1.1 	A bill for an act
1.2 	relating to human services; amending continuing care provisions, including 
1.3 	changes to medical assistance, nursing facilities, and data management;
1.4 	amending Minnesota Statutes 2008, sections 252.282, subdivisions 3, 5; 
1.5 	256B.0657, subdivision 5; 256B.0913, subdivision 12; 256B.0915, subdivision 
1.6 	2; 256B.431, subdivision 10; 256B.433, subdivision 1; 256B.441, subdivisions 
1.7 	5, 11; 256B.5011, subdivision 2; 256B.5012, subdivisions 6, 7; 256B.5013, 
1.8 	subdivisions 1, 6; 626.557, subdivision 12b; repealing Minnesota Statutes 2008, 
1.9 	section 256B.5013, subdivisions 2, 3, 5.
1.10 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.11 	Section 1. Minnesota Statutes 2008, section 252.282, subdivision 3, is amended to read:
1.12 		Subd. 3.Recommendations. (a) Upon completion of the local system needs 
1.13 	planning assessment, the host county shall make recommendations by May 15, 2000, and 
1.14 	by July 1 every two years thereafter beginning in 2001. If no change is recommended, a 
1.15 	copy of the assessment along with corresponding documentation shall be provided to the 
1.16 	commissioner by July 1 prior to the contract year.
1.17 	(b) Except as provided in section 252.292, subdivision 4, recommendations 
1.18 	regarding closures, relocations, or downsizings that include a rate increase shall be 
1.19 	submitted to the statewide advisory committee for review, along with the assessment, plan, 
1.20 	and corresponding documentation that supports the payment rate adjustment request.  
1.21 	(c) (b) Recommendations for closures, relocations, and downsizings that do not 
1.22 	include a rate increase and for modification of existing services for which a change in the 
1.23 	framework of service delivery is necessary shall be provided to the commissioner by July 
1.24 	1 prior to the contract year or at least 90 days prior to the anticipated change, along with 
1.25 	the assessment and corresponding documentation.

2.1 	Sec. 2. Minnesota Statutes 2008, section 252.282, subdivision 5, is amended to read:
2.2 		Subd. 5.Responsibilities of commissioner. (a) In collaboration with counties and 
2.3 	providers, the commissioner shall ensure that services recognize the preferences and needs 
2.4 	of persons with developmental disabilities and related conditions through a recurring 
2.5 	systemic review and assessment of ICF/MR facilities within the state.
2.6 	(b) The commissioner shall publish a notice in the State Register no less than 
2.7 	biannually to announce the opportunity for counties or providers to submit requests for 
2.8 	payment rate adjustments associated with plans for downsizing, relocation, and closure of 
2.9 	ICF/MR facilities.
2.10 	(c) The commissioner shall designate funding parameters to counties and to the 
2.11 	statewide advisory committee for the overall implementation of system needs within the 
2.12 	fiscal resources allocated by the legislature.
2.13 	(d) (b) The commissioner shall contract with ICF/MR providers. Contracts shall 
2.14 	be for two-year periods.

2.15 	Sec. 3. Minnesota Statutes 2008, section 256B.0657, subdivision 5, is amended to read:
2.16 		Subd. 5.Self-directed supports option plan requirements. (a) The plan for the 
2.17 	self-directed supports option must meet the following requirements:
2.18 	(1) the plan must be completed using a person-centered process that:
2.19 	(i) builds upon the recipient's capacity to engage in activities that promote 
2.20 	community life;
2.21 	(ii) respects the recipient's preferences, choices, and abilities;
2.22 	(iii) involves families, friends, and professionals in the planning or delivery of 
2.23 	services or supports as desired or required by the recipient; and 
2.24 	(iv) addresses the need for personal care assistant services identified in the recipient's 
2.25 	self-directed supports option assessment;
2.26 	(2) the plan shall be developed by the recipient or by the guardian of an adult 
2.27 	recipient or by a parent or guardian of a minor child, with the assistance of an enrolled 
2.28 	medical assistance home care targeted case manager and may be assisted by a provider 
2.29 	who meets the requirements established for using a person-centered planning process and 
2.30 	shall be reviewed at least annually upon reassessment or when there is a significant change 
2.31 	in the recipient's condition; and 
2.32 	(3) the plan must include the total budget amount available divided into monthly 
2.33 	amounts that cover the number of months of personal care assistant services authorization 
2.34 	included in the budget. The amount used each month may vary, but additional funds shall 
3.1 	not be provided above the annual personal care assistant services authorized amount 
3.2 	unless a change in condition is documented.
3.3 	(b) The commissioner shall:
3.4 	(1) establish the format and criteria for the plan as well as the requirements for 
3.5 	providers who assist with plan development;
3.6 	(2) review the assessment and plan and, within 30 days after receiving the 
3.7 	assessment and plan, make a decision on approval of the plan;
3.8 	(3) notify the recipient, parent, or guardian of approval or denial of the plan and 
3.9 	provide notice of the right to appeal under section 256.045; and 
3.10 	(4) provide a copy of the plan to the fiscal support entity selected by the recipient.

3.11 	Sec. 4. Minnesota Statutes 2008, section 256B.0913, subdivision 12, is amended to 
3.12 	read:
3.13 		Subd. 12.Client fees. (a) A fee is required for all alternative care eligible clients 
3.14 	to help pay for the cost of participating in the program. The amount of the fee for the 
3.15 	alternative care client shall be determined as follows:
3.16 	(1) when the alternative care client's income less recurring and predictable medical 
3.17 	expenses is less than 100 percent of the federal poverty guideline effective on July 1 of 
3.18 	the state fiscal year in which the fee is being computed, and total assets are less than 
3.19 	$10,000, the fee is zero;
3.20 	(2) when the alternative care client's income less recurring and predictable medical 
3.21 	expenses is equal to or greater than 100 percent but less than 150 percent of the federal 
3.22 	poverty guideline effective on July 1 of the state fiscal year in which the fee is being 
3.23 	computed, and total assets are less than $10,000, the fee is five percent of the cost of 
3.24 	alternative care services;
3.25 	(3) when the alternative care client's income less recurring and predictable medical 
3.26 	expenses is equal to or greater than 150 percent but less than 200 percent of the federal 
3.27 	poverty guidelines effective on July 1 of the state fiscal year in which the fee is being 
3.28 	computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative 
3.29 	care services;
3.30 	(4) when the alternative care client's income less recurring and predictable medical 
3.31 	expenses is equal to or greater than 200 percent of the federal poverty guidelines effective 
3.32 	on July 1 of the state fiscal year in which the fee is being computed and assets are less than 
3.33 	$10,000, the fee is 30 percent of the cost of alternative care services; and
3.34 	(5) when the alternative care client's assets are equal to or greater than $10,000, the 
3.35 	fee is 30 percent of the cost of alternative care services.
4.1 	For married persons, total assets are defined as the total marital assets less the 
4.2 	estimated community spouse asset allowance, under section 256B.059, if applicable. For 
4.3 	married persons, total income is defined as the client's income less the monthly spousal 
4.4 	allotment, under section 256B.058. 
4.5 	All alternative care services shall be included in the estimated costs for the purpose 
4.6 	of determining the fee.
4.7 	Fees are due and payable each month alternative care services are received unless the 
4.8 	actual cost of the services is less than the fee, in which case the fee is the lesser amount.
4.9 	(b) The fee shall be waived by the commissioner when:
4.10 	(1) a person is residing in a nursing facility;
4.11 	(2) a married couple is requesting an asset assessment under the spousal 
4.12 	impoverishment provisions;
4.13 	(3) a person is found eligible for alternative care, but is not yet receiving alternative 
4.14 	care services including case management services; or
4.15 	(4) a person has chosen to participate in a consumer-directed service plan for which 
4.16 	the cost is no greater than the total cost of the person's alternative care service plan less 
4.17 	the monthly fee amount that would otherwise be assessed.
4.18 	(c) The commissioner will bill and collect the fee from the client. Money collected 
4.19 	must be deposited in the general fund and is appropriated to the commissioner for the 
4.20 	alternative care program. The client must supply the lead agency with the client's Social 
4.21 	Security number at the time of application. The lead agency shall supply the commissioner 
4.22 	with the client's Social Security number and other information the commissioner requires 
4.23 	to collect the fee from the client. The commissioner shall collect unpaid fees using the 
4.24 	Revenue Recapture Act in chapter 270A and other methods available to the commissioner. 
4.25 	The commissioner may require lead agencies to inform clients of the collection procedures 
4.26 	that may be used by the state if a fee is not paid. This paragraph does not apply to 
4.27 	alternative care pilot projects authorized in Laws 1993, First Special Session chapter 1, 
4.28 	article 5, section 133, if a county operating under the pilot project reports the following 
4.29 	dollar amounts to the commissioner quarterly:
4.30 	(1) total fees billed to clients;
4.31 	(2) total collections of fees billed; and
4.32 	(3) balance of fees owed by clients.
4.33 	If a lead agency does not adhere to these reporting requirements, the commissioner may 
4.34 	terminate the billing, collecting, and remitting portions of the pilot project and require the 
4.35 	lead agency involved to operate under the procedures set forth in this paragraph.

5.1 	Sec. 5. Minnesota Statutes 2008, section 256B.0915, subdivision 2, is amended to read:
5.2 		Subd. 2.Spousal impoverishment policies. The commissioner shall apply:
5.3 	(1) the spousal impoverishment criteria as authorized under United States Code, title 
5.4 	42, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059;, 
5.5 	except that individuals with income at or below the special income standard according 
5.6 	to Code of Federal Regulations, title 42, section 435.236, receive the maintenance needs 
5.7 	amount in subdivision 1d.
5.8 	(2) the personal needs allowance permitted in section 256B.0575; and
5.9 	(3) an amount equivalent to the group residential housing rate as set by section 
5.10 	256I.03, subdivision 5, and according to the approved federal waiver and medical 
5.11 	assistance state plan. 

5.12 	Sec. 6. Minnesota Statutes 2008, section 256B.431, subdivision 10, is amended to read:
5.13 		Subd. 10.Property rate adjustments and construction projects. A nursing 
5.14 	facility's facility completing a construction project that is eligible for a rate adjustment 
5.15 	under section 256B.434, subdivision 4f, and that was not approved through the moratorium 
5.16 	exception process in section 144A.073 must request for from the commissioner a 
5.17 	property-related payment rate adjustment and the related supporting documentation of 
5.18 	project construction cost information must be submitted to the commissioner. If the 
5.19 	request is made within 60 days after the construction project's completion date to be 
5.20 	considered eligible for a property-related payment rate adjustment the effective date of 
5.21 	the rate adjustment is the first of the month following the completion date. If the request 
5.22 	is made more than 60 days after the completion date, the rate adjustment is effective on 
5.23 	the first of the month following the request. The commissioner shall provide a rate notice 
5.24 	reflecting the allowable costs within 60 days after receiving all the necessary information 
5.25 	to compute the rate adjustment. No sooner than the effective date of the rate adjustment 
5.26 	for the building construction project, a nursing facility may adjust its rates by the amount 
5.27 	anticipated to be allowed. Any amounts collected from private pay residents in excess of 
5.28 	the allowable rate must be repaid to private pay residents with interest at the rate used by 
5.29 	the commissioner of revenue for the late payment of taxes and in effect on the date the 
5.30 	rate increase is effective. Construction projects with completion dates within one year 
5.31 	of the completion date associated with the property rate adjustment request and phased 
5.32 	projects with project completion dates within three years of the last phase of the phased 
5.33 	project must be aggregated for purposes of the minimum thresholds in subdivisions 16 
5.34 	and 17, and the maximum threshold in section 144A.071, subdivision 2. "Construction 
6.1 	project" and "project construction costs" have the meanings given them in Minnesota 
6.2 	Statutes, section 144A.071, subdivision 1a. 

6.3 	Sec. 7. Minnesota Statutes 2008, section 256B.433, subdivision 1, is amended to read:
6.4 		Subdivision 1.Setting payment; monitoring use of therapy services. The 
6.5 	commissioner shall promulgate adopt rules pursuant tounder  the Administrative 
6.6 	Procedure Act to set the amount and method of payment for ancillary materials and 
6.7 	services provided to recipients residing in nursing facilities. Payment for materials and 
6.8 	services may be made to either the nursing facility in the operating cost per diem, to the 
6.9 	vendor of ancillary services pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475,
6.10 	or to a nursing facility pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475. 
6.11 	Payment for the same or similar service to a recipient shall not be made to both the nursing 
6.12 	facility and the vendor. The commissioner shall ensure the avoidance of double payments 
6.13 	through audits and adjustments to the nursing facility's annual cost report as required by 
6.14 	section 256B.47, and that charges and arrangements for ancillary materials and services 
6.15 	are cost-effective and as would be incurred by a prudent and cost-conscious buyer. 
6.16 	Therapy services provided to a recipient must be medically necessary and appropriate 
6.17 	to the medical condition of the recipient. If the vendor, nursing facility, or ordering 
6.18 	physician cannot provide adequate medical necessity justification, as determined by the 
6.19 	commissioner, the commissioner may recover or disallow the payment for the services 
6.20 	and may require prior authorization for therapy services as a condition of payment or 
6.21 	may impose administrative sanctions to limit the vendor, nursing facility, or ordering 
6.22 	physician's participation in the medical assistance program. If the provider number of a 
6.23 	nursing facility is used to bill services provided by a vendor of therapy services that is 
6.24 	not related to the nursing facility by ownership, control, affiliation, or employment status, 
6.25 	no withholding of payment shall be imposed against the nursing facility for services not 
6.26 	medically necessary except for funds due the unrelated vendor of therapy services as 
6.27 	provided in subdivision 3, paragraph (c). For the purpose of this subdivision, no monetary 
6.28 	recovery may be imposed against the nursing facility for funds paid to the unrelated 
6.29 	vendor of therapy services as provided in subdivision 3, paragraph (c), for services not 
6.30 	medically necessary. For purposes of this section and section 256B.47, therapy includes 
6.31 	physical therapy, occupational therapy, speech therapy, audiology, and mental health 
6.32 	services that are covered services according to Minnesota Rules, parts 9505.0170 to 
6.33 	9505.0475, and that could be reimbursed separately from the nursing facility per diem. 
6.34 	For purposes of this subdivision, "ancillary services" include transportation defined as 
6.35 	a covered service in section 256B.0625, subdivision 17.

7.1 	Sec. 8. Minnesota Statutes 2008, section 256B.441, subdivision 5, is amended to read:
7.2 		Subd. 5.Administrative costs. "Administrative costs" means the direct costs for 
7.3 	administering the overall activities of the nursing home. These costs include salaries and 
7.4 	wages of the administrator, assistant administrator, business office employees, security 
7.5 	guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases 
7.6 	related to business office functions, licenses, and permits except as provided in the external 
7.7 	fixed costs category, employee recognition, travel including meals and lodging, all training
7.8 	except as specified in subdivision 11, voice and data communication or transmission, 
7.9 	office supplies, liability insurance and other forms of insurance not designated to other 
7.10 	areas, personnel recruitment, legal services, accounting services, management or business 
7.11 	consultants, data processing, information technology, Web site, central or home office 
7.12 	costs, business meetings and seminars, postage, fees for professional organizations, 
7.13 	subscriptions, security services, advertising, board of director's fees, working capital 
7.14 	interest expense, and bad debts and bad debt collection fees.

7.15 	Sec. 9. Minnesota Statutes 2008, section 256B.441, subdivision 11, is amended to read:
7.16 		Subd. 11.Direct care costs. "Direct care costs" means costs for the wages of 
7.17 	nursing administration, staff education, direct care registered nurses, licensed practical 
7.18 	nurses, certified nursing assistants, trained medication aides, employees conducting 
7.19 	training in resident care topics and associated fringe benefits and payroll taxes; services 
7.20 	from a supplemental nursing services agency; supplies that are stocked at nursing stations 
7.21 	or on the floor and distributed or used individually, including, but not limited to: alcohol, 
7.22 	applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages, 
7.23 	water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, soap, 
7.24 	medication cups, diapers, plastic waste bags, sanitary products, thermometers, hypodermic 
7.25 	needles and syringes, clinical reagents or similar diagnostic agents, drugs that are not paid 
7.26 	on a separate fee schedule by the medical assistance program or any other payer, and 
7.27 	technology related to the provision of nursing care to residents, such as electronic charting 
7.28 	systems; costs of materials used for resident care training, and training courses outside of 
7.29 	the facility attended by direct care staff on resident care topics.

7.30 	Sec. 10. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to 
7.31 	read:
7.32 		Subd. 2.Contract provisions. (a) The service contract with each intermediate 
7.33 	care facility must include provisions for:
8.1 	(1) modifying payments when significant changes occur in the needs of the 
8.2 	consumers;
8.3 	(2) the establishment and use of a quality improvement plan. Using criteria and 
8.4 	options for performance measures developed by the commissioner, each intermediate care 
8.5 	facility must identify a minimum of one performance measure on which to focus its efforts 
8.6 	for quality improvement during the contract period;
8.7 	(3) (2) appropriate and necessary statistical information required by the 
8.8 	commissioner;
8.9 	(4) (3) annual aggregate facility financial information; and
8.10 	(5) (4) additional requirements for intermediate care facilities not meeting the 
8.11 	standards set forth in the service contract.
8.12 	(b) The commissioner of human services and the commissioner of health, in 
8.13 	consultation with representatives from counties, advocacy organizations, and the provider 
8.14 	community, shall review the consolidated standards under chapter 245B and the supervised 
8.15 	living facility rule under Minnesota Rules, chapter 4665, to determine what provisions 
8.16 	in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for 
8.17 	intermediate care facilities in order to enable facilities to implement the performance 
8.18 	measures in their contract and provide quality services to residents without a duplication 
8.19 	of or increase in regulatory requirements.

8.20 	Sec. 11. Minnesota Statutes 2008, section 256B.5012, subdivision 6, is amended to 
8.21 	read:
8.22 		Subd. 6.ICF/MR rate increases October 1, 2005, and October 1, 2006. (a) For 
8.23 	the rate periods beginning October 1, 2005, and October 1, 2006, the commissioner shall 
8.24 	make available to each facility reimbursed under this section an adjustment to the total 
8.25 	operating payment rate of 2.2553 percent.
8.26 	(b) 75 percent of the money resulting from the rate adjustment under paragraph (a) 
8.27 	must be used to increase wages and benefits and pay associated costs for  employees, 
8.28 	except for administrative and central office employees. 75 percent of the money received 
8.29 	by a facility as a result of the rate adjustment provided in paragraph (a) must be used only 
8.30 	for wage, benefit, and staff increases implemented on or after the effective date of the rate 
8.31 	increase each year, and must not be used for increases implemented prior to that date. The 
8.32 	wage adjustment eligible employees may receive may vary based on merit, seniority, or 
8.33 	other factors determined by the provider.
8.34 	(c) For each facility, the commissioner shall make available an adjustment, based 
8.35 	on occupied beds,  using the percentage specified in paragraph (a) multiplied by the total 
9.1 	payment rate, including variable rate but excluding the property-related payment rate, in 
9.2 	effect on the preceding day. The total payment rate shall include the adjustment provided 
9.3 	in section 256B.501, subdivision 12.
9.4 	(d) A facility whose payment rates are governed by closure agreements,or 
9.5 	receivership agreements, or Minnesota Rules, part 9553.0075, is not eligible for an 
9.6 	adjustment otherwise granted under this subdivision.
9.7 	(e) A facility may apply for the portion of the payment rate adjustment provided 
9.8 	under paragraph (a) for employee wages and benefits and associated costs. The application 
9.9 	must be made to the commissioner and contain a plan by which the facility will distribute 
9.10 	the funds according to paragraph (b). For facilities in which the employees are represented 
9.11 	by an exclusive bargaining representative, an agreement negotiated and agreed to by the 
9.12 	employer and the exclusive bargaining representative constitutes the plan. A negotiated 
9.13 	agreement may constitute the plan only if the agreement is finalized after the date of 
9.14 	enactment of all rate increases for the rate year. The commissioner shall review the plan to 
9.15 	ensure that the payment rate adjustment per diem is used as provided in this subdivision. 
9.16 	To be eligible, a facility must submit its plan by March 31, 2006, and December 31, 
9.17 	2006, respectively. If a facility's plan is effective for its employees after the first day of 
9.18 	the applicable rate period that the funds are available, the payment rate adjustment per 
9.19 	diem is effective the same date as its plan.
9.20 	(f) A copy of the approved distribution plan must be made available to all employees 
9.21 	by giving each employee a copy or by posting it in an area of the facility to which all 
9.22 	employees have access. If an employee does not receive the wage and benefit adjustment 
9.23 	described in the facility's approved plan and is unable to resolve the problem with the 
9.24 	facility's management or through the employee's union representative, the employee 
9.25 	may contact the commissioner at an address or telephone number provided by the 
9.26 	commissioner and included in the approved plan.

9.27 	Sec. 12. Minnesota Statutes 2008, section 256B.5012, subdivision 7, is amended to 
9.28 	read:
9.29 		Subd. 7.ICF/MR rate increases effective October 1, 2007, and October 1, 2008.
 9.30 	(a) For the rate year beginning October 1, 2007, the commissioner shall make available to 
9.31 	each facility reimbursed under this section operating payment rate adjustments equal to 
9.32 	2.0 percent of the operating payment rates in effect on September 30, 2007. For the rate 
9.33 	year beginning October 1, 2008, the commissioner shall make available to each facility 
9.34 	reimbursed under this section operating payment rate adjustments equal to 2.0 percent 
9.35 	of the operating payment rates in effect on September 30, 2008. For each facility, the 
10.1 	commissioner shall make available an adjustment, based on occupied beds, using the 
10.2 	percentage specified in this paragraph multiplied by the total payment rate, including the 
10.3 	variable rate but excluding the property-related payment rate, in effect on the preceding 
10.4 	day. The total payment rate shall include the adjustment provided in section 256B.501, 
10.5 	subdivision 12. A facility whose payment rates are governed by closure agreements,
10.6 	or receivership agreements, or Minnesota Rules, part 9553.0075, is not eligible for an 
10.7 	adjustment otherwise granted under this subdivision.
10.8 	(b) Seventy-five percent of the money resulting from the rate adjustments under 
10.9 	paragraph (a) must be used for increases in compensation-related costs for employees 
10.10 	directly employed by the facility on or after the effective date of the rate adjustments, 
10.11 	except:
10.12 	(1) the administrator;
10.13 	(2) persons employed in the central office of a corporation that has an ownership 
10.14 	interest in the facility or exercises control over the facility; and 
10.15 	(3) persons paid by the facility under a management contract.
10.16 	(c) Two-thirds of the money available under paragraph (b) must be used for wage 
10.17 	increases for all employees directly employed by the facility on or after the effective 
10.18 	date of the rate adjustments, except those listed in paragraph (b), clauses (1) to (3). The 
10.19 	wage adjustment that employees receive under this paragraph must be paid as an equal 
10.20 	hourly percentage wage increase for all eligible employees. All wage increases under this 
10.21 	paragraph must be effective on the same date. Only costs associated with the portion of 
10.22 	the equal hourly percentage wage increase that goes to all employees shall qualify under 
10.23 	this paragraph. Costs associated with wage increases in excess of the amount of the equal 
10.24 	hourly percentage wage increase provided to all employees shall be allowed only for 
10.25 	meeting the requirements in paragraph (b). This paragraph shall not apply to employees 
10.26 	covered by a collective bargaining agreement.
10.27 	(d) The commissioner shall allow as compensation-related costs all costs for:
10.28 	(1) wages and salaries;
10.29 	(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 
10.30 	compensation;
10.31 	(3) the employer's share of health and dental insurance, life insurance, disability 
10.32 	insurance, long-term care insurance, uniform allowance, and pensions; and
10.33 	(4) other benefits provided, subject to the approval of the commissioner.
10.34 	(e) The portion of the rate adjustments under paragraph (a) that is not subject to the 
10.35 	requirements in paragraphs (b) and (c) shall be provided to facilities effective October 
10.36 	1 of each year.
11.1 	(f) Facilities may apply for the portion of the rate adjustments under paragraph 
11.2 	(a) that is subject to the requirements in paragraphs (b) and (c). The application 
11.3 	must be submitted to the commissioner within six months of the effective date of the 
11.4 	rate adjustments, and the facility must provide additional information required by 
11.5 	the commissioner within nine months of the effective date of the rate adjustments. 
11.6 	The commissioner must respond to all applications within three weeks of receipt. 
11.7 	The commissioner may waive the deadlines in this paragraph under extraordinary 
11.8 	circumstances, to be determined at the sole discretion of the commissioner. The 
11.9 	application must contain:
11.10 	(1) an estimate of the amounts of money that must be used as specified in paragraphs 
11.11 	(b) and (c);
11.12 	(2) a detailed distribution plan specifying the allowable compensation-related and 
11.13 	wage increases the facility will implement to use the funds available in clause (1);
11.14 	(3) a description of how the facility will notify eligible employees of the contents of 
11.15 	the approved application, which must provide for giving each eligible employee a copy of 
11.16 	the approved application, excluding the information required in clause (1), or posting a 
11.17 	copy of the approved application, excluding the information required in clause (1), for 
11.18 	a period of at least six weeks in an area of the facility to which all eligible employees 
11.19 	have access; and
11.20 	(4) instructions for employees who believe they have not received the 
11.21 	compensation-related or wage increases specified in clause (2), as approved by the 
11.22 	commissioner, and which must include a mailing address, e-mail address, and the 
11.23 	telephone number that may be used by the employee to contact the commissioner or the 
11.24 	commissioner's representative.
11.25 	(g) The commissioner shall ensure that cost increases in distribution plans under 
11.26 	paragraph (f), clause (2), that may be included in approved applications, comply with 
11.27 	requirements in clauses (1) to (4):
11.28 	(1) costs to be incurred during the applicable rate year resulting from wage and 
11.29 	salary increases effective after October 1, 2006, and prior to the first day of the facility's 
11.30 	payroll period that includes October 1 of each year shall be allowed if they were not used 
11.31 	in the prior year's application and they meet the requirements of paragraphs (b) and (c);
11.32 	(2) a portion of the costs resulting from tenure-related wage or salary increases 
11.33 	may be considered to be allowable wage increases, according to formulas that the 
11.34 	commissioner shall provide, where employee retention is above the average statewide 
11.35 	rate of retention of direct care employees;
12.1 	(3) the annualized amount of increases in costs for the employer's share of health 
12.2 	and dental insurance, life insurance, disability insurance, and workers' compensation shall 
12.3 	be allowable compensation-related increases if they are effective on or after April 1 of 
12.4 	the year in which the rate adjustments are effective and prior to April 1 of the following 
12.5 	year; and 
12.6 	(4) for facilities in which employees are represented by an exclusive bargaining 
12.7 	representative, the commissioner shall approve the application only upon receipt of a letter 
12.8 	of acceptance of the distribution plan, as regards members of the bargaining unit, signed 
12.9 	by the exclusive bargaining agent and dated after May 25, 2007. Upon receipt of the letter 
12.10 	of acceptance, the commissioner shall deem all requirements of this section as having 
12.11 	been met in regard to the members of the bargaining unit.
12.12 	(h) The commissioner shall review applications received under paragraph (f) and 
12.13 	shall provide the portion of the rate adjustments under paragraphs (b) and (c) if the 
12.14 	requirements of this subdivision have been met. The rate adjustments shall be effective 
12.15 	October 1 of each year. Notwithstanding paragraph (a), if the approved application 
12.16 	distributes less money than is available, the amount of the rate adjustment shall be reduced 
12.17 	so that the amount of money made available is equal to the amount to be distributed.

12.18 	Sec. 13. Minnesota Statutes 2008, section 256B.5013, subdivision 1, is amended to 
12.19 	read:
12.20 		Subdivision 1.Variable rate adjustments. (a) For rate years beginning on or after 
12.21 	October 1, 2000, when there is a documented increase in the needs of a current ICF/MR 
12.22 	recipient, the county of financial responsibility may recommend a variable rate to enable 
12.23 	the facility to meet the individual's increased needs. Variable rate adjustments made under 
12.24 	this subdivision replace payments for persons with special needs under section 256B.501, 
12.25 	subdivision 8, and payments for persons with special needs for crisis intervention services 
12.26 	under section 256B.501, subdivision 8a. Effective July 1, 2003, facilities with a base rate 
12.27 	above the 50th percentile of the statewide average reimbursement rate for a Class A 
12.28 	facility or Class B facility, whichever matches the facility licensure, are not eligible for a 
12.29 	variable rate adjustment. Variable rate adjustments may not exceed a 12-month period, 
12.30 	except when approved for purposes established in paragraph (b), clause (1). Variable rate 
12.31 	adjustments approved solely on the basis of changes on a developmental disabilities 
12.32 	screening document will end June 30, 2002. 
12.33 	(b) A variable rate may be recommended by the county of financial responsibility 
12.34 	for increased needs in the following situations:
13.1 	(1) a need for resources due to an individual's full or partial retirement from 
13.2 	participation in a day training and habilitation service when the individual: (i) has reached 
13.3 	the age of 65 or has a change in health condition that makes it difficult for the person 
13.4 	to participate in day training and habilitation services over an extended period of time 
13.5 	because it is medically contraindicated; and (ii) has expressed a desire for change through 
13.6 	the developmental disability screening process under section 256B.092; 
13.7 	(2) a need for additional resources for intensive short-term programming which is 
13.8 	necessary prior to an individual's discharge to a less restrictive, more integrated setting;
13.9 	(3) a demonstrated medical need that significantly impacts the type or amount of 
13.10 	services needed by the individual; or
13.11 	(4) a demonstrated behavioral need that significantly impacts the type or amount of 
13.12 	services needed by the individual.
13.13 	(c) The county of financial responsibility must justify the purpose, the projected 
13.14 	length of time, and the additional funding needed for the facility to meet the needs of 
13.15 	the individual.
13.16 	(d) The facility shall provide a quarterly an annual report to the county case manager 
13.17 	on the use of the variable rate funds and the status of the individual on whose behalf the 
13.18 	funds were approved. The county case manager will forward the facility's report with a 
13.19 	recommendation to the commissioner to approve or disapprove a continuation of the 
13.20 	variable rate.
13.21 	(e) Funds made available through the variable rate process that are not used by 
13.22 	the facility to meet the needs of the individual for whom they were approved shall be 
13.23 	returned to the state.

13.24 	Sec. 14. Minnesota Statutes 2008, section 256B.5013, subdivision 6, is amended to 
13.25 	read:
13.26 		Subd. 6.Commissioner's responsibilities. The commissioner shall:
13.27 	(1) make a determination to approve, deny, or modify a request for a variable rate 
13.28 	adjustment within 30 days of the receipt of the completed application;
13.29 	(2) notify the ICF/MR facility and county case manager of the duration and 
13.30 	conditions of variable rate adjustment approvals; and
13.31 	(3) modify MMIS II service agreements to reimburse ICF/MR facilities for approved 
13.32 	variable rates; .
13.33 	(4) provide notification of legislatively appropriated funding for facility closures, 
13.34 	downsizings, and relocations;
14.1 	(5) assess the fiscal impacts of the proposals for closures, downsizings, and 
14.2 	relocations forwarded for consideration through the state advisory committee; and
14.3 	(6) review the payment rate process on a biannual basis and make recommendations 
14.4 	to the legislature for necessary adjustments to the review and approval process.

14.5 	Sec. 15. Minnesota Statutes 2008, section 626.557, subdivision 12b, is amended to 
14.6 	read:
14.7 		Subd. 12b.Data management. (a) In performing any of the duties of this section as 
14.8 	a lead agency, the county social service agency shall maintain appropriate records. Data 
14.9 	collected by the county social service agency under this section are welfare data under 
14.10 	section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data under this 
14.11 	paragraph that are inactive investigative data on an individual who is a vendor of services 
14.12 	are private data on individuals, as defined in section 13.02. The identity of the reporter 
14.13 	may only be disclosed as provided in paragraph (c).
14.14 	Data maintained by the common entry point are confidential data on individuals or 
14.15 	protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, 
14.16 	the common entry point shall destroy data maintain data for three calendar years after date 
14.17 	of receipt and then destroy the data unless otherwise directed by federal requirements.
14.18 	(b) The commissioners of health and human services shall prepare an investigation 
14.19 	memorandum for each report alleging maltreatment investigated under this section. 
14.20 	County social service agencies must maintain private data on individuals but are not 
14.21 	required to prepare an investigation memorandum. During an investigation by the 
14.22 	commissioner of health or the commissioner of human services, data collected under this 
14.23 	section are confidential data on individuals or protected nonpublic data as defined in 
14.24 	section 13.02. Upon completion of the investigation, the data are classified as provided in 
14.25 	clauses (1) to (3) and paragraph (c).
14.26 	(1) The investigation memorandum must contain the following data, which are 
14.27 	public:
14.28 	(i) the name of the facility investigated;
14.29 	(ii) a statement of the nature of the alleged maltreatment;
14.30 	(iii) pertinent information obtained from medical or other records reviewed;
14.31 	(iv) the identity of the investigator;
14.32 	(v) a summary of the investigation's findings;
14.33 	(vi) statement of whether the report was found to be substantiated, inconclusive, 
14.34 	false, or that no determination will be made;
14.35 	(vii) a statement of any action taken by the facility;
15.1 	(viii) a statement of any action taken by the lead agency; and
15.2 	(ix) when a lead agency's determination has substantiated maltreatment, a statement 
15.3 	of whether an individual, individuals, or a facility were responsible for the substantiated 
15.4 	maltreatment, if known.
15.5 	The investigation memorandum must be written in a manner which protects the 
15.6 	identity of the reporter and of the vulnerable adult and may not contain the names or, to 
15.7 	the extent possible, data on individuals or private data listed in clause (2).
15.8 	(2) Data on individuals collected and maintained in the investigation memorandum 
15.9 	are private data, including:
15.10 	(i) the name of the vulnerable adult;
15.11 	(ii) the identity of the individual alleged to be the perpetrator;
15.12 	(iii) the identity of the individual substantiated as the perpetrator; and
15.13 	(iv) the identity of all individuals interviewed as part of the investigation.
15.14 	(3) Other data on individuals maintained as part of an investigation under this section 
15.15 	are private data on individuals upon completion of the investigation.
15.16 	(c) The subject of the report may compel disclosure of the name of the reporter only 
15.17 	with the consent of the reporter or upon a written finding by a court that the report was 
15.18 	false and there is evidence that the report was made in bad faith. This subdivision does 
15.19 	not alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, 
15.20 	except that where the identity of the reporter is relevant to a criminal prosecution, the 
15.21 	district court shall do an in-camera review prior to determining whether to order disclosure 
15.22 	of the identity of the reporter.
15.23 	(d) Notwithstanding section 138.163, data maintained under this section by the 
15.24 	commissioners of health and human services must be destroyed maintained under the 
15.25 	following schedule and then destroyed unless otherwise directed by federal requirements:
15.26 	(1) data from reports determined to be false, two maintained for three years after the 
15.27 	finding was made;
15.28 	(2) data from reports determined to be inconclusive, maintained for four years after 
15.29 	the finding was made;
15.30 	(3) data from reports determined to be substantiated, maintained for seven years 
15.31 	after the finding was made; and
15.32 	(4) data from reports which were not investigated by a lead agency and for which 
15.33 	there is no final disposition, two maintained for three years from the date of the report.
15.34 	(e) The commissioners of health and human services shall each annually report to 
15.35 	the legislature and the governor on the number and type of reports of alleged maltreatment 
15.36 	involving licensed facilities reported under this section, the number of those requiring 
16.1 	investigation under this section, and the resolution of those investigations. The report 
16.2 	shall identify:
16.3 	(1) whether and where backlogs of cases result in a failure to conform with statutory 
16.4 	time frames;
16.5 	(2) where adequate coverage requires additional appropriations and staffing; and
16.6 	(3) any other trends that affect the safety of vulnerable adults.
16.7 	(f) Each lead agency must have a record retention policy.
16.8 	(g) Lead agencies, prosecuting authorities, and law enforcement agencies may 
16.9 	exchange not public data, as defined in section 13.02, if the agency or authority requesting 
16.10 	the data determines that the data are pertinent and necessary to the requesting agency in 
16.11 	initiating, furthering, or completing an investigation under this section. Data collected 
16.12 	under this section must be made available to prosecuting authorities and law enforcement 
16.13 	officials, local county agencies, and licensing agencies investigating the alleged 
16.14 	maltreatment under this section. The lead agency shall exchange not public data with the 
16.15 	vulnerable adult maltreatment review panel established in section 256.021 if the data are 
16.16 	pertinent and necessary for a review requested under that section. Upon completion of the 
16.17 	review, not public data received by the review panel must be returned to the lead agency.
16.18 	(h) Each lead agency shall keep records of the length of time it takes to complete its 
16.19 	investigations.
16.20 	(i) A lead agency may notify other affected parties and their authorized representative 
16.21 	if the agency has reason to believe maltreatment has occurred and determines the 
16.22 	information will safeguard the well-being of the affected parties or dispel widespread 
16.23 	rumor or unrest in the affected facility.
16.24 	(j) Under any notification provision of this section, where federal law specifically 
16.25 	prohibits the disclosure of patient identifying information, a lead agency may not provide 
16.26 	any notice unless the vulnerable adult has consented to disclosure in a manner which 
16.27 	conforms to federal requirements.

16.28 	Sec. 16.  REPEALER.
 16.29 	Minnesota Statutes 2008, section 256B.5013, subdivisions 2, 3, and 5, are repealed.