1.1 	A bill for an act
1.2 	relating to human services; making technical changes; amending health care 
1.3 	and miscellaneous provisions;amending Minnesota Statutes 2006, sections 
1.4 	254A.035, subdivision 2; 254A.04; 256.046; 256B.093, subdivision 1; 256L.07, 
1.5 	subdivision 5; Minnesota Statutes 2007 Supplement, sections 256.01, subdivision 
1.6 	2b; 256.476, subdivisions 4, 5; 256B.057, subdivision 2c; 256B.06, subdivision 
1.7 	4; 256B.0655, subdivision 12; 256D.03, subdivision 3; 256L.15, subdivision 2; 
1.8 	repealing Minnesota Statutes 2006, section 256B.039.
1.9 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.10 	ARTICLE 1
1.11 	HEALTH CARE AND CONTINUING CARE

1.12 	Section 1. Minnesota Statutes 2007 Supplement, section 256.01, subdivision 2b, 
1.13 	is amended to read:
1.14 		Subd. 2b.Performance payments. (a) The commissioner shall develop and 
1.15 	implement a pay-for-performance system to provide performance payments to eligible 
1.16 	medical groups and clinics that demonstrate optimum care in serving individuals 
1.17 	with chronic diseases who are enrolled in health care programs administered by the 
1.18 	commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any 
1.19 	federal matching money that is made available through the medical assistance program 
1.20 	for managed care oversight contracted through vendors, including consumer surveys, 
1.21 	studies, and external quality reviews as required by the federal Balanced Budget Act of 
1.22 	1997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external 
1.23 	quality review. Any federal money received for managed care oversight is appropriated 
1.24 	to the commissioner for this purpose. The commissioner may expend the federal money 
1.25 	received in either year of the biennium.
2.1 	(b) Effective July 1, 2009 2008, or upon federal approval, whichever is later, the 
2.2 	commissioner shall develop and implement a patient incentive health program to provide 
2.3 	incentives and rewards to patients who are enrolled in health care programs administered 
2.4 	by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and 
2.5 	have met personal health goals established with the patients' primary care providers to 
2.6 	manage a chronic disease or condition, including but not limited to diabetes, high blood 
2.7 	pressure, and coronary artery disease.

2.8 	Sec. 2. Minnesota Statutes 2006, section 256.046, is amended to read:
2.9 	256.046 ADMINISTRATIVE FRAUD DISQUALIFICATION HEARINGS.
2.10 		Subdivision 1.Hearing authority. A local agency must initiate an administrative 
2.11 	fraud disqualification hearing for individuals, including child care providers caring for 
2.12 	children receiving child care assistance, accused of wrongfully obtaining assistance or 
2.13 	intentional program violations, in lieu of a criminal action when it has not been pursued, in 
2.14 	the aid to families with dependent children program formerly codified in sections 256.72
2.15 	to 256.87, MFIP, the diversionary work program, child care assistance programs, general 
2.16 	assistance, family general assistance program formerly codified in section 256D.05, 
2.17 	subdivision 1, clause (15), Minnesota supplemental aid, food stamp programs, general 
2.18 	assistance medical care, MinnesotaCare for adults without children, and upon federal 
2.19 	approval, all categories of medical assistance and remaining categories of MinnesotaCare 
2.20 	except for children through age 18. The Department of Human Services, in lieu of a local 
2.21 	agency, may initiate an administrative fraud disqualification hearing when the state agency 
2.22 	is directly responsible for administration or investigation of the health care program for 
2.23 	which benefits were wrongfully obtained. The hearing is subject to the requirements of 
2.24 	section 256.045 and the requirements in Code of Federal Regulations, title 7, section 
2.25 	273.16, for the food stamp program and title 45, section 235.112, as of September 30, 1995, 
2.26 	for the cash grant, medical care programs, and child care assistance under chapter 119B.
2.27 		Subd. 2.Combined hearing. The referee may combine a fair hearing and 
2.28 	administrative fraud disqualification hearing into a single hearing if the factual issues 
2.29 	arise out of the same, or related, circumstances and the individual receives prior notice 
2.30 	that the hearings will be combined. If the administrative fraud disqualification hearing 
2.31 	and fair hearing are combined, the time frames for administrative fraud disqualification 
2.32 	hearings specified in Code of Federal Regulations, title 7, section 273.16, and title 45, 
2.33 	section 235.112, as of September 30, 1995, apply. If the individual accused of wrongfully 
2.34 	obtaining assistance is charged under section 256.98 for the same act or acts which are 
3.1 	the subject of the hearing, the individual may request that the hearing be delayed until 
3.2 	the criminal charge is decided by the court or withdrawn. 

3.3 	Sec. 3. Minnesota Statutes 2007 Supplement, section 256.476, subdivision 4, is 
3.4 	amended to read:
3.5 		Subd. 4.Support grants; criteria and limitations. (a) A county board may 
3.6 	choose to participate in the consumer support grant program. If a county has not chosen 
3.7 	to participate by July 1, 2002, the commissioner shall contract with another county or 
3.8 	other entity to provide access to residents of the nonparticipating county who choose 
3.9 	the consumer support grant option. The commissioner shall notify the county board 
3.10 	in a county that has declined to participate of the commissioner's intent to enter into 
3.11 	a contract with another county or other entity at least 30 days in advance of entering 
3.12 	into the contract. The local agency shall establish written procedures and criteria to 
3.13 	determine the amount and use of support grants. These procedures must include, at least, 
3.14 	the availability of respite care, assistance with daily living, and adaptive aids. The local 
3.15 	agency may establish monthly or annual maximum amounts for grants and procedures 
3.16 	where exceptional resources may be required to meet the health and safety needs of the 
3.17 	person on a time-limited basis, however, the total amount awarded to each individual may 
3.18 	not exceed the limits established in subdivision 11.
3.19 	(b) Support grants to a person, a person's legal representative, or other authorized 
3.20 	representative will be provided through a monthly subsidy payment and be in the form 
3.21 	of cash, voucher, or direct county payment to vendor. Support grant amounts must be 
3.22 	determined by the local agency. Each service and item purchased with a support grant 
3.23 	must meet all of the following criteria:
3.24 	(1) it must be over and above the normal cost of caring for the person if the person 
3.25 	did not have functional limitations;
3.26 	(2) it must be directly attributable to the person's functional limitations;
3.27 	(3) it must enable the person, a person's legal representative, or other authorized 
3.28 	representative to delay or prevent out-of-home placement of the person; and
3.29 	(4) it must be consistent with the needs identified in the service agreement, when 
3.30 	applicable.
3.31 	(c) Items and services purchased with support grants must be those for which there 
3.32 	are no other public or private funds available to the person, a person's legal representative, 
3.33 	or other authorized representative. Fees assessed to the person or the person's family for 
3.34 	health and human services are not reimbursable through the grant.
4.1 	(d) In approving or denying applications, the local agency shall consider the 
4.2 	following factors:
4.3 	(1) the extent and areas of the person's functional limitations;
4.4 	(2) the degree of need in the home environment for additional support; and
4.5 	(3) the potential effectiveness of the grant to maintain and support the person in the 
4.6 	family environment or the person's own home.
4.7 	(e) At the time of application to the program or screening for other services, the 
4.8 	person, a person's legal representative, or other authorized representative shall be provided 
4.9 	sufficient information to ensure an informed choice of alternatives by the person, the 
4.10 	person's legal representative, or other authorized representative, if any. The application 
4.11 	shall be made to the local agency and shall specify the needs of the person and family or 
4.12 	the person's legal representative or other authorized representative, the form and amount 
4.13 	of grant requested, the items and services to be reimbursed, and evidence of eligibility for 
4.14 	medical assistance.
4.15 	(f) Upon approval of an application by the local agency and agreement on a 
4.16 	support plan for the person or the person's family legal representative or other authorized 
4.17 	representative, the local agency shall make grants to the person or the person's family legal 
4.18 	representative or other authorized representative. The grant shall be in an amount for the 
4.19 	direct costs of the services or supports outlined in the service agreement.
4.20 	(g) Reimbursable costs shall not include costs for resources already available, 
4.21 	such as special education classes, day training and habilitation, case management, other 
4.22 	services to which the person is entitled, medical costs covered by insurance or other health 
4.23 	programs, or other resources usually available at no cost to the person or the person's 
4.24 	family legal representative or other authorized representative.
4.25 	(h) The state of Minnesota, the county boards participating in the consumer 
4.26 	support grant program, or the agencies acting on behalf of the county boards in the 
4.27 	implementation and administration of the consumer support grant program shall not be 
4.28 	liable for damages, injuries, or liabilities sustained through the purchase of support by 
4.29 	the individual, the individual's family, or the authorized representative under this section 
4.30 	with funds received through the consumer support grant program. Liabilities include but 
4.31 	are not limited to: workers' compensation liability, the Federal Insurance Contributions 
4.32 	Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, 
4.33 	participating county boards and agencies acting on behalf of county boards are exempt 
4.34 	from the provisions of section 268.04.

5.1 	Sec. 4. Minnesota Statutes 2007 Supplement, section 256.476, subdivision 5, is 
5.2 	amended to read:
5.3 		Subd. 5.Reimbursement, allocations, and reporting. (a) For the purpose of 
5.4 	transferring persons to the consumer support grant program from the family support 
5.5 	program and personal care assistant services, home health aide services, or private duty 
5.6 	nursing services, the amount of funds transferred by the commissioner between the 
5.7 	family support program account, the medical assistance account, or the consumer support 
5.8 	grant account shall be based on each county's participation in transferring persons to the 
5.9 	consumer support grant program from those programs and services.
5.10 	(b) At the beginning of each fiscal year, county allocations for consumer support 
5.11 	grants shall be based on:
5.12 	(1) the number of persons to whom the county board expects to provide consumer 
5.13 	supports grants;
5.14 	(2) their eligibility for current program and services;
5.15 	(3) the amount of nonfederal dollars allowed under subdivision 11; and
5.16 	(4) projected dates when persons will start receiving grants. County allocations shall 
5.17 	be adjusted periodically by the commissioner based on the actual transfer of persons or 
5.18 	service openings, and the nonfederal dollars associated with those persons or service 
5.19 	openings, to the consumer support grant program.
5.20 	(c) The amount of funds transferred by the commissioner from the medical 
5.21 	assistance account for an individual may be changed if it is determined by the county or its 
5.22 	agent that the individual's need for support has changed.
5.23 	(d) The authority to utilize funds transferred to the consumer support grant account 
5.24 	for the purposes of implementing and administering the consumer support grant program 
5.25 	will not be limited or constrained by the spending authority provided to the program 
5.26 	of origination.
5.27 	(e) The commissioner may use up to five percent of each county's allocation, as 
5.28 	adjusted, for payments for administrative expenses, to be paid as a proportionate addition 
5.29 	to reported direct service expenditures.
5.30 	(f) The county allocation for each individual person or individual's family the 
5.31 	person's legal representative or other authorized representative cannot exceed the amount 
5.32 	allowed under subdivision 11.
5.33 	(g) The commissioner may recover, suspend, or withhold payments if the county 
5.34 	board, local agency, or grantee does not comply with the requirements of this section.
6.1 	(h) Grant funds unexpended by consumers shall return to the state once a year. The 
6.2 	annual return of unexpended grant funds shall occur in the quarter following the end of 
6.3 	the state fiscal year.

6.4 	Sec. 5. Minnesota Statutes 2007 Supplement, section 256B.057, subdivision 2c, 
6.5 	is amended to read:
6.6 		Subd. 2c.Extended coverage for children. A child receiving medical assistance 
6.7 	under subdivision 2, who becomes ineligible due to excess income, is eligible for two 
6.8 	additional months of medical assistance. Eligibility under this section is effective 
6.9 	following any coverage available under section 256B.0625 256B.0635.
6.10 	A child eligible for extended coverage under this section is deemed automatically 
6.11 	eligible for MinnesotaCare until renewal. MinnesotaCare coverage begins in accordance 
6.12 	with section 256L.05, subdivision 3.

6.13 	Sec. 6. Minnesota Statutes 2007 Supplement, section 256B.06, subdivision 4, is 
6.14 	amended to read:
6.15 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
6.16 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
6.17 	other persons residing lawfully in the United States. Citizens or nationals of the United 
6.18 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
6.19 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
6.20 	Public Law 109-171.
6.21 	(b) "Qualified noncitizen" means a person who meets one of the following 
6.22 	immigration criteria:
6.23 	(1) admitted for lawful permanent residence according to United States Code, title 8;
6.24 	(2) admitted to the United States as a refugee according to United States Code, 
6.25 	title 8, section 1157;
6.26 	(3) granted asylum according to United States Code, title 8, section 1158;
6.27 	(4) granted withholding of deportation according to United States Code, title 8, 
6.28 	section 1253(h);
6.29 	(5) paroled for a period of at least one year according to United States Code, title 8, 
6.30 	section 1182(d)(5);
6.31 	(6) granted conditional entrant status according to United States Code, title 8, 
6.32 	section 1153(a)(7);
7.1 	(7) determined to be a battered noncitizen by the United States Attorney General 
7.2 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
7.3 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
7.4 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
7.5 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
7.6 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
7.7 	Public Law 104-200; or
7.8 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
7.9 	Law 96-422, the Refugee Education Assistance Act of 1980.
7.10 	(c) All qualified noncitizens who were residing in the United States before August 
7.11 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
7.12 	medical assistance with federal financial participation.
7.13 	(d) All qualified noncitizens who entered the United States on or after August 22, 
7.14 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
7.15 	medical assistance with federal financial participation through November 30, 1996.
7.16 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
7.17 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
7.18 	chapter are eligible for medical assistance with federal participation for five years if they 
7.19 	meet one of the following criteria:
7.20 	(i) refugees admitted to the United States according to United States Code, title 8, 
7.21 	section 1157;
7.22 	(ii) persons granted asylum according to United States Code, title 8, section 1158;
7.23 	(iii) persons granted withholding of deportation according to United States Code, 
7.24 	title 8, section 1253(h);
7.25 	(iv) veterans of the United States armed forces with an honorable discharge for 
7.26 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
7.27 	children; or
7.28 	(v) persons on active duty in the United States armed forces, other than for training, 
7.29 	their spouses and unmarried minor dependent children.
7.30 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
7.31 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
7.32 	participation as described in paragraph (j).
7.33 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), 
7.34 	who are lawfully residing present in the United States, as defined in Code of Federal 
7.35 	Regulations, title 8, section 103.12, and who otherwise meet the eligibility requirements of 
7.36 	this chapter, are eligible for medical assistance under clauses (1) to (3). These individuals 
8.1 	must cooperate with the United States Citizenship and Immigration Services to pursue any 
8.2 	applicable immigration status, including citizenship, that would qualify them for medical 
8.3 	assistance with federal financial participation.
8.4 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
8.5 	for medical assistance with federal financial participation through December 31, 1996.
8.6 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
8.7 	medical assistance without federal financial participation as described in paragraph (j).
8.8 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
8.9 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
8.10 	or after August 22, 1996, are eligible for medical assistance without federal financial 
8.11 	participation as described in paragraph (j).
8.12 	(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
8.13 	are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 
8.14 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
8.15 	Code, title 8, section 1101(a)(15).
8.16 	(g) Payment shall also be made for care and services that are furnished to noncitizens, 
8.17 	regardless of immigration status, who otherwise meet the eligibility requirements of 
8.18 	this chapter, if such care and services are necessary for the treatment of an emergency 
8.19 	medical condition, except for organ transplants and related care and services and routine 
8.20 	prenatal care.
8.21 	(h) For purposes of this subdivision, the term "emergency medical condition" means 
8.22 	a medical condition that meets the requirements of United States Code, title 42, section 
8.23 	1396b(v).
8.24 	(i) Pregnant noncitizens who are undocumented, nonimmigrants, or eligible for 
8.25 	medical assistance as described in paragraph (j), and who are not covered by a group 
8.26 	health plan or health insurance coverage according to Code of Federal Regulations, title 
8.27 	42, section 457.310, and who otherwise meet the eligibility requirements of this chapter, 
8.28 	are eligible for medical assistance through the period of pregnancy, including labor and 
8.29 	delivery, to the extent federal funds are available under title XXI of the Social Security 
8.30 	Act, and the state children's health insurance program, followed by 60 days postpartum 
8.31 	without federal financial participation.
8.32 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
8.33 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
8.34 	for medical assistance with federal financial participation and who otherwise meet the 
8.35 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
8.36 	assistance without federal financial participation. Qualified noncitizens as described 
9.1 	in paragraph (d) are only eligible for medical assistance without federal financial 
9.2 	participation for five years from their date of entry into the United States.
9.3 	(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
9.4 	services from a nonprofit center established to serve victims of torture and are otherwise 
9.5 	ineligible for medical assistance under this chapter are eligible for medical assistance 
9.6 	without federal financial participation. These individuals are eligible only for the period 
9.7 	during which they are receiving services from the center. Individuals eligible under this 
9.8 	paragraph shall not be required to participate in prepaid medical assistance.

9.9 	Sec. 7. Minnesota Statutes 2007 Supplement, section 256B.0655, subdivision 12, 
9.10 	is amended to read:
9.11 		Subd. 12.Personal care provider; employment prohibition. A personal care 
9.12 	provider shall not employ a person to provide personal care service for a qualified 
9.13 	recipient if the person:
9.14 	(1) refuses to provide full disclosure of criminal history records as specified in 
9.15 	subdivision 1g, clause (1) Minnesota Rules, part 9505.0335, subpart 12;
9.16 	(2) has been convicted of a crime that directly relates to the occupation of providing 
9.17 	personal care services to a qualified recipient;
9.18 	(3) has jeopardized the health or welfare of a vulnerable adult through physical 
9.19 	abuse, sexual abuse, or neglect as defined in section 626.557; or
9.20 	(4) is misusing or is dependent on mood-altering chemicals, including alcohol, to 
9.21 	the extent that the personal care provider knows or has reason to believe that the use of 
9.22 	chemicals has a negative effect on the person's ability to provide personal care services 
9.23 	or the use of chemicals is apparent during the hours the person is providing personal 
9.24 	care services.

9.25 	Sec. 8. Minnesota Statutes 2006, section 256B.093, subdivision 1, is amended to read:
9.26 		Subdivision 1.State traumatic brain injury program. The commissioner of 
9.27 	human services shall:
9.28 	(1) maintain a statewide traumatic brain injury program;
9.29 	(2) supervise and coordinate services and policies for persons with traumatic brain 
9.30 	injuries;
9.31 	(3) contract with qualified agencies or employ staff to provide statewide 
9.32 	administrative case management and consultation;
10.1 	(4) maintain an advisory committee to provide recommendations in reports to the 
10.2 	commissioner regarding program and service needs of persons with traumatic brain 
10.3 	injuries;
10.4 	(5) investigate the need for the development of rules or statutes for the traumatic 
10.5 	brain injury home and community-based services waiver;
10.6 	(6) investigate present and potential models of service coordination which can be 
10.7 	delivered at the local level; and
10.8 	(7) the advisory committee required by clause (4) must consist of no fewer than ten 
10.9 	members and no more than 30 members. The commissioner shall appoint all advisory 
10.10 	committee members to one- or two-year terms and appoint one member as chair. 
10.11 	Notwithstanding section 15.059, subdivision 5, the advisory committee does not terminate 
10.12 	until June 30, 2008 2012.

10.13 	Sec. 9. Minnesota Statutes 2007 Supplement, section 256D.03, subdivision 3, is 
10.14 	amended to read:
10.15 		Subd. 3.General assistance medical care; eligibility. (a) General assistance 
10.16 	medical care may be paid for any person who is not eligible for medical assistance under 
10.17 	chapter 256B, including eligibility for medical assistance based on a spenddown of excess 
10.18 	income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in 
10.19 	paragraph (b), except as provided in paragraph (c), and:
10.20 	(1) who is receiving assistance under section 256D.05, except for families with 
10.21 	children who are eligible under Minnesota family investment program (MFIP), or who is 
10.22 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
10.23 	(2) who is a resident of Minnesota; and
10.24 	(i) who has gross countable income not in excess of 75 percent of the federal poverty 
10.25 	guidelines for the family size, using a six-month budget period and whose equity in assets 
10.26 	is not in excess of $1,000 per assistance unit. General assistance medical care is not 
10.27 	available for applicants or enrollees who are otherwise eligible for medical assistance but 
10.28 	fail to verify their assets. Enrollees who become eligible for medical assistance shall be 
10.29 	terminated and transferred to medical assistance. Exempt assets, the reduction of excess 
10.30 	assets, and the waiver of excess assets must conform to the medical assistance program in 
10.31 	section 256B.056, subdivision subdivisions 3 and 3d, with the following exception: the 
10.32 	maximum amount of undistributed funds in a trust that could be distributed to or on behalf 
10.33 	of the beneficiary by the trustee, assuming the full exercise of the trustee's discretion under 
10.34 	the terms of the trust, must be applied toward the asset maximum;
11.1 	(ii) who has gross countable income above 75 percent of the federal poverty 
11.2 	guidelines but not in excess of 175 percent of the federal poverty guidelines for the 
11.3 	family size, using a six-month budget period, whose equity in assets is not in excess 
11.4 	of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient 
11.5 	hospitalization; or
11.6 	(iii) the commissioner shall adjust the income standards under this section each July 
11.7 	1 by the annual update of the federal poverty guidelines following publication by the 
11.8 	United States Department of Health and Human Services.
11.9 	(b) Effective for applications and renewals processed on or after September 1, 2006, 
11.10 	general assistance medical care may not be paid for applicants or recipients who are adults 
11.11 	with dependent children under 21 whose gross family income is equal to or less than 275 
11.12 	percent of the federal poverty guidelines who are not described in paragraph (e).
11.13 	(c) Effective for applications and renewals processed on or after September 1, 2006, 
11.14 	general assistance medical care may be paid for applicants and recipients who meet all 
11.15 	eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period 
11.16 	beginning the date of application. Immediately following approval of general assistance 
11.17 	medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04, 
11.18 	subdivision 7, with covered services as provided in section 256L.03 for the rest of the 
11.19 	six-month general assistance medical care eligibility period, until their six-month renewal. 
11.20 	(d) To be eligible for general assistance medical care following enrollment in 
11.21 	MinnesotaCare as required by paragraph (c), an individual must complete a new 
11.22 	application.
11.23 	(e) Applicants and recipients eligible under paragraph (a), clause (1); who have 
11.24 	applied for and are awaiting a determination of blindness or disability by the state medical 
11.25 	review team or a determination of eligibility for Supplemental Security Income or Social 
11.26 	Security Disability Insurance by the Social Security Administration; who fail to meet the 
11.27 	requirements of section 256L.09, subdivision 2; who are homeless as defined by United 
11.28 	States Code, title 42, section 11301, et seq.;  who are classified as end-stage renal disease 
11.29 	beneficiaries in the Medicare program; who are enrolled in private health care coverage as 
11.30 	defined in section 256B.02, subdivision 9; who are eligible under paragraph (j); or who 
11.31 	receive treatment funded pursuant to section 254B.02 are exempt from the MinnesotaCare 
11.32 	enrollment requirements of this subdivision.
11.33 	(f) For applications received on or after October 1, 2003, eligibility may begin no 
11.34 	earlier than the date of application. For individuals eligible under paragraph (a), clause 
11.35 	(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are 
12.1 	eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but 
12.2 	may reapply if there is a subsequent period of inpatient hospitalization.
12.3 	(g) Beginning September 1, 2006, Minnesota health care program applications and 
12.4 	renewals completed by recipients and applicants who are persons described in paragraph 
12.5 	(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility 
12.6 	by the county agency. If all other eligibility requirements of this subdivision are met, 
12.7 	eligibility for general assistance medical care shall be available in any month during which 
12.8 	MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare, 
12.9 	notice of termination for eligibility for general assistance medical care shall be sent to 
12.10 	an applicant or recipient. If all other eligibility requirements of this subdivision are 
12.11 	met, eligibility for general assistance medical care shall be available until enrollment in 
12.12 	MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
12.13 	(h) The date of an initial Minnesota health care program application necessary to 
12.14 	begin a determination of eligibility shall be the date the applicant has provided a name, 
12.15 	address, and Social Security number, signed and dated, to the county agency or the 
12.16 	Department of Human Services. If the applicant is unable to provide a name, address, 
12.17 	Social Security number, and signature when health care is delivered due to a medical 
12.18 	condition or disability, a health care provider may act on an applicant's behalf to establish 
12.19 	the date of an initial Minnesota health care program application by providing the county 
12.20 	agency or Department of Human Services with provider identification and a temporary 
12.21 	unique identifier for the applicant. The applicant must complete the remainder of the 
12.22 	application and provide necessary verification before eligibility can be determined. The 
12.23 	county agency must assist the applicant in obtaining verification if necessary.
12.24 	(i) County agencies are authorized to use all automated databases containing 
12.25 	information regarding recipients' or applicants' income in order to determine eligibility for 
12.26 	general assistance medical care or MinnesotaCare. Such use shall be considered sufficient 
12.27 	in order to determine eligibility and premium payments by the county agency.
12.28 	(j) General assistance medical care is not available for a person in a correctional 
12.29 	facility unless the person is detained by law for less than one year in a county correctional 
12.30 	or detention facility as a person accused or convicted of a crime, or admitted as an 
12.31 	inpatient to a hospital on a criminal hold order, and the person is a recipient of general 
12.32 	assistance medical care at the time the person is detained by law or admitted on a criminal 
12.33 	hold order and as long as the person continues to meet other eligibility requirements 
12.34 	of this subdivision.
12.35 	(k) General assistance medical care is not available for applicants or recipients who 
12.36 	do not cooperate with the county agency to meet the requirements of medical assistance.
13.1 	(l) In determining the amount of assets of an individual eligible under paragraph 
13.2 	(a), clause (2), item (i), there shall be included any asset or interest in an asset, including 
13.3 	an asset excluded under paragraph (a), that was given away, sold, or disposed of for 
13.4 	less than fair market value within the 60 months preceding application for general 
13.5 	assistance medical care or during the period of eligibility. Any transfer described in this 
13.6 	paragraph shall be presumed to have been for the purpose of establishing eligibility for 
13.7 	general assistance medical care, unless the individual furnishes convincing evidence to 
13.8 	establish that the transaction was exclusively for another purpose. For purposes of this 
13.9 	paragraph, the value of the asset or interest shall be the fair market value at the time it 
13.10 	was given away, sold, or disposed of, less the amount of compensation received. For any 
13.11 	uncompensated transfer, the number of months of ineligibility, including partial months, 
13.12 	shall be calculated by dividing the uncompensated transfer amount by the average monthly 
13.13 	per person payment made by the medical assistance program to skilled nursing facilities 
13.14 	for the previous calendar year. The individual shall remain ineligible until this fixed period 
13.15 	has expired. The period of ineligibility may exceed 30 months, and a reapplication for 
13.16 	benefits after 30 months from the date of the transfer shall not result in eligibility unless 
13.17 	and until the period of ineligibility has expired. The period of ineligibility begins in the 
13.18 	month the transfer was reported to the county agency, or if the transfer was not reported, 
13.19 	the month in which the county agency discovered the transfer, whichever comes first. For 
13.20 	applicants, the period of ineligibility begins on the date of the first approved application.
13.21 	(m) When determining eligibility for any state benefits under this subdivision, 
13.22 	the income and resources of all noncitizens shall be deemed to include their sponsor's 
13.23 	income and resources as defined in the Personal Responsibility and Work Opportunity 
13.24 	Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and 
13.25 	subsequently set out in federal rules.
13.26 	(n) Undocumented noncitizens and nonimmigrants are ineligible for general 
13.27 	assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual 
13.28 	in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and 
13.29 	an undocumented noncitizen is an individual who resides in the United States without the 
13.30 	approval or acquiescence of the United States Citizenship and Immigration Services.
13.31 	(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for 
13.32 	medical assistance due to the deeming of a sponsor's income and resources, is ineligible 
13.33 	for general assistance medical care.
13.34 	(p) Effective July 1, 2003, general assistance medical care emergency services end.

13.35 	Sec. 10. Minnesota Statutes 2006, section 256L.07, subdivision 5, is amended to read:
14.1 		Subd. 5.Voluntary disenrollment for members of military. Notwithstanding 
14.2 	section 256L.05, subdivision 3b, MinnesotaCare enrollees who are members of the 
14.3 	military and their families, who choose to voluntarily disenroll from the program when 
14.4 	one or more family members are called to active duty, may reenroll during or following 
14.5 	that member's tour of active duty. Those individuals and families shall be considered 
14.6 	to have good cause for voluntary termination under section 256L.06, subdivision 3, 
14.7 	paragraph (d). Income and asset increases reported at the time of reenrollment shall be 
14.8 	disregarded. All provisions of sections 256L.01 to 256L.18 shall apply to individuals and 
14.9 	families enrolled under this subdivision upon six-month12-month renewal.

14.10 	Sec. 11. Minnesota Statutes 2007 Supplement, section 256L.15, subdivision 2, is 
14.11 	amended to read:
14.12 		Subd. 2.Sliding fee scale; monthly gross individual or family income. (a) The 
14.13 	commissioner shall establish a sliding fee scale to determine the percentage of monthly 
14.14 	gross individual or family income that households at different income levels must pay 
14.15 	to obtain coverage through the MinnesotaCare program. The sliding fee scale must be 
14.16 	based on the enrollee's monthly gross individual or family income. The sliding fee scale 
14.17 	must contain separate tables based on enrollment of one, two, or three or more persons. 
14.18 	The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or 
14.19 	family income for individuals or families with incomes below the limits for the medical 
14.20 	assistance program for families and children in effect on January 1, 1999, and proceeds 
14.21 	through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. 
14.22 	These percentages are matched to evenly spaced income steps ranging from the medical 
14.23 	assistance income limit for families and children in effect on January 1, 1999, to 275 
14.24 	percent of the federal poverty guidelines for the applicable family size, up to a family size 
14.25 	of five. The sliding fee scale for a family of five must be used for families of more than 
14.26 	five. The sliding fee scale and percentages are not subject to the provisions of chapter 
14.27 	14. If a family or individual reports increased income after enrollment, premiums shall 
14.28 	be adjusted at the time the change in income is reported.
14.29 	(b) FamiliesChildren whose gross income is above 275 percent of the federal 
14.30 	poverty guidelines shall pay the maximum premium. The maximum premium is defined 
14.31 	as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare 
14.32 	cases paid the maximum premium, the total revenue would equal the total cost of 
14.33 	MinnesotaCare medical coverage and administration. In this calculation, administrative 
14.34 	costs shall be assumed to equal ten percent of the total. The costs of medical coverage 
14.35 	for pregnant women and children under age two and the enrollees in these groups shall 
15.1 	be excluded from the total. The maximum premium for two enrollees shall be twice the 
15.2 	maximum premium for one, and the maximum premium for three or more enrollees shall 
15.3 	be three times the maximum premium for one.

15.4 	ARTICLE 2
15.5 	MISCELLANEOUS

15.6 	Section 1. Minnesota Statutes 2006, section 254A.035, subdivision 2, is amended to 
15.7 	read:
15.8 		Subd. 2.Membership terms, compensation, removal and expiration. The 
15.9 	membership of this council shall be composed of 17 persons who are American Indians 
15.10 	and who are appointed by the commissioner. The commissioner shall appoint one 
15.11 	representative from each of the following groups: Red Lake Band of Chippewa Indians; 
15.12 	Fond du Lac Band, Minnesota Chippewa Tribe; Grand Portage Band, Minnesota 
15.13 	Chippewa Tribe; Leech Lake Band, Minnesota Chippewa Tribe; Mille Lacs Band, 
15.14 	Minnesota Chippewa Tribe; Bois Forte Band, Minnesota Chippewa Tribe; White Earth 
15.15 	Band, Minnesota Chippewa Tribe; Lower Sioux Indian Reservation; Prairie Island Sioux 
15.16 	Indian Reservation; Shakopee Mdewakanton Sioux Indian Reservation; Upper Sioux 
15.17 	Indian Reservation; International Falls Northern Range; Duluth Urban Indian Community; 
15.18 	and two representatives from the Minneapolis Urban Indian Community and two from the 
15.19 	St. Paul Urban Indian Community. The terms, compensation, and removal of American 
15.20 	Indian Advisory Council members shall be as provided in section 15.059. The council 
15.21 	expires June 30, 2008 2012.

15.22 	Sec. 2. Minnesota Statutes 2006, section 254A.04, is amended to read:
15.23 	254A.04 CITIZENS ADVISORY COUNCIL.
15.24 	There is hereby created an Alcohol and Other Drug Abuse Advisory Council to 
15.25 	advise the Department of Human Services concerning the problems of alcohol and 
15.26 	other drug dependency and abuse, composed of ten members. Five members shall be 
15.27 	individuals whose interests or training are in the field of alcohol dependency and abuse; 
15.28 	and five members whose interests or training are in the field of dependency and abuse of 
15.29 	drugs other than alcohol. The terms, compensation and removal of members shall be as 
15.30 	provided in section 15.059. The council expires June 30, 2008 2012. The commissioner 
15.31 	of human services shall appoint members whose terms end in even-numbered years. The 
15.32 	commissioner of health shall appoint members whose terms end in odd-numbered years.

15.33 	Sec. 3. CHILD CARE ADVISORY TASK FORCE.
 16.1 		Subdivision 1.Establishment. The commissioner of human services shall establish 
16.2 	a Child Care Advisory Task Force of stakeholders to review and make recommendations 
16.3 	to the legislature, as specified in subdivision 4, to remove barriers facing families applying 
16.4 	for and receiving child care assistance under Minnesota Statutes, chapter 119B.
16.5 		Subd. 2.Membership. By July 30, 2008, the commissioner of human services 
16.6 	shall appoint a Child Care Advisory Task Force composed of eight members. The Child 
16.7 	Care Advisory Task Force shall include:
16.8 	(1) two representatives from the Department of Human Services; 
16.9 	(2) two representatives from counties and nonprofit organizations administering the 
16.10 	child care assistance programs;
16.11 	(3) two representatives from the child care advocacy community; and
16.12 	(4) two representatives from the antipoverty advocacy community.
16.13 	The commissioner shall designate a member of the task force to convene the first 
16.14 	meeting within 30 days after the commissioner has completed appointments. The task 
16.15 	force shall select a chair from its membership.
16.16 		Subd. 3.Duties. The Child Care Advisory Task Force shall review child care 
16.17 	assistance laws, rules, and policies and make recommendations to remove barriers facing 
16.18 	families applying for child care assistance or completing reauthorization for child care 
16.19 	assistance to the legislative committees with jurisdiction over the child care assistance 
16.20 	programs under Minnesota Statutes, chapter 119B. Barriers to review include, but are 
16.21 	not limited to:
16.22 	(1) length of application forms;
16.23 	(2) consistency of application and reauthorization forms statewide;
16.24 	(3) documentation requirements, including frequency of producing documentation;
16.25 	(4) barriers facing parents with limited English; and
16.26 	(5) length of reauthorization periods.
16.27 		Subd. 4.Report. By January 15, 2010, the Department of Human Services shall 
16.28 	report recommendations under this section to the chairs and ranking minority members 
16.29 	of the legislative committees and divisions with jurisdiction over child care assistance 
16.30 	programs, including any necessary draft legislation to remove the barriers facing families 
16.31 	in applying for and receiving child care assistance.
16.32 		Subd. 5.Task force expenses. Task force members must not be paid a per diem or 
16.33 	reimbursed for any expenses associated with their membership on the task force.
16.34 		Subd. 6.Expiration. The Child Care Advisory Task Force expires June 30, 2010.

16.35 	Sec. 4. REPEALER.
 17.1 	Minnesota Statutes 2006, section 256B.039, is repealed.