1.1 	A bill for an act
1.2 	relating to human services; amending health care services provisions; making 
1.3 	changes to a managed care contract provision; increasing a HMO renewal fee; 
1.4 	changing provisions relating to sex offender program; changing a work activity 
1.5 	provision under MFIP; requiring a report; appropriating money;amending 
1.6 	Minnesota Statutes 2006, sections 13.851, by adding a subdivision; 125A.02, 
1.7 	subdivision 1; 144A.45, subdivision 1, by adding a subdivision; 150A.06, by 
1.8 	adding a subdivision; 214.40, by adding a subdivision; 246B.02; 253B.045, 
1.9 	subdivisions 1, 2, by adding a subdivision; 253B.18, subdivisions 4c, 5, 5a; 
1.10 	253B.185, subdivision 5, by adding a subdivision; 253B.19, subdivisions 2, 3; 
1.11 	256.01, by adding a subdivision; 256B.056, subdivisions 2, 4a, 11, by adding 
1.12 	a subdivision; 256B.057, subdivision 1; 256B.0571, subdivisions 6, 8, 9, 15, 
1.13 	by adding a subdivision; 256B.058; 256B.059, subdivisions 1, 1a; 256B.0594; 
1.14 	256B.0595, subdivisions 1, 2, 3, 4, by adding subdivisions; 256B.0625, 
1.15 	subdivisions 3c, 13g, 13h; 256B.075, subdivision 2; 256B.15, subdivision 4; 
1.16 	256B.69, subdivisions 3a, 6, 27, 28; 256B.692, subdivision 7; 524.3-803; 
1.17 	626.5572, subdivision 21; Minnesota Statutes 2007 Supplement, sections 
1.18 	253B.185, subdivision 1b; 256B.055, subdivision 14; 256B.0625, subdivision 
1.19 	49; 256D.03, subdivision 3; 256J.49, subdivision 13; Laws 2005, First Special 
1.20 	Session chapter 4, article 8, section 84, as amended; proposing coding for new 
1.21 	law in Minnesota Statutes, chapters 145; 246B; repealing Minnesota Statutes 
1.22 	2006, section 256B.0571, subdivision 8a; Laws 2003, First Special Session 
1.23 	chapter 5, section 11.
1.24 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.25 	ARTICLE 1
1.26 	HEALTH CARE

1.27 	Section 1. Minnesota Statutes 2006, section 125A.02, subdivision 1, is amended to 
1.28 	read:
1.29 		Subdivision 1.Child with a disability. Every child who has a hearing impairment, 
1.30 	blindness, visual disability, speech or language impairment, physical disability, other 
1.31 	health impairment, mental disability, emotional/behavioral disorder, specific learning 
2.1 	disability, autism, traumatic brain injury, multiple disabilities, or deaf/blind disability and 
2.2 	needs special instruction and services, as determined by the standards of the commissioner, 
2.3 	is a child with a disability. A licensed physician, an advanced practice nurse, or a licensed 
2.4 	psychologist is qualified to make a diagnosis and determination of attention deficit 
2.5 	disorder or attention deficit hyperactivity disorder for purposes of identifying a child 
2.6 	with a disability. In addition, every child under age three, and at local district discretion 
2.7 	from age three to age seven, who needs special instruction and services, as determined 
2.8 	by the standards of the commissioner, because the child has a substantial delay or has 
2.9 	an identifiable physical or mental condition known to hinder normal development is 
2.10 	a child with a disability.

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

2.12 	Sec. 2. Minnesota Statutes 2006, section 144A.45, subdivision 1, is amended to read:
2.13 		Subdivision 1.Rules. The commissioner shall adopt rules for the regulation of 
2.14 	home care providers pursuant to sections 144A.43 to 144A.47. The rules shall include 
2.15 	the following: 
2.16 	(a) (1) provisions to assure, to the extent possible, the health, safety and well-being, 
2.17 	and appropriate treatment of persons who receive home care services;
2.18 	(b) (2) requirements that home care providers furnish the commissioner with 
2.19 	specified information necessary to implement sections 144A.43 to 144A.47; 
2.20 	(c) (3) standards of training of home care provider personnel, which may vary 
2.21 	according to the nature of the services provided or the health status of the consumer;
2.22 	(d) (4) standards for medication management which may vary according to the 
2.23 	nature of the services provided, the setting in which the services are provided, or the 
2.24 	status of the consumer. Medication management includes the central storage, handling, 
2.25 	distribution, and administration of medications;
2.26 	(e) (5) standards for supervision of home care services requiring supervision by a 
2.27 	registered nurse or other appropriate health care professional which must occur on site 
2.28 	at least every 62 days, or more frequently if indicated by a clinical assessment, and in 
2.29 	accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that, 
2.30 	notwithstanding the provisions of Minnesota Rules, part 4668.0110, subpart 5, item B, 
2.31 	supervision of a person performing home care aide tasks for a class B licensee providing 
2.32 	paraprofessional services must occur only every 180 days, or more frequently if indicated 
2.33 	by a clinical assessment; 
2.34 	(f) (6) standards for client evaluation or assessment which may vary according to the 
2.35 	nature of the services provided or the status of the consumer;
3.1 	(g) (7) requirements for the involvement of a consumer's physician, the 
3.2 	documentation of physicians' orders, if required, and the consumer's treatment plan, and 
3.3 	the maintenance of accurate, current clinical records;
3.4 	(h) (8) the establishment of different classes of licenses for different types of 
3.5 	providers and different standards and requirements for different kinds of home care 
3.6 	services; and
3.7 	(i) (9) operating procedures required to implement the home care bill of rights.

3.8 	Sec. 3. Minnesota Statutes 2006, section 144A.45, is amended by adding a subdivision 
3.9 	to read:
3.10 		Subd. 1a.Home care aide tasks. Notwithstanding the provisions of Minnesota 
3.11 	Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting 
3.12 	toileting, transfers, and ambulation if the client is ambulatory and if the client has no 
3.13 	serious acute illness or infectious disease.

3.14 	Sec. 4. [145.1622] POLICY FOR NOTIFICATION OF DISPOSITION OPTIONS.
3.15 	Hospitals, clinics, and medical facilities must have in place by January 15, 2009, a 
3.16 	policy for informing a woman of available options for fetal disposition when the woman 
3.17 	experiences a miscarriage or is expected to experience a miscarriage.

3.18 	Sec. 5. Minnesota Statutes 2006, section 150A.06, is amended by adding a subdivision 
3.19 	to read:
3.20 		Subd. 9.Graduates of nonaccredited dental programs. A graduate of a 
3.21 	nonaccredited dental program who successfully completes the clinical licensure 
3.22 	examination, and meets all other applicant requirements of the board shall be licensed to 
3.23 	practice dentistry and granted a limited general dentist license by the board. The board 
3.24 	shall place limitations on the licensee's authority to practice by requiring the licensee to 
3.25 	practice under the general supervision of a Minnesota-licensed dentist approved by the 
3.26 	board. A person licensed under this subdivision must practice for three consecutive years 
3.27 	in Minnesota pursuant to a written agreement, approved by the board, between the licensee 
3.28 	and a Minnesota-licensed dentist who may limit the types of services authorized. At the 
3.29 	conclusion of the three-year period, the board shall grant an unlimited license without 
3.30 	further restrictions if all supervising dentists who had entered into written agreements with 
3.31 	the licensee during any part of the three-year period recommend unlimited licensure, and if 
3.32 	no corrective action or disciplinary action has been taken by the board against the licensee.

4.1 	Sec. 6. Minnesota Statutes 2006, section 214.40, is amended by adding a subdivision 
4.2 	to read:
4.3 		Subd. 8.Fee adjustment. The administrative services unit shall apportion between 
4.4 	the Board of Medical Practice, the Board of Dentistry, and the Board of Nursing an 
4.5 	amount to be raised through fees by the respective board. The amount apportioned to each 
4.6 	board shall be the total amount expended on medical professional liability insurance 
4.7 	coverage purchased for the providers regulated by the respective board. The respective 
4.8 	board may adjust the fees which the board is required to collect to compensate for the 
4.9 	amount apportioned to the board by the administrative services unit.

4.10 	Sec. 7. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 
4.11 	to read:
4.12 		Subd. 27.Statewide health information exchange. (a) The commissioner has the 
4.13 	authority to join and participate as a member in a legal entity developing and operating a 
4.14 	statewide health information exchange that shall meet the following criteria:
4.15 	(1) the legal entity must meet all constitutional and statutory requirements to allow 
4.16 	the commissioner to participate; and 
4.17 	(2) the commissioner or the commissioner's designated representative must have 
4.18 	the right to participate in the governance of the legal entity under the same terms and 
4.19 	conditions and subject to the same requirements as any other member in the legal entity 
4.20 	and in that role shall act to advance state interests and lessen the burdens of government.
4.21 	(b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated 
4.22 	share of development-related expenses of the legal entity retroactively from October 29, 
4.23 	2007, regardless of the date the commissioner joins the legal entity as a member.

4.24 	Sec. 8. Minnesota Statutes 2007 Supplement, section 256B.055, subdivision 14, 
4.25 	is amended to read:
4.26 		Subd. 14.Persons detained by law. (a) Medical assistance may be paid for an 
4.27 	inmate of a correctional facility who is conditionally released as authorized under section 
4.28 	241.26, 244.065, or 631.425, if the individual does not require the security of a public 
4.29 	detention facility and is housed in a halfway house or community correction center, or 
4.30 	under house arrest and monitored by electronic surveillance in a residence approved 
4.31 	by the commissioner of corrections, and if the individual meets the other eligibility 
4.32 	requirements of this chapter.
4.33 	(b) An individual who is enrolled in medical assistance, and who is charged with a 
4.34 	crime and incarcerated for less than 12 months shall be suspended from eligibility at the 
5.1 	time of incarceration until the individual is released. Upon release, medical assistance 
5.2 	eligibility is reinstated without reapplication using a reinstatement process and form, if the 
5.3 	individual is otherwise eligible.
5.4 	(c) An individual, regardless of age, who is considered an inmate of a public 
5.5 	institution as defined in Code of Federal Regulations, title 42, section 435.1009 435.1010, 
5.6 	is not eligible for medical assistance.

5.7 	Sec. 9. Minnesota Statutes 2006, section 256B.056, subdivision 2, is amended to read:
5.8 		Subd. 2.Homestead exclusion and homestead equity limit for institutionalized
5.9 	persons residing in a long-term care facility. (a) The homestead shall be excluded 
5.10 	for the first six calendar months of a person's stay in a long-term care facility and shall 
5.11 	continue to be excluded for as long as the recipient can be reasonably expected to return to 
5.12 	the homestead. For purposes of this subdivision, "reasonably expected to return to the 
5.13 	homestead" means the recipient's attending physician has certified that the expectation 
5.14 	is reasonable, and the recipient can show that the cost of care upon returning home will 
5.15 	be met through medical assistance or other sources. The homestead shall continue to 
5.16 	be excluded for persons residing in a long-term care facility if it is used as a primary 
5.17 	residence by one of the following individuals:
5.18 	(1) the spouse;
5.19 	(2) a child under age 21;
5.20 	(3) a child of any age who is blind or permanently and totally disabled as defined in 
5.21 	the supplemental security income program;
5.22 	(4) a sibling who has equity interest in the home and who resided in the home for at 
5.23 	least one year immediately before the date of the person's admission to the facility; or
5.24 	(5) a child of any age, or, subject to federal approval, a grandchild of any age, who 
5.25 	resided in the home for at least two years immediately before the date of the person's 
5.26 	admission to the facility, and who provided care to the person that permitted the person to 
5.27 	reside at home rather than in an institution.
5.28 	(b) Effective for applications filed on or after July 1, 2006, and for renewals after 
5.29 	July 1, 2006, for persons who first applied for payment of long-term care services on 
5.30 	or after January 2, 2006, the equity interest in the homestead of an individual whose 
5.31 	eligibility for long-term care services is determined on or after January 1, 2006, shall not 
5.32 	exceed $500,000, unless it is the lawful residence of the individual's spouse or child 
5.33 	who is under age 21, blind, or disabled. The amount specified in this paragraph shall be 
5.34 	increased beginning in year 2011, from year to year based on the percentage increase in 
5.35 	the Consumer Price Index for all urban consumers (all items; United States city average), 
6.1 	rounded to the nearest $1,000. This provision may be waived in the case of demonstrated 
6.2 	hardship by a process to be determined by the secretary of health and human services 
6.3 	pursuant to section 6014 of the Deficit Reduction Act of 2005, Public Law 109-171.

6.4 	Sec. 10. Minnesota Statutes 2006, section 256B.056, is amended by adding a 
6.5 	subdivision to read:
6.6 		Subd. 2a.Home equity limit for medical assistance payment of long-term 
6.7 	care services. (a) Effective for requests of medical assistance payment of long-term 
6.8 	care services filed on or after July 1, 2006, and for renewals on or after July 1, 2006, 
6.9 	for persons who received payment of long-term care services under a request filed on 
6.10 	or after January 1, 2006, the equity interest in the home of a person whose eligibility 
6.11 	for long-term care services is determined on or after January 1, 2006, shall not exceed 
6.12 	$500,000, unless it is the lawful residence of the person's spouse or child who is under 
6.13 	age 21, or a child of any age who is blind or permanently and totally disabled as defined 
6.14 	in the Supplemental Security Income program. The amount specified in this paragraph 
6.15 	shall be increased beginning in year 2011, from year to year based on the percentage 
6.16 	increase in the Consumer Price Index for all urban consumers (all items; United States city 
6.17 	average), rounded to the nearest $1,000.
6.18 	(b) For purposes of this subdivision, a "home" means any real or personal property 
6.19 	interest, including an interest in an agricultural homestead as defined under section 
6.20 	273.124, subdivision 1, that, at the time of the request for medical assistance payment of 
6.21 	long-term care services, is the primary dwelling of the person or was the primary dwelling 
6.22 	of the person before receipt of long-term care services began outside of the home.
6.23 	(c) A person denied or terminated from medical assistance payment of long-term 
6.24 	care services because the person's home equity exceeds the home equity limit may seek 
6.25 	a waiver based upon a hardship by filing a written request with the county agency. 
6.26 	Hardship is an imminent threat to the person's health and well-being that is demonstrated 
6.27 	by documentation of no alternatives for payment of long-term care services. The county 
6.28 	agency shall make a decision regarding the written request to waive the home equity limit 
6.29 	within 30 days if all necessary information has been provided. The county agency shall 
6.30 	send the person and the person's representative a written notice of decision on the request 
6.31 	for a demonstrated hardship waiver that also advises the person of appeal rights under the 
6.32 	fair hearing process of section 256.045.

6.33 	Sec. 11. Minnesota Statutes 2006, section 256B.056, subdivision 4a, is amended to 
6.34 	read:
7.1 		Subd. 4a.Asset verification. For purposes of verification, the value of an individual 
7.2 	is not required to make a good faith effort to sell a life estate that is not excluded under 
7.3 	subdivision 2 and the life estate shall be considered deemed not salable unless the owner 
7.4 	of the remainder interest intends to purchase the life estate, or the owner of the life estate 
7.5 	and the owner of the remainder sell the entire property. This subdivision applies only for 
7.6 	the purpose of determining eligibility for medical assistance, and does not apply to the 
7.7 	valuation of assets owned by either the institutional spouse or the community spouse 
7.8 	under section 256B.059, subdivision 2.

7.9 	Sec. 12. Minnesota Statutes 2006, section 256B.056, subdivision 11, is amended to 
7.10 	read:
7.11 		Subd. 11.Treatment of annuities. (a) Any individual applying for or seeking 
7.12 	recertification of eligibility for person requesting medical assistance payment of long-term 
7.13 	care services shall provide a complete description of any interest either the individual
7.14 	person or the individual'sperson's spouse has in annuities on a form designated by the 
7.15 	department. The form shall include a statement that the state becomes a preferred 
7.16 	remainder beneficiary of annuities or similar financial instruments by virtue of the receipt 
7.17 	of medical assistance payment of long-term care services. The individualperson and the 
7.18 	individual'sperson's spouse shall furnish the agency responsible for determining eligibility 
7.19 	with complete current copies of their annuities and related documents for review as part 
7.20 	of the application process on disclosure forms provided by the department as part of 
7.21 	their application and complete the form designating the state as the preferred remainder 
7.22 	beneficiary for each annuity in which the person or the person's spouse has an interest.
7.23 	(b) The disclosure form shall include a statement that the department becomes the 
7.24 	remainder beneficiary under the annuity or similar financial instrument by virtue of the 
7.25 	receipt of medical assistance. The disclosure form department shall include a provide
7.26 	notice to the issuer of the department's right under this section as a preferred remainder 
7.27 	beneficiary under the annuity or similar financial instrument for medical assistance 
7.28 	furnished to the individualperson or the individual'sperson's spouse, and require the 
7.29 	issuer to provide confirmation that a remainder beneficiary designation has been made 
7.30 	and to notify the county agency when there is a change in the amount of the income or 
7.31 	principal being withdrawn from the annuity or other similar financial instrument at the 
7.32 	time of the most recent disclosure required under this section. The individual and the 
7.33 	individual's spouse shall execute separate disclosure forms for each annuity or similar 
7.34 	financial instrument that they are required to disclose under this section and in which they 
7.35 	have an interest provide notice of the issuer's responsibilities as provided in paragraph (c).
8.1 	(c) An issuer of an annuity or similar financial instrument who receives notice 
8.2 	on a disclosure form of the state's right to be named a preferred remainder beneficiary
8.3 	as described in paragraph (b) shall provide confirmation to the requesting agency that 
8.4 	a remainder beneficiary designating the state has been made and a preferred remainder 
8.5 	beneficiary. The issuer shall also notify the county agency when there is a change in the 
8.6 	amount of income or principal being withdrawn from the annuity or other similar financial 
8.7 	instrument or a change in the state's preferred remainder beneficiary designation under 
8.8 	the annuity or other similar financial instrument occurs. The county agency shall provide 
8.9 	the issuer with the name, address, and telephone number of a unit within the department 
8.10 	that the issuer can contact to comply with this paragraph.
8.11 	(d) "Preferred remainder beneficiary" for purposes of this subdivision and sections 
8.12 	256B.0594 and 256B.0595 means the state is a remainder beneficiary in the first position in 
8.13 	an amount equal to the amount of medical assistance paid on behalf of the institutionalized 
8.14 	person, or is a remainder beneficiary in the second position if the institutionalized person 
8.15 	designates and is survived by a remainder beneficiary who is (1) a spouse who does not 
8.16 	reside in a medical institution, (2) a minor child, or (3) a child of any age who is blind or 
8.17 	permanently and totally disabled as defined in the Supplemental Security Income program. 
8.18 	Notwithstanding this paragraph, the state is the remainder beneficiary in the first position 
8.19 	if the spouse or child disposes of the remainder for less than fair market value.
8.20 	(e) For purposes of this subdivision, "institutionalized person" and "long-term care 
8.21 	services" have the meanings given in section 256B.0595, subdivision 1, paragraph (h).
8.22 	(f) For purposes of this subdivision, "medical institution" means a skilled 
8.23 	nursing facility, intermediate care facility, intermediate care facility for persons with 
8.24 	developmental disabilities, nursing facility, or inpatient hospital.

8.25 	Sec. 13. Minnesota Statutes 2006, section 256B.057, subdivision 1, is amended to read:
8.26 		Subdivision 1.Infants and pregnant women. (a)(1) An infant less than one year of 
8.27 	age or a pregnant woman who has written verification of a positive pregnancy test from a 
8.28 	physician or licensed registered nurse is eligible for medical assistance if countable family 
8.29 	income is equal to or less than 275 percent of the federal poverty guideline for the same 
8.30 	family size. A pregnant woman who has written verification of a positive pregnancy test 
8.31 	from a physician or licensed registered nurse is eligible for medical assistance if countable 
8.32 	family income is equal to or less than 200 percent of the federal poverty guideline for the 
8.33 	same family size. For purposes of this subdivision, "countable family income" means the 
8.34 	amount of income considered available using the methodology of the AFDC program 
8.35 	under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility 
9.1 	and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, 
9.2 	except for the earned income disregard and employment deductions.
9.3 	(2) For applications processed within one calendar month prior to the effective date, 
9.4 	eligibility shall be determined by applying the income standards and methodologies in 
9.5 	effect prior to the effective date for any months in the six-month budget period before 
9.6 	that date and the income standards and methodologies in effect on the effective date for 
9.7 	any months in the six-month budget period on or after that date. The income standards 
9.8 	for each month shall be added together and compared to the applicant's total countable 
9.9 	income for the six-month budget period to determine eligibility.
9.10 	(b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
9.11 	(2) For applications processed within one calendar month prior to July 1, 2003, 
9.12 	eligibility shall be determined by applying the income standards and methodologies in 
9.13 	effect prior to July 1, 2003, for any months in the six-month budget period before July 1, 
9.14 	2003, and the income standards and methodologies in effect on the expiration date for any 
9.15 	months in the six-month budget period on or after July 1, 2003. The income standards 
9.16 	for each month shall be added together and compared to the applicant's total countable 
9.17 	income for the six-month budget period to determine eligibility.
9.18 	(3) An amount equal to the amount of earned income exceeding 275 percent of 
9.19 	the federal poverty guideline, up to a maximum of the amount by which the combined 
9.20 	total of 185 percent of the federal poverty guideline plus the earned income disregards 
9.21 	and deductions allowed under the state's AFDC plan as of July 16, 1996, as required 
9.22 	by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public 
9.23 	Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for 
9.24 	pregnant women and infants less than one year of age.
9.25 	(c) Dependent care and child support paid under court order shall be deducted from 
9.26 	the countable income of pregnant women.
9.27 	(d) An infant born on or after January 1, 1991, to a woman who was eligible for and 
9.28 	receiving medical assistance on the date of the child's birth shall continue to be eligible for 
9.29 	medical assistance without redetermination until the child's first birthday, as long as the 
9.30 	child remains in the woman's household.

9.31 	Sec. 14. Minnesota Statutes 2006, section 256B.0571, subdivision 6, is amended to 
9.32 	read:
9.33 		Subd. 6.Partnership policy. "Partnership policy" means a long-term care insurance 
9.34 	policy that meets the requirements under subdivision 10 and was issued on or after the 
9.35 	effective date of the state plan amendment implementing the partnership program in 
10.1 	Minnesota. Policies that are exchanged or that have riders or endorsements added on or 
10.2 	after the effective date of the state plan amendment as authorized by the commissioner of 
10.3 	commerce qualify as a partnership policy.

10.4 	Sec. 15. Minnesota Statutes 2006, section 256B.0571, subdivision 8, is amended to 
10.5 	read:
10.6 		Subd. 8.Program established. (a) The commissioner, in cooperation with the 
10.7 	commissioner of commerce, shall establish the Minnesota partnership for long-term care 
10.8 	program to provide for the financing of long-term care through a combination of private 
10.9 	insurance and medical assistance.
10.10 	(b) An individual who meets the requirements in this paragraph is eligible to 
10.11 	participate in the partnership program. The individual must:
10.12 	(1) meet one of the following criteria:
10.13 	(i) be a beneficiary of, and a Minnesota resident at the time coverage first became 
10.14 	effective under the a partnership policy;
10.15 	(2) be a beneficiary of a partnership policy that (i) either  is issued on or after the 
10.16 	effective date of the state plan amendment implementing the partnership program in 
10.17 	Minnesota, or (ii) qualifies as a partnership policy under the provisions of subdivision 8a
10.18 	as authorized by the commissioner of commerce under subdivision 6; and or
10.19 	(ii) be a beneficiary of a policy recognized under subdivision 17; and
10.20 	(3)(2) have exhausted all of the benefits under the partnership policy as described 
10.21 	in this section. Benefits received under a long-term care insurance policy before July 1, 
10.22 	2006, do not count toward the exhaustion of benefits required in this subdivision.

10.23 	Sec. 16. Minnesota Statutes 2006, section 256B.0571, subdivision 9, is amended to 
10.24 	read:
10.25 		Subd. 9.Medical assistance eligibility. (a) Upon applicationrequest for medical 
10.26 	assistance program payment of long-term care services by an individual who meets the 
10.27 	requirements described in subdivision 8, the commissioner shall determine the individual's 
10.28 	eligibility for medical assistance according to paragraphs (b) to (i).
10.29 	(b) After determining assets subject to the asset limit under section 256B.056, 
10.30 	subdivision 3 or 3c, or 256B.057, subdivision 9 or 10, the commissioner shall allow 
10.31 	the individual to designate assets to be protected from recovery under subdivisions 13 
10.32 	and 15 up to the dollar amount of the benefits utilized under the partnership policy. 
10.33 	Designated assets shall be disregarded for purposes of determining eligibility for payment 
10.34 	of long-term care services.
11.1 	(c) The individual shall identify the designated assets and the full fair market value 
11.2 	of those assets and designate them as assets to be protected at the time of initial application 
11.3 	for medical assistance. The full fair market value of real property or interests in real 
11.4 	property shall be based on the most recent full assessed value for property tax purposes 
11.5 	for the real property, unless the individual provides a complete professional appraisal by 
11.6 	a licensed appraiser to establish the full fair market value. The extent of a life estate in 
11.7 	real property shall be determined using the life estate table in the health care program's 
11.8 	manual. Ownership of any asset in joint tenancy shall be treated as ownership as tenants 
11.9 	in common for purposes of its designation as a disregarded asset. The unprotected value 
11.10 	of any protected asset is subject to estate recovery according to subdivisions 13 and 15.
11.11 	(d) The right to designate assets to be protected is personal to the individual and 
11.12 	ends when the individual dies, except as otherwise provided in subdivisions 13 and 
11.13 	15. It does not include the increase in the value of the protected asset and the income, 
11.14 	dividends, or profits from the asset. It may be exercised by the individual or by anyone 
11.15 	with the legal authority to do so on the individual's behalf. It shall not be sold, assigned, 
11.16 	transferred, or given away.
11.17 	(e) If the dollar amount of the benefits utilized under a partnership policy is greater 
11.18 	than the full fair market value of all assets protected at the time of the application for 
11.19 	medical assistance long-term care services, the individual may designate additional assets 
11.20 	that become available during the individual's lifetime for protection under this section. 
11.21 	The individual must make the designation in writing to the county agency no later than 
11.22 	the last date on which the individual must report a change in circumstances to the county 
11.23 	agency, as provided for under the medical assistance program ten days from the date the 
11.24 	designation is requested by the county agency. Any excess used for this purpose shall not 
11.25 	be available to the individual's estate to protect assets in the estate from recovery under 
11.26 	section 256B.15 or 524.3-1202, or otherwise.
11.27 	(f) This section applies only to estate recovery under United States Code, title 42, 
11.28 	section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other 
11.29 	provisions of federal law, including, but not limited to, recovery from trusts under United 
11.30 	States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from 
11.31 	annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of 
11.32 	the Deficit Reduction Act of 2005, Public Law 109-171.
11.33 	(g) An individual's protected assets owned by the individual's spouse who applies 
11.34 	for payment of medical assistance long-term care services shall not be protected assets or 
11.35 	disregarded for purposes of eligibility of the individual's spouse solely because they were 
11.36 	protected assets of the individual.
12.1 	(h) Assets designated under this subdivision shall not be subject to penalty under 
12.2 	section 256B.0595.
12.3 	(i) The commissioner shall otherwise determine the individual's eligibility 
12.4 	for payment of long-term care services according to medical assistance eligibility 
12.5 	requirements.

12.6 	Sec. 17. Minnesota Statutes 2006, section 256B.0571, subdivision 15, is amended to 
12.7 	read:
12.8 		Subd. 15.Limitation on liens. (a) An individual's interest in real property shall not 
12.9 	be subject to a medical assistance lien under sections 514.980 to 514.985 or a notice of 
12.10 	potential claim lien arising under section 256B.15 while and to the extent it is protected 
12.11 	under subdivision 9. An individual's interest in real property that exceeds the value 
12.12 	protected under subdivision 9 is subject to a lien for recovery.
12.13 	(b) Medical assistance liens under sections 514.980 to 514.985 or liens arising 
12.14 	under notices of potential claims section 256B.15 against an individual's interests in real 
12.15 	property in the individual's estate that are designated as protected under subdivision 13, 
12.16 	paragraph (b), shall be released to the extent of the dollar value of the protection applied 
12.17 	to the interest.
12.18 	(c) If an interest in real property is protected from a lien for recovery of medical 
12.19 	assistance paid on behalf of the individual under paragraph (a) or (b), no lien for recovery 
12.20 	of medical assistance paid on behalf of that individual shall be filed against the protected 
12.21 	interest in real property after it is distributed to the individual's heirs or devisees.

12.22 	Sec. 18. Minnesota Statutes 2006, section 256B.0571, is amended by adding a 
12.23 	subdivision to read:
12.24 		Subd. 17.Reciprocal agreements. The commissioner may enter into an agreement 
12.25 	with any other state with a partnership program under United States Code, title 42, 
12.26 	section 1396p(b)(1)(C), for reciprocal recognition of qualified long-term care insurance 
12.27 	policies purchased under each state's partnership program. The commissioner shall notify 
12.28 	the secretary of the United States Department of Health and Human Services if the 
12.29 	commissioner declines to enter into a national reciprocal agreement.

12.30 	Sec. 19. Minnesota Statutes 2006, section 256B.058, is amended to read:
12.31 	256B.058 TREATMENT OF INCOME OF INSTITUTIONALIZED SPOUSE.
12.32 		Subdivision 1.Income not available. The income described in subdivisions 2 
12.33 	and 3 shall be deducted from an institutionalized spouse's monthly income and is not 
13.1 	considered available for payment of the monthly costs of an institutionalized person in 
13.2 	the institution spouse after the person has been the institutionalized spouse has been
13.3 	determined eligible for medical assistance.
13.4 		Subd. 2.Monthly income allowance for community spouse. (a) For an 
13.5 	institutionalized spouse with a spouse residing in the community, monthly income may be 
13.6 	allocated to the community spouse as a monthly income allowance for the community 
13.7 	spouse. Beginning with the first full calendar month the institutionalized spouse is 
13.8 	in the institution, the monthly income allowance is not considered available to the 
13.9 	institutionalized spouse for monthly payment of costs of care in the institution as long as 
13.10 	the income is made available to the community spouse.
13.11 	(b) The monthly income allowance is the amount by which the community spouse's 
13.12 	monthly maintenance needs allowance under paragraphs (c) and (d) exceeds the amount 
13.13 	of monthly income otherwise available to the community spouse.
13.14 	(c) The community spouse's monthly maintenance needs allowance is the lesser of 
13.15 	$1,500 or 122 percent of the monthly federal poverty guideline for a family of two plus 
13.16 	an excess shelter allowance. The excess shelter allowance is for the amount of shelter 
13.17 	expenses that exceed 30 percent of 122 percent of the federal poverty guideline line for a 
13.18 	family of two. Shelter expenses are the community spouse's expenses for rent, mortgage 
13.19 	payments including principal and interest, taxes, insurance, required maintenance charges 
13.20 	for a cooperative or condominium that is the community spouse's principal residence, 
13.21 	and the standard utility allowance under section 5(e) of the federal Food Stamp Act of 
13.22 	1977. If the community spouse has a required maintenance charge for a cooperative or 
13.23 	condominium, the standard utility allowance must be reduced by the amount of utility 
13.24 	expenses included in the required maintenance charge.
13.25 	If the community or institutionalized spouse establishes that the community spouse 
13.26 	needs income greater than the monthly maintenance needs allowance determined in this 
13.27 	paragraph due to exceptional circumstances resulting in significant financial duress, the 
13.28 	monthly maintenance needs allowance may be increased to an amount that provides 
13.29 	needed additional income.
13.30 	(d) The percentage of the federal poverty guideline used to determine the monthly 
13.31 	maintenance needs allowance in paragraph (c) is increased to 133 percent on July 1, 
13.32 	1991, and to 150 percent on July 1, 1992. Adjustments in the income limits due to annual 
13.33 	changes in the federal poverty guidelines shall be implemented the first day of July 
13.34 	following publication of the annual changes. The $1,500 maximum must be adjusted 
13.35 	January 1, 1990, and every January 1 after that by the same percentage increase in the 
14.1 	Consumer Price Index for all urban consumers (all items; United States city average) 
14.2 	between the two previous Septembers.
14.3 	(e) If a court has entered an order against an institutionalized spouse for monthly 
14.4 	income for support of the community spouse, the community spouse's monthly income 
14.5 	allowance under this subdivision shall not be less than the amount of the monthly income 
14.6 	ordered.
14.7 		Subd. 3.Family allowance. (a) A family allowance determined under paragraph 
14.8 	(b) is not considered available to the institutionalized spouse for monthly payment of costs 
14.9 	of care in the institution.
14.10 	(b) The family allowance is equal to one-third of the amount by which 122 percent 
14.11 	of the monthly federal poverty guideline for a family of two exceeds the monthly income 
14.12 	for that family member.
14.13 	(c) For purposes of this subdivision, the term family member only includes a 
14.14 	minor or dependent child as defined in the Internal Revenue Code, dependent parent, or 
14.15 	dependent sibling of the institutionalized or community spouse if the sibling resides with 
14.16 	the community spouse.
14.17 	(d) The percentage of the federal poverty guideline used to determine the family 
14.18 	allowance in paragraph (b) is increased to 133 percent on July 1, 1991, and to 150 percent 
14.19 	on July 1, 1992. Adjustments in the income limits due to annual changes in the federal 
14.20 	poverty guidelines shall be implemented the first day of July following publication of 
14.21 	the annual changes.
14.22 		Subd. 4.Treatment of income. (a) No income of the community spouse will 
14.23 	be considered available to an eligible institutionalized spouse, beginning the first full 
14.24 	calendar month of institutionalization, except as provided in this subdivision.
14.25 	(b) In determining the income of an institutionalized spouse or community spouse, 
14.26 	after the institutionalized spouse has been determined eligible for medical assistance, 
14.27 	the following rules apply.
14.28 	(1) For income that is not from a trust, availability is determined according to items 
14.29 	(i) to (v), unless the instrument providing the income otherwise specifically provides:
14.30 	(i) if payment is made solely in the name of one spouse, the income is considered 
14.31 	available only to that spouse;
14.32 	(ii) if payment is made in the names of both spouses, one-half of the income is 
14.33 	considered available to each;
14.34 	(iii) if payment is made in the names of one or both spouses together with one or 
14.35 	more other persons, the income is considered available to each spouse according to the 
15.1 	spouse's interest, or one-half of the joint interest is considered available to each spouse 
15.2 	if each spouse's interest is not specified;
15.3 	(iv) if there is no instrument that establishes ownership, one-half of the income is 
15.4 	considered available to each spouse; and
15.5 	(v) either spouse may rebut the determination of availability of income by showing 
15.6 	by a preponderance of the evidence that ownership interests are different than provided 
15.7 	above.
15.8 	(2) For income from a trust, income is considered available to each spouse as 
15.9 	provided in the trust. If the trust does not specify an amount available to either or both 
15.10 	spouses, availability will be determined according to items (i) to (iii):
15.11 	(i) if payment of income is made only to one spouse, the income is considered 
15.12 	available only to that spouse;
15.13 	(ii) if payment of income is made to both spouses, one-half is considered available to 
15.14 	each; and
15.15 	(iii) if payment is made to either or both spouses and one or more other persons, 
15.16 	the income is considered available to each spouse in proportion to each spouse's interest, 
15.17 	or if no such interest is specified, one-half of the joint interest is considered available 
15.18 	to each spouse.

15.19 	Sec. 20. Minnesota Statutes 2006, section 256B.059, subdivision 1, is amended to read:
15.20 		Subdivision 1.Definitions. (a) For purposes of this section and section sections 
15.21 	256B.058 and256B.0595, the terms defined in this subdivision have the meanings given 
15.22 	them. 
15.23 	(b) "Community spouse" means the spouse of an institutionalized spouse.
15.24 	(c) "Spousal share" means one-half of the total value of all assets, to the extent that 
15.25 	either the institutionalized spouse or the community spouse had an ownership interest at 
15.26 	the time of the first continuous period of institutionalization.
15.27 	(d) "Assets otherwise available to the community spouse" means assets individually 
15.28 	or jointly owned by the community spouse, other than assets excluded by subdivision 5, 
15.29 	paragraph (c).
15.30 	(e) "Community spouse asset allowance" is the value of assets that can be transferred 
15.31 	under subdivision 3.
15.32 	(f) "Institutionalized spouse" means a person who is:
15.33 	(1) in a hospital, nursing facility, or intermediate care facility for persons with 
15.34 	developmental disabilities, or receiving home and community-based services under 
16.1 	section 256B.0915or 256B.49, and is expected to remain in the facility or institution or 
16.2 	receive the home and community-based services for at least 30 consecutive days; and 
16.3 	(2) married to a person who is not in a hospital, nursing facility, or intermediate 
16.4 	care facility for persons with developmental disabilities, and is not receiving home and 
16.5 	community-based services under section 256B.0915, 256B.092,  or 256B.49. 
16.6 	(g) "For the sole benefit of" means no other individual or entity can benefit in any 
16.7 	way from the assets or income at the time of a transfer or at any time in the future.
16.8 	(h) "Continuous period of institutionalization" means a 30-consecutive-day period 
16.9 	of time in which a person is expected to stay in a medical or long-term care facility, 
16.10 	or receive home and community-based services that would qualify for coverage under 
16.11 	the elderly waiver (EW) or alternative care (AC) programs. For a stay in a facility, the 
16.12 	30-consecutive-day period begins on the date of entry into a medical or long-term care 
16.13 	facility. For receipt of home and community-based services, the 30-consecutive-day 
16.14 	period begins on the date that the following conditions are met:
16.15 	(1) the person is receiving services that meet the nursing facility level of care 
16.16 	determined by a long-term care consultation;
16.17 	(2) the person has received the long-term care consultation within the past 60 days;
16.18 	(3) the services are paid by the EW program under section 256B.0915 or the AC 
16.19 	program under section 256B.0913 or would qualify for payment under the EW or AC 
16.20 	programs if the person were otherwise eligible for either program, and but for the receipt 
16.21 	of such services the person would have resided in a nursing facility; and
16.22 	(4) the services are provided by a licensed provider qualified to provide home and 
16.23 	community-based services.

16.24 	Sec. 21. Minnesota Statutes 2006, section 256B.059, subdivision 1a, is amended to 
16.25 	read:
16.26 		Subd. 1a.Institutionalized spouse. The provisions of this section apply only 
16.27 	when a spouse is institutionalized for abegins the first continuous period beginningof 
16.28 	institutionalization on or after October 1, 1989.

16.29 	Sec. 22. Minnesota Statutes 2006, section 256B.0594, is amended to read:
16.30 	256B.0594 PAYMENT OF BENEFITS FROM AN ANNUITY.
16.31 	When payment becomes due under an annuity that names the department a 
16.32 	remainder beneficiary as described in section 256B.056, subdivision 11, the issuer shall 
16.33 	request and the department shall, within 45 days after receipt of the request, provide 
16.34 	a written statement of the total amount of the medical assistance paid or confirmation 
17.1 	that any family member designated as a remainder beneficiary meets requirements for 
17.2 	qualification as a beneficiary in the first position. Upon timely receipt of the written 
17.3 	statement of the amount of medical assistance paid, the issuer shall pay the department an 
17.4 	amount equal to the lesser of the amount due the department under the annuity or the total 
17.5 	amount of medical assistance paid on behalf of the individual or the individual's spouse. 
17.6 	Any amounts remaining after the issuer's payment to the department shall be payable 
17.7 	according to the terms of the annuity or similar financial instrument. The county agency 
17.8 	or the department shall provide the issuer with the name, address, and telephone number 
17.9 	of a unit within the department the issuer can contact to comply with this section. The 
17.10 	requirements of section 72A.201, subdivision 4, clause (3), shall not apply to payments 
17.11 	made under this section until the issuer has received final payment information from the 
17.12 	department, if the issuer has notified the beneficiary of the requirements of this section at 
17.13 	the time it initially requests payment information from the department.

17.14 	Sec. 23. Minnesota Statutes 2006, section 256B.0595, subdivision 1, is amended to 
17.15 	read:
17.16 		Subdivision 1.Prohibited transfers. (a) For transfers of assets made on or before 
17.17 	August 10, 1993, if a an institutionalized person or the institutionalized person's spouse 
17.18 	has given away, sold, or disposed of, for less than fair market value, any asset or interest 
17.19 	therein, except assets other than the homestead that are excluded under the supplemental 
17.20 	security program, within 30 months before or any time after the date of institutionalization 
17.21 	if the person has been determined eligible for medical assistance, or within 30 months 
17.22 	before or any time after the date of the first approved application for medical assistance 
17.23 	if the person has not yet been determined eligible for medical assistance, the person is 
17.24 	ineligible for long-term care services for the period of time determined under subdivision 
17.25 	2.
17.26 	(b) Effective for transfers made after August 10, 1993, a an institutionalized person, 
17.27 	a an institutionalized person's spouse, or any person, court, or administrative body with 
17.28 	legal authority to act in place of, on behalf of, at the direction of, or upon the request of the 
17.29 	institutionalized person or institutionalized person's spouse, may not give away, sell, or 
17.30 	dispose of, for less than fair market value, any asset or interest therein, except assets other 
17.31 	than the homestead that are excluded under the supplemental security income program, 
17.32 	for the purpose of establishing or maintaining medical assistance eligibility. This applies 
17.33 	to all transfers, including those made by a community spouse after the month in which 
17.34 	the institutionalized spouse is determined eligible for medical assistance. For purposes of 
17.35 	determining eligibility for long-term care services, any transfer of such assets within 36 
18.1 	months before or any time after an institutionalized person applies forrequests medical 
18.2 	assistance payment of long-term care services, or 36 months before or any time after a 
18.3 	medical assistance recipient becomes an institutionalized person, for less than fair market 
18.4 	value may be considered. Any such transfer is presumed to have been made for the purpose 
18.5 	of establishing or maintaining medical assistance eligibility and the institutionalized
18.6 	person is ineligible for long-term care services for the period of time determined under 
18.7 	subdivision 2, unless the institutionalized person furnishes convincing evidence to 
18.8 	establish that the transaction was exclusively for another purpose, or unless the transfer is 
18.9 	permitted under subdivision 3 or 4.  In the case of payments from a trust or portions of a 
18.10 	trust that are considered transfers of assets under federal law, or in the case of any other 
18.11 	disposal of assets made on or after February 8, 2006, any transfers made within 60 months 
18.12 	before or any time after an institutionalized person applies forrequests medical assistance 
18.13 	payment of long-term care services and within 60 months before or any time after a 
18.14 	medical assistance recipient becomes an institutionalized person, may be considered.
18.15 	(c) This section applies to transfers, for less than fair market value, of income 
18.16 	or assets, including assets that are considered income in the month received, such as 
18.17 	inheritances, court settlements, and retroactive benefit payments or income to which the
18.18 	institutionalized person or the institutionalized person's spouse is entitled but does not 
18.19 	receive due to action by the institutionalized person, the institutionalized person's spouse, 
18.20 	or any person, court, or administrative body with legal authority to act in place of, on 
18.21 	behalf of, at the direction of, or upon the request of the institutionalized person or the
18.22 	institutionalized person's spouse.
18.23 	(d) This section applies to payments for care or personal services provided by a 
18.24 	relative, unless the compensation was stipulated in a notarized, written agreement which 
18.25 	was in existence when the service was performed, the care or services directly benefited 
18.26 	the person, and the payments made represented reasonable compensation for the care 
18.27 	or services provided. A notarized written agreement is not required if payment for the 
18.28 	services was made within 60 days after the service was provided.
18.29 	(e) This section applies to the portion of any asset or interest that a an institutionalized
18.30 	person, a an institutionalized person's spouse, or any person, court, or administrative body 
18.31 	with legal authority to act in place of, on behalf of, at the direction of, or upon the request 
18.32 	of the institutionalized person or the institutionalized person's spouse, transfers to any 
18.33 	annuity that exceeds the value of the benefit likely to be returned to the institutionalized 
18.34 	person or institutionalized person's spouse while alive, based on estimated life expectancy 
18.35 	using the life expectancy tables employed by the supplemental security income program 
18.36 	to determine the value of an agreement for services for life as determined according to the 
19.1 	current actuarial tables published by the Office of the Chief Actuary of the Social Security 
19.2 	Administration. The commissioner may adopt rules reducing life expectancies based on 
19.3 	the need for long-term care. This section applies to an annuity described in this paragraph
19.4 	purchased on or after March 1, 2002, that:
19.5 	(1) is not purchased from an insurance company or financial institution that is 
19.6 	subject to licensing or regulation by the Minnesota Department of Commerce or a similar 
19.7 	regulatory agency of another state;
19.8 	(2) does not pay out principal and interest in equal monthly installments; or
19.9 	(3) does not begin payment at the earliest possible date after annuitization.
19.10 	(f) Effective for transactions, including the purchase of an annuity, occurring on 
19.11 	or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
19.12 	institutionalized person who has applied for or is receiving long-term care services or the 
19.13 	individual's institutionalized person's spouse shall be treated as the disposal of an asset for 
19.14 	less than fair market value unless the department is named as the a preferred remainder 
19.15 	beneficiary in first position for an amount equal to at least the total amount of medical 
19.16 	assistance paid on behalf of the individual or the individual's spouse; or the department 
19.17 	is named as the remainder beneficiary in second position for an amount equal to at least 
19.18 	the total amount of medical assistance paid on behalf of the individual or the individual's 
19.19 	spouse after the individual's community spouse or minor or disabled child and is named as 
19.20 	the remainder beneficiary in the first position if the community spouse or a representative 
19.21 	of the minor or disabled child disposes of the remainder for less than fair market value  as 
19.22 	described in section 256B.056, subdivision 11. Any subsequent change to the designation 
19.23 	of the department as a preferred remainder beneficiary shall result in the annuity being 
19.24 	treated as a disposal of assets for less than fair market value. The amount of such transfer 
19.25 	shall be the maximum amount the individual institutionalized person or the individual's
19.26 	institutionalized person's spouse could receive from the annuity or similar financial 
19.27 	instrument. Any change in the amount of the income or principal being withdrawn 
19.28 	from the annuity or other similar financial instrument at the time of the most recent 
19.29 	disclosure shall be deemed to be a transfer of assets for less than fair market value unless 
19.30 	the individual institutionalized person or the individual's institutionalized person's spouse 
19.31 	demonstrates that the transaction was for fair market value. In the event a distribution 
19.32 	of income or principal has been improperly distributed or disbursed from an annuity or 
19.33 	other retirement planning instrument of an institutionalized person or the institutionalized 
19.34 	person's spouse, a cause of action exists against the individual receiving the improper 
19.35 	distribution for the cost of medical assistance services provided or the amount of the 
19.36 	improper distribution, whichever is less.
20.1 	(g) Effective for transactions, including the purchase of an annuity, occurring on 
20.2 	or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
20.3 	institutionalized person applying for or receiving long-term care services shall be treated 
20.4 	as a disposal of assets for less than fair market value unless it is:
20.5 	(i) an annuity described in subsection (b) or (q) of section 408 of the Internal 
20.6 	Revenue Code of 1986; or 
20.7 	(ii) purchased with proceeds from:
20.8 	(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the 
20.9 	Internal Revenue Code;
20.10 	(B) a simplified employee pension within the meaning of section 408(k) of the 
20.11 	Internal Revenue Code; or
20.12 	(C) a Roth IRA described in section 408A of the Internal Revenue Code; or
20.13 	(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as 
20.14 	determined in accordance with actuarial publications of the Office of the Chief Actuary of 
20.15 	the Social Security Administration; and provides for payments in equal amounts during 
20.16 	the term of the annuity, with no deferral and no balloon payments made.
20.17 	 (h) For purposes of this section, long-term care services include services in a nursing 
20.18 	facility, services that are eligible for payment according to section 256B.0625, subdivision 
20.19 	2, because they are provided in a swing bed, intermediate care facility for persons with 
20.20 	developmental disabilities, and home and community-based services provided pursuant 
20.21 	to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and 
20.22 	subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient 
20.23 	in a nursing facility or in a swing bed, or intermediate care facility for persons with 
20.24 	developmental disabilities or who is receiving home and community-based services under 
20.25 	sections 256B.0915, 256B.092, and 256B.49. 
20.26 	(i) This section applies to funds used to purchase a promissory note, loan, or 
20.27 	mortgage unless the note, loan, or mortgage:
20.28 	(1) has a repayment term that is actuarially sound;
20.29 	(2) provides for payments to be made in equal amounts during the term of the loan, 
20.30 	with no deferral and no balloon payments made; and
20.31 	(3) prohibits the cancellation of the balance upon the death of the lender.
20.32 	In the case of a promissory note, loan, or mortgage that does not meet an exception 
20.33 	in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding 
20.34 	balance due as of the date of the individual's applicationinstitutionalized person's request 
20.35 	for medical assistance payment of long-term care services.
21.1 	(j) This section applies to the purchase of a life estate interest in another individual's
21.2 	person's home unless the purchaser resides in the home for a period of at least one year 
21.3 	after the date of purchase.

21.4 	Sec. 24. Minnesota Statutes 2006, section 256B.0595, subdivision 2, is amended to 
21.5 	read:
21.6 		Subd. 2.Period of ineligibility. (a) For any uncompensated transfer occurring on or 
21.7 	before August 10, 1993, the number of months of ineligibility for long-term care services 
21.8 	shall be the lesser of 30 months, or the uncompensated transfer amount divided by the 
21.9 	average medical assistance rate for nursing facility services in the state in effect on the 
21.10 	date of application. The amount used to calculate the average medical assistance payment 
21.11 	rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. 
21.12 	The period of ineligibility begins with the month in which the assets were transferred. 
21.13 	If the transfer was not reported to the local agency at the time of application, and the 
21.14 	applicant received long-term care services during what would have been the period of 
21.15 	ineligibility if the transfer had been reported, a cause of action exists against the transferee 
21.16 	for the cost of long-term care services provided during the period of ineligibility, or for the 
21.17 	uncompensated amount of the transfer, whichever is less. The action may be brought by 
21.18 	the state or the local agency responsible for providing medical assistance under chapter 
21.19 	256G. The uncompensated transfer amount is the fair market value of the asset at the time 
21.20 	it was given away, sold, or disposed of, less the amount of compensation received.
21.21 	(b) For uncompensated transfers made after August 10, 1993, the number of months 
21.22 	of ineligibility for long-term care services shall be the total uncompensated value of the 
21.23 	resources transferred divided by the average medical assistance rate for nursing facility 
21.24 	services in the state in effect on the date of application. The amount used to calculate the 
21.25 	average medical assistance payment rate shall be adjusted each July 1 to reflect payment 
21.26 	rates for the previous calendar year. The period of ineligibility begins with the first day 
21.27 	of the month after the month in which the assets were transferred except that if one or 
21.28 	more uncompensated transfers are made during a period of ineligibility, the total assets 
21.29 	transferred during the ineligibility period shall be combined and a penalty period calculated 
21.30 	to begin on the first day of the month after the month in which the first uncompensated 
21.31 	transfer was made. If the transfer was reported to the local agency after the date that 
21.32 	advance notice of a period of ineligibility that affects the next month could be provided to 
21.33 	the recipient and the recipient received medical assistance services or the transfer was not 
21.34 	reported to the local agency, and the applicant or recipient received medical assistance 
21.35 	services during what would have been the period of ineligibility if the transfer had been 
22.1 	reported, a cause of action exists against the transferee for the cost of medical assistance
22.2 	that portion of long-term care services provided during the period of ineligibility, or for 
22.3 	the uncompensated amount of the transfer, whichever is less. The action may be brought 
22.4 	by the state or the local agency responsible for providing medical assistance under chapter 
22.5 	256G. The uncompensated transfer amount is the fair market value of the asset at the 
22.6 	time it was given away, sold, or disposed of, less the amount of compensation received. 
22.7 	Effective for transfers made on or after March 1, 1996, involving persons who apply for 
22.8 	medical assistance on or after April 13, 1996, no cause of action exists for a transfer unless:
22.9 	(1) the transferee knew or should have known that the transfer was being made by a 
22.10 	person who was a resident of a long-term care facility or was receiving that level of care in 
22.11 	the community at the time of the transfer;
22.12 	(2) the transferee knew or should have known that the transfer was being made to 
22.13 	assist the person to qualify for or retain medical assistance eligibility; or
22.14 	(3) the transferee actively solicited the transfer with intent to assist the person to 
22.15 	qualify for or retain eligibility for medical assistance.
22.16 	(c) For uncompensated transfers made on or after February 8, 2006, the period 
22.17 	of ineligibility:
22.18 	(1) for uncompensated transfers by or on behalf of individuals receiving medical 
22.19 	assistance payment of long-term care services, begins on the first day of the month 
22.20 	in which following advance notice can be given following of the penalty period, but no 
22.21 	later than the first day of the month in which assets have been transferred for less than 
22.22 	fair market value, that follows three full calendar months from the date of the report 
22.23 	or discovery of the transfer; or 
22.24 	(2) for uncompensated transfers by individuals requesting medical assistance 
22.25 	payment of long-term care services, begins the date on which the individual is eligible 
22.26 	for medical assistance under the Medicaid state plan and would otherwise be receiving 
22.27 	long-term care services based on an approved application for such care but for the 
22.28 	application of the penalty period, whichever is later,; and which does not occur
22.29 	(3) cannot begin during any other period of ineligibility.
22.30 	(d) If a calculation of a penalty period results in a partial month, payments for 
22.31 	long-term care services shall be reduced in an amount equal to the fraction. 
22.32 	(e) In the case of multiple fractional transfers of assets in more than one month for 
22.33 	less than fair market value on or after February 8, 2006, the period of ineligibility is 
22.34 	calculated by treating the total, cumulative, uncompensated value of all assets transferred 
22.35 	during all months on or after February 8, 2006, as one transfer.

23.1 	Sec. 25. Minnesota Statutes 2006, section 256B.0595, subdivision 3, is amended to 
23.2 	read:
23.3 		Subd. 3.Homestead exception to transfer prohibition. (a) An institutionalized 
23.4 	person is not ineligible for long-term care services due to a transfer of assets for less than 
23.5 	fair market value if the asset transferred was a homestead and:
23.6 	(1) title to the homestead was transferred to the individual's:
23.7 	(i) spouse;
23.8 	(ii) child who is under age 21;
23.9 	(iii) blind or permanently and totally disabled child as defined in the supplemental 
23.10 	security income program;
23.11 	(iv) sibling who has equity interest in the home and who was residing in the home 
23.12 	for a period of at least one year immediately before the date of the individual's admission 
23.13 	to the facility; or
23.14 	(v) son or daughter who was residing in the individual's home for a period of at least 
23.15 	two years immediately before the date of the individual's admission to the facility the 
23.16 	individual became an institutionalized person, and who provided care to the individual 
23.17 	that, as certified by the individual's attending physician, permitted the individual to reside 
23.18 	at home rather than receive care in an institution or facility;
23.19 	(2) a satisfactory showing is made that the individual intended to dispose of the 
23.20 	homestead at fair market value or for other valuable consideration; or
23.21 	(3) the local agency grants a waiver of a penalty resulting from a transfer for less 
23.22 	than fair market value because denial of eligibility would cause undue hardship for the 
23.23 	individual, based on imminent threat to the individual's health and well-being. Whenever 
23.24 	an applicant or recipient is denied eligibility because of a transfer for less than fair market 
23.25 	value, the local agency shall notify the applicant or recipient that the applicant or recipient 
23.26 	may request a waiver of the penalty if the denial of eligibility will cause undue hardship. 
23.27 	With the written consent of the individual or the personal representative of the individual, 
23.28 	a long-term care facility in which an individual is residing may file an undue hardship 
23.29 	waiver request, on behalf of the individual who is denied eligibility for long-term care 
23.30 	services on or after July 1, 2006, due to a period of ineligibility resulting from a transfer on 
23.31 	or after February 8, 2006. In evaluating a waiver, the local agency shall take into account 
23.32 	whether the individual was the victim of financial exploitation, whether the individual has 
23.33 	made reasonable efforts to recover the transferred property or resource, and other factors 
23.34 	relevant to a determination of hardship. If the local agency does not approve a hardship 
23.35 	waiver, the local agency shall issue a written notice to the individual stating the reasons 
23.36 	for the denial and the process for appealing the local agency's decision.
24.1 	(b) When a waiver is granted under paragraph (a), clause (3), a cause of action exists 
24.2 	against the person to whom the homestead was transferred for that portion of long-term 
24.3 	care services granted provided within:
24.4 	(1) 30 months of a transfer made on or before August 10, 1993;
24.5 	(2) 60 months if the homestead was transferred after August 10, 1993, to a trust or 
24.6 	portion of a trust that is considered a transfer of assets under federal law; 
24.7 	(3) 36 months if transferred in any other manner after August 10, 1993, but prior 
24.8 	to February 8, 2006; or
24.9 	(4) 60 months if the homestead was transferred on or after February 8, 2006,
24.10 	or the amount of the uncompensated transfer, whichever is less, together with the 
24.11 	costs incurred due to the action. The action shall be brought by the state unless the 
24.12 	state delegates this responsibility to the local agency responsible for providing medical 
24.13 	assistance under chapter 256G.

24.14 	Sec. 26. Minnesota Statutes 2006, section 256B.0595, subdivision 4, is amended to 
24.15 	read:
24.16 		Subd. 4.Other exceptions to transfer prohibition. An institutionalized person 
24.17 	who has made, or whose spouse has made a transfer prohibited by subdivision 1, is not 
24.18 	ineligible for long-term care services if one of the following conditions applies:
24.19 	(1) the assets were transferred to the individual's spouse or to another for the sole 
24.20 	benefit of the spouse; or
24.21 	(2) the institutionalized spouse, prior to being institutionalized, transferred assets 
24.22 	to a spouse, provided that the spouse to whom the assets were transferred does not then 
24.23 	transfer those assets to another person for less than fair market value. (At the time when 
24.24 	one spouse is institutionalized, assets must be allocated between the spouses as provided 
24.25 	under section 256B.059); or
24.26 	(3) the assets were transferred to the individual's child who is blind or permanently 
24.27 	and totally disabled as determined in the supplemental security income program; or
24.28 	(4) a satisfactory showing is made that the individual intended to dispose of the 
24.29 	assets either at fair market value or for other valuable consideration; or
24.30 	(5) the local agency determines that denial of eligibility for long-term care services 
24.31 	would work an undue hardship and grants a waiver of a penalty resulting from a transfer 
24.32 	for less than fair market value based on an imminent threat to the individual's health 
24.33 	and well-being. Whenever an applicant or recipient is denied eligibility because of a 
24.34 	transfer for less than fair market value, the local agency shall notify the applicant or 
24.35 	recipient that the applicant or recipient may request a waiver of the penalty if the denial of 
25.1 	eligibility will cause undue hardship. With the written consent of the individual or the 
25.2 	personal representative of the individual, a long-term care facility in which an individual 
25.3 	is residing may file an undue hardship waiver request, on behalf of the individual who 
25.4 	is denied eligibility for long-term care services on or after July 1, 2006, due to a period 
25.5 	of ineligibility resulting from a transfer on or after February 8, 2006. In evaluating a 
25.6 	waiver, the local agency shall take into account whether the individual was the victim of 
25.7 	financial exploitation, whether the individual has made reasonable efforts to recover the 
25.8 	transferred property or resource, whether the individual has taken any action to prevent 
25.9 	the designation of the department as a remainder beneficiary on an annuity as described 
25.10 	in section 256B.056, subdivision 11, and other factors relevant to a determination of 
25.11 	hardship. The local agency shall make a determination within 30 days of the receipt of all 
25.12 	necessary information needed to make such a determination. If the local agency does not 
25.13 	approve a hardship waiver, the local agency shall issue a written notice to the individual 
25.14 	stating the reasons for the denial and the process for appealing the local agency's decision. 
25.15 	When a waiver is granted, a cause of action exists against the person to whom the assets 
25.16 	were transferred for that portion of long-term care services granted provided within:
25.17 	(i) 30 months of a transfer made on or before August 10, 1993;
25.18 	(ii) 60 months of a transfer if the assets were transferred after August 30, 1993, to a 
25.19 	trust or portion of a trust that is considered a transfer of assets under federal law; 
25.20 	(iii) 36 months of a transfer if transferred in any other manner after August 10, 1993, 
25.21 	but prior to February 8, 2006; or
25.22 	(iv) 60 months of any transfer made on or after February 8, 2006,
25.23 	or the amount of the uncompensated transfer, whichever is less, together with the 
25.24 	costs incurred due to the action. The action shall be brought by the state unless the 
25.25 	state delegates this responsibility to the local agency responsible for providing medical 
25.26 	assistance under this chapter; or
25.27 	(6) for transfers occurring after August 10, 1993, the assets were transferred by 
25.28 	the person or person's spouse: (i) into a trust established for the sole benefit of a son or 
25.29 	daughter of any age who is blind or disabled as defined by the Supplemental Security 
25.30 	Income program; or (ii) into a trust established for the sole benefit of an individual who is 
25.31 	under 65 years of age who is disabled as defined by the Supplemental Security Income 
25.32 	program.
25.33 	"For the sole benefit of" has the meaning found in section 256B.059, subdivision 1. 

25.34 	Sec. 27. Minnesota Statutes 2006, section 256B.0595, is amended by adding a 
25.35 	subdivision to read:
26.1 		Subd. 8.Cause of action; transfer prior to death. (a) A cause of action exists 
26.2 	against a transferee who receives assets for less than fair market value, either:
26.3 	(1) from a person who was a recipient of medical assistance and who made an 
26.4 	uncompensated transfer that was known to the county agency but a penalty period could 
26.5 	not be implemented under this section due to the death of the person; or
26.6 	(2) from a person who was a recipient of medical assistance who made an 
26.7 	uncompensated transfer that was not known to the county agency and the transfer was 
26.8 	made with the intent to hinder, delay, or defraud the state or local agency from recovering 
26.9 	as allowed under section 256B.15. In determining intent under this clause consideration 
26.10 	may be given, among other factors, to whether:
26.11 	(i) the transfer was to a family member;
26.12 	(ii) the transferor retained possession or control of the property after the transfer;
26.13 	(iii) the transfer was concealed;
26.14 	(iv) the transfer included the majority of the transferor's assets;
26.15 	(v) the value of the consideration received was not reasonably equivalent to the fair 
26.16 	market value of the property; and
26.17 	(vi) the transfer occurred shortly before the death of the transferor.
26.18 	(b) No cause of action exists under this subdivision unless:
26.19 	(1) the transferee knew or should have known that the transfer was being made by a 
26.20 	person who was receiving medical assistance as described in section 256B.15, subdivision 
26.21 	1, paragraph (b); and 
26.22 	(2) the transferee received the asset without providing a reasonable equivalent fair 
26.23 	market value in exchange for the transfer.
26.24 	(c) The cause of action is for the uncompensated amount of the transfer or the 
26.25 	amount of medical assistance paid on behalf of the person, whichever is less. The 
26.26 	uncompensated transfer amount is the fair market value of the asset at the time it was 
26.27 	given away, sold, or disposed of, less the amount of the compensation received.

26.28 	Sec. 28. Minnesota Statutes 2006, section 256B.0595, is amended by adding a 
26.29 	subdivision to read:
26.30 		Subd. 9.Filing cause of action; limitation. (a) The county of financial 
26.31 	responsibility under chapter 256G may bring a cause of action under any or all of the 
26.32 	following:
26.33 	(1) subdivision 1, paragraph (f);
26.34 	(2) subdivision 2, paragraphs (a) and (b);
26.35 	(3) subdivision 3, paragraph (b);
27.1 	(4) subdivision 4, clause (5); and
27.2 	(5) subdivision 8
27.3 	on behalf of the claimant who must be the commissioner.
27.4 	(b) Notwithstanding any other law to the contrary, a cause of action under 
27.5 	subdivision 2, paragraph (a) or (b), or 8, must be commenced within six years of the date 
27.6 	the local agency determines that a transfer was made for less than fair market value. 
27.7 	Notwithstanding any other law to the contrary, a cause of action under subdivision 3, 
27.8 	paragraph (b), or 4, clause (5), must be commenced within six years of the date of 
27.9 	approval of a waiver of the penalty period for a transfer for less than fair market value 
27.10 	based on undue hardship.

27.11 	Sec. 29. Minnesota Statutes 2006, section 256B.0625, subdivision 3c, is amended to 
27.12 	read:
27.13 		Subd. 3c.Health Services Policy Committee. The commissioner, after receiving 
27.14 	recommendations from professional physician associations, professional associations 
27.15 	representing licensed nonphysician health care professionals, and consumer groups, shall 
27.16 	establish a 13-member Health Services Policy Committee, which consists of 12 voting 
27.17 	members and one nonvoting member. The Health Services Policy Committee shall advise 
27.18 	the commissioner regarding health services pertaining to the administration of health 
27.19 	care benefits covered under the medical assistance, general assistance medical care, and 
27.20 	MinnesotaCare programs. The Health Services Policy Committee shall meet at least 
27.21 	quarterly. The Health Services Policy Committee shall annually elect a physician chair 
27.22 	from among its members, who shall work directly with the commissioner's medical 
27.23 	director, to establish the agenda for each meeting. The Health Services Policy Committee 
27.24 	shall also recommend criteria for verifying centers of excellence for specific aspects of 
27.25 	medical care where a specific set of combined services, a volume of patients necessary to 
27.26 	maintain a high level of competency, or a specific level of technical capacity is associated 
27.27 	with improved health outcomes.

27.28 	Sec. 30. Minnesota Statutes 2006, section 256B.0625, subdivision 13g, is amended to 
27.29 	read:
27.30 		Subd. 13g.Preferred drug list. (a) The commissioner shall adopt and implement a 
27.31 	preferred drug list by January 1, 2004. The commissioner may enter into a contract with 
27.32 	a vendor or one or more states for the purpose of participating in a multistate preferred 
27.33 	drug list and supplemental rebate program. The commissioner shall ensure that any 
27.34 	contract meets all federal requirements and maximizes federal financial participation. The 
28.1 	commissioner shall publish the preferred drug list annually in the State Register and shall 
28.2 	maintain an accurate and up-to-date list on the agency Web site.
28.3 	(b) The commissioner may add to, delete from, and otherwise modify the preferred 
28.4 	drug list, after consulting with the Formulary Committee and appropriate medical 
28.5 	specialists and providing public notice and the opportunity for public comment.
28.6 	(c) The commissioner shall adopt and administer the preferred drug list as part of the 
28.7 	administration of the supplemental drug rebate program. Reimbursement for prescription 
28.8 	drugs not on the preferred drug list may be subject to prior authorization, unless the drug 
28.9 	manufacturer signs a supplemental rebate contract.
28.10 	(d) For purposes of this subdivision, "preferred drug list" means a list of prescription 
28.11 	drugs within designated therapeutic classes selected by the commissioner, for which prior 
28.12 	authorization based on the identity of the drug or class is not required.
28.13 	(e) The commissioner shall seek any federal waivers or approvals necessary to 
28.14 	implement this subdivision.

28.15 	Sec. 31. Minnesota Statutes 2006, section 256B.0625, subdivision 13h, is amended to 
28.16 	read:
28.17 		Subd. 13h.Medication therapy management services. (a) Medical assistance 
28.18 	and general assistance medical care cover medication therapy management services for 
28.19 	a recipient taking four or more prescriptions to treat or prevent two or more chronic 
28.20 	medical conditions, or a recipient with a drug therapy problem that is identified or prior 
28.21 	authorized by the commissioner that has resulted or is likely to result in significant 
28.22 	nondrug program costs. The commissioner may cover medical therapy management 
28.23 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
28.24 	purposes of this subdivision, "medication therapy management" means the provision 
28.25 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
28.26 	therapeutic outcomes of the patient's medications:
28.27 	(1) performing or obtaining necessary assessments of the patient's health status;
28.28 	(2) formulating a medication treatment plan;
28.29 	(3) monitoring and evaluating the patient's response to therapy, including safety 
28.30 	and effectiveness;
28.31 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
28.32 	medication-related problems, including adverse drug events;
28.33 	(5) documenting the care delivered and communicating essential information to 
28.34 	the patient's other primary care providers;
29.1 	(6) providing verbal education and training designed to enhance patient 
29.2 	understanding and appropriate use of the patient's medications;
29.3 	(7) providing information, support services, and resources designed to enhance 
29.4 	patient adherence with the patient's therapeutic regimens; and
29.5 	(8) coordinating and integrating medication therapy management services within the 
29.6 	broader health care management services being provided to the patient.
29.7 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
29.8 	the pharmacist as defined in section 151.01, subdivision 27.
29.9 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
29.10 	must meet the following requirements:
29.11 	(1) have a valid license issued under chapter 151;
29.12 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
29.13 	completed a structured and comprehensive education program approved by the Board of 
29.14 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
29.15 	documentation of pharmaceutical care management services that has both clinical and 
29.16 	didactic elements;
29.17 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
29.18 	have developed a structured patient care process that is offered in a private or semiprivate 
29.19 	patient care area that is separate from the commercial business that also occurs in the 
29.20 	setting, or in home settings, excluding long-term care and group homes, if the service is 
29.21 	ordered by the provider-directed care coordination team; and
29.22 	(4) make use of an electronic patient record system that meets state standards.
29.23 	(c) For purposes of reimbursement for medication therapy management services, 
29.24 	the commissioner may enroll individual pharmacists as medical assistance and general 
29.25 	assistance medical care providers. The commissioner may also establish contact 
29.26 	requirements between the pharmacist and recipient, including limiting the number of 
29.27 	reimbursable consultations per recipient.
29.28 	(d) The commissioner, after receiving recommendations from professional medical 
29.29 	associations, professional pharmacy associations, and consumer groups, shall convene 
29.30 	an 11-member Medication Therapy Management Advisory Committee to advise 
29.31 	the commissioner on the implementation and administration of medication therapy 
29.32 	management services. The committee shall be comprised of: two licensed physicians; 
29.33 	two licensed pharmacists; two consumer representatives; two health plan company 
29.34 	representatives; and three members with expertise in the area of medication therapy 
29.35 	management, who may be licensed physicians or licensed pharmacists. The committee is 
30.1 	governed by section 15.059, except that committee members do not receive compensation 
30.2 	or reimbursement for expenses. The advisory committee expires on June 30, 2007.
30.3 	(e) The commissioner shall evaluate the effect of medication therapy management 
30.4 	on quality of care, patient outcomes, and program costs, and shall include a description 
30.5 	of any savings generated in the medical assistance and general assistance medical care 
30.6 	programs that can be attributable to this coverage. The evaluation shall be submitted to 
30.7 	the legislature by December 15, 2007. The commissioner may contract with a vendor 
30.8 	or an academic institution that has expertise in evaluating health care outcomes for the 
30.9 	purpose of completing the evaluation.

30.10 	Sec. 32. Minnesota Statutes 2007 Supplement, section 256B.0625, subdivision 49, 
30.11 	is amended to read:
30.12 		Subd. 49.Community health worker. (a) Medical assistance covers the care 
30.13 	coordination and patient education services provided by a community health worker if 
30.14 	the community health worker has: 
30.15 	(1) received a certificate from the Minnesota State Colleges and Universities System 
30.16 	approved community health worker curriculum; or
30.17 	(2) at least five years of supervised experience with an enrolled physician, registered 
30.18 	nurse, or advanced practice registered nurse, or dentist, or at least five years of supervised 
30.19 	experience by a certified public health nurse operating under the direct authority of an 
30.20 	enrolled unit of government.
30.21 	Community health workers eligible for payment under clause (2) must complete the 
30.22 	certification program by January 1, 2010, to continue to be eligible for payment.
30.23 	(b) Community health workers must work under the supervision of a medical 
30.24 	assistance enrolled physician, registered nurse, or advanced practice registered nurse, or 
30.25 	dentist, or work under the supervision of a certified public health nurse operating under 
30.26 	the direct authority of an enrolled unit of government.
30.27 	(c) Care coordination and patient education services covered under this subdivision 
30.28 	include, but are not limited to, services relating to oral health and dental care.

30.29 	Sec. 33. Minnesota Statutes 2006, section 256B.075, subdivision 2, is amended to read:
30.30 		Subd. 2.Fee-for-service. (a) The commissioner shall develop and implement 
30.31 	a disease management program for medical assistance and general assistance medical 
30.32 	care recipients who are not enrolled in the prepaid medical assistance or prepaid general 
30.33 	assistance medical care programs and who are receiving services on a fee-for-service basis. 
30.34 	The commissioner may contract with an outside organization to provide these services.
31.1 	(b) The commissioner shall seek any federal approval necessary to implement this 
31.2 	section and to obtain federal matching funds.
31.3 	(c) The commissioner shall develop and implement a pilot intensive care 
31.4 	management program for medical assistance children with complex and chronic medical 
31.5 	issues who are not able to participate in the metro-based U Special Kids program due 
31.6 	to geographic distance.

31.7 	Sec. 34. Minnesota Statutes 2006, section 256B.15, subdivision 4, is amended to read:
31.8 		Subd. 4.Other survivors. (a) If the decedent who was single or the surviving 
31.9 	spouse of a married couple is survived by one of the following persons, a claim exists 
31.10 	against the estate payable first from the value of the nonhomestead property included in 
31.11 	the estate and the personal representative shall make, execute, and deliver to the county 
31.12 	agency a lien against the homestead property in the estate for any unpaid balance of the 
31.13 	claim to the claimant as provided under this section:
31.14 	(a) (1) a sibling who resided in the decedent medical assistance recipient's home at 
31.15 	least one year before the decedent's institutionalization and continuously since the date 
31.16 	of institutionalization; or
31.17 	(b) (2) a son or daughter or a grandchild who resided in the decedent medical 
31.18 	assistance recipient's home for at least two years immediately before the parent's or 
31.19 	grandparent's institutionalization and continuously since the date of institutionalization, 
31.20 	and who establishes by a preponderance of the evidence having provided care to the 
31.21 	parent or grandparent who received medical assistance, that the care was provided before 
31.22 	institutionalization, and that the care permitted the parent or grandparent to reside at 
31.23 	home rather than in an institution.
31.24 	(b) For purposes of this subdivision, "institutionalization" means receiving care:
31.25 	(1) in a nursing facility or swing bed, or intermediate care facility for persons with 
31.26 	developmental disabilities; or
31.27 	(2) through home and community-based services under section 256B.0915, 
31.28 	256B.092, or 256B.49.

31.29 	Sec. 35. Minnesota Statutes 2006, section 256B.69, subdivision 3a, is amended to read:
31.30 		Subd. 3a.County authority. (a) The commissioner, when implementing the general 
31.31 	assistance medical care, or medical assistance prepayment program within a county, 
31.32 	must include the county board in the process of development, approval, and issuance of 
31.33 	the request for proposals to provide services to eligible individuals within the proposed 
31.34 	county. County boards must be given reasonable opportunity to make recommendations 
32.1 	regarding the development, issuance, review of responses, and changes needed in the 
32.2 	request for proposals. The commissioner must provide county boards the opportunity to 
32.3 	review each proposal based on the identification of community needs under chapters 145A 
32.4 	and 256E and county advocacy activities. If a county board finds that a proposal does not 
32.5 	address certain community needs, the county board and commissioner shall continue 
32.6 	efforts for improving the proposal and network prior to the approval of the contract. The 
32.7 	county board shall make recommendations regarding the approval of local networks 
32.8 	and their operations to ensure adequate availability and access to covered services. The 
32.9 	provider or health plan must respond directly to county advocates and the state prepaid 
32.10 	medical assistance ombudsperson regarding service delivery and must be accountable to 
32.11 	the state regarding contracts with medical assistance and general assistance medical care 
32.12 	funds. The county board may recommend a maximum number of participating health 
32.13 	plans after considering the size of the enrolling population; ensuring adequate access and 
32.14 	capacity; considering the client and county administrative complexity; and considering 
32.15 	the need to promote the viability of locally developed health plans. The county board 
32.16 	or a single entity representing a group of county boards and the commissioner shall 
32.17 	mutually select health plans for participation at the time of initial implementation of the 
32.18 	prepaid medical assistance program in that county or group of counties and at the time 
32.19 	of contract renewal. The commissioner shall also seek input for contract requirements 
32.20 	from the county or single entity representing a group of county boards at each contract 
32.21 	renewal and incorporate those recommendations into the contract negotiation process. 
32.22 	The commissioner, in conjunction with the county board, shall actively seek to develop 
32.23 	a mutually agreeable timetable prior to the development of the request for proposal, but 
32.24 	counties must agree to initial enrollment beginning on or before January 1, 1999, in 
32.25 	either the prepaid medical assistance and general assistance medical care programs or 
32.26 	county-based purchasing under section 256B.692. At least 90 days before enrollment in 
32.27 	the medical assistance and general assistance medical care prepaid programs begins in 
32.28 	a county in which the prepaid programs have not been established, the commissioner 
32.29 	shall provide a report to the chairs of senate and house committees having jurisdiction 
32.30 	over state health care programs which verifies that the commissioner complied with the 
32.31 	requirements for county involvement that are specified in this subdivision.
32.32 	(b) At the option of the county board, the board may develop contract requirements 
32.33 	related to the achievement of local public health goals to meet the health needs of medical 
32.34 	assistance and general assistance medical care enrollees. These requirements must be 
32.35 	reasonably related to the performance of health plan functions and within the scope of the 
32.36 	medical assistance and general assistance medical care benefit sets. If the county board 
33.1 	and the commissioner mutually agree to such requirements, the department shall include 
33.2 	such requirements in all health plan contracts governing the prepaid medical assistance 
33.3 	and general assistance medical care programs in that county at initial implementation of 
33.4 	the program in that county and at the time of contract renewal. The county board may 
33.5 	participate in the enforcement of the contract provisions related to local public health goals.
33.6 	(c) For counties in which prepaid medical assistance and general assistance medical 
33.7 	care programs have not been established, the commissioner shall not implement those 
33.8 	programs if a county board submits acceptable and timely preliminary and final proposals 
33.9 	under section 256B.692, until county-based purchasing is no longer operational in that 
33.10 	county. For counties in which prepaid medical assistance and general assistance medical 
33.11 	care programs are in existence on or after September 1, 1997, the commissioner must 
33.12 	terminate contracts with health plans according to section 256B.692, subdivision 5, if 
33.13 	the county board submits and the commissioner accepts preliminary and final proposals 
33.14 	according to that subdivision. The commissioner is not required to terminate contracts that 
33.15 	begin on or after September 1, 1997, according to section 256B.692 until two years have 
33.16 	elapsed from the date of initial enrollment. 
33.17 	(d) In the event that a county board or a single entity representing a group of county 
33.18 	boards and the commissioner cannot reach agreement regarding: (i) the selection of 
33.19 	participating health plans in that county; (ii) contract requirements; or (iii) implementation 
33.20 	and enforcement of county requirements including provisions regarding local public 
33.21 	health goals, the commissioner shall resolve all disputes after taking into account the 
33.22 	recommendations of a three-person mediation panel. The panel shall be composed of one 
33.23 	designee of the president of the association of Minnesota counties, one designee of the 
33.24 	commissioner of human services, and one designee of the commissioner of health person 
33.25 	selected jointly by the designee of the commissioner of human services and the designee 
33.26 	of the Association of Minnesota Counties. Within a reasonable period of time before 
33.27 	the hearing, the panelists must be provided all documents and information relevant to 
33.28 	the mediation. The parties to the mediation must be given 30 days' notice of a hearing 
33.29 	before the mediation panel.
33.30 	(e) If a county which elects to implement county-based purchasing ceases to 
33.31 	implement county-based purchasing, it is prohibited from assuming the responsibility of 
33.32 	county-based purchasing for a period of five years from the date it discontinues purchasing.
33.33 	(f) Notwithstanding the requirement in this subdivision that a county must agree to 
33.34 	initial enrollment on or before January 1, 1999, the commissioner shall grant a delay in 
33.35 	the implementation of the county-based purchasing authorized in section 256B.692 until 
33.36 	federal waiver authority and approval has been granted, if the county or group of counties 
34.1 	has submitted a preliminary proposal for county-based purchasing by September 1, 1997, 
34.2 	has not already implemented the prepaid medical assistance program before January 1, 
34.3 	1998, and has submitted a written request for the delay to the commissioner by July 
34.4 	1, 1998. In order for the delay to be continued, the county or group of counties must 
34.5 	also submit to the commissioner the following information by December 1, 1998. The 
34.6 	information must: 
34.7 	(1) identify the proposed date of implementation, as determined under section 
34.8 	256B.692, subdivision 5; 
34.9 	(2) include copies of the county board resolutions which demonstrate the continued 
34.10 	commitment to the implementation of county-based purchasing by the proposed date. 
34.11 	County board authorization may remain contingent on the submission of a final proposal 
34.12 	which meets the requirements of section 256B.692, subdivision 5, paragraph (b); 
34.13 	(3) demonstrate actions taken for the establishment of a governance structure 
34.14 	between the participating counties and describe how the fiduciary responsibilities of 
34.15 	county-based purchasing will be allocated between the counties, if more than one county 
34.16 	is involved in the proposal;
34.17 	(4) describe how the risk of a deficit will be managed in the event expenditures are 
34.18 	greater than total capitation payments. This description must identify how any of the 
34.19 	following strategies will be used:
34.20 	(i) risk contracts with licensed health plans;
34.21 	(ii) risk arrangements with providers who are not licensed health plans;
34.22 	(iii) risk arrangements with other licensed insurance entities; and
34.23 	(iv) funding from other county resources;
34.24 	(5) include, if county-based purchasing will not contract with licensed health plans 
34.25 	or provider networks, letters of interest from local providers in at least the categories of 
34.26 	hospital, physician, mental health, and pharmacy which express interest in contracting 
34.27 	for services. These letters must recognize any risk transfer identified in clause (4), item 
34.28 	(ii); and
34.29 	(6) describe the options being considered to obtain the administrative services 
34.30 	required in section 256B.692, subdivision 3, clauses (3) and (5). 
34.31 	(g) For counties which receive a delay under this subdivision, the final proposals 
34.32 	required under section 256B.692, subdivision 5, paragraph (b), must be submitted at 
34.33 	least six months prior to the requested implementation date. Authority to implement 
34.34 	county-based purchasing remains contingent on approval of the final proposal as required 
34.35 	under section 256B.692. 
35.1 	(h) If the commissioner is unable to provide county-specific, individual-level 
35.2 	fee-for-service claims to counties by June 4, 1998, the commissioner shall grant a delay 
35.3 	under paragraph (f) of up to 12 months in the implementation of county-based purchasing, 
35.4 	and shall require implementation not later than January 1, 2000. In order to receive an 
35.5 	extension of the proposed date of implementation under this paragraph, a county or group 
35.6 	of counties must submit a written request for the extension to the commissioner by August 
35.7 	1, 1998, must submit the information required under paragraph (f) by December 1, 1998, 
35.8 	and must submit a final proposal as provided under paragraph (g).
35.9 	(i) Notwithstanding other requirements of this subdivision, the commissioner 
35.10 	shall not require the implementation of the county-based purchasing authorized in 
35.11 	section 256B.692 until six months after federal waiver approval has been obtained for 
35.12 	county-based purchasing, if the county or counties have submitted the final plan as 
35.13 	required in section 256B.692, subdivision 5. The commissioner shall allow the county or 
35.14 	counties which submitted information under section 256B.692, subdivision 5, to submit 
35.15 	supplemental or additional information which was not possible to submit by April 1, 1999. 
35.16 	A county or counties shall continue to submit the required information and substantive 
35.17 	detail necessary to obtain a prompt response and waiver approval. If amendments to 
35.18 	the final plan are necessary due to the terms and conditions of the waiver approval, the 
35.19 	commissioner shall allow the county or group of counties 60 days to make the necessary 
35.20 	amendments to the final plan and shall not require implementation of the county-based 
35.21 	purchasing until six months after the revised final plan has been submitted. 
35.22 	(f) The commissioner shall not require that contractual disputes between 
35.23 	county-based purchasing entities and the commissioner be mediated by a panel that 
35.24 	includes a representative of the Minnesota Council of Health Plans.
35.25 	(g) At the request of a county-purchasing entity, the commissioner shall adopt a 
35.26 	contract reprocurement or renewal schedule under which all counties included in the 
35.27 	entity's service area are reprocured or renewed at the same time.
35.28 	(h) The commissioner shall provide a written report under section 3.195 to the chairs 
35.29 	of the legislative committees having jurisdiction over human services in the senate and the 
35.30 	house of representatives describing in detail the activities undertaken by the commissioner 
35.31 	to ensure full compliance with this section. The report must also provide an explanation 
35.32 	for any decisions of the commissioner not to accept the recommendations of a county or 
35.33 	group of counties required to be consulted under this section. The report must be provided 
35.34 	at least 30 days prior to the effective date of a new or renewed prepaid or managed care 
35.35 	contract in a county.

36.1 	Sec. 36. Minnesota Statutes 2006, section 256B.69, subdivision 6, is amended to read:
36.2 		Subd. 6.Service delivery. (a) Each demonstration provider shall be responsible for 
36.3 	the health care coordination for eligible individuals. Demonstration providers:
36.4 	(1) shall authorize and arrange for the provision of all needed health services 
36.5 	including but not limited to the full range of services listed in sections 256B.02, 
36.6 	subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered 
36.7 	to enrollees; notwithstanding section 256B.0621, demonstration providers that provide 
36.8 	nursing home and community-based services under this section shall provide relocation 
36.9 	service coordination to enrolled persons age 65 and over; 
36.10 	(2) shall accept the prospective, per capita payment from the commissioner in return 
36.11 	for the provision of comprehensive and coordinated health care services for eligible 
36.12 	individuals enrolled in the program;
36.13 	(3) may contract with other health care and social service practitioners to provide 
36.14 	services to enrollees; and
36.15 	(4) shall institute recipient grievance procedures according to the method established 
36.16 	by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved 
36.17 	through this process shall be appealable to the commissioner as provided in subdivision 11.
36.18 	(b) Demonstration providers must comply with the standards for claims settlement 
36.19 	under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health 
36.20 	care and social service practitioners to provide services to enrollees. A demonstration 
36.21 	provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, 
36.22 	section 447.45(b), within 30 business days of the date of acceptance of the claim. 

36.23 	Sec. 37. Minnesota Statutes 2006, section 256B.69, subdivision 27, is amended to read:
36.24 		Subd. 27.Information for persons with limited English-language proficiency.
 36.25 	Managed care contracts entered into under this section and sections 256D.03, subdivision 
36.26 	4, paragraph (c), and 256L.12 must require demonstration providers to inform enrollees 
36.27 	that upon request the enrollee can obtain a certificate of coverage in the following 
36.28 	languages: Spanish, Hmong, Laotian, Russian, Somali, Vietnamese, or Cambodian. 
36.29 	Upon request, the demonstration provider must provide the enrollee with a certificate of 
36.30 	coverage in the specified language of preference provide language assistance to enrollees 
36.31 	that ensures meaningful access to its programs and services according to Title VI of the 
36.32 	Civil Rights Act and federal regulations adopted under that law or any guidance from the 
36.33 	United States Department of Health and Human Services. 

36.34 	Sec. 38. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to read:
37.1 		Subd. 28.Medicare special needs plans; medical assistance basic health care.
 37.2 	(a) The commissioner may contract with qualified Medicare-approved special needs 
37.3 	plans to provide medical assistance basic health care services to persons with disabilities, 
37.4 	including those with developmental disabilities. Basic health care services include:
37.5 	(1) those services covered by the medical assistance state plan except for ICF/MR 
37.6 	services, home and community-based waiver services, case management for persons with 
37.7 	developmental disabilities under section 256B.0625, subdivision 20a, and personal care 
37.8 	and certain home care services defined by the commissioner in consultation with the 
37.9 	stakeholder group established under paragraph (d); and
37.10 	(2) basic health care services may also include risk for up to 100 days of nursing 
37.11 	facility services for persons who reside in a noninstitutional setting and home health 
37.12 	services related to rehabilitation as defined by the commissioner after consultation with 
37.13 	the stakeholder group.
37.14 	The commissioner may exclude other medical assistance services from the basic 
37.15 	health care benefit set. Enrollees in these plans can access any excluded services on the 
37.16 	same basis as other medical assistance recipients who have not enrolled.
37.17 	Unless a person is otherwise required to enroll in managed care, enrollment in these 
37.18 	plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 
37.19 	enrollment with an option to opt out is not voluntary enrollment. 
37.20 	(b) Beginning January 1, 2007, the commissioner may contract with qualified 
37.21 	Medicare special needs plans to provide basic health care services under medical 
37.22 	assistance to persons who are dually eligible for both Medicare and Medicaid and those 
37.23 	Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 
37.24 	The commissioner shall consult with the stakeholder group under paragraph (d) in 
37.25 	developing program specifications for these services. The commissioner shall report to 
37.26 	the chairs of the house and senate committees with jurisdiction over health and human 
37.27 	services policy and finance by February 1, 2007, on implementation of these programs and 
37.28 	the need for increased funding for the ombudsman for managed care and other consumer 
37.29 	assistance and protections needed due to enrollment in managed care of persons with 
37.30 	disabilities. Payment for Medicaid services provided under this subdivision for the months 
37.31 	of May and June will be made no earlier than July 1 of the same calendar year.
37.32 	(c) Beginning January 1, 2008, the commissioner may expand contracting under this 
37.33 	subdivision to all persons with disabilities not otherwise required to enroll in managed 
37.34 	care.
37.35 	(d) The commissioner shall establish a state-level stakeholder group to provide 
37.36 	advice on managed care programs for persons with disabilities, including both MnDHO 
38.1 	and contracts with special needs plans that provide basic health care services as described 
38.2 	in paragraphs (a) and (b). The stakeholder group shall provide advice on program 
38.3 	expansions under this subdivision and subdivision 23, including:
38.4 	(1) implementation efforts; 
38.5 	(2) consumer protections; and 
38.6 	(3) program specifications such as quality assurance measures, data collection and 
38.7 	reporting, and evaluation of costs, quality, and results.
38.8 	(e) Each plan under contract to provide medical assistance basic health care services 
38.9 	shall establish a local or regional stakeholder group, including representatives of the 
38.10 	counties covered by the plan, members, consumer advocates, and providers, for advice on 
38.11 	issues that arise in the local or regional area.
38.12 	(f) The commissioner is prohibited from providing the names of potential enrollees 
38.13 	to health plans for marketing purposes. The commissioner may mail marketing materials 
38.14 	to potential enrollees on behalf of health plans, in which case the health plans shall cover 
38.15 	any costs incurred by the commissioner for mailing marketing materials. 

38.16 	Sec. 39. Minnesota Statutes 2006, section 256B.692, subdivision 7, is amended to read:
38.17 		Subd. 7.Dispute resolution. In the event the commissioner rejects a proposal 
38.18 	under subdivision 6, the county board may request the recommendation of a three-person 
38.19 	mediation panel. The commissioner shall resolve all disputes after taking into account the 
38.20 	recommendations of the mediation panel. The panel shall be composed of one designee of 
38.21 	the president of the Association of Minnesota Counties, one designee of the commissioner 
38.22 	of human services, and one designee of the commissioner of health person selected jointly 
38.23 	by the designee of the commissioner of human services and the designee of the Association 
38.24 	of Minnesota Counties. Within a reasonable period of time before the hearing, the panelists 
38.25 	must be provided all documents and information relevant to the mediation. The parties to 
38.26 	the mediation must be given 30 days' notice of a hearing before the mediation panel.

38.27 	Sec. 40. Minnesota Statutes 2007 Supplement, section 256D.03, subdivision 3, is 
38.28 	amended to read:
38.29 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
38.30 	medical care may be paid for any person who is not eligible for medical assistance under 
38.31 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
38.32 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
38.33 	paragraph (b), except as provided in paragraph (c), and:
39.1 	(1) who is receiving assistance under section 256D.05, except for families with 
39.2 	children who are eligible under Minnesota family investment program (MFIP), or who is 
39.3 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
39.4 	(2) who is a resident of Minnesota; and
39.5 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
39.6 	guidelines for the family size, using a six-month budget period and whose equity in assets 
39.7 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
39.8 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
39.9 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
39.10 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
39.11 	assets, and the waiver of excess assets must conform to the medical assistance program in 
39.12 	section 256B.056, subdivision 3, with the following exception: the maximum amount of 
39.13 	undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by 
39.14 	the trustee, assuming the full exercise of the trustee's discretion under the terms of the 
39.15 	trust, must be applied toward the asset maximum;
39.16 	(ii) who has gross countable income above 75 percent of the federal poverty 
39.17 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
39.18 	family size, using a six-month budget period, whose equity in assets is not in excess 
39.19 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
39.20 	hospitalization; or
39.21 	(iii) the commissioner shall adjust the income standards under this section each July 
39.22 	1 by the annual update of the federal poverty guidelines following publication by the 
39.23 	United States Department of Health and Human Services.
39.24 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
39.25 	general assistance medical care may not be paid for applicants or recipients who are adults 
39.26 	with dependent children under 21 whose gross family income is equal to or less than 275 
39.27 	percent of the federal poverty guidelines who are not described in paragraph (e).
39.28 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
39.29 	general assistance medical care may be paid for applicants and recipients who meet all 
39.30 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
39.31 	beginning the date of application. Immediately following approval of general assistance 
39.32 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
39.33 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
39.34 	six-month general assistance medical care eligibility period, until their six-month renewal. 
40.1 	(d) To be eligible for general assistance medical care following enrollment in 
40.2 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
40.3 	application.
40.4 	(e) Applicants and recipients eligible under paragraph (a), clause (1); who, are 
40.5 	exempt from the MinnesotaCare enrollment requirements in this subdivision if they:
40.6 	(1) have applied for and are awaiting a determination of blindness or disability by 
40.7 	the state medical review team or a determination of eligibility for Supplemental Security 
40.8 	Income or Social Security Disability Insurance by the Social Security Administration; who
40.9 	(2) fail to meet the requirements of section 256L.09, subdivision 2; who
40.10 	(3) are homeless as defined by United States Code, title 42, section 11301, et seq.; 
40.11 	who
40.12 	(4)  are classified as end-stage renal disease beneficiaries in the Medicare program; 
40.13 	who
40.14 	(5) are enrolled in private health care coverage as defined in section 256B.02, 
40.15 	subdivision 9; who
40.16 	(6) are eligible under paragraph (j); or who
40.17 	(7) receive treatment funded pursuant to section 254B.02are exempt from the 
40.18 	MinnesotaCare enrollment requirements of this subdivision; or
40.19 	(8) reside in the Minnesota sex offender program defined in chapter 246B.
40.20 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
40.21 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
40.22 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
40.23 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
40.24 	may reapply if there is a subsequent period of inpatient hospitalization.
40.25 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
40.26 	renewals completed by recipients and applicants who are persons described in paragraph 
40.27 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
40.28 	by the county agency. If all other eligibility requirements of this subdivision are met, 
40.29 	eligibility for general assistance medical care shall be available in any month during which 
40.30 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
40.31 	notice of termination for eligibility for general assistance medical care shall be sent to 
40.32 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
40.33 	met, eligibility for general assistance medical care shall be available until enrollment in 
40.34 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
40.35 	(h) The date of an initial Minnesota health care program application necessary to 
40.36 	begin a determination of eligibility shall be the date the applicant has provided a name, 
41.1 	address, and Social Security number, signed and dated, to the county agency or the 
41.2 	Department of Human Services. If the applicant is unable to provide a name, address, 
41.3 	Social Security number, and signature when health care is delivered due to a medical 
41.4 	condition or disability, a health care provider may act on an applicant's behalf to establish 
41.5 	the date of an initial Minnesota health care program application by providing the county 
41.6 	agency or Department of Human Services with provider identification and a temporary 
41.7 	unique identifier for the applicant. The applicant must complete the remainder of the 
41.8 	application and provide necessary verification before eligibility can be determined. The 
41.9 	county agency must assist the applicant in obtaining verification if necessary.
41.10 	(i) County agencies are authorized to use all automated databases containing 
41.11 	information regarding recipients' or applicants' income in order to determine eligibility for 
41.12 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
41.13 	in order to determine eligibility and premium payments by the county agency.
41.14 	(j) General assistance medical care is not available for a person in a correctional 
41.15 	facility unless the person is detained by law for less than one year in a county correctional 
41.16 	or detention facility as a person accused or convicted of a crime, or admitted as an 
41.17 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
41.18 	assistance medical care at the time the person is detained by law or admitted on a criminal 
41.19 	hold order and as long as the person continues to meet other eligibility requirements 
41.20 	of this subdivision.
41.21 	(k) General assistance medical care is not available for applicants or recipients who 
41.22 	do not cooperate with the county agency to meet the requirements of medical assistance.
41.23 	(l) In determining the amount of assets of an individual eligible under paragraph 
41.24 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
41.25 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
41.26 	less than fair market value within the 60 months preceding application for general 
41.27 	assistance medical care or during the period of eligibility. Any transfer described in this 
41.28 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
41.29 	general assistance medical care, unless the individual furnishes convincing evidence to 
41.30 	establish that the transaction was exclusively for another purpose. For purposes of this 
41.31 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
41.32 	was given away, sold, or disposed of, less the amount of compensation received. For any 
41.33 	uncompensated transfer, the number of months of ineligibility, including partial months, 
41.34 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
41.35 	per person payment made by the medical assistance program to skilled nursing facilities 
41.36 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
42.1 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
42.2 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
42.3 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
42.4 	month the transfer was reported to the county agency, or if the transfer was not reported, 
42.5 	the month in which the county agency discovered the transfer, whichever comes first. For 
42.6 	applicants, the period of ineligibility begins on the date of the first approved application.
42.7 	(m) When determining eligibility for any state benefits under this subdivision, 
42.8 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
42.9 	income and resources as defined in the Personal Responsibility and Work Opportunity 
42.10 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
42.11 	subsequently set out in federal rules.
42.12 	(n) Undocumented noncitizens and nonimmigrants are ineligible for general 
42.13 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
42.14 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
42.15 	an undocumented noncitizen is an individual who resides in the United States without the 
42.16 	approval or acquiescence of the United States Citizenship and Immigration Services.
42.17 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
42.18 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
42.19 	for general assistance medical care.
42.20 	(p) Effective July 1, 2003, general assistance medical care emergency services end.

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

42.22 	Sec. 41. Minnesota Statutes 2006, section 524.3-803, is amended to read:
42.23 	524.3-803 LIMITATIONS ON PRESENTATION OF CLAIMS.
42.24 	(a) All claims as defined in section 524.1-201(6), against a decedent's estate which 
42.25 	arose before the death of the decedent, including claims of the state and any subdivision 
42.26 	thereof, whether due or to become due, absolute or contingent, liquidated or unliquidated, 
42.27 	if not barred earlier by other statute of limitations, are barred against the estate, the personal 
42.28 	representative, and the heirs and devisees of the decedent, unless presented as follows: 
42.29 	(1) in the case of a creditor who is only entitled, under the United States Constitution 
42.30 	and under the Minnesota Constitution, to notice by publication under section 524.3-801, 
42.31 	within four months after the date of the court administrator's notice to creditors which 
42.32 	is subsequently published pursuant to section 524.3-801; 
43.1 	(2) in the case of a creditor who was served with notice under section 524.3-801(c), 
43.2 	within the later to expire of four months after the date of the first publication of notice to 
43.3 	creditors or one month after the service; 
43.4 	(3) within the later to expire of one year after the decedent's death, or one year after 
43.5 	June 16, 1989, whether or not notice to creditors has been published or served under 
43.6 	section 524.3-801, provided, however, that in the case of a decedent who died before June 
43.7 	16, 1989, no claim which was then barred by any provision of law may be deemed to have 
43.8 	been revived by the amendment of this section. Claims authorized by section 246.53, 
43.9 	256B.15, or 256D.16 must not be barred after one year as provided in this clause.
43.10 	(b) All claims against a decedent's estate which arise at or after the death of the 
43.11 	decedent, including claims of the state and any subdivision thereof, whether due or to 
43.12 	become due, absolute or contingent, liquidated or unliquidated, are barred against the 
43.13 	estate, the personal representative, and the heirs and devisees of the decedent, unless 
43.14 	presented as follows:
43.15 	(1) a claim based on a contract with the personal representative, within four months 
43.16 	after performance by the personal representative is due;
43.17 	(2) any other claim, within four months after it arises.
43.18 	(c) Nothing in this section affects or prevents:
43.19 	(1) any proceeding to enforce any mortgage, pledge, or other lien upon property 
43.20 	of the estate;
43.21 	(2) any proceeding to establish liability of the decedent or the personal representative 
43.22 	for which there is protection by liability insurance, to the limits of the insurance protection 
43.23 	only;
43.24 	(3) the presentment and payment at any time within one year after the decedent's 
43.25 	death of any claim arising before the death of the decedent that is referred to in section 
43.26 	524.3-715, clause (18), although the same may be otherwise barred under this section; or 
43.27 	(4) the presentment and payment at any time before a petition is filed in compliance 
43.28 	with section 524.3-1001 or 524.3-1002 or a closing statement is filed under section 
43.29 	524.3-1003, of: 
43.30 	(i) any claim arising after the death of the decedent that is referred to in section 
43.31 	524.3-715, clause (18), although the same may be otherwise barred hereunder; 
43.32 	(ii) any other claim, including claims subject to clause (3), which would otherwise be 
43.33 	barred hereunder, upon allowance by the court upon petition of the personal representative 
43.34 	or the claimant for cause shown on notice and hearing as the court may direct.

43.35 	Sec. 42. NURSING FACILITY PENSION COSTS.
 44.1 	The commissioner of human services shall evaluate the extent to which the 
44.2 	alternative payment system reimbursement methodology for pension costs leads to 
44.3 	funding shortfalls for nursing facilities that convert from public to private ownership. The 
44.4 	commissioner shall report to the legislature by January 15, 2009, recommendations for 
44.5 	any changes to the alternative payment system reimbursement methodology for pension 
44.6 	costs necessary to ensure the financial viability of nursing facilities. The commissioner 
44.7 	shall pay for any costs related to this study using existing resources.

44.8 	Sec. 43. NURSING FACILITY RATE DISPARITY REPORT.
 44.9 	The commissioner of human services shall study and make a report to the legislature 
44.10 	by January 15, 2009, with recommendations to reduce rate disparities between nursing 
44.11 	facilities in various regions of the state. The recommendations shall include cost estimates 
44.12 	and may include a phase-in schedule. The study shall be accomplished using existing 
44.13 	resources.

44.14 	Sec. 44. HOME MODIFICATIONS.
 44.15 	Effective upon federal approval, the costs associated with home modifications 
44.16 	that add to the square footage of an unlicensed private residence when necessary to 
44.17 	complete a modification to configure a bathroom to accommodate a wheelchair may 
44.18 	be allowed expenses for home and community-based waiver services provided under 
44.19 	Minnesota Statutes, sections 256B.0916 and 256B.49, for persons with disabilities when 
44.20 	the following conditions are met:
44.21 	(1) the annual cost of the care and modifications for the waiver recipient does not 
44.22 	exceed the cost of care that would otherwise be incurred for the recipient without the 
44.23 	modification, as determined by the local lead agency;
44.24 	(2) the modification is based on the assessed needs, goals, and best interest of the 
44.25 	recipient as identified in the plan of care;
44.26 	(3) the modification has been found to be the least costly appropriate alternative after 
44.27 	other alternatives have been explored through an evaluation by the local lead agency; and
44.28 	(4) the modification is reasonable given the value and size of the home.

44.29 	Sec. 45. WAIVER AMENDMENT.
 44.30 	The commissioner of human services shall submit an amendment to the Centers for 
44.31 	Medicare and Medicaid Services consistent with section 44 by October 1, 2008.

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

45.1 	Sec. 46. APPROPRIATION.
 45.2 	$65,000 is appropriated in the fiscal year beginning July 1, 2008, from the 
45.3 	state government special revenue fund to the administrative services unit to pay for 
45.4 	medical professional liability insurance coverage required under Minnesota Statutes, 
45.5 	section 214.40. This appropriation shall become part of the base appropriation for 
45.6 	the administrative services unit and shall be annually adjusted based on the cost of the 
45.7 	coverage purchased to comply with Minnesota Statutes, section 214.40.

45.8 	Sec. 47.  REPEALER.
 45.9 	(a) Minnesota Statutes 2006, section 256B.0571, subdivision 8a, is repealed.
45.10 	(b) Laws 2003, First Special Session chapter 5, section 11, is repealed.

45.11 	ARTICLE 2
45.12 	SEX OFFENDER PROGRAM

45.13 	Section 1. Minnesota Statutes 2006, section 13.851, is amended by adding a 
45.14 	subdivision to read:
45.15 		Subd. 9.Civil commitment of sexual offenders. Data relating to the preparation 
45.16 	of a petition to commit an individual as a sexual psychopathic personality or sexually 
45.17 	dangerous person is governed by section 253B.185, subdivision 1b.

45.18 	Sec. 2. Minnesota Statutes 2006, section 246B.02, is amended to read:
45.19 	246B.02 ESTABLISHMENT OF MINNESOTA SEX OFFENDER PROGRAM.
45.20 	The commissioner of human services shall establish and maintain a secure facility 
45.21 	located in Moose Lake. The facility shall be operated by the Minnesota sex offender 
45.22 	program. The program shall provide care and treatment in secure treatment facilities 
45.23 	to persons on a court-hold order and residing in a secure treatment facility or program 
45.24 	pending commitment or committed by the courts as sexual psychopathic personalities 
45.25 	or sexually dangerous persons, or persons admitted there with the consent of the 
45.26 	commissioner of human services.

45.27 	Sec. 3. [246B.06] ESTABLISHMENT OF MINNESOTA STATE INDUSTRIES.
45.28 		Subdivision 1.Establishment; purpose. (a) The commissioner of human 
45.29 	services may establish, equip, maintain, and operate the Minnesota State Industries at 
45.30 	any Minnesota sex offender program facility under this chapter. The commissioner 
45.31 	may establish industrial and commercial activities for sex offender treatment patients 
45.32 	as the commissioner deems necessary and suitable to the profitable employment, 
46.1 	educational training, and development of proper work habits of patients consistent with 
46.2 	the requirements in section 246B.05. The industrial and commercial activities authorized 
46.3 	by this section are designated Minnesota State Industries and must be for the primary 
46.4 	purpose of sustaining and ensuring Minnesota State Industries' self-sufficiency, providing 
46.5 	educational training, meaningful employment, and the teaching of proper work habits to 
46.6 	the patients of the Minnesota sex offender program under this chapter, and not solely as 
46.7 	competitive business ventures. 
46.8 	(b) The net profits from Minnesota State Industries must be used for the benefit 
46.9 	of the patients as it relates to building education and self-sufficiency skills. Prior to 
46.10 	the establishment of any industrial and commercial activity, the commissioner of 
46.11 	human services shall consult with stakeholders including representatives of business, 
46.12 	industry, organized labor, the commissioner of education, the state Apprenticeship 
46.13 	Council, the commissioner of labor and industry, the commissioner of employment and 
46.14 	economic development, the commissioner of administration, and other stakeholders the 
46.15 	commissioner deems qualified. The purpose of the stakeholder consultation is to determine 
46.16 	the quantity and nature of the goods, wares, merchandise, and services to be made or 
46.17 	provided, and the types of processes to be used in their manufacture, processing, repair, 
46.18 	and production consistent with the greatest opportunity for the reform and educational 
46.19 	training of the patients, and with the best interests of the state, business, industry, and labor.
46.20 	(c) The commissioner of human services shall, at all times in the conduct of any 
46.21 	industrial or commercial activity authorized by this section, utilize patient labor to the 
46.22 	greatest extent feasible, provided that the commissioner may employ all administrative, 
46.23 	supervisory, and other skilled workers necessary to the proper instruction of the patients 
46.24 	and the profitable and efficient operation of the industrial and commercial activities 
46.25 	authorized by this section.
46.26 	(d) The commissioner of human services may authorize the director of any 
46.27 	Minnesota sex offender treatment facility under the commissioner's control to accept 
46.28 	work projects from outside sources for processing, fabrication, or repair, provided that 
46.29 	preference is given to the performance of work projects for state departments and agencies.
46.30 		Subd. 2.Revolving fund. As described in section 246B.05, subdivision 2, there 
46.31 	is established a Minnesota State Industries revolving fund under the control of the 
46.32 	commissioner of human services. The revolving fund must be used for Minnesota State 
46.33 	Industries authorized under this section, including, but not limited to, the purchase of 
46.34 	equipment and raw materials, the payment of salaries and wages, and other necessary 
46.35 	expenses as determined by the commissioner of human services. The purchase of 
46.36 	services, materials, and commodities used in and held for resale are not subject to the 
47.1 	competitive bidding procedures of section 16C.06, but are subject to all other provisions 
47.2 	of chapters 16B and 16C. When practical, purchases must be made from small targeted 
47.3 	group businesses designated under section 16C.16. Additionally, the expenses of patient 
47.4 	educational training and self-sufficiency skills may be financed from the revolving fund 
47.5 	in an amount to be determined by the commissioner or designee. The proceeds and 
47.6 	income from all Minnesota State Industries conducted at the Minnesota sex offender 
47.7 	treatment facilities must be deposited in the revolving  fund subject to disbursement under 
47.8 	subdivision 3. The commissioner of human services may request that money in the fund 
47.9 	be invested pursuant to section 11A.25. Proceeds from the investment not currently 
47.10 	needed must be accounted for separately and credited to the revolving fund. 
47.11 		Subd. 3.Disbursement from fund. The Minnesota State Industries revolving 
47.12 	fund must be deposited in the state treasury and paid out only on proper vouchers as 
47.13 	authorized and approved by the commissioner of human services, and in the same manner 
47.14 	and under the same restrictions as are now provided by law for the disbursement of funds 
47.15 	by the commissioner. An amount deposited in the state treasury equal to six months 
47.16 	of net operating cash as determined by the prior 12 months of revenue and cash flow 
47.17 	statements must be restricted for use only by Minnesota State Industries as described 
47.18 	under subdivision 2. For purposes of this subdivision, "net operating cash" means net 
47.19 	income, minus sales, plus cost of goods sold. Cost of goods sold  include all direct costs 
47.20 	of industry products attributable to the goods' production.
47.21 		Subd. 4.Revolving fund; borrowing.  The commissioner of human services is 
47.22 	authorized to borrow sums of money as the commissioner deems necessary to meet 
47.23 	current demands on the Minnesota State Industries revolving fund. The sums borrowed 
47.24 	must not exceed, in any calendar year, six months of net operating cash as determined 
47.25 	by the previous 12 months of the industries' revenue and cash flow statements. If the 
47.26 	commissioner of human services determines that borrowing of funds is necessary, the 
47.27 	commissioner of human services shall certify this need to the commissioner of finance. 
47.28 	Funds may be borrowed from general fund appropriations to the Minnesota sex offender 
47.29 	program with the authorization of the commissioner of finance. Upon authorization of the 
47.30 	commissioner of finance, the transfer must be made and credited to the Minnesota State 
47.31 	Industries revolving fund. The sum transferred to the Minnesota State Industries revolving 
47.32 	fund must be repaid by the commissioner of human services from the revolving fund to 
47.33 	the fund from which it was transferred in a time period specified by the commissioner 
47.34 	of finance, but by no later than the end of the biennium, as defined in section 16A.011, 
47.35 	in which the loan is made. When any transfer is made to the Minnesota State Industries 
48.1 	revolving fund, the commissioner of finance shall notify the commissioner of human 
48.2 	services of the amount transferred to the fund and the date the transfer is to be repaid.
48.3 		Subd. 5.Federal grant fund transfers. Grants received by the commissioner of 
48.4 	human services from the federal government for any vocational training program or for 
48.5 	administration by the commissioner of human services must (1) be credited to a federal 
48.6 	grant fund and then (2) be transferred from the federal grant fund to the credit of the 
48.7 	commissioner of human services in the appropriate account upon certification by the 
48.8 	commissioner of human services that the amounts requested to be transferred have been 
48.9 	earned or are required for the purposes of this section. Funds received by the federal 
48.10 	grant fund need not be budgeted as such, provided transfers from the fund are budgeted 
48.11 	for allotment purposes in the appropriate appropriation.
48.12 		Subd. 6.Wages. Notwithstanding section 177.24 or any other law to the 
48.13 	contrary, wages paid to patients working within this program are at the discretion of the 
48.14 	commissioner of human services.

48.15 	Sec. 4. Minnesota Statutes 2006, section 253B.045, subdivision 1, is amended to read:
48.16 		Subdivision 1.Restriction. Except when ordered by the court pursuant to a finding 
48.17 	of necessity to protect the life of the proposed patient or others, or as provided under 
48.18 	subdivision 1a, no person subject to the provisions of this chapter shall be confined in a 
48.19 	jail or correctional institution, except pursuant to chapter 242 or 244.

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

48.21 	Sec. 5. Minnesota Statutes 2006, section 253B.045, is amended by adding a 
48.22 	subdivision to read:
48.23 		Subd. 1a.Exception. A person who is being petitioned for commitment 
48.24 	under section 253B.185 and who is placed under a judicial hold order under section 
48.25 	253B.07, subdivision 2b or 7, may be confined at a Department of Corrections or a 
48.26 	county correctional or detention facility, rather than a secure treatment facility, until a 
48.27 	determination of the commitment petition as specified in this subdivision.
48.28 	(a) A court may order that a person who is being petitioned for commitment under 
48.29 	section 253B.185 be confined in a Department of Corrections facility pursuant to the 
48.30 	judicial hold order under the following circumstances and conditions:
48.31 	(1) The person is currently serving a sentence in a Department of Corrections 
48.32 	facility and the court determines that the person has made a knowing and voluntary (i) 
48.33 	waiver of the right to be held in a secure treatment facility and (ii) election to be held in a 
48.34 	Department of Corrections facility. The order confining the person in the Department of 
49.1 	Corrections facility shall remain in effect until the court vacates the order or the person's 
49.2 	criminal sentence and conditional release term expire.
49.3 	In no case may the person be held in a Department of Corrections facility pursuant 
49.4 	only to this subdivision, and not pursuant to any separate correctional authority, for more 
49.5 	than 210 days.
49.6 	(2)  A person who has elected to be confined in a Department of Corrections facility 
49.7 	under this subdivision may revoke the election by filing a written notice of intent to revoke 
49.8 	the election with the court and serving the notice upon the Department of Corrections and 
49.9 	the county attorney. The court shall order the person transferred to a secure treatment 
49.10 	facility within 15 days of the date that the notice of revocation was filed with the court, 
49.11 	except that, if the person has additional time to serve in prison at the end of the 15-day 
49.12 	period, the person shall not be transferred to a secure treatment facility until the person's 
49.13 	prison term expires. After a person has revoked an election to remain in a Department of 
49.14 	Corrections facility under this subdivision, the court may not adopt another election to 
49.15 	remain in a Department of Corrections facility without the agreement of both parties and 
49.16 	the Department of Corrections.
49.17 	(3) Upon petition by the commissioner of corrections, after notice to the parties 
49.18 	and opportunity for hearing and for good cause shown, the court may order that the 
49.19 	person's place of confinement be changed from the Department of Corrections to a secure 
49.20 	treatment facility.
49.21 	(4) While at a Department of Corrections facility pursuant to this subdivision, the 
49.22 	person shall remain subject to all rules and practices applicable to correctional inmates 
49.23 	in the facility in which the person is placed including, but not limited to, the powers and 
49.24 	duties of the commissioner of corrections under section 241.01, powers relating to use of 
49.25 	force under section 243.52, and the right of the commissioner of corrections to determine 
49.26 	the place of confinement in a prison, reformatory, or other facility.
49.27 	(5) A person may not be confined in a Department of Corrections facility under this 
49.28 	provision beyond the end of the person's executed sentence or the end of any applicable 
49.29 	conditional release period, whichever is later. If a person confined in a Department of 
49.30 	Corrections facility pursuant to this provision reaches the person's supervised release 
49.31 	date and is subject to a period of conditional release, the period of conditional release 
49.32 	shall commence on the supervised release date even though the person remains in the 
49.33 	Department of Corrections facility pursuant to this provision. At the end of the later of 
49.34 	the executed sentence or any applicable conditional release period, the person shall be 
49.35 	transferred to a secure treatment facility.
50.1 	(6) Nothing in this section may be construed to establish a right of an inmate in a 
50.2 	state correctional facility to participate in sex offender treatment. This section must be 
50.3 	construed in a manner consistent with the provisions of section 244.03.
50.4 	(b) The committing county may offer a person who is being petitioned for 
50.5 	commitment under section 253B.185 and who is placed under a judicial hold order under 
50.6 	section 253B.07, subdivision 2b or 7, the option to be held in a county correctional or 
50.7 	detention facility rather than a secure treatment facility, under such terms as may be agreed 
50.8 	to by the county, the commitment petitioner, and the commitment respondent. If a person 
50.9 	makes such an election under this paragraph, the court hold order shall specify the terms 
50.10 	of the agreement, including the conditions for revoking the election.

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

50.12 	Sec. 6. Minnesota Statutes 2006, section 253B.045, subdivision 2, is amended to read:
50.13 		Subd. 2.Facilities. Each county or a group of counties shall maintain or provide 
50.14 	by contract a facility for confinement of persons held temporarily for observation, 
50.15 	evaluation, diagnosis, treatment, and care. When the temporary confinement is provided 
50.16 	at a regional treatment center, the commissioner shall charge the county of financial 
50.17 	responsibility for the costs of confinement of persons hospitalized under section 253B.05, 
50.18 	subdivisions 1 and 2, and section 253B.07, subdivision 2b, except that the commissioner 
50.19 	shall bill the responsible health plan first. If the person has health plan coverage, but the 
50.20 	hospitalization does not meet the criteria in subdivision 6 or section 62M.07, 62Q.53, 
50.21 	or 62Q.535, the county is responsible. When a person is temporarily confined in a 
50.22 	Department of Corrections facility solely under subdivision 1a, and not based on any 
50.23 	separate correctional authority:
50.24 	(1) the commissioner of corrections may charge the county of financial responsibility 
50.25 	for the costs of confinement; and 
50.26 	(2) the Department of Human Services shall use existing appropriations to fund 
50.27 	all remaining nonconfinement costs. The funds received by the commissioner for the 
50.28 	confinement and nonconfinement costs are appropriated to the department for these 
50.29 	purposes.
50.30 	"County of financial responsibility" means the county in which the person resides at the 
50.31 	time of confinement or, if the person has no residence in this state, the county which 
50.32 	initiated the confinement. The charge for confinement in a facility operated by the 
50.33 	commissioner of human services shall be based on the commissioner's determination of 
50.34 	the cost of care pursuant to section 246.50, subdivision 5. When there is a dispute as to 
51.1 	which county is the county of financial responsibility, the county charged for the costs of 
51.2 	confinement shall pay for them pending final determination of the dispute over financial 
51.3 	responsibility. Disputes about the county of financial responsibility shall be submitted to 
51.4 	the commissioner to be settled in the manner prescribed in section 256G.09.

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

51.6 	Sec. 7. Minnesota Statutes 2006, section 253B.18, subdivision 4c, is amended to read:
51.7 		Subd. 4c.Special review board. (a) The commissioner shall establish one or more 
51.8 	panels of a special review board for persons committed as mentally ill and dangerous to 
51.9 	the public. The board shall consist of three members experienced in the field of mental 
51.10 	illness. One member of each special review board panel shall be a psychiatrist and one 
51.11 	member shall be an attorney. No member shall be affiliated with the Department of 
51.12 	Human Services. The special review board shall meet at least every six months and at 
51.13 	the call of the commissioner. It shall hear and consider all petitions for a reduction in 
51.14 	custody or to appeal a revocation of provisional discharge. A "reduction in custody" 
51.15 	means transfer from a secure treatment facility; all petitions for, discharge, and provisional 
51.16 	discharge, and revocation of provisional discharge; and make recommendations to the 
51.17 	commissioner concerning them. Patients may be transferred by the commissioner between 
51.18 	secure treatment facilities without a special review board hearing.
51.19 	(b) Members of the special review board shall receive compensation and 
51.20 	reimbursement for expenses as established by the commissioner.
51.21 	(b) A petition filed by a person committed as mentally ill and dangerous to the 
51.22 	public under this section must be heard as provided in subdivision 5 and, as applicable, 
51.23 	subdivision 13. A petition filed by a person committed as a sexual psychopathic 
51.24 	personality or as a sexually dangerous person under section 253B.185, or committed 
51.25 	as both mentally ill and dangerous to the public under this section and as a sexual 
51.26 	psychopathic personality or as a sexually dangerous person must be heard as provided in 
51.27 	section 253B.185, subdivision 9.

51.28 	Sec. 8. Minnesota Statutes 2006, section 253B.18, subdivision 5, is amended to read:
51.29 		Subd. 5.Petition; notice of hearing; attendance; order. (a) A petition for an 
51.30 	order of transfer, discharge, provisional discharge,a reduction in custody or revocation of 
51.31 	provisional discharge shall be filed with the commissioner and may be filed by the patient 
51.32 	or by the head of the treatment facility. A patient may not petition the special review 
51.33 	board for six months following commitment under subdivision 3 or following the final 
52.1 	disposition of any previous petition and subsequent appeal by the patient. The medical 
52.2 	director may petition at any time.
52.3 	(b) Fourteen days prior to the hearing, the committing court, the county attorney of 
52.4 	the county of commitment, the designated agency, interested person, the petitioner, and 
52.5 	the petitioner's counsel shall be given written notice by the commissioner of the time and 
52.6 	place of the hearing before the special review board. Only those entitled to statutory notice 
52.7 	of the hearing or those administratively required to attend may be present at the hearing. 
52.8 	The patient may designate interested persons to receive notice by providing the names 
52.9 	and addresses to the commissioner at least 21 days before the hearing. The board shall 
52.10 	provide the commissioner with written findings of fact and recommendations within 21 
52.11 	days of the hearing. The commissioner shall issue an order no later than 14 days after 
52.12 	receiving the recommendation of the special review board. A copy of the order shall be 
52.13 	sent by certified mail mailed to every person entitled to statutory notice of the hearing 
52.14 	within five days after it is signed. No order by the commissioner shall be effective sooner 
52.15 	than 30 days after the order is signed, unless the county attorney, the patient, and the 
52.16 	commissioner agree that it may become effective sooner.
52.17 	(c) The special review board shall hold a hearing on each petition prior to making 
52.18 	its recommendation to the commissioner. The special review board proceedings are not 
52.19 	contested cases as defined in chapter 14. Any person or agency receiving notice that 
52.20 	submits documentary evidence to the special review board prior to the hearing shall also 
52.21 	provide copies to the patient, the patient's counsel, the county attorney of the county of 
52.22 	commitment, the case manager, and the commissioner.
52.23 	(d) Prior to the final decision by the commissioner, the special review board may be 
52.24 	reconvened to consider events or circumstances that occurred subsequent to the hearing.
52.25 	(e) In making their recommendations and order, the special review board and 
52.26 	commissioner must consider any statements received from victims under subdivision 5a.

52.27 	Sec. 9. Minnesota Statutes 2006, section 253B.18, subdivision 5a, is amended to read:
52.28 		Subd. 5a.Victim notification of petition and release; right to submit statement.
 52.29 	(a) As used in this subdivision:
52.30 	(1) "crime" has the meaning given to "violent crime" in section 609.1095, and 
52.31 	includes criminal sexual conduct in the fifth degree and offenses within the definition of 
52.32 	"crime against the person" in section 253B.02, subdivision 4a, and also includes offenses 
52.33 	listed in section 253B.02, subdivision 7a, paragraph (b), regardless of whether they are 
52.34 	sexually motivated;
53.1 	(2) "victim" means a person who has incurred loss or harm as a result of a crime 
53.2 	the behavior for which forms the basis for a commitment under this section or section 
53.3 	253B.185; and
53.4 	(3) "convicted" and "conviction" have the meanings given in section 609.02, 
53.5 	subdivision 5, and also include juvenile court adjudications, findings under Minnesota 
53.6 	Rules of Criminal Procedure, Rule 20.02, that the elements of a crime have been proved, 
53.7 	and findings in commitment cases under this section or section 253B.185 that an act or 
53.8 	acts constituting a crime occurred.
53.9 	(b) A county attorney who files a petition to commit a person under this section 
53.10 	or section 253B.185 shall make a reasonable effort to provide prompt notice of filing 
53.11 	the petition to any victim of a crime for which the person was convicted. In addition, 
53.12 	the county attorney shall make a reasonable effort to promptly notify the victim of the 
53.13 	resolution of the petition.
53.14 	(c) Before provisionally discharging, discharging, granting pass-eligible status, 
53.15 	approving a pass plan, or otherwise permanently or temporarily releasing a person 
53.16 	committed under this section or section 253B.185 from a treatment facility, the head of the 
53.17 	treatment facility shall make a reasonable effort to notify any victim of a crime for which 
53.18 	the person was convicted that the person may be discharged or released and that the victim 
53.19 	has a right to submit a written statement regarding decisions of the medical director, 
53.20 	special review board, or commissioner with respect to the person. To the extent possible, 
53.21 	the notice must be provided at least 14 days before any special review board hearing or 
53.22 	before a determination on a pass plan. Notwithstanding section 611A.06, subdivision 4, 
53.23 	the commissioner shall provide the judicial appeal panel with victim information in order 
53.24 	to comply with the provisions of this section. The judicial appeal panel shall ensure that 
53.25 	the data on victims remains private as provided for in section 611A.06, subdivision 4.
53.26 	(d) This subdivision applies only to victims who have requested notification by 
53.27 	contacting, in writing, the county attorney in the county where the conviction for the crime 
53.28 	occurred. A county attorney who receives a request for notification under this paragraph 
53.29 	shall promptly forward the request to the commissioner of human services.
53.30 	(e) The rights under this subdivision are in addition to rights available to a victim 
53.31 	under chapter 611A. This provision does not give a victim all the rights of a "notified 
53.32 	person" or a person "entitled to statutory notice" under subdivision 4a, 4b, or 5.

53.33 	Sec. 10. Minnesota Statutes 2007 Supplement, section 253B.185, subdivision 1b, 
53.34 	is amended to read:
54.1 		Subd. 1b.County attorney access to data. Notwithstanding sections 144.291 
54.2 	to 144.298; 245.467, subdivision 6; 245.4876, subdivision 7; 260B.171; 260B.235, 
54.3 	subdivision 8; 260C.171; and 609.749, subdivision 6, or any provision of chapter 13 
54.4 	or other state law, prior to filing a petition for commitment as a sexual psychopathic 
54.5 	personality or as a sexually dangerous person, and upon notice to the proposed patient, 
54.6 	the county attorney or the county attorney's designee may move the court for an order 
54.7 	granting access to any records or data, to the extent it relates to the proposed patient, for 
54.8 	the purpose of determining whether good cause exists to file a petition and, if a petition 
54.9 	is filed, to support the allegations set forth in the petition. 
54.10 	The court may grant the motion if: (1) the Department of Corrections refers the case 
54.11 	for commitment as a sexual psychopathic personality or a sexually dangerous person; or 
54.12 	(2) upon a showing that the requested category of data or records may be relevant to 
54.13 	the determination by the county attorney or designee. The court shall decide a motion 
54.14 	under this subdivision within 48 hours after a hearing on the motion. Notice to the 
54.15 	proposed patient need not be given upon a showing that such notice may result in harm or 
54.16 	harassment of interested persons or potential witnesses.
54.17 	Notwithstanding any provision of chapter 13 or other state law, a county attorney 
54.18 	considering the civil commitment of a person under this section may obtain records and 
54.19 	data from the Department of Corrections or any probation or parole agency in this state 
54.20 	upon request, without a court order, for the purpose of determining whether good cause 
54.21 	exists to file a petition and, if a petition is filed, to support the allegations set forth in the 
54.22 	petition. At the time of the request for the records, the county attorney shall provide notice 
54.23 	of the request to the person who is the subject of the records.
54.24 	Data collected pursuant to this subdivision shall retain their original status and, if not 
54.25 	public, are inadmissible in any court proceeding unrelated to civil commitment, unless 
54.26 	otherwise permitted.

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

54.28 	Sec. 11. Minnesota Statutes 2006, section 253B.185, subdivision 5, is amended to read:
54.29 		Subd. 5.Financial responsibility. (a) For purposes of this subdivision, "state 
54.30 	facility" has the meaning given in section 246.50 and also includes a Department of 
54.31 	Corrections facility when the proposed patient is confined in such a facility pursuant to 
54.32 	section 253B.045, subdivision 1a. 
54.33 	(b) Notwithstanding sections 246.54, 253B.045, and any other law to the contrary, 
54.34 	when a petition is filed for commitment under this section pursuant to the notice required 
55.1 	in section 244.05, subdivision 7, the state and county are each responsible for 50 percent of 
55.2 	the cost of the person's confinement at a state facility or county jail, prior to commitment. 
55.3 	(c) The county shall submit an invoice to the state court administrator for 
55.4 	reimbursement of the state's share of the cost of confinement.
55.5 	(d) Notwithstanding paragraph (b), the state's responsibility for reimbursement is 
55.6 	limited to the amount appropriated for this purpose.

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

55.8 	Sec. 12. Minnesota Statutes 2006, section 253B.185, is amended by adding a 
55.9 	subdivision to read:
55.10 		Subd. 9.Petition for reduction in custody. (a) This subdivision applies only 
55.11 	to committed persons as defined in paragraph (b). The procedures in section 253B.18, 
55.12 	subdivision 5a, for victim notification and right to submit a statement under section 
55.13 	253B.18 apply to petitions filed and reductions in custody recommended under this 
55.14 	subdivision.
55.15 	(b) As used in this subdivision:
55.16 	(1) "committed person" means an individual committed under this section, or under 
55.17 	this section and under section 253B.18, as mentally ill and dangerous. It does not include 
55.18 	persons committed only as mentally ill and dangerous under section 253B.18; and
55.19 	(2) "reduction in custody" means transfer out of a secure treatment facility, a 
55.20 	provisional discharge, or a discharge from commitment. A reduction in custody is 
55.21 	considered to be a commitment proceeding under section 8.01.
55.22 	(c) A petition for a reduction in custody or an appeal of a revocation of provisional 
55.23 	discharge may be filed by either the committed person or by the head of the treatment 
55.24 	facility and must be filed with and considered by the special review board. A committed 
55.25 	person may not petition the special review board any sooner than six months following 
55.26 	either:
55.27 	(1) the entry of judgment in the district court of the order for commitment issued 
55.28 	under section 253B.18, subdivision 3, or upon the exhaustion of all related appeal rights 
55.29 	in state court relating to that order, whichever is later; or
55.30 	(2) any recommendation of the special review board or order of the judicial appeal 
55.31 	panel, or upon the exhaustion of all appeal rights in state court, whichever is later. The 
55.32 	medical director may petition at any time. The special review board proceedings are not 
55.33 	contested cases as defined in chapter 14.
55.34 	(d) The special review board shall hold a hearing on each petition before issuing a 
55.35 	recommendation under paragraph (f). Fourteen days before the hearing, the committing 
56.1 	court, the county attorney of the county of commitment, the designated agency, an 
56.2 	interested person, the petitioner and the petitioner's counsel, and the committed person 
56.3 	and the committed person's counsel must be given written notice by the commissioner of 
56.4 	the time and place of the hearing before the special review board. Only those entitled to 
56.5 	statutory notice of the hearing or those administratively required to attend may be present 
56.6 	at the hearing. The patient may designate interested persons to receive notice by providing 
56.7 	the names and addresses to the commissioner at least 21 days before the hearing.
56.8 	(e) A person or agency receiving notice that submits documentary evidence to the 
56.9 	special review board before the hearing must also provide copies to the committed person, 
56.10 	the committed person's counsel, the county attorney of the county of commitment, the case 
56.11 	manager, and the commissioner. The special review board must consider any statements 
56.12 	received from victims under section 253B.18, subdivision 5a.
56.13 	(f) Within 30 days of the hearing, the special review board shall issue written 
56.14 	findings of fact and shall recommend denial or approval of the petition to the judicial 
56.15 	appeal panel established under section 253B.19. The commissioner shall forward the 
56.16 	recommendation of the special review board to the judicial appeal panel and to every 
56.17 	person entitled to statutory notice. No reduction in custody or reversal of a revocation 
56.18 	of provisional discharge recommended by the special review board is effective until it 
56.19 	has been reviewed by the judicial appeal panel and until 15 days after an order from the 
56.20 	judicial appeal panel affirming, modifying, or denying the recommendation.

56.21 	Sec. 13. Minnesota Statutes 2006, section 253B.19, subdivision 2, is amended to read:
56.22 		Subd. 2.Petition; hearing. The committed person or the county attorney of the 
56.23 	county from which a patient was committed as a person who is mentally ill and dangerous 
56.24 	to the public, or as a sexual psychopathic personality or as a sexually dangerous person 
56.25 	may petition the appeal panel for a rehearing and reconsideration of a decision by the 
56.26 	commissioner. The petition shall be filed with the Supreme Court within 30 days after the 
56.27 	decision of the commissioner is signed. The Supreme Court shall refer the petition to the 
56.28 	chief judge of the appeal panel. (a) A person committed as mentally ill and dangerous to 
56.29 	the public under section 253B.18, or the county attorney of the county from which the 
56.30 	person was committed or the county of financial responsibility, may petition the judicial 
56.31 	appeal panel for a rehearing and reconsideration of a decision by the commissioner under 
56.32 	section 253B.18, subdivision 5. The judicial appeal panel must not consider petitions for 
56.33 	relief other than those considered by the commissioner from which the appeal is taken. 
56.34 	The petition must be filed with the Supreme Court within 30 days after the decision of 
57.1 	the commissioner is signed. The hearing must be held within 45 days of the filing of the 
57.2 	petition unless an extension is granted for good cause.
57.3 	(b) A person committed as a sexual psychopathic personality or as a sexually 
57.4 	dangerous person under section 253B.185, or committed as both mentally ill and 
57.5 	dangerous to the public under section 253B.18 and as a sexual psychopathic personality or 
57.6 	as a sexually dangerous person under section 253B.185; the county attorney of the county 
57.7 	from which the person was committed or the county of financial responsibility; or the 
57.8 	commissioner may petition the judicial appeal panel for a rehearing and reconsideration 
57.9 	of a decision of the special review board under section 253B.185, subdivision 9. The 
57.10 	petition must be filed with the Supreme Court within 30 days after the decision is mailed 
57.11 	by the commissioner as required in section 253B.185, subdivision 9, paragraph (f). The 
57.12 	hearing must be held within 180 days of the filing of the petition unless an extension is 
57.13 	granted for good cause. If no party petitions the judicial appeal panel for a rehearing 
57.14 	or reconsideration within 30 days, the judicial appeal panel shall either issue an order 
57.15 	adopting the recommendations of the special review board or set the matter on for a 
57.16 	hearing pursuant to this paragraph.
57.17 	(c) For an appeal under paragraph (a) or (b), the Supreme Court shall refer the 
57.18 	petition to the chief judge of the judicial appeal panel. The chief judge shall notify the 
57.19 	patient, the county attorney of the county of commitment, the designated agency, the 
57.20 	commissioner, the head of the treatment facility, any interested person, and other persons 
57.21 	the chief judge designates, of the time and place of the hearing on the petition. The notice 
57.22 	shall be given at least 14 days prior to the date of the hearing. The hearing shall be within 
57.23 	45 days of the filing of the petition unless an extension is granted for good cause.
57.24 	(d) Any person may oppose the petition. The patient, the patient's counsel, the 
57.25 	county attorney of the committing county or the county of financial responsibility, and the 
57.26 	commissioner shall participate as parties to the proceeding pending before the judicial 
57.27 	appeal panel and shall, no later than 20 days before the hearing on the petition, inform the 
57.28 	judicial appeal panel and the opposing party in writing whether they support or oppose the 
57.29 	petition and provide a summary of facts in support of their position. The judicial appeal 
57.30 	panel may appoint examiners and may adjourn the hearing from time to time. It shall hear 
57.31 	and receive all relevant testimony and evidence and make a record of all proceedings. The 
57.32 	patient, the patient's counsel, and the county attorney of the committing county may
57.33 	or the county of financial responsibility have the right to be present and may present 
57.34 	and cross-examine all witnesses and offer a factual and legal basis in support of their 
57.35 	positions. The petitioning party bears the burden of going forward with the evidence. The 
58.1 	party opposing discharge bears the burden of proof by clear and convincing evidence that 
58.2 	the respondent is in need of commitment.

58.3 	Sec. 14. Minnesota Statutes 2006, section 253B.19, subdivision 3, is amended to read:
58.4 		Subd. 3.Decision. A majority of the judicial appeal panel shall rule upon the 
58.5 	petition. The panel shall consider the petition de novo. The order of the judicial appeal 
58.6 	panel shall supersede thean order of the commissioner in the cases under section 253B.18, 
58.7 	subdivision 5. No order of the judicial appeal panel granting a transfer, discharge or 
58.8 	provisional discharge shall be made effective sooner than 15 days after it is issued. 
58.9 	The panel may not consider petitions for relief other than those considered by the 
58.10 	commissioner or special review board from which the appeal is taken. The judicial appeal
58.11 	panel may not grant a transfer or provisional discharge on terms or conditions that were 
58.12 	not presented to the commissioner or the special review board.

58.13 	Sec. 15. Minnesota Statutes 2006, section 626.5572, subdivision 21, is amended to 
58.14 	read:
58.15 		Subd. 21.Vulnerable adult. "Vulnerable adult" means any person 18 years of 
58.16 	age or older who:
58.17 	(1) is a resident or inpatient of a facility;
58.18 	(2) receives services at or from a facility required to be licensed to serve adults 
58.19 	under sections 245A.01 to 245A.15, except that a person receiving outpatient services for 
58.20 	treatment of chemical dependency or mental illness, or one who is served in the Minnesota 
58.21 	sex offender program on a court-hold order for commitment, or is committed as a sexual 
58.22 	psychopathic personality or as a sexually dangerous person under chapter 253B, is not 
58.23 	considered a vulnerable adult unless the person meets the requirements of clause (4);
58.24 	(3) receives services from a home care provider required to be licensed under section 
58.25 	144A.46; or from a person or organization that exclusively offers, provides, or arranges 
58.26 	for personal care assistant services under the medical assistance program as authorized 
58.27 	under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and 
58.28 	256B.0653 to 256B.0656; or
58.29 	(4) regardless of residence or whether any type of service is received, possesses a 
58.30 	physical or mental infirmity or other physical, mental, or emotional dysfunction:
58.31 	(i) that impairs the individual's ability to provide adequately for the individual's 
58.32 	own care without assistance, including the provision of food, shelter, clothing, health 
58.33 	care, or supervision; and
59.1 	(ii) because of the dysfunction or infirmity and the need for assistance, the individual 
59.2 	has an impaired ability to protect the individual from maltreatment.

59.3 	Sec. 16. MINNESOTA SEX OFFENDER PROGRAM; OPERATING 
59.4 	STANDARDS.
 59.5 	The commissioner of human services shall convene a working group of interested 
59.6 	parties to develop standards and guidelines for the operations of the Minnesota sex 
59.7 	offender program. The standards and guidelines shall include, but not be limited to:
59.8 	(1) criteria to establish a sex offender treatment advisory board;
59.9 	(2) criteria to ensure the necessary provision of health and dental care for patients;
59.10 	(3) criteria to ensure the necessary provision of mental health care; and
59.11 	(4) fire and safety criteria.
59.12 	The standards and guidelines shall be developed by the commissioner in consultation 
59.13 	with the working group members by February 1, 2009, and presented to the chairs of 
59.14 	the policy and finance committees having jurisdiction over the Minnesota sex offender 
59.15 	program for review.

59.16 	ARTICLE 3
59.17 	MFIP

59.18 	Section 1. Minnesota Statutes 2007 Supplement, section 256J.49, subdivision 13, 
59.19 	is amended to read:
59.20 		Subd. 13.Work activity. "Work activity" means any activity in a participant's 
59.21 	approved employment plan that leads to employment. For purposes of the MFIP program, 
59.22 	this includes activities that meet the definition of work activity under the participation 
59.23 	requirements of TANF. Work activity includes:
59.24 	(1) unsubsidized employment, including work study and paid apprenticeships or 
59.25 	internships;
59.26 	(2) subsidized private sector or public sector employment, including grant diversion 
59.27 	as specified in section 256J.69, on-the-job training as specified in section 256J.66, 
59.28 	the self-employment investment demonstration program (SEID) as specified in section 
59.29 	256J.65, paid work experience, and supported work when a wage subsidy is provided; 
59.30 	(3) unpaid work experience, including community service, volunteer work, 
59.31 	the community work experience program as specified in section 256J.67, unpaid 
59.32 	apprenticeships or internships, and supported work when a wage subsidy is not provided. 
59.33 	Unpaid work experience is only an option if the participant has been unable to obtain or 
59.34 	maintain paid employment in the competitive labor market, and no paid work experience 
60.1 	programs are available to the participant. Prior to placing a participant in unpaid work, 
60.2 	the county must inform the participant that the participant will be notified if a paid 
60.3 	work experience or supported work position becomes available. Unless a participant 
60.4 	consents in writing to participatingparticipate in unpaid work experience, the participant's 
60.5 	employment plan may only include unpaid work experience if including the unpaid work 
60.6 	experience in the plan will meet the following criteria:
60.7 	(i) the unpaid work experience will provide the participant specific skills or 
60.8 	experience that cannot be obtained through other work activity options where the 
60.9 	participant resides or is willing to reside; and 
60.10 	(ii) the skills or experience gained through the unpaid work experience will result 
60.11 	in higher wages for the participant than the participant could earn without the unpaid 
60.12 	work experience;
60.13 	(4) job search including job readiness assistance, job clubs, job placement, 
60.14 	job-related counseling, and job retention services;
60.15 	(5) job readiness education, including English as a second language (ESL) or 
60.16 	functional work literacy classes as limited by the provisions of section 256J.531, 
60.17 	subdivision 2, general educational development (GED) course work, high school 
60.18 	completion, and adult basic education as limited by the provisions of section 256J.531, 
60.19 	subdivision 1; 
60.20 	(6) job skills training directly related to employment, including education and 
60.21 	training that can reasonably be expected to lead to employment, as limited by the 
60.22 	provisions of section 256J.53; 
60.23 	(7) providing child care services to a participant who is working in a community 
60.24 	service program;
60.25 	(8) activities included in the employment plan that is developed under section 
60.26 	256J.521, subdivision 3; and 
60.27 	(9) preemployment activities including chemical and mental health assessments, 
60.28 	treatment, and services; learning disabilities services; child protective services; family 
60.29 	stabilization services; or other programs designed to enhance employability.

60.30 	ARTICLE 4
60.31 	MANAGED CARE CONTRACT

60.32 	Section 1. Laws 2005, First Special Session chapter 4, article 8, section 84, as amended 
60.33 	by Laws 2006, chapter 264, section 15, is amended to read:
60.34 	Sec. 84. SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE 
60.35 	CONTRACT.
 61.1 	(a) Notwithstanding Minnesota Statutes, section 256B.692, subdivision 6, clause 
61.2 	(1), paragraph (c), the commissioner of human services shall approve a county-based 
61.3 	purchasing health plan proposal, submitted on behalf of Cass, Crow Wing, Morrison, 
61.4 	Todd, and Wadena Counties, that requires county-based purchasing on a single-plan basis 
61.5 	contract if the implementation of the single-plan purchasing proposal does not limit an 
61.6 	enrollee's provider choice or access to services and all other requirements applicable to 
61.7 	health plan purchasing are satisfied. The commissioner shall continuesingle health plan 
61.8 	purchasing arrangements with county-based purchasing entities in the service areas in 
61.9 	existence on May 1, 2006, including arrangements for which a proposal was submitted by 
61.10 	May 1, 2006, on behalf of Cass, Crow Wing, Morrison, Todd, and Wadena Counties, in 
61.11 	response to a request for proposals issued by the commissioner. The commissioner shall 
61.12 	continue to use single-health plan, county-based purchasing arrangements for medical 
61.13 	assistance and general assistance medical care programs and products for the counties 
61.14 	that were in single-health plan, county-based purchasing arrangements on March 1, 2008. 
61.15 	This paragraph does not require the commissioner to terminate an existing contract with a 
61.16 	noncounty-based purchasing plan that had enrollment in a medical assistance program 
61.17 	or product in these counties on March 1, 2008. This paragraph expires on December 31, 
61.18 	2010, or the effective date of a new contract for medical assistance and general assistance 
61.19 	medical care managed care programs entered into at the conclusion of the commissioner's 
61.20 	next scheduled reprocurement process for the county-based purchasing entities covered by 
61.21 	this paragraph, whichever is later.
61.22 	(b) The commissioner shall consider, and may approve, contracting on a 
61.23 	single-health plan basis with other county-based purchasing plans, or with other qualified 
61.24 	health plans that have coordination arrangements with counties, to serve persons with a 
61.25 	disability who voluntarily enroll, in order to promote better coordination or integration of 
61.26 	health care services, social services and other community-based services, provided that all 
61.27 	requirements applicable to health plan purchasing, including those in Minnesota Statutes, 
61.28 	section 256B.69, subdivision 23, are satisfied. By January 15, 2007, the commissioner 
61.29 	shall report to the chairs of the appropriate legislative committees in the house and senate 
61.30 	an analysis of the advantages and disadvantages of using single-health plan purchasing 
61.31 	to serve persons with a disability who are eligible for health care programs. The report 
61.32 	shall include consideration of the impact of federal health care programs and policies for 
61.33 	persons who are eligible for both federal and state health care programs and shall consider 
61.34 	strategies to improve coordination between federal and state health care programs for 
61.35 	those persons.Nothing in this paragraph supersedes or modifies the requirements in 
61.36 	paragraph (a).