical gift, either expressly or by inconsistency.370.17    (b) A record signed pursuant to paragraph (a), clause (1), item (iii), must:370.18    (1) be witnessed by at least two adults, at least one of whom is a disinterested 370.19witness, who have signed at the request of the donor or the other person; and370.20    (2) state that it has been signed and witnessed as provided in clause (1).370.21    (c) Subject to section 525A.08, a donor or other person authorized to make an 370.22anatomical gift under section 525A.04 may revoke an anatomical gift by the destruction or 370.23cancellation of the document of gift, or the portion of the document of gift used to make 370.24the gift, with the intent to revoke the gift.370.25    (d) A donor may amend or revoke an anatomical gift that was not made in a will 370.26by any form of communication during a terminal illness or injury addressed to at least 370.27two adults, at least one of whom is a disinterested witness.370.28    (e) A donor who makes an anatomical gift in a will may amend or revoke the gift in 370.29the manner provided for amendment or revocation of wills or as provided in paragraph (a).370.30    Sec. 39. [525A.07] REFUSAL TO MAKE ANATOMICAL GIFT; EFFECT OF 370.31REFUSAL.370.32    (a) An individual may refuse to make an anatomical gift of the individual's body 370.33or part by:370.34    (1) a record signed by:371.1    (i) the individual; or371.2    (ii) subject to paragraph (b), another individual acting at the direction of the 371.3individual if the individual is physically unable to sign;371.4    (2) the individual's will, whether or not the will is admitted to probate or invalidated 371.5after the individual's death; or371.6    (3) any form of communication made by the individual during the individual's 371.7terminal illness or injury addressed to at least two adults, at least one of whom is a 371.8disinterested witness.371.9    (b) A record signed pursuant to paragraph (a), clause (1), item (ii), must:371.10    (1) be witnessed by at least two adults, at least one of whom is a disinterested 371.11witness, who have signed at the request of the individual; and371.12    (2) state that it has been signed and witnessed as provided in clause (1).371.13    (c) An individual who has made a refusal may amend or revoke the refusal:371.14    (1) in the manner provided in paragraph (a) for making a refusal;371.15    (2) by subsequently making an anatomical gift pursuant to section 525A.05 that is 371.16inconsistent with the refusal; or371.17    (3) by destroying or canceling the record evidencing the refusal, or the portion of the 371.18record used to make the refusal, with the intent to revoke the refusal.371.19    (d) Except as otherwise provided in section 525A.08, paragraph (h), in the absence 371.20of an express, contrary indication by the individual set forth in the refusal, an individual's 371.21unrevoked refusal to make an anatomical gift of the individual's body or part bars all other 371.22persons from making an anatomical gift of the individual's body or part.371.23    Sec. 40. [525A.08] PRECLUSIVE EFFECT OF ANATOMICAL GIFT, 371.24AMENDMENT, OR REVOCATION.371.25    (a) Except as otherwise provided in paragraph (g) and subject to paragraph (f), in the 371.26absence of an express, contrary indication by the donor, a person other than the donor is 371.27barred from making, amending, or revoking an anatomical gift of a donor's body or part if 371.28the donor made an anatomical gift of the donor's body or part under section 525A.05 or an 371.29amendment to an anatomical gift of the donor's body or part under section 525A.06. An 371.30anatomical gift made in a will, a designation on a driver's license or identification card, or 371.31a health care directive under chapter 145C, and not revoked, establishes the intent of the 371.32person making the designation and may not be overridden by any other person.371.33    (b) A donor's revocation of an anatomical gift of the donor's body or part under 371.34section 525A.06 is not a refusal and does not bar another person specified in section 372.1525A.04 or 525A.09 from making an anatomical gift of the donor's body or part under 372.2section 525A.05 or 525A.10.372.3    (c) If a person other than the donor makes an unrevoked anatomical gift of the 372.4donor's body or part under section 525A.05 or an amendment to an anatomical gift of the 372.5donor's body or part under section 525A.06, another person may not make, amend, or 372.6revoke the gift of the donor's body or part under section 525A.10.372.7    (d) A revocation of an anatomical gift of a donor's body or part under section 372.8525A.06 by a person other than the donor does not bar another person from making an 372.9anatomical gift of the body or part under section 525A.05 or 525A.10.372.10    (e) In the absence of an express, contrary indication by the donor or other person 372.11authorized to make an anatomical gift under section 525A.04, an anatomical gift of a part 372.12is neither a refusal to give another part nor a limitation on the making of an anatomical gift 372.13of another part at a later time by the donor or another person.372.14    (f) In the absence of an express, contrary indication by the donor or other person 372.15authorized to make an anatomical gift under section 525A.04, an anatomical gift of a 372.16part for one or  more of the purposes set forth in section 525A.04 is not a limitation on 372.17the making of an anatomical gift of the part for any of the other purposes by the donor 372.18or any other person under section 525A.05 or 525A.10.372.19    (g) If a donor who is an unemancipated minor dies, a parent of the donor who is 372.20reasonably available may revoke or amend an anatomical gift of the donor's body or part.372.21    (h) If an unemancipated minor who signed a refusal dies, a parent of the minor who 372.22is reasonably available may revoke the minor's refusal.372.23    Sec. 41. [525A.09] WHO MAY MAKE ANATOMICAL GIFT OF DECEDENT'S 372.24BODY OR PART.372.25    (a) Subject to paragraphs (b) and (c) and unless barred by section 525A.07 or 372.26525A.08, an anatomical gift of a decedent's body or part for the purpose of transplantation, 372.27therapy, research, or education may be made by any member of the following classes of 372.28persons who is reasonably available, in the order of priority listed:372.29    (1) an agent of the decedent at the time of death who could have made an anatomical 372.30gift under section 525A.04, clause (2), immediately before the decedent's death;372.31    (2) the spouse of the decedent;372.32    (3) adult children of the decedent;372.33    (4) parents of the decedent;372.34    (5) adult siblings of the decedent;372.35    (6) adult grandchildren of the decedent;373.1    (7) grandparents of the decedent;373.2    (8) an adult who exhibited special care and concern for the decedent;373.3    (9) the persons who were acting as the guardians of the person of the decedent 373.4at the time of death; and 373.5    (10) any other person having the authority to dispose of the decedent's body.373.6    (b) If there is more than one member of a class listed in paragraph (a), clause (1), 373.7(3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an anatomical gift may 373.8be made by a member of the class unless that member or a person to which the gift may 373.9pass under section 525A.11 knows of an objection by another member of the class. If 373.10an objection is known, the gift may be made only by a majority of the members of the 373.11class who are reasonably available.373.12    (c) A person may not make an anatomical gift if, at the time of the decedent's death, 373.13a person in a prior class under paragraph (a) is reasonably available to make or to object to 373.14the making of an anatomical gift.373.15    Sec. 42. [525A.10] MANNER OF MAKING, AMENDING, OR REVOKING 373.16ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.373.17    (a) A person authorized to make an anatomical gift under section 525A.09 may 373.18make an anatomical gift by a document of gift signed by the person making the gift or by 373.19that person's oral communication that is electronically recorded or is contemporaneously 373.20reduced to a record and signed by the individual receiving the oral communication.373.21    (b) Subject to paragraph (c), an anatomical gift by a person authorized under section 373.22525A.09 may be amended or revoked orally or in a record by any member of a prior class 373.23who is reasonably available. If more than one member of the prior class is reasonably 373.24available, the gift made by a person authorized under section 525A.09 may be:373.25    (1) amended only if a majority of the reasonably available members agree to the 373.26amending of the gift; or373.27    (2) revoked only if a majority of the reasonably available members agree to the 373.28revoking of the gift or if they are equally divided as to whether to revoke the gift.373.29    (c) A revocation under paragraph (b) is effective only if, before an incision has been 373.30made to remove a part from the donor's body or before invasive procedures have begun to 373.31prepare the recipient, the procurement organization, transplant hospital, or physician or 373.32technician knows of the revocation.373.33    Sec. 43. [525A.11] PERSONS THAT MAY RECEIVE ANATOMICAL GIFT; 373.34PURPOSE OF ANATOMICAL GIFT.374.1    (a) An anatomical gift may be made to the following persons named in the document 374.2of gift:374.3    (1) a hospital; accredited medical school, dental school, college, or university; organ 374.4procurement organization; or nonprofit organization in medical education or research, 374.5for research or education;374.6    (2) subject to paragraph (b), an individual designated by the person making the 374.7anatomical gift if the individual is the recipient of the part; and 374.8    (3) an eye bank or tissue bank.374.9    (b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be 374.10transplanted into the individual, the part passes in accordance with paragraph (g) in the 374.11absence of an express, contrary indication by the person making the anatomical gift.374.12    (c) If an anatomical gift of one or more specific parts or of all parts is made in a 374.13document of gift that does not name a person described in paragraph (a) but identifies the 374.14purpose for which an anatomical gift may be used, the following rules apply:374.15    (1) if the part is an eye and the gift is for the purpose of transplantation or therapy, 374.16the gift passes to the appropriate eye bank;374.17    (2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the 374.18gift passes to the appropriate tissue bank;374.19    (3) if the part is an organ and the gift is for the purpose of transplantation or therapy, 374.20the gift passes to the appropriate organ procurement organization as custodian of the 374.21organ; and374.22    (4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research 374.23or education, the gift passes to the appropriate procurement organization.374.24    (d) For the purpose of paragraph (c), if there is more than one purpose of an 374.25anatomical gift set forth in the document of gift but the purposes are not set forth in any 374.26priority, the gift must be used for transplantation or therapy, if suitable. If the gift cannot 374.27be used for transplantation or therapy, the gift may be used for research or education. 374.28    (e) If an anatomical gift of one or more specific parts is made in a document of gift 374.29that does not name a person described in paragraph (a) and does not identify the purpose 374.30of the gift, the gift may be used only for transplantation or therapy, and the gift passes in 374.31accordance with paragraph (g).374.32    (f) If a document of gift specifies only a general intent to make an anatomical gift 374.33by words such as "donor," "organ donor," or "body donor," or by a symbol or statement 374.34of similar import, the gift may be used only for transplantation or therapy, and the gift 374.35passes in accordance with paragraph (g).374.36    (g) For purposes of paragraphs (b), (e), and (f), the following rules apply:375.1    (1) if the part is an eye, the gift passes to the appropriate eye bank;375.2    (2) if the part is tissue, the gift passes to the appropriate tissue bank; and375.3    (3) if the part is an organ, the gift passes to the appropriate organ procurement 375.4organization as custodian of the organ.375.5    (h) An anatomical gift of an organ for transplantation or therapy, other than 375.6an anatomical gift under paragraph (a), clause (2), passes to the organ procurement 375.7organization as custodian of the organ.375.8    (i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the 375.9decedent's body or part is not used for transplantation, therapy, research, or education, 375.10custody of the body or part passes to the person under obligation to dispose of the body or 375.11part.375.12    (j) A person may not accept an anatomical gift if the person knows that the gift was 375.13not effectively made under section 525A.05 or 525A.10 or if the person knows that the 375.14decedent made a refusal under section 525A.07 that was not revoked. For purposes of 375.15this paragraph, if a person knows that an anatomical gift was made on a document of gift, 375.16the person is deemed to know of any amendment or revocation of the gift or any refusal 375.17to make an anatomical gift on the same document of gift.375.18    (k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter 375.19affects the allocation of organs for transplantation or therapy.375.20    Sec. 44. [525A.12] SEARCH AND NOTIFICATION.375.21    (a) The following persons shall make a reasonable search of an individual who 375.22the person reasonably believes is dead or near death for a document of gift or other 375.23information identifying the individual as a donor or as an individual who made a refusal:375.24    (1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer 375.25finding the individual; and375.26    (2) if no other source of the information is immediately available, a hospital, as soon 375.27as practical after the individual's arrival at the hospital.375.28    (b) If a document of gift or a refusal to make an anatomical gift is located by the 375.29search required by paragraph (a), clause (1), and the individual or deceased individual to 375.30whom it relates is taken to a hospital, the person responsible for conducting the search 375.31shall send the document of gift or refusal to the hospital. If a body is transferred to 375.32the custody of the medical examiner, the person who discovered the body must notify 375.33the person's dispatcher. A dispatcher notified under this section must notify the state's 375.34federally designated organ procurement organization and inform the organization of the 375.35deceased's name, donor status, and location.376.1    (c) A person is not subject to criminal or civil liability for failing to discharge the 376.2duties imposed by this section but may be subject to administrative sanctions.376.3    Sec. 45. [525A.13] DELIVERY OF DOCUMENT OF GIFT NOT REQUIRED; 376.4RIGHT TO EXAMINE.376.5    (a) A document of gift need not be delivered during the donor's lifetime to be 376.6effective.376.7    (b) Upon or after an individual's death, a person in possession of a document of 376.8gift or a refusal to make an anatomical gift with respect to the individual shall allow 376.9examination and copying of the document of gift or refusal by a person authorized to 376.10make or object to the making of an anatomical gift with respect to the individual or by a 376.11person to which the gift could pass under section 525A.11.376.12    Sec. 46. [525A.14] RIGHTS AND DUTIES OF PROCUREMENT 376.13ORGANIZATION AND OTHERS.376.14    (a) When a hospital refers an individual at or near death to a procurement 376.15organization, the organization shall make a reasonable search of the records of the 376.16Department of Public Safety and any donor registry that it knows exists for the 376.17geographical area in which the individual resides to ascertain whether the individual has 376.18made an anatomical gift.376.19    (b) A procurement organization must be allowed reasonable access to information 376.20in the records of the Department of Public Safety to ascertain whether an individual at 376.21or near death is a donor.376.22    (c) When a hospital refers an individual at or near death to a procurement 376.23organization, the organization may conduct any reasonable examination necessary to 376.24ensure the medical suitability of a part that is or could be the subject of an anatomical gift 376.25for transplantation, therapy, research, or education from a donor or a prospective donor. 376.26During the examination period, measures necessary to ensure the medical suitability of the 376.27part may not be withdrawn unless the hospital or procurement organization knows that 376.28the individual expressed a contrary intent.376.29    (d) Unless prohibited by law other than this chapter, at any time after a donor's death, 376.30the person to which a part passes under section 525A.11 may conduct any reasonable 376.31examination necessary to ensure the medical suitability of the body or part for its intended 376.32purpose.377.1    (e) Unless prohibited by law other than this chapter, an examination under paragraph 377.2(c) or (d) may include an examination of all medical and dental records of the donor or 377.3prospective donor.377.4    (f) Upon the death of a minor who was a donor or had signed a refusal, unless a 377.5procurement organization knows the minor is emancipated, the procurement organization 377.6shall conduct a reasonable search for the parents of the minor and provide the parents with 377.7an opportunity to revoke or amend the anatomical gift or revoke the refusal.377.8    (g) Upon referral by a hospital under paragraph (a), a procurement organization shall 377.9make a reasonable search for any person listed in section 525A.09 having priority to make 377.10an anatomical gift on behalf of a prospective donor. If a procurement organization receives 377.11information that an anatomical gift to any other person was made, amended, or revoked, it 377.12shall promptly advise the other person of all relevant information.377.13    (h) Subject to sections 525A.11, paragraph (i), and 525A.23, the rights of the person 377.14to which a part passes under section 525A.11 are superior to the rights of all others with 377.15respect to the part. The person may accept or reject an anatomical gift in whole or in part. 377.16Subject to the terms of the document of gift and this chapter, a person that accepts an 377.17anatomical gift of an entire body may allow embalming, burial, or cremation, and use of 377.18remains in a funeral service. If the gift is of a part, the person to which the part passes 377.19under section 525A.11, upon the death of the donor and before embalming, burial, or 377.20cremation, shall cause the part to be removed without unnecessary mutilation.377.21    (i) Neither the physician who attends the decedent at death nor the physician who 377.22determines the time of the decedent's death may participate in the procedures for removing 377.23or transplanting a part from the decedent.377.24    (j) A physician or technician may remove a donated part from the body of a donor 377.25that the physician or technician is qualified to remove.377.26    Sec. 47. [525A.15] COORDINATION OF PROCUREMENT AND USE.377.27    Each hospital in this state shall enter into agreements or affiliations with procurement 377.28organizations for coordination of procurement and use of anatomical gifts.377.29    Sec. 48. [525A.16] SALE OR PURCHASE OF PARTS PROHIBITED; FELONY.377.30    (a) Except as otherwise provided in paragraph (b), a person that, for valuable 377.31consideration, knowingly purchases or sells a part for transplantation or therapy if removal 377.32of a part from an individual is intended to occur after the individual's death, commits a 377.33felony and upon conviction is subject to a fine not exceeding $10,000 or imprisonment 377.34not exceeding five years, or both.378.1    (b) A person may charge a reasonable amount for the removal, processing, 378.2preservation, quality control, storage, transportation, implantation, or disposal of a part.378.3    Sec. 49. [525A.17] PROHIBITED ACTS; FELONY.378.4    A person that, in order to obtain a financial gain, intentionally falsifies, forges, 378.5conceals, defaces, or obliterates a document of gift, an amendment or revocation of a 378.6document of gift, or a refusal commits a felony and upon conviction is subject to a fine not 378.7exceeding $10,000 or imprisonment not exceeding five years, or both.378.8    Sec. 50. [525A.18] IMMUNITY.378.9    (a) A person that acts in accordance with this chapter or with the applicable 378.10anatomical gift law of another state, or attempts in good faith to do so, is not liable for the 378.11act in a civil action, criminal prosecution, or administrative proceeding.378.12    (b) Neither the person making an anatomical gift nor the donor's estate is liable for 378.13any injury or damage that results from the making or use of the gift.378.14    (c) In determining whether an anatomical gift has been made, amended, or revoked 378.15under this chapter, a person may rely upon representations of an individual listed in 378.16section 525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating to the 378.17individual's relationship to the donor or prospective donor unless the person knows that 378.18the representation is untrue.378.19    (d) An anatomical gift under this chapter is not a sale of goods as that term is defined 378.20in section 336.2-105, paragraph (1), or the sale of a product.378.21    Sec. 51. [525A.19] LAW GOVERNING VALIDITY; CHOICE OF LAW AS TO 378.22EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.378.23    (a) A document of gift is valid if executed in accordance with:378.24    (1) this chapter;378.25    (2) the laws of the state or country where it was executed; or378.26    (3) the laws of the state or country where the person making the anatomical gift 378.27was domiciled, has a place of residence, or was a national at the time the document of 378.28gift was executed.378.29    (b) If a document of gift is valid under this section, the law of this state governs 378.30the interpretation of the document of gift.378.31    (c) A person may presume that a document of gift or amendment of an anatomical 378.32gift is valid unless that person knows that it was not validly executed or was revoked.379.1    Sec. 52. [525A.20] DONOR REGISTRY.379.2    (a) The Department of Health may establish or contract for the establishment of a 379.3donor registry.379.4    (b) The Department of Public Safety shall cooperate with a person that administers 379.5any donor registry that this state establishes, contracts for, or recognizes for the purpose 379.6of transferring to the donor registry all relevant information regarding a donor's making, 379.7amendment to, or revocation of an anatomical gift.379.8    (c) A donor registry must:379.9    (1) allow a donor or other person authorized under section 525A.04 to include on 379.10the donor registry a statement or symbol that the donor has made, amended, or revoked 379.11an anatomical gift;379.12    (2) be accessible to a procurement organization to allow it to obtain relevant 379.13information on the donor registry to determine, at or near death of the donor or a 379.14prospective donor, whether the donor or prospective donor has made, amended, or revoked 379.15an anatomical gift; and379.16    (3) be accessible, for purposes of clauses (1) and (2), seven days a week on a 379.1724-hour basis.379.18    (d) Personally identifiable information on a donor registry about a donor or 379.19prospective donor may not be used or disclosed without the express consent of the donor, 379.20prospective donor, or person that made the anatomical gift for any purpose other than 379.21to determine, at or near death of the donor or prospective donor, whether the donor or 379.22prospective donor has made, amended, or revoked an anatomical gift.379.23    (e) This section does not prohibit any person from creating or maintaining a donor 379.24registry that is not established by or under contract with the state. Any such registry 379.25must comply with paragraphs (c) and (d).379.26    Sec. 53. [525A.21] EFFECT OF ANATOMICAL GIFT ON ADVANCE HEALTH 379.27CARE DIRECTIVE.379.28    (a) In this section:379.29    (1) "advance health care directive" means a power of attorney for health care 379.30or a record signed by a prospective donor containing the prospective donor's direction 379.31concerning a health care decision for the prospective donor;379.32    (2) "declaration" means a record signed by a prospective donor specifying the 379.33circumstances under which a life support system may be withheld or withdrawn from 379.34the prospective donor; and380.1    (3) "health care decision" means any decision made regarding the health care of the 380.2prospective donor.380.3    (b) If a prospective donor has a declaration or advance health care directive, 380.4measures necessary to ensure the medical suitability of an organ for transplantation 380.5or therapy may not be withheld or withdrawn from the prospective donor, unless the 380.6declaration expressly provides to the contrary.380.7    Sec. 54. [525A.22] COOPERATION BETWEEN MEDICAL EXAMINER AND 380.8PROCUREMENT ORGANIZATION.380.9    (a) A medical examiner shall cooperate with procurement organizations to maximize 380.10the opportunity to recover anatomical gifts for the purpose of transplantation, therapy, 380.11research, or education.380.12    (b) If a medical examiner receives notice from a procurement organization that an 380.13anatomical gift might be available or was made with respect to a decedent whose body is 380.14under the jurisdiction of the medical examiner and a postmortem examination is going to 380.15be performed, unless the medical examiner denies recovery in accordance with section 380.16525A.23, the medical examiner or designee shall conduct a postmortem examination of 380.17the body or the part in a manner and within a period compatible with its preservation for 380.18the purposes of the gift.380.19    (c) A part may not be removed from the body of a decedent under the jurisdiction 380.20of a medical examiner for transplantation, therapy, research, or education unless the part 380.21is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the 380.22medical examiner may not be delivered to a person for research or education unless the 380.23body is the subject of an anatomical gift. This paragraph does not preclude a medical 380.24examiner from performing the medicolegal investigation upon the body or parts of a 380.25decedent under the jurisdiction of the medical examiner.380.26    Sec. 55. [525A.23] FACILITATION OF ANATOMICAL GIFT FROM 380.27DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL 380.28EXAMINER.380.29    (a) Upon request of a procurement organization, a medical examiner shall release to 380.30the procurement organization the name, contact information, and available medical and 380.31social history of a decedent whose body is under the jurisdiction of the medical examiner. 380.32If the decedent's body or part is medically suitable for transplantation, therapy, research, 380.33or education, the medical examiner shall release postmortem examination results to 380.34the procurement organization. The procurement organization may make a subsequent 381.1disclosure of the postmortem examination results or other information received from the 381.2medical examiner only if relevant to transplantation or therapy.381.3    (b) The medical examiner may conduct a medicolegal examination by reviewing 381.4all medical records, laboratory test results, x-rays, other diagnostic results, and other 381.5information that any person possesses about a donor or prospective donor whose body is 381.6under the jurisdiction of the medical examiner which the medical examiner determines 381.7may be relevant to the investigation.381.8    (c) A person that has any information requested by a medical examiner pursuant 381.9to paragraph (b) shall provide that information as expeditiously as possible to allow the 381.10medical examiner to conduct the medicolegal investigation within a period compatible 381.11with the preservation of parts for the purpose of transplantation, therapy, research, or 381.12education.381.13    (d) If an anatomical gift has been or might be made of a part of a decedent whose 381.14body is under the jurisdiction of the medical examiner and a postmortem examination 381.15is not required, or the medical examiner determines that a postmortem examination is 381.16required but that the recovery of the part that is the subject of an anatomical gift will 381.17not interfere with the examination, the medical examiner and procurement organization 381.18shall cooperate in the timely removal of the part from the decedent for the purpose of 381.19transplantation, therapy, research, or education.381.20    (e) If an anatomical gift of a part from the decedent under the jurisdiction of 381.21the medical examiner has been or might be made, but the medical examiner initially 381.22believes that the recovery of the part could interfere with the postmortem investigation 381.23into the decedent's cause or manner of death, the medical examiner shall consult with 381.24the procurement organization or physician or technician designated by the procurement 381.25organization about the proposed recovery. After consultation, the medical examiner may 381.26allow the recovery.381.27    (f) Following the consultation under paragraph (e), in the absence of mutually 381.28agreed-upon protocols to resolve conflict between the medical examiner and the 381.29procurement organization, if the medical examiner intends to deny recovery of an organ 381.30for transplantation, the medical examiner or designee, at the request of the procurement 381.31organization, shall attend the removal procedure for the part before making a final 381.32determination not to allow the procurement organization to recover the part. During 381.33the removal procedure, the medical examiner or designee may allow recovery by the 381.34procurement organization to proceed, or, if the medical examiner or designee reasonably 381.35believes that the part may be involved in determining the decedent's cause or manner of 381.36death, deny recovery by the procurement organization.382.1    (g) If the medical examiner or designee denies recovery under paragraph (f), the 382.2medical examiner or designee shall:382.3    (1) explain in a record the specific reasons for not allowing recovery of the part;382.4    (2) include the specific reasons in the records of the medical examiner; and382.5    (3) provide a record with the specific reasons to the procurement organization.382.6    (h) If the medical examiner or designee allows recovery of a part under paragraph 382.7(d), (e), or (f), the procurement organization, upon request, shall cause the physician 382.8or technician who removes the part to provide the medical examiner with a record 382.9describing the condition of the part, a biopsy, a photograph, and any other information and 382.10observations that would assist in the postmortem examination.382.11    (i) If a medical examiner or designee is required to be present at a removal procedure 382.12under paragraph (f), upon request the procurement organization requesting the recovery 382.13of the part shall reimburse the medical examiner or designee for the additional costs 382.14incurred in complying with paragraph (f).382.15    Sec. 56. [525A.24] RELATION TO ELECTRONIC SIGNATURES IN GLOBAL 382.16AND NATIONAL COMMERCE ACT.382.17    This chapter modifies, limits, and supersedes the Electronic Signatures in Global and 382.18National Commerce Act, United States Code, title 15, section 7001 et seq., but does not 382.19modify, limit, or supersede section 101(a) of that act, United States Code, title 15, section 382.207001, or authorize electronic delivery of any of the notices described in section 103(b) 382.21of that act, United States Code, title 15, section 7003(b).382.22    Sec. 57. Laws 2005, chapter 98, article 3, section 25, is amended to read:382.23    Sec. 25. REPEALER.382.24    Minnesota Statutes 2004, sections 
         245.713, subdivisions 2 and subdivision 4; 382.25245.716
         ; and 
         626.5551, subdivision 4, are repealed.382.26EFFECTIVE DATE.This section is effective retroactively from August 1, 2005.382.27    Sec. 58. SOBER HOUSES.382.28    Subdivision 1.Sober house defined.For purposes of this section, a "sober house" 382.29means a cooperative living residence that:382.30    (1) provides temporary housing to persons with alcohol or other drug dependency 382.31and abuse problems in exchange for compensation;382.32    (2) stipulates residents must abstain from using alcohol or drugs and meet other 382.33requirements as a condition of living in the residence; and383.1    (3) does not provide counseling or treatment services to those residents within the 383.2meaning of Minnesota Statutes, chapter 148C or 254A.383.3    Subd. 2.Work group creation; membership.The commissioner of human services 383.4shall convene a sober house work group which is comprised of the following members:383.5    (1) sober house landlords;383.6    (2) sober house residents;383.7    (3) community members with knowledge of sober housing;383.8    (4) representatives of cities and counties;383.9    (5) a representative from the Department of Human Services, Chemical Health 383.10Division;383.11    (6) a representative from the Department of Human Services, Licensing Division;383.12    (7) a representative of chemical dependency treatment providers; 383.13    (8) a representative from the Department of Health;383.14    (9) a representative from the Minnesota Association of Sober Homes; and383.15    (10) a representative from the Association of Halfway House Alcoholism Programs 383.16of North America.383.17    Subd. 3.Report.The work group created in subdivision 2 is directed to study 383.18the issue of sober houses in the state and determine whether state licensing or other 383.19regulation of sober houses is appropriate. The work group shall also study and include 383.20recommendations for minimum housing standards, client rights, and ways to ensure 383.21transition to safe housing for vulnerable evicted tenants. Based on findings of the work 383.22group, the commissioner of human services shall submit a report of recommendations to 383.23the legislature by January 1, 2008.383.24    Sec. 59. INTERPRETER SERVICES WORK GROUP.383.25    (a) The commissioner of health shall, in consultation with the commissioners of 383.26commerce, human services, and employee relations, convene a work group to study the 383.27provision of interpreter services to patients in medical and dental care settings. The work 383.28group shall include one representative from each of the following groups:383.29    (1) consumers;383.30    (2) interpreters;383.31    (3) interpreter service providers or agencies;383.32    (4) health plan companies;383.33    (5) self-insured purchasers;383.34    (6) hospitals;383.35    (7) health care providers;384.1    (8) dental providers;384.2    (9) clinic administrators;384.3    (10) state agency staff from the Departments of Health, Human Services, and 384.4Employee Relations;384.5    (11) Minnesota Registry of Interpreters for the Deaf;384.6    (12) local county social services agencies;384.7    (13) local public health agencies;384.8    (14) interpreting stakeholders group;384.9    (15) one interpreter trainer; and384.10    (16) one interpreter certification examiner.384.11    (b) The work group shall develop findings and recommendations on the following: 384.12    (1) assuring access to interpreter services;384.13    (2) compliance with requirements of federal law and guidance;384.14    (3) developing a quality assurance program to ensure the quality of health care 384.15interpreting services, including requirements for training and establishing a certification 384.16process; and 384.17    (4) identifying broad-based funding mechanisms for interpreter services.384.18    (c) Based on the discussions of the work group, the commissioner shall make 384.19recommendations to the chairs of the health policy and finance committees in the house 384.20and senate by January 15, 2008, on how to ensure high quality interpreter services for 384.21patients in medical and dental settings, and for a broad-based funding mechanism for 384.22delivering these services.384.23EFFECTIVE DATE.This section is effective the day following final enactment.384.24    Sec. 60. FEDERAL GRANTS.384.25    The Board of Pharmacy shall apply for any applicable federal grants or other nonstate 384.26funds to establish and fully implement the prescription electronic reporting system.384.27EFFECTIVE DATE.This section is effective the day following final enactment.384.28    Sec. 61. BOARD OF PHARMACY.384.29    The Board of Pharmacy shall not increase the license fees of pharmacists or 384.30pharmacies in order to adequately fund the prescription electronic reporting system under 384.31Minnesota Statutes, section 152.126, without specific authority from the legislature.384.32EFFECTIVE DATE.This section is effective the day following final enactment.385.1    Sec. 62. BOARD OF MEDICAL PRACTICE.385.2    The Board of Medical Practice shall convene a work group to discuss the appropriate 385.3prescribing of controlled substances listed in Minnesota Statutes, section 152.02, 385.4subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 385.5Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and 385.6shall report to the legislature by December 15, 2007.385.7    Sec. 63. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.385.8    Subdivision 1.Pilot project requirements.The commissioner of commerce shall 385.9authorize a joint self-insurance pilot project administered by a trust sponsored by one 385.10or more agricultural cooperatives organized under Minnesota Statutes, chapter 308A, 385.11or under a federal charter for the purpose of offering health coverage to members of 385.12the cooperatives and their families, provided the project satisfies the requirements of 385.13Minnesota Statutes, chapter 62H, except as follows:385.14    (1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;385.15    (2) the notice period required under Minnesota Statutes, section 62H.02, paragraph 385.16(e), is 90 days;385.17    (3) the commissioner shall grant necessary waivers and approve an alternative 385.18arrangement that fully funds the plan's liability or incurred but unpaid claims under 385.19Minnesota Statutes, section 62H.02, paragraph (f), unless the commissioner provides 385.20evidence demonstrating that the insolvency protection proposed is substantially less than 385.21that typically provided by self-insured group plans of a similar size in Minnesota;385.22    (4) notwithstanding Minnesota Statutes, section 62H.04, paragraph (a), the joint 385.23self-insurance plan shall be considered a large group and not subject to the small group 385.24insurance requirements in Minnesota Statutes, chapter 62L, even if some employer 385.25groups enrolled in the plan would be defined as small employers, except that the joint 385.26self-insurance plan may elect to treat the sale of a health plan to or for an employer that 385.27has only one eligible employee who has not waived coverage as the sale of an individual 385.28health plan as allowed under Minnesota Statutes, section 62L.02, subdivision 26;385.29    (5) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), does not 385.30apply; and 385.31    (6) the trust must pay the assessment for the Minnesota comprehensive health 385.32association as provided under Minnesota Statutes, section 62E.11.385.33    Subd. 2.Evaluation and renewal.The pilot project authorized under this section 385.34is for a period of four years from the date of initial enrollment. The commissioner shall 385.35grant an extension of four additional years if the trust provides evidence that it remains in 386.1compliance with the requirements of this section and other applicable laws and rules. If the 386.2commissioner determines that the operation of the trust has not improved access, expanded 386.3health plan choices, or improved affordability of health coverage for farm families, or 386.4that it has significantly damaged access, choice, or affordability for other consumers not 386.5enrolled in the trust, the commissioner shall provide at least 180 days' advance written 386.6notice to the trust and to the chairs of the senate and house finance and policy committees 386.7with jurisdiction over health and insurance matters of the commissioner's intention not to 386.8renew the pilot project at the expiration of a four-year period.386.9EFFECTIVE DATE.This section is effective the day following final enactment.386.10    Sec. 64. HEALTH PLAN PURCHASING POOL STUDY GROUP.386.11    Subdivision 1.Creation; membership.A health care purchasing pool study group 386.12is created to study and make recommendations regarding the creation of a voluntary, 386.13statewide health care purchasing pool that would contract directly with providers to 386.14provide affordable health coverage to eligible Minnesota residents. The study group is 386.15composed of:386.16    (1) the chief house and senate authors of this act;386.17    (2) the chairs of the senate Committee on Health, Housing, and Family Security and 386.18the Health and Human Services Budget Division;386.19    (3) the chairs of the house Health Care and Human Services Committee and the 386.20Health Care and Human Services Division;386.21    (4) the attorney general or the attorney general's designated representative; 386.22    (5) three representatives of health care providers appointed as follows:386.23    (i) one member appointed by the governor;386.24    (ii) one member appointed by the speaker of the house; and386.25    (iii) one member appointed by the Subcommittee on Committees of the senate 386.26Committee on Rules and Administration; and386.27    (6) two consumers of health care appointed by the governor.386.28    All appointments to be made under this subdivision must be made within 30 days 386.29of the effective date of this act.386.30    Subd. 2.Study; report.The study group shall study and make recommendations 386.31on the following issues related to the creation, maintenance, and funding of a voluntary, 386.32statewide health plan purchasing pool to provide comprehensive, cost-effective, and 386.33medically appropriate health coverage to all public and private employees in Minnesota 386.34and all Minnesota residents:386.35    (1) the creation of an independent public entity to administer the pool; 387.1    (2) eligibility and participation requirements for existing public and private health 387.2care purchasing pools, public and private employers, and residents of this state; 387.3    (3) how to contract directly with providers to provide comprehensive coverage for 387.4preventive, mental health, dental and other medical services, and comprehensive drug 387.5benefits to enrollees and maximize the cost savings and other efficiencies that a large 387.6purchasing pool would be expected to generate without the need for a public subsidy; 387.7    (4) provisions that allow the pool to contract directly with health care providers 387.8to provide coverage to enrollees;387.9    (5) incentives designed to attract and retain the maximum number of enrollees; 387.10    (6) recommendations for the administration of the pool and the plans that will be 387.11available to enrollees including, but not limited to, recommendations to keep the pool 387.12solvent and profitable so that public subsidies are not necessary; and 387.13    (7) other elements the study group concludes are necessary or desirable for the 387.14pool to possess. 387.15    The study group shall submit its report and the draft legislation necessary to 387.16implement its recommendations to the chairs of the legislative committees and divisions 387.17with jurisdiction over health care policy and finance, the Health Care Access Commission, 387.18and the governor by February 1, 2008. 387.19    Subd. 3.Staffing.State agencies shall assist the study group with any requests for 387.20information the study group considers necessary to complete the study and report under 387.21subdivision 2.387.22    Subd. 4.Removal; vacancies; expenses.Removal of members, vacancies, and 387.23expenses for members shall be as provided in Minnesota Statutes, section 15.059.387.24    Subd. 5.Expiration.This section expires after the submission of the report as 387.25required in subdivision 2.387.26EFFECTIVE DATE.This section is effective the day following final enactment.387.27    Sec. 65.  REPEALER.387.28(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16; 387.29254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 387.30254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.387.31(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.387.32(c) Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213; 387.33525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222; 387.34525.9223; and 525.9224, are repealed.388.1ARTICLE 8388.2CHILDREN'S HEALTH SECURITY PROGRAM388.3    Section 1. [16A.726] CHILDREN'S HEALTH SECURITY ACCOUNT.388.4    A children's health security account is created in a special revenue fund in the 388.5state treasury. The commissioner shall deposit to the credit of the account money made 388.6available to the account. Notwithstanding section 11A.20, any investment income 388.7attributable to the investment of the children's health security account not currently needed 388.8shall be credited to the children's health security account.388.9    Sec. 2. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended to read:388.10    Subd. 8. Children under age two. Medical assistance may be paid for a child under 388.11two years of age whose countable family income is above 275 300 percent of the federal 388.12poverty guidelines for the same size family but less than or equal to 280 305 percent of the 388.13federal poverty guidelines for the same size family.388.14EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal 388.15approval, whichever is later.388.16    Sec. 3. [256N.01] CITATION.388.17    This chapter may be cited as the "Children's Health Security Act."388.18    Sec. 4. [256N.02] DEFINITIONS.388.19    Subdivision 1.Applicability.The terms used in this chapter have the following 388.20meanings unless otherwise provided for by text.388.21    Subd. 2.Child."Child" means an individual under age 21.388.22    Subd. 3.Commissioner."Commissioner" means the commissioner of human 388.23services.388.24    Subd. 4.Dependent child."Dependent child" means an unmarried child under 388.25age 25 who is claimed as a dependent for federal income tax purposes by a parent, 388.26grandparent, foster parent, relative caretaker, or legal guardian.388.27    Sec. 5. [256N.03] ESTABLISHMENT.388.28    The commissioner shall establish the children's health security program. The 388.29commissioner shall begin implementation of the program on October 1, 2008, or upon 389.1federal approval, whichever is later. The children's health security program must comply 389.2with title XIX of the federal Social Security Act, and waivers granted under title XIX.389.3    Sec. 6. [256N.05] ELIGIBILITY.389.4    Subdivision 1.General requirements.Children meeting the eligibility 389.5requirements of this section are eligible for the children's health security program.389.6    Subd. 2.Income limit.(a) Effective October 1, 2008, children in families with 389.7gross household incomes equal to or less than 225 percent of the federal poverty 389.8guidelines are eligible for the children's health security program. In determining gross 389.9income, the commissioner shall use the income methodology applied to children under the 389.10MinnesotaCare program.389.11    (b) Effective October 1, 2008, a dependent child who meets the program income 389.12limits under paragraph (a) and all other program eligibility requirements is eligible for 389.13state-funded benefits under this section. 389.14    (c) Effective January 1, 2011, or upon federal approval, whichever is later, children 389.15in families with household incomes equal to or less than 300 percent of the federal poverty 389.16guidelines must be included in the children's health security program.389.17    (d) The Legislative Task Force On Children's Health Care Coverage established 389.18under section 19 shall develop recommendations on options for extending health insurance 389.19coverage to children in families with household incomes in excess of 300 percent of the 389.20federal poverty guidelines.389.21    Subd. 3.Residency.Program participants must meet the residency requirements of 389.22section 256B.056, subdivision 1.389.23    Subd. 4.Enrollment voluntary.Enrollment in the children's health security 389.24program is voluntary. Parents or guardians may retain private sector or Medicare coverage 389.25for a child as the sole source of coverage. Parents or guardians who have private sector or 389.26Medicare coverage for children may also enroll children in the children's health security 389.27program. If private sector or Medicare coverage is available, coverage under the children's 389.28health security program is secondary to the private sector or Medicare coverage.389.29    Subd. 5.Emergency services.Payment must be made for care and services that 389.30are furnished to noncitizens, regardless of immigration status, who otherwise meet the 389.31eligibility requirements of this chapter, if the care and services are necessary for the 389.32treatment of an emergency medical condition, except for organ transplants and related 389.33care and services and routine prenatal care. For purposes of this subdivision, "emergency 389.34medical condition" means a medical condition that meets the requirements of United 389.35States Code, title 42, section 1396b(v).390.1    Subd. 6.Medical assistance standards and procedures.(a) Unless otherwise 390.2specified in this chapter, the commissioner shall use medical assistance procedures and 390.3methodology when determining initial eligibility and redetermining eligibility for the 390.4children's health security program.390.5    (b) The procedures and income standard specified in section 256B.056, subdivisions 390.65 and 5c, paragraph (a), apply to children who would be eligible for the children's health 390.7security program, except for excess income.390.8    (c) Retroactive coverage for the children's health security program must be provided 390.9as specified in section 256B.056, subdivision 7.390.10    Sec. 7. [256N.07] COVERED SERVICES.390.11    Covered services under the children's health security program must consist of all 390.12covered services under chapter 256B.390.13    Sec. 8. [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.390.14    In order to ensure broad access to coverage, the children's health security program 390.15has no enrollee premium or cost-sharing requirements.390.16    Sec. 9. [256N.11] APPLICATION PROCEDURES; ELIGIBILITY 390.17DETERMINATION.390.18    Subdivision 1.Application procedure.The application form for the program 390.19must be easily understandable and must not exceed two pages in length. Applications for 390.20the program must be made available to provider offices, local human services agencies, 390.21school districts, schools, community health offices, and other sites willing to cooperate in 390.22program outreach. These sites may accept applications and forward applications to the 390.23commissioner, and counties where applicable. Applications may also be made directly to 390.24the commissioner and to counties that determine eligibility.390.25    Subd. 2.Eligibility determination.Counties that determine eligibility for 390.26MinnesotaCare as of March 1, 2007, shall determine eligibility for the children's health 390.27security program. The commissioner, and counties where applicable, shall determine an 390.28applicant's eligibility for the program within 30 days of the date the application is received, 390.29according to the procedures in Code of Federal Regulations, title 42, section 435.911.390.30    Subd. 3.Presumptive eligibility.Coverage under the program is available during a 390.31presumptive eligibility period for children under age 19 whose family income does not 390.32exceed the applicable income standard. The presumptive eligibility period begins on the 390.33date on which a health care provider enrolled in the program, or other entity designated by 391.1the commissioner, determines, based on preliminary information, that the child's family 391.2income does not exceed the applicable income standard. The presumptive eligibility period 391.3ends the earlier of the day on which a determination is made of eligibility under this section 391.4or the last day of the month following the month presumptive eligibility was determined. 391.5    Subd. 4.Renewal of eligibility.The commissioner shall require enrollees to renew 391.6eligibility every 12 months.391.7    Subd. 5.Continuous eligibility.Children under the age of 19 who are eligible 391.8under this section shall be continuously eligible until the earlier of the next renewal period, 391.9or the time that a child exceeds age 19.391.10    Sec. 10. [256N.12] COUNTY ROLE.391.11    Counties not required to determine eligibility under section 256N.11, subdivision 391.122, may choose to determine eligibility under that section. Counties may also choose 391.13to provide assistance to applicants under section 256N.17, subdivision 1, and provide 391.14ombudsperson services under section 256N.17, subdivision 2. This must not limit the 391.15ability of the commissioner to establish reasonable staffing standards that relate to the 391.16number of persons served, and that provide a county option to hire part-time staff or pursue 391.17multicounty implementation models. If a county chooses not to deliver these services, they 391.18must be delivered by the commissioner. State and federal funding to support these services 391.19must be the same, whether delivered by the state or by a county or group of counties.391.20    Sec. 11. [256N.13] SERVICE DELIVERY.391.21    Subdivision 1.Contracts for service delivery.The commissioner, within each 391.22county, may contract with managed care organizations, including health maintenance 391.23organizations licensed under chapter 62D, community integrated service networks licensed 391.24under chapter 62N, accountable provider networks licensed under chapter 62T, and 391.25county-based purchasing plans established under section 256B.692, to provide covered 391.26health care services to program enrollees under a managed care system, and may contract 391.27with health care and social service providers to provide services on a fee-for-service basis. 391.28Section 256B.69, subdivision 26, applies to contracts with managed care organizations. In 391.29determining the method for service delivery, the commissioner shall consider the cost and 391.30quality of health care services; the breadth of services offered, including medical, dental 391.31and mental health services; the breadth of choice of medical providers for enrollees; the 391.32ease of access to quality medical care for enrollees; the efficiency and cost-effectiveness of 391.33service delivery; and the integration of best medical practice standards into the children's 391.34health security program.392.1    Subd. 2.Managed care organization requirements.(a) Managed care 392.2organizations under contract are responsible for coordinating covered health care services 392.3provided to eligible individuals. Managed care organizations under contract:392.4    (1) shall authorize and arrange for the provision of all needed covered health 392.5services under chapter 256B, with the exception of services available only under a medical 392.6assistance home and community-based waiver, in order to ensure appropriate health care 392.7is delivered to enrollees;392.8    (2) shall comply with the requirements of section 256B.69, subdivision 26;392.9    (3) shall accept the prospective, per capita payment from the commissioner in return 392.10for the provision of comprehensive and coordinated health care services for enrollees;392.11    (4) may contract with health care and social service providers to provide covered 392.12services to enrollees; and392.13    (5) shall institute enrollee grievance procedures according to the method established 392.14by the commissioner, utilizing applicable requirements of chapter 62D and Code of 392.15Federal Regulations, title 42, section 438, subpart F. Disputes may also be appealed to 392.16the commissioner using the procedures in section 256.045.392.17    (b) Upon implementation of the children's health security program, the commissioner 392.18shall withhold five percent of managed care organization payments pending completion 392.19of performance targets, including lead screening, well child services, immunizations, 392.20vision screening, and customer service performance targets. Effective January 1, 2011, 392.21the commissioner shall add treatment of asthma and screening for mental health as new 392.22performance targets. Each performance target must apply uniformly to all managed care 392.23organizations, and be qualitative, objective, measurable, and reasonably attainable, except 392.24in the case of a performance target based on federal or state law or rule. Criteria for 392.25assessment of each performance target must be outlined in writing prior to the contract 392.26effective date. The withhold funds must be returned no sooner than July of the following 392.27year if performance targets in the contract are achieved. The success of each managed care 392.28organization in reaching performance targets must be reported to the legislature annually.392.29    Subd. 3.Fee-for-service delivery.Disputes related to services provided under 392.30the fee-for-service system may be appealed to the commissioner using the procedures 392.31in section 256.045.392.32    Subd. 4.Contracts for waiver services.The commissioner, when services 392.33are delivered through managed care, may contract with health care and social service 392.34providers on a fee-for-service basis to provide program enrollees with covered services 392.35available only under a medical assistance home and community-based waiver. The 392.36commissioner shall determine eligibility for home and community-based waiver services 393.1using the criteria and procedures in chapter 256B. Disputes related to services provided 393.2on a fee-for-service basis may be appealed to the commissioner using the procedures 393.3in section 256.045.393.4    Subd. 5.Service delivery for Minnesota disabilities health option recipient.393.5    Individuals who voluntarily enroll in the Minnesota Disability Health Option (MnDHO), 393.6established under section 256B.69, subdivision 23, shall continue to receive their home 393.7and community-based waiver services through MnDHO.393.8    Subd. 6.Disabled or blind children.Children eligible for medical assistance due 393.9to blindness or disability as determined by the Social Security Administration or the state 393.10medical review team are exempt from enrolling in a managed care organization and shall 393.11be provided health benefits on a fee-for-service basis.393.12    Sec. 12. [256N.15] PAYMENT RATES.393.13    Subdivision 1.Establishment.The commissioner, in consultation with a health 393.14care actuary, shall establish the method and amount of payments for services. The 393.15commissioner shall annually contract with eligible entities to provide services to program 393.16enrollees. The commissioner, in consultation with the Risk Adjustment Association 393.17established under section 62Q.03, subdivision 6, shall develop and implement a risk 393.18adjustment system for the program.393.19    Subd. 2.Provider rates.In establishing the payment amount under subdivision 393.201, the commissioner shall ensure that fee-for-service payment rates for preventative 393.21care services provided on or after October 1, 2008, are at least five percent above the 393.22medical assistance rates for preventative services in effect on September 30, 2008, and 393.23shall ensure that fee-for-service payment rates for all other services provided on or after 393.24October 1, 2008, are at least three percent above the medical assistance rates for those 393.25services in effect on September 30, 2008. The commissioner shall adjust managed care 393.26capitation rates to reflect these increases, and shall require managed care organizations, as 393.27a condition of contract, to pass these increases on to providers under contract.393.28    Sec. 13. [256N.17] CONSUMER ASSISTANCE.393.29    Subdivision 1.Assistance to applicants.The commissioner shall assist applicants 393.30in choosing a managed care organization or fee-for-service provider by:393.31    (1) establishing a Web site to provide information about managed care organizations 393.32and fee-for-service providers and to allow online enrollment;393.33    (2) make information on managed care organizations and fee-for-service providers 393.34available at the sites specified in section 256N.11, subdivision 1;394.1    (3) make applications and information on managed care organizations and 394.2fee-for-service providers available to applicants and enrollees according to Title VI of the 394.3Civil Rights Act and federal regulations adopted under that law or any guidance from the 394.4United States Department of Health and Human Services; and394.5    (4) make benefit educators available to assist applicants in choosing a managed care 394.6organization or fee-for-service provider.394.7    Subd. 2.Ombudsperson.The commissioner shall designate an ombudsperson 394.8to advocate for children enrolled in the children's health security program. The 394.9ombudsperson shall assist enrollees in understanding and making use of complaint and 394.10appeal procedures and ensure that necessary medical services are provided to enrollees. At 394.11the time of enrollment, the commissioner shall inform enrollees about the ombudsperson 394.12program, the right to a resolution of the enrollee's complaint by the managed care 394.13organization if the enrollee experiences a problem with the managed care organization 394.14or its providers, and appeal rights under section 256.045.394.15    Sec. 14. [256N.19] MONITORING AND EVALUATION OF QUALITY AND 394.16COSTS.394.17    (a) The commissioner, as a condition of contract, shall require each participating 394.18managed care organization and participating provider to submit, in the form and manner 394.19specified by the commissioner, data required for assessing enrollee satisfaction, quality 394.20of care, cost, and utilization of services. The commissioner shall evaluate this data, in 394.21order to:394.22    (1) make summary information on the quality of care across managed care 394.23organizations, medical clinics, and providers available to consumers;394.24    (2) require managed care organizations and providers, as a condition of contract, to 394.25implement quality improvement plans; and394.26    (3) compare the cost and quality of services under the program to the cost and 394.27quality of services provided to private sector enrollees.394.28    (b) The commissioner shall implement this section to the extent allowed by federal 394.29and state laws on data privacy.394.30    Sec. 15. [256N.21] FEDERAL APPROVAL.394.31    The commissioner shall seek all federal waivers and approvals necessary to 394.32implement this chapter including, but not limited to, waivers and approvals necessary to:394.33    (1) coordinate medical assistance and MinnesotaCare coverage for children with the 394.34children's health security program;395.1    (2) use federal medical assistance and MinnesotaCare dollars to pay for health care 395.2services under the children's health security program;395.3    (3) maximize receipt of the federal medical assistance match for covered children, 395.4by increasing income standards through the use of more liberal income methodologies as 395.5provided under United States Code, title 42, sections 1396a and 1396u-1;395.6    (4) extend presumptive eligibility and continuous eligibility to children under age 395.721; and395.8    (5) use federal medical assistance and MinnesotaCare dollars to provide benefits to 395.9dependent children.395.10    Sec. 16. [256N.23] RULEMAKING.395.11    The commissioner shall adopt rules to implement this chapter.395.12    Sec. 17. [256N.25] CHILDREN'S HEALTH SECURITY PROGRAM 395.13OUTREACH.395.14    Subdivision 1.Grant awards.The commissioner shall award grants to public or 395.15private organizations to:395.16    (1) provide information, in areas of the state with high uninsured populations, on the 395.17importance of maintaining insurance coverage and on how to obtain coverage through 395.18the children's health security program; and395.19    (2) monitor and provide ongoing support to ensure enrolled children remain covered.395.20    Subd. 2.Criteria.In awarding the grants, the commissioner shall consider the 395.21following:395.22    (1) geographic areas and populations with high uninsured rates;395.23    (2) the ability to raise matching funds;395.24    (3) the ability to contact, effectively communicate with, or serve eligible populations; 395.25and395.26    (4) the applicant's plan to monitor and provide support to ensure enrolled children 395.27remain covered.395.28    Subd. 3.Monitoring and termination.The commissioner shall monitor the grants 395.29and may terminate a grant if the outreach effort does not increase enrollment in the 395.30children's health security program.395.31    Sec. 18. IMPLEMENTATION PLAN.395.32    The commissioner of human services shall develop an implementation plan for the 395.33children's health security program, which includes a health delivery plan based on the 396.1criteria specified in Minnesota Statutes, section 256N.13, subdivision 1. The commissioner 396.2shall present this plan, any necessary draft legislation, and a draft of proposed rules 396.3to the legislature by December 15, 2007. The plan must include recommendations 396.4for any additional legislative changes necessary to coordinate medical assistance and 396.5MinnesotaCare coverage for children with the children's health security program. The 396.6commissioner shall evaluate the provision of services under the program to children with 396.7disabilities and shall present recommendations to the legislature by December 15, 2009, 396.8for any program changes necessary to ensure the quality and continuity of care.396.9    Sec. 19. LEGISLATIVE TASK FORCE ON CHILDREN'S HEALTH CARE 396.10COVERAGE.396.11    Subdivision 1.Establishment; membership.(a) The Legislative Task Force on 396.12Children's Health Care Coverage is established. The task force is made up of 12 voting 396.13members and six nonvoting members.396.14    (b) The voting members are:396.15    (1) six members of the house of representatives appointed by the speaker, three from 396.16the majority party and three from the minority party; and396.17    (2) six members of the senate appointed by the Subcommittee on Committees of the 396.18senate Committee on Rules and Administration, three from the majority party and three 396.19from the minority party.396.20    (c) The nonvoting members are one representative selected by each of the following 396.21organizations:396.22    (1) the American Academy of Pediatrics, Minnesota chapter;396.23    (2) the Minnesota Nurses Association;396.24    (3) the Minnesota Council of Health Plans;396.25    (4) the Minnesota Children's Platform Coalition;396.26    (5) the Minnesota Universal Health Care Coalition; and396.27    (6) the Minnesota Business Partnership.396.28    (d) The task force members must be appointed by September 1, 2007. The majority 396.29leader of the senate and the speaker of the house of representatives must each designate 396.30a chair from their appointments. The chair appointed by the speaker of the house of 396.31representatives shall convene and chair the first meeting of the task force. The chair 396.32appointed by the majority leader of the senate shall chair the next meeting of the task 396.33force. The chairs shall then alternate for the duration of the task force.397.1    Subd. 2.Study; staff support.(a) The task force shall study viable options to extend 397.2coverage to all children as provided in Minnesota Statutes, section 256N.05, subdivision 397.32, paragraph (d), and provide recommendations to the legislature. The study must:397.4    (1) evaluate methods to achieve universal coverage for children, including, but not 397.5limited to, changes to the employer-based coverage system and an expansion of eligibility 397.6for the children's health security program established under Minnesota Statutes, chapter 397.7256N;397.8    (2) examine health care reform and cost containment methods that will contain costs 397.9and increase access and improve health outcomes;397.10    (3) examine how to increase access to preventive care and health care services; and397.11    (4) examine how to reduce health disparities among minority populations. 397.12    (b) The task force, through the Legislative Coordinating Commission, may hire staff 397.13or contract for staff support for the study.397.14    (c) The task force, in developing recommendations, shall hold meetings to hear 397.15public testimony at locations throughout the state, including locations outside of the 397.16seven-county metropolitan area.397.17    Subd. 3.Recommendations.The task force shall report its recommendations to 397.18the legislature by December 15, 2009. Recommendations must be consistent with the 397.19following criteria:397.20    (1) health care coverage must include preventive care and all other medically 397.21necessary services;397.22    (2) health care coverage must be affordable for families, with the family share of 397.23premium costs and cost-sharing in total not exceeding five percent of family income;397.24    (3) the system of coverage must give priority to ensuring access to and the quality 397.25and continuity of care; and397.26    (4) enrollment must be simple and seamless for families.397.27    Subd. 4.Expiration.This section expires December 16, 2009.397.28ARTICLE 9397.29HEALTH CARE REFORM397.30    Section 1. Minnesota Statutes 2006, section 62A.65, subdivision 3, is amended to read:397.31    Subd. 3. Premium rate restrictions. No individual health plan may be offered, 397.32sold, issued, or renewed to a Minnesota resident unless the premium rate charged is 397.33determined in accordance with the following requirements:397.34    (a) Premium rates must be no more than 25 percent above and no more than 25 397.35percent below the index rate charged to individuals for the same or similar coverage, 398.1adjusted pro rata for rating periods of less than one year. The premium variations 398.2permitted by this paragraph must be based only upon health status, claims experience, 398.3and occupation. For purposes of this paragraph, health status includes refraining from 398.4tobacco use or other actuarially valid lifestyle factors associated with good health, 398.5provided that the lifestyle factor and its effect upon premium rates have been determined 398.6by the commissioner to be actuarially valid and have been approved by the commissioner. 398.7Variations permitted under this paragraph must not be based upon age or applied 398.8differently at different ages. This paragraph does not prohibit use of a constant percentage 398.9adjustment for factors permitted to be used under this paragraph.398.10    (b) Premium rates may vary based upon the ages of covered persons only as 398.11provided in this paragraph. In addition to the variation permitted under paragraph (a), 398.12each health carrier may use an additional premium variation based upon age for adults 398.13aged 19 and above of up to plus or minus 50 percent of the index rate. Premium rates for 398.14children under the age of 19 may not vary based on age, regardless of whether the child is 398.15covered as a dependent or as a primary insured.398.16    (c) A health carrier may request approval by the commissioner to establish separate 398.17geographic regions determined by the health carrier and to establish separate index rates 398.18for each such region. The commissioner shall grant approval if the following conditions 398.19are met: 398.20    (1) the geographic regions must be applied uniformly by the health carrier;398.21    (2) each geographic region must be composed of no fewer than seven counties that 398.22create a contiguous region; and398.23    (3) the health carrier provides actuarial justification acceptable to the commissioner 398.24for the proposed geographic variations in index rates, establishing that the variations are 398.25based upon differences in the cost to the health carrier of providing coverage.398.26    (d) Health carriers may use rate cells and must file with the commissioner the rate 398.27cells they use. Rate cells must be based upon the number of adults or children covered 398.28under the policy and may reflect the availability of Medicare coverage. The rates for 398.29different rate cells must not in any way reflect generalized differences in expected costs 398.30between principal insureds and their spouses.398.31    (e) In developing its index rates and premiums for a health plan, a health carrier shall 398.32take into account only the following factors:398.33    (1) actuarially valid differences in rating factors permitted under paragraphs (a) 398.34and (b); and398.35    (2) actuarially valid geographic variations if approved by the commissioner as 398.36provided in paragraph (c).399.1    (f) All premium variations must be justified in initial rate filings and upon request of 399.2the commissioner in rate revision filings. All rate variations are subject to approval by 399.3the commissioner.399.4    (g) The loss ratio must comply with the section 
         62A.021 requirements for individual 399.5health plans. 399.6    (h) The rates must not be approved, unless the commissioner has determined that the 399.7rates are reasonable. In determining reasonableness, the commissioner shall consider the 399.8growth rates applied under section 
         62J.04, subdivision 1, paragraph (b), to the calendar 399.9year or years that the proposed premium rate would be in effect, actuarially valid changes 399.10in risks associated with the enrollee populations, and actuarially valid changes as a result 399.11of statutory changes in Laws 1992, chapter 549. 399.12    (i) An insurer may, as part of a minimum lifetime loss ratio guarantee filing under 399.13section 
         62A.02, subdivision 3a, include a rating practices guarantee as provided in this 399.14paragraph. The rating practices guarantee must be in writing and must guarantee that 399.15the policy form will be offered, sold, issued, and renewed only with premium rates and 399.16premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices 399.17guarantee must be accompanied by an actuarial memorandum that demonstrates that the 399.18premium rates and premium rating system used in connection with the policy form will 399.19satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to 399.20policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4, 399.21or 5. An insurer that complies with this paragraph in connection with a policy form is 399.22exempt from the requirement of prior approval by the commissioner under paragraphs 399.23(c), (f), and (h).399.24    Sec. 2. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.399.25    Subdivision 1.Title; citation.This section may be cited as the "Minnesota Health 399.26Insurance Exchange."399.27    Subd. 2.Creation; tax exemption.The Minnesota Health Insurance Exchange 399.28is created for the limited purpose of providing individuals with greater access, choice, 399.29portability, and affordability of health insurance products. The Minnesota Health 399.30Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c) 399.31of the Internal Revenue Code.399.32    Subd. 3.Definitions.The following terms have the meanings given them unless 399.33otherwise provided in text.399.34    (a) "Board" means the board of directors of the Minnesota Health Insurance 399.35Exchange under subdivision 13.400.1    (b) "Commissioner" means: 400.2    (1) the commissioner of commerce for health insurers subject to the jurisdiction 400.3of the Department of Commerce; 400.4    (2) the commissioner of health for health insurers subject to the jurisdiction of the 400.5Department of Health; or 400.6    (3) either commissioner's designated representative.400.7    (c) "Exchange" means the Minnesota Health Insurance Exchange.400.8    (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.400.9    (e) "Individual market health plans," unless otherwise specified, means individual 400.10market health plans defined in section 62A.011.400.11    (f) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of 400.12the Internal Revenue Code that allows employees to pay for health insurance premiums 400.13with pretax dollars.400.14    Subd. 4.Insurer and health plan participation.All health plans as defined in 400.15section 62A.011, subdivision 3, issued or renewed in the individual market shall participate 400.16in the exchange. No health plans in the individual market may be issued or renewed 400.17outside of the exchange. Group health plans as defined in section 62A.10 shall not be 400.18offered through the exchange. Health plans offered through the Minnesota Comprehensive 400.19Health Association as defined in section 62E.10 are offered through the exchange to 400.20eligible enrollees as determined by the Minnesota Comprehensive Health Association. 400.21Health plans offered through MinnesotaCare under chapter 256L are offered through the 400.22exchange to eligible enrollees as determined by the commissioner of human services.400.23    Subd. 5.Approval of health plans.No health plan may be offered through the 400.24exchange unless the commissioner has first certified that:400.25    (1) the insurer seeking to offer the health plan is licensed to issue health insurance in 400.26the state; and400.27    (2) the health plan meets the requirements of this section, and the health plan and the 400.28insurer are in compliance with all other applicable health insurance laws.400.29    Subd. 6.Individual market health plans.Individual market health plans offered 400.30through the exchange continue to be regulated by the commissioner as specified in 400.31chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions 400.32that apply to all health plans issued or renewed through the exchange:400.33    (1) premiums for children under the age of 19 shall not vary by age in the exchange; 400.34and400.35    (2) premiums for children under the age of 19 must be excluded from rating factors 400.36under section 62A.65, subdivision 3, paragraph (b).401.1    Subd. 7.Individual participation and eligibility.Individuals are eligible to 401.2purchase health plans directly through the exchange or through an employer Section 401.3125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of 401.4individual market health plans offered through the exchange. Individuals are eligible to 401.5purchase individual market health plans through the exchange by meeting one or more 401.6of the following qualifications:401.7    (1) the individual is a Minnesota resident, meaning the individual is physically 401.8residing on a permanent basis in a place that is the person's principal residence and from 401.9which the person is absent only for temporary purposes;401.10    (2) the individual is a student attending an institution outside of Minnesota and 401.11maintains Minnesota residency;401.12    (3) the individual is not a Minnesota resident but is employed by an employer 401.13physically located within the state and the individual's employer is required to offer a 401.14Section 125 Plan under section 62A.68;401.15    (4) the individual is not a Minnesota resident but is self-employed and the 401.16individual's principal place of business is in the state; or401.17    (5) the individual is a dependent as defined in section 62L.02, of another individual 401.18who is eligible to participate in the exchange.401.19    Subd. 8.Continuation of coverage.Enrollment in a health plan may be canceled 401.20for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under 401.21chapter 256L. Enrollment in an individual market health plan may not be canceled or 401.22nonrenewed because of any change in employer or employment status, marital status, 401.23health status, age, residence, or any other change that does not affect eligibility as defined 401.24in this section.401.25    Subd. 9.Responsibilities of the exchange.The exchange shall serve as the sole 401.26entity for enrollment and collection and transfer of premium payments for health plans 401.27sold to individuals through the exchange. The exchange shall be responsible for the 401.28following functions:401.29    (1) publicize the exchange, including but not limited to its functions, eligibility 401.30rules, and enrollment procedures;401.31    (2) provide assistance to employers to establish Section 125 Plans under section 401.3262A.68;401.33    (3) provide education and assistance to employers to help them understand the 401.34requirements of Section 125 Plans and compliance with applicable regulations;401.35    (4) create a system to allow individuals to compare and enroll in health plans offered 401.36through the exchange;402.1    (5) create a system to collect and transmit to the applicable plans all premium 402.2payments made by individuals, including developing mechanisms to receive and process 402.3automatic payroll deductions for individuals who purchase coverage through employer 402.4Section 125 Plans;402.5    (6) not accept premium payments for individual market health plans from an 402.6employer Section 125 Plan if the employer offers a group health plan as defined in section 402.762A.10, or if the employer is a self-insurer as defined in section 62E.02;402.8    (7) provide jointly with health insurers a cancellation notice directly to the primary 402.9insured at least ten days prior to termination of coverage for nonpayment of premium;402.10    (8) bill the employer for the premiums payable by an employee, provided that the 402.11employer is not liable for payment except from payroll deductions for that purpose;402.12    (9) refer individuals interested in MinnesotaCare under chapter 256L to the 402.13Department of Human Services to determine eligibility;402.14    (10) establish a mechanism with the Department of Human Services to transfer 402.15premiums and subsidies for MinnesotaCare to qualify for federal matching payments;402.16    (11) upon request, issue certificates of previous coverage according to the provisions 402.17of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be 402.18covered by a participating health plan through the exchange;402.19    (12) establish procedures to account for all funds received and disbursed by the 402.20exchange for individual participants of the exchange; 402.21    (13) make available to the public, at the end of each calendar year, a report of an 402.22independent audit of the exchange's accounts; and402.23    (14) provide copies of written and signed statements from employers stating that 402.24the employer is not contributing to the employee's premiums for health plans purchased 402.25by an employee through the exchange to all health insurers with enrolled employees of 402.26the employer.402.27    Health insurers may rely on the employer's statement in clause (4) provided by the 402.28Minnesota Health Insurance Exchange and are not required to guarantee-issue individual 402.29health plans to the employer's employees.402.30    Subd. 10.State not liable.The state of Minnesota shall not be liable for the actions 402.31of the Minnesota Health Insurance Exchange.402.32    Subd. 11.Powers of the exchange.The exchange shall have the power to:402.33    (1) contract with insurance producers licensed in accident and health insurance 402.34under chapter 60K and vendors to perform one or more of the functions specified in 402.35subdivision 10;403.1    (2) contract with employers to collect premiums through a Section 125 Plan for 403.2eligible individuals who purchase an individual market health plan through the exchange;403.3    (3) establish and assess fees on health plan premiums of health plans purchased 403.4through the exchange to fund the cost of administering the exchange;403.5    (4) seek and directly receive grant funding from government agencies or private 403.6philanthropic organizations to defray the costs of operating the exchange;403.7    (5) establish and administer rules and procedures governing the operations of the 403.8exchange;403.9    (6) establish one or more service centers within Minnesota;403.10    (7) sue or be sued or otherwise take any necessary or proper legal action;403.11    (8) establish bank accounts and borrow money; and403.12    (9) enter into agreements with the commissioners of commerce, health, human 403.13services, revenue, employment and economic development, and other state agencies as 403.14necessary for the exchange to implement the provisions of this section.403.15    Subd. 12.Dispute resolution.The exchange shall establish procedures for 403.16resolving disputes with respect to the eligibility of an individual to participate in the 403.17exchange. The exchange does not have the authority or responsibility to intervene in or 403.18resolve disputes between an individual and a health plan or health insurer. The exchange 403.19shall refer complaints from individuals participating in the exchange to the commissioner 403.20to be resolved according to sections 62Q.68 to 62Q.73.403.21    Subd. 13.Governance.The exchange shall be governed by a board of directors 403.22with 11 members. The board shall convene on or before July 1, 2007, after the initial board 403.23members have been selected. The initial board membership consists of the following:403.24    (1) the commissioner of commerce;403.25    (2) the commissioner of human services;403.26    (3) the commissioner of health;403.27    (4) four members appointed by a joint committee of the Minnesota senate and the 403.28Minnesota house of representatives to serve three-year terms; and403.29    (5) four members appointed by the governor to serve three-year terms.403.30    Subd. 14.Subsequent board membership.Ongoing membership of the exchange 403.31consists of the following effective July 1, 2010:403.32    (1) the commissioner of commerce;403.33    (2) the commissioner of human services;403.34    (3) the commissioner of health;403.35    (4) two members appointed by the governor with the approval of a joint committee 403.36of the senate and house of representatives to serve two-year terms; and404.1    (5) six members elected by the membership of the exchange of which three 404.2are elected to serve a two-year term and three are elected to serve a three-year term. 404.3Appointed and elected members may serve more than one term.404.4    Subd. 15.Operations of the board.Officers of the board of directors are elected by 404.5members of the board and serve one-year terms. Six members of the board constitutes a 404.6quorum, and the affirmative vote of six members of the board is necessary and sufficient 404.7for any action taken by the board. Board members serve without pay, but are reimbursed 404.8for actual expenses incurred in the performance of their duties.404.9    Subd. 16.Operations of the exchange.The board of directors shall appoint an 404.10exchange director who shall:404.11    (1) be a full-time employee of the exchange;404.12    (2) administer all of the activities and contracts of the exchange; and 404.13    (3) hire and supervise the staff of the exchange.404.14    Subd. 17.Insurance producers.An individual has the right to choose any 404.15insurance producer licensed in accident and health insurance under chapter 60K to assist 404.16them in purchasing an individual market health plan through the exchange. When a 404.17producer licensed in accident and health insurance under chapter 60K enrolls an eligible 404.18individual in the exchange, the health plan chosen by an individual may pay the producer 404.19a commission.404.20    Subd. 18.Implementation.Health plan coverage through the exchange begins on 404.21January 1, 2009. The exchange must be operational to assist employers and individuals 404.22by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees 404.23of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive 404.24Health Association as of December 2, 2008, are automatically enrolled in the exchange 404.25on January 1, 2009, in the same health plan and at the same premium that they were 404.26enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1, 404.272009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota 404.28Comprehensive Health Association shall make premium payments to the exchange.404.29    Sec. 3. [62A.68] SECTION 125 PLANS.404.30    Subdivision 1.Definitions.The following terms have the meanings given unless 404.31otherwise provided in text:404.32    (a) "Current employee" means an employee currently on an employer's payroll other 404.33than a retiree or disabled former employee.405.1    (b) "Employer" means a person, firm, corporation, partnership, association, business 405.2trust, or other entity employing one or more persons, including a political subdivision of 405.3the state, filing payroll tax information on such employed person or persons.405.4    (c) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 405.5of the Internal Revenue Code that allows employees to purchase health insurance with 405.6pretax dollars.405.7    (d) "Exchange" means the Minnesota Health Insurance Exchange under section 405.862A.67.405.9    (e) "Exchange director" means the appointed director under section 62A.67, 405.10subdivision 16.405.11    Subd. 2.Section 125 Plan requirement.(a) Effective January 1, 2009, all 405.12employers with 11 or more current employees shall establish a Section 125 Plan to 405.13allow their employees to purchase individual market health plan coverage with pretax 405.14dollars. Nothing in this section requires or mandates employers to offer or purchase 405.15health insurance coverage for their employees. The following employers are exempt 405.16from the Section 125 Plan requirement:405.17    (1) employers that offer a group health insurance plan as defined in 62A.10;405.18    (2) employers that are self-insurers as defined in section 62E.02; and405.19    (3) employers with fewer than 11 current employees, except that employers under 405.20this clause may voluntarily offer a Section 125 Plan.405.21    (b) Employers that offer a Section 125 Plan may enter into an agreement with the 405.22exchange to administer the employer's Section 125 Plan.405.23    Subd. 3.Tracking compliance.By July 1, 2008, the exchange, in consultation with 405.24the commissioners of commerce, health, employment and economic development, and 405.25revenue shall establish a method for tracking employer compliance with the Section 125 405.26Plan requirement.405.27    Subd. 4.Employer requirements.Employers that are required to offer or choose 405.28to offer a Section 125 Plan shall:405.29    (1) allow employees to purchase any individual market health plan for themselves 405.30and their dependents through the exchange;405.31    (2) allow employees to choose any insurance producer licensed in accident and 405.32health insurance under chapter 60K to assist them in purchasing an individual market 405.33health plan through the exchange;405.34    (3) provide a written and signed statement to the exchange stating that the employer 405.35is not contributing to the employee's premiums for health plans purchased by an employee 405.36through the exchange;406.1    (4) upon an employee's request, deduct premium amounts on a pretax basis in an 406.2amount not to exceed an employee's wages, and remit these employee payments to the 406.3exchange; and406.4    (5) provide notice to employees that individual market health plans purchased 406.5through the exchange are not employer-sponsored or administered. Employers shall be 406.6held harmless from any and all liability claims related to the individual market health 406.7plans purchased through the exchange by employees under a Section 125 Plan.406.8    Subd. 5.Section 125 eligible health plans.Individuals who are eligible to use 406.9an employer Section 125 Plan to pay for health insurance coverage purchased through 406.10the exchange may enroll in any health plan offered through the exchange for which the 406.11individual is eligible including individual market health plans, MinnesotaCare, and the 406.12Minnesota Comprehensive Health Association.406.13    Sec. 4. Minnesota Statutes 2006, section 62E.141, is amended to read:406.1462E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.406.15    No employee of an employer that offers a group health plan, under which the 406.16employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in 406.17the comprehensive health association, except for enrollment or continued enrollment 406.18necessary to cover conditions that are subject to an unexpired preexisting condition 406.19limitation, preexisting condition exclusion, or exclusionary rider under the employer's 406.20health plan. This section does not apply to persons enrolled in the Comprehensive Health 406.21Association as of June 30, 1993. With respect to persons eligible to enroll in the health 406.22plan of an employer that has more than 29 current employees, as defined in section 406.2362L.02
         , this section does not apply to persons enrolled in the Comprehensive Health 406.24Association as of December 31, 1994. 406.25    Sec. 5. Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:406.26    Subd. 3. Cost containment duties. The commissioner shall:406.27    (1) establish statewide and regional cost containment goals for total health care 406.28spending under this section and, collect data as described in sections 
         62J.38 to 
         62J.41 to 406.29monitor statewide achievement of the cost containment goals, and annually report to the 406.30legislature on whether the goals were achieved and, if not, what action should be taken to 406.31ensure that goals are achieved in the future; 406.32    (2) divide the state into no fewer than four regions, with one of those regions being 406.33the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 406.34Wright, and Sherburne Counties, for purposes of fostering the development of regional 407.1health planning and coordination of health care delivery among regional health care 407.2systems and working to achieve the cost containment goals;407.3    (3) monitor the quality of health care throughout the state and take action as 407.4necessary to ensure an appropriate level of quality;407.5    (4) issue recommendations regarding uniform billing forms, uniform electronic 407.6billing procedures and data interchanges, patient identification cards, and other uniform 407.7claims and administrative procedures for health care providers and private and public 407.8sector payers. In developing the recommendations, the commissioner shall review the 407.9work of the work group on electronic data interchange (WEDI) and the American National 407.10Standards Institute (ANSI) at the national level, and the work being done at the state and 407.11local level. The commissioner may adopt rules requiring the use of the Uniform Bill 407.1282/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 407.13version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 407.14forms or procedures;407.15    (5) undertake health planning responsibilities;407.16    (6) authorize, fund, or promote research and experimentation on new technologies 407.17and health care procedures;407.18    (7) within the limits of appropriations for these purposes, administer or contract for 407.19statewide consumer education and wellness programs that will improve the health of 407.20Minnesotans and increase individual responsibility relating to personal health and the 407.21delivery of health care services, undertake prevention programs including initiatives to 407.22improve birth outcomes, expand childhood immunization efforts, and provide start-up 407.23grants for worksite wellness programs;407.24    (8) undertake other activities to monitor and oversee the delivery of health care 407.25services in Minnesota with the goal of improving affordability, quality, and accessibility of 407.26health care for all Minnesotans; and407.27    (9) make the cost containment goal data available to the public in a 407.28consumer-oriented manner.407.29EFFECTIVE DATE.This section is effective July 1, 2007.407.30    Sec. 6. [62J.431] EVIDENCE-BASED HEALTH CARE GUIDELINES.407.31    Evidence-based guidelines must meet the following criteria:407.32    (1) the scope and application are clear;407.33    (2) authorship is stated and any conflicts of interest disclosed;407.34    (3) authors represent all pertinent clinical fields or other means of input have been 407.35used;408.1    (4) the development process is explicitly stated;408.2    (5) the guideline is grounded in evidence;408.3    (6) the evidence is cited and grated;408.4    (7) the document itself is clear and practical;408.5    (8) the document is flexible in use, with exceptions noted or provided for with 408.6general statements;408.7    (9) measures are included for use in systems improvement; and408.8    (10) the guideline has scheduled reviews and updating.408.9    Sec. 7. Minnesota Statutes 2006, section 62J.495, is amended to read:408.1062J.495 HEALTH INFORMATION TECHNOLOGY AND 408.11INFRASTRUCTURE ADVISORY COMMITTEE.408.12    Subdivision 1. Establishment; members; duties Implementation.By January 408.131, 2012, all hospitals and health care providers must have in place an interoperable 408.14electronic health records system within their hospital system or clinical practice setting. 408.15The commissioner of health, in consultation with the Health Information Technology and 408.16Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, 408.17including the adoption of uniform standards to be used for the interoperable system for 408.18sharing and synchronizing patient data across systems. The standards must be compatible 408.19with federal efforts. The uniform standards must be refined and adopted for use when 408.20a standard development organization accredited by the American National Standards 408.21Institute completes the development of a standard for sharing and synchronizing patient 408.22data across systems.408.23    Subd. 2. Health Information Technology and Infrastructure Advisory 408.24Committee. (a) The commissioner shall establish a Health Information Technology 408.25and Infrastructure Advisory Committee governed by section 
         15.059 to advise the 408.26commissioner on the following matters:408.27    (1) assessment of the use of health information technology by the state, licensed 408.28health care providers and facilities, and local public health agencies;408.29    (2) recommendations for implementing a statewide interoperable health information 408.30infrastructure, to include estimates of necessary resources, and for determining standards 408.31for administrative data exchange, clinical support programs, patient privacy requirements, 408.32and maintenance of the security and confidentiality of individual patient data; and408.33    (3) recommendations for encouraging use of innovative health care applications 408.34using information technology and systems to improve patient care and reduce the cost 408.35of care, including applications relating to disease management and personal health 409.1management that enable remote monitoring of patients' conditions, especially those with 409.2chronic conditions; and409.3    (3)(4) other related issues as requested by the commissioner.409.4    (b) The members of the Health Information Technology and Infrastructure Advisory 409.5Committee shall include the commissioners, or commissioners' designees, of health, 409.6human services, administration, and commerce and additional members to be appointed 409.7by the commissioner to include persons representing Minnesota's local public health 409.8agencies, licensed hospitals and other licensed facilities and providers, private purchasers, 409.9the medical and nursing professions, health insurers and health plans, the state quality 409.10improvement organization, academic and research institutions, consumer advisory 409.11organizations with an interest and expertise in health information technology, and other 409.12stakeholders as identified by the Health Information Technology and Infrastructure 409.13Advisory Committee.409.14    Subd. 2.Annual report.(c) The commissioner shall prepare and issue an annual 409.15report not later than January 30 of each year outlining progress to date in implementing a 409.16statewide health information infrastructure and recommending future projects.409.17    Subd. 3.Expiration.(d) Notwithstanding section 
         15.059, this sectionsubdivision 409.18expires June 30, 2009 2012.409.19    Sec. 8. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 409.20ACCOUNT AND LOAN PROGRAM.409.21    Subdivision 1.Account establishment.The commissioner of finance shall establish 409.22and implement a revolving account in the state government special revenue fund to 409.23provide loans to eligible borrowers to assist in financing the installation or support of 409.24an interoperable health record system. The system must provide for the interoperable 409.25exchange of health care information between the applicant and, at a minimum, a hospital 409.26system, pharmacy, and a health care clinic or other physician group.409.27    Subd. 2.Eligibility.(a) "Eligible borrower" means one of the following:409.28    (1) community clinics, as defined under section 145.9268;409.29    (2) hospitals eligible for rural hospital capital improvement grants, as defined 409.30in section 144.148;409.31    (3) physician clinics located in a community with a population of less than 50,000 409.32according to United States Census Bureau statistics and outside the seven-county 409.33metropolitan area;409.34    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and410.1    (5) other providers of health or health care services approved by the commissioner 410.2for which interoperable electronic health record capability would improve quality of 410.3care, patient safety, or community health.410.4    (b) To be eligible for a loan under this section, the applicant must submit a loan 410.5application to the commissioner of health on forms prescribed by the commissioner. The 410.6application must include, at a minimum:410.7    (1) the amount of the loan requested and a description of the purpose or project 410.8for which the loan proceeds will be used;410.9    (2) a quote from a vendor;410.10    (3) a description of the health care entities and other groups participating in the 410.11project;410.12    (4) evidence of financial stability and a demonstrated ability to repay the loan; and410.13    (5) a description of how the system to be financed interconnects or plans in the 410.14future to interconnect with other health care entities and provider groups located in the 410.15same geographical area.410.16    Subd. 3.Loans.(a) The commissioner of health may make a no interest loan 410.17to a provider or provider group who is eligible under subdivision 2 on a first-come, 410.18first-served basis provided that the applicant is able to comply with this section. The total 410.19accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of 410.20health has discretion over the size and number of loans made.410.21    (b) The commissioner of health may prescribe forms and establish an application 410.22process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 410.23application fee to cover the cost of administering the loan program.410.24    (c) The borrower must begin repaying the principal no later than two years from the 410.25date of the loan. Loans must be amortized no later than six years from the date of the loan.410.26    (d) Repayments must be credited to the account.410.27    Subd. 4.Data classification.Data collected by the commissioner of health on the 410.28application to determine eligibility under subdivision 2 and to monitor borrowers' default 410.29risk or collect payments owed under subdivision 3 are (1) private data on individuals as 410.30defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section 410.3113.02, subdivision 9. The names of borrowers and the amounts of the loans granted are 410.32public data.410.33    Sec. 9. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND 410.34IMPLEMENTATION GUIDE STANDARDS.411.1    Subdivision 1.Electronic claims and eligibility transactions required.(a) 411.2Beginning January 15, 2009, all group purchasers must accept from health care providers 411.3the eligibility for a health plan transaction described under Code of Federal Regulations, 411.4title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept 411.5from health care providers the health care claims or equivalent encounter information 411.6transaction described under Code of Federal Regulations, title 45, part 162, subpart K.411.7    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the 411.8eligibility for a health plan transaction described under Code of Federal Regulations, title 411.945, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit 411.10to providers the health care payment and remittance advice transaction described under 411.11Code of Federal Regulations, title 45, part 162, subpart P.411.12    (c) Beginning January 15, 2009, all health care providers must submit to group 411.13purchasers the eligibility for a health plan transaction described under Code of Federal 411.14Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care 411.15providers must submit to group purchasers the health care claims or equivalent encounter 411.16information transaction described under Code of Federal Regulations, title 45, part 162, 411.17subpart K.411.18    (d) Beginning January 15, 2009, all health care providers must accept from group 411.19purchasers the eligibility for a health plan transaction described under Code of Federal 411.20Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care 411.21providers must accept from group purchasers the health care payment and remittance 411.22advice transaction described under Code of Federal Regulations, title 45, part 162, subpart 411.23P.411.24    (e) Each of the transactions described in paragraphs (a) to (d) shall require the use 411.25of a single, uniform companion guide to the implementation guides described under 411.26Code of Federal Regulations, title 45, part 162. The companion guides will be developed 411.27pursuant to subdivision 2.411.28    (f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group 411.29purchasers and health care providers must exchange claims and eligibility information 411.30electronically using the transactions, companion guides, implementation guides, and 411.31timelines required under this subdivision. Group purchasers may not impose any fee on 411.32providers for the use of the transactions prescribed in this subdivision.411.33    (g) Nothing in this subdivision shall prohibit group purchasers and health care 411.34providers from using a direct data entry, Web-based methodology for complying with 411.35the requirements of this subdivision. Any direct data entry method for conducting 411.36the transactions specified in this subdivision must be consistent with the data content 412.1component of the single, uniform companion guides required in paragraph (e) and the 412.2implementation guides described under Code of Federal Regulations, title 45, part 162.412.3    Subd. 2.Establishing uniform, standard companion guides.(a) At least 12 412.4months prior to the timelines required in subdivision 1, the commissioner of health shall 412.5promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers 412.6and health care providers to use the transactions and the uniform, standard companion 412.7guides required under subdivision 1, paragraph (e).412.8    (b) The commissioner of health must consult with the Minnesota Administrative 412.9Uniformity Committee on the development of the single, uniform companion guides 412.10required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1. 412.11The single uniform companion guides required under subdivision 1, paragraph (e), must 412.12specify uniform billing and coding standards. The commissioner of health shall base the 412.13companion guides required under subdivision 1, paragraph (e), billing and coding rules, 412.14and standards on the Medicare program, with modifications that the commissioner deems 412.15appropriate after consulting the Minnesota Administrative Uniformity Committee.412.16    (c) No group purchaser or health care provider may add to or modify the single, 412.17uniform companion guides defined in subdivision 1, paragraph (e), through additional 412.18companion guides or other requirements.412.19    (d) In promulgating the rules in paragraph (a), the commissioner shall not require 412.20data content that is not essential to accomplish the purpose of the transactions in 412.21subdivision 1.412.22    Sec. 10. Minnesota Statutes 2006, section 62J.60, is amended by adding a subdivision 412.23to read:412.24    Subd. 3a.Required statement.An identification card issued to an enrollee by a 412.25health plan company or other entity governed by Minnesota health coverage laws must 412.26contain the following statement: "Subject to Minnesota law."412.27    Sec. 11. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:412.28    Subdivision 1. Definitions. For purposes of this section, the following definitions 412.29apply:412.30    (a) "Accredited clinical training" means the clinical training provided by a 412.31medical education program that is accredited through an organization recognized by the 412.32Department of Education, the Centers for Medicare and Medicaid Services, or another 412.33national body who reviews the accrediting organizations for multiple disciplines and 412.34whose standards for recognizing accrediting organizations are reviewed and approved by 413.1the commissioner of health in consultation with the Medical Education and Research 413.2Advisory Committee.413.3    (b) "Commissioner" means the commissioner of health.413.4    (c) "Clinical medical education program" means the accredited clinical training of 413.5physicians (medical students and residents), doctor of pharmacy practitioners, doctors 413.6of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 413.7registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 413.8physician assistants.413.9    (d) "Sponsoring institution" means a hospital, school, or consortium located in 413.10Minnesota that sponsors and maintains primary organizational and financial responsibility 413.11for a clinical medical education program in Minnesota and which is accountable to the 413.12accrediting body.413.13    (e) "Teaching institution" means a hospital, medical center, clinic, or other 413.14organization that conducts a clinical medical education program in Minnesota.413.15    (f) "Trainee" means a student or resident involved in a clinical medical education 413.16program.413.17    (g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time 413.18equivalent counts, that are at training sites located in Minnesota with acurrently 413.19active medical assistance provider numberenrollment status and a National Provider 413.20Identification (NPI) number where training occurs in either an inpatient or ambulatory 413.21patient care setting and where the training is funded, in part, by patient care revenues.413.22    Sec. 12. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:413.23    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute 413.2490 percent of available medical education funds transferred according to section 413.25256B.69, subdivision 5c, paragraph (a), clause (1), to all qualifying applicants based on a 413.26distribution formula that reflects a summation of two factors:413.27    (1) an education factor, which is determined by the total number of eligible trainee 413.28FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical 413.29medical education program; and413.30    (2) a public program volume factor, which is determined by the total volume of 413.31public program revenue received by each training site as a percentage of all public 413.32program revenue received by all training sites in the fund pool.413.33    In this formula, the education factor is weighted at 67 percent and the public program 413.34volume factor is weighted at 33 percent.414.1    Public program revenue for the distribution formula includes revenue from medical 414.2assistance, prepaid medical assistance, general assistance medical care, and prepaid 414.3general assistance medical care. Training sites that receive no public program revenue 414.4are ineligible for funds available under this paragraph. Total statewide average costs per 414.5trainee for medical residents is based on audited clinical training costs per trainee in 414.6primary care clinical medical education programs for medical residents. Total statewide 414.7average costs per trainee for dental residents is based on audited clinical training costs 414.8per trainee in clinical medical education programs for dental students. Total statewide 414.9average costs per trainee for pharmacy residents is based on audited clinical training costs 414.10per trainee in clinical medical education programs for pharmacy students.414.11    (b) The commissioner shall annually distribute ten percent of total available medical 414.12education funds transferred according to section 256B.69, subdivision 5c, paragraph (a), 414.13clause (1), to all qualifying applicants based on the percentage received by each applicant 414.14under paragraph (a). These funds are to be used to offset clinical education costs at 414.15eligible clinical training sites based on criteria developed by the clinical medical education 414.16program. Applicants may choose to distribute funds allocated under this paragraph based 414.17on the distribution formula described in paragraph (a).414.18    (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated 414.19to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal 414.20financial participation on these funds and on funds transferred under subdivision 10, to all 414.21qualifying applicants based on a distribution formula that gives 100 percent weight to a 414.22public program volume factor, which is determined by the total volume of public program 414.23revenue received by each training site as a percentage of all public program revenue 414.24received by all training sites in the fund pool. If federal approval is not obtained for 414.25federal financial participation on any portion of funds distributed under this paragraph, 414.2690 percent of the unmatched funds shall be distributed by the commissioner based on 414.27the formula described in paragraph (a) and ten percent of the unmatched funds shall be 414.28distributed by the commissioner based on the formula described in paragraph (b).414.29    (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the 414.30commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving 414.31100 percent weight to an education factor, which is determined by the total number of 414.32eligible trainee full-time equivalents and the total statewide average costs per trainee, by 414.33type of trainee, in each clinical medical education program. If no matching funds are 414.34received on funds distributed under paragraph (c), funds distributed under this paragraph 414.35shall be distributed by the commissioner based on the formula described in paragraph (a).415.1    (e) The commissioner shall annually distribute $340,000 of funds dedicated to the 415.2commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants 415.3based on the percentage received by each applicant under paragraph (a). These funds are 415.4to be used to offset clinical education costs at eligible clinical training sites based on 415.5criteria developed by the clinical medical education program. Applicants may choose to 415.6distribute funds allocated under this paragraph based on the distribution formula described 415.7in paragraph (a). If no matching funds are received on funds distributed under paragraph 415.8(c), funds distributed under this paragraph shall be distributed by the commissioner based 415.9on the formula described in paragraph (b).415.10    (c) (f) Funds distributed shall not be used to displace current funding appropriations 415.11from federal or state sources.415.12    (d) (g) Funds shall be distributed to the sponsoring institutions indicating the amount 415.13to be distributed to each of the sponsor's clinical medical education programs based on 415.14the criteria in this subdivision and in accordance with the commissioner's approval letter. 415.15Each clinical medical education program must distribute funds allocated under paragraph 415.16(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 415.17institutions, which are accredited through an organization recognized by the Department 415.18of Education or the Centers for Medicare and Medicaid Services, may contract directly 415.19with training sites to provide clinical training. To ensure the quality of clinical training, 415.20those accredited sponsoring institutions must:415.21    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical 415.22training conducted at sites; and415.23    (2) take necessary action if the contract requirements are not met. Action may 415.24include the withholding of payments under this section or the removal of students from 415.25the site.415.26    (e) (h) Any funds not distributed in accordance with the commissioner's approval 415.27letter must be returned to the medical education and research fund within 30 days of 415.28receiving notice from the commissioner. The commissioner shall distribute returned funds 415.29to the appropriate training sites in accordance with the commissioner's approval letter.415.30    (f) (i) The commissioner shall distribute by June 30 of each year an amount equal to 415.31the funds transferred under subdivision 10, plus five percent interest to the University of 415.32Minnesota Board of Regents for the instructional costs of health professional programs 415.33at the Academic Health Center and for interdisciplinary academic initiatives within the 415.34Academic Health Center.416.1    (g) (j) A maximum of $150,000 of the funds dedicated to the commissioner 416.2under section 
         297F.10, subdivision 1, paragraph (b), clause (2), may be used by the 416.3commissioner for administrative expenses associated with implementing this section.416.4    Sec. 13. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:416.5    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner 416.6shall award grants to teaching institutions and clinical training sites for projects that 416.7increase dental access for underserved populations and promote innovative clinical 416.8training of dental professionals.416.9    (b) The commissioner shall award grants to teaching institutions and clinical training 416.10sites for projects that increase mental health access for underserved populations, promote 416.11innovative clinical training of mental health professionals, increase the number of mental 416.12health providers in rural or underserved areas, and promote the incorporation of patient 416.13safety principles into clinical medical education programs.416.14    (c) In awarding the grants, the commissioner, in consultation with the commissioner 416.15of human services, shall consider the following:416.16    (1) potential to successfully increase access to an underserved population;416.17    (2) the long-term viability of the project to improve access beyond the period 416.18of initial funding;416.19    (3) evidence of collaboration between the applicant and local communities;416.20    (4) the efficiency in the use of the funding; and416.21    (5) the priority level of the project in relation to state clinical education, access, 416.22patient safety, and workforce goals.; and416.23    (6) the potential of the project to impact the number or distribution of the health 416.24care workforce.416.25    (b) (d) The commissioner shall periodically evaluate the priorities in awarding the 416.26innovations grants in order to ensure that the priorities meet the changing workforce 416.27needs of the state.416.28    Sec. 14. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:416.29    Subd. 8. Federal financial participation. (a) The commissioner of human 416.30services shall seek to maximize federal financial participation in payments for medical 416.31education and research costs. If the commissioner of human services determines that 416.32federal financial participation is available for the medical education and research, the 416.33commissioner of health shall transfer to the commissioner of human services the amount 416.34of state funds necessary to maximize the federal funds available. The amount transferred 417.1to the commissioner of human services, plus the amount of federal financial participation, 417.2shall be distributed to medical assistance providers in accordance with the distribution 417.3methodology described in subdivision 4.417.4    (b) For the purposes of paragraph (a), the commissioner shall use physician clinic 417.5rates where possible to maximize federal financial participation.417.6    Sec. 15. Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:417.7    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the 417.8Academic Health Center under section 
         297F.10, subdivision 1, clause (1), $4,850,000 417.9shall be transferred annually to the commissioner of health no later than April 15 of each 417.10year for distribution under subdivision 4, paragraph (f) (i).417.11    Sec. 16. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:417.12    Subdivision 1. Required disclosure of estimated payment. (a) A health care 417.13provider, as defined in section 
         62J.03, subdivision 8, or the provider's designee as agreed 417.14to by that designee, shall, at the request of a consumer, provide that consumer with a good 417.15faith estimate of the reimbursementallowable payment the provider expects to receive 417.16from the health plan company in which the consumer is enrolled has agreed to accept from 417.17the consumer's health plan company for the services specified by the consumer, specifying 417.18the amount of the allowable payment due from the health plan company. Health plan 417.19companies must allow contracted providers, or their designee, to release this information. 417.20A good faith estimate must also be made available at the request of a consumer who 417.21is not enrolled in a health plan company.If a consumer has no applicable public or 417.22private coverage, the health care provider must give the consumer a good faith estimate 417.23of the average allowable reimbursement the provider accepts as payment from private 417.24third-party payers for the services specified by the consumer and the estimated amount 417.25the noncovered consumer will be required to pay. Payment information provided by a 417.26provider, or by the provider's designee as agreed to by that designee, to a patient pursuant 417.27to this subdivision does not constitute a legally binding estimate of the allowable charge 417.28for or cost to the consumer of services. 417.29    (b) A health plan company, as defined in section 
         62J.03, subdivision 10, shall, at 417.30the request of an enrollee or the enrollee's designee, provide that enrollee with a good 417.31faith estimate of the reimbursementallowable amount the health plan company would 417.32expect to pay tohas contracted for with a specified provider within the network as total 417.33payment for a health care service specified by the enrollee and the portion of the allowable 417.34amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the 418.1enrollee, the health plan company shall also provide to the enrollee a good faith estimate 418.2of the enrollee's out-of-pocket cost for the health care service. An estimate provided to 418.3an enrollee under this paragraph is not a legally binding estimate of the reimbursement418.4allowable amount or enrollee's out-of-pocket cost.418.5EFFECTIVE DATE.This section is effective August 1, 2007.418.6    Sec. 17. Minnesota Statutes 2006, section 62J.82, is amended to read:418.762J.82 HOSPITAL CHARGEINFORMATION REPORTING DISCLOSURE.418.8    Subdivision 1.Required information. The Minnesota Hospital Association shall 418.9develop a Web-based system, available to the public free of charge, for reporting charge 418.10information the following, for Minnesota residents,:418.11    (1) hospital-specific performance on the measures of care developed under section 418.12256B.072 for acute myocardial infarction, heart failure, and pneumonia; 418.13    (2) by January 1, 2009, hospital-specific performance on the public reporting 418.14measures for hospital-acquired infections as published by the National Quality Forum 418.15and collected by the Minnesota Hospital Association and Stratis Health in collaboration 418.16with infection control practitioners; and 418.17    (3) charge information, including, but not limited to, number of discharges, average 418.18length of stay, average charge, average charge per day, and median charge, for each of the 418.1950 most common inpatient diagnosis-related groups and the 25 most common outpatient 418.20surgical procedures as specified by the Minnesota Hospital Association. 418.21    Subd. 2.Web site. The Web site must provide information that compares 418.22hospital-specific data to hospital statewide data. The Web site must be established by 418.23October 1, 2006, and must be updated annually. The commissioner shall provide a link to 418.24this reporting information on the department's Web site.418.25    Subd. 3.Enforcement.The commissioner shall provide a link to this information 418.26on the department's Web site. If a hospital does not provide this information to the 418.27Minnesota Hospital Association, the commissioner of health may require the hospital to 418.28do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a 418.29link to this information on the department's Web site.418.30    Sec. 18. [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.418.31    Subdivision 1.Task force.The governor shall convene a health care transformation 418.32task force to advise and assist the governor and the Minnesota legislature. The task force 418.33shall consist of:419.1    (1) four legislators from the house of representatives appointed by the speaker, two 419.2from the majority party and two from the minority party, and four legislators from the 419.3senate appointed by the Subcommittee on Committees of the senate Committee on Rules 419.4and Administration, two from the majority party and two from the minority party;419.5    (2) four representatives of the governor and state agencies appointed by the governor;419.6    (3) at least four persons appointed by the governor who have demonstrated 419.7leadership in health care organizations, health improvement initiatives, health care trade or 419.8professional associations, or other collaborative health system improvement activities; and419.9    (4) at least two persons appointed by the governor who have demonstrated leadership 419.10in employer and group purchaser activities related to health system improvement, at least 419.11one of which must be from a labor organization.419.12    Subd. 2.Public input.The commissioner of health shall review available research, 419.13and conduct statewide, regional, and local surveys, focus groups, and other activities as 419.14needed to fill gaps in existing research, to determine Minnesotans' values, preferences, 419.15opinions, and perceptions related to health care and to the issues confronting the task 419.16force, and shall report the findings to the task force.419.17    Subd. 3.Inventory and assessment of existing activities; action plan.The task 419.18force shall complete an inventory and assessment of all public and private organized 419.19activities, coalitions, and collaboratives working on tasks relating to health system 419.20improvement including, but not limited to, patient safety, quality measurement and 419.21reporting, evidence-based practice, adoption of health information technology, disease 419.22management and chronic care coordination, medical homes, access to health care, 419.23cultural competence, prevention and public health, consumer incentives, price and cost 419.24transparency, nonprofit organization community benefits, education, research, and health 419.25care workforce.419.26    Subd. 4.Action plan.By December 15, 2007, the governor, with the advice 419.27and assistance of the task force, shall develop and present to the legislature a statewide 419.28action plan for transforming the health care system to improve affordability, quality, 419.29and access. The plan shall include draft legislation needed to implement the plan. The 419.30plan may consist of legislative actions, administrative actions of governmental entities, 419.31collaborative actions, and actions of individuals and individual organizations. Among 419.32other things, the action plan must include the following, with specific and measurable 419.33goals and deadlines for each:419.34    (1) proposed actions that will slow the rate of increase in health care costs to a rate 419.35that does not exceed the increase in the Consumer Price Index for urban consumers for the 420.1preceding calendar year plus two percentage points, plus an additional percentage based 420.2on the added costs necessary to implement legislation enacted in 2007;420.3    (2) actions that will increase the affordable health coverage options for uninsured 420.4and underinsured Minnesotans and other strategies that will ensure that all Minnesotans 420.5will have health coverage by January 2011;420.6    (3) actions to improve the quality and safety of health care and reduce racial and 420.7ethnic disparities in access and quality;420.8    (4) actions that will reduce the rate of preventable chronic illness through prevention 420.9and public health and wellness initiatives; and420.10    (5) proposed changes to state health care purchasing and payment strategies used for 420.11state health care programs and state employees that will promote higher quality, lower 420.12cost health care through incentives that reward prevention and early intervention, use 420.13of cost-effective primary care, effective care coordination, and management of chronic 420.14disease;420.15    (6) actions that will promote the appropriate and cost-effective investment in new 420.16facilities, technologies, and drugs;420.17    (7) actions to reduce administrative costs; and420.18    (8) the results of the inventory completed under subdivision 3 and recommendations 420.19for how these activities can be coordinated and improved.420.20    Subd. 5.Options for small employers.The task force shall study and report back 420.21to the legislature by December 15, 2007, on options for serving small employers and their 420.22employees, and self-employed individuals.420.23    Sec. 19. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:420.24    Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual 420.25conversion policies to eligible employees otherwise eligible for conversion coverage under 420.26section 
         62D.104 as a result of leaving a health maintenance organization's service area.420.27    (b) A health carrier may sell, issue, or renew individual conversion policies to 420.28eligible employees otherwise eligible for conversion coverage as a result of the expiration 420.29of any continuation of group coverage required under sections 
         62A.146, 
         62A.17, 
         62A.21, 420.3062C.142
         , 
         62D.101, and 
         62D.105.420.31    (c) A health carrier may sell, issue, or renew conversion policies under section 420.3262E.16
          to eligible employees.420.33    (d) A health carrier may sell, issue, or renew individual continuation policies to 420.34eligible employees as required.421.1    (e) A health carrier may sell, issue, or renew individual health plans if the coverage 421.2is appropriate due to an unexpired preexisting condition limitation or exclusion applicable 421.3to the person under the employer's group health plan or due to the person's need for health 421.4care services not covered under the employer's group health plan.421.5    (f) A health carrier may sell, issue, or renew an individual health plan, if the 421.6individual has elected to buy the individual health plan not as part of a general plan to 421.7substitute individual health plans for a group health plan nor as a result of any violation of 421.8subdivision 3 or 4.421.9    (g) Nothing in this subdivision relieves a health carrier of any obligation to provide 421.10continuation or conversion coverage otherwise required under federal or state law.421.11    (h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage 421.12issued as a supplement to Medicare under sections 
         62A.3099 to 
         62A.44, or policies or 421.13contracts that supplement Medicare issued by health maintenance organizations, or those 421.14contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social 421.15Security Act, United States Code, title 42, section 1395 et seq., as amended.421.16    (i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual 421.17health plans necessary to comply with a court order.421.18    (j) A health carrier may offer, issue, sell, or renew an individual health plan to 421.19persons eligible for an employer group health plan, if the individual health plan is a high 421.20deductible health plan for use in connection with an existing health savings account, in 421.21compliance with the Internal Revenue Code, section 223. In that situation, the same or 421.22a different health carrier may offer, issue, sell, or renew a group health plan to cover 421.23the other eligible employees in the group.421.24    (k) A health carrier may offer, sell, issue, or renew an individual health plan to one 421.25or more employees of a small employer if the individual health plan is marketed directly421.26through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 to 421.27all employees of the small employer and the small employer does not contribute directly 421.28or indirectly to the premiums or facilitate the administration of the individual health 421.29plan. The requirement to market an individual health plan to all employees through the 421.30Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 does not require 421.31the health carrier to offer or issue an individual health plan to any employee. For purposes 421.32of this paragraph, an employer is not contributing to the premiums or facilitating the 421.33administration of the individual health plan if the employer does not contribute to the 421.34premium and merely collects the premiums from an employee's wages or salary through 421.35payroll deductions and submits payment for the premiums of one or more employees in a 421.36lump sum to the health carrier to the Minnesota Health Insurance Exchange under section 422.162A.67 or 62A.68. Except for coverage under section 
         62A.65, subdivision 5, paragraph 422.2(b), or 
         62E.16, at the request of an employee, the health carrier Minnesota Health Insurance 422.3Exchange under section 62A.67 or 62A.68 may bill the employer for the premiums 422.4payable by the employee, provided that the employer is not liable for payment except 422.5from payroll deductions for that purpose. If an employer is submitting payments under 422.6this paragraph, the health carrier and the Minnesota Health Insurance Exchange under 422.7section 62A.67 or 62A.68 shall jointly provide a cancellation notice directly to the primary 422.8insured at least ten days prior to termination of coverage for nonpayment of premium. 422.9Individual coverage under this paragraph may be offered only if the small employer has 422.10not provided coverage under section 62L.03 to the employees within the past 12 months.422.11    The employer must provide a written and signed statement to the health carrier422.12Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the employer 422.13is not contributing directly or indirectly to the employee's premiums. The Minnesota 422.14Health Insurance Exchange under section 62A.67 or 62A.68 shall provide all health 422.15carriers with enrolled employees of the employer with a copy of the employer's statement. 422.16The health carrier may rely on the employer's statement provided by the Minnesota Health 422.17Insurance Exchange under section 62A.67 or 62A.68 and is not required to guarantee-issue 422.18individual health plans to the employer's other current or future employees.422.19    Sec. 20. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:422.20    Subd. 4. Employer prohibition. A small employer offering a health benefit plan 422.21shall not encourage or direct an employee or applicant to:422.22    (1) refrain from filing an application for health coverage when other similarly 422.23situated employees may file an application for health coverage;422.24    (2) file an application for health coverage during initial eligibility for coverage, 422.25the acceptance of which is contingent on health status, when other similarly situated 422.26employees may apply for health coverage, the acceptance of which is not contingent on 422.27health status;422.28    (3) seek coverage from another health carrier, including, but not limited to, MCHA; 422.29or422.30    (4) cause coverage to be issued on different terms because of the health status or 422.31claims experience of that person or the person's dependents.422.32    Sec. 21. [62Q.101] EVALUATION OF PROVIDER PERFORMANCE.423.1    A health plan company, or a vendor of risk management services as defined under 423.2section 60A.23, subdivision 8, shall, in evaluating the performance of a health care 423.3provider:423.4    (1) conduct the evaluation using a bona fide baseline based upon practice experience 423.5of the provider group; and423.6    (2) disclose the baseline to the health care provider in writing and prior to the 423.7beginning of the time period used for the evaluation.423.8    Sec. 22. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:423.9    Subdivision 1. Definition. It is the commitment of the state to achieve universal 423.10health coverage for all Minnesotans by the year 2011. Universal coverage is achieved 423.11when:423.12    (1) every Minnesotan has access to a full range of quality health care services;423.13    (2) every Minnesotan is able to obtain affordable health coverage which pays for the 423.14full range of services, including preventive and primary care; and423.15    (3) every Minnesotan pays into the health care system according to that person's 423.16ability.423.17EFFECTIVE DATE.This section is effective July 1, 2007.423.18    Sec. 23. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:423.19    Subd. 2. Goal. It is the goal of the state to make continuous progress toward 423.20reducing the number of Minnesotans who do not have health coverage so that by January 423.211, 2000, fewer than four percent of the state's population will be without health coverage423.222011, all Minnesota residents have access to affordable health care. The goal will be 423.23achieved by improving access to private health coverage through insurance reforms and 423.24market reforms, by making health coverage more affordable for low-income Minnesotans 423.25through purchasing pools and state subsidies, and by reducing the cost of health coverage 423.26through cost containment programs and methods of ensuring that all Minnesotans are 423.27paying into the system according to their ability.423.28EFFECTIVE DATE.This section is effective July 1, 2007.423.29    Sec. 24. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:423.30    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 423.31coverage program, a community-based health initiative shall submit to the commissioner 423.32of health for approval the community-based health care coverage program developed by 424.1the initiative. The commissioner shall only approve a program that has been awarded 424.2a community access program grant from the United States Department of Health and 424.3Human Services. The commissioner shall ensure that the program meets the federal grant 424.4requirements and any requirements described in this section and is actuarially sound based 424.5on a review of appropriate records and methods utilized by the community-based health 424.6initiative in establishing premium rates for the community-based health care coverage 424.7program. 424.8    (b) Prior to approval, the commissioner shall also ensure that:424.9    (1) the benefits offered comply with subdivision 8 and that there are adequate 424.10numbers of health care providers participating in the community-based health network to 424.11deliver the benefits offered under the program;424.12    (2) the activities of the program are limited to activities that are exempt under this 424.13section or otherwise from regulation by the commissioner of commerce;424.14    (3) the complaint resolution process meets the requirements of subdivision 10; and 424.15    (4) the data privacy policies and procedures comply with state and federal law.424.16    Sec. 25. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:424.17    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 424.18by the commissioner of health a community-based health care coverage program. The 424.19operational structure established by the initiative shall include, but is not limited to: 424.20    (1) establishing a process for enrolling eligible individuals and their dependents; 424.21    (2) collecting and coordinating premiums from enrollees and employers of enrollees;424.22    (3) providing payment to participating providers; 424.23    (4) establishing a benefit set according to subdivision 8 and establishing premium 424.24rates and cost-sharing requirements; 424.25    (5) creating incentives to encourage primary care and wellness services; and 424.26    (6) initiating disease management services, as appropriate. 424.27    (b) The payments collected under paragraph (a), clause (2), may be used to capture 424.28available federal funds.424.29    Sec. 26. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:424.30    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 424.31commissioner of health on January 15, April 15, July 15, and October 15 of each year, 424.32with the first report due January 15, 2007 2008. The status report shall include:424.33    (1) the financial status of the program, including the premium rates, cost per member 424.34per month, claims paid out, premiums received, and administrative expenses; 425.1    (2) a description of the health care benefits offered and the services utilized; 425.2    (3) the number of employers participating, the number of employees and dependents 425.3covered under the program, and the number of health care providers participating; 425.4    (4) a description of the health outcomes to be achieved by the program and a status 425.5report on the performance measurements to be used and collected; and 425.6    (5) any other information requested by the commissioner of health or commerce or 425.7the legislature. 425.8    (b) The initiative shall contract with an independent entity to conduct an evaluation 425.9of the program to be submitted to the commissioners of health and commerce and the 425.10legislature by January 15, 2009 2010. The evaluation shall include:425.11    (1) an analysis of the health outcomes established by the initiative and the 425.12performance measurements to determine whether the outcomes are being achieved;425.13    (2) an analysis of the financial status of the program, including the claims to 425.14premiums loss ratio and utilization and cost experience; 425.15    (3) the demographics of the enrollees, including their age, gender, family income, 425.16and the number of dependents; 425.17    (4) the number of employers and employees who have been denied access to the 425.18program and the basis for the denial; 425.19    (5) specific analysis on enrollees who have aggregate medical claims totaling over 425.20$5,000 per year, including data on the enrollee's main diagnosis and whether all the 425.21medical claims were covered by the program; 425.22    (6) number of enrollees referred to state public assistance programs; 425.23    (7) a comparison of employer-subsidized health coverage provided in a comparable 425.24geographic area to the designated community-based geographic area served by the 425.25program, including, to the extent available: 425.26    (i) the difference in the number of employers with 50 or fewer employees offering 425.27employer-subsidized health coverage; 425.28    (ii) the difference in uncompensated care being provided in each area; and425.29    (iii) a comparison of health care outcomes and measurements established by the 425.30initiative; and 425.31    (8) any other information requested by the commissioner of health or commerce.425.32    Sec. 27. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:425.33    Subd. 14. Sunset. This section expires December 31, 2011 2012.425.34    Sec. 28. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:426.1    Subdivision 1. Yearly reports.(a) Each hospital and each outpatient surgical center, 426.2which has not filed the financial information required by this section with a voluntary, 426.3nonprofit reporting organization pursuant to section 
         144.702, shall file annually with the 426.4commissioner of health after the close of the fiscal year: 426.5    (1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or 426.6outpatient surgical center;426.7    (2) a detailed statement of income and expenses;426.8    (3) a copy of its most recent cost report, if any, filed pursuant to requirements of 426.9Title XVIII of the United States Social Security Act;426.10    (4) a copy of all changes to articles of incorporation or bylaws;426.11    (5) information on services provided to benefit the community, including services 426.12provided at no cost or for a reduced fee to patients unable to pay, teaching and research 426.13activities, or other community or charitable activities;426.14    (6) information required on the revenue and expense report form set in effect on 426.15July 1, 1989, or as amended by the commissioner in rule;426.16    (7) information on changes in ownership or control; and426.17    (8) other information required by the commissioner in rule.;426.18    (9) information on the number of available hospital beds that are dedicated to certain 426.19specialized services, as designated by the commissioner, and annual occupancy rates for 426.20those beds, separately for adult and pediatric care;426.21    (10) from outpatient surgical centers, the total number of surgeries; and426.22    (11) a report on health care capital expenditures during the previous year, as required 426.23by section 62J.17.426.24    (b) Beginning with hospital fiscal year 2009, each nonprofit hospital shall report on 426.25community benefits under paragraph (a), clause (5). "Community benefit" means the costs 426.26of community care, underpayment for services provided under state health care programs, 426.27research costs, community health services costs, financial and in-kind contributions, costs 426.28of community building activities, costs of community benefit operations, education, and 426.29the cost of operating subsidized services. The cost of bad debts and underpayment for 426.30Medicare services are not included in the calculation of community benefit.426.31    Sec. 29. Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision 426.32to read:426.33    Subd. 5.Annual reports on community benefit, community care amounts, 426.34and state program underfunding.(a) For each hospital reporting health care cost 426.35information under section 144.698 or 144.702, the commissioner shall report annually 427.1on the hospital's community benefit, community care, and underpayment for state public 427.2health care programs.427.3    (b) For purposes of this subdivision, "community benefits" has the definition given 427.4in section 144.698, paragraph (b).427.5    (c) For purposes of this subdivision, "community care" means the costs for medical 427.6care for which a hospital has determined is charity care, as defined under Minnesota Rules, 427.7part 4650.0115, or for which the hospital determines after billing for the services that there 427.8is a demonstrated inability to pay. Any costs forgiven under a hospital's community care 427.9plan or under section 62J.83 may be counted in the hospital's calculation of community 427.10care. Bad debt expenses and discounted charges available to the uninsured shall not be 427.11included in the calculation of community care. The amount of community care is the value 427.12of costs incurred and not the charges made for services.427.13    (d) For purposes of this subdivision, underpayment for services provided by state 427.14public health care programs is the difference between hospital costs and public program 427.15payments. The information shall be reported in terms of total dollars and as a percentage 427.16of total operating costs for each hospital.427.17    Sec. 30. [145.985] HEALTH PROMOTION AND WELLNESS.427.18    Community health boards as defined in section 145A.02, subdivision 5, may work 427.19with schools, health care providers, and others to coordinate health and wellness programs 427.20in their communities. In order to meet the requirements of this section, community 427.21health boards may:427.22    (1) provide instruction, technical assistance, and recommendations on how to 427.23evaluate project outcomes;427.24    (2) assist with on-site health and wellness programs utilizing volunteers and others 427.25addressing health and wellness topics including smoking, nutrition, obesity, and others; and427.26    (3) encourage health and wellness programs consistent with the Centers for Disease 427.27Control and Prevention's Community Guide and goals consistent with the Centers for 427.28Disease Control and Prevention's Healthy People 2010 initiative.427.29    Sec. 31. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:427.30    Subd. 2b. Performance payments.(a) The commissioner shall develop and 427.31implement a pay-for-performance system to provide performance payments to:427.32    (1) eligible medical groups and clinics that demonstrate optimum care in serving 427.33individuals with chronic diseases who are enrolled in health care programs administered 427.34by the commissioner under chapters 256B, 256D, and 256L.;428.1    (2) medical groups that implement effective medical home models of patient care 428.2that improve quality and reduce costs through effective primary and preventive care, care 428.3coordination, and management of chronic conditions; and428.4    (3) eligible medical groups and clinics that evaluate medical provider usage patterns 428.5and provide feedback to individual medical providers on that provider's practice patterns 428.6relative to peer medical providers.428.7    (b) The commissioner shall also develop and implement a patient incentive health 428.8program to provide incentives and rewards to patients who are enrolled in health care 428.9programs administered by the commissioner under chapters 256B, 256D, and 256L, and 428.10who have agreed to and meet personal health goals established with their primary care 428.11provider to manage a chronic disease or condition including, but not limited to, diabetes, 428.12high blood pressure, and coronary artery disease.428.13    (c) The commissioner may receive any federal matching money that is made 428.14available through the medical assistance program for managed care oversight contracted 428.15through vendors including consumer surveys, studies, and external quality reviews as 428.16required by the Federal Balanced Budget Act of 1997, Code of Federal Regulations, 428.17title 42, part 438, subpart E. Any federal money received for managed care oversight is 428.18appropriated to the commissioner for this purpose. The commissioner may expend the 428.19federal money received in either year of the biennium.428.20EFFECTIVE DATE.This section is effective July 1, 2007.428.21    Sec. 32. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 428.22subdivision to read:428.23    Subd. 49.Provider-directed care coordination services.The commissioner 428.24shall develop and implement a provider-directed care coordination program for medical 428.25assistance recipients who are not enrolled in the prepaid medical assistance program and 428.26who are receiving services on a fee-for-service basis. This program provides payment 428.27to primary care clinics for care coordination for people who have complex and chronic 428.28medical conditions. Clinics must meet certain criteria such as the capacity to develop care 428.29plans; have a dedicated care coordinator; and have an adequate number of fee-for-service 428.30clients, evaluation mechanisms, and quality improvement processes to qualify for 428.31reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic 428.32designated as the patient's first point of contact for medical care, available 24 hours a 428.33day, seven days a week, that provides or arranges for the patient's comprehensive health 428.34care needs, and provides overall integration, coordination and continuity over time and 428.35referrals for specialty care.429.1    Sec. 33. HEALTH CARE PAYMENT SYSTEM REFORM.429.2    Subdivision 1.Payment reform plan.The commissioners of employee relations, 429.3human services, commerce, and health shall develop a plan for promoting and facilitating 429.4changes in payment rates and methods for paying for health care services, drugs, devices, 429.5supplies, and equipment in order to:429.6    (1) reward the provision of cost-effective primary and preventive care;429.7    (2) reward the use of evidence-based care;429.8    (3) discourage underutilization, overuse, and misuse;429.9    (4) reward the use of the most cost-effective settings, drugs, devices, providers, 429.10and treatments; and429.11    (5) encourage consumers to maintain good health and use the health care system 429.12appropriately.429.13    In developing the plan, the commissioners shall analyze existing data to determine 429.14specific services and health conditions for which changes in payment rates and methods 429.15would lead to significant improvements in quality of care. The commissioners shall 429.16include a definition of the term "quality" for uniform understanding of the plan's impact.429.17    Subd. 2.Report.The commissioners shall submit a report to the legislature by 429.18December 15, 2007, describing the payment reform plan. The report must include 429.19proposed legislation for implementing those components of the plan requiring legislative 429.20action or appropriations of money.429.21EFFECTIVE DATE.This section is effective July 1, 2007.429.22    Sec. 34. COMMUNITY COLLABORATIVE PILOT PROJECTS TO COVER 429.23THE UNINSURED.429.24    Subdivision 1.Community collaboratives.The commissioner of human services 429.25shall provide grants to and authorization for up to three community collaboratives that 429.26satisfy the requirements in this section. To be eligible to receive a grant and authorization 429.27under this section, a community collaborative must include:429.28    (1) one or more counties;429.29    (2) one or more local hospitals;429.30    (3) one or more local employers who collectively provide at least 300 jobs in the 429.31community;429.32    (4) one or more health care clinics or physician groups; and429.33    (5) a third-party payer, which may be a county-based purchasing plan operating 429.34under Minnesota Statutes, section 256B.692, a self-insured employer, or a health plan 429.35company as defined in Minnesota Statutes, section 62Q.01, subdivision 4.430.1    Subd. 2.Pilot project requirements.(a) Community collaborative pilot projects 430.2must:430.3    (1) identify and enroll persons in the community who are uninsured, and who have, 430.4or are at risk of developing, one of the following chronic conditions: mental illness, 430.5diabetes, asthma, hypertension, or other chronic condition designated by the project;430.6    (2) assist uninsured persons to obtain private-sector health insurance coverage if 430.7possible or to enroll in any public health care programs for which they are eligible. If the 430.8uninsured individual is unable to obtain health coverage, the community collaborative 430.9must enroll the individual in a local health care assistance program that provides specified 430.10services to prevent or effectively manage the chronic condition;430.11    (3) include components to help uninsured persons retain employment or to become 430.12employable, if currently unemployed;430.13    (4) ensure that each uninsured person enrolled in the program has a medical home 430.14responsible for providing, or arranging for, health care services and assisting in the 430.15effective management of the chronic condition;430.16    (5) coordinate services between all providers and agencies serving an enrolled 430.17individual; and430.18    (6) be coordinated with the state's Q-Care initiative and improve the use of 430.19evidence-based treatments and effective disease management programs in the broader 430.20community, beyond those individuals enrolled in the project.430.21    (b) Projects established under this section are not insurance and are not subject to 430.22state-mandated benefit requirements or insurance regulations.430.23    Subd. 3.Criteria.Proposals must be evaluated by actuarial, financial, and clinical 430.24experts based on the likelihood that the project would produce a positive return on 430.25investment for the community. In awarding grants, the commissioner of human services 430.26shall give preference to proposals that:430.27    (1) have broad community support from local businesses, provider counties, and 430.28other public and private organizations;430.29    (2) would provide services to uninsured persons who have, or are at risk of 430.30developing, multiple, co-occurring chronic conditions;430.31    (3) integrate or coordinate resources from multiple sources, such as employer 430.32contributions, county funds, social service programs, and provider financial or in-kind 430.33support;430.34    (4) provide continuity of treatment and services when uninsured individuals in 430.35the program become eligible for public or private health insurance or when insured 430.36individuals lose their coverage;431.1    (5) demonstrate how administrative costs for health plan companies and providers 431.2can be reduced through greater simplification, coordination, consolidation, standardization, 431.3reducing billing errors, or other methods; and431.4    (6) involve local contributions to the cost of the pilot projects.431.5    Subd. 4.Grants.The commissioner of human services shall provide 431.6implementation grants of up to one-half of the community collaborative's costs for 431.7planning, administration, and evaluation. The commissioner shall also provide grants to 431.8community collaboratives to develop a fund to pay up to 50 percent of the cost of the 431.9services provided to uninsured individuals. The remaining costs must be paid for through 431.10other sources or by agreement of a health care provider to contribute the cost as charity 431.11care.431.12    Subd. 5.Evaluation.The commissioner of human services shall evaluate the 431.13effectiveness of each community collaborative project awarded a grant, by comparing 431.14actual costs for serving the identified uninsured persons to the predicted costs that would 431.15have been incurred in the absence of early intervention and consistent treatment to manage 431.16the chronic condition, including the costs to medical assistance, MinnesotaCare, and 431.17general assistance medical care. The commissioner shall require community collaborative 431.18projects, as a condition of receipt of a grant award, to provide the commissioner with all 431.19information necessary for this evaluation.431.20EFFECTIVE DATE.This section is effective July 1, 2007.431.21    Sec. 35. HEALTH CARE PAYMENT REFORM PILOT PROJECTS.431.22    Subdivision 1.Pilot projects.(a) The commissioners of health, human services, 431.23and employee relations shall develop and administer payment reform pilot projects for 431.24state employees and persons enrolled in medical assistance, MinnesotaCare, or general 431.25assistance medical care, to the extent permitted by federal requirements. The purpose of 431.26the projects is to promote and facilitate changes in payment rates and methods for paying 431.27for health care services, drugs, devices, supplies, and equipment in order to:431.28    (1) reward the provision of cost-effective primary and preventive care;431.29    (2) reward the use of evidence-based care;431.30    (3) reward coordination of care for patients with chronic conditions;431.31    (4) discourage overuse and misuse;431.32    (5) reward the use of the most cost-effective settings, drugs, devices, providers, 431.33and treatments;431.34    (6) encourage consumers to maintain good health and use the health care system 431.35appropriately.432.1    (b) The pilot projects must involve the use of designated care professionals or 432.2clinics to serve as a patient's medical home and be responsible for coordinating health 432.3care services across the continuum of care. The pilot projects must evaluate different 432.4payment reform models and must be coordinated with the Minnesota senior health options 432.5program and the Minnesota disability health options program. To the extent possible, the 432.6commissioners shall coordinate state purchasing activities with other public employers 432.7and with private purchasers, self-insured groups, and health plan companies to promote 432.8the use of pilot projects encompassing both public and private purchasers and markets.432.9    Subd. 2.Payment methods and incentives.The commissioners shall modify 432.10existing payment methods and rates for those enrollees and health care providers 432.11participating in the pilot project in order to provide incentives for care management, 432.12team-based care, and practice redesign, and increase resources for primary care, chronic 432.13condition care, and care provided to complex patients. The commissioners may create 432.14financial incentives for patients to select a medical home under the pilot project by 432.15reducing, modifying, or eliminating deductibles and co-payments for certain services, or 432.16through other incentives. The commissioners may require patients to remain with their 432.17designated medical home for a specified period of time. Alternative payment methods 432.18may include complete or partial capitation, fee-for-service payments, or other payment 432.19methodologies. The payment methods may provide for the payment of bonuses to medical 432.20home providers or other providers, or to patients, for the achievement of performance 432.21goals. The payment methods may include allocating a portion of the payment that 432.22would otherwise be paid to health plans under state prepaid health care programs to the 432.23designated medical home for specified services.432.24    Subd. 3.Requirements.In order to be designated a medical home under the pilot 432.25project, health care professionals or clinics must demonstrate their ability to:432.26    (1) be the patient's first point of contact by telephone or other means, 24 hours a 432.27day, seven days a week;432.28    (2) provide or arrange for patients' comprehensive health care needs, including the 432.29ability to structure planned chronic disease visits and to manage chronic disease through 432.30the use of disease registries;432.31    (3) coordinate patients' care when care must be provided outside the medical home;432.32    (4) provide longitudinal care, not just episodic care, including meeting long-term 432.33and unique personal needs;432.34    (5) utilize an electronic health record and incorporate a plan to develop and make 432.35available to patients that choose a medical home an electronic personal health record that 433.1is prepopulated with the patient's data, consumer-directed, connected to the provider, 433.224-hour accessible, and owned and controlled by the patient;433.3    (6) systematically improve quality of care using, among other inputs, patient 433.4feedback; and433.5    (7) create a provider network that provides for increased reimbursement for a 433.6medical home in a cost-neutral manner.433.7    Subd. 4.Evaluation.Pilot projects must be evaluated based on patient satisfaction, 433.8provider satisfaction, clinical process and outcome measures, program costs and savings, 433.9and economic impact on health care providers. Pilot projects must be evaluated based 433.10on the extent to which the medical home:433.11    (1) coordinated health care services across the continuum of care and thereby 433.12reduced duplication of services and enhanced communication across providers;433.13    (2) provided safe and high-quality care by increasing utilization of effective 433.14treatments, reduced use of ineffective treatments, reduced barriers to essential care and 433.15services, and eliminated barriers to access;433.16    (3) reduced unnecessary hospitalizations and emergency room visits and increased 433.17use of cost-effective care and settings;433.18    (4) encouraged long-term patient and provider relationships by shifting from 433.19episodic care to consistent, coordinated communication and care with a specified team of 433.20providers or individual providers;433.21    (5) engaged and educated consumers by encouraging shared patient and provider 433.22responsibility and accountability for disease prevention, health promotion, chronic 433.23disease management, acute care, and overall well-being, encouraging informed medical 433.24decision-making, ensuring the availability of accurate medical information, and facilitated 433.25the transfer of accurate medical information;433.26    (6) encouraged innovation in payment methodologies by using patient and provider 433.27incentives to coordinate care and utilize medical home services and fostering the 433.28expansion of a technology infrastructure that supports collaboration; and433.29    (7) reduced overall health care costs as compared to conventional payment methods 433.30for similar patient populations.433.31    Subd. 5.Rulemaking.The commissioners are exempt from administrative 433.32rulemaking under chapter 14 for purposes of developing, administering, contracting 433.33for, and evaluating pilot projects under this section. The commissioner shall publish a 433.34proposed request for proposals in the State Register and allow 30 days for comment 433.35before issuing the final request for proposals.434.1    Subd. 6.Regulatory and payment barriers.The commissioners shall study state 434.2and federal statutory and regulatory barriers to the creation of medical homes and provide 434.3a report and recommendations to the legislature by December 15, 2007.434.4    Sec. 36. HEALTH CARE SYSTEM CONSOLIDATION.434.5    (a) The commissioner of health shall study the effect of health care provider and 434.6health plan company consolidation in the four metropolitan statistical areas in Minnesota 434.7on: health care costs, including provider payment rates; quality of care; and access 434.8to care. The commissioner shall separately consider hospitals, specialty groups, and 434.9primary care groups. The commissioner shall include a definition of the terms "quality 434.10of care" and "access to care" to provide uniform understanding of the study's findings. 434.11The commissioner shall present findings and recommendations to the legislature by 434.12December 15, 2007.434.13    (b) For purposes of this study, health carriers, provider networks, and other health 434.14care providers shall provide data on network participation, contracted payment rates, 434.15charges, costs, payments received, patient referrals, and other information requested by 434.16the commissioner, in the form and manner specified by the commissioner. Provider-level 434.17information on contracted payment rates and payments from health plans provided to the 434.18commissioner of health for the purposes of this study are (1) private data on individuals as 434.19defined in Minnesota Statutes, section 13.02, subdivision 12, and (2) nonpublic data as 434.20defined in Minnesota Statutes, section 13.02, subdivision 9. The commissioner may not 434.21collect patient-identified data for purposes of this study. Data collected for purposes of 434.22this study may not be used for any other purposes.434.23    Sec. 37.  REPEALER.434.24Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective 434.25August 1, 2007.434.26ARTICLE 10434.27PUBLIC HEALTH434.28    Section 1. Minnesota Statutes 2006, section 13.3806, is amended by adding a 434.29subdivision to read:434.30    Subd. 21.Birth defects registry system.Data on individuals collected by the 434.31birth defects registry system are private data on individuals and classified pursuant to 434.32section 144.2215.435.1    Sec. 2. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision 435.2to read:435.3    Subd. 3b.Window fall prevention device code.The commissioner of labor and 435.4industry shall adopt rules for window fall prevention devices as part of the state Building 435.5Code. Window fall prevention devices include, but are not limited to, safety screens, 435.6hardware, guards, and other devices that comply with the standards established by the 435.7commissioner of labor and industry. The rules must require compliance with standards 435.8for window fall prevention devices developed by ASTM International, contained in the 435.9International Building Code as the model language with amendments deemed necessary to 435.10coordinate with the other adopted building codes in Minnesota. The rules must establish a 435.11scope that includes the applicable building occupancies, and the types, locations, and sizes 435.12of windows that will require the installation of fall devices. The rules will be effective July 435.131, 2009. The commissioner shall report to the legislature on the status of the rulemaking 435.14on or before February 15, 2008.435.15    Sec. 3. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:435.16    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable 435.17application fee of $175 $215 to cover the administrative cost of processing a request for a 435.18variance or modification of rules adopted by the commissioner under this chapter.435.19EFFECTIVE DATE.This section is effective July 1, 2008.435.20    Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:435.21    Subdivision 1. Well notification fee. The well notification fee to be paid by a 435.22property owner is:435.23    (1) for a new water supply well, $175 $215, which includes the state core function 435.24fee;435.25    (2) for a well sealing, $35 $50 for each well, which includes the state core function 435.26fee, except that for monitoring wells constructed on a single property, having depths 435.27within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of 435.28$35 $50; and435.29    (3) for construction of a dewatering well, $175 $215, which includes the state core 435.30function fee, for each dewatering well except a dewatering project comprising five or 435.31more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering 435.32wells recorded on the notification.435.33EFFECTIVE DATE.This section is effective July 1, 2008.436.1    Sec. 5. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:436.2    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:436.3    (1) for a water supply well that is not in use under a maintenance permit, $150 $175436.4annually;436.5    (2) for construction of a monitoring well, $175 $215, which includes the state 436.6core function fee;436.7    (3) for a monitoring well that is unsealed under a maintenance permit, $150 $175436.8annually;436.9    (4) for monitoring wells used as a leak detection device at a single motor fuel retail 436.10outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 436.11chemical facility site, the construction permit fee is $175 $215, which includes the state 436.12core function fee, per site regardless of the number of wells constructed on the site, and 436.13the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per 436.14site regardless of the number of monitoring wells located on site;436.15    (5) for a groundwater thermal exchange device, in addition to the notification fee for 436.16water supply wells, $175 $215, which includes the state core function fee;436.17    (6) for a vertical heat exchanger, $175 $215;436.18    (7) for a dewatering well that is unsealed under a maintenance permit, $150 $175436.19annually for each dewatering well, except a dewatering project comprising more than five 436.20dewatering wells shall be issued a single permit for $750 $875 annually for dewatering 436.21wells recorded on the permit; and436.22    (8) for an elevator boring, $175 $215 for each boring.436.23EFFECTIVE DATE.This section is effective July 1, 2008.436.24    Sec. 6. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:436.25    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to 436.26sell or transfer real property, the seller must disclose in writing to the buyer information 436.27about the status and location of all known wells on the property, by delivering to the buyer 436.28either a statement by the seller that the seller does not know of any wells on the property, 436.29or a disclosure statement indicating the legal description and county, and a map drawn 436.30from available information showing the location of each well to the extent practicable. 436.31In the disclosure statement, the seller must indicate, for each well, whether the well is in 436.32use, not in use, or sealed.436.33    (b) At the time of closing of the sale, the disclosure statement information, name and 436.34mailing address of the buyer, and the quartile, section, township, and range in which each 437.1well is located must be provided on a well disclosure certificate signed by the seller or a 437.2person authorized to act on behalf of the seller.437.3    (c) A well disclosure certificate need not be provided if the seller does not know 437.4of any wells on the property and the deed or other instrument of conveyance contains 437.5the statement: "The Seller certifies that the Seller does not know of any wells on the 437.6described real property."437.7    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate 437.8required by this subdivision shall be signed by the buyer or a person authorized to act on 437.9behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure 437.10certificate is not required if the following statement appears on the deed followed by the 437.11signature of the grantee or, if there is more than one grantee, the signature of at least one 437.12of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the 437.13described real property." The statement and signature of the grantee may be on the front 437.14or back of the deed or on an attached sheet and an acknowledgment of the statement by 437.15the grantee is not required for the deed to be recordable.437.16    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:437.17    (1) that consists solely of a sale or transfer of severed mineral interests; or437.18    (2) that consists of an individual condominium unit as described in chapters 515 437.19and 515B.437.20    (f) For an area owned in common under chapter 515 or 515B the association or other 437.21responsible person must report to the commissioner by July 1, 1992, the location and 437.22status of all wells in the common area. The association or other responsible person must 437.23notify the commissioner within 30 days of any change in the reported status of wells.437.24    (g) For real property sold by the state under section 
         92.67, the lessee at the time of 437.25the sale is responsible for compliance with this subdivision.437.26    (h) If the seller fails to provide a required well disclosure certificate, the buyer, or 437.27a person authorized to act on behalf of the buyer, may sign a well disclosure certificate 437.28based on the information provided on the disclosure statement required by this section 437.29or based on other available information.437.30    (i) A county recorder or registrar of titles may not record a deed or other instrument 437.31of conveyance dated after October 31, 1990, for which a certificate of value is required 437.32under section 
         272.115, or any deed or other instrument of conveyance dated after October 437.3331, 1990, from a governmental body exempt from the payment of state deed tax, unless 437.34the deed or other instrument of conveyance contains the statement made in accordance 437.35with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all 437.36the information required by paragraph (b) or (d). The county recorder or registrar of titles 438.1must not accept a certificate unless it contains all the required information. The county 438.2recorder or registrar of titles shall note on each deed or other instrument of conveyance 438.3accompanied by a well disclosure certificate that the well disclosure certificate was 438.4received. The notation must include the statement "No wells on property" if the disclosure 438.5certificate states there are no wells on the property. The well disclosure certificate shall not 438.6be filed or recorded in the records maintained by the county recorder or registrar of titles. 438.7After noting "No wells on property" on the deed or other instrument of conveyance, the 438.8county recorder or registrar of titles shall destroy or return to the buyer the well disclosure 438.9certificate. The county recorder or registrar of titles shall collect from the buyer or the 438.10person seeking to record a deed or other instrument of conveyance, a fee of $40 $45438.11for receipt of a completed well disclosure certificate. By the tenth day of each month, 438.12the county recorder or registrar of titles shall transmit the well disclosure certificates 438.13to the commissioner of health. By the tenth day after the end of each calendar quarter, 438.14the county recorder or registrar of titles shall transmit to the commissioner of health 438.15$32.50 $37.50 of the fee for each well disclosure certificate received during the quarter. 438.16The commissioner shall maintain the well disclosure certificate for at least six years. The 438.17commissioner may store the certificate as an electronic image. A copy of that image 438.18shall be as valid as the original.438.19    (j) No new well disclosure certificate is required under this subdivision if the buyer 438.20or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed 438.21or other instrument of conveyance that the status and number of wells on the property 438.22have not changed since the last previously filed well disclosure certificate. The following 438.23statement, if followed by the signature of the person making the statement, is sufficient 438.24to comply with the certification requirement of this paragraph: "I am familiar with the 438.25property described in this instrument and I certify that the status and number of wells on 438.26the described real property have not changed since the last previously filed well disclosure 438.27certificate." The certification and signature may be on the front or back of the deed or on 438.28an attached sheet and an acknowledgment of the statement is not required for the deed or 438.29other instrument of conveyance to be recordable.438.30    (k) The commissioner in consultation with county recorders shall prescribe the form 438.31for a well disclosure certificate and provide well disclosure certificate forms to county 438.32recorders and registrars of titles and other interested persons.438.33    (l) Failure to comply with a requirement of this subdivision does not impair:438.34    (1) the validity of a deed or other instrument of conveyance as between the parties 438.35to the deed or instrument or as to any other person who otherwise would be bound by 438.36the deed or instrument; or439.1    (2) the record, as notice, of any deed or other instrument of conveyance accepted for 439.2filing or recording contrary to the provisions of this subdivision.439.3EFFECTIVE DATE.This section is effective July 1, 2008.439.4    Sec. 7. Minnesota Statutes 2006, section 144.123, is amended to read:439.5144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES; 439.6EXCEPTIONS.439.7    Subdivision 1. Who must pay. Except for the limitation contained in this section, 439.8the commissioner of health shall charge a handling fee for each specimen submitted to 439.9the Department of Health for analysis for diagnostic purposes by any hospital, private 439.10laboratory, private clinic, or physician. No fee shall be charged to any entity which 439.11receives direct or indirect financial assistance from state or federal funds administered by 439.12the Department of Health, including any public health department, nonprofit community 439.13clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar 439.14entity. No fee will be charged for any biological materials submitted to the Department 439.15of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological 439.16materials requested by the department to gather information for disease prevention or 439.17control purposes. The commissioner of health may establish by rule other exceptions to 439.18the handling fee as may be necessary to gather information for epidemiologic purposes439.19protect the public's health. All fees collected pursuant to this section shall be deposited in 439.20the state treasury and credited to the state government special revenue fund.439.21    Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate 439.22rules, in accordance with chapter 14, which shall specify the amount of the charge a439.23handling fee prescribed in subdivision 1. The fee shall approximate the costs to the 439.24department of handling specimens including reporting, postage, specimen kit preparation, 439.25and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen 439.26until the commissioner promulgates rules pursuant to this subdivision.439.27    Sec. 8. Minnesota Statutes 2006, section 144.125, is amended to read:439.28144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL 439.29DISORDERS.439.30    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative 439.31officer or other person in charge of each institution caring for infants 28 days or less 439.32of age, (2) the person required in pursuance of the provisions of section 
         144.215, to 439.33register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 440.1birth, to arrange to have administered to every infant or child in its care tests for heritable 440.2and congenital disorders according to subdivision 2 and rules prescribed by the state 440.3commissioner of health. Testing and the recording and reporting of test results shall be 440.4performed at the times and in the manner prescribed by the commissioner of health. The 440.5commissioner shall charge laboratory service fees a fee so that the total of fees collected 440.6will approximate the costs of conducting the tests and implementing and maintaining 440.7a system to follow-up infants with heritable or congenital disorders. The laboratory 440.8service fee is $61 $101 per specimen. Costs associated with capital expenditures and 440.9the development of new procedures may be prorated over a three-year period when 440.10calculating the amount of the fees. 440.11    Subd. 2. Determination of tests to be administered. The commissioner shall 440.12periodically revise the list of tests to be administered for determining the presence of a 440.13heritable or congenital disorder. Revisions to the list shall reflect advances in medical 440.14science, new and improved testing methods, or other factors that will improve the public 440.15health. In determining whether a test must be administered, the commissioner shall take 440.16into consideration the adequacy of laboratory analytical methods to detect the heritable 440.17or congenital disorder, the ability to treat or prevent medical conditions caused by the 440.18heritable or congenital disorder, and the severity of the medical conditions caused by the 440.19heritable or congenital disorder. The list of tests to be performed may be revised if the 440.20changes are recommended by the advisory committee established under section 
         144.1255, 440.21approved by the commissioner, and published in the State Register. The revision is 440.22exempt from the rulemaking requirements in chapter 14, and sections 
         14.385 and 
         14.386440.23do not apply. 440.24    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under 440.25subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to 440.26perform testing thereunder as well as the results of such testing may be retained by the 440.27Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that 440.28the following options are available to them with respect to the testing: (i) to decline to 440.29have the tests, or (ii) to elect to have the tests but to require that all blood samples and 440.30records of test results be destroyed within 24 months of the testing. If the parents of 440.31an infant object in writing to testing for heritable and congenital disorders or elect to 440.32require that blood samples and test results be destroyed, the objection or election shall 440.33be recorded on a form that is signed by a parent or legal guardian and made part of the 440.34infant's medical record. A written objection exempts an infant from the requirements of 440.35this section and section 
         144.128. 441.1    Sec. 9. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to read:441.2    Subdivision 1. Establishment.Within the limits of available appropriations, the 441.3commissioner of health shall establish and maintain an information system containing data 441.4on the cause, treatment, prevention, and cure of major birth defects. The commissioner 441.5shall consult with representatives and experts in epidemiology, medicine, insurance, 441.6health maintenance organizations, genetics, consumers, and voluntary organizations in 441.7developing the system and may phase in the implementation of the system. After the 441.8parents have provided informed consent under section 144.2216, subdivision 4, the 441.9commissioner shall offer the parents with their informed consent a visit by a trained health 441.10care worker to interview the parents about:441.11    (1) all previous home addresses, occupations, and places of work including from 441.12childhood;441.13    (2) the time and place of any military service; and441.14    (3) known occasions or sites of toxic exposures.441.15    Sec. 10. Minnesota Statutes 2006, section 144.672, subdivision 1, is amended to read:441.16    Subdivision 1. Rule authority. The commissioner of health shall collect cancer 441.17incidence information, analyze the information, and conduct special studies designed to 441.18determine the potential public health significance of an increase in cancer incidence.441.19    The commissioner shall adopt rules to administer the system, collect information, 441.20and distribute data. The rules must include, but not be limited to, the following:441.21    (1) the type of data to be reported, which must include current and previous 441.22occupational and residential data;441.23    (2) standards for reporting specific types of data;441.24    (3) payments allowed to hospitals, pathologists, and registry systems to defray their 441.25costs in providing information to the system;441.26    (4) criteria relating to contracts made with outside entities to conduct studies using 441.27data collected by the system. The criteria may include requirements for a written protocol 441.28outlining the purpose and public benefit of the study, the description, methods, and 441.29projected results of the study, peer review by other scientists, the methods and facilities 441.30to protect the privacy of the data, and the qualifications of the researcher proposing to 441.31undertake the study; and441.32    (5) specification of fees to be charged under section 
         13.03, subdivision 3, for all 441.33out-of-pocket expenses for data summaries or specific analyses of data requested by 441.34public and private agencies, organizations, and individuals, and which are not otherwise 442.1included in the commissioner's annual summary reports. Fees collected are appropriated 442.2to the commissioner to offset the cost of providing the data.442.3    Sec. 11. Minnesota Statutes 2006, section 144.9502, subdivision 3, is amended to read:442.4    Subd. 3. Reports of blood lead analysis required. (a) Every hospital, medical 442.5clinic, medical laboratory, other facility, or individual performing blood lead analysis 442.6shall report the results after the analysis of each specimen analyzed, for both capillary 442.7and venous specimens, and epidemiologic information required in this section to the 442.8commissioner of health, within the time frames set forth in clauses (1) and (2):442.9    (1) within two working days by telephone, fax, or electronic transmission, with 442.10written or electronic confirmation within one month, for a venous blood lead level equal to 442.11or greater than 15 ten micrograms of lead per deciliter of whole blood; or442.12    (2) within one month in writing or by electronic transmission, for any capillary 442.13result or for a venous blood lead level less than 15 ten micrograms of lead per deciliter of 442.14whole blood.442.15    (b) If a blood lead analysis is performed outside of Minnesota and the facility 442.16performing the analysis does not report the blood lead analysis results and epidemiological 442.17information required in this section to the commissioner, the provider who collected the 442.18blood specimen must satisfy the reporting requirements of this section. For purposes of 442.19this section, "provider" has the meaning given in section 
         62D.02, subdivision 9. 442.20    (c) The commissioner shall coordinate with hospitals, medical clinics, medical 442.21laboratories, and other facilities performing blood lead analysis to develop a universal 442.22reporting form and mechanism.442.23    Sec. 12. Minnesota Statutes 2006, section 144.9504, subdivision 2, is amended to read:442.24    Subd. 2. Lead risk assessment. (a) An assessing agency shall conduct a lead risk 442.25assessment of a residence according to the venous blood lead level and time frame set 442.26forth in clauses (1) to (4) for purposes of secondary prevention:442.27    (1) within 48 hours of a child or pregnant female in the residence being identified to 442.28the agency as having a venous blood lead level equal to or greater than 60 45 micrograms 442.29of lead per deciliter of whole blood;442.30    (2) within five working days of a child or pregnant female in the residence being 442.31identified to the agency as having a venous blood lead level equal to or greater than 45 15442.32micrograms of lead per deciliter of whole blood;443.1    (3) within ten working days of a child in the residence being identified to the agency 443.2as having a venous blood lead level equal to or greater than 15 ten micrograms of lead 443.3per deciliter of whole blood; or443.4    (4) within ten working days of a pregnant female in the residence being identified to 443.5the agency as having a venous blood lead level equal to or greater than ten micrograms of 443.6lead per deciliter of whole blood.443.7    (b) Within the limits of available local, state, and federal appropriations, an assessing 443.8agency may also conduct a lead risk assessment for children with any elevated blood 443.9lead level.443.10    (c) In a building with two or more dwelling units, an assessing agency shall assess 443.11the individual unit in which the conditions of this section are met and shall inspect all 443.12common areas accessible to a child. If a child visits one or more other sites such as another 443.13residence, or a residential or commercial child care facility, playground, or school, the 443.14assessing agency shall also inspect the other sites. The assessing agency shall have one 443.15additional day added to the time frame set forth in this subdivision to complete the lead 443.16risk assessment for each additional site.443.17    (d) Within the limits of appropriations, the assessing agency shall identify the 443.18known addresses for the previous 12 months of the child or pregnant female with venous 443.19blood lead levels of at least 15 ten micrograms per deciliter for the child or at least ten 443.20micrograms per deciliter for the pregnant female; notify the property owners, landlords, 443.21and tenants at those addresses that an elevated blood lead level was found in a person 443.22who resided at the property; and give them primary prevention information. Within the 443.23limits of appropriations, the assessing agency may perform a risk assessment and issue 443.24corrective orders in the properties, if it is likely that the previous address contributed to 443.25the child's or pregnant female's blood lead level. The assessing agency shall provide the 443.26notice required by this subdivision without identifying the child or pregnant female with 443.27the elevated blood lead level. The assessing agency is not required to obtain the consent of 443.28the child's parent or guardian or the consent of the pregnant female for purposes of this 443.29subdivision. This information shall be classified as private data on individuals as defined 443.30under section 
         13.02, subdivision 12.443.31    (e) The assessing agency shall conduct the lead risk assessment according to rules 443.32adopted by the commissioner under section 
         144.9508. An assessing agency shall have 443.33lead risk assessments performed by lead risk assessors licensed by the commissioner 443.34according to rules adopted under section 
         144.9508. If a property owner refuses to allow 443.35a lead risk assessment, the assessing agency shall begin legal proceedings to gain entry 443.36to the property and the time frame for conducting a lead risk assessment set forth in this 444.1subdivision no longer applies. A lead risk assessor or assessing agency may observe the 444.2performance of lead hazard reduction in progress and shall enforce the provisions of this 444.3section under section 
         144.9509. Deteriorated painted surfaces, bare soil, and dust must be 444.4tested with appropriate analytical equipment to determine the lead content, except that 444.5deteriorated painted surfaces or bare soil need not be tested if the property owner agrees to 444.6engage in lead hazard reduction on those surfaces. The lead content of drinking water 444.7must be measured if another probable source of lead exposure is not identified. Within a 444.8standard metropolitan statistical area, an assessing agency may order lead hazard reduction 444.9of bare soil without measuring the lead content of the bare soil if the property is in a 444.10census tract in which soil sampling has been performed according to rules established by 444.11the commissioner and at least 25 percent of the soil samples contain lead concentrations 444.12above the standard in section 
         144.9508.444.13    (f) Each assessing agency shall establish an administrative appeal procedure which 444.14allows a property owner to contest the nature and conditions of any lead order issued by 444.15the assessing agency. Assessing agencies must consider appeals that propose lower cost 444.16methods that make the residence lead safe. The commissioner shall use the authority and 444.17appeal procedure granted under sections 
         144.989 to 
         144.993.444.18    (g) Sections 
         144.9501 to 
         144.9509 neither authorize nor prohibit an assessing agency 444.19from charging a property owner for the cost of a lead risk assessment.444.20    Sec. 13. Minnesota Statutes 2006, section 144.9507, is amended by adding a 444.21subdivision to read:444.22    Subd. 6.Medical assistance.Medical assistance reimbursement for lead risk 444.23assessment services under section 256B.0625, subdivision 49, shall not be used to replace 444.24or decrease existing state or local funding for lead services and lead-related activities.444.25    Sec. 14. Minnesota Statutes 2006, section 144.9512, is amended to read:444.26144.9512 LEAD ABATEMENT PROGRAM.444.27    Subdivision 1. Definitions. (a) The definitions in section 
         144.9501 and in this 444.28subdivision apply to this section.444.29    (b) "Eligible organization" means a lead contractor, city, board of health, community 444.30health department, community action agency as defined in section 256E.30, or community 444.31development corporation.444.32    (c) "Commissioner" means the commissioner of health, or the commissioner of the 444.33Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.445.1    Subd. 2. Grants; administration. Within the limits of the available appropriation, 445.2the commissioner must develop a swab team services program which may shall make 445.3demonstration and training grants to eligible organizationsa nonprofit organization 445.4currently operating the CLEARCorps lead hazard reduction project to train workers to 445.5provide swab team services and swab team services for residential property. Grants may 445.6be awarded to nonprofit organizations to provide technical assistance and training to 445.7ensure quality and consistency within the statewide program. Grants must be awarded to 445.8help ensure full-time employment to workers providing swab team services and must be 445.9awarded for a two-year period.445.10    Grants awarded under this section must be made in consultation with the 445.11commissioner of the Housing Finance Agency and representatives of neighborhood 445.12groups from areas at high risk for toxic lead exposure, a labor organization, the lead 445.13coalition, community action agencies, and the legal aid society. The consulting team must 445.14review grant applications and recommend awards to eligible organizations that meet 445.15requirements for receiving a grant under this section.445.16    Subd. 3.Applicants.(a) Interested eligible organizations may apply to the 445.17commissioner for grants under this section. Two or more eligible organizations may 445.18jointly apply for a grant. Priority shall be given to community action agencies in greater 445.19Minnesota and to either community action agencies or neighborhood based nonprofit 445.20organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may 445.21be used for administrative purposes. The commissioner may deviate from this percentage 445.22if a grantee can justify the need for a larger administrative allowance. Of this amount, 445.23up to five percent may be used by the commissioner for state administrative purposes. 445.24Applications must provide information requested by the commissioner, including at least 445.25the information required to assess the factors listed in paragraph (d).445.26    (b) The commissioner must consult with boards of health to provide swab team 445.27services for purposes of secondary prevention. The priority for swab teams created 445.28by grants to eligible organizations under this section must be work assigned by the 445.29commissioner of health, or by a board of health if so designated by the commissioner of 445.30health, to provide secondary prevention swab team services to fulfill the requirements 445.31of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned 445.32work under this section by the commissioner, that are not engaged daily in fulfilling the 445.33requirements of section 144.9504, subdivision 6, must deliver swab team services in 445.34response to elevated blood lead levels as defined in section 144.9501, subdivision 9, 445.35where lead orders were not issued, and for purposes of primary prevention in census 446.1tracts known to be in areas at high risk for toxic lead exposure as described in section 446.2144.9503, subdivision 2.446.3    (c) Any additional money must be used for grants to establish swab teams for 446.4primary prevention under section 144.9503, in census tracts in areas at high risk for toxic 446.5lead exposure as determined under section 144.9503, subdivision 2.446.6    (d) In evaluating grant applications, the commissioner must consider the following 446.7criteria:446.8    (1) the use of lead contractors and lead workers for residential swab team services;446.9    (2) the participation of neighborhood groups and individuals, as swab team workers, 446.10in areas at high risk for toxic lead exposure;446.11    (3) plans for the provision of swab team services for primary and secondary 446.12prevention as required under subdivision 4;446.13    (4) plans for supervision, training, career development, and postprogram placement 446.14of swab team members;446.15    (5) plans for resident and property owner education on lead safety;446.16    (6) plans for distributing cleaning supplies to area residents and educating residents 446.17and property owners on cleaning techniques;446.18    (7) sources of other funding and cost estimates for training, lead inspections, swab 446.19team services, equipment, monitoring, testing, and administration;446.20    (8) measures of program effectiveness;446.21    (9) coordination of program activities with other federal, state, and local public 446.22health, job training, apprenticeship, and housing renovation programs including programs 446.23under sections 116L.86 to 116L.881; and446.24    (10) prior experience in providing swab team services.446.25    Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible 446.26organizations and lead supervisors or certified firms may participate in the swab team 446.27program. An eligible organization The nonprofit receiving a grant under this section 446.28must assure ensure that all participating lead supervisors or certified firms are licensed 446.29and that all swab team workers are certified by the Department of Health under section 446.30144.9505
         . Eligible organizations and lead supervisors or certified firms may distinguish 446.31between interior and exterior services in assigning duties and The nonprofit organization446.32may participate in the program by: 446.33    (1) providing on-the-job training for swab team workers;446.34    (2) providing swab team services to meet the requirements of sections 
         144.9503, 446.35subdivision 4
         , and 
         144.9504, subdivision 6; 447.1    (3) providing a removal and replacement component using skilled craft workers 447.2under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501, 447.3subdivision 17;447.4    (4) providing lead testing according to subdivision 8;447.5    (5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as 447.6described in section 
         144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or447.7    (6) (5) having a swab team worker instruct residents and property owners on 447.8appropriate lead control techniques, including the lead-safe directives developed by the 447.9commissioner of health.;447.10    (6) conducting blood lead testing events including screening children and pregnant 447.11women according to Department of Health screening guidelines;447.12    (7) performing case management services according to Department of Health case 447.13management guidelines; or447.14    (8) conducting mandated risk assessments under Minnesota Statutes, section 447.15144.9504, subdivision 2.447.16    (b) Participating lead supervisors or certified firms must:447.17    (1) demonstrate proof of workers' compensation and general liability insurance 447.18coverage;447.19    (2) be knowledgeable about lead abatement requirements established by the 447.20Department of Housing and Urban Development and the Occupational Safety and Health 447.21Administration and lead hazard reduction requirements and lead-safe directives of the 447.22commissioner of health;447.23    (3) demonstrate experience with on-the-job training programs;447.24    (4) demonstrate an ability to recruit employees from areas at high risk for toxic 447.25lead exposure; and447.26    (5) demonstrate experience in working with low-income clients.447.27    Subd. 5. Swab team workers. Each worker engaged in swab team services 447.28established under this section must have blood lead concentrations below 15 micrograms 447.29of lead per deciliter of whole blood as determined by a baseline blood lead screening. 447.30Any The nonprofit organization receiving a grant under this section is responsible for lead 447.31screening and must assure ensure that all swab team workers meet the standards established 447.32in this subdivision. Grantees The nonprofit organization must use appropriate workplace 447.33procedures including following the lead-safe directives developed by the commissioner of 447.34health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization447.35and participating contractors must report all employee blood lead levels that exceed 15 447.36micrograms of lead per deciliter of whole blood to the commissioner of health.448.1    Subd. 6.On-the-job training component.(a) Programs established under this 448.2section must provide on-the-job training for swab team workers.448.3    (b) Swab team workers must receive monetary compensation equal to the prevailing 448.4wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed 448.5contractor's principal business. 448.6    Subd. 7.Removal and replacement component.(a) Within the limits of the 448.7available appropriation and if a need is identified by a lead inspector, the commissioner 448.8may establish a component for removal and replacement of deteriorated paint in residential 448.9properties according to the following criteria:448.10    (1) components within a residence must have both deteriorated lead-based paint and 448.11substrate damage beyond repair or rotting wooden framework to be eligible for removal 448.12and replacement;448.13    (2) all removal and replacement must be done using least-cost methods and 448.14following lead-safe directives;448.15    (3) whenever windows and doors or other components covered with deteriorated 448.16lead-based paint have sound substrate or are not rotting, those components should be 448.17repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or 448.18covered with protective guards instead of being replaced, provided that such an activity is 448.19the least-cost method of providing the swab team service;448.20    (4) removal and replacement or repair must be done by lead contractors using skilled 448.21craft workers or trained swab team members; and448.22    (5) all craft work that requires a state license must be supervised by a person with 448.23a state license in the craft work being supervised. The grant recipient may contract for 448.24this supervision.448.25    (b) The program design must:448.26    (1) identify the need for on-the-job training of swab team workers to be removal and 448.27replacement workers; and448.28    (2) describe plans to involve appropriate groups in designing methods to meet the 448.29need for training swab team workers.448.30    Subd. 8.Testing and evaluation.(a) Testing of the environment is not necessary 448.31by swab teams whose work is assigned by the commissioner of health or a designated 448.32board of health under section 144.9504. The commissioner of health or designated board 448.33of health must share the analytical testing data collected on each residence for purposes 448.34of secondary prevention under section 144.9504 with the swab team workers in order to 448.35provide constructive feedback on their work and to the commissioner for the purposes 448.36set forth in paragraph (c).449.1    (b) For purposes of primary prevention evaluation, the following samples must be 449.2collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a 449.3notation of the extent and location of bare soil and of deteriorated lead-based paint. The 449.4analytical testing data collected on each residence for purposes of primary prevention 449.5under section 144.9503 must be shared with the swab team workers in order to provide 449.6constructive feedback on their work and to the commissioner for the purposes set forth in 449.7paragraph (c).449.8    (c) The commissioner of health must establish a program to collect appropriate data 449.9as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of 449.10swab team services for primary and secondary prevention. Within the limits of available 449.11appropriations, the commissioner of health must conduct on up to 1,000 residences which 449.12have received primary or secondary prevention swab team services, a postremediation 449.13evaluation, on at least a quarterly basis for a period of at least two years for each residence. 449.14The evaluation must note the condition of the paint within the residence, the extent of bare 449.15soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample. 449.16The data collected must be evaluated to determine the efficacy of providing swab team 449.17services as a method of reducing lead exposure in young children. In evaluating this data, 449.18the commissioner of health must consider city size, community location, historic traffic 449.19flow, soil lead level of the property by area or census tract, distance to industrial point 449.20sources that emit lead, season of the year, age of the housing, age and number of children 449.21living at the residence, the presence of pets that move in and out of the residence, and 449.22other relevant factors as the commissioner of health may determine.449.23    Subd. 9. Program benefits. As a condition of providing swab team services under 449.24this section, an the nonprofit organization may require a property owner to not increase 449.25rents on a property solely as a result of a substantial improvement made with public 449.26funds under the programs in this section.449.27    Subd. 10. Requirements of organizations receiving grants the nonprofit 449.28organization.An eligible The nonprofit organization that is awarded a training and 449.29demonstration grant under this section must prepare and submit a quarterly progress report 449.30to the commissioner beginning three months after receipt of the grant.449.31    Sec. 15. [144.966] EARLY HEARING DETECTION AND INTERVENTION 449.32ACT.449.33    Subdivision 1.Definitions.(a) "Child" means a person 18 years of age or younger.450.1    (b) "False positive rate" means the proportion of infants identified as having a 450.2significant hearing loss by the screening process who are ultimately found to not have a 450.3significant hearing loss.450.4    (c) "False negative rate" means the proportion of infants not identified as having 450.5a significant hearing loss by the screening process who are ultimately found to have a 450.6significant hearing loss.450.7    (d) "Hearing screening test" means automated auditory brain stem response, 450.8otoacoustic emissions, or another appropriate screening test approved by the Department 450.9of Health.450.10    (e) "Hospital" means a birthing health care facility or birthing center licensed in 450.11this state that provides obstetrical services.450.12    (f) "Infant" means a child who is not a newborn and has not attained the age of 450.13one year.450.14    (g) "Newborn" means an infant 28 days old or younger.450.15    (h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or 450.16custodian of a newborn or infant.450.17    Subd. 2.Newborn Hearing Screening Advisory Committee.(a) The 450.18commissioner of health shall appoint a Newborn Hearing Screening Advisory Committee 450.19to advise and assist the Department of Health and the Department of Education in:450.20    (1) developing protocols and timelines for screening, rescreening, and diagnostic 450.21audiological assessment and early medical, audiological, and educational intervention 450.22services for children who are deaf or hard-of-hearing;450.23    (2) designing protocols for tracking children from birth through age three that may 450.24have passed newborn screening but are at risk for delayed or late onset of permanent 450.25hearing loss;450.26    (3) designing a technical assistance program to support facilities implementing the 450.27screening program and facilities conducting rescreening and diagnostic audiological 450.28assessment;450.29    (4) designing implementation and evaluation of a system of follow-up and tracking; 450.30and450.31    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure 450.32culturally appropriate services for children with a confirmed hearing loss and their families.450.33    (b) Membership of the committee shall include at least one member from each of the 450.34following groups with no less than two of the members being deaf or hard-of-hearing:450.35    (1) a representative from a consumer organization representing culturally deaf 450.36persons;451.1    (2) a parent with a child with hearing loss representing a parent organization;451.2    (3) a consumer from an organization representing oral communication options;451.3    (4) a consumer from an organization representing cued speech communication 451.4options;451.5    (5) an audiologist who has experience in evaluation and intervention of infants 451.6and young children;451.7    (6) a speech-language pathologist who has experience in evaluation and intervention 451.8of infants and young children;451.9    (7) two primary care providers who have experience in the care of infants and young 451.10children, one of which shall be a pediatrician;451.11    (8) a representative from the early hearing detection intervention teams;451.12    (9) a representative from the Department of Education resource center for the deaf 451.13and hard-of-hearing or their designee;451.14    (10) a representative of the Minnesota Commission Serving Deaf and Hard of 451.15Hearing People;451.16    (11) a representative from the Department of Human Services Deaf and Hard of 451.17Hearing Services Division;451.18    (12) one or more of the Part C coordinators from the Department of Education, the 451.19Department of Health, or the Department of Human Services or their designee;451.20    (13) the Department of Health early hearing detection and intervention coordinators;451.21    (14) two birth hospital representatives from one rural and one urban hospital;451.22    (15) a pediatric geneticist;451.23    (16) an otolaryngologist;451.24    (17) a representative from the Newborn Screening Advisory Committee under 451.25this subdivision; and451.26    (18) a representative of the Department of Education regional low-incidence 451.27facilitators.451.28    The Department of Health member shall chair the first meeting of the committee. 451.29At the first meeting, the committee shall elect a chairperson from its membership. The 451.30committee shall meet at the call of the chairperson, at least four times a year. The 451.31committee shall adopt written bylaws to govern its activities. The Department of Health 451.32shall provide technical and administrative support services as required by the committee. 451.33These services shall include technical support from individuals qualified to administer 451.34infant hearing screening, rescreening, and diagnostic audiological assessments.452.1    Members of the committee shall receive no compensation for their service, but 452.2shall be reimbursed for expenses incurred as a result of their duties as members of the 452.3committee.452.4    Subd. 3.Early hearing detection and intervention programs.All hospitals 452.5shall establish a Early Hearing Detection and Intervention (EHDI) program. Each EHDI 452.6program shall:452.7    (1) in advance of any hearing screening testing, provide to the newborn's or infant's 452.8parents or parent information concerning the nature of the screening procedure, applicable 452.9costs of the screening procedure, the potential risks and effects of hearing loss, and the 452.10benefits of early detection and intervention;452.11    (2) comply with parental consent under section 144.125, subdivision 3;452.12    (3) develop policies and procedures for screening and rescreening based on 452.13Department of Health recommendations;452.14    (4) provide appropriate training and monitoring of individuals responsible for 452.15performing hearing screening tests as recommended by the Department of Health;452.16    (5) test the newborn's hearing prior to discharge, or, if the newborn is expected to 452.17remain in the hospital for a prolonged period, testing shall be performed prior to three 452.18months of age, or when medically feasible;452.19    (6) develop and implement procedures for documenting the results of all hearing 452.20screening tests;452.21    (7) inform the baby's parents or parent, primary care physician, and the Department 452.22of Health according to recommendations of the Department of Health of the results of the 452.23hearing screening test or rescreening if conducted, or if the newborn or infant was not 452.24successfully tested. The hospital that discharges the baby to home is responsible for 452.25the screening; and452.26    (8) collect performance data specified by the Department of Health. 452.27    Subd. 4.Notification and information.(a) Notification to the parents, primary 452.28care provider, and Department of Health shall occur prior to discharge or no later than ten 452.29days following the date of testing. Notification shall include information recommended by 452.30the Department of Health.452.31    (b) A physician, nurse, midwife, or other health professional attending a birth outside 452.32a hospital or institution shall provide information, orally and in writing, as established by 452.33the Department of Health, to parents regarding places where the parents may have their 452.34infants' hearing screened and the importance of such screening.453.1    (c) The professional conducting the diagnostic procedure to confirm the hearing loss 453.2must report the results to the parents, primary care provider, and Department of Health 453.3according to the Department of Health recommendations.453.4    Subd. 5.Oversight responsibility.The Department of Health shall exercise 453.5oversight responsibility for EHDI programs, including establishing a performance data set 453.6and reviewing performance data collected by each hospital.453.7    Subd. 6.Civil and criminal immunity and penalties.(a) No physician or hospital 453.8shall be civilly or criminally liable for failure to conduct hearing screening testing.453.9    (b) No physician, midwife, nurse, other health professional, or hospital acting in 453.10compliance with this section shall be civilly or criminally liable for any acts conforming 453.11with this section, including furnishing information required according to this section.453.12    Subd. 7. Fees.The commissioner shall charge a fee according to section 16A.1285 453.13so that the total of fees collected will approximate the costs of implementing and 453.14maintaining a system to follow up infants, provide technical assistance, a tracking system, 453.15data management, and evaluation.453.16EFFECTIVE DATE.This section is effective the day following final enactment.453.17    Sec. 16. [144.967] ARSENIC HEALTH RISK STANDARD.453.18    Subdivision 1.Arsenic health risk standard established.The commissioner of 453.19health in cooperation with the commissioners of agriculture and the Pollution Control 453.20Agency responsible for monitoring land and water cleanup and soil contamination 453.21information shall determine a health risk standard for human exposure to arsenic. The 453.22commissioner of health shall ensure that the established arsenic health risk standard is 453.23included in all information provided to the public.453.24    Subd. 2.Information.The commissioner of health, in consultation with the 453.25commissioners of agriculture and the Pollution Control Agency with jurisdiction over 453.26soil and water contamination, shall establish a central information source available to 453.27the public to provide accurate information on arsenic soil and water contamination in 453.28residential areas.453.29    Subd. 3.Testing for arsenic.(a) The commissioner of health shall ensure access 453.30to medical testing for arsenical pesticide exposure to persons living within one mile of 453.31the CMC Heartland Lite Yard Superfund site who are not covered by health insurance or 453.32medical assistance.453.33    (b) Through an agreement with the United States Environmental Protection Agency, 453.34the commissioner shall ensure soil testing is available to households within one mile of the 453.35CMC Heartland Lite Yard Superfund site at no cost to the residents.454.1    Subd. 4.Evaluation.The commissioner of health shall evaluate the cumulative 454.2health impact burdens of environmental toxins in the residential communities impacted by 454.3arsenic-contaminated soil from the CMC Heartland Lite Yard Superfund site. The first 454.4priority shall be to evaluate health burdens to those communities experiencing health 454.5disparities as documented by the Minority and Multicultural Health Division of the 454.6Minnesota Department of Health.454.7    Sec. 17. [144.995] DEFINITIONS.454.8    (a) For purposes of sections 144.995 to 144.998, the terms in this section have 454.9the meanings given.454.10    (b) "Advisory panel" means the Environmental Health Tracking and Biomonitoring 454.11Advisory Panel established under section 144.998.454.12    (c) "Biomonitoring" means the process by which chemicals and their metabolites are 454.13identified and measured within a biospecimen.454.14    (d) "Biospecimen" means a sample of human fluid, serum, or tissue that is reasonably 454.15available as a medium to measure the presence and concentration of chemicals or their 454.16metabolites in a human body.454.17    (e) "Commissioner" means the commissioner of the Department of Health.454.18    (f) "Community" means geographically or nongeographically-based populations 454.19that may participate in the biomonitoring program. A "nongeographical community" 454.20includes, but is not limited to, populations that may share a common chemical exposure 454.21through similar occupations, populations experiencing a common health outcome that 454.22may be linked to chemical exposures, or populations that may experience similar chemical 454.23exposures because of comparable consumption, lifestyle, product use, or subpopulations 454.24that share ethnicity, age, or gender.454.25    (g) "Department" means the Department of Health.454.26    (h) "Designated chemicals" means those chemicals that are known to, or strongly 454.27suspected of, adversely impacting human health or development, based upon scientific, 454.28peer-reviewed animal, human, or in vitro studies, and baseline human exposure data, 454.29and consists of chemical families or metabolites that are included in the federal Centers 454.30for Disease Control and Prevention studies that are known collectively as the National 454.31Reports on Human Exposure to Environmental Chemicals program and any substances 454.32specified under section 144.998, subdivision 3, clause (6).454.33    (i) "Environmental hazard" means a chemical, metal, or other substance for which 454.34scientific, peer-reviewed studies of humans, animals, or cells have demonstrated that the 454.35chemical is known or reasonably anticipated to adversely impact human health.455.1    (j) "Environmental health tracking" means collection, integration, analysis, and 455.2dissemination of data on human exposures to  chemicals in the environment and on 455.3diseases potentially caused or aggravated by those chemicals.455.4    Sec. 18. [144.996] ENVIRONMENTAL HEALTH TRACKING; 455.5BIOMONITORING.455.6    Subdivision 1.Environmental health tracking.In cooperation with the 455.7commissioner of the Pollution Control Agency, the commissioner shall establish an 455.8environmental health tracking program to:455.9    (1) coordinate data collection activities with the Pollution Control Agency, 455.10Department of Agriculture, University of Minnesota, and any other relevant state agency 455.11and work to promote the sharing of and access to health and environmental databases 455.12in order to develop an environmental health tracking system for Minnesota, consistent 455.13with applicable data practices laws;455.14    (2) facilitate the dissemination of aggregate public health tracking data to the public 455.15and researchers in accessible format and provide technical assistance on interpreting 455.16the data;455.17    (3) develop written data sharing agreements with the Minnesota Pollution Control 455.18Agency, Department of Agriculture, and other relevant state agencies and organizations, 455.19and develop additional procedures as needed to protect individual privacy;455.20    (4) develop a strategic plan that includes a mission statement, the identification 455.21of core priorities for research and epidemiologic surveillance, and the identification of 455.22internal and external stakeholders, and a work plan describing future program development 455.23and addressing issues having to do with compatibility with the Centers for Disease Control 455.24and Prevention's National Environmental Public Health Tracking Program;455.25    (5) organize, analyze, and interpret available data, in order to:455.26    (i) characterize statewide and localized trends and geographic patterns of 455.27population-based measures of chronic diseases, including, but not limited to, cancer, 455.28respiratory diseases, reproductive problems, birth defects, neurologic diseases, and 455.29developmental disorders;455.30    (ii) recommend to the commissioner methods to improve data collection on 455.31statewide population rates of chronic diseases and the occurrence of environmental 455.32hazards and exposures;455.33    (iii) characterize statewide and localized trends and geographic patterns in the 455.34occurrence of environmental hazards and exposures;456.1    (iv) assess the feasibility of integrating disease rate data and indicators of exposure 456.2such as biomonitoring data, and other health and environmental data;456.3    (v) incorporate newly collected and existing health tracking and biomonitoring 456.4data into efforts to identify communities with elevated rates of chronic disease, higher 456.5likelihood of exposure to environmental pollutants, or both;456.6    (vi) analyze occurrence of environmental hazards, exposures, and diseases with 456.7relation to socioeconomic status, race, and ethnicity;456.8    (vii) develop and implement targeted plans to conduct more intensive health tracking 456.9and biomonitoring among communities;456.10    (viii) work with the Pollution Control Agency, the Department of Agriculture, and 456.11other relevant state agency personnel and organizations to develop, implement, and 456.12evaluate preventive measures to reduce elevated rates of diseases and exposures identified 456.13through activities performed under sections 144.995 to 144.998; and456.14    (ix) provide baseline data and present descriptive information relevant to policy 456.15formation that are consistent with existing goals of the department; and456.16    (6) submit a biennial report to the legislature by January 15, beginning January 456.1715, 2009, on the status of environmental health tracking activities and related research 456.18programs, and making recommendations regarding the continuation and improvement of 456.19the programs.456.20    Subd. 2.Biomonitoring.The commissioner shall:456.21    (1) conduct biomonitoring of communities on a voluntary  basis by collecting and 456.22analyzing biospecimens, as appropriate, to assess environmental exposures to designated 456.23chemicals;456.24    (2) conduct biomonitoring of pregnant women and minors on a voluntary basis, 456.25when scientifically appropriate; 456.26    (3) communicate findings to the public, and plan ensuing stages of biomonitoring 456.27and disease tracking work to further develop and refine the integrated analysis;456.28    (4) share analytical results with the advisory panel and work with the panel 456.29to interpret results, communicate findings to the public, and plan ensuing stages of 456.30biomonitoring work; and456.31    (5) submit a biennial report to the legislature by January 15, beginning January 456.3215, 2009, on the status of the biomonitoring program and any recommendations for 456.33improvement.456.34    Subd. 3.Health data.Data collected under the biomonitoring program are health 456.35data under section 13.3805.457.1    Sec. 19. [144.997] BIOMONITORING PILOT PROGRAM.457.2    Subdivision 1.Pilot program.With advice from the advisory panel and after the 457.3program guidelines in subdivision 4 are developed, the commissioner shall develop a 457.4biomonitoring pilot program. The program shall collect one biospecimen from each of 457.5the voluntary participants. The biospecimen selected must be the biospecimen that most 457.6accurately represents body concentration of the chemical of interest. Each biospecimen 457.7from the voluntary participants must be analyzed for one type or class of related chemicals 457.8or metals, based on recommendations from the advisory panel. The panel shall determine 457.9the chemical or class of chemicals that community members were most likely exposed to. 457.10The program shall collect and assess biospecimens in accordance with the following: 457.11    (1) 30 voluntary participants from each of three communities that the advisory panel 457.12identifies as likely to have been exposed to a designated chemical; 457.13    (2) 100 voluntary participants from each of two communities: (i) that the advisory 457.14panel identifies as likely to have been exposed to arsenic and (ii) that the advisory panel 457.15identifies as likely to have been exposed to mercury; and 457.16    (3) 100 voluntary participants from each of two communities that the advisory panel 457.17identifies as likely to have been exposed to perfluorinated chemicals.457.18    Subd. 2.Base program.Following the conclusion of the pilot program and within 457.19the appropriations available, the commissioner shall:457.20    (1) work with the advisory panel to assess the usefulness of continuing biomonitoring 457.21among members of communities assessed during the pilot program and to identify other 457.22communities and other designated chemicals to be assessed via biomonitoring;457.23    (2) work with the advisory panel to assess the pilot program, including but not 457.24limited to, the validity and accuracy of the analytical measurements and adequacy of the 457.25guidelines and protocols;457.26    (3) communicate the results of the pilot program to the public; and457.27    (4) after consideration of the findings and recommendations in clauses (1) and (2), 457.28and within the appropriations available, develop and implement a base program.457.29    Subd. 3.Participation.(a) Participation in the biomonitoring program by providing 457.30biospecimens is voluntary and requires written, informed consent. Minors may participate 457.31in the program if a written consent is signed by the minor's parent or legal guardian. 457.32The written consent must include the information required to be provided under this 457.33subdivision to all voluntary participants.457.34    (b) All participants shall be evaluated for the presence of the designated chemical 457.35of interest as a component of the biomonitoring process. Participants shall be provided 457.36with information and fact sheets about the program's activities and its findings. 458.1Individual participants shall, if requested, receive their complete results. Any results 458.2provided to participants shall be subject to the Department of Health Institutional 458.3Review Board protocols and guidelines. When either physiological or chemical data 458.4obtained from a participant indicate a significant known health risk, program staff 458.5experienced in communicating biomonitoring results shall consult with the individual 458.6and recommend follow-up steps, as appropriate. Program administrators shall receive 458.7training in administering the program in an ethical, culturally sensitive, participatory, 458.8and community-based manner.458.9    Subd. 4.Program guidelines.(a) The commissioner, in consultation with the 458.10advisory panel, shall develop:458.11    (1) protocols or program guidelines that address the science and practice of 458.12biomonitoring to be utilized and procedures for changing those protocols to incorporate 458.13new and more accurate or efficient technologies as they become available. The 458.14commissioner and the advisory panel shall be guided by protocols and guidelines 458.15developed by the Centers for Disease Control and Prevention and the National 458.16Biomonitoring Program;458.17    (2) guidelines for ensuring the privacy of information; informed consent; follow-up 458.18counseling and support; and communicating findings to participants, communities, and 458.19the general public. The informed consent used for the program must meet the informed 458.20consent protocols developed by the National Institutes of Health;458.21    (3) educational and outreach materials that are culturally appropriate for 458.22dissemination to program participants and communities. Priority shall be given to the 458.23development of materials specifically designed to ensure that parents are informed about 458.24all of the benefits of breastfeeding so that the program does not result in an unjustified fear 458.25of toxins in breast milk, which might inadvertently lead parents to avoid breastfeeding. 458.26The materials shall communicate relevant scientific findings; data on the accumulation 458.27of pollutants to community health; and the required responses by local, state, and other 458.28governmental entities in regulating toxicant exposures;458.29    (4) a training program that is culturally sensitive specifically for health care 458.30providers, health educators, and other program administrators; 458.31    (5) a designation process for state and private laboratories that are qualified to 458.32analyze biospecimens and report the findings; and 458.33    (6) a method for informing affected communities and local governments representing 458.34those communities concerning biomonitoring activities and for receiving comments from 458.35citizens concerning those activities.459.1    (b) The commissioner may enter into contractual agreements with health clinics, 459.2community-based organizations, or experts in a particular field to perform any of the 459.3activities described under this section.459.4    Sec. 20. [144.998] ENVIRONMENTAL HEALTH TRACKING AND 459.5BIOMONITORING ADVISORY PANEL.459.6    Subdivision 1.Creation.The commissioner shall establish the Environmental 459.7Health Tracking and Biomonitoring Advisory Panel. The commissioner shall appoint, 459.8from the panel's membership, a chair. The panel shall meet as often as it deems necessary 459.9but, at a minimum, on a quarterly basis. Members of the panel shall serve without 459.10compensation but shall be reimbursed for travel and other necessary expenses incurred 459.11through performance of their duties. Members appointed under this subdivision are 459.12appointed for a three-year term and may be reappointed.459.13    Subd. 2.Members.The commissioner shall appoint eight members, none of whom 459.14may be lobbyists registered under chapter 10A, who have backgrounds or training in 459.15designing, implementing, and interpreting health tracking and biomonitoring studies or 459.16in related fields of science, including epidemiology, biostatistics, environmental health, 459.17laboratory sciences, occupational health, industrial hygiene, toxicology, and public health, 459.18including:459.19    (1) two scientists who represent nongovernmental organizations with a focus on 459.20environmental health, environmental justice, children's health, or on specific chronic 459.21diseases; and459.22    (2) one scientist who is a representative of the University of Minnesota.459.23    In addition, the commissioner shall appoint one member representing each of the 459.24following departments or divisions: the department's health promotion and chronic disease 459.25division, the Pollution Control Agency, and the Department of Agriculture.459.26    Subd. 3.Duties.The advisory panel shall make recommendations to the 459.27commissioner and the legislature on:459.28    (1) priorities for health tracking;459.29    (2) priorities for biomonitoring that are based on sound science and practice, and 459.30that will advance the state of public health in Minnesota;459.31    (3) specific chronic diseases to study under the environmental health tracking system;459.32    (4) specific environmental pollutant exposures to study under the environmental 459.33health tracking system, with the agreement of at least seven of the advisory panel members;459.34    (5) specific communities and geographic areas on which to focus environmental 459.35health tracking and biomonitoring efforts;460.1    (6) specific chemicals and metals to study under the biomonitoring program that meet 460.2the following criteria, with the agreement of at least seven of the advisory panel members:460.3    (i) the degree of potential exposure to the public or specific subgroups, including, 460.4but not limited to, occupational;460.5    (ii) the likelihood of a chemical being a carcinogen or toxicant based on 460.6peer-reviewed health data, the chemical structure, or the toxicology of chemically related 460.7compounds;460.8    (iii) the limits of laboratory detection for the chemical, including the ability to detect 460.9the chemical at low enough levels that could be expected in the general population;460.10    (iv) exposure or potential exposure to the public or specific subgroups;460.11    (v) the known or suspected health effects resulting from the same level of exposure 460.12based on peer-reviewed scientific studies;460.13    (vi) the need to assess the efficacy of public health actions to reduce exposure to a 460.14chemical;460.15    (vii) the availability of a biomonitoring analytical method with adequate accuracy, 460.16precision, sensitivity, specificity, and speed;460.17    (viii) the availability of adequate biospecimen samples; and460.18    (ix) other criteria that the panel may agree to; and460.19    (7) other aspects of the design, implementation, and evaluation of the environmental 460.20health tracking and biomonitoring system, including, but not limited to:460.21    (i) identifying possible community partners and sources of additional public or 460.22private funding;460.23    (ii) developing outreach and educational methods and materials; and460.24    (iii) disseminating environmental health tracking and biomonitoring findings to 460.25the public.460.26    Subd. 4.Liability.No member of the panel shall be held civilly or criminally liable 460.27for an act or omission by that person if the act or omission was in good faith and within 460.28the scope of the member's responsibilities under sections 144.995 to 144.998.460.29    Sec. 21. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:460.30    Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life 460.31support ambulance shall be staffed by at least two ambulance service personnel, at least 460.32one of which must be an EMT, who provide a level of care so as to ensure that:460.33    (1) life-threatening situations and potentially serious injuries are recognized;460.34    (2) patients are protected from additional hazards;461.1    (3) basic treatment to reduce the seriousness of emergency situations is administered; 461.2and461.3    (4) patients are transported to an appropriate medical facility for treatment.461.4    (b) A basic life support service shall provide basic airway management.461.5    (c) By January 1, 2001, a basic life support service shall provide automatic 461.6defibrillation, as provided in section 
         144E.103, subdivision 1, paragraph (b). 461.7    (d) A basic life support service licensee's medical director may authorize the 461.8ambulance service personnel to carry and to use medical antishock trousers and to perform 461.9intravenous infusion if the ambulance service personnel have been properly trained.461.10    (e) Upon application from an ambulance service that includes evidence 461.11demonstrating hardship, the board may grant a temporary variance from the staff 461.12requirements in paragraph (a) and may authorize a basic life support ambulance to be 461.13staffed by one EMT and one first responder. The variance shall apply to basic life support 461.14ambulances operated by the ambulance service for up to one year from the date of the 461.15variance's issuance until the ambulance service renews its license. When a variance 461.16expires, an ambulance service may apply for a new variance under this paragraph. For 461.17purposes of this paragraph, "ambulance service" means either an ambulance service whose 461.18primary service area is located outside the metropolitan counties listed in section 
         473.121, 461.19subdivision 4
         , and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 461.20Cloud; or an ambulance service based in a community with a population of less than 1,000. 461.21    Sec. 22. Minnesota Statutes 2006, section 144E.127, is amended to read:461.22144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.461.23    Subdivision 1.Interhospital transfers. When transporting a patient from one 461.24licensed hospital to another, a licensee may substitute for one of the required ambulance 461.25service personnel, a physician, a registered nurse, or physician's assistant who has been 461.26trained to use the equipment in the ambulance and is knowledgeable of the licensee's 461.27ambulance service protocols.461.28    Subd. 2.Interfacility transfers.In an interfacility transport, a licensee whose 461.29primary service area is located outside the metropolitan counties listed in section 473.121, 461.30subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 461.31Cloud; or an ambulance service based in a community with a population of less than 1,000, 461.32may substitute one EMT with a registered first responder if an EMT or EMT-paramedic, 461.33physician, registered nurse, or physician's assistant is in the patient compartment. If using 461.34a physician, registered nurse, or physician's assistant as the sole provider in the patient 462.1compartment, the individual must be trained to use the equipment in the ambulance and be 462.2knowledgeable of the ambulance service protocols.462.3    Sec. 23. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:462.4    Subdivision 1. Repayment for volunteer training.Any political subdivision, or 462.5nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall 462.6be reimbursed by the board for the necessary expense of the initial training of a volunteer 462.7ambulance attendant upon successful completion by the attendant of a basic emergency 462.8care course, or a continuing education course for basic emergency care, or both, which has 462.9been approved by the board, pursuant to section 
         144E.285. Reimbursement may include 462.10tuition, transportation, food, lodging, hourly payment for the time spent in the training 462.11course, and other necessary expenditures, except that in no instance shall a volunteer 462.12ambulance attendant be reimbursed more than $450$600 for successful completion of a 462.13basic course, and $225$275 for successful completion of a continuing education course. 462.14    Sec. 24. [145.958] BISPHENOL-A IN PRODUCTS FOR CHILDREN.462.15    Subdivision. 1.Bisphenol-A and phthalates committee.The commissioner of 462.16health shall create a committee under the direction of the environmental health division 462.17of the Department of Health to study the scientific literature and make recommendations 462.18to the legislature on the health impact of bisphenol-A and phthalates on children in 462.19products intended for use by young children, including, but not limited to, toys, pacifiers, 462.20baby bottles, and teethers, and report back by January 15, 2008. The committee shall 462.21also identify least harmful alternatives. Of the seven committee members at least one 462.22shall be a representative of the Department of Health, one shall be a representative of 462.23environmental health sciences research, one shall be a representative of the Minnesota 462.24Nurses Association, one shall be a representative of environmental health consumer 462.25advocates, one shall be a member of a children's product manufacturer's association, 462.26and one shall be a representative of the University of Minnesota, chemical engineering 462.27and material science department.462.28    Subd. 2.Definitions.For the purposes of this section, the following terms have 462.29the meanings given them:462.30    (a) "Toy" means all products designed or intended by the manufacturer to be used by 462.31children when they play.462.32    (b) "Child care article" means all products designed or intended by the manufacturer 462.33to facilitate sleep, relaxation, or the feeding of children or to help children with sucking or 462.34teething.463.1    Sec. 25. Minnesota Statutes 2006, section 145A.17, is amended to read:463.2145A.17 FAMILY HOME VISITING PROGRAMS.463.3    Subdivision 1. Establishment; goals. The commissioner shall establish a program 463.4to fund family home visiting programs designed to foster a healthy beginning for children 463.5in families at or below 200 percent of the federal poverty guidelines beginnings, improve 463.6pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce 463.7juvenile delinquency, promote positive parenting and resiliency in children, and promote 463.8family health and economic self-sufficiency for children and families. The commissioner 463.9shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of 463.10professionals and paraprofessionals from the fields of public health nursing, social work, 463.11and early childhood education. A program funded under this section must serve families 463.12at or below 200 percent of the federal poverty guidelines, and other families determined 463.13to be at risk, including but not limited to being at risk for child abuse, child neglect, or 463.14juvenile delinquency. Programs must give priority for services to families considered to 463.15be in need of services, including but not limited tobegin prenatally whenever possible and 463.16must be targeted to families with:463.17    (1) adolescent parents;463.18    (2) a history of alcohol or other drug abuse;463.19    (3) a history of child abuse, domestic abuse, or other types of violence;463.20    (4) a history of domestic abuse, rape, or other forms of victimization;463.21    (5) reduced cognitive functioning;463.22    (6) a lack of knowledge of child growth and development stages;463.23    (7) low resiliency to adversities and environmental stresses; or463.24    (8) insufficient financial resources to meet family needs;463.25    (9) a history of homelessness;463.26    (10) a risk of long-term welfare dependence or family instability due to employment 463.27barriers; or463.28    (11) other risk factors as determined by the commissioner.463.29    Subd. 3. Requirements for programs; process. (a) Before a community health 463.30board or tribal government may receive an allocation under subdivision 2, a community 463.31health board or tribal government must submit a proposal to the commissioner that 463.32includes identification, based on a community assessment, of the populations at or below 463.33200 percent of the federal poverty guidelines that will be served and the other populations 463.34that will be served. Each program that receives funds must Community health boards 463.35and tribal governments that receive funding under this section must submit a plan to 463.36the commissioner describing a multidisciplinary approach to targeted home visiting for 464.1families. The plan must be submitted on forms provided by the commissioner. At a 464.2minimum, the plan must include the following:464.3    (1) a description of outreach strategies to families prenatally or at birth;464.4    (2) provisions for the seamless delivery of health, safety, and early learning services; 464.5    (3) methods to promote continuity of services when families move within the state;464.6    (4) a description of the community demographics;464.7    (5) a plan for meeting outcome measures; and464.8    (6) a proposed work plan that includes:464.9    (i) coordination to ensure nonduplication of services for children and families;464.10    (ii) a description of the strategies to ensure that children and families at greatest risk 464.11receive appropriate services; and464.12    (iii) collaboration with multidisciplinary partners including public health, 464.13ECFE, Head Start, community health workers, social workers, community home 464.14visiting programs, school districts, and other relevant partners. Letters of intent from 464.15multidisciplinary partners must be submitted with the plan.464.16    (b) Each program that receives funds must accomplish the following program 464.17requirements:464.18    (1) use either a broad community-based or selective community-based strategy to 464.19provide preventive and early intervention home visiting services;464.20    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 464.21home visit must occur prenatally or as soon after birth as possible and must include a 464.22public health nursing assessment by a public health nurse;464.23    (3) offer, at a minimum, information on infant care, child growth and development, 464.24positive parenting, preventing diseases, preventing exposure to environmental hazards, 464.25and support services available in the community;464.26    (4) provide information on and referrals to health care services, if needed, including 464.27information on and assistance in applying for health care coverage for which the child or 464.28family may be eligible; and provide information on preventive services, developmental 464.29assessments, and the availability of public assistance programs as appropriate;464.30    (5) provide youth development programs when appropriate;464.31    (6) recruit home visitors who will represent, to the extent possible, the races, 464.32cultures, and languages spoken by families that may be served;464.33    (7) train and supervise home visitors in accordance with the requirements established 464.34under subdivision 4;464.35    (8) maximize resources and minimize duplication by coordinating activitiesor 464.36contracting with local social and human services organizations, education organizations, 465.1and other appropriate governmental entities and community-based organizations and 465.2agencies; and465.3    (9) utilize appropriate racial and ethnic approaches to providing home visiting 465.4services; and465.5    (10) connect eligible families, as needed, to additional resources available in the 465.6community, including, but not limited to, early care and education programs, health or 465.7mental health services, family literacy programs, employment agencies, social services, 465.8and child care resources and referral agencies.465.9    (c) When available, programs that receive funds under this section must offer or 465.10provide the family with a referral to center-based or group meetings that meet at least 465.11once per month for those families identified with additional needs. The meetings must 465.12focus on further enhancing the information, activities, and skill-building addressed during 465.13home visitation; offering opportunities for parents to meet with and support each other; 465.14and offering infants and toddlers a safe, nurturing, and stimulating environment for 465.15socialization and supervised play with qualified teachers.465.16    (b)(d) Funds available under this section shall not be used for medical services. The 465.17commissioner shall establish an administrative cost limit for recipients of funds. The 465.18outcome measures established under subdivision 6 must be specified to recipients of 465.19funds at the time the funds are distributed.465.20    (c)(e) Data collected on individuals served by the home visiting programs must 465.21remain confidential and must not be disclosed by providers of home visiting services 465.22without a specific informed written consent that identifies disclosures to be made. 465.23Upon request, agencies providing home visiting services must provide recipients with 465.24information on disclosures, including the names of entities and individuals receiving the 465.25information and the general purpose of the disclosure. Prospective and current recipients 465.26of home visiting services must be told and informed in writing that written consent for 465.27disclosure of data is not required for access to home visiting services.465.28    Subd. 4. Training. The commissioner shall establish training requirements for 465.29home visitors and minimum requirements for supervision by a public health nurse. The 465.30requirements for nurses must be consistent with chapter 148. The commissioner must 465.31provide training for home visitors. Training must include child development, positive 465.32parenting techniques, screening and referrals for child abuse and neglect, and diverse 465.33cultural practices in child rearing and family systems the following:465.34    (1) effective relationships for engaging and retaining families and ensuring family 465.35health, safety, and early learning;466.1    (2) effective methods of implementing parent education, conducting home visiting, 466.2and promoting quality early childhood development;466.3    (3) early childhood development from birth to age five;466.4    (4) diverse cultural practices in child rearing and family systems;466.5    (5) recruiting, supervising, and retaining qualified staff;466.6    (6) increasing services for underserved populations; and 466.7    (7) relevant issues related to child welfare and protective services, with information 466.8provided being consistent with state child welfare agency training.466.9    Subd. 5. Technical assistance. The commissioner shall provide administrative 466.10and technical assistance to each program, including assistance in data collection and 466.11other activities related to conducting short- and long-term evaluations of the programs 466.12as required under subdivision 7. The commissioner may request research and evaluation 466.13support from the University of Minnesota.466.14    Subd. 6. Outcome and performance measures. The commissioner shall establish 466.15outcomesmeasures to determine the impact of family home visiting programs funded 466.16under this section on the following areas:466.17    (1) appropriate utilization of preventive health care;466.18    (2) rates of substantiated child abuse and neglect;466.19    (3) rates of unintentional child injuries;466.20    (4) rates of children who are screened and who pass early childhood screening; and466.21    (5) rates of children accessing early care and educational services;466.22    (6) program retention rates;466.23    (7) number of home visits provided compared to the number of home visits planned;466.24    (8) participant satisfaction;466.25    (9) rates of at-risk populations reached; and466.26    (10) any additional qualitative goals and quantitative measures established by the 466.27commissioner.466.28    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and 466.29performance measures established under subdivisions 1 and 6, the commissioner shall 466.30conduct ongoing evaluations of the programs funded under this section. Community 466.31health boards and tribal governments shall cooperate with the commissioner in the 466.32evaluations and shall provide the commissioner with the information necessary to conduct 466.33the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact 466.34of the programs on the outcome measures listed in subdivision 6, and shall periodically 466.35determine whether home visiting programs are the best way to achieve the qualitative 466.36goals established under subdivisions 1 and 6. If the commissioner determines that home 467.1visiting programs are not the best way to achieve these goals, the commissioner shall 467.2provide the legislature with alternative methods for achieving them.467.3    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered 467.4year thereafter, the commissioner shall submit a report to the legislature on the family 467.5home visiting programs funded under this section and on the results of the evaluations 467.6conducted under subdivision 7.467.7    Subd. 9. No supplanting of existing funds. Funding available under this section 467.8may be used only to supplement, not to replace, nonstate funds being used for home 467.9visiting services as of July 1, 2001.467.10    Sec. 26. Minnesota Statutes 2006, section 156.001, is amended by adding a subdivision 467.11to read:467.12    Subd. 10a.Program for the Assessment of Veterinary Education Equivalence; 467.13PAVE certificate.A "Program for the Assessment of Veterinary Education Equivalence" 467.14or "PAVE" certificate is issued by the American Association of Veterinary State Boards, 467.15indicating that the holder has demonstrated knowledge and skill equivalent to that 467.16possessed by a graduate of an accredited or approved college of veterinary medicine.467.17    Sec. 27. [156.015] FEES.467.18    Subdivision 1.Verification of licensure.The board may charge a fee of $25 per 467.19license verification to a licensee for verification of licensure status provided to other 467.20veterinary licensing boards.467.21    Subd. 2.Continuing education review.The board may charge a fee of $50 per 467.22submission to a sponsor for review and approval of individual continuing education 467.23seminars, courses, wet labs, and lectures. This fee does not apply to continuing education 467.24sponsors that already meet the criteria for preapproval under Minnesota Rules, part 467.259100.1000, subpart 3, item A.467.26    Sec. 28. Minnesota Statutes 2006, section 156.02, subdivision 1, is amended to read:467.27    Subdivision 1. License application. Application for a license to practice veterinary 467.28medicine in this state shall be made in writing to the Board of Veterinary Medicine upon a 467.29form furnished by the board, accompanied by satisfactory evidence that the applicant is at 467.30least 18 years of age, is of good moral character, and has one of the following:467.31    (1) a diploma conferring the degree of doctor of veterinary medicine, or an 467.32equivalent degree, from an accredited or approved college of veterinary medicine;467.33    (2) an ECFVG or PAVE certificate; or468.1    (3) a certificate from the dean of an accredited or approved college of veterinary 468.2medicine stating that the applicant is a student in good standing expecting to be graduated 468.3at the completion of the current academic year of the college in which the applicant is 468.4enrolled.468.5    The application shall contain the information and material required by subdivision 468.62 and any other information that the board may, in its sound judgment, require. The 468.7application shall be filed with the board at least 60 days before the date of the examination. 468.8If the board deems it advisable, it may require that such application be verified by the 468.9oath of the applicant.468.10    Sec. 29. Minnesota Statutes 2006, section 156.02, subdivision 2, is amended to read:468.11    Subd. 2. Required with application. Every application shall contain the following 468.12information and material:468.13    (1) the application fee set by the board in the form of a check or money order payable 468.14to the board, which fee is not returnable in the event permission to take the examination 468.15is denied for good cause;468.16    (2) a copy of a diploma from an accredited or approved college of veterinary 468.17medicine or a certificate from the dean or secretary of an accredited or approved college of 468.18veterinary medicine showing the time spent in the school and the date when the applicant 468.19was duly and regularly graduated or will duly and regularly graduate or verification of 468.20ECFVG or PAVE certification;468.21    (3) affidavits of at least two veterinarians and three adults who are not related to 468.22the applicant setting forth how long a time, when, and under what circumstances they 468.23have known the applicant, and any other facts as may be proper to enable the board to 468.24determine the qualifications of the applicant; and468.25    (4) if the applicant has served in the armed forces, a copy of discharge papers.468.26    Sec. 30. Minnesota Statutes 2006, section 156.04, is amended to read:468.27156.04 BOARD TO ISSUE LICENSE.468.28    The Board of Veterinary Medicine shall issue to every applicant who has successfully 468.29passed the required examination, who has received a diploma conferring the degree of 468.30doctor of veterinary medicine or an equivalent degree from an accredited or approved 468.31college of veterinary medicine or an ECFVG or PAVE certificate, and who shall have been 468.32adjudged to be duly qualified to practice veterinary medicine, a license to practice.468.33    Sec. 31. Minnesota Statutes 2006, section 156.072, subdivision 2, is amended to read:469.1    Subd. 2. Required with application. Such doctor of veterinary medicine shall 469.2accompany the application by the following:469.3    (1) a copy of a diploma from an accredited or approved college of veterinary 469.4medicine or certification from the dean, registrar, or secretary of an accredited or approved 469.5college of veterinary medicine attesting to the applicant's graduation from an accredited 469.6or approved college of veterinary medicine, or a certificate of satisfactory completion of 469.7the ECFVG or PAVE program.469.8    (2) affidavits of two licensed practicing doctors of veterinary medicine residing in 469.9the United States or Canadian licensing jurisdiction in which the applicant is currently 469.10practicing, attesting that they are well acquainted with the applicant, that the applicant is a 469.11person of good moral character, and has been actively engaged in practicing or teaching in 469.12such jurisdiction for the period above prescribed;469.13    (3) a certificate from the regulatory agency having jurisdiction over the conduct of 469.14practice of veterinary medicine that such applicant is in good standing and is not the 469.15subject of disciplinary action or pending disciplinary action;469.16    (4) a certificate from all other jurisdictions in which the applicant holds a currently 469.17active license or held a license within the past ten years, stating that the applicant is and 469.18was in good standing and has not been subject to disciplinary action;469.19    (5) in lieu of clauses (3) and (4), certification from the Veterinary Information 469.20Verification Agency that the applicant's licensure is in good standing;469.21    (6) a fee as set by the board in form of check or money order payable to the board, 469.22no part of which shall be refunded should the application be denied;469.23    (7) score reports on previously taken national examinations in veterinary medicine, 469.24certified by the Veterinary Information Verification Agency; and469.25    (8) if requesting waiver of examination, provide evidence of meeting licensure 469.26requirements in the state of the applicant's original licensure that were substantially equal 469.27to the requirements for licensure in Minnesota in existence at that time.469.28    Sec. 32. Minnesota Statutes 2006, section 156.073, is amended to read:469.29156.073 TEMPORARY PERMIT.469.30    The board may issue without examination a temporary permit to practice veterinary 469.31medicine in this state to a person who has submitted an application approved by the 469.32board for license pending examination, and holds a doctor of veterinary medicine degree 469.33or an equivalent degree from an approved or accredited college of veterinary medicine 469.34or an ECFVG or PAVE certification. The temporary permit shall expire the day after 469.35publication of the notice of results of the first examination given after the permit is 470.1issued. No temporary permit may be issued to any applicant who has previously failed 470.2the national examination and is currently not licensed in any licensing jurisdiction of the 470.3United States or Canada or to any person whose license has been revoked or suspended 470.4or who is currently subject to a disciplinary order in any licensing jurisdiction of the 470.5United States or Canada.470.6    Sec. 33. Minnesota Statutes 2006, section 156.12, subdivision 2, is amended to read:470.7    Subd. 2. Authorized activities. No provision of this chapter shall be construed to 470.8prohibit:470.9    (a) a person from rendering necessary gratuitous assistance in the treatment of any 470.10animal when the assistance does not amount to prescribing, testing for, or diagnosing, 470.11operating, or vaccinating and when the attendance of a licensed veterinarian cannot be 470.12procured;470.13    (b) a person who is a regular student in an accredited or approved college of 470.14veterinary medicine from performing duties or actions assigned by instructors or 470.15preceptors or working under the direct supervision of a licensed veterinarian;470.16    (c) a veterinarian regularly licensed in another jurisdiction from consulting with a 470.17licensed veterinarian in this state;470.18    (d) the owner of an animal and the owner's regular employee from caring for and 470.19administering to the animal belonging to the owner, except where the ownership of the 470.20animal was transferred for purposes of circumventing this chapter;470.21    (e) veterinarians who are in compliance with subdivision 6 and who are employed by 470.22the University of Minnesota from performing their duties with the College of Veterinary 470.23Medicine, College of Agriculture, Agricultural Experiment Station, Agricultural Extension 470.24Service, Medical School, School of Public Health, or other unit within the university; or 470.25a person from lecturing or giving instructions or demonstrations at the university or in 470.26connection with a continuing education course or seminar to veterinarians or pathologists 470.27at the University of Minnesota Veterinary Diagnostic Laboratory;470.28    (f) any person from selling or applying any pesticide, insecticide or herbicide;470.29    (g) any person from engaging in bona fide scientific research or investigations which 470.30reasonably requires experimentation involving animals;470.31    (h) any employee of a licensed veterinarian from performing duties other than 470.32diagnosis, prescription or surgical correction under the direction and supervision of the 470.33veterinarian, who shall be responsible for the performance of the employee;470.34    (i) a graduate of a foreign college of veterinary medicine from working under the 470.35direct personal instruction, control, or supervision of a veterinarian faculty member of 471.1the College of Veterinary Medicine, University of Minnesota in order to complete the 471.2requirements necessary to obtain an ECFVG or PAVE certificate.471.3    Sec. 34. Minnesota Statutes 2006, section 156.12, subdivision 4, is amended to read:471.4    Subd. 4. Titles. It is unlawful for a person who has not received a professional 471.5degree from an accredited or approved college of veterinary medicine, or ECFVG or PAVE 471.6certification, to use any of the following titles or designations: Veterinary, veterinarian, 471.7animal doctor, animal surgeon, animal dentist, animal chiropractor, animal acupuncturist, 471.8or any other title, designation, word, letter, abbreviation, sign, card, or device tending to 471.9indicate that the person is qualified to practice veterinary medicine.471.10    Sec. 35. Minnesota Statutes 2006, section 156.12, subdivision 6, is amended to read:471.11    Subd. 6. Faculty licensure. (a) Veterinary Medical Center clinicians at the College 471.12of Veterinary Medicine, University of Minnesota, who are engaged in the practice of 471.13veterinary medicine as defined in subdivision 1 and who treat animals owned by clients of 471.14the Veterinary Medical Center must possess the same license required by other veterinary 471.15practitioners in the state of Minnesota except for persons covered by paragraphs (b) and (c).471.16    (b) A specialty practitioner in a hard-to-fill faculty position who has been employed 471.17at the College of Veterinary Medicine, University of Minnesota, for five years or 471.18more prior to 2003 or is specialty board certified by the American Veterinary Medical 471.19Association or the European Board of Veterinary Specialization may be granted a specialty 471.20faculty Veterinary Medical Center clinician license which will allow the licensee to 471.21practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's 471.22training and only within the scope of employment at the Veterinary Medical Center.471.23    (c) A specialty practitioner in a hard-to-fill faculty position at the College of 471.24Veterinary Medicine, University of Minnesota, who has graduated from a board-approved 471.25foreign veterinary school may be granted a temporary faculty Veterinary Medical Center 471.26clinician license. The temporary faculty Veterinary Medical Center clinician license 471.27expires in two years and allows the licensee to practice veterinary medicine as defined 471.28in subdivision 1 and treat animals owned by clients of the Veterinary Medical Center. 471.29The temporary faculty Veterinary Medical Center clinician license allows the licensee to 471.30practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's 471.31training and only within the scope of employment at the Veterinary Medical Center while 471.32under the direct supervision of a veterinarian currently licensed and actively practicing 471.33veterinary medicine in Minnesota, as defined in section 156.04. The direct supervising 471.34veterinarian shall not have any current or past conditions, restrictions, or probationary 472.1status imposed on the veterinarian's license by the board within the past five years. The 472.2holder of a temporary faculty Veterinary Medical Center clinician license who is enrolled 472.3in a PhD program may apply for up to two additional consecutive two-year extensions 472.4of an expiring temporary faculty Veterinary Medical Center clinician license. Any other 472.5holder of a temporary faculty Veterinary Medical Center clinician license may apply for 472.6one two-year extension of the expiring temporary faculty Veterinary Medical Center 472.7clinician license. Temporary faculty Veterinary Medical Center clinician licenses that are 472.8allowed to expire may not be renewed. The board shall grant an extension to a licensee 472.9who demonstrates suitable progress toward completing the requirements of their academic 472.10program, specialty board certification, or full licensure in Minnesota by a graduate of a 472.11foreign veterinary college.472.12    (d) Temporary and specialty faculty Veterinary Medical Center clinician licensees 472.13must abide by all the laws governing the practice of veterinary medicine in the state 472.14of Minnesota and are subject to the same disciplinary action as any other veterinarian 472.15licensed in the state of Minnesota.472.16    (e) The fee for a license issued under this subdivision is the same as for a regular 472.17license to practice veterinary medicine in Minnesota. License payment deadlines, late 472.18payment fees, and other license requirements are also the same as for regular licenses.472.19    Sec. 36. Minnesota Statutes 2006, section 156.15, subdivision 2, is amended to read:472.20    Subd. 2. Service. Service of an order under this section is effective if the order is 472.21served on the person or counsel of record personally or by certified United States mail to 472.22the most recent address provided to the board for the person or counsel of record.472.23    Sec. 37. Minnesota Statutes 2006, section 156.16, subdivision 3, is amended to read:472.24    Subd. 3. Dispensing. "Dispensing" means distribution of veterinary prescription 472.25drugs or over-the-counter drugs for extra-label use or human drugs for extra-label use by a 472.26person licensed as a pharmacist by the Board of Pharmacy or a person licensed by the 472.27Board of Veterinary Medicine.472.28    Sec. 38. Minnesota Statutes 2006, section 156.16, subdivision 10, is amended to read:472.29    Subd. 10. Prescription. "Prescription" means an order from a veterinarian to a 472.30pharmacist or another veterinarian authorizing the dispensing of a veterinary prescription 472.31drug drugs, human drugs for extra-label use, or over-the-counter drugs for extra-label use472.32to a client for use on or in a patient.473.1    Sec. 39. Minnesota Statutes 2006, section 156.18, subdivision 1, is amended to read:473.2    Subdivision 1. Prescription. (a) A person may not dispense a veterinary 473.3prescription drug to a client without a prescription or other veterinary authorization. A 473.4person may not make extra-label use of an animal or human drug for an animal without a 473.5prescription from a veterinarian. A veterinarian or the veterinarian's authorized employee 473.6may dispense a veterinary prescription drug todrugs, human drugs for extra-label use, or 473.7an over-the-counter drug for extra-label use by a client or oversee the extra-label use of 473.8a veterinary drug directly by a client without a separate written prescription, providing 473.9there is documentation of the prescription in the medical record and there is an existing 473.10veterinarian-client-patient relationship. The prescribing veterinarian must monitor the use 473.11of veterinary prescription drugs, human drugs for extra-label use, or over-the-counter 473.12drugs for extra-label use by a client.473.13    (b) A veterinarian may dispense prescription veterinary drugs and prescribe and 473.14dispense extra-label use drugs to a client without personally examining the animal if 473.15a bona fide veterinarian-client-patient relationship exists and in the judgment of the 473.16veterinarian the client has sufficient knowledge to use the drugs properly.473.17    (c) A veterinarian may issue a prescription or other veterinary authorization by oral or 473.18written communication to the dispenser, or by computer connection. If the communication 473.19is oral, the veterinarian must enter it into the patient's record. The dispenser must record 473.20the veterinarian's prescription or other veterinary authorization within 72 hours.473.21    (d) A prescription or other veterinary authorization must include:473.22    (1) the name, address, and, if written, the signature of the prescriber;473.23    (2) the name and address of the client;473.24    (3) identification of the species for which the drug is prescribed or ordered;473.25    (4) the name, strength, and quantity of the drug;473.26    (5) the date of issue;473.27    (6) directions for use; and473.28    (7) withdrawal time., if applicable; and473.29    (8) number of authorized refills.473.30    (e) A veterinarian may, in the course of professional practice and an existing 473.31veterinarian-client-patient relationship, prepare medicaments that combine drugs approved 473.32by the United States Food and Drug Administration and other legally obtained ingredients 473.33with appropriate vehicles.473.34    (f) A veterinarian or a bona fide employee of a veterinarian may dispense veterinary 473.35prescription drugs to a person on the basis of a prescription issued by a licensed 473.36veterinarian. The provisions of paragraphs (c) and (d) apply.474.1    (g) This section does not limit the authority of the Minnesota Racing Commission to 474.2regulate veterinarians providing services at a licensed racetrack.474.3    Sec. 40. Minnesota Statutes 2006, section 156.18, subdivision 2, is amended to read:474.4    Subd. 2. Label of dispensed veterinary drugs. (a) A veterinarian or the 474.5veterinarian's authorized agent or employee dispensing a veterinary prescription drug 474.6or prescribing the extra-label use of an over-the-counter drug, an over-the-counter drug 474.7for extra-label use, or a human drug for extra-label use must provide written information 474.8which includes the name and address of the veterinarian, date of filling, species of patient, 474.9name or names of drug, strength of drug or drugs, directions for use, withdrawal time, 474.10and cautionary statements, if any, appropriate for the drug.474.11    (b) If the veterinary drug has been prepared, mixed, formulated, or packaged by the 474.12dispenser, all of the information required in paragraph (a) must be provided on a label 474.13affixed to the container.474.14    (c) If the veterinary drug is in the manufacturer's original package, the information 474.15required in paragraph (a) must be supplied in writing but need not be affixed to the 474.16container. Information required in paragraph (a) that is provided by the manufacturer on 474.17the original package does not need to be repeated in the separate written information. 474.18Written information required by this paragraph may be written on the sales invoice.474.19    Sec. 41. Minnesota Statutes 2006, section 156.19, is amended to read:474.20156.19 EXTRA-LABEL USE.474.21    A person, other than a veterinarian or a person working under the controlan 474.22employee of a veterinarian, must not make extra-label use of a veterinary drug in or 474.23on a food-producing animal, unless permitted by the prescription of a veterinarian. A 474.24veterinarian may prescribe the extra-label use of a veterinary drug if:474.25    (1) the veterinarian makes a careful medical diagnosis within the context of a valid 474.26veterinarian-client-patient relationship;474.27    (2) the veterinarian determines that there is no marketed drug specifically labeled to 474.28treat the condition diagnosed, or that drug therapy as recommended by the labeling has, in 474.29the judgment of the attending veterinarian, been found to be clinically ineffective;474.30    (3) the veterinarian recommends procedures to ensure that the identity of the treated 474.31animal will be carefully maintained; and474.32    (4) the veterinarian prescribes a significantly extended time period for drug 474.33withdrawal before marketing meat, milk, or eggs.; and475.1    (5) the veterinarian has met the criteria established in Code of Federal Regulations, 475.2title 21, part 530, which define the extra-label use of medication in or on animals.475.3    Sec. 42. Minnesota Statutes 2006, section 198.075, is amended to read:475.4198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED 475.5FROM COMMISSARY PRIVILEGES.475.6    Except as provided in this section, no commissary privileges including food, laundry 475.7service, janitorial service, and household supplies shall be furnished to any employee of 475.8the Minnesota veterans homes. An employee of the Minnesota veterans homes who works 475.9a second shift that is consecutive with a regularly scheduled shift may be allowed one free 475.10meal at the veterans home on the day of that extra shift.475.11    Sec. 43. Minnesota Statutes 2006, section 256B.0625, subdivision 14, is amended to 475.12read:475.13    Subd. 14. Diagnostic, screening, and preventive services. (a) Medical assistance 475.14covers diagnostic, screening, and preventive services.475.15    (b) "Preventive services" include services related to pregnancy, including:475.16    (1) services for those conditions which may complicate a pregnancy and which may 475.17be available to a pregnant woman determined to be at risk of poor pregnancy outcome;475.18    (2) prenatal HIV risk assessment, education, counseling, and testing; and475.19    (3) alcohol abuse assessment, education, and counseling on the effects of alcohol 475.20usage while pregnant. Preventive services available to a woman at risk of poor pregnancy 475.21outcome may differ in an amount, duration, or scope from those available to other 475.22individuals eligible for medical assistance.475.23    (c) "Screening services" include, but are not limited to, blood lead tests. Screening 475.24services also include, for children with blood lead levels equal to or greater than ten 475.25micrograms of lead per deciliter of whole blood, environmental investigations to 475.26determine the source of lead exposure. Reimbursement is limited to a health professional's 475.27time and activities during an on-site investigation of a child's home or primary residence.475.28    Sec. 44. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 475.29subdivision to read:475.30    Subd. 49.Lead risk assessments.(a) Effective October 1, 2007, or six months after 475.31federal approval, whichever is later, medical assistance covers lead risk assessments 475.32provided by a lead risk assessor who is licensed by the commissioner of health under 475.33section 144.9505 and employed by an assessing agency as defined in section 144.9501. 476.1Medical assistance covers a onetime on-site investigation of a recipient's home or primary 476.2residence to determine the existence of lead so long as the recipient is under the age 476.3of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2, 476.4paragraph (a).476.5    (b) Medical assistance reimbursement covers the lead risk assessor's time to 476.6complete the following activities:476.7    (1) gathering samples;476.8    (2) interviewing family members;476.9    (3) gathering data, including meter readings; and476.10    (4) providing a report with the results of the investigation and options for reducing 476.11lead-based paint hazards.476.12    Medical assistance coverage of lead risk assessment does not include testing of 476.13environmental substances such as water, paint, or soil or any other laboratory services. 476.14Medical assistance coverage of lead risk assessments is not included in the capitated 476.15services for children enrolled in health plans through the prepaid medical assistance 476.16program and the MinnesotaCare program.476.17    (c) Payment for lead risk assessment must be cost-based and must meet the criteria 476.18for federal financial participation under the Medicaid program. The rate must be based 476.19on allowable expenditures from cost information gathered. Under section 144.9507, 476.20subdivision 5, federal medical assistance funds may not replace existing funding for 476.21lead-related activities. The nonfederal share of costs for services provided under this 476.22subdivision must be from state or local funds and is the responsibility of the agency 476.23providing the risk assessment. Eligible expenditures for the nonfederal share of costs may 476.24not be made from federal funds or funds used to match other federal funds. Any federal 476.25disallowances are the responsibility of the agency providing risk assessment services.476.26    Sec. 45. [325E.385] PRODUCTS CONTAINING POLYBROMINATED 476.27DIPHENYL ETHER.476.28    Subdivision 1.Definitions.For the purposes of sections 325E.386 to 325E.388, 476.29the terms in this section have the meanings given them.476.30    Subd. 2.Commercial decabromodiphenyl ether."Commercial 476.31decabromodiphenyl ether" means the chemical mixture of decabromodiphenyl ether, 476.32including associated polybrominated diphenyl ether impurities not intentionally added.476.33    Subd. 3.Commissioner."Commissioner" means the commissioner of the Pollution 476.34Control Agency.477.1    Subd. 4.Manufacturer."Manufacturer" means any person, firm, association, 477.2partnership, corporation, governmental entity, organization, or joint venture that produces 477.3a product containing polybrominated diphenyl ethers or an importer or domestic 477.4distributor of a noncomestible product containing polybrominated diphenyl ethers.477.5    Subd. 5.Polybrominated diphenyl ethers or PBDE's."Polybrominated diphenyl 477.6ethers" or "PBDE's" means chemical forms that consist of diphenyl ethers bound with 477.7bromine atoms. Polybrominated diphenyl ethers include, but are not limited to, the 477.8three primary forms of the commercial mixtures known as pentabromodiphenyl ether, 477.9octabromodiphenyl ether, and decabromodiphenyl ether.477.10    Subd. 6.Retailer."Retailer" means a person who offers a product for sale at retail 477.11through any means, including, but not limited to, remote offerings such as sales outlets, 477.12catalogs, or the Internet, but does not include a sale that is a wholesale transaction with a 477.13distributor or a retailer.477.14    Subd. 7.Used product."Used product" means any product that has been previously 477.15owned, purchased, or sold in commerce. Used product does not include any product 477.16manufactured after January 1, 2008.477.17    Sec. 46. [325E.386] PRODUCTS CONTAINING CERTAIN 477.18POLYBROMINATED DIPHENYL ETHERS BANNED; EXEMPTIONS.477.19    Subdivision 1.Penta- and octabromodiphenyl ethers.Except as provided in 477.20subdivision 3, beginning January 1, 2008, a person may not manufacture, process, or 477.21distribute in commerce a product or flame-retardant part of a product containing more 477.22than one-tenth of one percent of pentabromodiphenyl ether or octabromodiphenyl ether 477.23by mass.477.24    Subd. 2.Exemptions.The following products containing polybrominated diphenyl 477.25ethers are exempt from subdivision 1 and section 325E.387, subdivision 2:477.26    (1) the sale or distribution of any used transportation vehicle with component parts 477.27containing polybrominated diphenyl ethers;477.28    (2) the sale or distribution of any used transportation vehicle parts or new 477.29transportation vehicle parts manufactured before January 1, 2008, that contain 477.30polybrominated diphenyl ethers;477.31    (3) the manufacture, sale, repair, distribution, maintenance, refurbishment, or 477.32modification of equipment containing polybrominated diphenyl ethers and used primarily 477.33for military or federally funded space program applications. This exemption does not 477.34cover consumer-based goods with broad applicability;478.1    (4) the sale or distribution by a business, charity, public entity, or private party of 478.2any used product containing polybrominated diphenyl ethers;478.3    (5) the manufacture, sale, or distribution of new carpet cushion made from recycled 478.4foam containing more than one-tenth of one percent penta polybrominated diphenyl ether; 478.5    (6) medical devices; or478.6    (7) the manufacture, sale, repair, distribution, maintenance, refurbishment, or 478.7modification of telecommunications equipment containing polybrominated diphenyl 478.8ethers used by entities eligible to hold authorization in the Public Safety Pool under Code 478.9of Federal Regulations, title 47, part 90.478.10    In-state retailers in possession of products on January 1, 2008, that are banned for 478.11sale under subdivision 1 may exhaust their stock through sales to the public. Nothing in 478.12this section restricts the ability of a manufacturer, importer, or distributor  from transporting 478.13products containing polybrominated diphenyl ethers through the state,  or storing such 478.14products in the state for later distribution outside the state.478.15    Sec. 47. [325E.387] REVIEW OF DECABROMODIPHENYL ETHER.478.16    Subdivision 1.Commissioner duties.The commissioner in consultation 478.17with the commissioners of health and public safety shall review uses of commercial 478.18decabromodiphenyl ether, availability of technically feasible and safer alternatives, fire 478.19safety and any evidence regarding the potential harm to public health and the environment 478.20posed by commercial decabromodiphenyl ether and the alternatives. The commissioner 478.21must consult with key stakeholders. The commissioner must also review the findings from 478.22similar state and federal agencies and must report their findings and recommendations to 478.23the appropriate committees of the legislature no later than January 15, 2008.478.24    Subd. 2.State procurement.By January 1, 2008, the commissioner of 478.25administration shall make available for purchase and use by all state agencies only 478.26equipment, supplies, and other products that do not contain polybrominated diphenyl 478.27ethers, unless exempted under section 325E.386, subdivision 2.478.28    Sec. 48. [325E.388] PENALTIES.478.29    A manufacturer who violates sections 325E.386 to 325E.388 is subject to a 478.30civil penalty not to exceed $1,000 for each violation in the case of a first offense. A 478.31manufacturer is subject to a civil penalty not to exceed $5,000 for each repeat offense. 478.32Penalties collected under this section must be deposited in an account in the special 478.33revenue fund and are appropriated in fiscal years 2008 and 2009 to the commissioner to 478.34implement and enforce this section.479.1    Sec. 49. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2, 479.2is amended to read:

479.3479.4Subd. 2.Community and Family Health Improvement

479.5Summary by Fund479.6General40,413,00040,382,000479.7479.8State Government 
                  		Special Revenue141,000128,000479.9Health Care Access3,510,0003,516,000479.10Federal TANF6,000,0006,000,000

479.11Family Planning Base Reduction. Base 479.12level funding for the family planning 479.13special projects grant program is reduced 479.14by $1,877,000 each year of the biennium 479.15beginning July 1, 2007, provided that 479.16this reduction shall only take place 479.17upon full implementation of the family 479.18planning project section of the 1115 waiver. 479.19Notwithstanding Minnesota Statutes, section 479.20145.925, the commissioner shall give priority 479.21to community health care clinics providing 479.22family planning services that either serve a 479.23high number of women who do not qualify 479.24for medical assistance or are unable to 479.25participate in the medical assistance program 479.26as a medical assistance provider when 479.27allocating the remaining appropriations. 479.28Notwithstanding section 15, this paragraph 479.29shall not expire.479.30Shaken Baby Video. Of the state 479.31government special revenue fund 479.32appropriation, $13,000 in 2006 is 479.33appropriated to the commissioner of health 479.34to provide a video to hospitals on shaken 479.35baby syndrome. The commissioner of health 479.36shall assess a fee to hospitals to cover the 479.37cost of the approved shaken baby video and 480.1the revenue received is to be deposited in the 480.2state government special revenue fund.480.3    Sec. 50. WATER LEVEL STANDARDS.480.4    (a) Until the commissioner of health adopts rules setting the health risk limits 480.5required in paragraph (c), the health risk limit for all contaminants in private wells and 480.6public water systems must be the more stringent of the state standards or the federal 480.7standards determined by the United States Environmental Protection Agency.480.8    (b) The legislature finds:480.9    (1) the child-based standards became effective in 2001, under Minnesota Statutes, 480.10section 144.0751;480.11    (2) Minnesota Statutes, section 103H.201, subdivision 3, requires the commissioner 480.12to update standards every four years; and480.13    (3) the commissioner of health has not complied with Minnesota Statutes, section 480.14103H.201, subdivision 3.480.15    (c) By March 1, 2008, the commissioner of health must publish in the State Register 480.16notice of intent to adopt rules relating to health risk limits for commonly detected 480.17contaminants. The commissioner of health shall review current scientific information to 480.18establish health risk limits for commonly detected contaminants in groundwater and 480.19in private wells that provides a reasonable margin of safety to adequately protect the 480.20health of developing fetuses, infants, and children, in accordance with the requirements 480.21of section 144.0751. Nothing in paragraph (a) prohibits the commissioner from setting 480.22standards that are stricter than the federal standards.480.23    Sec. 51. FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.480.24    The commissioner of health, in conjunction with the commissioner of the Pollution 480.25Control Agency, shall establish an environmental justice mapping program and shall 480.26apply for federal funding to renew and expand the state's environmental justice mapping 480.27capacity in order to promote public health tracking. The commissioner shall coordinate 480.28the project with the Pollution Control Agency and the Department of Agriculture in order 480.29to explore possible links between environmental health and toxic exposures and to help 480.30create a system for environmental public health tracking. The commissioner shall also 480.31make recommendations to the legislature for additional sources of funding within the state.480.32EFFECTIVE DATE.This section is effective the day following final enactment.480.33    Sec. 52. LEGISLATIVE FINDINGS AND PURPOSE.481.1    The legislature hereby finds that hearing loss occurs in newborn infants more 481.2frequently than any other health condition for which newborn infant screening is required. 481.3Early detection of hearing loss in a child and early intervention and treatment has been 481.4demonstrated to be highly effective in facilitating a child's healthy development in a 481.5manner consistent with the child's age, language acquisition, and cognitive ability. 481.6Without early hearing detection and intervention, children with hearing loss experience 481.7serious delays in language acquisition and social and cognitive development. With 481.8appropriate testing and identification of newborn infants, hearing loss screening will 481.9facilitate early intervention and treatment and will serve the public purpose of promoting 481.10the healthy development of children.481.11    For these reasons, the legislature hereby determines that it is beneficial and in the 481.12best interests of the development of the children of the state of Minnesota that newborn 481.13infants' hearing be screened.481.14    Sec. 53. INFORMATION SHARING.481.15    By August 1, 2007, the commissioner of health, the Pollution Control Agency, the 481.16commissioner of agriculture, and the University of Minnesota are requested to jointly 481.17develop and sign a memorandum of understanding declaring their intent to share new 481.18and existing environmental hazard, exposure, and health outcome data, consistent with 481.19applicable data practices laws, and to cooperate and communicate effectively to ensure 481.20sufficient clarity and understanding of the data between these organizations.481.21    Sec. 54. COMMISSIONER OF HEALTH REPORT; ROUTINE RADIATION 481.22EMISSIONS.481.23    The commissioner of health, within the limits of available appropriations, in 481.24cooperation with the utilities that own the Monticello and Prairie Island nuclear plants, 481.25shall issue a report detailing where routine radiation releases go and the health impacts of 481.26the radiation emissions on affected communities. By April 1, 2008, the report must be 481.27distributed to house and senate committees having jurisdiction over public health and to 481.28all communities that are part of the emergency response planning.481.29    Sec. 55. FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.481.30    Subdivision 1.Purpose.Recognizing that scented products may trigger asthma or 481.31chemical sensitivity reactions in students and school staff, which can contribute to learning 481.32and breathing problems, the commissioner of health shall develop a fragrance-free schools 481.33education pilot project.482.1    Subd. 2.Education.The commissioner of health, in collaboration with the 482.2commissioner of education and the Minneapolis Board of Education, shall establish a 482.3working group composed of at least three students, two teachers, one school administrator, 482.4and one member of the Minneapolis Board of Education to recommend an education 482.5campaign in Minneapolis public schools to inform students and parents about the 482.6potentially harmful effects of the use of fragrance products on sensitive students and 482.7school personnel in Minneapolis schools. The commissioner shall report findings to the 482.8legislature by February 1, 2008.482.9EFFECTIVE DATE.This section is effective the day following final enactment.482.10    Sec. 56. LINDANE COMMITTEE.482.11    The commissioner of health shall create a committee of stakeholders, including 482.12at least one environmental health research scientist and at least one parent consumer 482.13advocate, to review the scientific literature and make recommendations to the legislature 482.14on the health impact of Lindane on children and report back by January 15, 2008.482.15    Sec. 57. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.482.16    The commissioner of human services shall ensure that testing for arsenic under 482.17Minnesota Statutes, section 144.967, is covered under medical assistance.482.18    Sec. 58. BLOOD LEAD TESTING STUDY.482.19    The commissioner of health, in consultation with the Department of Human 482.20Services; cities of the first class; health care providers; and other interested parties shall 482.21conduct a study to evaluate blood lead testing methods used to confirm elevated blood 482.22lead status. The study shall examine and/or develop:482.23    (1) the false positive rate of capillary tests for children less than 72 months old;482.24    (2) current protocols for conducting capillary testing, including filter paper 482.25methodology;482.26    (3) existing guidelines and regulations from other states and federal agencies 482.27regarding lead testing;482.28    (4) recommendations regarding the use of capillary tests to initiate environmental 482.29investigations and case management, including number and timing of tests and fiscal 482.30implications for state and local lead programs; and482.31    (5) recommendations regarding reducing the state mandatory intervention to ten 482.32micrograms of lead per deciliter of whole blood.483.1    The commissioner shall submit the results of the study and any recommendations, 483.2including any necessary legislative changes, to the legislature by February 15, 2008.483.3    Sec. 59. WINDOW SAFETY EDUCATION.483.4    The commissioner of health shall create in the department's current educational 483.5safety program a component targeted at parents and caregivers of young children to 483.6provide awareness of the need to take precautions to prevent children from falling 483.7through open windows. The commissioner of health shall consult with representatives 483.8of the residential building industry, the window products industry, the child safety 483.9advocacy community, and the Department of Labor and Industry to create the window 483.10safety program component. The program must include the gathering of data about 483.11falls from windows that result in severe injury in order to measure the effectiveness of 483.12the safety program. The commissioner of health may consult with other child safety 483.13advocacy groups, experts, and interested parties in the development and implementation 483.14of the window safety program. The commissioner of health shall prepare and submit 483.15a final report on the window safety program to the legislature by March 1, 2011. The 483.16commissioner shall prepare and submit a yearly progress report to the legislature by 483.17March 1 of each year beginning in 2008 until the submission of the final report. The 483.18final report must include a summary of the safety program, the impact of the program on 483.19children falling from windows, and any recommendations for further study or action.483.20    Sec. 60. REVISOR'S INSTRUCTION.483.21    The revisor of statutes shall change the range reference "144.9501 to 144.9509" 483.22to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and 483.23Minnesota Rules.483.24    Sec. 61.  REPEALER.483.25Laws 2004, chapter 288, article 6, section 27, is repealed.483.26ARTICLE 11483.27HUMAN SERVICES FORECAST ADJUSTMENTS

483.28483.29Section 1.  SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

483.30    The dollar amounts shown are added to or, if shown in parentheses, are subtracted 483.31from the appropriations in Laws 2006, chapter 282, from the general fund, or any other 483.32fund named, to the Department of Human Services for the purposes specified in this 484.1article, to be available for the fiscal year indicated for each purpose. The figure "2007" 484.2used in this article means that the appropriation or appropriations listed are available 484.3for the fiscal year ending June 30, 2007.

484.42007484.5General Fund$(25,226,000)484.6Health Care Access$(53,980,000)484.7TANF$(24,805,000)484.8Total$(104,011,000)

484.9484.10Sec. 2. COMMISSIONER OF HUMAN SERVICES

484.11Subdivision 1.Total Appropriation$(104,011,000)

484.12Appropriations by Fund484.132007484.14General(25,226,000)484.15Health Care Access(53,980,000)484.16TANF(24,805,000)

484.17Subd. 2.Revenue and Pass Through

484.18TANF(106,000)

484.19484.20Subd. 3.Children and Economic Assistance Grants

484.21General3,221,000484.22TANF(24,699,000)

484.23The amounts that may be spent from this 484.24appropriation for each purpose are as follows:

484.25(a) MFIP/DWP Grants484.26General13,827,000484.27TANF(24,699,000)

484.28(b) MFIP Child Care Assistance Grants484.29General(4,733,000)

484.30(c) General Assistance Grants484.31General1,081,000

484.32(d) Minnesota Supplemental Aid Grants484.33General(1,099,000)

484.34(e) Group Residential Housing Grants484.35General(5,855,000)

485.1Subd. 4.Basic Health Care Grants

485.2General17,592,000485.3Health Care Access(53,980,000)

485.4The amounts that may be spent from this 485.5appropriation for each purpose are as follows:

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

485.7(b) MA Basic Health Care - Families and Children485.8General15,729,000

485.9(c) MA Basic Health Care - Elderly and Disabled485.10General(4,540,000)

485.11(d) General Assistance Medical Care485.12General6,403,000

485.13Subd. 5.Continuing Care Grants

485.14General(46,039,000)

485.15The amounts that may be spent from this 485.16appropriation for each purpose are as follows:

485.17(a) MA Long-Term Care Facilities485.18General(15,028,000)

485.19(b) MA Long-Term Care Waivers485.20General(20,677,000)

485.21(c) Chemical Dependency Entitlement Grants485.22General(10,334,000)

485.23    Sec. 3. EFFECTIVE DATE.485.24    Sections 1 and 2 are effective the day following final enactment.485.25ARTICLE 12485.26HUMAN SERVICES APPROPRIATIONS

485.27Section 1. SUMMARY OF APPROPRIATIONS.

485.28    The amounts shown in this section summarize direct appropriations, by fund, made 485.29in this article.

485.3020082009Total485.31General$4,836,759,000$5,194,751,000$10,031,510,000486.1486.2State Government Special Revenue55,737,00056,428,000112,165,000486.3Health Care Access436,050,000549,573,000985,623,000486.4Federal TANF266,864,000277,866,000544,730,000486.5Environment Fund300,000300,000600,000486.6Lottery Prize Fund2,184,0001,787,0003,971,000486.7Total$5,597,894,000$6,080,705,000$11,678,599,000

486.8Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

486.9    The sums shown in the columns marked "Appropriations" are appropriated to the 486.10agencies and for the purposes specified in this article. The appropriations are from the 486.11general fund, or another named fund, and are available for the fiscal years indicated 486.12for each purpose. The figures "2008" and "2009" used in this article mean that the 486.13appropriations listed under them are available for the fiscal year ending June 30, 2008, or 486.14June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal 486.15year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal 486.16year ending June 30, 2007, are effective the day following final enactment.

486.17APPROPRIATIONS486.18Available for the Year486.19Ending June 30486.2020082009

486.21Sec. 3. HUMAN SERVICES

486.22Subdivision 1.Total Appropriation$5,356,970,000$5,848,682,000

486.23Appropriations by Fund486.2420082009486.25General4,688,475,0005,050,169,000486.26486.27State Government Special Revenue545,000555,000486.28Health Care Access409,602,000529,655,000486.29Federal TANF255,514,000265,866,000486.30Lottery Prize Fund2,184,0001,787,000

486.31The amounts that may be spent for each 486.32purpose are specified in the following 486.33subdivisions.486.34Receipts for Systems Projects.486.35Appropriations and federal receipts for 486.36information system projects for MAXIS, 487.1PRISM, MMIS, and SSIS must be deposited 487.2in the state system account authorized in 487.3Minnesota Statutes, section 256.014. Money 487.4appropriated for computer projects approved 487.5by the Minnesota Office of Enterprise 487.6Technology, funded by the legislature, and 487.7approved by the commissioner of finance, 487.8may be transferred from one project to 487.9another and from development to operations 487.10as the commissioner of human services 487.11considers necessary. Any unexpended 487.12balance in the appropriation for these 487.13projects does not cancel but is available for 487.14ongoing development and operations.487.15Systems Continuity. In the event of 487.16disruption of technical systems or computer 487.17operations, the commissioner may use 487.18available grant appropriations to ensure 487.19continuity of payments for maintaining the 487.20health, safety, and well-being of clients 487.21served by programs administered by the 487.22Department of Human Services. Grant funds 487.23must be used in a manner consistent with the 487.24original intent of the appropriation.487.25Nonfederal Share Transfers. The 487.26nonfederal share of activities for which 487.27federal administrative reimbursement is 487.28appropriated to the commissioner may be 487.29transferred to the special revenue fund.487.30Gifts. Notwithstanding Minnesota 487.31Statutes, sections 16A.013 to 16A.016, the 487.32commissioner may accept, on behalf of the 487.33state, additional funding from sources other 487.34than state funds for the purpose of financing 487.35the cost of assistance program grants or 488.1nongrant administration. All additional 488.2funding is appropriated to the commissioner 488.3for use as designated by the grantor of 488.4funding.488.5TANF Funds Appropriated to Other 488.6Entities. Any expenditures from the TANF 488.7block grant shall be expended according 488.8to the requirements and limitations of part 488.9A of title IV of the Social Security Act, as 488.10amended, and any other applicable federal 488.11requirement or limitation. Prior to any 488.12expenditure of these funds, the commissioner 488.13shall ensure that funds are expended in 488.14compliance with the requirements and 488.15limitations of federal law and that any 488.16reporting requirements of federal law are 488.17met. It shall be the responsibility of any entity 488.18to which these funds are appropriated to 488.19implement a memorandum of understanding 488.20with the commissioner that provides the 488.21necessary assurance of compliance prior to 488.22any expenditure of funds. The commissioner 488.23shall receipt TANF funds appropriated 488.24to other state agencies and coordinate all 488.25related interagency accounting transactions 488.26necessary to implement these appropriations. 488.27Unexpended TANF funds appropriated to 488.28any state, local, or nonprofit entity cancel 488.29at the end of the state fiscal year unless 488.30appropriating or statutory language permits 488.31otherwise.488.32TANF Block Grant. Of this amount, 488.33$750,000 the first year and $750,000 the 488.34second year are onetime appropriations 488.35from the state's federal TANF block grant 488.36under Title I of Public Law 104-193. If the 489.1appropriation in either year is insufficient, the 489.2appropriation for the other year is available.489.3TANF Maintenance of Effort. (a) In 489.4order to meet the basic maintenance of 489.5effort (MOE) requirements of the TANF 489.6block grant specified under Code of Federal 489.7Regulations, title 45, section 263.1, the 489.8commissioner may only report nonfederal 489.9money expended for allowable activities 489.10listed in the following clauses as TANF/MOE 489.11expenditures:489.12(1) MFIP cash, diversionary work program, 489.13and food assistance benefits under Minnesota 489.14Statutes, chapter 256J;489.15(2) the child care assistance programs 489.16under Minnesota Statutes, sections 119B.03 489.17and 119B.05, and county child care 489.18administrative costs under Minnesota 489.19Statutes, section 119B.15;489.20(3) state and county MFIP administrative 489.21costs under Minnesota Statutes, chapters 489.22256J and 256K;489.23(4) state, county, and tribal MFIP 489.24employment services under Minnesota 489.25Statutes, chapters 256J and 256K;489.26(5) expenditures made on behalf of 489.27noncitizen MFIP recipients who qualify 489.28for the medical assistance without federal 489.29financial participation program under 489.30Minnesota Statutes, section 256B.06, 489.31subdivision 4, paragraphs (d), (e), and (j); 489.32and490.1(6) qualifying working family credit 490.2expenditures under Minnesota Statutes, 490.3section 290.0671.490.4(b) The commissioner shall ensure that 490.5sufficient qualified nonfederal expenditures 490.6are made each year to meet the state's 490.7TANF/MOE requirements. For the activities 490.8listed in paragraph (a), clauses (2) to 490.9(6), the commissioner may only report 490.10expenditures that are excluded from the 490.11definition of assistance under Code of 490.12Federal Regulations, title 45, section 260.31.490.13(c) The commissioner shall ensure that 490.14the maintenance of effort used by the 490.15commissioner of finance for the February 490.16and November forecasts required under 490.17Minnesota Statutes, section 16A.103, 490.18contains expenditures under paragraph (a), 490.19clause (1), equal to at least 25 percent of 490.20the total required under Code of Federal 490.21Regulations, title 45, section 263.1.490.22(d) Minnesota Statutes, section 256.011, 490.23subdivision 3, which requires that federal 490.24grants or aids secured or obtained under that 490.25subdivision be used to reduce any direct 490.26appropriations provided by law, does not 490.27apply if the grants or aids are federal TANF 490.28funds.490.29(e) Notwithstanding section 13, this rider 490.30expires June 30, 2011.490.31Working Family Credit Expenditures 490.32as TANF/MOE. The commissioner may 490.33claim as TANF maintenance of effort up 490.34to $6,707,000 per year for fiscal year 2008 491.1through fiscal year 2011. Notwithstanding 491.2section 13, this rider expires June 30, 2011.491.3Additional Working Family Credit 491.4Expenditures to be Claimed for 491.5TANF/MOE. In addition to the amounts 491.6provided in this section, the commissioner 491.7may count the following amounts of working 491.8family credit expenditure as TANF/MOE:491.9(1) fiscal year 2008, $4,269,000; and491.10(2) fiscal year 2009, $4,889,000.491.11Notwithstanding section 13, this rider expires 491.12June 30, 2011.491.13Capitation Rate Increase. Of the health care 491.14access fund appropriations to the University 491.15of Minnesota in the higher education 491.16omnibus appropriation bill, $2,157,000 in 491.17fiscal year 2008 and $2,157,000 in fiscal year 491.182009 are to be used to increase the capitation 491.19payments under Minnesota Statutes, section 491.20256B.69. 491.21Health Care Access Fund Transfer.491.22Notwithstanding Minnesota Statutes, section 491.23295.581, in addition to the transfers in 491.24Minnesota Statutes, section 16A.724, 491.25subdivision 2, the commissioner of finance 491.26shall transfer up to the following amounts 491.27from the health care access fund to the 491.28general fund on June 30 of each fiscal year:491.29(1) fiscal year 2008, $6,416,000;491.30(2) fiscal year 2009, $5,643,000;491.31(3) fiscal year 2010, $6,677,000; and491.32(4) fiscal year 2011, $7,866,000.492.1Notwithstanding section 13, this rider expires 492.2June 30, 2011.

492.3Subd. 2.Agency Management57,727,00058,161,000

492.4Appropriations by Fund492.5General48,413,00048,882,000492.6492.7State Government Special Revenue424,000432,000492.8Health Care Access8,018,0007,975,000492.9Federal TANF222,000222,000

492.10The amounts that may be spent from the 492.11appropriation for each purpose are as follows:

492.12(a) Financial Operations

492.13Appropriations by Fund492.14General7,102,0007,523,000492.15Health Care Access889,000880,000492.16Federal TANF122,000122,000

492.17(b) Legal and Regulation Operations

492.18Appropriations by Fund492.19General13,037,00013,138,000492.20492.21State Government Special Revenue424,000432,000492.22Health Care Access891,000908,000492.23Federal TANF100,000100,000

492.24Base Adjustment. The general fund base is 492.25decreased by $177,000 in fiscal year 2010 492.26and $353,000 in fiscal year 2011 for legal 492.27and regulatory.492.28Child Care Licensing. $697,000 is 492.29appropriated from the general fund to 492.30the commissioner of human services for 492.31the biennium beginning July 1, 2007, for 492.32purposes of completing background studies 492.33for family and group family child care 492.34providers under Minnesota Statutes, chapter 492.35245C. This appropriation will be $288,000 in 493.1fiscal year 2010 and $112,000 in fiscal year 493.22011.

493.3(c) Management Operations

493.4Appropriations by Fund493.5General4,390,0004,433,000493.6Health Care Access234,000238,000

493.7(d) Information Technology Operations

493.8Appropriations by Fund493.9General23,884,00023,788,000493.10Health Care Access6,004,0005,949,000

493.11493.12Subd. 3.Revenue and Pass-Through Expenditures66,842,00069,723,000

493.13Federal TANF 66,842,00069,723,000

493.14TANF Transfer to Federal Child Care 493.15and Development Fund. The following 493.16TANF fund amounts are appropriated to 493.17the commissioner for the purposes of MFIP 493.18transition year child care under MFIP, 493.19Minnesota Statutes, section 119B.05:493.20(1) fiscal year 2008, $10,333,000493.21(2) fiscal year 2009, $12,826,000493.22(3) fiscal year 2010, $4,104,000 and493.23(4) fiscal year 2011, $5,460,000.493.24The commissioner shall authorize transfer 493.25of sufficient TANF funds to the federal 493.26child care and development fund to meet 493.27this appropriation and shall ensure that all 493.28transferred funds are expended according 493.29the federal child care and development fund 493.30regulations.

493.31493.32Subd. 4.Children and Economic Assistance Grants747,318,000730,623,000

493.33Appropriations by Fund493.34General559,814,000535,898,000494.1Federal TANF187,254,000194,725,000494.2Health Care Access250,000-0-

494.3The amounts that may be spent from this 494.4appropriation for each purpose are as follows:

494.5(a) MFIP/DWP Grants

494.6Appropriations by Fund494.7General62,000,00061,911,000494.8Federal TANF82,532,00090,003,000

494.9(b) Support Services Grants

494.10Appropriations by Fund494.11General8,815,0009,465,000494.12Federal TANF103,382,000103,382,000

494.13TANF Prior Appropriation Cancellation.494.14Notwithstanding Laws 2001, First Special 494.15Session chapter 9, article 17, section 494.162, subdivision 11, paragraph (b), any 494.17unexpended TANF funds appropriated to the 494.18commissioner to contract with the Board of 494.19Trustees of Minnesota State Colleges and 494.20Universities, to provide tuition waivers to 494.21employees of health care and human service 494.22providers that are members of qualifying 494.23consortia operating under Minnesota 494.24Statutes, sections 116L.10 to 116L.15, must 494.25cancel at the end of fiscal year 2007.494.26MFIP Pilot Program. Of the general fund 494.27appropriation, $100,000 in fiscal year 2008 494.28and $750,000 in fiscal year 2009 are for a 494.29grant to the Stearns-Benton Employment and 494.30Training Council for the Workforce U pilot 494.31program.494.32Work Study. $750,000 in fiscal year 494.332008 and $750,000 in fiscal year 2009 are 494.34appropriated from the TANF reserve account 495.1to the Minnesota Office of Higher Education 495.2for work study grants under Minnesota 495.3Statutes, section 136A.233, specifically 495.4for low-income individuals who receive 495.5assistance under Minnesota Statutes, chapter 495.6256J.

495.7(c) MFIP Child Care Assistance Grants

495.8General74,797,00073,699,000

495.9495.10(d) Basic Sliding Fee Child Care Assistance Grants

495.11General43,012,00045,432,000

495.12Base Adjustment. The general fund base 495.13is increased by $1,262,000 in fiscal year 495.142010 and decreased by $951,000 in fiscal 495.15year 2011 for basic sliding fee child care 495.16assistance grants.

495.17(e) Child Care Development Grants

495.18General5,865,0005,865,000

495.19Child Care Services Grants. $5,000,000 495.20is appropriated from the general fund to 495.21the commissioner of human services for 495.22the biennium beginning July 1, 2007, for 495.23purposes of providing child care services 495.24grants under Minnesota Statutes, section 495.25119B.21, subdivision 5. This appropriation 495.26is for the 2008-2009 biennium only, and does 495.27not increase the base funding.495.28Early Childhood Professional 495.29Development System. $2,000,000 is 495.30appropriated from the general fund to 495.31the commissioner of human services for 495.32the biennium beginning July 1, 2007, for 495.33purposes of the early childhood professional 495.34development system, which increases the 496.1quality and continuum of professional 496.2development opportunities for child care 496.3practitioners. This appropriation is for the 496.42008-2009 biennium only, and does not 496.5increase the base funding.496.6Family, Friend, and Neighbor Grant 496.7Program. $750,000 in fiscal year 2008 and 496.8$750,000 in fiscal year 2009 are appropriated 496.9from the general fund to the commissioner 496.10of human services for the family, friend, and 496.11neighbor grant program in article 1, section 496.1294. Any balance in the first year does not 496.13cancel but is available in the second year. 496.14This appropriation is for the 2008-2009 496.15biennium only, and does not increase the 496.16base funding. 496.17(f) Increased Child Care Provider 496.18Connections. (1) $200,000 is appropriated 496.19from the general fund to the commissioner of 496.20human services for the biennium beginning 496.21July 1, 2007, for the following purposes: 496.22$100,000 each year is for a grant to Hennepin 496.23County, and  $100,000 each year is for a grant 496.24to Ramsey County. The two counties shall 496.25each contract with a nonprofit organization 496.26to work with the contracting county 496.27and county-based licensed family child 496.28care providers to facilitate county-based 496.29information regarding family and children's 496.30resources and to make training and peer 496.31support available to licensed family child 496.32care providers consistent with clause (2). 496.33These appropriations are available until 496.34June 30, 2009, and shall not become part 496.35of base-level funding for the biennium 496.36beginning July 1, 2009.497.1(2) Programs to improve child care provider 497.2connections to county services shall be 497.3established in Hennepin and Ramsey 497.4counties to:497.5(i) improve county contact activities 497.6with county-licensed family child care 497.7providers that facilitate utilization of county 497.8educational, social service, public health, 497.9and economic assistance services by eligible 497.10families, parents, and children using licensed 497.11family child care; and497.12(ii) support licensed family child care 497.13providers to qualify as quality-rated child 497.14care providers through peer support and 497.15coaching networks. 497.16Hennepin and Ramsey Counties shall 497.17contract with a nonprofit organization under 497.18clause (1) that utilizes licensed family child 497.19care providers as contacts for families using 497.20licensed family child care and to provide 497.21peer support to licensed family child care 497.22providers.497.23(3) Hennepin and Ramsey Counties must 497.24report back on successful strategies for 497.25increasing contact with county-based 497.26licensed family child care providers and 497.27report their findings to the appropriate 497.28legislative committees by February 15, 2010.497.29Base Adjustment. The general fund base 497.30is $1,515,000 for each of fiscal years 2010 497.31and 2011.

497.32(g) Child Support Enforcement Grants

497.33General9,038,0003,705,000

498.1Child Support Enforcement. $5,333,000 498.2for fiscal year 2008 is to make grants to 498.3counties for child support enforcement 498.4programs to make up for the loss under the 498.52006 federal Deficit Reduction Act of federal 498.6matching funds for federal incentive funds 498.7passed on to the counties by the state.498.8This appropriation is available until spent.

498.9(h) Children's Services Grants

498.10Appropriations by Fund498.11General62,745,00073,133,000498.12Health Care Access250,000-0-

498.13Base Adjustment. The general fund base 498.14is decreased by $673,000 in fiscal year 498.152010 and $670,000 in fiscal year 2011 for 498.16children's services grants.498.17Privatized Adoption Grants. Federal 498.18reimbursement for privatized adoption grant 498.19and foster care recruitment grant expenditures 498.20is appropriated to the commissioner for 498.21adoption grants and foster care and adoption 498.22administrative purposes.498.23Adoption Assistance Incentive Grants.498.24Federal funds available during fiscal year 498.252008 and fiscal year 2009 for the adoption 498.26incentive grants are appropriated to the 498.27commissioner for these purposes.498.28Adoption Assistance and Relative Custody 498.29Assistance. The commissioner may transfer 498.30unencumbered appropriation balances for 498.31adoption assistance and relative custody 498.32assistance between fiscal years and between 498.33programs.499.1Adoption Assistance and Relative 499.2Custody Assistance Subsidy Payment 499.3Increase. Notwithstanding Minnesota 499.4Rules, part 9560.0083, subparts 5 and 6, the 499.5commissioner shall increase the payment 499.6schedules for basic and supplemental 499.7maintenance needs subsidies by 3.95 percent 499.8effective July 1, 2007. The commissioner 499.9may make cost-neutral adjustments between 499.10schedules and between brackets within 499.11schedules to allow for whole-dollar bracket 499.12levels and account for differential cost 499.13increases in caring for children with special 499.14needs. Counties have until December 31, 499.152007, to implement the relative custody 499.16assistance payment increases and shall make 499.17payment adjustments retroactive to July 1, 499.182007.499.19Crisis Nurseries. $1,100,000 in fiscal year 499.202008 and $1,100,000 in fiscal year 2009 are 499.21appropriated from the general fund for the 499.22crisis nurseries program. Of this amount, 499.23$100,000 each year is to be made available 499.24for capacity development and technical 499.25support for crisis nurseries.499.26Respite Care. Of the general fund 499.27appropriation, $1,250,000 in fiscal year 499.282008 and $2,500,000 in fiscal year 2009 are 499.29to the commissioner of human services to 499.30fund respite care for children who have a 499.31diagnosis of emotional disturbance or severe 499.32emotional disturbance.499.33Childhood Trauma; Grants. Of the general 499.34fund appropriation, $125,000 in fiscal year 499.352008 and $250,000 in fiscal year 2009 are 500.1to the commissioner of human services to 500.2make grants for the purpose of maintaining 500.3and expanding evidence-based practices that 500.4support children and youth who have been 500.5exposed to violence or who are refugees.500.6Collaborative Services for High-Risk 500.7Children. Of the general fund appropriation, 500.8$2,632,000 in fiscal year 2008 and 500.9$6,150,000 in fiscal year 2009 are to the 500.10commissioner of human services to fund 500.11early intervention collaborative programs.500.12Evidence-Based Practice. Of the general 500.13fund appropriation, $2,175,000 in fiscal year 500.142008 and $4,350,000 in fiscal year 2009 500.15are to the commissioner of human services 500.16to develop and implement evidence-based 500.17practice in children's mental health care and 500.18treatment.500.19MFIP and Children's Mental Health Pilot 500.20Project. Of the general fund appropriation, 500.21$100,000 in fiscal year 2008 and $200,000 500.22in fiscal year 2009 are to the commissioner 500.23of human services to fund the MFIP and 500.24children's mental health pilot project.500.25Regional Children's Mental Health 500.26Initiative. $700,000 in fiscal year 2008 and 500.27$700,000 in fiscal year 2009 are appropriated 500.28to the commissioner of human services to 500.29fund the Regional Children's Mental Health 500.30Initiative pilot project. This is a onetime 500.31appropriation.500.32Child Safety Efforts. $1,000,000 in fiscal 500.33year 2008 and $1,000,000 in fiscal year 2009 500.34are appropriated to counties based on their 500.35population of residents under age 18. Funds 501.1are to be used to maintain and improve child 501.2safety services. By February 1, 2008, each 501.3county shall submit a report regarding current 501.4child safety efforts, child safety funding, and 501.5unmet needs including investments needed. 501.6The report shall also include methods and 501.7community partners available to ensure 501.8early identification of at-risk families. The 501.9Association of Minnesota Counties and 501.10county agencies shall develop a uniform 501.11report structure so that statewide data can 501.12be easily summarized. This is a onetime 501.13appropriation.501.14Fetal Alcohol Syndrome. Of the general 501.15fund appropriation, $75,000 in fiscal year 501.162008 and $75,000 in fiscal year 2009 are 501.17for three programs that provide services 501.18to reduce fetal alcohol syndrome under 501.19Minnesota Statutes, section 145.9266. The 501.20three program grantees are the University 501.21of Minnesota, the Meeker-McLeod-Sibley 501.22Community, and the American Indian Family 501.23Center. This appropriation shall become part 501.24of the base appropriation.501.25Base Adjustment. The general fund base is 501.26increased by $366,000 in fiscal year 2010 and 501.27$369,000 in fiscal year 2011 for children's 501.28services grants.

501.29(i) Children and Community Services Grants

501.30General108,802,00069,567,000

501.31Base Adjustment. The general fund base is 501.32increased by $99,000 in each of fiscal years 501.332010 and 2011 for children and community 501.34services grants.502.1Targeted Case Management Temporary 502.2Funding. Of the general fund appropriation, 502.3$38,000,000 in fiscal year 2008 is allocated to 502.4counties and tribes affected by reductions in 502.5targeted case management federal Medicaid 502.6revenue as a result of the provisions in 502.7the federal Deficit Reduction Act of 2005, 502.8Public Law 109-171. The commissioner 502.9shall distribute the funds proportionate 502.10to each affected county or tribe's targeted 502.11case management federal earnings for 502.12calendar year 2005. Prior to distribution 502.13of funds, the commissioner shall estimate 502.14and certify the amount by which the federal 502.15regulations will reduce case management 502.16revenue over the 2008-2009 biennium. The 502.17commissioner may provide grants up to the 502.18amount of the estimated reduction, not to 502.19exceed $38,000,000 for the biennium. The 502.20commissioner may determine the timing and 502.21frequency of payments to counties. These 502.22funds are available in either year of the 502.23biennium. Counties shall use these funds to 502.24pay for social service-related costs, but the 502.25funds are not subject to provisions of the 502.26Children and Community Services Act grant 502.27under Minnesota Statutes, chapter 256M.502.28Child Welfare Project. Of the general fund 502.29appropriation, $2,000,000 for the biennium 502.30beginning July 1, 2007, is for expanding 502.31the American Indian chid welfare project 502.32under Minnesota Statutes, section 256.01, 502.33subdivision 14b, to include the Red Lake 502.34Band of Chippewa Indians Tribe, provided 502.35the tribe meets the criteria in Minnesota 502.36Statutes, section 256.01, subdivision 14b.

503.1(j) General Assistance Grants

503.2General37,876,00038,253,000

503.3General Assistance Standard. The 503.4commissioner shall set the monthly standard 503.5of assistance for general assistance units 503.6consisting of an adult recipient who is 503.7childless and unmarried or living apart 503.8from parents or a legal guardian at $203. 503.9The commissioner may reduce this amount 503.10according to Laws 1997, chapter 85, article 503.113, section 54.503.12Emergency General Assistance. The 503.13amount appropriated for emergency general 503.14assistance funds is limited to no more 503.15than $7,889,812 in fiscal year 2008 and 503.16$7,889,812 in fiscal year 2009. Funds 503.17to counties must be allocated by the 503.18commissioner using the allocation method 503.19specified in Minnesota Statutes, section 503.20256D.06.

503.21(k) Minnesota Supplemental Aid Grants

503.22General30,798,00031,439,000

503.23Emergency Minnesota Supplemental 503.24Aid Funds. The amount appropriated for 503.25emergency Minnesota supplemental aid 503.26funds is limited to no more than $1,100,000 503.27in fiscal year 2008 and $1,100,000 in fiscal 503.28year 2009. Funds to counties must be 503.29allocated by the commissioner using the 503.30allocation method specified in Minnesota 503.31Statutes, section 256D.46.

503.32(l) Group Residential Housing Grants

503.33General91,441,00099,304,000

504.1Base Adjustment. The general fund base is 504.2increased by $6,665,000 in fiscal year 2010 504.3and $13,419,000 in fiscal year 2011.504.4People Incorporated. $460,000 in fiscal 504.5year 2008 and $460,000 in fiscal year 2009 504.6are appropriated from the general fund to the 504.7commissioner of human services to augment 504.8community support and mental health 504.9services provided to individuals residing in 504.10facilities under Minnesota Statutes, section 504.11256I.05, subdivision 1h.

504.12504.13(m) Other Children and Economic Assistance Grants

504.14General24,625,00024,125,000

504.15Federal TANF1,340,0001,340,000

504.16Base Adjustment. The general fund base 504.17shall be $20,447,000 in each of fiscal years 504.182010 and 2011.504.19New Chance. $140,000 in fiscal year 504.202008 and $140,000 in fiscal year 2009 are 504.21appropriated from federal TANF funds to the 504.22Hennepin County new chance program.504.23Mothers First. Of the TANF appropriation, 504.24$450,000 in fiscal year 2008 and $450,000 504.25in fiscal year 2009 are to fund the Ramsey 504.26County mothers first program. The 504.27appropriations are available until spent and 504.28are a onetime appropriation.504.29Homeless and Runaway Youth. $3,500,000 504.30in the first year and $3,500,000 in the second 504.31year are for the Runaway and Homeless 504.32Youth Act under Minnesota Statutes, section 504.33256K.45. Funds shall be spent in each area 504.34of the continuum of care to ensure that 505.1programs are meeting the greatest need. The 505.2base is decreased by $2,000,000 each year in 505.3fiscal year 2010 and fiscal year 2011. 505.4Transitional Housing and Emergency 505.5Services.505.6(1) $750,000 each year from the federal 505.7TANF fund is for transitional housing 505.8programs under Minnesota Statutes, section 505.9256E.33. The TANF appropriations 505.10are onetime. The general fund base for 505.11transitional housing is increased by $422,000 505.12each year for the fiscal 2010-2011 biennium. 505.13Up to ten percent of this appropriation may 505.14be used for housing and services which 505.15extend beyond 24 months. $300,000 in each 505.16year of this amount is for grants for safe 505.17housing pilot projects for battered women 505.18and families in Anoka County, Houston 505.19County, and Beltrami County; and505.20(2) $527,000 each year is added to the 505.21base for emergency services grants under 505.22Laws 1997, chapter 162, article 3, section 505.237. The base for emergency services grants 505.24is decreased each year by $300,000 in fiscal 505.25year 2010 and fiscal year 2011.505.26Foodshelf Programs. $575,000 each year 505.27is added to the base for foodshelf programs 505.28under Minnesota Statutes, section 256E.34. 505.29The base is decreased by $250,000 each year 505.30in fiscal year 2010 and fiscal year 2011.505.31Long-term Homeless Services. $2,440,000 505.32each year is added to the base for the 505.33long-term homeless services under 505.34Minnesota Statutes, section 256K.26. The 506.1base is decreased by $1,000,000 each year in 506.2fiscal year 2010 and fiscal year 2011.506.3Minnesota Community Action Grants.506.4$1,500,000 each year is added to the base for 506.5the purposes of Minnesota community action 506.6grants under Minnesota Statutes, sections 506.7256E.30 to 256E.32. The base is reduced by 506.8$500,000 each year in fiscal year 2010 and 506.9fiscal year 2011.506.10Tenant Hotline Services Program. $50,000 506.11each year is added to the base for a grant to 506.12HOME Line for the tenant hotline services 506.13program. This is a onetime appropriation.

506.14506.15Subd. 5.Children and Economic Assistance Management47,035,00046,884,000

506.16Appropriations by Fund506.17General45,492,00045,335,000506.18Health Care Access347,000354,000506.19Federal TANF1,196,0001,196,000

506.20The amounts that may be spent from the 506.21appropriation for each purpose are as follows:

506.22506.23(a) Children and Economic Assistance Administration

506.24Appropriations by Fund506.25General9,725,0009,612,000506.26Federal TANF1,196,0001,196,000

506.27Base Adjustment. The general fund base is 506.28$9,574,000 in each of fiscal years 2010 and 506.292011.

506.30506.31(b) Children and Economic Assistance Operations

506.32Appropriations by Fund506.33General35,767,00035,722,000506.34Health Care Access347,000354,000

507.1Spending Authority for Food Stamps 507.2Bonus Awards. In the event that Minnesota 507.3qualifies for the United States Department 507.4of Agriculture Food and Nutrition Services 507.5Food Stamp Program performance bonus 507.6awards, the funding is appropriated to the 507.7commissioner. The commissioner shall 507.8retain 25 percent of the funding, with the 507.9other 75 percent divided among the counties 507.10according to a formula that takes into account 507.11each county's impact on state performance in 507.12the applicable bonus categories.507.13Child Support Payment Center. Payments 507.14to the commissioner from other governmental 507.15units, private enterprises, and individuals 507.16for services performed by the child support 507.17payment center must be deposited in the state 507.18systems account authorized under Minnesota 507.19Statutes, section 256.014. These payments 507.20are appropriated to the commissioner for the 507.21operation of the child support payment center 507.22or system, according to Minnesota Statutes, 507.23section 256.014.507.24Financial Institution Data Match and 507.25Payment of Fees. The commissioner is 507.26authorized to allocate up to $310,000 each 507.27year in fiscal years 2008 and 2009 from the 507.28PRISM special revenue account to make 507.29payments to financial institutions in exchange 507.30for performing data matches between account 507.31information held by financial institutions 507.32and the public authority's database of child 507.33support obligors as authorized by Minnesota 507.34Statutes, section 13B.06, subdivision 7.508.1Base Adjustment. The general fund base is 508.2decreased by $22,000 in each of fiscal years 508.32010 and 2011.

508.4Subd. 6.Basic Health Care Grants2,397,260,0002,739,194,000

508.5Appropriations by Fund508.6General2,019,435,0002,246,743,000508.7Health Care Access377,825,000492,451,000

508.8The amounts that may be spent from the 508.9appropriation for each purpose are as follows:

508.10(a) MinnesotaCare Grants

508.11Health Care Access376,938,000459,891,000

508.12MinnesotaCare Federal Receipts. Receipts 508.13received as a result of federal participation 508.14in administering costs of the Minnesota 508.15health care reform waiver must be deposited 508.16as nondedicated revenue in the health care 508.17access fund. Receipts received as a result of 508.18federal participation in making grants must 508.19be deposited in the federal fund and must 508.20offset health care access funds for payments 508.21to providers.508.22MinnesotaCare Funding. The 508.23commissioner may expend money 508.24appropriated from the health care access fund 508.25for MinnesotaCare in either fiscal year of the 508.26biennium.508.27HealthMatch Delay. Of this appropriation, 508.28$2,560,000 in fiscal year 2008 and 508.29$29,647,000 in fiscal year 2009 are for 508.30MinnesotaCare program costs related to 508.31implementation of the HealthMatch program.

508.32508.33(b) MA Basic Health Care - Families and Children

509.1Appropriations by Fund509.2General758,212,000847,163,000509.3Health Care Access-0-31,661,000

509.4509.5(c) MA Basic Health Care - Elderly and Disabled

509.6General1,019,297,0001,145,789,000

509.7Provider-Directed Care Coordination. In 509.8addition to medical assistance reimbursement 509.9under Minnesota Statutes, sections 509.10256B.0625 and 256B.76, clinics participating 509.11in provider-directed care coordination under 509.12Minnesota Statutes, section 256B.0625, also 509.13receive a monthly payment per client when 509.14the clinic serves an eligible client. The 509.15payments across the program must average 509.16$50 per month per client.509.17Services for Developmentally Disabled.509.18The commissioner must serve: an additional 509.19200 persons in the MR/RC waiver program; 509.20an additional 200 persons in the family 509.21support grant program under Minnesota 509.22Statutes, section 252.32; and an additional 509.23200 persons in the semi-independent living 509.24services program under Minnesota Statutes, 509.25section 252.275.509.26County CADI allocation adjustment. (1) 509.27The commissioner shall adjust 2007 home 509.28and community-based allocations under 509.29section 256B.49 to qualifying counties 509.30that transferred persons to the community 509.31alternatives for disabled individuals 509.32(CADI) waiver program under Laws 2006, 509.33chapter 282, article 20, section 35. The 509.34adjustment shall reflect the amount that 509.35county-authorized funding for CADI waiver 510.1services exceeded the allowable amount 510.2as shown in the Medicaid Management 510.3Information System (MMIS) on March 1, 510.42007.510.5(2) A county that may qualify under 510.6paragraph (1) shall apply to the commissioner 510.7by June 10, 2007. Following a review of the 510.8county request and the MMIS documentation, 510.9the commissioner shall adjust the county 510.10allocation, as appropriate, by June 25, 2007.510.11(3) The amounts provided to a county under 510.12this section shall become part of the county's 510.13base level state allocation for the CADI 510.14waiver for the biennium beginning July 1, 510.152007.510.16(4) This rider is effective the day following 510.17final enactment.

510.18(d) General Assistance Medical Care Grants

510.19General238,887,000251,082,000

510.20(e) Other Health Care Grants

510.21General3,039,0002,709,000510.22Health Care Access887,000899,000

510.23Care Coordination. Of the general fund 510.24appropriation, $500,000 in fiscal year 2008 510.25and $1,000,000 in fiscal year 2009 are for 510.26the commissioner of human services for 510.27contracting for care coordination with the 510.28U special kids program under Minnesota 510.29Statutes, section 256B.0751.510.30Community-Based Health Care. Of the 510.31general fund appropriation, $1,050,000 510.32for the biennium beginning July 1, 2007, 510.33is to the commissioner of human services 510.34for the demonstration project grant 511.1described in Minnesota Statutes, section 511.262Q.80, subdivision 1a. This is a onetime 511.3appropriation and is available until June 30, 511.42012.511.5Health Care Payment Reform Pilot. Of 511.6the general fund appropriation, $1,018,000 511.7in fiscal year 2008 and $1,027,000 in fiscal 511.8year 2009 are for the health care payment 511.9reform pilot project. These are onetime 511.10appropriations.511.11Patient Incentive Programs. Of the general 511.12fund appropriation, $500,000 in fiscal year 511.132008 and $500,000 in fiscal year 2009 are 511.14for patient incentive programs.511.15State Health Policies Grant. Of the general 511.16fund appropriation, $300,000 in fiscal year 511.172008 is to provide a grant to a research center 511.18associated with a safety net hospital and 511.19county-affiliated health system to develop 511.20the capabilities necessary for evaluating the 511.21effects of changes in state health policies 511.22on low-income and uninsured individuals, 511.23including the impact on state health care 511.24program costs, health outcomes, cost-shifting 511.25to different units and levels of government, 511.26and utilization patterns including use of 511.27emergency room care and hospitalization 511.28rates.511.29Neighborhood Health Care Network. Of 511.30the general fund appropriation, $150,000 in 511.31fiscal year 2008 and $150,000 in fiscal year 511.322009 are for a grant to the Neighborhood 511.33Health Care Network to maintain and staff a 511.34toll-free health care access telephone number.

511.35Subd. 7.Health Care Management54,536,00058,696,000

512.1Appropriations by Fund512.2General32,416,00030,571,000512.3Health Care Access22,120,00028,125,000

512.4The amounts that may be spent from the 512.5appropriation for each purpose are as follows:

512.6(a) Health Care Policy Administration

512.7Appropriations by Fund512.8General10,236,0008,813,000512.9Health Care Access2,323,00010,074,000

512.10Minnesota Senior Health Options 512.11Reimbursement. Federal administrative 512.12reimbursement resulting from the Minnesota 512.13senior health options project is appropriated 512.14to the commissioner for this activity.512.15Utilization Review. Federal administrative 512.16reimbursement resulting from prior 512.17authorization and inpatient admission 512.18certification by a professional review 512.19organization is dedicated to the commissioner 512.20for these purposes. A portion of these funds 512.21must be used for activities to decrease 512.22unnecessary pharmaceutical costs in medical 512.23assistance.512.24Dental Access for Persons with Disabilities.512.25Of the general fund appropriation, $82,000 512.26in fiscal year 2008 is for a study on access to 512.27dental services for persons with disabilities.512.28Base Adjustment. The health care access 512.29fund base is $10,716,000 in fiscal year 2010 512.30and $8,870,000 in fiscal year 2011, for health 512.31care administration.

512.32(b) Health Care Operations

513.1Appropriations by Fund513.2General22,180,00021,758,000513.3Health Care Access19,797,00018,051,000

513.4Base Adjustment. The general fund base is 513.5decreased by $214,000 in fiscal year 2010 513.6for health care operations.

513.7Subd. 8.Continuing Care Grants1,699,359,0001,858,283,000

513.8Appropriations by Fund513.9General1,696,876,0001,855,900,000513.10Health Care Access750,000750,000513.11Lottery Prize1,733,0001,633,000

513.12The amounts that may be spent from the 513.13appropriation for each purpose are as follows: 

513.14(a) Aging and Adult Services Grants

513.15General15,986,00016,605,000

513.16Information and Assistance 513.17Reimbursement. Federal administrative 513.18reimbursement obtained from information 513.19and assistance services provided by the 513.20Senior LinkAge Line to people who are 513.21identified as eligible for medical assistance 513.22are appropriated to the commissioner for this 513.23activity.513.24Senior Companion Program. Of the 513.25general fund appropriation, $191,000 in 513.26fiscal year 2008 and $191,000 in fiscal year 513.272009 are for the senior companion program 513.28under Minnesota Statutes, section 256.977.513.29Volunteer Senior Citizens. Of the general 513.30fund appropriation, $192,000 in fiscal year 513.312008 and $192,000 in fiscal year 2009 are 513.32for the volunteer programs for retired senior 513.33citizens under Minnesota Statutes, section 513.34256.9753.514.1Foster Grandparent Program. Of the 514.2general fund appropriation, $192,000 in 514.3fiscal year 2008 and $192,000 in fiscal year 514.42009 are for the foster grandparent program 514.5in Minnesota Statutes, section 256.976.514.6Senior Nutrition. Of the general fund 514.7appropriation, $250,000 in fiscal year 514.82008 and $250,000 in fiscal year 2009 are 514.9for the senior nutrition programs under 514.10Minnesota Statutes, section 256.9752. 514.11The commissioner shall give priority to 514.12increase services to: (1) persons facing 514.13language or cultural barriers, (2) persons with 514.14special diets, (3) persons living in isolated 514.15rural areas, and (4) other hard-to-serve 514.16populations.514.17Living At Home/Block Nurse Program. Of 514.18the general fund appropriation, $580,000 in 514.19fiscal year 2008 and $655,000 in fiscal year 514.202009 are for the living at home/block nurse 514.21program. The purpose of the appropriation is 514.22to increase base funding levels to $25,000 514.23per program year, provide base funding for 514.24nine programs currently operating without 514.25base funding, provide base funding for five 514.26new programs beginning July 1, 2007, and 514.27provide base funding for six additional 514.28programs beginning July 1, 2008.514.29$76,000 in fiscal year 2008 and $62,000 in 514.30fiscal year 2009 are for increased staff for 514.31the ombudsman for older Minnesotans and 514.32related costs.514.33$150,000 in fiscal year 2008 and $150,000 in 514.34fiscal year 2009 are to increase the base of 514.35the Senior LinkAge line program.515.1Minnesota Kinship Caregivers 515.2Association. (1) Of the general fund 515.3appropriation, $175,000 in fiscal year 515.42008 and $175,000 in fiscal year 2009 515.5are transferred to a nonprofit organization 515.6experienced in kinship caregiver programs, 515.7with at least 50 percent of its board 515.8composed of kinship caregivers for purposes 515.9of providing support to grandparents or 515.10relatives who are raising kinship children. 515.11(2) The demonstration grant sites must 515.12include the Minnesota Kinship Caregivers 515.13Association central site in the metropolitan 515.14area and another site in the Bemidji region. 515.15The support must provide a one-stop services 515.16program. The services that may be provided 515.17include but are not limited to legal services, 515.18education, information, family activities, 515.19support groups, mental health access, 515.20advocacy, mentors, and information related 515.21to foster care licensing. The funds may also 515.22be used for a media campaign to inform 515.23kinship families about available information 515.24and services, support sites, and other program 515.25development. The general fund base for the 515.26program shall be $160,000 in fiscal year 515.272010 and $160,000 in fiscal year 2011.515.28Base Adjustment. The general fund base 515.29is increased by $72,000 in fiscal year 2010 515.30and $72,000 in fiscal year 2011 for aging and 515.31adult services grants.

515.32(b) Alternative Care Grants

515.33General50,063,00052,511,000

515.34Alternative Care Transfer. Any money 515.35allocated to the alternative care program that 516.1is not spent for the purposes indicated does 516.2not cancel but is transferred to the medical 516.3assistance account.516.4Base Adjustment. The general fund base is 516.5increased by $547,000 in fiscal year 2010 and 516.6$784,000 in fiscal year 2011 for alternative 516.7care grants.

516.8516.9(c) Medical Assistance Grants - Long-Term Care Facilities

516.10General501,278,000513,016,000

516.11New Nursing Facility Reimbursement 516.12System Delay. Notwithstanding Minnesota 516.13Statutes, section 256B.441, subdivision 1, 516.14paragraph (c), the commissioner shall begin 516.15to phase in the new reimbursement system 516.16for nursing facilities on or after October 1, 516.172009.516.18Long-Term Care Consultation Funding 516.19Increase. For the rate year beginning 516.20October 1, 2008, the county long-term 516.21care consultation allocations in Minnesota 516.22Statutes, section 256B.0911, subdivision 516.236, must be increased based on the number 516.24of transitional long-term care consultation 516.25visits projected by the commissioner in 516.26each county. For the rate year beginning 516.27October 1, 2009, final allocations must be 516.28determined based on the average between 516.29the actual number of transitional long-term 516.30care visits that were conducted in the prior 516.3112-month period and the projected number 516.32of consultations that will be provided in 516.33the rate year beginning October 1, 2009. 516.34Notwithstanding section 13, this rider expires 516.35June 30, 2010.517.1Life Safety Code Compliance. (1) Of the 517.2general fund appropriation, $1,000,000 in 517.3fiscal year 2008 is for payments to nursing 517.4facilities for life safety code compliance 517.5under Minnesota Statutes, section 256B.434, 517.6subdivision 4, paragraph (e). This is a 517.7onetime appropriation and available until 517.8spent.517.9(2) Of the general fund appropriation, 517.10$2,000,000 for the biennium beginning July 517.111, 2007, is for nursing facility rate adjustment 517.12assistance grants for the commissioner of 517.13human services to provide rate adjustment 517.14to nursing facilities in a financial danger of 517.15closing. This is a onetime appropriation and 517.16shall not become part of the agency base.

517.17517.18(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

517.19General966,623,0001,099,540,000

517.20(e) Mental Health Grants

517.21Appropriations by Fund517.22General57,522,00060,678,000517.23Health Care Access750,000750,000517.24Lottery Prize1,733,0001,633,000

517.25Dual Diagnosis; Demonstration Project.517.26Of the general fund appropriation, $800,000 517.27in fiscal year 2008 and $1,600,000 in fiscal 517.28year 2009 are to the commissioner of 517.29human services to fund the dual diagnosis 517.30demonstration project.517.31Mobile Mental Health Crisis Services. Of 517.32the general fund appropriation, $2,500,000 517.33in fiscal year 2008 and $3,625,000 in fiscal 517.34year 2009 are to the commissioner of human 517.35services for statewide funding of adult mobile 518.1mental health crisis services. Providers must 518.2utilize all available funding streams.518.3National Council on Problem Gambling.518.4(1) $225,000 in fiscal year 2008 and $225,000 518.5in fiscal year 2009 are appropriated from 518.6the lottery prize fund to the commissioner 518.7of human services for a grant to the state 518.8affiliate recognized by the National Council 518.9on Problem Gambling. The affiliate must 518.10provide services to increase public awareness 518.11of problem gambling, education, and training 518.12for individuals and organizations providing 518.13effective treatment services to problem 518.14gamblers and their families, and research 518.15relating to problem gambling. These 518.16services must be complementary to and not 518.17duplicative of the services provided through 518.18the problem gambling program administered 518.19by the commissioner of human services. This 518.20grant does not prevent the commissioner 518.21from regular monitoring and oversight of the 518.22grant or the ability to reallocate the funds to 518.23other services within the problem gambling 518.24program for nonperformance of duties by 518.25the grantee.518.26(2) Of this appropriation, $100,000 in 518.27fiscal year 2008 and $100,000 in fiscal year 518.282009 are contingent on the contribution 518.29of nonstate matching funds. Matching 518.30funds may be either cash or qualifying 518.31in-kind contributions. The commissioner of 518.32finance may disburse the state portion of the 518.33matching funds in increments of $25,000 518.34upon receipt of a commitment for an equal 518.35amount of matching nonstate funds. The 519.1general fund base shall be $100,000 in fiscal 519.2year 2010 and $100,000 in fiscal year 2011519.3(3) $100,000 in fiscal year 2008 is 519.4appropriated from the lottery prize fund to 519.5the commissioner of human services for a 519.6grant or grants to be awarded competitively 519.7to develop programs and services for 519.8problem gambling treatment, prevention, 519.9and education in immigrant communities. 519.10This appropriation is available until June 519.1130, 2009, at which time the project must 519.12be completed and final products delivered, 519.13unless an earlier completion date is specified 519.14in the work program.519.15Compulsive Gambling. $300,000 in fiscal 519.16year 2008 and $100,000 in fiscal year 2009 519.17are appropriated from the lottery prize fund 519.18to the commissioner of human services for 519.19purposes of compulsive gambling education, 519.20assessment, and treatment under Minnesota 519.21Statutes, section 245.98.519.22Compulsive Gambling Study. $100,000 519.23in fiscal year 2008 is to continue the 519.24study currently being done on compulsive 519.25gambling treatment effectiveness and 519.26long-term effects of gambling.519.27Base Adjustment. The general fund base is 519.28increased by $266,000 in fiscal year 2010.

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

519.30General1,932,0002,380,000

519.31Hearing Loss Mentors. Of the general fund 519.32appropriation, $80,000 is to provide mentors 519.33who have a hearing loss to parents of newly 520.1identified infants and children with hearing 520.2loss.520.3Base Adjustment. The general fund base 520.4is increased by $7,000 in fiscal year 2010 520.5and $7,000 in fiscal year 2011 for deaf and 520.6hard-of-hearing grants.

520.7(g) Chemical Dependency Entitlement Grants

520.8General78,749,00089,946,000

520.9520.10(h) Chemical Dependency Nonentitlement Grants

520.11General1,055,0001,055,000

520.12(i) Other Continuing Care Grants

520.13Appropriations by Fund520.14General23,668,00020,169,000

520.15Native American Juvenile Treatment 520.16Center. Of the general fund appropriation, 520.17$50,000 is to conduct a feasibility study 520.18of and to predesign a Native American 520.19juvenile treatment center on or near the 520.20White Earth Reservation. The facility must 520.21house and treat Native American juveniles 520.22and provide culturally specific programming 520.23to juveniles placed in the treatment center. 520.24The commissioner of human services may 520.25contract with parties who have experience 520.26in the design and construction of juvenile 520.27treatment centers to assist in the feasibility 520.28study and predesign. On or before January 520.2915, 2008, the commissioner shall present 520.30the results of the feasibility study and the 520.31predesign of the facility to the chairs of house 520.32of representatives and senate committees 520.33having jurisdiction over human services 521.1finance, public safety finance, and capital 521.2investment.521.3Leech Lake Youth Treatment Center. Of 521.4the general fund appropriation, $75,000 in 521.5fiscal year 2008 and $75,000 in fiscal year 521.62009 are for a grant to the Leech Lake Youth 521.7Treatment Center project partners, in order 521.8to pay the salaries and other directly related 521.9costs associated with the development of this 521.10project.521.11Assistive Technology. Of the general fund 521.12appropriation, $300,000 in fiscal year 2008 is 521.13to the Minnesota State Council on Disability 521.14for the purposes of providing $100,000 521.15in financial support to the Minnesota 521.16Regions Assistive Technology Collaborative 521.17and $200,000 in fiscal year 2008 is for 521.18a local match required to access the 521.19federal Technology-Related Assistance for 521.20Individuals with Disabilities Act, alternate 521.21finance project.521.22Repayment. For the fiscal year ending June 521.2330, 2008, $5,287,000 is appropriated to the 521.24commissioner of human services to repay 521.25the amount of overspending in the waiver 521.26program for persons with developmental 521.27disabilities incurred by affected counties in 521.28calendar years 2004 and 2005.521.29Base Adjustment. The general fund base 521.30is $20,276,000 in fiscal year 2010 and 521.31$20,332,000 in fiscal year 2011 for other 521.32continuing care grants.

521.33Subd. 9.Continuing Care Management20,248,00019,400,000

522.1Appropriations by Fund522.2General19,384,00019,123,000522.3522.4State Government Special Revenue121,000123,000522.5Health Care Access292,000-0-522.6Lottery Prize451,000154,000

522.7Community Trainee and Consultation.522.8Of the general fund appropriation, $125,000 522.9in fiscal year 2008 is to the commissioner 522.10of human services to contract for training 522.11and consultation for clinical supervisors and 522.12staff of community mental health centers 522.13who provide services to children and adults. 522.14The purpose of the training and consultation 522.15is to improve clinical supervision of 522.16staff, strengthen compliance with federal 522.17and state rules and regulations, and to 522.18recommend strategies for standardization and 522.19simplification of administrative functions 522.20among community mental health centers.522.21Mental Health Tracking System. Of the 522.22general fund appropriation, $448,000 in fiscal 522.23year 2008 and $324,000 in fiscal year 2009 522.24are to the commissioner of human services 522.25to fund implementation of the mental health 522.26services outcomes and tracking system.522.27Quality Management; Assurance; and 522.28Improvement System for Minnesotans 522.29Receiving Disability Services. Of the 522.30general fund appropriation, up to $300,000 522.31for the biennium beginning July 1, 2007, 522.32may be used for the purposes of the quality 522.33management, assurance, and improvement 522.34system for Minnesotans receiving disability 522.35services. Federal Medicaid matching funds 523.1obtained for this purpose shall be dedicated 523.2to the commissioner for this purpose.523.3Base Adjustment. The health care access 523.4fund base is $0 in each of the fiscal years 2010 523.5and 2011 for continuing care management.523.6Disability Linkage Line. Of the general 523.7fund appropriation, $650,000 in fiscal year 523.82008 and $626,000 in fiscal year 2009 are to 523.9establish and maintain the disability linkage 523.10line.

523.11Subd. 10.State-Operated Services266,645,000267,718,000

523.12General266,645,000267,718,000

523.13Remembering With Dignity Project. (1) 523.14$200,000 is appropriated from the general 523.15fund to the commissioner of human services 523.16to be available until September 30, 2008, to 523.17make a grant to Advocating Change Together 523.18for the purposes of the Remembering With 523.19Dignity project in paragraph (2).523.20(2) As part of the Remembering With Dignity 523.21project, the grant recipient shall:523.22(i) conduct necessary research on persons 523.23buried in state cemeteries who were residents 523.24of state hospitals or regional treatment 523.25centers and buried in numbered or unmarked 523.26graves;523.27(ii) purchase and install headstones that are 523.28properly inscribed with their names on the 523.29graves of those persons; and523.30(iii) collaborate with community groups 523.31and state and local government agencies to 523.32build community involvement and public 523.33awareness, ensure public access to the 524.1graves, and ensure appropriate perpetual 524.2maintenance of state cemeteries.524.3(3) This rider is effective the day following 524.4final enactment.524.5Transfer Authority Related to 524.6State-Operated Services. Money 524.7appropriated to finance state-operated 524.8services programs and administrative 524.9services may be transferred between fiscal 524.10years of the biennium with the approval of 524.11the commissioner of finance.524.12The amounts that may be spent from the 524.13appropriation for each purpose are as follows:

524.14(a) Mental Health Services

524.15General116,270,000120,095,000

524.16Appropriation Limitation. No part of 524.17the appropriation in this article to the 524.18commissioner for mental health treatment 524.19services at the regional treatment centers 524.20shall be used for the Minnesota sex offender 524.21program.

524.22(b) Minnesota Sex Offender Services

524.23General67,719,00062,787,000

524.24524.25(c) Minnesota Security Hospital and METO Services

524.26General82,656,00084,836,000

524.27Minnesota Security Hospital. For the 524.28purposes of enhancing the safety of 524.29the public, improving supervision, and 524.30enhancing community-based mental health 524.31treatment, state-operated services may 524.32establish additional community capacity 524.33for providing treatment and supervision 525.1of clients who have been ordered into a 525.2less restrictive alternative care from the 525.3state-operated services transitional services 525.4program consistent with Minnesota Statutes, 525.5section 246.014.

525.6Sec. 4. COMMISSIONER OF HEALTH

525.7Subdivision 1.Total Appropriation$176,686,000$165,689,000

525.8Appropriations by Fund525.920082009525.10General98,737,00092,829,000525.11525.12State Government Special Revenue39,851,00040,642,000525.13Health Care Access26,448,00019,918,000525.14Federal TANF11,350,00012,000,000525.15Environment300,000300,000

525.16525.17Subd. 2.Community and Family Health Promotion

525.18Appropriations by Fund525.19General59,881,00059,978,000525.20525.21State Government Special Revenue468,000471,000525.22Health Care Access3,539,0003,562,000525.23Federal TANF8,667,0009,002,000

525.24TANF Appropriations. (a) $3,579,000 of 525.25the TANF funds is appropriated in each year 525.26of the biennium to the commissioner for 525.27home visiting and nutritional services listed 525.28under Minnesota Statutes, section 145.882, 525.29subdivision 7, clauses (6) and (7). Funding 525.30shall be distributed to community health 525.31boards based on Minnesota Statutes, section 525.32145A.131, subdivision 1.525.33(b) $5,088,000 in the first year and $5,423,000 525.34in the second year are appropriated to the 525.35commissioner of health for the family home 525.36visiting grant program. The commissioner 525.37shall distribute funds to community health 526.1boards using a formula developed in 526.2conjunction with the state Community 526.3Health Services Advisory Committee. The 526.4commissioner may use five percent of the 526.5funds appropriated in each fiscal year to 526.6conduct the ongoing evaluations required 526.7under Minnesota Statutes, section 145A.17, 526.8subdivision 7, and may use ten percent of 526.9the funds appropriated each fiscal year to 526.10provide training and technical assistance as 526.11required under Minnesota Statutes, section 526.12145A.17, subdivisions 4 and 5.526.13TANF Carryforward. Any unexpended 526.14balance of the TANF appropriation in the 526.15first year of the biennium does not cancel but 526.16is available for the second year.526.17Loan Forgiveness. $605,000 the first year 526.18and $775,000 the second year and thereafter 526.19are for the loan forgiveness program under 526.20Minnesota Statutes, section 144.1501. This 526.21funding is in addition to the loan forgiveness 526.22program base.526.23MN ENABL. Base level funding for the MN 526.24ENABL program, under Minnesota Statutes, 526.25section 145.9255, is reduced by $220,000 526.26each year of the biennium beginning July 1, 526.272007.526.28Fetal Alcohol Spectrum Disorder. (a) 526.29$900,000 each year is added to the base for 526.30fetal alcohol spectrum disorder. On July 1 526.31each fiscal year, the portion of the general 526.32fund appropriation to the commissioner of 526.33health for fetal alcohol spectrum disorder 526.34administration and grants shall be transferred 526.35to a statewide organization that focuses 527.1solely on prevention of and intervention with 527.2fetal alcohol spectrum disorder as follows:527.3(1) on July 1, 2007, $2,090,000; and527.4(2) on July 2, 2008, and annually thereafter, 527.5$2,090,000.527.6(b) The money shall be used for prevention 527.7and intervention services and programs, 527.8including, but not limited to, community 527.9grants, professional education, public 527.10awareness, and diagnosis. The organization 527.11may retain $60,000 of the transferred money 527.12for administrative costs. The organization 527.13shall report to the commissioner annually 527.14by January 15 on the services and programs 527.15funded by the appropriation.527.16Deaf or Hearing Loss Support. $100,000 527.17for the first year and $100,000 for the second 527.18year is for the purpose of providing family 527.19support and assistance to families with 527.20children who are deaf or have a hearing 527.21loss. The family support provided must 527.22include direct parent-to-parent assistance and 527.23information on communication, educational, 527.24and medical options. The commissioner 527.25may contract with a nonprofit organization 527.26that has the ability to provide these services 527.27throughout the state.527.28Heart Disease and Stroke Prevention.527.29$200,000 is appropriated in the first year for 527.30the heart disease and stroke prevention unit 527.31of the Department of Health to fund data 527.32collection and other activities to improve 527.33cardiovascular health and reduce the burden 527.34of heart disease and stroke in Minnesota. 527.35This is a onetime appropriation.528.1Family Planning Grants. $1,000,000 each 528.2year is for family planning grants under 528.3Minnesota Statutes, section 145.925. This 528.4funding is in addition to the family planning 528.5grants base funding.528.6Bright Smiles Pilot Project. (a) $384,000 528.7in the first year and $50,000 in the second 528.8year is to fund a grant for the Bright Smiles 528.9pilot project.528.10(b) Of these amounts, $50,000 each year is to 528.11fund a dental health coordinator position at 528.12the Minnesota Department of Health.528.13(c) The commissioner of health shall 528.14establish a pilot project to fund a Bright 528.15Smiles program designed to increase access 528.16to oral health care for low-income and 528.17immigrant children, ages birth to five 528.18years, and their families and to build the 528.19knowledge and ability of parents to care 528.20for the oral health of their children. Under 528.21this pilot project, a Bright Smiles program 528.22shall serve the medically underserved areas 528.23in Minneapolis and the Bemidji area, as 528.24determined by the commissioner of health.528.25(d) A grant shall be used to fund costs related 528.26to improving oral health outreach, education, 528.27screening, and access to care for families 528.28with children, ages birth to five years.528.29(e) Grant applicants shall submit to 528.30the commissioner a written plan that 528.31demonstrates the ability to provide the 528.32following:528.33(1) new programs or continued expansion 528.34of current access programs that have 528.35demonstrated success in providing dental 529.1services in underserved areas of Minneapolis 529.2and the Bemidji area;529.3(2) programs for screening children entering 529.4the Minneapolis and the Bemidji area public 529.5school systems and facilitating access to care 529.6for their families;529.7(3) programs testing new models of care 529.8that are sensitive to cultural needs of the 529.9recipients;529.10(4) programs creating new educational 529.11campaigns that inform individuals of the 529.12importance of good oral health and the 529.13link between dental diseases, overall health 529.14status, and success in school; and529.15(5) programs testing new delivery models 529.16by creating partnerships between local early 529.17childhood and school-age education and 529.18community clinic dental providers.529.19(f) Qualified applicants are partnerships 529.20among early childhood experts, Minneapolis 529.21or Bemidji area public schools, and nonprofit 529.22clinics that are established to provide health 529.23services to low-income patients, provide 529.24preventive and dental care services, and 529.25utilize a sliding-scale fee or other method of 529.26providing charity care that ensures that no 529.27person is denied services because of inability 529.28to pay.529.29(g) Applicants shall submit to the 529.30commissioner an application and supporting 529.31documentation, in the form and manner 529.32specified by the commissioner. Applicants 529.33must be able to provide culturally appropriate 529.34outreach, screenings, and access to dental 529.35care for children, ages birth to five years, 530.1their parents, and pregnant women most at 530.2risk of poor oral health due to lack of access 530.3to dental care. Applicants must also meet the 530.4following criteria:530.5(1) have the potential to successfully increase 530.6access to families with children, ages birth 530.7to five years;530.8(2) incorporate quality program evaluation;530.9(3) maximize use of grant funds; and530.10(4) have experience in providing services to 530.11the target populations of this program.530.12(h) The commissioner shall evaluate the 530.13effectiveness of this pilot program on the 530.14oral health of children and their families and 530.15report to the house of representatives and 530.16senate committees with jurisdiction over 530.17public health policy and finance by January 530.181, 2009, with recommendations as to how to 530.19develop programs throughout Minnesota that 530.20provide education and access to oral health 530.21care for low-income and immigrant children.530.22Suicide prevention programs. $600,000 530.23each year is to fund the suicide prevention 530.24program. The base for fiscal years 2010 and 530.252011 is reduced by $300,000.530.26Hearing Aid Loan Bank. Of the general 530.27fund appropriation, $70,000 in fiscal year 530.282008 and $70,000 in fiscal year 2009 are 530.29for the purpose of providing a statewide 530.30hearing aid and instrument loan bank to 530.31families with children newly diagnosed with 530.32hearing loss from birth to the age of ten. This 530.33appropriation shall cover the administrative 530.34costs of the program.531.1Medical Home Learning Collaborative.531.2Of the general fund appropriation, $500,000 531.3in fiscal year 2008 and $500,000 in fiscal 531.4year 2009 are to expand the medical 531.5home learning collaborative initiative in 531.6collaboration with the commissioner of 531.7human services. Services provided under this 531.8funding must support a medical home model 531.9for children with special health care needs. 531.10The collaborative shall report back to the 531.11legislature on use of the funds by January 15, 531.122010. This appropriation shall not become 531.13part of the base funding for the 2010-2011 531.14biennium.531.15Community Collaboratives. Of the general 531.16fund appropriation, $330,000 in fiscal year 531.172008 and $850,000 in fiscal year 2009 are to 531.18provide grants to community collaboratives 531.19to cover the uninsured. These are onetime 531.20appropriations.531.21Base Adjustment. General fund base is 531.22$46,143,000 in each of fiscal years 2010 and 531.232011.

531.24Subd. 3.Policy, Quality, and Compliance51,209,00045,590,000

531.25Appropriations by Fund531.26General14,897,00015,737,000531.27531.28State Government Special Revenue13,403,00013,497,000531.29Health Care Access22,909,00016,356,000

531.30Health Care Access Survey. Of the 531.31health care access fund appropriation, 531.32$600,000 in fiscal year 2008 is appropriated 531.33to the commissioner to conduct a health 531.34insurance survey of Minnesota households, 531.35in partnership with the State Health Access 531.36Data Assistance Center at the University 532.1of Minnesota. The commissioner shall 532.2contract with the State Health Access Data 532.3Assistance Center to conduct a survey that 532.4provides information on the characteristics 532.5of the uninsured in Minnesota and the 532.6reasons for changing patterns of insurance 532.7coverage and access to health care services. 532.8This appropriation shall become part of the 532.9agency's base budget for even-numbered 532.10fiscal years.532.11MERC. Of the general fund appropriation, 532.12$8,000,000 each fiscal year is for distribution 532.13of MERC grants as follows:532.14(1) $5,000,000 according to Minnesota 532.15Statutes, section 62J.692, subdivision 4, 532.16paragraph (c);532.17(2) $900,000 according to Minnesota 532.18Statutes, section 62J.692, subdivision 4, 532.19paragraph (d);532.20(3) $100,000 according to Minnesota 532.21Statutes, section 62J.692, subdivision 4, 532.22paragraph (e); and532.23(4) $2,000,000 according to Minnesota 532.24Statutes, section 62J.692, subdivision 7a, 532.25paragraph (b).532.26Health Information Technology. Of 532.27the health care access fund appropriation, 532.28$6,750,000 each fiscal year is to implement 532.29Minnesota Statutes, section 144.3345. Up 532.30to $350,000 each fiscal year is available for 532.31grant administration and health information 532.32technology technical assistance and 532.33$6,400,000 each year is to be transferred 532.34to the commissioner of finance to establish 532.35and implement a revolving account under 533.1Minnesota Statutes, section 62J.496. This 533.2appropriation shall not be included in the 533.3agency's base budget for the fiscal year 533.4beginning July 1, 2009.533.5Health Insurance Exchange. Of the health 533.6care access fund appropriation, $6,000,000 533.7in fiscal year 2008 is appropriated to 533.8the commissioner to establish the health 533.9insurance exchange in Minnesota Statutes, 533.10section 62A.76. Up to $50,000 in fiscal year 533.112008 is available for administrative costs 533.12incurred by the Department of Health in 533.13establishing and providing grant funding to 533.14the legal entity responsible for implementing 533.15the health insurance exchange. This is a 533.16onetime appropriation.533.17Uncompensated Care Fund. Of the general 533.18fund appropriation, $65,000 in fiscal year 533.192008 is for the commissioner of health to 533.20study and present recommendations to the 533.21governor and the legislature by January 533.2215, 2008, on the design, operation, and 533.23funding of an uncompensated care fund to 533.24be used to provide subsidies to hospitals, 533.25community clinics, federally qualified health 533.26centers, community mental health centers, 533.27and other health care providers that serve 533.28a disproportionately large percentage of 533.29uninsured patients. An organization must not 533.30provide or perform abortion services under 533.31this program.533.32Uniform Electronic Transactions. Of the 533.33general fund appropriation, $146,000 in fiscal 533.34year 2008 is for development of uniform 533.35electronic transactions and implementation 534.1guide standards under Minnesota Statutes, 534.2section 62J.536.534.3Federally Qualified Health Centers. Of the 534.4general fund appropriation, $3,000,000 in 534.5fiscal year 2008 and $3,900,000 in fiscal year 534.62009 are for subsidies to federally qualified 534.7health centers under Minnesota Statutes, 534.8section 145.9269.534.9Base Adjustment. The general fund base 534.10is reduced $500,000 in each of fiscal years 534.112010 and 2011. The health care access fund 534.12base is $3,456,000 in fiscal year 2010 and 534.13$2,856,000 in fiscal year 2011.

534.14Subd. 4.Health Protection

534.15Appropriations by Fund534.16General20,544,00013,900,000534.17534.18State Government Special Revenue25,980,00026,674,000534.19Environment300,000300,000

534.20Pandemic Influenza Preparedness. Of 534.21the general fund appropriation to the 534.22commissioner, $6,035,000 in fiscal year 2008 534.23is for preparation, planning, and response 534.24to a pandemic influenza outbreak. This 534.25appropriation is available until June 30, 2009.534.26Base funding for the 2010-2011 biennium is 534.27$0 each fiscal year.534.28Environmental Health Tracking and 534.29Biomonitoring. (a) $500,000 in the first 534.30year and $900,000 in the second year are 534.31for the environmental health tracking and 534.32biomonitoring program. The base for fiscal 534.33year 2010 and fiscal year 2011 is increased 534.34by $300,000 each year.535.1(b) $300,000 each year is from the 535.2environmental fund to the Pollution Control 535.3Agency for transfer to the Department 535.4of Health for the health tracking and 535.5biomonitoring program. The base for the 535.6environmental fund is $0 in fiscal year 2010 535.7and after.535.8AIDS Prevention Initiative Focusing 535.9on African-born Residents. $300,000 in 535.102008 is for an AIDS prevention initiative 535.11focusing on African-born residents. This 535.12appropriation is a onetime appropriation 535.13and shall not become part of the base-level 535.14funding for the 2010-2011 biennium.535.15The commissioner of health shall award 535.16grants in accordance with Minnesota Statutes, 535.17section 145.924, paragraph (b), for a public 535.18education and awareness campaign targeting 535.19communities of African-born Minnesota 535.20residents. The grants shall be designed to 535.21promote knowledge and understanding about 535.22HIV and to increase knowledge in order 535.23to eliminate and reduce the risk for HIV 535.24infection; to encourage screening and testing 535.25for HIV; and to link individuals to public 535.26health and health care resources. The grants 535.27must be awarded to collaborative efforts that 535.28bring together nonprofit community-based 535.29groups with demonstrated experience in 535.30addressing the public health, health care, 535.31and social service needs of African-born 535.32communities.535.33Arsenic Health Risk Standard. $920,000 in 535.34the first year and $461,000 in the second year 535.35is to fund the study relating to arsenic health 536.1risk standards, under Minnesota Statutes, 536.2section 144.967. Of this amount, $100,000 536.3in 2008 is for a study relating to water supply 536.4health risk limit standards under Minnesota 536.5Statutes, section 103H.201. This is a onetime 536.6appropriation.536.7Lindane and Bisphenol-A Studies.536.8$114,000 in the first year is for the Lindane 536.9committee and the study of bisphenol-A, 536.10under Minnesota Statutes, section 145.958. 536.11This is a onetime appropriation.536.12Decabromodiphenyl Ether Study.536.13$118,000 in the first year is for transfer to the 536.14commissioner of the pollution control agency 536.15for the study of decabromodiphenyl ether 536.16under Minnesota Statutes, section 325E.387. 536.17This is a onetime appropriation.536.18Radiation Study. $45,000 in the first year 536.19from the general fund and $15,000 in the 536.20first year from the state government special 536.21revenue fund are for the radiation study in 536.22article 10, section 53. This is a onetime 536.23appropriation.536.24Lead Abatement. $925,000 in the first 536.25year and $950,000 in the second year are 536.26for changes in lead abatement requirements. 536.27Of this amount, $6,000 in the first year and 536.28$11,000 in the second year are for transfer 536.29to the commissioner of human services for 536.30increased medical assistance costs. A portion 536.31of this amount may be used to reimburse 536.32local governments for costs of implementing 536.33the new requirements.536.34Water Treatment. $40,000 in fiscal year 536.352008 is to augment any appropriation from the 537.1remediation fund to conduct an evaluation of 537.2point of use water treatment units at removing 537.3perfluorooctanoic acid, perfluorooctane 537.4sulfonate, and perfluorobutanoic acid from 537.5known concentrations of these compounds 537.6in drinking water. The evaluation shall be 537.7completed by December 31, 2007, and the 537.8commissioner may contract for services to 537.9complete the evaluation. This is a onetime 537.10appropriation.537.11Environmental Justice Mapping. $137,000 537.12in the first year and $53,000 in the second 537.13year is for environmental justice mapping.537.14HIV Information. $80,000 each year 537.15is to fund a community-based nonprofit 537.16organization with demonstrated capacity to 537.17operate a statewide HIV information and 537.18referral service using telephone, Internet, and 537.19other appropriate technologies.537.20Lead Hazard Reduction. $250,000 is 537.21appropriated each year of the biennium for a 537.22grant to a nonprofit organization operating 537.23the CLEARCorps to conduct a pilot project 537.24to determine the incidence of lead hazards in 537.25pre-1978 rental property. Any balance in the 537.26first year does not cancel but is available in 537.27the second year.537.28Minnesota Birth Defects Information 537.29System. $750,000 each year is to maintain 537.30the birth defects information system that was 537.31established by Minnesota Statutes, section 537.32144.2215.

537.33Subd. 5.Minority and Multicultural Health

538.1Appropriations by Fund538.2General5,042,0005,052,000538.3Federal TANF2,683,0002,998,000

538.4TANF Appropriations. (a) $2,421,000 of 538.5the TANF funds is appropriated in each year 538.6of the biennium to the commissioner for 538.7home visiting and nutritional services listed 538.8under Minnesota Statutes, section 145.882, 538.9subdivision 7, clauses (6) and (7). Funding 538.10shall be distributed to tribal governments 538.11based on Minnesota Statutes, section 538.12145A.14, subdivision 2a, paragraph (b).538.13(b) $262,000 in the first year and $577,000 538.14in the second year are appropriated 538.15to the commissioner of health for the 538.16family home visiting grant program. The 538.17commissioner shall distribute funds to tribal 538.18governments using a formula developed in 538.19conjunction with tribal governments. The 538.20commissioner may use five percent of the 538.21funds appropriated in each fiscal year to 538.22conduct the ongoing evaluations required 538.23under Minnesota Statutes, section 145A.17, 538.24subdivision 7, and may use ten percent of 538.25the funds appropriated each fiscal year to 538.26provide training and technical assistance as 538.27required under Minnesota Statutes, section 538.28145A.17, subdivisions 4 and 5.538.29TANF Carryforward. Any unexpended 538.30balance of the TANF appropriation in the 538.31first year of the biennium does not cancel but 538.32is available for the second year.

538.33Subd. 6.Administrative Support Services

538.34Appropriations by Fund538.35General 11,047,000 11,197,000

539.1Disease Surveillance. $2,000,000 each fiscal 539.2year is for redesigning and implementing 539.3coordinated and modern disease surveillance 539.4systems for the department, and for ensuring 539.5that occupational and residential histories 539.6are included in the Minnesota Cancer 539.7Surveillance database. Base level funding for 539.8the 2012-2013 biennium will be $600,000 539.9each fiscal year for maintaining and operating 539.10the systems.

539.11539.12Sec. 5. VETERANS NURSING HOMES BOARD$44,124,000$46,244,000

539.13Veterans Homes Special Revenue Account.539.14The general fund  appropriations made to 539.15the board may be transferred to a veterans 539.16homes special revenue account in the 539.17special revenue fund in the same manner 539.18as other receipts are deposited according to 539.19Minnesota Statutes, section 198.34, and are 539.20appropriated to the board for the operation of 539.21board facilities and programs.539.22Repair and Betterment. Of this 539.23appropriation, $4,000,000 in fiscal year 539.242008 and $4,000,000 in fiscal year 2009 539.25are to be used for repair, maintenance, 539.26rehabilitation, and betterment activities at 539.27facilities statewide.539.28Base Adjustment. The general fund base is 539.29decreased by $2,000,000 in fiscal year 2010 539.30and $2,000,000 in fiscal year 2011.

539.31Sec. 6. HEALTH-RELATED BOARDS

539.32539.33Subdivision 1.Total Appropriation; State Government Special Revenue Fund$14,654,000$14,527,000

540.1The commissioner of finance shall not permit 540.2the allotment, encumbrance, or expenditure 540.3of money appropriated in this section in 540.4excess of the anticipated biennial revenues 540.5or accumulated surplus revenues from fees 540.6collected by the boards.

540.7Subd. 2.Board of Chiropractic Examiners450,000447,000

540.8Subd. 3.Board of Dentistry987,0001,009,000

540.9540.10Subd. 4.Board of Dietetic and Nutrition Practice103,000119,000

540.11Base Adjustment. Of this appropriation in 540.12fiscal year 2009, $14,000 is onetime.

540.13540.14Subd. 5.Board of Marriage and Family Therapy134,000154,000

540.15Base Adjustment. Of this appropriation in 540.16fiscal year 2009, $17,000 is onetime.

540.17Subd. 6.Board of Medical Practice4,120,0003,674,000

540.18Subd. 7.Board of Nursing3,985,0004,146,000

540.19540.20Subd. 8.Board of Nursing Home Administrators633,000647,000

540.21Administrative Services Unit. Of this 540.22appropriation, $430,000 in fiscal year 540.232008 and $439,000 in fiscal year 2009 are 540.24for the administrative services unit. The 540.25administrative services unit may receive 540.26and expend reimbursements for services 540.27performed by other agencies.

540.28Subd. 9.Board of Optometry98,000114,000

540.29Base Adjustment. Of this appropriation in 540.30fiscal year 2009, $13,000 is onetime.

540.31Subd. 10.Board of Pharmacy1,375,0001,442,000

540.32Base Adjustment. Of this appropriation in 540.33fiscal year 2009, $29,000 is onetime.

541.1Subd. 11.Board of Physical Therapy306,000295,000

541.2Subd. 12.Board of Podiatry54,00063,000

541.3Base Adjustment. Of this appropriation in 541.4fiscal year 2009, $7,000 is onetime.

541.5Subd. 13.Board of Psychology788,000806,000

541.6Subd. 14.Board of Social Work997,0001,022,000

541.7Subd. 15.Board of Veterinary Medicine230,000195,000

541.8541.9Subd. 16.Board of Behavioral Health and Therapy394,000394,000

541.10541.11Sec. 7. EMERGENCY MEDICAL SERVICES BOARD$4,617,000$4,645,000

541.12Appropriations by Fund541.1320082009541.14General3,023,0003,041,000541.15541.16State Government Special Revenue687,000704,000

541.17Regional Emergency Medical Services 541.18Programs. $400,000 each year is for 541.19regional emergency medical services 541.20programs, to be distributed equally to the 541.21eight emergency medical service regions. 541.22This amount shall be added to the base 541.23funding. Notwithstanding Minnesota 541.24Statutes, section 144E.50, 100 percent of 541.25the appropriation shall be passed on to the 541.26emergency medical service regions.541.27Health Professional Services Program.541.28$687,000 in fiscal year 2008 and $704,000 in 541.29fiscal year 2009 from the state government 541.30special revenue fund are for the health 541.31professional services program.

541.32Sec. 8. COUNCIL ON DISABILITY$582,000$590,000

542.1Options Too. (a) $75,000 for the first 542.2year and $75,000 for the second year are 542.3to continue the work of the Options Too 542.4disability services interagency work group 542.5established under Laws 2005, First Special 542.6Session chapter 4, article 7, section 57. 542.7Funds shall be used to monitor and assist the 542.8work group and the Options Too Steering 542.9Committee in the implementation of the 542.10recommendations in the Options Too report 542.11dated February 15, 2007.542.12(b) For purposes of this section, the Options 542.13Too Steering Committee shall consist of the 542.14following members:542.15(1) a representative from the Minnesota 542.16Housing Finance Agency;542.17(2) a representative from the Minnesota State 542.18Council on Disability; 542.19(3) a representative from the Department of 542.20Veterans Affairs;542.21(4) a representative from the Department of 542.22Transportation;542.23(5) a representative from the Department of 542.24Human Services; and542.25(6) representatives from interested 542.26stakeholders including counties, local 542.27public housing authorities, the Metropolitan 542.28Council, disability service providers, and 542.29disability advocacy organizations who are 542.30appointed by the Minnesota State Council on 542.31Disability for two-year terms.542.32(c) Notwithstanding Laws 2005, First Special 542.33Session chapter 4, article 7, section 57, the 542.34interagency work group shall be administered 543.1by the Minnesota Housing Finance Agency, 543.2the Minnesota State Council on Disability, 543.3Department of Human Services, and the 543.4Department of Transportation.543.5(d) The Options Too Steering Committee 543.6shall report to the chairs of the health 543.7and human services policy and finance 543.8committees of the senate and house of 543.9representatives by October 15, 2007, and 543.10October 15, 2008, on the continued progress 543.11of the work group towards implementing the 543.12recommendations in the Options Too report 543.13dated February 15, 2007.

543.14543.15543.16Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES$1,567,000$1,621,000

543.17Sec. 10. OMBUDSMAN FOR FAMILIES$251,000$257,000

543.18    Sec. 11. TRANSFERS.543.19    Subdivision 1.Grants.The commissioner of human services, with the approval 543.20of the commissioner of finance and after notifying the chairs of the senate and house 543.21committees with jurisdiction, may transfer unencumbered appropriation balances for the 543.22biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance; 543.23general assistance medical care; medical assistance; MFIP child care assistance under 543.24Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential 543.25housing programs; and the entitlement portion of the chemical dependency consolidated 543.26treatment fund and between fiscal years of the biennium.543.27    Subd. 2.Administration.Positions, salary money, and nonsalary administrative 543.28money may be transferred within the Departments of Human Services and Health and 543.29within the programs operated by the Veterans Nursing Homes Board as the commissioners 543.30and the board consider necessary, with the advance approval of the commissioner of 543.31finance. The commissioner or the board shall inform the chairs of the house and senate 543.32committees with jurisdiction quarterly about transfers made under this provision.543.33    Sec. 12. INDIRECT COSTS NOT TO FUND PROGRAMS.544.1    The commissioners of health and of human services shall not use indirect cost 544.2allocations to pay for the operational costs of any program for which they are responsible.544.3    Sec. 13. SUNSET OF UNCODIFIED LANGUAGE.544.4    All uncodified language contained in this article expires on June 30, 2009, unless a 544.5different expiration date is explicit.544.6    Sec. 14. EFFECTIVE DATE.544.7    The provisions in this article are effective July 1, 2007, unless a different effective 544.8date is specified.