as introduced - 82nd Legislature, 2001 1st Special Session (2001 - 2002) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 12/23/2002 |
1.1 A bill for an act 1.2 relating to the operation of state government; 1.3 modifying provisions relating to health; health 1.4 department; health care; human services; human 1.5 services department; continuing care; consumer 1.6 information; long-term care system reform and 1.7 reimbursement; workforce recruitment and retention; 1.8 nursing services; agencies; long-term care insurance; 1.9 assistance programs; child welfare and child support; 1.10 licensing; vital statistics; appropriating money for 1.11 health and human services and criminal justice; 1.12 amending Minnesota Statutes 2000, sections 13.46, 1.13 subdivision 4; 13B.06, subdivision 7; 62A.48, 1.14 subdivision 4, by adding subdivisions; 62J.152, 1.15 subdivision 8; 62J.451, subdivision 5; 62S.01, by 1.16 adding subdivisions; 62S.26; 103I.101, subdivision 6; 1.17 103I.112; 103I.208, subdivisions 1, 2; 103I.235, 1.18 subdivision 1; 103I.525, subdivisions 2, 6, 8, 9; 1.19 103I.531, subdivisions 2, 6, 8, 9; 103I.535, 1.20 subdivisions 2, 6, 8, 9; 103I.541, subdivisions 2b, 4, 1.21 5; 103I.545; 116L.11, subdivision 4; 116L.12, 1.22 subdivisions 4, 5; 116L.13, subdivision 1; 144.057; 1.23 144.0721, subdivision 1; 144.1202, subdivision 4; 1.24 144.1491, subdivision 1; 144.212, subdivisions 2a, 3, 1.25 5, 7, 8, 9, 11; 144.214, subdivisions 1, 3, 4; 1.26 144.215, subdivisions 1, 3, 4, 6, 7; 144.217; 144.218; 1.27 144.221, subdivisions 1, 3; 144.222, subdivision 2; 1.28 144.223; 144.225, subdivisions 1, 2, 2a, 3, 7, as 1.29 amended; 144.226, subdivisions 1, 3, 4; 144.227; 1.30 144.551, subdivision 1; 144.98, subdivision 3; 1.31 144A.071, subdivisions 1, 1a, 2; 144A.073, subdivision 1.32 4; 144A.44, subdivision 1; 144A.4605, subdivision 4; 1.33 144D.03, subdivision 2; 144D.04, subdivisions 2, 3; 1.34 144D.06; 145.881, subdivision 2; 145.882, by adding a 1.35 subdivision; 145.885, subdivision 2; 148.212; 148.284; 1.36 148B.21, subdivision 6a; 148B.22, subdivision 3; 1.37 157.16, subdivision 3; 157.22, as amended; 214.104; 1.38 245.462, subdivisions 8, 18, by adding subdivisions; 1.39 245.474, by adding a subdivision; 245.4871, 1.40 subdivisions 10, 27, by adding a subdivision; 1.41 245.4876, subdivision 1, by adding a subdivision; 1.42 245.4885, subdivision 1; 245.4886, subdivision 1; 1.43 245.99, subdivision 4; 245A.02, subdivisions 1, 9, by 1.44 adding a subdivision; 245A.03, subdivisions 2, 2b, by 1.45 adding a subdivision; 245A.035, subdivision 1; 1.46 245A.04, subdivisions 3, 3a, 3b, 3c, 3d, 6, 11, by 2.1 adding a subdivision; 245A.05; 245A.06; 245A.07; 2.2 245A.08; 245A.13, subdivisions 7, 8; 245A.16, 2.3 subdivision 1; 245B.08, subdivision 3; 252.275, 2.4 subdivision 4b; 252A.02, subdivisions 12, 13, by 2.5 adding a subdivision; 252A.111, subdivision 6; 2.6 252A.16, subdivision 1; 252A.19, subdivision 2; 2.7 252A.20, subdivision 1; 253B.02, subdivision 10; 2.8 253B.03, subdivisions 5, 10, by adding a subdivision; 2.9 253B.04, subdivisions 1, 1a, by adding a subdivision; 2.10 253B.045, subdivision 6; 253B.05, subdivision 1; 2.11 253B.065, subdivision 5; 253B.066, subdivision 1; 2.12 253B.07, subdivisions 1, 2, 7; 253B.09, subdivision 1; 2.13 253B.10, subdivision 4; 254B.09, by adding a 2.14 subdivision; 256.01, subdivision 2, by adding a 2.15 subdivision; 256.045, subdivisions 3, 3b, 4; 256.476, 2.16 subdivisions 1, 2, 3, 4, 5, 8, by adding a 2.17 subdivision; 256.741, subdivisions 1, 5, 8; 256.9657, 2.18 subdivision 2; 256.975, by adding a subdivision; 2.19 256.979, subdivisions 5, 6; 256.98, subdivision 8; 2.20 256B.04, by adding a subdivision; 256B.056, 2.21 subdivision 4b; 256B.0625, subdivisions 3b, 7, 13, 2.22 13a, 19a, 19c, 20, 34, by adding subdivisions; 2.23 256B.0627, subdivisions 1, 2, 4, 5, 7, 8, 10, 11, by 2.24 adding subdivisions; 256B.0911, subdivisions 1, 3, 5, 2.25 6, 7, by adding subdivisions; 256B.0913, subdivisions 2.26 1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 13, 14; 256B.0915, 2.27 subdivisions 1d, 3, 5; 256B.0916, subdivisions 7, 9, 2.28 by adding a subdivision; 256B.0917, subdivision 7; 2.29 256B.092, subdivision 5; 256B.093, subdivision 3; 2.30 256B.431, by adding subdivisions; 256B.433, 2.31 subdivision 3a; 256B.49, by adding subdivisions; 2.32 256B.69, subdivision 23, by adding a subdivision; 2.33 256B.75; 256D.35, by adding subdivisions; 256D.44, 2.34 subdivision 5; 256J.08, subdivision 55a, by adding a 2.35 subdivision; 256J.09, subdivisions 1, 2, 3, by adding 2.36 subdivisions; 256J.24, subdivisions 2, 9, 10; 256J.31, 2.37 subdivision 4; 256J.39, subdivision 2; 256J.42, 2.38 subdivisions 1, 3; 256J.45, subdivision 1; 256J.48, by 2.39 adding a subdivision; 256J.49, subdivisions 2, 13, by 2.40 adding a subdivision; 256J.50, by adding a 2.41 subdivision; 256J.57, subdivision 2; 256J.62, 2.42 subdivision 2a; 256J.645; 256L.05, subdivision 2; 2.43 256L.06, subdivision 3; 256L.12, by adding a 2.44 subdivision; 257.0725; 260C.201, subdivision 1, as 2.45 amended; 260C.317, subdivision 4; 268.0122, 2.46 subdivision 2; 326.38; 393.07, by adding a 2.47 subdivision; 518.5513, subdivision 5; 518.575, 2.48 subdivision 1; 518.5851, by adding a subdivision; 2.49 518.5853, by adding a subdivision; 518.6111, 2.50 subdivision 5; 518.6195; 518.64, subdivision 2, as 2.51 amended; 518.641, subdivisions 1, 2, 3, by adding a 2.52 subdivision; 548.091, subdivision 1a; 626.556, 2.53 subdivisions 10, as amended, 10d, as amended, 12; 2.54 626.557, subdivisions 3, 9d, 12b; 626.5572, 2.55 subdivision 17; 626.559, subdivision 2; Laws 1999, 2.56 chapter 152, section 1; Laws 1999, chapter 245, 2.57 article 3, section 45, as amended; Laws 1999, chapter 2.58 245, article 4, section 110; Laws 2000, chapter 364, 2.59 section 2; proposing coding for new law in Minnesota 2.60 Statutes, chapters 62Q; 62S; 116L; 144; 144A; 145; 2.61 214; 245A; 256; 256B; 299A; 325F; repealing Minnesota 2.62 Statutes 2000, sections 116L.12, subdivisions 2, 7; 2.63 144.148, subdivision 8; 144.1761; 144.217, subdivision 2.64 4; 144.219; 144A.16; 145.882, subdivisions 3, 4; 2.65 145.927; 252A.111, subdivision 3; 256B.0911, 2.66 subdivisions 2, 2a, 4, 9; 256B.0913, subdivisions 3, 2.67 15a, 15b, 15c, 16; 256B.0915, subdivisions 3a, 3b, 3c; 2.68 256B.434, subdivision 5; 518.641, subdivisions 4, 5; 2.69 Minnesota Rules, parts 4655.6810; 4655.6820; 2.70 4655.6830; 4658.1600; 4658.1605; 4658.1610; 4658.1690; 2.71 9505.2390; 9505.2395; 9505.2396; 9505.2400; 9505.2405; 3.1 9505.2410; 9505.2413; 9505.2415; 9505.2420; 9505.2425; 3.2 9505.2426; 9505.2430; 9505.2435; 9505.2440; 9505.2445; 3.3 9505.2450; 9505.2455; 9505.2458; 9505.2460; 9505.2465; 3.4 9505.2470; 9505.2473; 9505.2475; 9505.2480; 9505.2485; 3.5 9505.2486; 9505.2490; 9505.2495; 9505.2496; 9505.2500; 3.6 9543.3000; 9543.3010; 9543.3020; 9543.3030; 9543.3040; 3.7 9543.3050; 9543.3060; 9543.3080; 9543.3090; 9546.0010; 3.8 9546.0020; 9546.0030; 9546.0040; 9546.0050; 9546.0060. 3.9 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.10 ARTICLE 1 3.11 DEPARTMENT OF HEALTH 3.12 Section 1. Minnesota Statutes 2000, section 62J.152, 3.13 subdivision 8, is amended to read: 3.14 Subd. 8. [REPEALER.] This section and sections 62J.15 and 3.15 62J.156 are repealed effective July 1,20012005. 3.16 Sec. 2. Minnesota Statutes 2000, section 62J.451, 3.17 subdivision 5, is amended to read: 3.18 Subd. 5. [HEALTH CARE ELECTRONIC DATA INTERCHANGE 3.19 SYSTEM.](a)The health data institute shall establish an 3.20 electronic data interchange system that electronically 3.21 transmits, collects, archives, and provides users of data with 3.22 the data necessary for their specific interests, in order to 3.23 promote a high quality, cost-effective, consumer-responsive 3.24 health care system. This public-private information system 3.25 shall be developed to make health care claims processing and 3.26 financial settlement transactions more efficient and to provide 3.27 an efficient, unobtrusive method for meeting the shared 3.28 electronic data interchange needs of consumers, group 3.29 purchasers, providers, and the state. 3.30(b) The health data institute shall operate the Minnesota3.31center for health care electronic data interchange established3.32in section 62J.57, and shall integrate the goals, objectives,3.33and activities of the center with those of the health data3.34institute's electronic data interchange system.3.35 Sec. 3. Minnesota Statutes 2000, section 103I.101, 3.36 subdivision 6, is amended to read: 3.37 Subd. 6. [FEES FOR VARIANCES.] The commissioner shall 3.38 charge a nonrefundable application fee of$120$150 to cover the 3.39 administrative cost of processing a request for a variance or 4.1 modification of rules adopted by the commissioner under this 4.2 chapter. 4.3 [EFFECTIVE DATE.] This section is effective July 1, 2002. 4.4 Sec. 4. Minnesota Statutes 2000, section 103I.112, is 4.5 amended to read: 4.6 103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 4.7 (a) The commissioner of health may not charge fees required 4.8 under this chapter to a federal agency, state agency, or a local 4.9 unit of government or to a subcontractor performing work for the 4.10 state agency or local unit of government. 4.11 (b) "Local unit of government" means a statutory or home 4.12 rule charter city, town, county, or soil and water conservation 4.13 district, watershed district, an organization formed for the 4.14 joint exercise of powers under section 471.59, a board of health 4.15 or community health board, or other special purpose district or 4.16 authority with local jurisdiction in water and related land 4.17 resources management. 4.18 [EFFECTIVE DATE.] This section is effective July 1, 2002. 4.19 Sec. 5. Minnesota Statutes 2000, section 103I.208, 4.20 subdivision 1, is amended to read: 4.21 Subdivision 1. [WELL NOTIFICATION FEE.] The well 4.22 notification fee to be paid by a property owner is: 4.23 (1) for a new well,$120$150, which includes the state 4.24 core function fee; 4.25 (2) for a well sealing,$20$30 for each well, which 4.26 includes the state core function fee, except that for monitoring 4.27 wells constructed on a single property, having depths within a 4.28 25 foot range, and sealed within 48 hours of start of 4.29 construction, a single fee of$20$30; and 4.30 (3) for construction of a dewatering well,$120$150, which 4.31 includes the state core function fee, for each well except a 4.32 dewatering project comprising five or more wells shall be 4.33 assessed a single fee of$600$750 for the wells recorded on the 4.34 notification. 4.35 [EFFECTIVE DATE.] This section is effective July 1, 2002. 4.36 Sec. 6. Minnesota Statutes 2000, section 103I.208, 5.1 subdivision 2, is amended to read: 5.2 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 5.3 property owner is: 5.4 (1) for a well that is not in use under a maintenance 5.5 permit,$100$125 annually; 5.6 (2) for construction of a monitoring well,$120$150, which 5.7 includes the state core function fee; 5.8 (3) for a monitoring well that is unsealed under a 5.9 maintenance permit,$100$125 annually; 5.10 (4) for monitoring wells used as a leak detection device at 5.11 a single motor fuel retail outlet, a single petroleum bulk 5.12 storage site excluding tank farms, or a single agricultural 5.13 chemical facility site, the construction permit fee 5.14 is$120$150, which includes the state core function fee, per 5.15 site regardless of the number of wells constructed on the site, 5.16 and the annual fee for a maintenance permit for unsealed 5.17 monitoring wells is$100$125 per site regardless of the number 5.18 of monitoring wells located on site; 5.19 (5) for a groundwater thermal exchange device, in addition 5.20 to the notification fee for wells,$120$150, which includes the 5.21 state core function fee; 5.22 (6) for a vertical heat exchanger,$120$150; 5.23 (7) for a dewatering well that is unsealed under a 5.24 maintenance permit,$100$125 annually for each well, except a 5.25 dewatering project comprising more than five wells shall be 5.26 issued a single permit for$500$625 annually for wells recorded 5.27 on the permit; and 5.28 (8) for excavating holes for the purpose of installing 5.29 elevator shafts,$120$150 for each hole. 5.30 [EFFECTIVE DATE.] This section is effective July 1, 2002. 5.31 Sec. 7. Minnesota Statutes 2000, section 103I.235, 5.32 subdivision 1, is amended to read: 5.33 Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before 5.34 signing an agreement to sell or transfer real property, the 5.35 seller must disclose in writing to the buyer information about 5.36 the status and location of all known wells on the property, by 6.1 delivering to the buyer either a statement by the seller that 6.2 the seller does not know of any wells on the property, or a 6.3 disclosure statement indicating the legal description and 6.4 county, and a map drawn from available information showing the 6.5 location of each well to the extent practicable. In the 6.6 disclosure statement, the seller must indicate, for each well, 6.7 whether the well is in use, not in use, or sealed. 6.8 (b) At the time of closing of the sale, the disclosure 6.9 statement information, name and mailing address of the buyer, 6.10 and the quartile, section, township, and range in which each 6.11 well is located must be provided on a well disclosure 6.12 certificate signed by the seller or a person authorized to act 6.13 on behalf of the seller. 6.14 (c) A well disclosure certificate need not be provided if 6.15 the seller does not know of any wells on the property and the 6.16 deed or other instrument of conveyance contains the statement: 6.17 "The Seller certifies that the Seller does not know of any wells 6.18 on the described real property." 6.19 (d) If a deed is given pursuant to a contract for deed, the 6.20 well disclosure certificate required by this subdivision shall 6.21 be signed by the buyer or a person authorized to act on behalf 6.22 of the buyer. If the buyer knows of no wells on the property, a 6.23 well disclosure certificate is not required if the following 6.24 statement appears on the deed followed by the signature of the 6.25 grantee or, if there is more than one grantee, the signature of 6.26 at least one of the grantees: "The Grantee certifies that the 6.27 Grantee does not know of any wells on the described real 6.28 property." The statement and signature of the grantee may be on 6.29 the front or back of the deed or on an attached sheet and an 6.30 acknowledgment of the statement by the grantee is not required 6.31 for the deed to be recordable. 6.32 (e) This subdivision does not apply to the sale, exchange, 6.33 or transfer of real property: 6.34 (1) that consists solely of a sale or transfer of severed 6.35 mineral interests; or 6.36 (2) that consists of an individual condominium unit as 7.1 described in chapters 515 and 515B. 7.2 (f) For an area owned in common under chapter 515 or 515B 7.3 the association or other responsible person must report to the 7.4 commissioner by July 1, 1992, the location and status of all 7.5 wells in the common area. The association or other responsible 7.6 person must notify the commissioner within 30 days of any change 7.7 in the reported status of wells. 7.8 (g) For real property sold by the state under section 7.9 92.67, the lessee at the time of the sale is responsible for 7.10 compliance with this subdivision. 7.11 (h) If the seller fails to provide a required well 7.12 disclosure certificate, the buyer, or a person authorized to act 7.13 on behalf of the buyer, may sign a well disclosure certificate 7.14 based on the information provided on the disclosure statement 7.15 required by this section or based on other available information. 7.16 (i) A county recorder or registrar of titles may not record 7.17 a deed or other instrument of conveyance dated after October 31, 7.18 1990, for which a certificate of value is required under section 7.19 272.115, or any deed or other instrument of conveyance dated 7.20 after October 31, 1990, from a governmental body exempt from the 7.21 payment of state deed tax, unless the deed or other instrument 7.22 of conveyance contains the statement made in accordance with 7.23 paragraph (c) or (d) or is accompanied by the well disclosure 7.24 certificate containing all the information required by paragraph 7.25 (b) or (d). The county recorder or registrar of titles must not 7.26 accept a certificate unless it contains all the required 7.27 information. The county recorder or registrar of titles shall 7.28 note on each deed or other instrument of conveyance accompanied 7.29 by a well disclosure certificate that the well disclosure 7.30 certificate was received. The notation must include the 7.31 statement "No wells on property" if the disclosure certificate 7.32 states there are no wells on the property. The well disclosure 7.33 certificate shall not be filed or recorded in the records 7.34 maintained by the county recorder or registrar of titles. After 7.35 noting "No wells on property" on the deed or other instrument of 7.36 conveyance, the county recorder or registrar of titles shall 8.1 destroy or return to the buyer the well disclosure certificate. 8.2 The county recorder or registrar of titles shall collect from 8.3 the buyer or the person seeking to record a deed or other 8.4 instrument of conveyance, a fee of$20$30 for receipt of a 8.5 completed well disclosure certificate. By the tenth day of each 8.6 month, the county recorder or registrar of titles shall transmit 8.7 the well disclosure certificates to the commissioner of health. 8.8 By the tenth day after the end of each calendar quarter, the 8.9 county recorder or registrar of titles shall transmit to the 8.10 commissioner of health$17.50$27.50 of the fee for each well 8.11 disclosure certificate received during the quarter. The 8.12 commissioner shall maintain the well disclosure certificate for 8.13 at least six years. The commissioner may store the certificate 8.14 as an electronic image. A copy of that image shall be as valid 8.15 as the original. 8.16 (j) No new well disclosure certificate is required under 8.17 this subdivision if the buyer or seller, or a person authorized 8.18 to act on behalf of the buyer or seller, certifies on the deed 8.19 or other instrument of conveyance that the status and number of 8.20 wells on the property have not changed since the last previously 8.21 filed well disclosure certificate. The following statement, if 8.22 followed by the signature of the person making the statement, is 8.23 sufficient to comply with the certification requirement of this 8.24 paragraph: "I am familiar with the property described in this 8.25 instrument and I certify that the status and number of wells on 8.26 the described real property have not changed since the last 8.27 previously filed well disclosure certificate." The 8.28 certification and signature may be on the front or back of the 8.29 deed or on an attached sheet and an acknowledgment of the 8.30 statement is not required for the deed or other instrument of 8.31 conveyance to be recordable. 8.32 (k) The commissioner in consultation with county recorders 8.33 shall prescribe the form for a well disclosure certificate and 8.34 provide well disclosure certificate forms to county recorders 8.35 and registrars of titles and other interested persons. 8.36 (l) Failure to comply with a requirement of this 9.1 subdivision does not impair: 9.2 (1) the validity of a deed or other instrument of 9.3 conveyance as between the parties to the deed or instrument or 9.4 as to any other person who otherwise would be bound by the deed 9.5 or instrument; or 9.6 (2) the record, as notice, of any deed or other instrument 9.7 of conveyance accepted for filing or recording contrary to the 9.8 provisions of this subdivision. 9.9 [EFFECTIVE DATE.] This section is effective July 1, 2002. 9.10 Sec. 8. Minnesota Statutes 2000, section 103I.525, 9.11 subdivision 2, is amended to read: 9.12 Subd. 2. [APPLICATION FEE.] The application fee for a well 9.13 contractor's license is$50$75. The commissioner may not act 9.14 on an application until the application fee is paid. 9.15 [EFFECTIVE DATE.] This section is effective July 1, 2002. 9.16 Sec. 9. Minnesota Statutes 2000, section 103I.525, 9.17 subdivision 6, is amended to read: 9.18 Subd. 6. [LICENSE FEE.] The fee for a well contractor's 9.19 license is $250, except the fee for an individual well 9.20 contractor's license is$50$75. 9.21 [EFFECTIVE DATE.] This section is effective July 1, 2002. 9.22 Sec. 10. Minnesota Statutes 2000, section 103I.525, 9.23 subdivision 8, is amended to read: 9.24 Subd. 8. [RENEWAL.] (a) A licensee must file an 9.25 application and a renewal application fee to renew the license 9.26 by the date stated in the license. 9.27 (b) The renewal application feeshall be set by the9.28commissioner under section 16A.1285for a well contractor's 9.29 license is $250. 9.30 (c) The renewal application must include information that 9.31 the applicant has met continuing education requirements 9.32 established by the commissioner by rule. 9.33 (d) At the time of the renewal, the commissioner must have 9.34 on file all properly completed well reports, well sealing 9.35 reports, reports of excavations to construct elevator shafts, 9.36 well permits, and well notifications for work conducted by the 10.1 licensee since the last license renewal. 10.2 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.3 Sec. 11. Minnesota Statutes 2000, section 103I.525, 10.4 subdivision 9, is amended to read: 10.5 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 10.6 to submit all information required for renewal in subdivision 8 10.7 or submits the application and information after the required 10.8 renewal date: 10.9 (1) the licensee must includean additionala late feeset10.10by the commissionerof $75; and 10.11 (2) the licensee may not conduct activities authorized by 10.12 the well contractor's license until the renewal application, 10.13 renewal application fee, late fee, and all other information 10.14 required in subdivision 8 are submitted. 10.15 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.16 Sec. 12. Minnesota Statutes 2000, section 103I.531, 10.17 subdivision 2, is amended to read: 10.18 Subd. 2. [APPLICATION FEE.] The application fee for a 10.19 limited well/boring contractor's license is$50$75. The 10.20 commissioner may not act on an application until the application 10.21 fee is paid. 10.22 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.23 Sec. 13. Minnesota Statutes 2000, section 103I.531, 10.24 subdivision 6, is amended to read: 10.25 Subd. 6. [LICENSE FEE.] The fee for a limited well/boring 10.26 contractor's license is$50$75. 10.27 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.28 Sec. 14. Minnesota Statutes 2000, section 103I.531, 10.29 subdivision 8, is amended to read: 10.30 Subd. 8. [RENEWAL.] (a) A person must file an application 10.31 and a renewal application fee to renew the limited well/boring 10.32 contractor's license by the date stated in the license. 10.33 (b) The renewal application feeshall be set by the10.34commissioner under section 16A.1285for a limited well/boring 10.35 contractor's license is $75. 10.36 (c) The renewal application must include information that 11.1 the applicant has met continuing education requirements 11.2 established by the commissioner by rule. 11.3 (d) At the time of the renewal, the commissioner must have 11.4 on file all properly completed well sealing reports, well 11.5 permits, vertical heat exchanger permits, and well notifications 11.6 for work conducted by the licensee since the last license 11.7 renewal. 11.8 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.9 Sec. 15. Minnesota Statutes 2000, section 103I.531, 11.10 subdivision 9, is amended to read: 11.11 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 11.12 to submit all information required for renewal in subdivision 8 11.13 or submits the application and information after the required 11.14 renewal date: 11.15 (1) the licensee must includean additionala late feeset11.16by the commissionerof $75; and 11.17 (2) the licensee may not conduct activities authorized by 11.18 the limited well/boring contractor's license until the renewal 11.19 application, renewal application fee, and late fee, and all 11.20 other information required in subdivision 8 are submitted. 11.21 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.22 Sec. 16. Minnesota Statutes 2000, section 103I.535, 11.23 subdivision 2, is amended to read: 11.24 Subd. 2. [APPLICATION FEE.] The application fee for an 11.25 elevator shaft contractor's license is$50$75. The 11.26 commissioner may not act on an application until the application 11.27 fee is paid. 11.28 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.29 Sec. 17. Minnesota Statutes 2000, section 103I.535, 11.30 subdivision 6, is amended to read: 11.31 Subd. 6. [LICENSE FEE.] The fee for an elevator shaft 11.32 contractor's license is$50$75. 11.33 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.34 Sec. 18. Minnesota Statutes 2000, section 103I.535, 11.35 subdivision 8, is amended to read: 11.36 Subd. 8. [RENEWAL.] (a) A person must file an application 12.1 and a renewal application fee to renew the license by the date 12.2 stated in the license. 12.3 (b) The renewal application feeshall be set by the12.4commissioner under section 16A.1285for an elevator shaft 12.5 contractor's license is $75. 12.6 (c) The renewal application must include information that 12.7 the applicant has met continuing education requirements 12.8 established by the commissioner by rule. 12.9 (d) At the time of renewal, the commissioner must have on 12.10 file all reports and permits for elevator shaft work conducted 12.11 by the licensee since the last license renewal. 12.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.13 Sec. 19. Minnesota Statutes 2000, section 103I.535, 12.14 subdivision 9, is amended to read: 12.15 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 12.16 to submit all information required for renewal in subdivision 8 12.17 or submits the application and information after the required 12.18 renewal date: 12.19 (1) the licensee must includean additionala late feeset12.20by the commissionerof $75; and 12.21 (2) the licensee may not conduct activities authorized by 12.22 the elevator shaft contractor's license until the renewal 12.23 application, renewal application fee, and late fee, and all 12.24 other information required in subdivision 8 are submitted. 12.25 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.26 Sec. 20. Minnesota Statutes 2000, section 103I.541, 12.27 subdivision 2b, is amended to read: 12.28 Subd. 2b. [APPLICATION FEE.] The application fee for a 12.29 monitoring well contractor registration is$50$75. The 12.30 commissioner may not act on an application until the application 12.31 fee is paid. 12.32 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.33 Sec. 21. Minnesota Statutes 2000, section 103I.541, 12.34 subdivision 4, is amended to read: 12.35 Subd. 4. [RENEWAL.] (a) A person must file an application 12.36 and a renewal application fee to renew the registration by the 13.1 date stated in the registration. 13.2 (b) The renewal application feeshall be set by the13.3commissioner under section 16A.1285for a monitoring well 13.4 contractor's registration is $75. 13.5 (c) The renewal application must include information that 13.6 the applicant has met continuing education requirements 13.7 established by the commissioner by rule. 13.8 (d) At the time of the renewal, the commissioner must have 13.9 on file all well reports, well sealing reports, well permits, 13.10 and notifications for work conducted by the registered person 13.11 since the last registration renewal. 13.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.13 Sec. 22. Minnesota Statutes 2000, section 103I.541, 13.14 subdivision 5, is amended to read: 13.15 Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered 13.16 person submits a renewal application after the required renewal 13.17 date: 13.18 (1) the registered person must includean additionala late 13.19 feeset by the commissionerof $75; and 13.20 (2) the registered person may not conduct activities 13.21 authorized by the monitoring well contractor's registration 13.22 until the renewal application, renewal application fee, late 13.23 fee, and all other information required in subdivision 4 are 13.24 submitted. 13.25 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.26 Sec. 23. Minnesota Statutes 2000, section 103I.545, is 13.27 amended to read: 13.28 103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 13.29 Subdivision 1. [DRILLING MACHINE.] (a) A person may not 13.30 use a drilling machine such as a cable tool, rotary tool, hollow 13.31 rod tool, or auger for a drilling activity requiring a license 13.32 or registration under this chapter unless the drilling machine 13.33 is registered with the commissioner. 13.34 (b) A person must apply for the registration on forms 13.35 prescribed by the commissioner and submit a$50$75 registration 13.36 fee. 14.1 (c) A registration is valid for one year. 14.2 Subd. 2. [PUMP HOIST.] (a) A person may not use a machine 14.3 such as a pump hoist for an activity requiring a license or 14.4 registration under this chapter to repair wells or borings, seal 14.5 wells or borings, or install pumps unless the machine is 14.6 registered with the commissioner. 14.7 (b) A person must apply for the registration on forms 14.8 prescribed by the commissioner and submit a$50$75 registration 14.9 fee. 14.10 (c) A registration is valid for one year. 14.11 [EFFECTIVE DATE.] This section is effective July 1, 2002. 14.12 Sec. 24. [144.0751] [HEALTH STANDARDS.] 14.13 When establishing or revising safe drinking water or air 14.14 quality standards, the commissioner shall take into account 14.15 department of health technical staff reviewed or otherwise 14.16 peer-reviewed, scientifically acceptable information in setting 14.17 standards that include a reasonable margin of safety to 14.18 adequately protect the health of infants, children, and adults, 14.19 by taking into consideration each of the following specific 14.20 risks: 14.21 (1) reproductive development and function; 14.22 (2) respiratory function; 14.23 (3) immunologic suppression or hypersensitization; 14.24 (4) development of the brain and nervous system; 14.25 (5) endocrine (hormonal) function; 14.26 (6) cancer; 14.27 (7) general infant and child development; and 14.28 (8) any other important health outcomes identified by the 14.29 commissioner. 14.30 Sec. 25. Minnesota Statutes 2000, section 144.1202, 14.31 subdivision 4, is amended to read: 14.32 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 14.33 agreement entered into before August 2,20022003, must remain 14.34 in effect until terminated under the Atomic Energy Act of 1954, 14.35 United States Code, title 42, section 2021, paragraph (j). The 14.36 governor may not enter into an initial agreement with the 15.1 Nuclear Regulatory Commission after August 1,20022003. If an 15.2 agreement is not entered into by August 1,20022003, any rules 15.3 adopted under this section are repealed effective August 1,200215.4 2003. 15.5 (b) An agreement authorized under subdivision 1 must be 15.6 approved by law before it may be implemented. 15.7 Sec. 26. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 15.8 SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 15.9 Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When 15.10 a license is required for radioactive material or source or 15.11 special nuclear material by a rule adopted under section 15.12 144.1202, subdivision 2, an application fee according to 15.13 subdivision 4 must be paid upon initial application for a 15.14 license. The licensee must renew the license 60 days before the 15.15 expiration date of the license by paying a license renewal fee 15.16 equal to the application fee under subdivision 4. The 15.17 expiration date of a license is the date set by the United 15.18 States Nuclear Regulatory Commission before transfer of the 15.19 licensing program under section 144.1202 and thereafter as 15.20 specified by rule of the commissioner of health. 15.21 Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee 15.22 at least 60 days before the anniversary date of the issuance of 15.23 the license. The annual fee is an amount equal to 80 percent of 15.24 the application fee under subdivision 4, rounded to the nearest 15.25 whole dollar. 15.26 Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL 15.27 LICENSING CATEGORIES.] (a) Fee categories under this section are 15.28 equivalent to the licensing categories used by the United States 15.29 Nuclear Regulatory Commission under Code of Federal Regulations, 15.30 title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 15.31 provided in paragraph (b). 15.32 (b) The category of "Academic, small" is the type of 15.33 license required for the use of radioactive materials in a 15.34 teaching institution. Radioactive materials are limited to ten 15.35 radionuclides not to exceed a total activity amount of one curie. 15.36 Subd. 4. [APPLICATION FEE.] A licensee must pay an 16.1 application fee as follows: 16.2 Radioactive material, Application U.S. Nuclear Regulatory 16.3 source and fee Commission licensing 16.4 special material category as reference 16.6 Type A broadscope $20,000 Medical institution type A 16.7 Type B broadscope $15,000 Research and development 16.8 type B 16.9 Type C broadscope $10,000 Academic type C 16.10 Medical use $4,000 Medical 16.11 Medical institution 16.12 Medical private practice 16.13 Mobile nuclear 16.14 medical laboratory $4,000 Mobile medical laboratory 16.15 Medical special use 16.16 sealed sources $6,000 Teletherapy 16.17 High dose rate remote 16.18 afterloaders 16.19 Stereotactic 16.20 radiosurgery devices 16.21 In vitro testing $2,300 In vitro testing 16.22 laboratories 16.23 Measuring gauge, 16.24 sealed sources $2,000 Fixed gauges 16.25 Portable gauges 16.26 Analytical instruments 16.27 Measuring systems - other 16.28 Gas chromatographs $1,200 Gas chromatographs 16.29 Manufacturing and 16.30 distribution $14,700 Manufacturing and 16.31 distribution - other 16.32 Distribution only $8,800 Distribution of 16.33 radioactive material 16.34 for commercial use only 16.35 Other services $1,500 Other services 16.36 Nuclear medicine 17.1 pharmacy $4,100 Nuclear pharmacy 17.2 Waste disposal $9,400 Waste disposal service 17.3 prepackage 17.4 Waste disposal service 17.5 processing/repackage 17.6 Waste storage only $7,000 To receive and store 17.7 radioactive material waste 17.8 Industrial 17.9 radiography $8,400 Industrial radiography 17.10 fixed location 17.11 Industrial radiography 17.12 portable/temporary sites 17.13 Irradiator - 17.14 self-shielded $4,100 Irradiators self-shielded 17.15 less than 10,000 curies 17.16 Irradiator - 17.17 less than 10,000 Ci $7,500 Irradiators less than 17.18 10,000 curies 17.19 Irradiator - 17.20 more than 10,000 Ci $11,500 Irradiators greater than 17.21 10,000 curies 17.22 Research and 17.23 development, 17.24 no distribution $4,100 Research and development 17.25 Radioactive material 17.26 possession only $1,000 Byproduct possession only 17.27 Source material $1,000 Source material shielding 17.28 Special nuclear 17.29 material, less than 17.30 200 grams $1,000 Special nuclear material 17.31 plutonium-neutron sources 17.32 less than 200 grams 17.33 Pacemaker 17.34 manufacturing $1,000 Pacemaker byproduct 17.35 and/or special nuclear 17.36 material - medical 18.1 institution 18.2 General license 18.3 distribution $2,100 General license 18.4 distribution 18.5 General license 18.6 distribution, exempt $1,500 General license 18.7 distribution - 18.8 certain exempt items 18.9 Academic, small $1,000 Possession limit of ten 18.10 radionuclides, not to 18.11 exceed a total of one curie 18.12 of activity 18.13 Veterinary $2,000 Veterinary use 18.14 Well logging $5,000 Well logging 18.15 Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a 18.16 license renewal fee submitted to the commissioner after the due 18.17 date specified by rule must be accompanied by an additional 18.18 amount equal to 25 percent of the fee due. 18.19 Subd. 6. [INSPECTIONS.] The commissioner of health shall 18.20 make periodic safety inspections of the radioactive material and 18.21 source and special nuclear material of a licensee. The 18.22 commissioner shall prescribe the frequency of safety inspections 18.23 by rule. 18.24 Subd. 7. [RECOVERY OF REINSPECTION COST.] If the 18.25 commissioner finds serious violations of public health standards 18.26 during an inspection under subdivision 6, the licensee must pay 18.27 all costs associated with subsequent reinspection of the 18.28 source. The costs shall be the actual costs incurred by the 18.29 commissioner and include, but are not limited to, labor, 18.30 transportation, per diem, materials, legal fees, testing, and 18.31 monitoring costs. 18.32 Subd. 8. [RECIPROCITY FEE.] A licensee submitting an 18.33 application for reciprocal recognition of a materials license 18.34 issued by another agreement state or the United States Nuclear 18.35 Regulatory Commission for a period of 180 days or less during a 18.36 calendar year must pay one-half of the application fee specified 19.1 under subdivision 4. For a period of 181 days or more, the 19.2 licensee must pay the entire application fee under subdivision 4. 19.3 Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must 19.4 pay a fee to amend a license as follows: 19.5 (1) to amend a license requiring no license review 19.6 including, but not limited to, facility name change or removal 19.7 of a previously authorized user, no fee; 19.8 (2) to amend a license requiring review including, but not 19.9 limited to, addition of isotopes, procedure changes, new 19.10 authorized users, or a new radiation safety officer, $200; and 19.11 (3) to amend a license requiring review and a site visit 19.12 including, but not limited to, facility move or addition of 19.13 processes, $400. 19.14 [EFFECTIVE DATE.] This section is effective July 1, 2002. 19.15 Sec. 27. Minnesota Statutes 2000, section 144.226, 19.16 subdivision 4, is amended to read: 19.17 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee 19.18 prescribed under subdivision 1, there is a nonrefundable 19.19 surcharge of$3$2 for each certified and noncertified birth or 19.20 death record, and for a certification that the record cannot be 19.21 found. The local or state registrar shall forward this amount 19.22 to the state treasurer to be deposited into the state government 19.23 special revenue fund. This surcharge shall not be charged under 19.24 those circumstances in which no fee for a birth or death record 19.25 is permitted under subdivision 1, paragraph (a).This surcharge19.26requirement expires June 30, 2002.19.27 Sec. 28. Minnesota Statutes 2000, section 144.551, 19.28 subdivision 1, is amended to read: 19.29 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 19.30 (a) The following construction or modification may not be 19.31 commenced: 19.32 (1) any erection, building, alteration, reconstruction, 19.33 modernization, improvement, extension, lease, or other 19.34 acquisition by or on behalf of a hospital that increases the bed 19.35 capacity of a hospital, relocates hospital beds from one 19.36 physical facility, complex, or site to another, or otherwise 20.1 results in an increase or redistribution of hospital beds within 20.2 the state; and 20.3 (2) the establishment of a new hospital. 20.4 (b) This section does not apply to: 20.5 (1) construction or relocation within a county by a 20.6 hospital, clinic, or other health care facility that is a 20.7 national referral center engaged in substantial programs of 20.8 patient care, medical research, and medical education meeting 20.9 state and national needs that receives more than 40 percent of 20.10 its patients from outside the state of Minnesota; 20.11 (2) a project for construction or modification for which a 20.12 health care facility held an approved certificate of need on May 20.13 1, 1984, regardless of the date of expiration of the 20.14 certificate; 20.15 (3) a project for which a certificate of need was denied 20.16 before July 1, 1990, if a timely appeal results in an order 20.17 reversing the denial; 20.18 (4) a project exempted from certificate of need 20.19 requirements by Laws 1981, chapter 200, section 2; 20.20 (5) a project involving consolidation of pediatric 20.21 specialty hospital services within the Minneapolis-St. Paul 20.22 metropolitan area that would not result in a net increase in the 20.23 number of pediatric specialty hospital beds among the hospitals 20.24 being consolidated; 20.25 (6) a project involving the temporary relocation of 20.26 pediatric-orthopedic hospital beds to an existing licensed 20.27 hospital that will allow for the reconstruction of a new 20.28 philanthropic, pediatric-orthopedic hospital on an existing site 20.29 and that will not result in a net increase in the number of 20.30 hospital beds. Upon completion of the reconstruction, the 20.31 licenses of both hospitals must be reinstated at the capacity 20.32 that existed on each site before the relocation; 20.33 (7) the relocation or redistribution of hospital beds 20.34 within a hospital building or identifiable complex of buildings 20.35 provided the relocation or redistribution does not result in: 20.36 (i) an increase in the overall bed capacity at that site; (ii) 21.1 relocation of hospital beds from one physical site or complex to 21.2 another; or (iii) redistribution of hospital beds within the 21.3 state or a region of the state; 21.4 (8) relocation or redistribution of hospital beds within a 21.5 hospital corporate system that involves the transfer of beds 21.6 from a closed facility site or complex to an existing site or 21.7 complex provided that: (i) no more than 50 percent of the 21.8 capacity of the closed facility is transferred; (ii) the 21.9 capacity of the site or complex to which the beds are 21.10 transferred does not increase by more than 50 percent; (iii) the 21.11 beds are not transferred outside of a federal health systems 21.12 agency boundary in place on July 1, 1983; and (iv) the 21.13 relocation or redistribution does not involve the construction 21.14 of a new hospital building; 21.15 (9) a construction project involving up to 35 new beds in a 21.16 psychiatric hospital in Rice county that primarily serves 21.17 adolescents and that receives more than 70 percent of its 21.18 patients from outside the state of Minnesota; 21.19 (10) a project to replace a hospital or hospitals with a 21.20 combined licensed capacity of 130 beds or less if: (i) the new 21.21 hospital site is located within five miles of the current site; 21.22 and (ii) the total licensed capacity of the replacement 21.23 hospital, either at the time of construction of the initial 21.24 building or as the result of future expansion, will not exceed 21.25 70 licensed hospital beds, or the combined licensed capacity of 21.26 the hospitals, whichever is less; 21.27 (11) the relocation of licensed hospital beds from an 21.28 existing state facility operated by the commissioner of human 21.29 services to a new or existing facility, building, or complex 21.30 operated by the commissioner of human services; from one 21.31 regional treatment center site to another; or from one building 21.32 or site to a new or existing building or site on the same 21.33 campus; 21.34 (12) the construction or relocation of hospital beds 21.35 operated by a hospital having a statutory obligation to provide 21.36 hospital and medical services for the indigent that does not 22.1 result in a net increase in the number of hospital beds;or22.2 (13) a construction project involving the addition of up to 22.3 31 new beds in an existing nonfederal hospital in Beltrami 22.4 county; or 22.5 (14) a construction project involving the addition of up to 22.6 eight new beds in an existing nonfederal hospital in Otter Tail 22.7 county with 100 licensed acute care beds. 22.8 Sec. 29. Minnesota Statutes 2000, section 144.98, 22.9 subdivision 3, is amended to read: 22.10 Subd. 3. [FEES.] (a) An application for certification 22.11 under subdivision 1 must be accompanied by the biennial fee 22.12 specified in this subdivision. The fees are for: 22.13 (1) nonrefundable base certification fee,$500$1,200; and 22.14 (2) test category certification fees: 22.15 Test Category Certification Fee 22.16 Clean water program bacteriology$200$600 22.17 Safe drinking water program bacteriology $600 22.18 Clean water program inorganic chemistry,22.19fewer than four constituents$100$600 22.20 Safe drinking water program inorganic chemistry,22.21four or more constituents$300$600 22.22 Clean water program chemistry metals,22.23fewer than four constituents$200$800 22.24 Safe drinking water program chemistry metals,22.25four or more constituents$500$800 22.26 Resource conservation and recovery program 22.27 chemistry metals $800 22.28 Clean water program volatile organic compounds$600$1,200 22.29 Safe drinking water program 22.30 volatile organic compounds $1,200 22.31 Resource conservation and recovery program 22.32 volatile organic compounds $1,200 22.33 Underground storage tank program 22.34 volatile organic compounds $1,200 22.35 Clean water program other organic compounds$600$1,200 22.36 Safe drinking water program other organic compounds $1,200 23.1 Resource conservation and recovery program 23.2 other organic compounds $1,200 23.3 (b) The total biennial certification fee is the base fee 23.4 plus the applicable test category fees.The biennial23.5certification fee for a contract laboratory is 1.5 times the23.6total certification fee.23.7 (c) Laboratories located outside of this state that require 23.8 an on-site survey will be assessed an additional$1,200$2,500 23.9 fee. 23.10 (d) Fees must be set so that the total fees support the 23.11 laboratory certification program. Direct costs of the 23.12 certification service include program administration, 23.13 inspections, the agency's general support costs, and attorney 23.14 general costs attributable to the fee function. 23.15 (e) A change fee shall be assessed if a laboratory requests 23.16 additional analytes or methods at any time other than when 23.17 applying for or renewing its certification. The change fee is 23.18 equal to the test category certification fee for the analyte. 23.19 (f) A variance fee shall be assessed if a laboratory 23.20 requests and is granted a variance from a rule adopted under 23.21 this section. The variance fee is $500 per variance. 23.22 (g) Refunds or credits shall not be made for analytes or 23.23 methods requested but not approved. 23.24 (h) Certification of a laboratory shall not be awarded 23.25 until all fees are paid. 23.26 Sec. 30. Minnesota Statutes 2000, section 144A.44, 23.27 subdivision 1, is amended to read: 23.28 Subdivision 1. [STATEMENT OF RIGHTS.] A person who 23.29 receives home care services has these rights: 23.30 (1) the right to receive written information about rights 23.31 in advance of receiving care or during the initial evaluation 23.32 visit before the initiation of treatment, including what to do 23.33 if rights are violated; 23.34 (2) the right to receive care and services according to a 23.35 suitable and up-to-date plan, and subject to accepted medical or 23.36 nursing standards, to take an active part in creating and 24.1 changing the plan and evaluating care and services; 24.2 (3) the right to be told in advance of receiving care about 24.3 the services that will be provided, the disciplines that will 24.4 furnish care, the frequency of visits proposed to be furnished, 24.5 other choices that are available, and the consequences of these 24.6 choices including the consequences of refusing these services; 24.7 (4) the right to be told in advance of any change in the 24.8 plan of care and to take an active part in any change; 24.9 (5) the right to refuse services or treatment; 24.10 (6) the right to know, in advance, any limits to the 24.11 services available from a provider, and the provider's grounds 24.12 for a termination of services; 24.13 (7) the right to know in advance of receiving care whether 24.14 the services are covered by health insurance, medical 24.15 assistance, or other health programs, the charges for services 24.16 that will not be covered by Medicare, and the charges that the 24.17 individual may have to pay; 24.18 (8) the right to know what the charges are for services, no 24.19 matter who will be paying the bill; 24.20 (9) the right to know that there may be other services 24.21 available in the community, including other home care services 24.22 and providers, and to know where to go for information about 24.23 these services; 24.24 (10) the right to choose freely among available providers 24.25 and to change providers after services have begun, within the 24.26 limits of health insurance, medical assistance, or other health 24.27 programs; 24.28 (11) the right to have personal, financial, and medical 24.29 information kept private, and to be advised of the provider's 24.30 policies and procedures regarding disclosure of such 24.31 information; 24.32 (12) the right to be allowed access to records and written 24.33 information from records in accordance with section 144.335; 24.34 (13) the right to be served by people who are properly 24.35 trained and competent to perform their duties; 24.36 (14) the right to be treated with courtesy and respect, and 25.1 to have the patient's property treated with respect; 25.2 (15) the right to be free from physical and verbal abuse; 25.3 (16) the right to reasonable, advance notice of changes in 25.4 services or charges, including at least ten days' advance notice 25.5 of the termination of a service by a provider, except in cases 25.6 where: 25.7 (i) the recipient of services engages in conduct that 25.8 alters the conditions of employment as specified in the 25.9 employment contract between the home care provider and the 25.10 individual providing home care services, or creates an abusive 25.11 or unsafe work environment for the individual providing home 25.12 care services; or 25.13 (ii) an emergency for the informal caregiver or a 25.14 significant change in the recipient's condition has resulted in 25.15 service needs that exceed the current service provider agreement 25.16 and that cannot be safely met by the home care provider; 25.17 (17) the right to a coordinated transfer when there will be 25.18 a change in the provider of services; 25.19 (18) the right to voice grievances regarding treatment or 25.20 care that is, or fails to be, furnished, or regarding the lack 25.21 of courtesy or respect to the patient or the patient's property; 25.22 (19) the right to know how to contact an individual 25.23 associated with the provider who is responsible for handling 25.24 problems and to have the provider investigate and attempt to 25.25 resolve the grievance or complaint; 25.26 (20) the right to know the name and address of the state or 25.27 county agency to contact for additional information or 25.28 assistance; and 25.29 (21) the right to assert these rights personally, or have 25.30 them asserted by the patient's family or guardian when the 25.31 patient has been judged incompetent, without retaliation. 25.32 Sec. 31. Minnesota Statutes 2000, section 144A.4605, 25.33 subdivision 4, is amended to read: 25.34 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 25.35 establishment registered under chapter 144D that is required to 25.36 obtain a home care license must obtain an assisted living home 26.1 care license according to this section or a class A or class E 26.2 license according to rule. A housing with services 26.3 establishment that obtains a class E license under this 26.4 subdivision remains subject to the payment limitations in 26.5 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 26.6 subdivision 3, paragraph (g). 26.7 (b) A board and lodging establishment registered for 26.8 special services as of December 31, 1996, and also registered as 26.9 a housing with services establishment under chapter 144D, must 26.10 deliver home care services according to sections 144A.43 to 26.11 144A.48, and may apply for a waiver from requirements under 26.12 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 26.13 licensed agency under the standards of section 157.17. Such 26.14 waivers as may be granted by the department will expire upon 26.15 promulgation of home care rules implementing section 144A.4605. 26.16 (c) An adult foster care provider licensed by the 26.17 department of human services and registered under chapter 144D 26.18 may continue to provide health-related services under its foster 26.19 care license until the promulgation of home care rules 26.20 implementing this section. 26.21 (d) An assisted living home care provider licensed under 26.22 this section must comply with the disclosure provisions of 26.23 section 325F.691 to the extent they are applicable. 26.24 Sec. 32. Minnesota Statutes 2000, section 144D.03, 26.25 subdivision 2, is amended to read: 26.26 Subd. 2. [REGISTRATION INFORMATION.] The establishment 26.27 shall provide the following information to the commissioner in 26.28 order to be registered: 26.29 (1) the business name, street address, and mailing address 26.30 of the establishment; 26.31 (2) the name and mailing address of the owner or owners of 26.32 the establishment and, if the owner or owners are not natural 26.33 persons, identification of the type of business entity of the 26.34 owner or owners, and the names and addresses of the officers and 26.35 members of the governing body, or comparable persons for 26.36 partnerships, limited liability corporations, or other types of 27.1 business organizations of the owner or owners; 27.2 (3) the name and mailing address of the managing agent, 27.3 whether through management agreement or lease agreement, of the 27.4 establishment, if different from the owner or owners, and the 27.5 name of the on-site manager, if any; 27.6 (4) verification that the establishment has entered into an 27.7 elderly housing with services contract, as required in section 27.8 144D.04, with each resident or resident's representative; 27.9 (5) verification that the establishment is complying with 27.10 the requirements of section 325F.691, if applicable; 27.11(5)(6) the name and address of at least one natural person 27.12 who shall be responsible for dealing with the commissioner on 27.13 all matters provided for in sections 144D.01 to 144D.06, and on 27.14 whom personal service of all notices and orders shall be made, 27.15 and who shall be authorized to accept service on behalf of the 27.16 owner or owners and the managing agent, if any; and 27.17(6)(7) the signature of the authorized representative of 27.18 the owner or owners or, if the owner or owners are not natural 27.19 persons, signatures of at least two authorized representatives 27.20 of each owner, one of which shall be an officer of the owner. 27.21 Personal service on the person identified under clause(5)27.22 (6) by the owner or owners in the registration shall be 27.23 considered service on the owner or owners, and it shall not be a 27.24 defense to any action that personal service was not made on each 27.25 individual or entity. The designation of one or more 27.26 individuals under this subdivision shall not affect the legal 27.27 responsibility of the owner or owners under sections 144D.01 to 27.28 144D.06. 27.29 Sec. 33. Minnesota Statutes 2000, section 144D.04, 27.30 subdivision 2, is amended to read: 27.31 Subd. 2. [CONTENTS OF CONTRACT.] An elderly housing with 27.32 services contract, which need not be entitled as such to comply 27.33 with this section, shall include at least the following elements 27.34 in itself or through supporting documents or attachments: 27.35 (1) name, street address, and mailing address of the 27.36 establishment; 28.1 (2) the name and mailing address of the owner or owners of 28.2 the establishment and, if the owner or owners is not a natural 28.3 person, identification of the type of business entity of the 28.4 owner or owners; 28.5 (3) the name and mailing address of the managing agent, 28.6 through management agreement or lease agreement, of the 28.7 establishment, if different from the owner or owners; 28.8 (4) the name and address of at least one natural person who 28.9 is authorized to accept service on behalf of the owner or owners 28.10 and managing agent; 28.11 (5) statement describing the registration and licensure 28.12 status of the establishment and any provider providing 28.13 health-related or supportive services under an arrangement with 28.14 the establishment; 28.15 (6) term of the contract; 28.16 (7) description of the services to be provided to the 28.17 resident in the base rate to be paid by resident; 28.18 (8) description of any additional services available for an 28.19 additional fee from the establishment directly or through 28.20 arrangements with the establishment; 28.21 (9) fee schedules outlining the cost of any additional 28.22 services; 28.23 (10) description of the process through which the contract 28.24 may be modified, amended, or terminated; 28.25 (11) description of the establishment's complaint 28.26 resolution process available to residents including the 28.27 toll-free complaint line for the office of ombudsman for older 28.28 Minnesotans; 28.29 (12) the resident's designated representative, if any; 28.30 (13) the establishment's referral procedures if the 28.31 contract is terminated; 28.32 (14) criteria used by the establishment to determine who 28.33 may continue to reside in the elderly housing with services 28.34 establishment; 28.35 (15) billing and payment procedures and requirements; 28.36 (16) statement regarding the ability of residents to 29.1 receive services from service providers with whom the 29.2 establishment does not have an arrangement; and 29.3 (17) statement regarding the availability of public funds 29.4 for payment for residence or services in the establishment. 29.5 Sec. 34. Minnesota Statutes 2000, section 144D.04, 29.6 subdivision 3, is amended to read: 29.7 Subd. 3. [CONTRACTS IN PERMANENT FILES.] Elderly housing 29.8 with services contracts and related documents executed by each 29.9 resident or resident's representative shall be maintained by the 29.10 establishment in files from the date of execution until three 29.11 years after the contract is terminated. The contracts and the 29.12 written disclosures required under section 325F.691, if 29.13 applicable, shall be made available for on-site inspection by 29.14 the commissioner upon request at any time. 29.15 Sec. 35. Minnesota Statutes 2000, section 144D.06, is 29.16 amended to read: 29.17 144D.06 [OTHER LAWS.] 29.18 A housing with services establishment shall obtain and 29.19 maintain all other licenses, permits, registrations, or other 29.20 governmental approvals required of it in addition to 29.21 registration under this chapter. A housing with services 29.22 establishment is subject to the provisions of section 325F.691 29.23 and chapter 504B. 29.24 Sec. 36. [145.56] [SUICIDE PREVENTION.] 29.25 Subdivision 1. [SUICIDE PREVENTION PLAN.] The commissioner 29.26 of health shall refine, coordinate, and implement the state's 29.27 suicide prevention plan using an evidence-based, public health 29.28 approach focused on prevention, in collaboration with the 29.29 commissioner of human services; the commissioner of public 29.30 safety; the commissioner of children, families, and learning; 29.31 and appropriate agencies, organizations, and institutions in the 29.32 community. 29.33 Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 29.34 shall establish a grant program to fund: 29.35 (1) community-based programs to provide education, 29.36 outreach, and advocacy services to populations who may be at 30.1 risk for suicide; 30.2 (2) community-based programs that educate community helpers 30.3 and gatekeepers, such as family members, spiritual leaders, 30.4 coaches, and business owners, employers, and coworkers on how to 30.5 prevent suicide by encouraging help-seeking behaviors; 30.6 (3) community-based programs that educate populations at 30.7 risk for suicide and community helpers and gatekeepers that must 30.8 include information on the symptoms of depression and other 30.9 psychiatric illnesses, the warning signs of suicide, skills for 30.10 preventing suicides, and making or seeking effective referrals 30.11 to intervention and community resources; and 30.12 (4) community-based programs to provide evidence-based 30.13 suicide prevention and intervention education to school staff, 30.14 parents, and students in grades kindergarten through 12. 30.15 Subd. 3. [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 30.16 commissioner shall promote the use of employee assistance and 30.17 workplace programs to support employees with depression and 30.18 other psychiatric illnesses and substance abuse disorders, and 30.19 refer them to services. In promoting these programs, the 30.20 commissioner shall collaborate with employer and professional 30.21 associations, unions, and safety councils. 30.22 (b) The commissioner shall provide training and technical 30.23 assistance to local public health and other community-based 30.24 professionals to provide for integrated implementation of best 30.25 practices for preventing suicides. 30.26 Subd. 4. [COLLECTION AND REPORTING SUICIDE DATA.] The 30.27 commissioner shall coordinate with federal, regional, local, and 30.28 other state agencies to collect, analyze, and annually issue a 30.29 public report on Minnesota-specific data on suicide and suicidal 30.30 behaviors. 30.31 Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 30.32 commissioner shall conduct periodic evaluations of the impact of 30.33 and outcomes from implementation of the state's suicide 30.34 prevention plan and each of the activities specified in this 30.35 section. By July 1, 2002, and July 1 of each even-numbered year 30.36 thereafter, the commissioner shall report the results of these 31.1 evaluations to the chairs of the policy and finance committees 31.2 in the house and senate with jurisdiction over health and human 31.3 services issues. 31.4 Sec. 37. Minnesota Statutes 2000, section 145.881, 31.5 subdivision 2, is amended to read: 31.6 Subd. 2. [DUTIES.] The advisory task force shall meet on a 31.7 regular basis to perform the following duties: 31.8 (a) review and report on the health care needs of mothers 31.9 and children throughout the state of Minnesota; 31.10 (b) review and report on the type, frequency and impact of 31.11 maternal and child health care services provided to mothers and 31.12 children under existing maternal and child health care programs, 31.13 including programs administered by the commissioner of health; 31.14 (c) establish, review, and report to the commissioner a 31.15 list of program guidelines and criteria which the advisory task 31.16 force considers essential to providing an effective maternal and 31.17 child health care program to low income populations and high 31.18 risk persons and fulfilling the purposes defined in section 31.19 145.88; 31.20 (d) review staff recommendations of the department of 31.21 health regarding maternal and child health grant awards before 31.22 the awards are made; 31.23 (e) make recommendations to the commissioner for the use of 31.24 other federal and state funds available to meet maternal and 31.25 child health needs; 31.26 (f) make recommendations to the commissioner of health on 31.27 priorities for funding the following maternal and child health 31.28 services: (1) prenatal, delivery and postpartum care, (2) 31.29 comprehensive health care for children, especially from birth 31.30 through five years of age, (3) adolescent health services, (4) 31.31 family planning services, (5) preventive dental care, (6) 31.32 special services for chronically ill and handicapped children 31.33 and (7) any other services which promote the health of mothers 31.34 and children;and31.35 (g) make recommendations to the commissioner of health on 31.36 the process to distribute, award and administer the maternal and 32.1 child health block grant funds; and 32.2 (h) review the measures that are used to define the 32.3 variables of the funding distribution formula in section 32.4 145.882, subdivision 4a, every two years and make 32.5 recommendations to the commissioner of health for changes based 32.6 upon principles established by the advisory task force for this 32.7 purpose. 32.8 Sec. 38. Minnesota Statutes 2000, section 145.882, is 32.9 amended by adding a subdivision to read: 32.10 Subd. 4a. [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 32.11 Federal maternal and child health block grant money remaining 32.12 after distributions made under subdivision 2 and money 32.13 appropriated for allocation to community health boards must be 32.14 allocated according to paragraphs (b) to (d) to community health 32.15 boards as defined in section 145A.02, subdivision 5. 32.16 (b) All community health boards must receive 95 percent of 32.17 the funding awarded to them for the 1998-1999 funding cycle. If 32.18 the amount of state and federal funding available is less than 32.19 95 percent of the amount awarded to community health boards for 32.20 the 1998-1999 funding cycle, the available funding must be 32.21 apportioned to reflect a proportional decrease for each 32.22 recipient. 32.23 (c) The federal and state funding remaining after 32.24 distributions made under paragraph (b) must be allocated to each 32.25 community health board based on the following three variables: 32.26 (1) 25 percent based on the maternal and child population 32.27 in the area served by the community health board; 32.28 (2) 50 percent based on the following factors, as 32.29 determined by averaging the data available for the three most 32.30 recent years: 32.31 (i) the proportion of infants in the area served by the 32.32 community health board whose weight at birth was less than 2,500 32.33 grams; 32.34 (ii) the proportion of mothers in the area served by the 32.35 community health board who received inadequate or no prenatal 32.36 care; 33.1 (iii) the proportion of births in the area served by the 33.2 community health board to women under age 19; and 33.3 (iv) the proportion of births in the area served by the 33.4 community health board to American Indian women and women of 33.5 color; and 33.6 (3) 25 percent based on the income of the maternal and 33.7 child population in the area served by the community health 33.8 board. 33.9 (d) Each variable must be expressed as a city or county 33.10 score consisting of the city or county frequency of each 33.11 variable in relation to the statewide frequency of the 33.12 variable. A total score for each city or county jurisdiction 33.13 must be computed by totaling the scores of the three variables. 33.14 Each community health board must be allocated an amount equal to 33.15 the total score obtained for the city, county, or counties in 33.16 its area multiplied by the amount of money available. 33.17 Sec. 39. Minnesota Statutes 2000, section 145.885, 33.18 subdivision 2, is amended to read: 33.19 Subd. 2. [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 33.20 HEALTH.] Applications by community health boards as defined in 33.21 section 145A.02, subdivision 5, under section 145.882, 33.22 subdivision34a, must also contain a summary of the process 33.23 used to develop the local program, including evidence that the 33.24 community health board notified local public and private 33.25 providers of the availability of funding through the community 33.26 health board for maternal and child health services; a list of 33.27 all public and private agency requests for grants submitted to 33.28 the community health board indicating which requests were 33.29 included in the grant application; and an explanation of how 33.30 priorities were established for selecting the requests to be 33.31 included in the grant application. The community health board 33.32 shall include, with the grant application, a written statement 33.33 of the criteria to be applied to public and private agency 33.34 requests for funding. 33.35 Sec. 40. Minnesota Statutes 2000, section 157.16, 33.36 subdivision 3, is amended to read: 34.1 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 34.2 following fees are required for food and beverage service 34.3 establishments, hotels, motels, lodging establishments, and 34.4 resorts licensed under this chapter. Food and beverage service 34.5 establishments must pay the highest applicable fee under 34.6 paragraph (e), clause (1), (2), (3), or (4), and establishments 34.7 serving alcohol must pay the highest applicable fee under 34.8 paragraph (e), clause (6) or (7). The license fee for new 34.9 operators previously licensed under this chapter for the same 34.10 calendar year is one-half of the appropriate annual license fee, 34.11 plus any penalty that may be required. The license fee for 34.12 operators opening on or after October 1 is one-half of the 34.13 appropriate annual license fee, plus any penalty that may be 34.14 required. 34.15 (b) All food and beverage service establishments, except 34.16 special event food stands, and all hotels, motels, lodging 34.17 establishments, and resorts shall pay an annual base fee of 34.18$100$145. 34.19 (c) A special event food stand shall pay a flat fee 34.20 of$30$35 annually. "Special event food stand" means a fee 34.21 category where food is prepared or served in conjunction with 34.22 celebrations, county fairs, or special events from a special 34.23 event food stand as defined in section 157.15. 34.24 (d) In addition to the base fee in paragraph (b), each food 34.25 and beverage service establishment, other than a special event 34.26 food stand, and each hotel, motel, lodging establishment, and 34.27 resort shall pay an additional annual fee for each fee category 34.28 as specified in this paragraph: 34.29 (1) Limited food menu selection,$30$40. "Limited food 34.30 menu selection" means a fee category that provides one or more 34.31 of the following: 34.32 (i) prepackaged food that receives heat treatment and is 34.33 served in the package; 34.34 (ii) frozen pizza that is heated and served; 34.35 (iii) a continental breakfast such as rolls, coffee, juice, 34.36 milk, and cold cereal; 35.1 (iv) soft drinks, coffee, or nonalcoholic beverages; or 35.2 (v) cleaning for eating, drinking, or cooking utensils, 35.3 when the only food served is prepared off site. 35.4 (2) Small establishment, including boarding establishments, 35.5$55$75. "Small establishment" means a fee category that has no 35.6 salad bar and meets one or more of the following: 35.7 (i) possesses food service equipment that consists of no 35.8 more than a deep fat fryer, a grill, two hot holding containers, 35.9 and one or more microwave ovens; 35.10 (ii) serves dipped ice cream or soft serve frozen desserts; 35.11 (iii) serves breakfast in an owner-occupied bed and 35.12 breakfast establishment; 35.13 (iv) is a boarding establishment; or 35.14 (v) meets the equipment criteria in clause (3), item (i) or 35.15 (ii), and has a maximum patron seating capacity of not more than 35.16 50. 35.17 (3) Medium establishment,$150$210. "Medium establishment" 35.18 means a fee category that meets one or more of the following: 35.19 (i) possesses food service equipment that includes a range, 35.20 oven, steam table, salad bar, or salad preparation area; 35.21 (ii) possesses food service equipment that includes more 35.22 than one deep fat fryer, one grill, or two hot holding 35.23 containers; or 35.24 (iii) is an establishment where food is prepared at one 35.25 location and served at one or more separate locations. 35.26 Establishments meeting criteria in clause (2), item (v), 35.27 are not included in this fee category. 35.28 (4) Large establishment,$250$350. "Large establishment" 35.29 means either: 35.30 (i) a fee category that (A) meets the criteria in clause 35.31 (3), items (i) or (ii), for a medium establishment, (B) seats 35.32 more than 175 people, and (C) offers the full menu selection an 35.33 average of five or more days a week during the weeks of 35.34 operation; or 35.35 (ii) a fee category that (A) meets the criteria in clause 35.36 (3), item (iii), for a medium establishment, and (B) prepares 36.1 and serves 500 or more meals per day. 36.2 (5) Other food and beverage service, including food carts, 36.3 mobile food units, seasonal temporary food stands, and seasonal 36.4 permanent food stands,$30$40. 36.5 (6) Beer or wine table service,$30$40. "Beer or wine 36.6 table service" means a fee category where the only alcoholic 36.7 beverage service is beer or wine, served to customers seated at 36.8 tables. 36.9 (7) Alcoholic beverage service, other than beer or wine 36.10 table service,$75$105. 36.11 "Alcohol beverage service, other than beer or wine table 36.12 service" means a fee category where alcoholic mixed drinks are 36.13 served or where beer or wine are served from a bar. 36.14 (8) Lodging per sleeping accommodation unit,$4$6, 36.15 including hotels, motels, lodging establishments, and resorts, 36.16 up to a maximum of$400$600. "Lodging per sleeping 36.17 accommodation unit" means a fee category including the number of 36.18 guest rooms, cottages, or other rental units of a hotel, motel, 36.19 lodging establishment, or resort; or the number of beds in a 36.20 dormitory. 36.21 (9) First public swimming pool,$100$140; each additional 36.22 public swimming pool,$50$80. "Public swimming pool" means a 36.23 fee category that has the meaning given in Minnesota Rules, part 36.24 4717.0250, subpart 8. 36.25 (10) First spa,$50$80; each additional spa,$25$40. 36.26 "Spa pool" means a fee category that has the meaning given in 36.27 Minnesota Rules, part 4717.0250, subpart 9. 36.28 (11) Private sewer or water,$30$40. "Individual private 36.29 water" means a fee category with a water supply other than a 36.30 community public water supply as defined in Minnesota Rules, 36.31 chapter 4720. "Individual private sewer" means a fee category 36.32 with an individual sewage treatment system which uses subsurface 36.33 treatment and disposal. 36.34 (e)A fee is not required for a food and beverage service36.35establishment operated by a school as defined in sections36.36120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.37.1(f)A fee of $150 for review of the construction plans must 37.2 accompany the initial license application for food and beverage 37.3 service establishments, hotels, motels, lodging establishments, 37.4 or resorts. 37.5(g)(f) When existing food and beverage service 37.6 establishments, hotels, motels, lodging establishments, or 37.7 resorts are extensively remodeled, a fee of $150 must be 37.8 submitted with the remodeling plans. 37.9(h)(g) Seasonal temporary food stands and special event 37.10 food stands are not required to submit construction or 37.11 remodeling plans for review. 37.12 [EFFECTIVE DATE.] This section is effective January 1, 2002. 37.13 Sec. 41. Minnesota Statutes 2000, section 157.22, as 37.14 amended by Laws 2001, chapter 65, section 1, is amended to read: 37.15 157.22 [EXEMPTIONS.] 37.16 This chapter shall not be construed to apply to: 37.17 (1) interstate carriers under the supervision of the United 37.18 States Department of Health and Human Services; 37.19 (2) any building constructed and primarily used for 37.20 religious worship; 37.21 (3) any building owned, operated, and used by a college or 37.22 university in accordance with health regulations promulgated by 37.23 the college or university under chapter 14; 37.24 (4) any person, firm, or corporation whose principal mode 37.25 of business is licensed under sections 28A.04 and 28A.05, is 37.26 exempt at that premises from licensure as a food or beverage 37.27 establishment; provided that the holding of any license pursuant 37.28 to sections 28A.04 and 28A.05 shall not exempt any person, firm, 37.29 or corporation from the applicable provisions of this chapter or 37.30 the rules of the state commissioner of health relating to food 37.31 and beverage service establishments; 37.32 (5) family day care homes and group family day care homes 37.33 governed by sections 245A.01 to 245A.16; 37.34 (6) nonprofit senior citizen centers for the sale of 37.35 home-baked goods; 37.36 (7) fraternal or patriotic organizations that are tax 38.1 exempt under section 501(c)(3), 501(c)(4), 501(c)(6), 501(c)(7), 38.2 501(c)(10), or 501(c)(19) of the Internal Revenue Code of 1986, 38.3 or organizations related to or affiliated with such fraternal or 38.4 patriotic organizations. Such organizations may organize events 38.5 at which home-prepared food is donated by organization members 38.6 for sale at the events, provided: 38.7 (i) the event is not a circus, carnival, or fair; 38.8 (ii) the organization controls the admission of persons to 38.9 the event, the event agenda, or both; and 38.10 (iii) the organization's licensed kitchen is not used in 38.11 any manner for the event;and38.12 (8) food not prepared at an establishment and brought in by 38.13 individuals attending a potluck event for consumption at the 38.14 potluck event. An organization sponsoring a potluck event under 38.15 this clause may advertise the potluck event to the public 38.16 through any means. Individuals who are not members of an 38.17 organization sponsoring a potluck event under this clause may 38.18 attend the potluck event and consume the food at the event. 38.19 Licensed food establishments other than schools cannot be 38.20 sponsors of potluck events. A school may sponsor and hold 38.21 potluck events in areas of the school other than the school's 38.22 kitchen, provided that the school's kitchen is not used in any 38.23 manner for the potluck event. For purposes of this clause, 38.24 "school" means a public school as defined in section 120A.05, 38.25 subdivisions 9, 11, 13, and 17, or a nonpublic school, church, 38.26 or religious organization at which a child is provided with 38.27 instruction in compliance with sections 120A.22 and 120A.24. 38.28 Potluck event food shall not be brought into a licensed food 38.29 establishment kitchen; and 38.30 (9) a home school in which a child is provided instruction 38.31 at home. 38.32 Sec. 42. Minnesota Statutes 2000, section 326.38, is 38.33 amended to read: 38.34 326.38 [LOCAL REGULATIONS.] 38.35 Any city having a system of waterworks or sewerage, or any 38.36 town in which reside over 5,000 people exclusive of any 39.1 statutory cities located therein, or the metropolitan airports 39.2 commission, may, by ordinance, adopt local regulations providing 39.3 for plumbing permits, bonds, approval of plans, and inspections 39.4 of plumbing, which regulations are not in conflict with the 39.5 plumbing standards on the same subject prescribed by the state 39.6 commissioner of health. No city or such town shall prohibit 39.7 plumbers licensed by the state commissioner of health from 39.8 engaging in or working at the business, except cities and 39.9 statutory cities which, prior to April 21, 1933, by ordinance 39.10 required the licensing of plumbers. Any city by ordinance may 39.11 prescribe regulations, reasonable standards, and inspections and 39.12 grant permits to any person, firm, or corporation engaged in the 39.13 business of installing water softeners, who is not licensed as a 39.14 master plumber or journeyman plumber by the state commissioner 39.15 of health, to connect water softening and water filtering 39.16 equipment to private residence water distribution systems, where 39.17 provision has been previously made therefor and openings left 39.18 for that purpose or by use of cold water connections to a 39.19 domestic water heater; where it is not necessary to rearrange, 39.20 make any extension or alteration of, or addition to any pipe, 39.21 fixture or plumbing connected with the water system except to 39.22 connect the water softener, and provided the connections so made 39.23 comply with minimum standards prescribed by the state 39.24 commissioner of health. 39.25 Sec. 43. [325F.691] [DISCLOSURE OF SPECIAL CARE STATUS 39.26 REQUIRED.] 39.27 Subdivision 1. [PERSONS TO WHOM DISCLOSURE IS 39.28 REQUIRED.] Housing with services establishments, as defined in 39.29 sections 144D.01 to 144D.07, that secure, segregate, or provide 39.30 a special program or special unit for residents with a diagnosis 39.31 of probable Alzheimer's disease or a related disorder or that 39.32 advertise, market, or otherwise promote the establishment as 39.33 providing specialized care for Alzheimer's disease or a related 39.34 disorder are considered a "special care unit." All special care 39.35 units shall provide a written disclosure to the following: 39.36 (1) the commissioner of health, if requested; 40.1 (2) the office of ombudsman for older Minnesotans; and 40.2 (3) each person seeking placement within a residence, or 40.3 the person's authorized representative, before an agreement to 40.4 provide the care is entered into. 40.5 Subd. 2. [CONTENT.] Written disclosure shall include, but 40.6 is not limited to, the following: 40.7 (1) a statement of the overall philosophy and how it 40.8 reflects the special needs of residents with Alzheimer's disease 40.9 or other dementias; 40.10 (2) the criteria for determining who may reside in the 40.11 special care unit; 40.12 (3) the process used for assessment and establishment of 40.13 the service plan or agreement, including how the plan is 40.14 responsive to changes in the resident's condition; 40.15 (4) staffing credentials, job descriptions, and staff 40.16 duties and availability, including any training specific to 40.17 dementia; 40.18 (5) physical environment as well as design and security 40.19 features that specifically address the needs of residents with 40.20 Alzheimer's disease or other dementias; 40.21 (6) frequency and type of programs and activities for 40.22 residents of the special care unit; 40.23 (7) involvement of families in resident care and 40.24 availability of family support programs; 40.25 (8) fee schedules for additional services to the residents 40.26 of the special care unit; and 40.27 (9) a statement that residents will be given a written 40.28 notice 30 days prior to changes in the fee schedule. 40.29 Subd. 3. [DUTY TO UPDATE.] Substantial changes to 40.30 disclosures must be reported to the parties listed in 40.31 subdivision 1 at the time the change is made. 40.32 Subd. 4. [REMEDY.] The attorney general may seek the 40.33 remedies set forth in section 8.31 for repeated and intentional 40.34 violations of this section. However, no private right of action 40.35 may be maintained as provided under section 8.31, subdivision 3a. 40.36 Sec. 44. [RECOMMENDATIONS; INCENTIVES FOR MAGNET 41.1 HOSPITALS.] 41.2 The commissioner of health shall develop recommendations 41.3 for incentives that may be implemented to increase the number of 41.4 magnet hospitals in Minnesota. These recommendations must be 41.5 reported by December 1, 2001 to the chairs of the house and 41.6 senate committees with jurisdiction over health and human 41.7 services policy and finance issues. 41.8 Sec. 45. [STUDY; FACTORS INFLUENCING PATIENT CARE AND 41.9 PATIENT SAFETY.] 41.10 The commissioner of health, in consultation with relevant 41.11 stakeholders, shall review available research and literature and 41.12 identify the major factors influencing patient care and patient 41.13 safety, including but not limited to staffing levels for nurses 41.14 and other health care professionals in health care facilities. 41.15 This report must be coordinated, to the extent possible, with 41.16 other studies relating to health quality and patient safety 41.17 authorized by the 2001 legislature. The commissioner shall 41.18 report findings from the study, including recommendations on 41.19 ongoing analysis and measurement of these factors for the 41.20 Minnesota health care system, to the chairs of the policy and 41.21 finance committees in the house and senate with jurisdiction 41.22 over health and human services issues by February 15, 2002. 41.23 Sec. 46. [STUDY; IMPACT OF WORKFORCE SHORTAGE ON HEALTH 41.24 CARE COSTS.] 41.25 The commissioner of health shall review available data, 41.26 research, and literature and assess the effects of health care 41.27 labor availability and its impact on health care costs. The 41.28 commissioner shall report findings and recommendations to the 41.29 chairs of the policy and finance committees in the house and 41.30 senate with jurisdiction over health and human services issues 41.31 by February 15, 2002. 41.32 Sec. 47. [MEDICATIONS DISPENSED IN SCHOOLS STUDY.] 41.33 (a) The commissioner of health, in consultation with the 41.34 board of nursing, shall study the relationship between the Nurse 41.35 Practice Act, Minnesota Statutes, sections 148.171 to 148.285; 41.36 and 121A.22, which specifies the administration of medications 42.1 in schools and the activities authorized under these sections, 42.2 including the administration of prescription and nonprescription 42.3 medications and medications needed by students to manage a 42.4 chronic illness. The commissioner shall also make 42.5 recommendations on necessary statutory changes needed to promote 42.6 student health and safety in relation to administering 42.7 medications in schools and addressing the changing health needs 42.8 of students. 42.9 (b) The commissioner shall convene a work group to assist 42.10 in the study and recommendations. The work group shall consist 42.11 of representatives of the commissioner of human services; the 42.12 commissioner of children, families, and learning; the board of 42.13 nursing; the board of teaching; school nurses; parents; school 42.14 administrators; school board associations; the American Academy 42.15 of Pediatrics; and the Minnesota Nurse's Association. 42.16 (c) The commissioner shall submit these recommendations and 42.17 any recommended statutory changes to the legislature by January 42.18 15, 2002. 42.19 Sec. 48. [REPEALER.] 42.20 (a) Minnesota Statutes 2000, section 144.148, subdivision 42.21 8, is repealed. 42.22 (b) Minnesota Statutes 2000, sections 145.882, subdivisions 42.23 3 and 4; and 145.927, are repealed. 42.24 [EFFECTIVE DATE.] Paragraph (a) of this section is 42.25 effective the day following final enactment. 42.26 ARTICLE 2 42.27 HEALTH CARE 42.28 Section 1. Minnesota Statutes 2000, section 256.01, 42.29 subdivision 2, is amended to read: 42.30 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 42.31 section 241.021, subdivision 2, the commissioner of human 42.32 services shall: 42.33 (1) Administer and supervise all forms of public assistance 42.34 provided for by state law and other welfare activities or 42.35 services as are vested in the commissioner. Administration and 42.36 supervision of human services activities or services includes, 43.1 but is not limited to, assuring timely and accurate distribution 43.2 of benefits, completeness of service, and quality program 43.3 management. In addition to administering and supervising human 43.4 services activities vested by law in the department, the 43.5 commissioner shall have the authority to: 43.6 (a) require county agency participation in training and 43.7 technical assistance programs to promote compliance with 43.8 statutes, rules, federal laws, regulations, and policies 43.9 governing human services; 43.10 (b) monitor, on an ongoing basis, the performance of county 43.11 agencies in the operation and administration of human services, 43.12 enforce compliance with statutes, rules, federal laws, 43.13 regulations, and policies governing welfare services and promote 43.14 excellence of administration and program operation; 43.15 (c) develop a quality control program or other monitoring 43.16 program to review county performance and accuracy of benefit 43.17 determinations; 43.18 (d) require county agencies to make an adjustment to the 43.19 public assistance benefits issued to any individual consistent 43.20 with federal law and regulation and state law and rule and to 43.21 issue or recover benefits as appropriate; 43.22 (e) delay or deny payment of all or part of the state and 43.23 federal share of benefits and administrative reimbursement 43.24 according to the procedures set forth in section 256.017; 43.25 (f) make contracts with and grants to public and private 43.26 agencies and organizations, both profit and nonprofit, and 43.27 individuals, using appropriated funds; and 43.28 (g) enter into contractual agreements with federally 43.29 recognized Indian tribes with a reservation in Minnesota to the 43.30 extent necessary for the tribe to operate a federally approved 43.31 family assistance program or any other program under the 43.32 supervision of the commissioner. The commissioner shall consult 43.33 with the affected county or counties in the contractual 43.34 agreement negotiations, if the county or counties wish to be 43.35 included, in order to avoid the duplication of county and tribal 43.36 assistance program services. The commissioner may establish 44.1 necessary accounts for the purposes of receiving and disbursing 44.2 funds as necessary for the operation of the programs. 44.3 (2) Inform county agencies, on a timely basis, of changes 44.4 in statute, rule, federal law, regulation, and policy necessary 44.5 to county agency administration of the programs. 44.6 (3) Administer and supervise all child welfare activities; 44.7 promote the enforcement of laws protecting handicapped, 44.8 dependent, neglected and delinquent children, and children born 44.9 to mothers who were not married to the children's fathers at the 44.10 times of the conception nor at the births of the children; 44.11 license and supervise child-caring and child-placing agencies 44.12 and institutions; supervise the care of children in boarding and 44.13 foster homes or in private institutions; and generally perform 44.14 all functions relating to the field of child welfare now vested 44.15 in the state board of control. 44.16 (4) Administer and supervise all noninstitutional service 44.17 to handicapped persons, including those who are visually 44.18 impaired, hearing impaired, or physically impaired or otherwise 44.19 handicapped. The commissioner may provide and contract for the 44.20 care and treatment of qualified indigent children in facilities 44.21 other than those located and available at state hospitals when 44.22 it is not feasible to provide the service in state hospitals. 44.23 (5) Assist and actively cooperate with other departments, 44.24 agencies and institutions, local, state, and federal, by 44.25 performing services in conformity with the purposes of Laws 44.26 1939, chapter 431. 44.27 (6) Act as the agent of and cooperate with the federal 44.28 government in matters of mutual concern relative to and in 44.29 conformity with the provisions of Laws 1939, chapter 431, 44.30 including the administration of any federal funds granted to the 44.31 state to aid in the performance of any functions of the 44.32 commissioner as specified in Laws 1939, chapter 431, and 44.33 including the promulgation of rules making uniformly available 44.34 medical care benefits to all recipients of public assistance, at 44.35 such times as the federal government increases its participation 44.36 in assistance expenditures for medical care to recipients of 45.1 public assistance, the cost thereof to be borne in the same 45.2 proportion as are grants of aid to said recipients. 45.3 (7) Establish and maintain any administrative units 45.4 reasonably necessary for the performance of administrative 45.5 functions common to all divisions of the department. 45.6 (8) Act as designated guardian of both the estate and the 45.7 person of all the wards of the state of Minnesota, whether by 45.8 operation of law or by an order of court, without any further 45.9 act or proceeding whatever, except as to persons committed as 45.10 mentally retarded. For children under the guardianship of the 45.11 commissioner whose interests would be best served by adoptive 45.12 placement, the commissioner may contract with a licensed 45.13 child-placing agency to provide adoption services. A contract 45.14 with a licensed child-placing agency must be designed to 45.15 supplement existing county efforts and may not replace existing 45.16 county programs, unless the replacement is agreed to by the 45.17 county board and the appropriate exclusive bargaining 45.18 representative or the commissioner has evidence that child 45.19 placements of the county continue to be substantially below that 45.20 of other counties. Funds encumbered and obligated under an 45.21 agreement for a specific child shall remain available until the 45.22 terms of the agreement are fulfilled or the agreement is 45.23 terminated. 45.24 (9) Act as coordinating referral and informational center 45.25 on requests for service for newly arrived immigrants coming to 45.26 Minnesota. 45.27 (10) The specific enumeration of powers and duties as 45.28 hereinabove set forth shall in no way be construed to be a 45.29 limitation upon the general transfer of powers herein contained. 45.30 (11) Establish county, regional, or statewide schedules of 45.31 maximum fees and charges which may be paid by county agencies 45.32 for medical, dental, surgical, hospital, nursing and nursing 45.33 home care and medicine and medical supplies under all programs 45.34 of medical care provided by the state and for congregate living 45.35 care under the income maintenance programs. 45.36 (12) Have the authority to conduct and administer 46.1 experimental projects to test methods and procedures of 46.2 administering assistance and services to recipients or potential 46.3 recipients of public welfare. To carry out such experimental 46.4 projects, it is further provided that the commissioner of human 46.5 services is authorized to waive the enforcement of existing 46.6 specific statutory program requirements, rules, and standards in 46.7 one or more counties. The order establishing the waiver shall 46.8 provide alternative methods and procedures of administration, 46.9 shall not be in conflict with the basic purposes, coverage, or 46.10 benefits provided by law, and in no event shall the duration of 46.11 a project exceed four years. It is further provided that no 46.12 order establishing an experimental project as authorized by the 46.13 provisions of this section shall become effective until the 46.14 following conditions have been met: 46.15 (a) The secretary of health and human services of the 46.16 United States has agreed, for the same project, to waive state 46.17 plan requirements relative to statewide uniformity. 46.18 (b) A comprehensive plan, including estimated project 46.19 costs, shall be approved by the legislative advisory commission 46.20 and filed with the commissioner of administration. 46.21 (13) According to federal requirements, establish 46.22 procedures to be followed by local welfare boards in creating 46.23 citizen advisory committees, including procedures for selection 46.24 of committee members. 46.25 (14) Allocate federal fiscal disallowances or sanctions 46.26 which are based on quality control error rates for the aid to 46.27 families with dependent children program formerly codified in 46.28 sections 256.72 to 256.87, medical assistance, or food stamp 46.29 program in the following manner: 46.30 (a) One-half of the total amount of the disallowance shall 46.31 be borne by the county boards responsible for administering the 46.32 programs. For the medical assistance and the AFDC program 46.33 formerly codified in sections 256.72 to 256.87, disallowances 46.34 shall be shared by each county board in the same proportion as 46.35 that county's expenditures for the sanctioned program are to the 46.36 total of all counties' expenditures for the AFDC program 47.1 formerly codified in sections 256.72 to 256.87, and medical 47.2 assistance programs. For the food stamp program, sanctions 47.3 shall be shared by each county board, with 50 percent of the 47.4 sanction being distributed to each county in the same proportion 47.5 as that county's administrative costs for food stamps are to the 47.6 total of all food stamp administrative costs for all counties, 47.7 and 50 percent of the sanctions being distributed to each county 47.8 in the same proportion as that county's value of food stamp 47.9 benefits issued are to the total of all benefits issued for all 47.10 counties. Each county shall pay its share of the disallowance 47.11 to the state of Minnesota. When a county fails to pay the 47.12 amount due hereunder, the commissioner may deduct the amount 47.13 from reimbursement otherwise due the county, or the attorney 47.14 general, upon the request of the commissioner, may institute 47.15 civil action to recover the amount due. 47.16 (b) Notwithstanding the provisions of paragraph (a), if the 47.17 disallowance results from knowing noncompliance by one or more 47.18 counties with a specific program instruction, and that knowing 47.19 noncompliance is a matter of official county board record, the 47.20 commissioner may require payment or recover from the county or 47.21 counties, in the manner prescribed in paragraph (a), an amount 47.22 equal to the portion of the total disallowance which resulted 47.23 from the noncompliance, and may distribute the balance of the 47.24 disallowance according to paragraph (a). 47.25 (15) Develop and implement special projects that maximize 47.26 reimbursements and result in the recovery of money to the 47.27 state. For the purpose of recovering state money, the 47.28 commissioner may enter into contracts with third parties. Any 47.29 recoveries that result from projects or contracts entered into 47.30 under this paragraph shall be deposited in the state treasury 47.31 and credited to a special account until the balance in the 47.32 account reaches $1,000,000. When the balance in the account 47.33 exceeds $1,000,000, the excess shall be transferred and credited 47.34 to the general fund. All money in the account is appropriated 47.35 to the commissioner for the purposes of this paragraph. 47.36 (16) Have the authority to make direct payments to 48.1 facilities providing shelter to women and their children 48.2 according to section 256D.05, subdivision 3. Upon the written 48.3 request of a shelter facility that has been denied payments 48.4 under section 256D.05, subdivision 3, the commissioner shall 48.5 review all relevant evidence and make a determination within 30 48.6 days of the request for review regarding issuance of direct 48.7 payments to the shelter facility. Failure to act within 30 days 48.8 shall be considered a determination not to issue direct payments. 48.9 (17) Have the authority to establish and enforce the 48.10 following county reporting requirements: 48.11 (a) The commissioner shall establish fiscal and statistical 48.12 reporting requirements necessary to account for the expenditure 48.13 of funds allocated to counties for human services programs. 48.14 When establishing financial and statistical reporting 48.15 requirements, the commissioner shall evaluate all reports, in 48.16 consultation with the counties, to determine if the reports can 48.17 be simplified or the number of reports can be reduced. 48.18 (b) The county board shall submit monthly or quarterly 48.19 reports to the department as required by the commissioner. 48.20 Monthly reports are due no later than 15 working days after the 48.21 end of the month. Quarterly reports are due no later than 30 48.22 calendar days after the end of the quarter, unless the 48.23 commissioner determines that the deadline must be shortened to 48.24 20 calendar days to avoid jeopardizing compliance with federal 48.25 deadlines or risking a loss of federal funding. Only reports 48.26 that are complete, legible, and in the required format shall be 48.27 accepted by the commissioner. 48.28 (c) If the required reports are not received by the 48.29 deadlines established in clause (b), the commissioner may delay 48.30 payments and withhold funds from the county board until the next 48.31 reporting period. When the report is needed to account for the 48.32 use of federal funds and the late report results in a reduction 48.33 in federal funding, the commissioner shall withhold from the 48.34 county boards with late reports an amount equal to the reduction 48.35 in federal funding until full federal funding is received. 48.36 (d) A county board that submits reports that are late, 49.1 illegible, incomplete, or not in the required format for two out 49.2 of three consecutive reporting periods is considered 49.3 noncompliant. When a county board is found to be noncompliant, 49.4 the commissioner shall notify the county board of the reason the 49.5 county board is considered noncompliant and request that the 49.6 county board develop a corrective action plan stating how the 49.7 county board plans to correct the problem. The corrective 49.8 action plan must be submitted to the commissioner within 45 days 49.9 after the date the county board received notice of noncompliance. 49.10 (e) The final deadline for fiscal reports or amendments to 49.11 fiscal reports is one year after the date the report was 49.12 originally due. If the commissioner does not receive a report 49.13 by the final deadline, the county board forfeits the funding 49.14 associated with the report for that reporting period and the 49.15 county board must repay any funds associated with the report 49.16 received for that reporting period. 49.17 (f) The commissioner may not delay payments, withhold 49.18 funds, or require repayment under paragraph (c) or (e) if the 49.19 county demonstrates that the commissioner failed to provide 49.20 appropriate forms, guidelines, and technical assistance to 49.21 enable the county to comply with the requirements. If the 49.22 county board disagrees with an action taken by the commissioner 49.23 under paragraph (c) or (e), the county board may appeal the 49.24 action according to sections 14.57 to 14.69. 49.25 (g) Counties subject to withholding of funds under 49.26 paragraph (c) or forfeiture or repayment of funds under 49.27 paragraph (e) shall not reduce or withhold benefits or services 49.28 to clients to cover costs incurred due to actions taken by the 49.29 commissioner under paragraph (c) or (e). 49.30 (18) Allocate federal fiscal disallowances or sanctions for 49.31 audit exceptions when federal fiscal disallowances or sanctions 49.32 are based on a statewide random sample for the foster care 49.33 program under title IV-E of the Social Security Act, United 49.34 States Code, title 42, in direct proportion to each county's 49.35 title IV-E foster care maintenance claim for that period. 49.36 (19) Be responsible for ensuring the detection, prevention, 50.1 investigation, and resolution of fraudulent activities or 50.2 behavior by applicants, recipients, and other participants in 50.3 the human services programs administered by the department. 50.4 (20) Require county agencies to identify overpayments, 50.5 establish claims, and utilize all available and cost-beneficial 50.6 methodologies to collect and recover these overpayments in the 50.7 human services programs administered by the department. 50.8 (21) Have the authority to administer a drug rebate program 50.9 for drugs purchased pursuant to the prescription drug program 50.10 established under section 256.955 after the beneficiary's 50.11 satisfaction of any deductible established in the program. The 50.12 commissioner shall require a rebate agreement from all 50.13 manufacturers of covered drugs as defined in section 256B.0625, 50.14 subdivision 13. Rebate agreements for prescription drugs 50.15 delivered on or after July 1, 2002, must include rebates for 50.16 individuals covered under the prescription drug program who are 50.17 under 65 years of age. For each drug, the amount of the rebate 50.18 shall be equal to the basic rebate as defined for purposes of 50.19 the federal rebate program in United States Code, title 42, 50.20 section 1396r-8(c)(1). This basic rebate shall be applied to 50.21 single-source and multiple-source drugs. The manufacturers must 50.22 provide full payment within 30 days of receipt of the state 50.23 invoice for the rebate within the terms and conditions used for 50.24 the federal rebate program established pursuant to section 1927 50.25 of title XIX of the Social Security Act. The manufacturers must 50.26 provide the commissioner with any information necessary to 50.27 verify the rebate determined per drug. The rebate program shall 50.28 utilize the terms and conditions used for the federal rebate 50.29 program established pursuant to section 1927 of title XIX of the 50.30 Social Security Act. 50.31 (22) Have the authority to administer the federal drug 50.32 rebate program for drugs purchased under the medical assistance 50.33 program as allowed by section 1927 of title XIX of the Social 50.34 Security Act and according to the terms and conditions of 50.35 section 1927. Rebates shall be collected for all drugs that 50.36 have been dispensed or administered in an outpatient setting and 51.1 that are from manufacturers who have signed a rebate agreement 51.2 with the United States Department of Health and Human Services. 51.3(22)(23) Operate the department's communication systems 51.4 account established in Laws 1993, First Special Session chapter 51.5 1, article 1, section 2, subdivision 2, to manage shared 51.6 communication costs necessary for the operation of the programs 51.7 the commissioner supervises. A communications account may also 51.8 be established for each regional treatment center which operates 51.9 communications systems. Each account must be used to manage 51.10 shared communication costs necessary for the operations of the 51.11 programs the commissioner supervises. The commissioner may 51.12 distribute the costs of operating and maintaining communication 51.13 systems to participants in a manner that reflects actual usage. 51.14 Costs may include acquisition, licensing, insurance, 51.15 maintenance, repair, staff time and other costs as determined by 51.16 the commissioner. Nonprofit organizations and state, county, 51.17 and local government agencies involved in the operation of 51.18 programs the commissioner supervises may participate in the use 51.19 of the department's communications technology and share in the 51.20 cost of operation. The commissioner may accept on behalf of the 51.21 state any gift, bequest, devise or personal property of any 51.22 kind, or money tendered to the state for any lawful purpose 51.23 pertaining to the communication activities of the department. 51.24 Any money received for this purpose must be deposited in the 51.25 department's communication systems accounts. Money collected by 51.26 the commissioner for the use of communication systems must be 51.27 deposited in the state communication systems account and is 51.28 appropriated to the commissioner for purposes of this section. 51.29(23)(24) Receive any federal matching money that is made 51.30 available through the medical assistance program for the 51.31 consumer satisfaction survey. Any federal money received for 51.32 the survey is appropriated to the commissioner for this 51.33 purpose. The commissioner may expend the federal money received 51.34 for the consumer satisfaction survey in either year of the 51.35 biennium. 51.36(24)(25) Incorporate cost reimbursement claims from First 52.1 Call Minnesota and Greater Twin Cities United Way into the 52.2 federal cost reimbursement claiming processes of the department 52.3 according to federal law, rule, and regulations. Any 52.4 reimbursement received is appropriated to the commissioner and 52.5 shall be disbursed to First Call Minnesota and Greater Twin 52.6 Cities United Way according to normal department payment 52.7 schedules. 52.8(25)(26) Develop recommended standards for foster care 52.9 homes that address the components of specialized therapeutic 52.10 services to be provided by foster care homes with those services. 52.11 Sec. 2. [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.] 52.12 Subdivision 1. [DEFINITIONS.] For purposes of this 52.13 section, the following definitions apply: 52.14 (a) "Commissioner" means the commissioner of human services. 52.15 (b) "Health plan" means a policy, contract, or certificate 52.16 issued by a health plan company to a qualifying purchasing 52.17 alliance. Any health plan issued to the members of a qualifying 52.18 purchasing alliance must meet the requirements of chapter 62L. 52.19 (c) "Health plan company" means: 52.20 (1) a health carrier as defined under section 62A.011, 52.21 subdivision 2; 52.22 (2) a community integrated service network operating under 52.23 chapter 62N; or 52.24 (3) an accountable provider network operating under chapter 52.25 62T. 52.26 (d) "Qualifying employer" means an employer who: 52.27 (1) is a member of a qualifying purchasing alliance; 52.28 (2) has at least one employee but no more than ten 52.29 employees or is a sole proprietor or farmer; 52.30 (3) did not offer employer-subsidized health care coverage 52.31 to its employees for at least 12 months prior to joining the 52.32 purchasing alliance; and 52.33 (4) is offering health coverage through the purchasing 52.34 alliance to all employees who work at least 20 hours per week 52.35 unless the employee is eligible for Medicare. 52.36 For purposes of this subdivision, "employer-subsidized health 53.1 coverage" means health coverage for which the employer pays at 53.2 least 50 percent of the cost of coverage for the employee. 53.3 (e) "Qualifying enrollee" means an employee of a qualifying 53.4 employer or the employee's dependent covered by a health plan. 53.5 (f) "Qualifying purchasing alliance" means a purchasing 53.6 alliance as defined in section 62T.01, subdivision 2, that: 53.7 (1) meets the requirements of chapter 62T; 53.8 (2) services a geographic area located in outstate 53.9 Minnesota, excluding the city of Duluth; and 53.10 (3) is organized and operating before May 1, 2001. 53.11 The criteria used by the qualifying purchasing alliance for 53.12 membership must be approved by the commissioner of health. A 53.13 qualifying purchasing alliance may begin enrolling qualifying 53.14 employers after July 1, 2001, with enrollment ending by December 53.15 31, 2003. 53.16 Subd. 2. [CREATION OF ACCOUNT.] A purchasing alliance 53.17 stop-loss fund account is established in the general fund. The 53.18 commissioner shall use the money to establish a stop-loss fund 53.19 from which a health plan company may receive reimbursement for 53.20 claims paid for qualifying enrollees. The account consists of 53.21 money appropriated by the legislature. Money from the account 53.22 must be used for the stop-loss fund. 53.23 Subd. 3. [REIMBURSEMENT.] (a) A health plan company may 53.24 receive reimbursement from the fund for 90 percent of the 53.25 portion of the claim that exceeds $30,000 but not of the portion 53.26 that exceeds $100,000 in a calendar year for a qualifying 53.27 enrollee. 53.28 (b) Claims shall be reported and funds shall be distributed 53.29 on a calendar-year basis. Claims shall be eligible for 53.30 reimbursement only for the calendar year in which the claims 53.31 were paid. 53.32 (c) Once claims paid on behalf of a qualifying enrollee 53.33 reach $100,000 in a given calendar year, no further claims may 53.34 be submitted for reimbursement on behalf of that enrollee in 53.35 that calendar year. 53.36 Subd. 4. [REQUEST PROCESS.] (a) Each health plan company 54.1 must submit a request for reimbursement from the fund on a form 54.2 prescribed by the commissioner. Requests for payment must be 54.3 submitted no later than April 1 following the end of the 54.4 calendar year for which the reimbursement request is being made, 54.5 beginning April 1, 2002. 54.6 (b) The commissioner may require a health plan company to 54.7 submit claims data as needed in connection with the 54.8 reimbursement request. 54.9 Subd. 5. [DISTRIBUTION.] (a) The commissioner shall 54.10 calculate the total claims reimbursement amount for all 54.11 qualifying health plan companies for the calendar year for which 54.12 claims are being reported and shall distribute the stop-loss 54.13 funds on an annual basis. 54.14 (b) In the event that the total amount requested for 54.15 reimbursement by the health plan companies for a calendar year 54.16 exceeds the funds available for distribution for claims paid by 54.17 all health plan companies during the same calendar year, the 54.18 commissioner shall provide for the pro rata distribution of the 54.19 available funds. Each health plan company shall be eligible to 54.20 receive only a proportionate amount of the available funds as 54.21 the health plan company's total eligible claims paid compares to 54.22 the total eligible claims paid by all health plan companies. 54.23 (c) In the event that funds available for distribution for 54.24 claims paid by all health plan companies during a calendar year 54.25 exceed the total amount requested for reimbursement by all 54.26 health plan companies during the same calendar year, any excess 54.27 funds shall be reallocated for distribution in the next calendar 54.28 year. 54.29 Subd. 6. [DATA.] Upon the request of the commissioner, 54.30 each health plan company shall furnish such data as the 54.31 commissioner deems necessary to administer the fund. The 54.32 commissioner may require that such data be submitted on a per 54.33 enrollee, aggregate, or categorical basis. Any data submitted 54.34 under this section shall be classified as private data or 54.35 nonpublic data as defined in section 13.02. 54.36 Subd. 7. [DELEGATION.] The commissioner may delegate any 55.1 or all of the commissioner's administrative duties to another 55.2 state agency or to a private contractor. 55.3 Subd. 8. [REPORT.] The commissioner of commerce, in 55.4 consultation with the office of rural health and the qualifying 55.5 purchasing alliances, shall evaluate the extent to which the 55.6 purchasing alliance stop-loss fund increases the availability of 55.7 employer-subsidized health care coverage for residents residing 55.8 in the geographic areas served by the qualifying purchasing 55.9 alliances. A preliminary report must be submitted to the 55.10 legislature by February 15, 2003, and a final report must be 55.11 submitted by February 15, 2004. 55.12 Subd. 9. [SUNSET.] This section shall expire January 1, 55.13 2005. 55.14 Sec. 3. [256.958] [RETIRED DENTIST PROGRAM.] 55.15 Subdivision 1. [PROGRAM.] The commissioner of human 55.16 services shall establish a program to reimburse a retired 55.17 dentist for the dentist's license fee and for the reasonable 55.18 cost of malpractice insurance compared to other dentists in the 55.19 community in exchange for the dentist providing 100 hours of 55.20 dental services on a volunteer basis within a 12-month period at 55.21 a community dental clinic or a dental training clinic located at 55.22 a Minnesota state college or university. 55.23 Subd. 2. [DOCUMENTATION.] Upon completion of the required 55.24 hours, the retired dentist shall submit to the commissioner the 55.25 following: 55.26 (1) documentation of the service provided; 55.27 (2) the cost of malpractice insurance for the 12-month 55.28 period; and 55.29 (3) the cost of the license. 55.30 Subd. 3. [REIMBURSEMENT.] Upon receipt of the information 55.31 described in subdivision 2, the commissioner shall provide 55.32 reimbursement to the retired dentist for the cost of malpractice 55.33 insurance for the previous 12-month period and the cost of the 55.34 license. 55.35 Sec. 4. [256.959] [DENTAL PRACTICE DONATION PROGRAM.] 55.36 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 56.1 services shall establish a dental practice donation program that 56.2 coordinates the donation of a qualifying dental practice to a 56.3 qualified charitable organization and assists in locating a 56.4 dentist licensed under chapter 150A who wishes to maintain the 56.5 dental practice. 56.6 Subd. 2. [QUALIFYING DENTAL PRACTICE.] To qualify for the 56.7 dental practice donation program, a dental practice must meet 56.8 the following requirements: 56.9 (1) the dental practice must be owned by the donating 56.10 dentist; 56.11 (2) the dental practice must be located in a designated 56.12 underserved area of the state as defined by the commissioner; 56.13 and 56.14 (3) the practice must be equipped with the basic dental 56.15 equipment necessary to maintain a dental practice as determined 56.16 by the commissioner. 56.17 Subd. 3. [COORDINATION.] The commissioner shall establish 56.18 a procedure for dentists to donate their dental practices to a 56.19 qualified charitable organization. The commissioner shall 56.20 authorize a practice for donation only if it meets the 56.21 requirements of subdivision 2 and there is a licensed dentist 56.22 who is interested in entering into an agreement as described in 56.23 subdivision 4. Upon donation of the practice, the commissioner 56.24 shall provide the donating dentist with a statement verifying 56.25 that a donation of the practice was made to a qualifying 56.26 charitable organization for purposes of state and federal income 56.27 tax returns. 56.28 Subd. 4. [DONATED DENTAL PRACTICE AGREEMENT.] (a) A 56.29 dentist accepting the donated practice must enter into an 56.30 agreement with the qualified charitable organization to maintain 56.31 the dental practice for a minimum of five years at the donated 56.32 practice site and to provide services to underserved populations 56.33 up to a preagreed percentage of patients served. 56.34 (b) The agreement must include the terms for the recovery 56.35 of the donated dental practice if the dentist accepting the 56.36 practice does not fulfill the service commitment required under 57.1 this subdivision. 57.2 (c) Any costs associated with operating the dental practice 57.3 during the service commitment time period are the financial 57.4 responsibility of the dentist accepting the practice. 57.5 Sec. 5. Minnesota Statutes 2000, section 256.9657, 57.6 subdivision 2, is amended to read: 57.7 Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1, 57.8 1992, each Minnesota hospital except facilities of the federal 57.9 Indian Health Service and regional treatment centers shall pay 57.10 to the medical assistance account a surcharge equal to 1.4 57.11 percent of net patient revenues excluding net Medicare revenues 57.12 reported by that provider to the health care cost information 57.13 system according to the schedule in subdivision 4. 57.14 (b) Effective July 1, 1994, the surcharge under paragraph 57.15 (a) is increased to 1.56 percent. 57.16 (c) Notwithstanding the Medicare cost finding and allowable 57.17 cost principles, the hospital surcharge is not an allowable cost 57.18 for purposes of rate setting under sections 256.9685 to 256.9695. 57.19 Sec. 6. Minnesota Statutes 2000, section 256B.04, is 57.20 amended by adding a subdivision to read: 57.21 Subd. 1b. [CONTRACT FOR ADMINISTRATIVE SERVICES FOR 57.22 AMERICAN INDIAN CHILDREN.] Notwithstanding subdivision 1, the 57.23 commissioner may contract with federally recognized Indian 57.24 tribes with a reservation in Minnesota for the provision of 57.25 early and periodic screening, diagnosis, and treatment 57.26 administrative services for American Indian children, according 57.27 to Code of Federal Regulations, title 42, section 441, subpart 57.28 B, and Minnesota Rules, part 9505.1693 et seq., when the tribe 57.29 chooses to provide such services. For purposes of this 57.30 subdivision, "American Indian" has the meaning given to persons 57.31 to whom services will be provided for in Code of Federal 57.32 Regulations, title 42, section 36.12. Notwithstanding Minnesota 57.33 Rules, part 9505.1748, subpart 1, the commissioner, the local 57.34 agency, and the tribe may contract with any entity for the 57.35 provision of early and periodic screening, diagnosis, and 57.36 treatment administrative services. 58.1 [EFFECTIVE DATE.] This section is effective the day 58.2 following final enactment. 58.3 Sec. 7. Minnesota Statutes 2000, section 256B.056, 58.4 subdivision 4b, is amended to read: 58.5 Subd. 4b. [INCOME VERIFICATION.] The local agency shall 58.6 not require a monthly income verification form for a recipient 58.7 who is a resident of a long-term care facility and who has 58.8 monthly earned income of $80 or less. The commissioner or 58.9 county agency shall use electronic verification as the primary 58.10 method of income verification. If there is a discrepancy 58.11 between reported income and electronically verified income, an 58.12 individual may be required to submit additional verification. 58.13 Sec. 8. Minnesota Statutes 2000, section 256B.0625, 58.14 subdivision 3b, is amended to read: 58.15 Subd. 3b. [TELEMEDICINE CONSULTATIONS.](a)Medical 58.16 assistance covers telemedicine consultations. Telemedicine 58.17 consultations must be made via two-way, interactive video or 58.18 store-and-forward technology. Store-and-forward technology 58.19 includes telemedicine consultations that do not occur in real 58.20 time via synchronous transmissions, and that do not require a 58.21 face-to-face encounter with the patient for all or any part of 58.22 any such telemedicine consultation. The patient record must 58.23 include a written opinion from the consulting physician 58.24 providing the telemedicine consultation. A communication 58.25 between two physicians that consists solely of a telephone 58.26 conversation is not a telemedicine consultation. Coverage is 58.27 limited to three telemedicine consultations per recipient per 58.28 calendar week. Telemedicine consultations shall be paid at the 58.29 full allowable rate. 58.30(b) This subdivision expires July 1, 2001.58.31 Sec. 9. Minnesota Statutes 2000, section 256B.0625, 58.32 subdivision 13, is amended to read: 58.33 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 58.34 except for fertility drugs when specifically used to enhance 58.35 fertility, if prescribed by a licensed practitioner and 58.36 dispensed by a licensed pharmacist, by a physician enrolled in 59.1 the medical assistance program as a dispensing physician, or by 59.2 a physician or a nurse practitioner employed by or under 59.3 contract with a community health board as defined in section 59.4 145A.02, subdivision 5, for the purposes of communicable disease 59.5 control. The commissioner, after receiving recommendations from 59.6 professional medical associations and professional pharmacist 59.7 associations, shall designate a formulary committee to advise 59.8 the commissioner on the names of drugs for which payment is 59.9 made, recommend a system for reimbursing providers on a set fee 59.10 or charge basis rather than the present system, and develop 59.11 methods encouraging use of generic drugs when they are less 59.12 expensive and equally effective as trademark drugs. The 59.13 formulary committee shall consist of nine members, four of whom 59.14 shall be physicians who are not employed by the department of 59.15 human services, and a majority of whose practice is for persons 59.16 paying privately or through health insurance, three of whom 59.17 shall be pharmacists who are not employed by the department of 59.18 human services, and a majority of whose practice is for persons 59.19 paying privately or through health insurance, a consumer 59.20 representative, and a nursing home representative. Committee 59.21 members shall serve three-year terms and shall serve without 59.22 compensation. Members may be reappointed once. 59.23 (b) The commissioner shall establish a drug formulary. Its 59.24 establishment and publication shall not be subject to the 59.25 requirements of the Administrative Procedure Act, but the 59.26 formulary committee shall review and comment on the formulary 59.27 contents. The formulary committee shall review and recommend 59.28 drugs which require prior authorization. The formulary 59.29 committee may recommend drugs for prior authorization directly 59.30 to the commissioner, as long as opportunity for public input is 59.31 provided. Prior authorization may be requested by the 59.32 commissioner based on medical and clinical criteria before 59.33 certain drugs are eligible for payment. Before a drug may be 59.34 considered for prior authorization at the request of the 59.35 commissioner: 59.36 (1) the drug formulary committee must develop criteria to 60.1 be used for identifying drugs; the development of these criteria 60.2 is not subject to the requirements of chapter 14, but the 60.3 formulary committee shall provide opportunity for public input 60.4 in developing criteria; 60.5 (2) the drug formulary committee must hold a public forum 60.6 and receive public comment for an additional 15 days; and 60.7 (3) the commissioner must provide information to the 60.8 formulary committee on the impact that placing the drug on prior 60.9 authorization will have on the quality of patient care and 60.10 information regarding whether the drug is subject to clinical 60.11 abuse or misuse. Prior authorization may be required by the 60.12 commissioner before certain formulary drugs are eligible for 60.13 payment. The formulary shall not include: 60.14 (i) drugs or products for which there is no federal 60.15 funding; 60.16 (ii) over-the-counter drugs, except for antacids, 60.17 acetaminophen, family planning products, aspirin, insulin, 60.18 products for the treatment of lice, vitamins for adults with 60.19 documented vitamin deficiencies, vitamins for children under the 60.20 age of seven and pregnant or nursing women, and any other 60.21 over-the-counter drug identified by the commissioner, in 60.22 consultation with the drug formulary committee, as necessary, 60.23 appropriate, and cost-effective for the treatment of certain 60.24 specified chronic diseases, conditions or disorders, and this 60.25 determination shall not be subject to the requirements of 60.26 chapter 14; 60.27 (iii) anorectics, except that medically necessary 60.28 anorectics shall be covered for a recipient previously diagnosed 60.29 as having pickwickian syndrome and currently diagnosed as having 60.30 diabetes and being morbidly obese; 60.31 (iv) drugs for which medical value has not been 60.32 established; and 60.33 (v) drugs from manufacturers who have not signed a rebate 60.34 agreement with the Department of Health and Human Services 60.35 pursuant to section 1927 of title XIX of the Social Security Act. 60.36 The commissioner shall publish conditions for prohibiting 61.1 payment for specific drugs after considering the formulary 61.2 committee's recommendations. An honorarium of $100 per meeting 61.3 and reimbursement for mileage shall be paid to each committee 61.4 member in attendance. 61.5 (c) The basis for determining the amount of payment shall 61.6 be the lower of the actual acquisition costs of the drugs plus a 61.7 fixed dispensing fee; the maximum allowable cost set by the 61.8 federal government or by the commissioner plus the fixed 61.9 dispensing fee; or the usual and customary price charged to the 61.10 public. The pharmacy dispensing fee shall be $3.65, except that 61.11 the dispensing fee for intravenous solutions which must be 61.12 compounded by the pharmacist shall be $8 per bag, $14 per bag 61.13 for cancer chemotherapy products, and $30 per bag for total 61.14 parenteral nutritional products dispensed in one liter 61.15 quantities, or $44 per bag for total parenteral nutritional 61.16 products dispensed in quantities greater than one liter. Actual 61.17 acquisition cost includes quantity and other special discounts 61.18 except time and cash discounts. The actual acquisition cost of 61.19 a drug shall be estimated by the commissioner, at average 61.20 wholesale price minus nine percent, except that where a drug has 61.21 had its wholesale price reduced as a result of the actions of 61.22 the National Association of Medicaid Fraud Control Units, the 61.23 estimated actual acquisition cost shall be the reduced average 61.24 wholesale price, without the nine percent deduction. The 61.25 maximum allowable cost of a multisource drug may be set by the 61.26 commissioner and it shall be comparable to, but no higher than, 61.27 the maximum amount paid by other third-party payors in this 61.28 state who have maximum allowable cost programs. The 61.29 commissioner shall set maximum allowable costs for multisource 61.30 drugs that are not on the federal upper limit list as described 61.31 in United States Code, title 42, chapter 7, section 1396r-8(e), 61.32 the Social Security Act, and Code of Federal Regulations, title 61.33 42, part 447, section 447.332. Establishment of the amount of 61.34 payment for drugs shall not be subject to the requirements of 61.35 the Administrative Procedure Act. An additional dispensing fee 61.36 of $.30 may be added to the dispensing fee paid to pharmacists 62.1 for legend drug prescriptions dispensed to residents of 62.2 long-term care facilities when a unit dose blister card system, 62.3 approved by the department, is used. Under this type of 62.4 dispensing system, the pharmacist must dispense a 30-day supply 62.5 of drug. The National Drug Code (NDC) from the drug container 62.6 used to fill the blister card must be identified on the claim to 62.7 the department. The unit dose blister card containing the drug 62.8 must meet the packaging standards set forth in Minnesota Rules, 62.9 part 6800.2700, that govern the return of unused drugs to the 62.10 pharmacy for reuse. The pharmacy provider will be required to 62.11 credit the department for the actual acquisition cost of all 62.12 unused drugs that are eligible for reuse. Over-the-counter 62.13 medications must be dispensed in the manufacturer's unopened 62.14 package. The commissioner may permit the drug clozapine to be 62.15 dispensed in a quantity that is less than a 30-day supply. 62.16 Whenever a generically equivalent product is available, payment 62.17 shall be on the basis of the actual acquisition cost of the 62.18 generic drug, unless the prescriber specifically indicates 62.19 "dispense as written - brand necessary" on the prescription as 62.20 required by section 151.21, subdivision 2. 62.21 (d) For purposes of this subdivision, "multisource drugs" 62.22 means covered outpatient drugs, excluding innovator multisource 62.23 drugs for which there are two or more drug products, which: 62.24 (1) are related as therapeutically equivalent under the 62.25 Food and Drug Administration's most recent publication of 62.26 "Approved Drug Products with Therapeutic Equivalence 62.27 Evaluations"; 62.28 (2) are pharmaceutically equivalent and bioequivalent as 62.29 determined by the Food and Drug Administration; and 62.30 (3) are sold or marketed in Minnesota. 62.31 "Innovator multisource drug" means a multisource drug that was 62.32 originally marketed under an original new drug application 62.33 approved by the Food and Drug Administration. 62.34 (e) The basis for determining the amount of payment for 62.35 drugs administered in an outpatient setting shall be the lower 62.36 of the usual and customary cost submitted by the provider; the 63.1 average wholesale price minus five percent; or the maximum 63.2 allowable cost set by the federal government under United States 63.3 Code, title 42, chapter 7, section 1396r-8(e) and Code of 63.4 Federal Regulations, title 42, section 447.332, or by the 63.5 commissioner under paragraph (c). 63.6 Sec. 10. Minnesota Statutes 2000, section 256B.0625, 63.7 subdivision 13a, is amended to read: 63.8 Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member 63.9 drug utilization review board is established. The board is 63.10 comprised of at least three but no more than four licensed 63.11 physicians actively engaged in the practice of medicine in 63.12 Minnesota; at least three licensed pharmacists actively engaged 63.13 in the practice of pharmacy in Minnesota; and one consumer 63.14 representative; the remainder to be made up of health care 63.15 professionals who are licensed in their field and have 63.16 recognized knowledge in the clinically appropriate prescribing, 63.17 dispensing, and monitoring of covered outpatient drugs. The 63.18 board shall be staffed by an employee of the department who 63.19 shall serve as an ex officio nonvoting member of the board. The 63.20 members of the board shall be appointed by the commissioner and 63.21 shall serve three-year terms. The members shall be selected 63.22 from lists submitted by professional associations. The 63.23 commissioner shall appoint the initial members of the board for 63.24 terms expiring as follows: three members for terms expiring 63.25 June 30, 1996; three members for terms expiring June 30, 1997; 63.26 and three members for terms expiring June 30, 1998. Members may 63.27 be reappointed once. The board shall annually elect a chair 63.28 from among the members. 63.29 The commissioner shall, with the advice of the board: 63.30 (1) implement a medical assistance retrospective and 63.31 prospective drug utilization review program as required by 63.32 United States Code, title 42, section 1396r-8(g)(3); 63.33 (2) develop and implement the predetermined criteria and 63.34 practice parameters for appropriate prescribing to be used in 63.35 retrospective and prospective drug utilization review; 63.36 (3) develop, select, implement, and assess interventions 64.1 for physicians, pharmacists, and patients that are educational 64.2 and not punitive in nature; 64.3 (4) establish a grievance and appeals process for 64.4 physicians and pharmacists under this section; 64.5 (5) publish and disseminate educational information to 64.6 physicians and pharmacists regarding the board and the review 64.7 program; 64.8 (6) adopt and implement procedures designed to ensure the 64.9 confidentiality of any information collected, stored, retrieved, 64.10 assessed, or analyzed by the board, staff to the board, or 64.11 contractors to the review program that identifies individual 64.12 physicians, pharmacists, or recipients; 64.13 (7) establish and implement an ongoing process to (i) 64.14 receive public comment regarding drug utilization review 64.15 criteria and standards, and (ii) consider the comments along 64.16 with other scientific and clinical information in order to 64.17 revise criteria and standards on a timely basis; and 64.18 (8) adopt any rules necessary to carry out this section. 64.19 The board may establish advisory committees. The 64.20 commissioner may contract with appropriate organizations to 64.21 assist the board in carrying out the board's duties. The 64.22 commissioner may enter into contracts for services to develop 64.23 and implement a retrospective and prospective review program. 64.24 The board shall report to the commissioner annually on the 64.25 date the Drug Utilization Review Annual Report is due to the 64.26 Health Care Financing Administration. This report is to cover 64.27 the preceding federal fiscal year. The commissioner shall make 64.28 the report available to the public upon request. The report 64.29 must include information on the activities of the board and the 64.30 program; the effectiveness of implemented interventions; 64.31 administrative costs; and any fiscal impact resulting from the 64.32 program. An honorarium of$50$100 per meeting and 64.33 reimbursement for mileage shall be paid to each board member in 64.34 attendance. 64.35 Sec. 11. Minnesota Statutes 2000, section 256B.0625, 64.36 subdivision 34, is amended to read: 65.1 Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical 65.2 assistance payments and MinnesotaCare payments to facilities of 65.3 the Indian health service and facilities operated by a tribe or 65.4 tribal organization under funding authorized by United States 65.5 Code, title 25, sections 450f to 450n, or title III of the 65.6 Indian Self-Determination and Education Assistance Act, Public 65.7 Law Number 93-638, for enrollees who are eligible for federal 65.8 financial participation, shall be at the option of the facility 65.9 in accordance with the rate published by the United States 65.10 Assistant Secretary for Health under the authority of United 65.11 States Code, title 42, sections 248(a) and 249(b). General 65.12 assistance medical care payments to facilities of the Indian 65.13 health services and facilities operated by a tribe or tribal 65.14 organization for the provision of outpatient medical care 65.15 services billed after June 30, 1990, must be in accordance with 65.16 the general assistance medical care rates paid for the same 65.17 services when provided in a facility other than a facility of 65.18 the Indian health service or a facility operated by a tribe or 65.19 tribal organization. MinnesotaCare payments for enrollees who 65.20 are not eligible for federal financial participation at 65.21 facilities of the Indian Health Service and facilities operated 65.22 by a tribe or tribal organization for the provision of 65.23 outpatient medical services must be in accordance with the 65.24 medical assistance rates paid for the same services when 65.25 provided in a facility other than a facility of the Indian 65.26 Health Service or a facility operated by a tribe or tribal 65.27 organization. 65.28 [EFFECTIVE DATE.] This section is effective the day 65.29 following final enactment. 65.30 Sec. 12. Minnesota Statutes 2000, section 256B.0625, is 65.31 amended by adding a subdivision to read: 65.32 Subd. 43. [TARGETED CASE MANAGEMENT SERVICES.] Medical 65.33 assistance covers case management services for vulnerable adults 65.34 and persons with developmental disabilities not receiving home 65.35 and community-based waiver services. 65.36 Sec. 13. [256B.0924] [TARGETED CASE MANAGEMENT SERVICES 66.1 FOR VULNERABLE ADULTS AND PERSONS WITH DEVELOPMENTAL 66.2 DISABILITIES.] 66.3 Subdivision 1. [PURPOSE.] The state recognizes that 66.4 targeted case management services can decrease the need for more 66.5 costly services such as multiple emergency room visits or 66.6 hospitalizations by linking eligible individuals with less 66.7 costly services available in the community. 66.8 Subd. 2. [DEFINITIONS.] For purposes of this section, the 66.9 following terms have the meanings given: 66.10 (a) "Targeted case management" means services which will 66.11 assist medical assistance eligible persons to gain access to 66.12 needed medical, social, educational, and other services. 66.13 Targeted case management does not include therapy, treatment, 66.14 legal, or outreach services. 66.15 (b) "Targeted case management for adults" means activities 66.16 that coordinate and link social and other services designed to 66.17 help eligible persons gain access to needed protective services, 66.18 social, health care, mental health, habilitative, educational, 66.19 vocational, recreational, advocacy, legal, chemical, health, and 66.20 other related services. 66.21 Subd. 3. [ELIGIBILITY.] Persons are eligible to receive 66.22 targeted case management services under this section if the 66.23 requirements in paragraphs (a) and (b) are met. 66.24 (a) The person must be assessed and determined by the local 66.25 county agency to: 66.26 (1) be age 18 or older; 66.27 (2) be receiving medical assistance; 66.28 (3) have significant functional limitations; and 66.29 (4) be in need of service coordination to attain or 66.30 maintain living in an integrated community setting. 66.31 (b) The person must be a vulnerable adult in need of adult 66.32 protection as defined in section 626.5572, or is an adult with 66.33 mental retardation as defined in section 252A.02, subdivision 2, 66.34 or a related condition as defined in section 252.27, subdivision 66.35 1a, and is not receiving home and community-based waiver 66.36 services. 67.1 Subd. 4. [TARGETED CASE MANAGEMENT SERVICE 67.2 ACTIVITIES.] (a) For persons with mental retardation or a 67.3 related condition, targeted case management services must meet 67.4 the provisions of section 256B.092. 67.5 (b) For persons not eligible as a person with mental 67.6 retardation or a related condition, targeted case management 67.7 service activities include: 67.8 (1) an assessment of the person's need for targeted case 67.9 management services; 67.10 (2) the development of a written personal service plan; 67.11 (3) a regular review and revision of the written personal 67.12 service plan with the recipient and the recipient's legal 67.13 representative, and others as identified by the recipient, to 67.14 ensure access to necessary services and supports identified in 67.15 the plan; 67.16 (4) effective communication with the recipient and the 67.17 recipient's legal representative and others identified by the 67.18 recipient; 67.19 (5) coordination of referrals for needed services with 67.20 qualified providers; 67.21 (6) coordination and monitoring of the overall service 67.22 delivery to ensure the quality and effectiveness of services; 67.23 (7) assistance to the recipient and the recipient's legal 67.24 representative to help make an informed choice of services; 67.25 (8) advocating on behalf of the recipient when service 67.26 barriers are encountered or referring the recipient and the 67.27 recipient's legal representative to an independent advocate; 67.28 (9) monitoring and evaluating services identified in the 67.29 personal service plan to ensure personal outcomes are met and to 67.30 ensure satisfaction with services and service delivery; 67.31 (10) conducting face-to-face monitoring with the recipient 67.32 at least twice a year; 67.33 (11) completing and maintain necessary documentation that 67.34 supports verifies the activities in this section; 67.35 (12) coordinating with the medical assistance facility 67.36 discharge planner in the 180-day period prior to the recipient's 68.1 discharge into the community; and 68.2 (13) a personal service plan developed and reviewed at 68.3 least annually with the recipient and the recipient's legal 68.4 representative. The personal service plan must be revised when 68.5 there is a change in the recipient's status. The personal 68.6 service plan must identify: 68.7 (i) the desired personal short and long-term outcomes; 68.8 (ii) the recipient's preferences for services and supports, 68.9 including development of a person-centered plan if requested; 68.10 and 68.11 (iii) formal and informal services and supports based on 68.12 areas of assessment, such as: social, health, mental health, 68.13 residence, family, educational and vocational, safety, legal, 68.14 self-determination, financial, and chemical health as determined 68.15 by the recipient and the recipient's legal representative and 68.16 the recipient's support network. 68.17 Subd. 5. [PROVIDER STANDARDS.] County boards or providers 68.18 who contract with the county are eligible to receive medical 68.19 assistance reimbursement for adult targeted case management 68.20 services. To qualify as a provider of targeted case management 68.21 services the vendor must: 68.22 (1) have demonstrated the capacity and experience to 68.23 provide the activities of case management services defined in 68.24 subdivision 4; 68.25 (2) be able to coordinate and link community resources 68.26 needed by the recipient; 68.27 (3) have the administrative capacity and experience to 68.28 serve the eligible population in providing services and to 68.29 ensure quality of services under state and federal requirements; 68.30 (4) have a financial management system that provides 68.31 accurate documentation of services and costs under state and 68.32 federal requirements; 68.33 (5) have the capacity to document and maintain individual 68.34 case records complying with state and federal requirements; 68.35 (6) coordinate with county social service agencies 68.36 responsible for planning for community social services under 69.1 chapters 256E and 256F; conducting adult protective 69.2 investigations under section 626.557, and conducting prepetition 69.3 screenings for commitments under section 253B.07; 69.4 (7) coordinate with health care providers to ensure access 69.5 to necessary health care services; 69.6 (8) have a procedure in place that notifies the recipient 69.7 and the recipient's legal representative of any conflict of 69.8 interest if the contracted targeted case management service 69.9 provider also provides the recipient's services and supports and 69.10 provides information on all potential conflicts of interest and 69.11 obtains the recipient's informed consent and provides the 69.12 recipient with alternatives; and 69.13 (9) have demonstrated the capacity to achieve the following 69.14 performance outcomes: access, quality, and consumer 69.15 satisfaction. 69.16 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 69.17 Medical assistance and MinnesotaCare payment for targeted case 69.18 management shall be made on a monthly basis. In order to 69.19 receive payment for an eligible adult, the provider must 69.20 document at least one contact per month and not more than two 69.21 consecutive months without a face-to-face contact with the adult 69.22 or the adult's legal representative. 69.23 (b) Payment for targeted case management provided by county 69.24 staff under this subdivision shall be based on the monthly rate 69.25 methodology under section 256B.094, subdivision 6, paragraph 69.26 (b), calculated as one combined average rate together with adult 69.27 mental health case management under section 256B.0625, 69.28 subdivision 20, except for calendar year 2002. In calendar year 69.29 2002, the rate for case management under this section shall be 69.30 the same as the rate for adult mental health case management in 69.31 effect as of December 31, 2001. Billing and payment must 69.32 identify the recipient's primary population group to allow 69.33 tracking of revenues. 69.34 (c) Payment for targeted case management provided by 69.35 county-contracted vendors shall be based on a monthly rate 69.36 negotiated by the host county. The negotiated rate must not 70.1 exceed the rate charged by the vendor for the same service to 70.2 other payers. If the service is provided by a team of 70.3 contracted vendors, the county may negotiate a team rate with a 70.4 vendor who is a member of the team. The team shall determine 70.5 how to distribute the rate among its members. No reimbursement 70.6 received by contracted vendors shall be returned to the county, 70.7 except to reimburse the county for advance funding provided by 70.8 the county to the vendor. 70.9 (d) If the service is provided by a team that includes 70.10 contracted vendors and county staff, the costs for county staff 70.11 participation on the team shall be included in the rate for 70.12 county-provided services. In this case, the contracted vendor 70.13 and the county may each receive separate payment for services 70.14 provided by each entity in the same month. In order to prevent 70.15 duplication of services, the county must document, in the 70.16 recipient's file, the need for team targeted case management and 70.17 a description of the different roles of the team members. 70.18 (e) Notwithstanding section 256B.19, subdivision 1, the 70.19 nonfederal share of costs for targeted case management shall be 70.20 provided by the recipient's county of responsibility, as defined 70.21 in sections 256G.01 to 256G.12, from sources other than federal 70.22 funds or funds used to match other federal funds. 70.23 (f) The commissioner may suspend, reduce, or terminate 70.24 reimbursement to a provider that does not meet the reporting or 70.25 other requirements of this section. The county of 70.26 responsibility, as defined in sections 256G.01 to 256G.12, is 70.27 responsible for any federal disallowances. The county may share 70.28 this responsibility with its contracted vendors. 70.29 (g) The commissioner shall set aside five percent of the 70.30 federal funds received under this section for use in reimbursing 70.31 the state for costs of developing and implementing this section. 70.32 (h) Notwithstanding section 256.025, subdivision 2, 70.33 payments to counties for targeted case management expenditures 70.34 under this section shall only be made from federal earnings from 70.35 services provided under this section. Payments to contracted 70.36 vendors shall include both the federal earnings and the county 71.1 share. 71.2 (i) Notwithstanding section 256B.041, county payments for 71.3 the cost of case management services provided by county staff 71.4 shall not be made to the state treasurer. For the purposes of 71.5 targeted case management services provided by county staff under 71.6 this section, the centralized disbursement of payments to 71.7 counties under section 256B.041 consists only of federal 71.8 earnings from services provided under this section. 71.9 (j) If the recipient is a resident of a nursing facility, 71.10 intermediate care facility, or hospital, and the recipient's 71.11 institutional care is paid by medical assistance, payment for 71.12 targeted case management services under this subdivision is 71.13 limited to the last 180 days of the recipient's residency in 71.14 that facility and may not exceed more than six months in a 71.15 calendar year. 71.16 (k) Payment for targeted case management services under 71.17 this subdivision shall not duplicate payments made under other 71.18 program authorities for the same purpose. 71.19 (l) Any growth in targeted case management services and 71.20 cost increases under this section shall be the responsibility of 71.21 the counties. 71.22 Subd. 7. [IMPLEMENTATION AND EVALUATION.] The commissioner 71.23 of human services in consultation with county boards shall 71.24 establish a program to accomplish the provisions of subdivisions 71.25 1 to 6. The commissioner in consultation with county boards 71.26 shall establish performance measures to evaluate the 71.27 effectiveness of the targeted case management services. If a 71.28 county fails to meet agreed upon performance measures, the 71.29 commissioner may authorize contracted providers other than the 71.30 county. Providers contracted by the commissioner shall also be 71.31 subject to the standards in subdivision 6. 71.32 [EFFECTIVE DATE.] This section is effective January 1, 2002. 71.33 Sec. 14. [256B.55] [DENTAL ACCESS ADVISORY COMMITTEE.] 71.34 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 71.35 establish a dental access advisory committee to monitor the 71.36 purchasing, administration, and coverage of dental care services 72.1 for the public health care programs to ensure dental care access 72.2 and quality for public program recipients. 72.3 Subd. 2. [MEMBERSHIP.] (a) The membership of the advisory 72.4 committee shall include, but is not limited to, representatives 72.5 of dentists, including a dentist practicing in the seven-county 72.6 metropolitan area and a dentist practicing outside the 72.7 seven-county metropolitan area; oral surgeons; pediatric 72.8 dentists; dental hygienists; community clinics; client advocacy 72.9 groups; public health; health service plans; the University of 72.10 Minnesota school of dentistry and the department of pediatrics; 72.11 and the commissioner of health. 72.12 (b) The advisory committee is governed by section 15.059 72.13 for membership terms and removal of members. Members shall not 72.14 receive per diem compensation or reimbursement for expenses. 72.15 Subd. 3. [DUTIES.] The advisory committee shall provide 72.16 recommendations on the following: 72.17 (1) how to reduce the administrative burden governing 72.18 dental care coverage policies in order to promote administrative 72.19 simplification, including prior authorization, coverage limits, 72.20 and co-payment collections; 72.21 (2) developing and implementing an action plan to improve 72.22 the oral health of children and persons with special needs in 72.23 the state; 72.24 (3) exploring alternative ways of purchasing and improving 72.25 access to dental services; 72.26 (4) developing ways to foster greater responsibility among 72.27 health care program recipients in seeking and obtaining dental 72.28 care, including initiatives to keep dental appointments and 72.29 comply with dental care plans; 72.30 (5) exploring innovative ways for dental providers to 72.31 schedule public program patients in order to reduce or minimize 72.32 the effect of appointment no shows; 72.33 (6) exploring ways to meet the barriers that may be present 72.34 in providing dental services to health care program recipients 72.35 such as language, culture, disability, and lack of 72.36 transportation; and 73.1 (7) exploring the possibility of pediatricians, family 73.2 physicians, and nurse practitioners providing basic oral health 73.3 screenings and basic preventive dental services. 73.4 Subd. 4. [REPORT.] The commissioner shall submit a report 73.5 by February 1, 2002, and by February 1, 2003, summarizing the 73.6 activities and recommendations of the advisory committee. 73.7 Subd. 5. [SUNSET.] Notwithstanding section 15.059, 73.8 subdivision 5, this section expires June 30, 2003. 73.9 Sec. 15. Minnesota Statutes 2000, section 256B.69, is 73.10 amended by adding a subdivision to read: 73.11 Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The 73.12 commissioner shall establish a dental services demonstration 73.13 project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 73.14 for provision of dental services to medical assistance, general 73.15 assistance medical care, and MinnesotaCare recipients. The 73.16 commissioner may contract on a prospective per capita payment 73.17 basis for these dental services with an organization licensed 73.18 under chapter 62C, 62D, or 62N in accordance with section 73.19 256B.037 or may establish and administer a fee-for-service 73.20 system for the reimbursement of dental services. 73.21 Sec. 16. Minnesota Statutes 2000, section 256B.69, 73.22 subdivision 23, is amended to read: 73.23 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 73.24 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 73.25 implement demonstration projects to create alternative 73.26 integrated delivery systems for acute and long-term care 73.27 services to elderly persons and persons with disabilities as 73.28 defined in section 256B.77, subdivision 7a, that provide 73.29 increased coordination, improve access to quality services, and 73.30 mitigate future cost increases. The commissioner may seek 73.31 federal authority to combine Medicare and Medicaid capitation 73.32 payments for the purpose of such demonstrations. Medicare funds 73.33 and services shall be administered according to the terms and 73.34 conditions of the federal waiver and demonstration provisions. 73.35 For the purpose of administering medical assistance funds, 73.36 demonstrations under this subdivision are subject to 74.1 subdivisions 1 to 22. The provisions of Minnesota Rules, parts 74.2 9500.1450 to 9500.1464, apply to these demonstrations, with the 74.3 exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 74.4 subpart 1, items B and C, which do not apply to persons 74.5 enrolling in demonstrations under this section. An initial open 74.6 enrollment period may be provided. Persons who disenroll from 74.7 demonstrations under this subdivision remain subject to 74.8 Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is 74.9 enrolled in a health plan under these demonstrations and the 74.10 health plan's participation is subsequently terminated for any 74.11 reason, the person shall be provided an opportunity to select a 74.12 new health plan and shall have the right to change health plans 74.13 within the first 60 days of enrollment in the second health 74.14 plan. Persons required to participate in health plans under 74.15 this section who fail to make a choice of health plan shall not 74.16 be randomly assigned to health plans under these demonstrations. 74.17 Notwithstanding section 256L.12, subdivision 5, and Minnesota 74.18 Rules, part 9505.5220, subpart 1, item A, if adopted, for the 74.19 purpose of demonstrations under this subdivision, the 74.20 commissioner may contract with managed care organizations, 74.21 including counties, to serve only elderly persons eligible for 74.22 medical assistance, elderly and disabled persons, or disabled 74.23 persons only. For persons with primary diagnoses of mental 74.24 retardation or a related condition, serious and persistent 74.25 mental illness, or serious emotional disturbance, the 74.26 commissioner must ensure that the county authority has approved 74.27 the demonstration and contracting design. Enrollment in these 74.28 projects for persons with disabilities shall be voluntaryuntil74.29July 1, 2001. The commissioner shall not implement any 74.30 demonstration project under this subdivision for persons with 74.31 primary diagnoses of mental retardation or a related condition, 74.32 serious and persistent mental illness, or serious emotional 74.33 disturbance, without approval of the county board of the county 74.34 in which the demonstration is being implemented. 74.35 Before implementation of a demonstration project for 74.36 disabled persons, the commissioner must provide information to 75.1 appropriate committees of the house of representatives and 75.2 senate and must involve representatives of affected disability 75.3 groups in the design of the demonstration projects. 75.4 (b) A nursing facility reimbursed under the alternative 75.5 reimbursement methodology in section 256B.434 may, in 75.6 collaboration with a hospital, clinic, or other health care 75.7 entity provide services under paragraph (a). The commissioner 75.8 shall amend the state plan and seek any federal waivers 75.9 necessary to implement this paragraph. 75.10 Sec. 17. Minnesota Statutes 2000, section 256B.75, is 75.11 amended to read: 75.12 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 75.13 (a) For outpatient hospital facility fee payments for 75.14 services rendered on or after October 1, 1992, the commissioner 75.15 of human services shall pay the lower of (1) submitted charge, 75.16 or (2) 32 percent above the rate in effect on June 30, 1992, 75.17 except for those services for which there is a federal maximum 75.18 allowable payment. Effective for services rendered on or after 75.19 January 1, 2000, payment rates for nonsurgical outpatient 75.20 hospital facility fees and emergency room facility fees shall be 75.21 increased by eight percent over the rates in effect on December 75.22 31, 1999, except for those services for which there is a federal 75.23 maximum allowable payment. Services for which there is a 75.24 federal maximum allowable payment shall be paid at the lower of 75.25 (1) submitted charge, or (2) the federal maximum allowable 75.26 payment. Total aggregate payment for outpatient hospital 75.27 facility fee services shall not exceed the Medicare upper 75.28 limit. If it is determined that a provision of this section 75.29 conflicts with existing or future requirements of the United 75.30 States government with respect to federal financial 75.31 participation in medical assistance, the federal requirements 75.32 prevail. The commissioner may, in the aggregate, prospectively 75.33 reduce payment rates to avoid reduced federal financial 75.34 participation resulting from rates that are in excess of the 75.35 Medicare upper limitations. 75.36 (b) Notwithstanding paragraph (a), payment for outpatient, 76.1 emergency, and ambulatory surgery hospital facility fee services 76.2 for critical access hospitals designated under section 144.1483, 76.3 clause (11), shall be paid on a cost-based payment system that 76.4 is based on the cost-finding methods and allowable costs of the 76.5 Medicare program. 76.6 (c) Effective for services provided on or after July 1, 76.7 2002, rates that are based on the Medicare outpatient 76.8 prospective payment system shall be replaced by a budget neutral 76.9 prospective payment system that is derived using medical 76.10 assistance data. The commissioner shall provide a proposal to 76.11 the 2002 legislature to define and implement this provision. 76.12 Sec. 18. Minnesota Statutes 2000, section 256L.05, 76.13 subdivision 2, is amended to read: 76.14 Subd. 2. [COMMISSIONER'S DUTIES.] The commissionershall76.15use individuals' social security numbers as identifiers for76.16purposes of administering the plan and conduct data matches to76.17verify income. Applicants shall submit evidence of individual76.18and family income, earned and unearned, such as the most recent76.19income tax return, wage slips, or other documentation that is76.20determined by the commissioner as necessary to verify income76.21eligibilityor county agency shall use electronic verification 76.22 as the primary method of income verification. If there is a 76.23 discrepancy between reported income and electronically verified 76.24 income, an individual may be required to submit additional 76.25 verification. In addition, the commissioner shall perform 76.26 random audits to verify reported income and eligibility. The 76.27 commissioner may execute data sharing arrangements with the 76.28 department of revenue and any other governmental agency in order 76.29 to perform income verification related to eligibility and 76.30 premium payment under the MinnesotaCare program. 76.31 Sec. 19. Minnesota Statutes 2000, section 256L.06, 76.32 subdivision 3, is amended to read: 76.33 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 76.34 Premiums are dedicated to the commissioner for MinnesotaCare. 76.35 (b) The commissioner shall develop and implement procedures 76.36 to: (1) require enrollees to report changes in income; (2) 77.1 adjust sliding scale premium payments, based upon changes in 77.2 enrollee income; and (3) disenroll enrollees from MinnesotaCare 77.3 for failure to pay required premiums. Failure to pay includes 77.4 payment with a dishonored check, a returned automatic bank 77.5 withdrawal, or a refused credit card or debit card payment. The 77.6 commissioner may demand a guaranteed form of payment, including 77.7 a cashier's check or a money order, as the only means to replace 77.8 a dishonored, returned, or refused payment. 77.9 (c) Premiums are calculated on a calendar month basis and 77.10 may be paid on a monthly, quarterly, or annual basis, with the 77.11 first payment due upon notice from the commissioner of the 77.12 premium amount required. The commissioner shall inform 77.13 applicants and enrollees of these premium payment options. 77.14 Premium payment is required before enrollment is complete and to 77.15 maintain eligibility in MinnesotaCare. 77.16 (d) Nonpayment of the premium will result in disenrollment 77.17 from the planwithin one calendar month after the due date77.18 effective for the calendar month for which the premium was due. 77.19 Persons disenrolled for nonpayment or who voluntarily terminate 77.20 coverage from the program may not reenroll until four calendar 77.21 months have elapsed. Persons disenrolled for nonpayment who pay 77.22 all past due premiums as well as current premiums due, including 77.23 premiums due for the period of disenrollment, within 20 days of 77.24 disenrollment, shall be reenrolled retroactively to the first 77.25 day of disenrollment. Persons disenrolled for nonpayment or who 77.26 voluntarily terminate coverage from the program may not reenroll 77.27 for four calendar months unless the person demonstrates good 77.28 cause for nonpayment. Good cause does not exist if a person 77.29 chooses to pay other family expenses instead of the premium. 77.30 The commissioner shall define good cause in rule. 77.31 [EFFECTIVE DATE.] This section is effective July 1, 2002. 77.32 Sec. 20. Minnesota Statutes 2000, section 256L.12, is 77.33 amended by adding a subdivision to read: 77.34 Subd. 11. [COVERAGE AT INDIAN HEALTH SERVICE 77.35 FACILITIES.] For American Indian enrollees of MinnesotaCare, 77.36 MinnesotaCare shall cover health care services provided at 78.1 Indian Health Service facilities and facilities operated by a 78.2 tribe or tribal organization under funding authorized by United 78.3 States Code, title 25, sections 450f to 450n, or title III of 78.4 the Indian Self-Determination and Education Act, Public Law 78.5 Number 93-638, if those services would otherwise be covered 78.6 under section 256L.03. Payments for services provided under 78.7 this subdivision shall be made on a fee-for-service basis, and 78.8 may, at the option of the tribe or organization, be made at the 78.9 rates authorized under sections 256.969, subdivision 16, and 78.10 256B.0625, subdivision 34, for those MinnesotaCare enrollees 78.11 eligible for coverage at medical assistance rates. For purposes 78.12 of this subdivision, "American Indian" has the meaning given to 78.13 persons to whom services will be provided for in the Code of 78.14 Federal Regulations, title 42, section 36.12. 78.15 [EFFECTIVE DATE.] This section is effective the day 78.16 following final enactment. 78.17 Sec. 21. Laws 1999, chapter 245, article 4, section 110, 78.18 is amended to read: 78.19 Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.] 78.20 The commissioner of human services shall study the 78.21 eligibility criteria of and benefits provided to persons age 65 78.22 and over through the array of cash assistance and health care 78.23 programs administered by the department, and the extent to which 78.24 these programs can be combined, simplified, or coordinated to 78.25 reduce administrative costs and improve access. The 78.26 commissioner shall also study potential barriers to enrollment 78.27 for low-income seniors who would otherwise deplete resources 78.28 necessary to maintain independent community living. At a 78.29 minimum, the study must include an evaluation of asset 78.30 requirements and enrollment sites. The commissioner shall 78.31 report study findings and recommendations to the legislature by 78.32June 30, 2001January 15, 2002. 78.33 Sec. 22. [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE 78.34 PROGRAM PROVIDERS.] 78.35 The commissioner of human services, in consultation with 78.36 providers participating in state health care programs, shall 79.1 identify nonfinancial barriers to increased provider enrollment 79.2 and provider retention in state health care programs, and shall 79.3 implement procedures to address these barriers. Areas to be 79.4 examined by the commissioner shall include, but are not limited 79.5 to, regulatory complexity and inconsistencies between state 79.6 health care programs, provider requirements, provision of 79.7 technical assistance to providers, responsiveness to provider 79.8 inquiries and complaints, claims processing turnaround times, 79.9 and policies for rejecting provider claims. The commissioner 79.10 shall report to the legislature by February 15, 2002, on any 79.11 changes to the administration of state health care programs that 79.12 will be implemented as a result of the study, and present 79.13 recommendations for any necessary changes in state law. 79.14 ARTICLE 3 79.15 CONTINUING CARE 79.16 Section 1. Minnesota Statutes 2000, section 245A.13, 79.17 subdivision 7, is amended to read: 79.18 Subd. 7. [RATE RECOMMENDATION.] The commissioner of human 79.19 services may review rates of a residential program participating 79.20 in the medical assistance program which is in receivership and 79.21 that has needs or deficiencies documented by the department of 79.22 health or the department of human services. If the commissioner 79.23 of human services determines that a review of the rate 79.24 established undersection 256B.501sections 256B.5012 and 79.25 256B.5013 is needed, the commissioner shall: 79.26 (1) review the order or determination that cites the 79.27 deficiencies or needs; and 79.28 (2) determine the need for additional staff, additional 79.29 annual hours by type of employee, and additional consultants, 79.30 services, supplies, equipment, repairs, or capital assets 79.31 necessary to satisfy the needs or deficiencies. 79.32 Sec. 2. Minnesota Statutes 2000, section 245A.13, 79.33 subdivision 8, is amended to read: 79.34 Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates 79.35 under subdivision 7, the commissioner may adjust the residential 79.36 program's payment rate. The commissioner shall review the 80.1 circumstances, together with the residentialprogram cost report80.2 program's most recent income and expense report, to determine 80.3 whether or not the deficiencies or needs can be corrected or met 80.4 by reallocating residential program staff, costs, revenues, 80.5 or any other resources includinganyinvestments, efficiency80.6incentives, or allowances. If the commissioner determines that 80.7 any deficiency cannot be corrected or the need cannot be met 80.8 with the payment rate currently being paid, the commissioner 80.9 shall determine the payment rate adjustment by dividing the 80.10 additional annual costs established during the commissioner's 80.11 review by the residential program's actual resident days from 80.12 the most recentdesk-audited costincome and expense report or 80.13 the estimated resident days in the projected receivership 80.14 period. The payment rate adjustmentmust meet the conditions in80.15Minnesota Rules, parts 9553.0010 to 9553.0080, andremains in 80.16 effect during the period of the receivership or until another 80.17 date set by the commissioner. Upon the subsequent sale, 80.18 closure, or transfer of the residential program, the 80.19 commissioner may recover amounts that were paid as payment rate 80.20 adjustments under this subdivision. This recovery shall be 80.21 determined through a review of actual costs and resident days in 80.22 the receivership period. The costs the commissioner finds to be 80.23 allowable shall be divided by the actual resident days for the 80.24 receivership period. This rate shall be compared to the rate 80.25 paid throughout the receivership period, with the difference 80.26 multiplied by resident days, being the amount to be repaid to 80.27 the commissioner. Allowable costs shall be determined by the 80.28 commissioner as those ordinary, necessary, and related to 80.29 resident care by prudent and cost-conscious management. The 80.30 buyer or transferee shall repay this amount to the commissioner 80.31 within 60 days after the commissioner notifies the buyer or 80.32 transferee of the obligation to repay. This provision does not 80.33 limit the liability of the seller to the commissioner pursuant 80.34 to section 256B.0641. 80.35 Sec. 3. Minnesota Statutes 2000, section 252.275, 80.36 subdivision 4b, is amended to read: 81.1 Subd. 4b. [GUARANTEED FLOOR.] Each countywith an original81.2allocation for the preceding year that is equal to or less than81.3the guaranteed floor minimum index shall have a guaranteed floor81.4equal to its original allocation for the preceding year. Each81.5county with an original allocation for the preceding year that81.6is greater than the guaranteed floor minimum indexshall have a 81.7 guaranteed floor equal to the lesser of clause (1) or (2): 81.8 (1) the county's original allocation for the preceding 81.9 year; or 81.10 (2) 70 percent of the county's reported expenditures 81.11 eligible for reimbursement during the 12 months ending on June 81.12 30 of the preceding calendar year. 81.13For calendar year 1993, the guaranteed floor minimum index81.14shall be $20,000. For each subsequent year, the index shall be81.15adjusted by the projected change in the average value in the81.16United States Department of Labor Bureau of Labor Statistics81.17consumer price index (all urban) for that year.81.18 Notwithstanding this subdivision, no county shall be 81.19 allocated a guaranteed floor of less than $1,000. 81.20 When the amount of funds available for allocation is less 81.21 than the amount available in the previous year, each county's 81.22 previous year allocation shall be reduced in proportion to the 81.23 reduction in the statewide funding, to establish each county's 81.24 guaranteed floor. 81.25 Sec. 4. Minnesota Statutes 2000, section 254B.09, is 81.26 amended by adding a subdivision to read: 81.27 Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 81.28 INDIANS.] The commissioner may set rates for chemical dependency 81.29 services according to the American Indian Health Improvement 81.30 Act, Public Law Number 94-437, for eligible vendors. These 81.31 rates shall supersede rates set in county purchase of service 81.32 agreements when payments are made on behalf of clients eligible 81.33 according to Public Law Number 94-437. 81.34 Sec. 5. Minnesota Statutes 2000, section 256.01, is 81.35 amended by adding a subdivision to read: 81.36 Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 82.1 WITH HIV OR AIDS.] The commissioner may award grants to eligible 82.2 vendors for the development, implementation, and evaluation of 82.3 case management services for individuals infected with the human 82.4 immunodeficiency virus. HIV/AIDs case management services will 82.5 be provided to increase access to cost effective health care 82.6 services, to reduce the risk of HIV transmission, to ensure that 82.7 basic client needs are met, and to increase client access to 82.8 needed community supports or services. 82.9 Sec. 6. Minnesota Statutes 2000, section 256.476, 82.10 subdivision 1, is amended to read: 82.11 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 82.12 human services shall establish a consumer support grant 82.13 programto assistfor individuals with functional limitations 82.14 and their familiesin purchasing and securing supports which the82.15individuals need to live as independently and productively in82.16the community as possiblewho wish to purchase and secure their 82.17 own supports. The commissioner and local agencies shall jointly 82.18 develop an implementation plan which must include a way to 82.19 resolve the issues related to county liability. The program 82.20 shall: 82.21 (1) make support grants or exception grants described in 82.22 subdivision 11 available to individuals or families as an 82.23 effective alternative to existing programs and services, such as 82.24 the developmental disability family support program,the82.25alternative care program,personal care attendant services, home 82.26 health aide services, and private duty nursingfacility82.27 services; 82.28 (2) provide consumers more control, flexibility, and 82.29 responsibility overthe needed supportstheir services and 82.30 supports; 82.31 (3) promote local program management and decision making; 82.32 and 82.33 (4) encourage the use of informal and typical community 82.34 supports. 82.35 Sec. 7. Minnesota Statutes 2000, section 256.476, 82.36 subdivision 2, is amended to read: 83.1 Subd. 2. [DEFINITIONS.] For purposes of this section, the 83.2 following terms have the meanings given them: 83.3 (a) "County board" means the county board of commissioners 83.4 for the county of financial responsibility as defined in section 83.5 256G.02, subdivision 4, or its designated representative. When 83.6 a human services board has been established under sections 83.7 402.01 to 402.10, it shall be considered the county board for 83.8 the purposes of this section. 83.9 (b) "Family" means the person's birth parents, adoptive 83.10 parents or stepparents, siblings or stepsiblings, children or 83.11 stepchildren, grandparents, grandchildren, niece, nephew, aunt, 83.12 uncle, or spouse. For the purposes of this section, a family 83.13 member is at least 18 years of age. 83.14 (c) "Functional limitations" means the long-term inability 83.15 to perform an activity or task in one or more areas of major 83.16 life activity, including self-care, understanding and use of 83.17 language, learning, mobility, self-direction, and capacity for 83.18 independent living. For the purpose of this section, the 83.19 inability to perform an activity or task results from a mental, 83.20 emotional, psychological, sensory, or physical disability, 83.21 condition, or illness. 83.22 (d) "Informed choice" means a voluntary decision made by 83.23 the person or the person's legal representative, after becoming 83.24 familiarized with the alternatives to: 83.25 (1) select a preferred alternative from a number of 83.26 feasible alternatives; 83.27 (2) select an alternative which may be developed in the 83.28 future; and 83.29 (3) refuse any or all alternatives. 83.30 (e) "Local agency" means the local agency authorized by the 83.31 county board or, for counties not participating in the consumer 83.32 grant program by July 1, 2002, the commissioner, to carry out 83.33 the provisions of this section. 83.34 (f) "Person" or "persons" means a person or persons meeting 83.35 the eligibility criteria in subdivision 3. 83.36 (g) "Authorized representative" means an individual 84.1 designated by the person or their legal representative to act on 84.2 their behalf. This individual may be a family member, guardian, 84.3 representative payee, or other individual designated by the 84.4 person or their legal representative, if any, to assist in 84.5 purchasing and arranging for supports. For the purposes of this 84.6 section, an authorized representative is at least 18 years of 84.7 age. 84.8 (h) "Screening" means the screening of a person's service 84.9 needs under sections 256B.0911 and 256B.092. 84.10 (i) "Supports" means services, care, aids,home84.11 environmental modifications, or assistance purchased by the 84.12 person or the person's family. Examples of supports include 84.13 respite care, assistance with daily living, andadaptive aids84.14 assistive technology. For the purpose of this section, 84.15 notwithstanding the provisions of section 144A.43, supports 84.16 purchased under the consumer support program are not considered 84.17 home care services. 84.18 (j) "Program of origination" means the program the 84.19 individual transferred from when approved for the consumer 84.20 support grant program. 84.21 Sec. 8. Minnesota Statutes 2000, section 256.476, 84.22 subdivision 3, is amended to read: 84.23 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 84.24 is eligible to apply for a consumer support grant if the person 84.25 meets all of the following criteria: 84.26 (1) the person is eligible for and has been approved to 84.27 receive services under medical assistance as determined under 84.28 sections 256B.055 and 256B.056or the person is eligible for and84.29has been approved to receive services under alternative care84.30services as determined under section 256B.0913or the person has 84.31 been approved to receive a grant under the developmental 84.32 disability family support program under section 252.32; 84.33 (2) the person is able to direct and purchase the person's 84.34 own care and supports, or the person has a family member, legal 84.35 representative, or other authorized representative who can 84.36 purchase and arrange supports on the person's behalf; 85.1 (3) the person has functional limitations, requires ongoing 85.2 supports to live in the community, and is at risk of or would 85.3 continue institutionalization without such supports; and 85.4 (4) the person will live in a home. For the purpose of 85.5 this section, "home" means the person's own home or home of a 85.6 person's family member. These homes are natural home settings 85.7 and are not licensed by the department of health or human 85.8 services. 85.9 (b) Persons may not concurrently receive a consumer support 85.10 grant if they are: 85.11 (1) receiving home and community-based services under 85.12 United States Code, title 42, section 1396h(c); personal care 85.13 attendant and home health aide services under section 256B.0625; 85.14 a developmental disability family support grant; or alternative 85.15 care services under section 256B.0913; or 85.16 (2) residing in an institutional or congregate care setting. 85.17 (c) A person or person's family receiving a consumer 85.18 support grant shall not be charged a fee or premium by a local 85.19 agency for participating in the program. 85.20 (d) The commissioner may limit the participation ofnursing85.21facility residents, residents of intermediate care facilities85.22for persons with mental retardation, and therecipients of 85.23 services from federal waiver programs in the consumer support 85.24 grant program if the participation of these individuals will 85.25 result in an increase in the cost to the state. 85.26 (e) The commissioner shall establish a budgeted 85.27 appropriation each fiscal year for the consumer support grant 85.28 program. The number of individuals participating in the program 85.29 will be adjusted so the total amount allocated to counties does 85.30 not exceed the amount of the budgeted appropriation. The 85.31 budgeted appropriation will be adjusted annually to accommodate 85.32 changes in demand for the consumer support grants. 85.33 Sec. 9. Minnesota Statutes 2000, section 256.476, 85.34 subdivision 4, is amended to read: 85.35 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 85.36 county board may choose to participate in the consumer support 86.1 grant program. If a countyboard chooses to participate in the86.2program,has not chosen to participate by July 1, 2002, the 86.3 commissioner shall contract with another county or other entity 86.4 to provide access to residents of the nonparticipating county 86.5 who choose the consumer support grant option. The commissioner 86.6 shall notify the county board in a county that has declined to 86.7 participate of the commissioner's intent to enter into a 86.8 contract with another county or other entity at least 30 days in 86.9 advance of entering into the contract. The local agency shall 86.10 establish written procedures and criteria to determine the 86.11 amount and use of support grants. These procedures must 86.12 include, at least, the availability of respite care, assistance 86.13 with daily living, and adaptive aids. The local agency may 86.14 establish monthly or annual maximum amounts for grants and 86.15 procedures where exceptional resources may be required to meet 86.16 the health and safety needs of the person on a time-limited 86.17 basis, however, the total amount awarded to each individual may 86.18 not exceed the limits established insubdivision 5, paragraph86.19(f)subdivision 11. 86.20 (b) Support grants to a person or a person's family will be 86.21 provided through a monthly subsidy payment and be in the form of 86.22 cash, voucher, or direct county payment to vendor. Support 86.23 grant amounts must be determined by the local agency. Each 86.24 service and item purchased with a support grant must meet all of 86.25 the following criteria: 86.26 (1) it must be over and above the normal cost of caring for 86.27 the person if the person did not have functional limitations; 86.28 (2) it must be directly attributable to the person's 86.29 functional limitations; 86.30 (3) it must enable the person or the person's family to 86.31 delay or prevent out-of-home placement of the person; and 86.32 (4) it must be consistent with the needs identified in the 86.33 service plan, when applicable. 86.34 (c) Items and services purchased with support grants must 86.35 be those for which there are no other public or private funds 86.36 available to the person or the person's family. Fees assessed 87.1 to the person or the person's family for health and human 87.2 services are not reimbursable through the grant. 87.3 (d) In approving or denying applications, the local agency 87.4 shall consider the following factors: 87.5 (1) the extent and areas of the person's functional 87.6 limitations; 87.7 (2) the degree of need in the home environment for 87.8 additional support; and 87.9 (3) the potential effectiveness of the grant to maintain 87.10 and support the person in the family environment or the person's 87.11 own home. 87.12 (e) At the time of application to the program or screening 87.13 for other services, the person or the person's family shall be 87.14 provided sufficient information to ensure an informed choice of 87.15 alternatives by the person, the person's legal representative, 87.16 if any, or the person's family. The application shall be made 87.17 to the local agency and shall specify the needs of the person 87.18 and family, the form and amount of grant requested, the items 87.19 and services to be reimbursed, and evidence of eligibility for 87.20 medical assistanceor alternative care program. 87.21 (f) Upon approval of an application by the local agency and 87.22 agreement on a support plan for the person or person's family, 87.23 the local agency shall make grants to the person or the person's 87.24 family. The grant shall be in an amount for the direct costs of 87.25 the services or supports outlined in the service agreement. 87.26 (g) Reimbursable costs shall not include costs for 87.27 resources already available, such as special education classes, 87.28 day training and habilitation, case management, other services 87.29 to which the person is entitled, medical costs covered by 87.30 insurance or other health programs, or other resources usually 87.31 available at no cost to the person or the person's family. 87.32 (h) The state of Minnesota, the county boards participating 87.33 in the consumer support grant program, or the agencies acting on 87.34 behalf of the county boards in the implementation and 87.35 administration of the consumer support grant program shall not 87.36 be liable for damages, injuries, or liabilities sustained 88.1 through the purchase of support by the individual, the 88.2 individual's family, or the authorized representative under this 88.3 section with funds received through the consumer support grant 88.4 program. Liabilities include but are not limited to: workers' 88.5 compensation liability, the Federal Insurance Contributions Act 88.6 (FICA), or the Federal Unemployment Tax Act (FUTA). For 88.7 purposes of this section, participating county boards and 88.8 agencies acting on behalf of county boards are exempt from the 88.9 provisions of section 268.04. 88.10 Sec. 10. Minnesota Statutes 2000, section 256.476, 88.11 subdivision 5, is amended to read: 88.12 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 88.13 For the purpose of transferring persons to the consumer support 88.14 grant program from specific programs or services, such as the 88.15 developmental disability family support program andalternative88.16care program,personal careattendantassistant services, home 88.17 health aide services, ornursing facilityprivate duty nursing 88.18 services, the amount of funds transferred by the commissioner 88.19 between the developmental disability family support program 88.20 account,the alternative care account,the medical assistance 88.21 account, or the consumer support grant account shall be based on 88.22 each county's participation in transferring persons to the 88.23 consumer support grant program from those programs and services. 88.24 (b) At the beginning of each fiscal year, county 88.25 allocations for consumer support grants shall be based on: 88.26 (1) the number of persons to whom the county board expects 88.27 to provide consumer supports grants; 88.28 (2) their eligibility for current program and services; 88.29 (3) the amount of nonfederal dollarsexpended on those88.30individuals for those programs and services or, in situations88.31where an individual is unable to obtain the support needed from88.32the program of origination due to the unavailability of service88.33providers at the time or the location where the supports are88.34needed, the allocation will be based on the county's best88.35estimate of the nonfederal dollars that would have been expended88.36if the services had been availableallowed under subdivision 11; 89.1 and 89.2 (4) projected dates when persons will start receiving 89.3 grants. County allocations shall be adjusted periodically by 89.4 the commissioner based on the actual transfer of persons or 89.5 service openings, and the nonfederal dollars associated with 89.6 those persons or service openings, to the consumer support grant 89.7 program. 89.8 (c) The amount of funds transferred by the commissioner 89.9 fromthe alternative care account andthe medical assistance 89.10 account for an individual may be changed if it is determined by 89.11 the county or its agent that the individual's need for support 89.12 has changed. 89.13 (d) The authority to utilize funds transferred to the 89.14 consumer support grant account for the purposes of implementing 89.15 and administering the consumer support grant program will not be 89.16 limited or constrained by the spending authority provided to the 89.17 program of origination. 89.18 (e) The commissionershallmay use up to five percent of 89.19 each county's allocation, as adjusted, for paymentsto that89.20countyfor administrative expenses, to be paid as a 89.21 proportionate addition to reported direct service expenditures. 89.22 (f)Except as provided in this paragraph,The county 89.23 allocation for each individual or individual's family cannot 89.24 exceed80 percent of the total nonfederal dollars expended on89.25the individual by the program of origination except for the89.26developmental disabilities family support grant program which89.27can be approved up to 100 percent of the nonfederal dollars and89.28in situations as described in paragraph (b), clause (3). In89.29situations where exceptional need exists or the individual's89.30need for support increases, up to 100 percent of the nonfederal89.31dollars expended may be allocated to the county. Allocations89.32that exceed 80 percent of the nonfederal dollars expended on the89.33individual by the program of origination must be approved by the89.34commissioner. The remainder of the amount expended on the89.35individual by the program of origination will be used in the89.36following proportions: half will be made available to the90.1consumer support grant program and participating counties for90.2consumer training, resource development, and other costs, and90.3half will be returned to the state general fundthe amount 90.4 allowed under subdivision 11. 90.5 (g) The commissioner may recover, suspend, or withhold 90.6 payments if the county board, local agency, or grantee does not 90.7 comply with the requirements of this section. 90.8 (h) Grant funds unexpended by consumers shall return to the 90.9 state once a year. The annual return of unexpended grant funds 90.10 shall occur in the quarter following the end of the state fiscal 90.11 year. 90.12 Sec. 11. Minnesota Statutes 2000, section 256.476, 90.13 subdivision 8, is amended to read: 90.14 Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner 90.15 shall: 90.16 (1) transfer and allocate funds pursuant tothis90.17sectionsubdivision 11; 90.18 (2) determine allocations based on projected and actual 90.19 local agency use; 90.20 (3) monitor and oversee overall program spending; 90.21 (4) evaluate the effectiveness of the program; 90.22 (5) provide training and technical assistance for local 90.23 agencies and consumers to help identify potential applicants to 90.24 the program; and 90.25 (6) develop guidelines for local agency program 90.26 administration and consumer information; and90.27(7) apply for a federal waiver or take any other action90.28necessary to maximize federal funding for the program by90.29September 1, 1999. 90.30 Sec. 12. Minnesota Statutes 2000, section 256.476, is 90.31 amended by adding a subdivision to read: 90.32 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 90.33 2001.] (a) Effective July 1, 2001, the commissioner shall 90.34 allocate consumer support grant resources to serve additional 90.35 individuals based on a review of Medicaid authorization and 90.36 payment information of persons eligible for a consumer support 91.1 grant from the most recent fiscal year. The commissioner shall 91.2 use the following methodology to calculate maximum allowable 91.3 monthly consumer support grant levels: 91.4 (1) for individuals whose program of origination is medical 91.5 assistance home care under section 256B.0627, the maximum 91.6 allowable monthly grant levels are calculated by: 91.7 (i) determining the nonfederal share of the average service 91.8 authorization for each home care rating; 91.9 (ii) calculating the overall ratio of actual payments to 91.10 service authorizations by program; 91.11 (iii) applying the overall ratio to the average service 91.12 authorization level of each home care rating; 91.13 (iv) adjusting the result for any authorized rate increases 91.14 provided by the legislature; and 91.15 (v) adjusting the result for the average monthly 91.16 utilization per recipient; and 91.17 (2) for persons with programs of origination other than the 91.18 program described in clause (1), the maximum grant level for an 91.19 individual shall not exceed the total of the nonfederal dollars 91.20 expended on the individual by the program of origination. 91.21 (b) Persons receiving consumer support grants prior to July 91.22 1, 2001, may continue to receive the grant amount established 91.23 prior to July 1, 2001. 91.24 (c) The commissioner may provide up to 200 exception 91.25 grants, including grants in use under paragraph (b). Eligible 91.26 persons shall be provided an exception grant in priority order 91.27 based upon the date of the commissioner's receipt of the county 91.28 request. The maximum allowable grant level for an exception 91.29 grant shall be based upon the nonfederal share of the average 91.30 service authorization from the most recent fiscal year for each 91.31 home care rating category. The amount of each exception grant 91.32 shall be based upon the commissioner's determination of the 91.33 nonfederal dollars that would have been expended if services had 91.34 been available for an individual who is unable to obtain the 91.35 support needed from the program of origination due to the 91.36 unavailability of qualified service providers at the time or the 92.1 location where the supports are needed. 92.2 Sec. 13. Minnesota Statutes 2000, section 256B.0625, 92.3 subdivision 7, is amended to read: 92.4 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 92.5 private duty nursing services in a recipient's home. Recipients 92.6 who are authorized to receive private duty nursing services in 92.7 their home may use approved hours outside of the home during 92.8 hours when normal life activities take them outside of their 92.9 homeand when, without the provision of private duty nursing,92.10their health and safety would be jeopardized. To use private 92.11 duty nursing services at school, the recipient or responsible 92.12 party must provide written authorization in the care plan 92.13 identifying the chosen provider and the daily amount of services 92.14 to be used at school. Medical assistance does not cover private 92.15 duty nursing services for residents of a hospital, nursing 92.16 facility, intermediate care facility, or a health care facility 92.17 licensed by the commissioner of health, except as authorized in 92.18 section 256B.64 for ventilator-dependent recipients in hospitals 92.19 or unless a resident who is otherwise eligible is on leave from 92.20 the facility and the facility either pays for the private duty 92.21 nursing services or forgoes the facility per diem for the leave 92.22 days that private duty nursing services are used. Total hours 92.23 of service and payment allowed for services outside the home 92.24 cannot exceed that which is otherwise allowed in an in-home 92.25 setting according to section 256B.0627. All private duty 92.26 nursing services must be provided according to the limits 92.27 established under section 256B.0627. Private duty nursing 92.28 services may not be reimbursed if the nurse is thespouse of the92.29recipient or the parent orfoster care provider of a recipient 92.30 who is under age 18, or the recipient's legal guardian. 92.31 Sec. 14. Minnesota Statutes 2000, section 256B.0625, 92.32 subdivision 19a, is amended to read: 92.33 Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical 92.34 assistance covers personal care assistant services in a 92.35 recipient's home. To qualify for personal care assistant 92.36 services, recipients or responsible parties must be able to 93.1 identify the recipient's needs, direct and evaluate task 93.2 accomplishment, and provide for health and safety. Approved 93.3 hours may be used outside the home when normal life activities 93.4 take them outside the homeand when, without the provision of93.5personal care, their health and safety would be jeopardized. To 93.6 use personal care assistant services at school, the recipient or 93.7 responsible party must provide written authorization in the care 93.8 plan identifying the chosen provider and the daily amount of 93.9 services to be used at school. Total hours for services, 93.10 whether actually performed inside or outside the recipient's 93.11 home, cannot exceed that which is otherwise allowed for personal 93.12 care assistant services in an in-home setting according to 93.13 section 256B.0627. Medical assistance does not cover personal 93.14 care assistant services for residents of a hospital, nursing 93.15 facility, intermediate care facility, health care facility 93.16 licensed by the commissioner of health, or unless a resident who 93.17 is otherwise eligible is on leave from the facility and the 93.18 facility either pays for the personal care assistant services or 93.19 forgoes the facility per diem for the leave days that personal 93.20 care assistant services are used. All personal care assistant 93.21 services must be provided according to section 256B.0627. 93.22 Personal care assistant services may not be reimbursed if the 93.23 personal care assistant is the spouse or legal guardian of the 93.24 recipient or the parent of a recipient under age 18, or the 93.25 responsible party or the foster care provider of a recipient who 93.26 cannot direct the recipient's own care unless, in the case of a 93.27 foster care provider, a county or state case manager visits the 93.28 recipient as needed, but not less than every six months, to 93.29 monitor the health and safety of the recipient and to ensure the 93.30 goals of the care plan are met. Parents of adult recipients, 93.31 adult children of the recipient or adult siblings of the 93.32 recipient may be reimbursed for personal care assistant services 93.33if they are not the recipient's legal guardian and, if they are 93.34 granted a waiver under section 256B.0627.Until July 1, 2001,93.35andNotwithstanding the provisions of section 256B.0627, 93.36 subdivision 4, paragraph (b), clause (4), the noncorporate legal 94.1 guardian or conservator of an adult, who is not the responsible 94.2 party and not the personal care provider organization, may be 94.3 granted a hardship waiver under section 256B.0627, to be 94.4 reimbursed to provide personal care assistant services to the 94.5 recipient, and shall not be considered to have a service 94.6 provider interest for purposes of participation on the screening 94.7 team under section 256B.092, subdivision 7. 94.8 Sec. 15. Minnesota Statutes 2000, section 256B.0625, 94.9 subdivision 19c, is amended to read: 94.10 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 94.11 personal care assistant services provided by an individual who 94.12 is qualified to provide the services according to subdivision 94.13 19a and section 256B.0627, where the services are prescribed by 94.14 a physician in accordance with a plan of treatment and are 94.15 supervised by the recipientunder the fiscal agent option94.16according to section 256B.0627, subdivision 10,or a qualified 94.17 professional. "Qualified professional" means a mental health 94.18 professional as defined in section 245.462, subdivision 18, or 94.19 245.4871, subdivision 27; or a registered nurse as defined in 94.20 sections 148.171 to 148.285. As part of the assessment, the 94.21 county public health nurse willconsult withassist the 94.22 recipient or responsible partyandto identify the most 94.23 appropriate person to provide supervision of the personal care 94.24 assistant. The qualified professional shall perform the duties 94.25 described in Minnesota Rules, part 9505.0335, subpart 4. 94.26 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 94.27 subdivision 20, is amended to read: 94.28 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 94.29 extent authorized by rule of the state agency, medical 94.30 assistance covers case management services to persons with 94.31 serious and persistent mental illness and children with severe 94.32 emotional disturbance. Services provided under this section 94.33 must meet the relevant standards in sections 245.461 to 94.34 245.4888, the Comprehensive Adult and Children's Mental Health 94.35 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 94.36 9505.0322, excluding subpart 10. 95.1 (b) Entities meeting program standards set out in rules 95.2 governing family community support services as defined in 95.3 section 245.4871, subdivision 17, are eligible for medical 95.4 assistance reimbursement for case management services for 95.5 children with severe emotional disturbance when these services 95.6 meet the program standards in Minnesota Rules, parts 9520.0900 95.7 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 95.8 (c) Medical assistance and MinnesotaCare payment for mental 95.9 health case management shall be made on a monthly basis. In 95.10 order to receive payment for an eligible child, the provider 95.11 must document at least a face-to-face contact with the child, 95.12 the child's parents, or the child's legal representative. To 95.13 receive payment for an eligible adult, the provider must 95.14 document: 95.15 (1) at least a face-to-face contact with the adult or the 95.16 adult's legal representative; or 95.17 (2) at least a telephone contact with the adult or the 95.18 adult's legal representative and document a face-to-face contact 95.19 with the adult or the adult's legal representative within the 95.20 preceding two months. 95.21 (d) Payment for mental health case management provided by 95.22 county or state staff shall be based on the monthly rate 95.23 methodology under section 256B.094, subdivision 6, paragraph 95.24 (b), with separate rates calculated for child welfare and mental 95.25 health, and within mental health, separate rates for children 95.26 and adults. 95.27 (e) Payment for mental health case management provided by 95.28 county-contracted vendors shall be based on a monthly rate 95.29 negotiated by the host county. The negotiated rate must not 95.30 exceed the rate charged by the vendor for the same service to 95.31 other payers. If the service is provided by a team of 95.32 contracted vendors, the county may negotiate a team rate with a 95.33 vendor who is a member of the team. The team shall determine 95.34 how to distribute the rate among its members. No reimbursement 95.35 received by contracted vendors shall be returned to the county, 95.36 except to reimburse the county for advance funding provided by 96.1 the county to the vendor. 96.2 (f) If the service is provided by a team which includes 96.3 contracted vendors and county or state staff, the costs for 96.4 county or state staff participation in the team shall be 96.5 included in the rate for county-provided services. In this 96.6 case, the contracted vendor and the county may each receive 96.7 separate payment for services provided by each entity in the 96.8 same month. In order to prevent duplication of services, the 96.9 county must document, in the recipient's file, the need for team 96.10 case management and a description of the roles of the team 96.11 members. 96.12 (g) The commissioner shall calculate the nonfederal share 96.13 of actual medical assistance and general assistance medical care 96.14 payments for each county, based on the higher of calendar year 96.15 1995 or 1996, by service date, project that amount forward to 96.16 1999, and transfer one-half of the result from medical 96.17 assistance and general assistance medical care to each county's 96.18 mental health grants under sections 245.4886 and 256E.12 for 96.19 calendar year 1999. The annualized minimum amount added to each 96.20 county's mental health grant shall be $3,000 per year for 96.21 children and $5,000 per year for adults. The commissioner may 96.22 reduce the statewide growth factor in order to fund these 96.23 minimums. The annualized total amount transferred shall become 96.24 part of the base for future mental health grants for each county. 96.25 (h) Any net increase in revenue to the county as a result 96.26 of the change in this section must be used to provide expanded 96.27 mental health services as defined in sections 245.461 to 96.28 245.4888, the Comprehensive Adult and Children's Mental Health 96.29 Acts, excluding inpatient and residential treatment. For 96.30 adults, increased revenue may also be used for services and 96.31 consumer supports which are part of adult mental health projects 96.32 approved under Laws 1997, chapter 203, article 7, section 25. 96.33 For children, increased revenue may also be used for respite 96.34 care and nonresidential individualized rehabilitation services 96.35 as defined in section 245.492, subdivisions 17 and 23. 96.36 "Increased revenue" has the meaning given in Minnesota Rules, 97.1 part 9520.0903, subpart 3. 97.2 (i) Notwithstanding section 256B.19, subdivision 1, the 97.3 nonfederal share of costs for mental health case management 97.4 shall be provided by the recipient's county of responsibility, 97.5 as defined in sections 256G.01 to 256G.12, from sources other 97.6 than federal funds or funds used to match other federal funds. 97.7 (j) The commissioner may suspend, reduce, or terminate the 97.8 reimbursement to a provider that does not meet the reporting or 97.9 other requirements of this section. The county of 97.10 responsibility, as defined in sections 256G.01 to 256G.12, is 97.11 responsible for any federal disallowances. The county may share 97.12 this responsibility with its contracted vendors. 97.13 (k) The commissioner shall set aside a portion of the 97.14 federal funds earned under this section to repay the special 97.15 revenue maximization account under section 256.01, subdivision 97.16 2, clause (15). The repayment is limited to: 97.17 (1) the costs of developing and implementing this section; 97.18 and 97.19 (2) programming the information systems. 97.20 (l) Notwithstanding section 256.025, subdivision 2, 97.21 payments to counties for case management expenditures under this 97.22 section shall only be made from federal earnings from services 97.23 provided under this section. Payments to contracted vendors 97.24 shall include both the federal earnings and the county share. 97.25 (m) Notwithstanding section 256B.041, county payments for 97.26 the cost of mental health case management services provided by 97.27 county or state staff shall not be made to the state treasurer. 97.28 For the purposes of mental health case management services 97.29 provided by county or state staff under this section, the 97.30 centralized disbursement of payments to counties under section 97.31 256B.041 consists only of federal earnings from services 97.32 provided under this section. 97.33 (n) Case management services under this subdivision do not 97.34 include therapy, treatment, legal, or outreach services. 97.35 (o) If the recipient is a resident of a nursing facility, 97.36 intermediate care facility, or hospital, and the recipient's 98.1 institutional care is paid by medical assistance, payment for 98.2 case management services under this subdivision is limited to 98.3 the last30180 days of the recipient's residency in that 98.4 facility and may not exceed more thantwosix months in a 98.5 calendar year. 98.6 (p) Payment for case management services under this 98.7 subdivision shall not duplicate payments made under other 98.8 program authorities for the same purpose. 98.9 (q) By July 1, 2000, the commissioner shall evaluate the 98.10 effectiveness of the changes required by this section, including 98.11 changes in number of persons receiving mental health case 98.12 management, changes in hours of service per person, and changes 98.13 in caseload size. 98.14 (r) For each calendar year beginning with the calendar year 98.15 2001, the annualized amount of state funds for each county 98.16 determined under paragraph (g) shall be adjusted by the county's 98.17 percentage change in the average number of clients per month who 98.18 received case management under this section during the fiscal 98.19 year that ended six months prior to the calendar year in 98.20 question, in comparison to the prior fiscal year. 98.21 (s) For counties receiving the minimum allocation of $3,000 98.22 or $5,000 described in paragraph (g), the adjustment in 98.23 paragraph (r) shall be determined so that the county receives 98.24 the higher of the following amounts: 98.25 (1) a continuation of the minimum allocation in paragraph 98.26 (g); or 98.27 (2) an amount based on that county's average number of 98.28 clients per month who received case management under this 98.29 section during the fiscal year that ended six months prior to 98.30 the calendar year in question, in comparison to the prior fiscal 98.31 year, times the average statewide grant per person per month for 98.32 counties not receiving the minimum allocation. 98.33 (t) The adjustments in paragraphs (r) and (s) shall be 98.34 calculated separately for children and adults. 98.35 Sec. 17. Minnesota Statutes 2000, section 256B.0625, is 98.36 amended by adding a subdivision to read: 99.1 Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of 99.2 subdivisions 43a to 43h, the following terms have the meanings 99.3 given them: 99.4 (1) "home care service recipients" means those individuals 99.5 receiving the following services under section 256B.0627: 99.6 skilled nursing visits, home health aide visits, private duty 99.7 nursing, personal care assistants, or therapies provided through 99.8 a home health agency; 99.9 (2) "home care targeted case management" means the 99.10 provision of targeted case management services for the purpose 99.11 of assisting home care service recipients to gain access to 99.12 needed services and supports so that they may remain in the 99.13 community; 99.14 (3) "institutions" means hospitals, consistent with Code of 99.15 Federal Regulations, title 42, section 440.10; regional 99.16 treatment center inpatient services, consistent with section 99.17 245.474; nursing facilities; and intermediate care facilities 99.18 for persons with mental retardation; 99.19 (4) "relocation targeted case management" means the 99.20 provision of targeted case management services for the purpose 99.21 of assisting recipients to gain access to needed services and 99.22 supports if they choose to move from an institution to the 99.23 community. Relocation targeted case management may be provided 99.24 during the last 180 consecutive days of an eligible recipient's 99.25 institutional stay; and 99.26 (5) "targeted case management" means case management 99.27 services provided to help recipients gain access to needed 99.28 medical, social, educational, and other services and supports. 99.29 Sec. 18. Minnesota Statutes 2000, section 256B.0625, is 99.30 amended by adding a subdivision to read: 99.31 Subd. 43a. [ELIGIBILITY.] The following persons are 99.32 eligible for relocation targeted case management or home 99.33 care-targeted case management: 99.34 (1) medical assistance eligible persons residing in 99.35 institutions who choose to move into the community are eligible 99.36 for relocation targeted case management services; and 100.1 (2) medical assistance eligible persons receiving home care 100.2 services, who are not eligible for any other medical assistance 100.3 reimbursable case management service, are eligible for home 100.4 care-targeted case management services beginning January 1, 2003. 100.5 Sec. 19. Minnesota Statutes 2000, section 256B.0625, is 100.6 amended by adding a subdivision to read: 100.7 Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 100.8 QUALIFICATIONS.] The following qualifications and certification 100.9 standards must be met by providers of relocation targeted case 100.10 management: 100.11 (a) The commissioner must certify each provider of 100.12 relocation targeted case management before enrollment. The 100.13 certification process shall examine the provider's ability to 100.14 meet the requirements in this subdivision and other federal and 100.15 state requirements of this service. A certified relocation 100.16 targeted case management provider may subcontract with another 100.17 provider to deliver relocation targeted case management 100.18 services. Subcontracted providers must demonstrate the ability 100.19 to provide the services outlined in subdivision 43d. 100.20 (b) A relocation targeted case management provider is an 100.21 enrolled medical assistance provider who is determined by the 100.22 commissioner to have all of the following characteristics: 100.23 (1) the legal authority to provide public welfare under 100.24 sections 393.01, subdivision 7; and 393.07; or a federally 100.25 recognized Indian tribe; 100.26 (2) the demonstrated capacity and experience to provide the 100.27 components of case management to coordinate and link community 100.28 resources needed by the eligible population; 100.29 (3) the administrative capacity and experience to serve the 100.30 target population for whom it will provide services and ensure 100.31 quality of services under state and federal requirements; 100.32 (4) the legal authority to provide complete investigative 100.33 and protective services under section 626.556, subdivision 10; 100.34 and child welfare and foster care services under section 393.07, 100.35 subdivisions 1 and 2; or a federally recognized Indian tribe; 100.36 (5) a financial management system that provides accurate 101.1 documentation of services and costs under state and federal 101.2 requirements; and 101.3 (6) the capacity to document and maintain individual case 101.4 records under state and federal requirements. 101.5 A provider of targeted case management under subdivision 20 may 101.6 be deemed a certified provider of relocation targeted case 101.7 management. 101.8 Sec. 20. Minnesota Statutes 2000, section 256B.0625, is 101.9 amended by adding a subdivision to read: 101.10 Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 101.11 QUALIFICATIONS.] The following qualifications and certification 101.12 standards must be met by providers of home care targeted case 101.13 management. 101.14 (a) The commissioner must certify each provider of home 101.15 care targeted case management before enrollment. The 101.16 certification process shall examine the provider's ability to 101.17 meet the requirements in this subdivision and other state and 101.18 federal requirements of this service. 101.19 (b) A home care targeted case management provider is an 101.20 enrolled medical assistance provider who has a minimum of a 101.21 bachelor's degree or a license in a health or human services 101.22 field, and is determined by the commissioner to have all of the 101.23 following characteristics: 101.24 (1) the demonstrated capacity and experience to provide the 101.25 components of case management to coordinate and link community 101.26 resources needed by the eligible population; 101.27 (2) the administrative capacity and experience to serve the 101.28 target population for whom it will provide services and ensure 101.29 quality of services under state and federal requirements; 101.30 (3) a financial management system that provides accurate 101.31 documentation of services and costs under state and federal 101.32 requirements; 101.33 (4) the capacity to document and maintain individual case 101.34 records under state and federal requirements; and 101.35 (5) the capacity to coordinate with county administrative 101.36 functions. 102.1 Sec. 21. Minnesota Statutes 2000, section 256B.0625, is 102.2 amended by adding a subdivision to read: 102.3 Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for 102.4 medical assistance reimbursement as targeted case management 102.5 include: 102.6 (1) assessment of the recipient's need for targeted case 102.7 management services; 102.8 (2) development, completion, and regular review of a 102.9 written individual service plan, which is based upon the 102.10 assessment of the recipient's needs and choices, and which will 102.11 ensure access to medical, social, educational, and other related 102.12 services and supports; 102.13 (3) routine contact or communication with the recipient, 102.14 recipient's family, primary caregiver, legal representative, 102.15 substitute care provider, service providers, or other relevant 102.16 persons identified as necessary to the development or 102.17 implementation of the goals of the individual service plan; 102.18 (4) coordinating referrals for, and the provision of, case 102.19 management services for the recipient with appropriate service 102.20 providers, consistent with section 1902(a)(23) of the Social 102.21 Security Act; 102.22 (5) coordinating and monitoring the overall service 102.23 delivery to ensure quality of services, appropriateness, and 102.24 continued need; 102.25 (6) completing and maintaining necessary documentation that 102.26 supports and verifies the activities in this subdivision; 102.27 (7) traveling to conduct a visit with the recipient or 102.28 other relevant person necessary to develop or implement the 102.29 goals of the individual service plan; and 102.30 (8) coordinating with the institution discharge planner in 102.31 the 180-day period before the recipient's discharge. 102.32 Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 102.33 amended by adding a subdivision to read: 102.34 Subd. 43e. [TIME LINES.] The following time lines must be 102.35 met for assigning a case manager: 102.36 (1) for relocation targeted case management, an eligible 103.1 recipient must be assigned a case manager who visits the person 103.2 within 20 working days of requesting a case manager from their 103.3 county of financial responsibility as determined under chapter 103.4 256G. If a county agency does not provide case management 103.5 services as required, the recipient may, after written notice to 103.6 the county agency, obtain targeted relocation case management 103.7 services from a home care targeted case management provider, as 103.8 defined in subdivision 43c; and 103.9 (2) for home care targeted case management, an eligible 103.10 recipient must be assigned a case manager within 20 working days 103.11 of requesting a case manager from a home care targeted case 103.12 management provider, as defined in subdivision 43c. 103.13 Sec. 23. Minnesota Statutes 2000, section 256B.0625, is 103.14 amended by adding a subdivision to read: 103.15 Subd. 43f. [EVALUATION.] The commissioner shall evaluate 103.16 the delivery of targeted case management, including, but not 103.17 limited to, access to case management services, consumer 103.18 satisfaction with case management services, and quality of case 103.19 management services. 103.20 Sec. 24. Minnesota Statutes 2000, section 256B.0625, is 103.21 amended by adding a subdivision to read: 103.22 Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must 103.23 document each face-to-face and telephone contact with the 103.24 recipient and others involved in the recipient's individual 103.25 service plan. 103.26 Sec. 25. Minnesota Statutes 2000, section 256B.0625, is 103.27 amended by adding a subdivision to read: 103.28 Subd. 43h. [PAYMENT RATES.] The commissioner shall set 103.29 payment rates for targeted case management under this 103.30 subdivision. Case managers may bill according to the following 103.31 criteria: 103.32 (1) for relocation targeted case management, case managers 103.33 may bill for direct case management activities, including 103.34 face-to-face and telephone contacts, in the 180 days preceding 103.35 an eligible recipient's discharge from an institution; 103.36 (2) for home care targeted case management, case managers 104.1 may bill for direct case management activities, including 104.2 face-to-face and telephone contacts; and 104.3 (3) billings for targeted case management services under 104.4 this subdivision shall not duplicate payments made under other 104.5 program authorities for the same purpose. 104.6 Sec. 26. Minnesota Statutes 2000, section 256B.0627, 104.7 subdivision 1, is amended to read: 104.8 Subdivision 1. [DEFINITION.] (a) "Activities of daily 104.9 living" includes eating, toileting, grooming, dressing, bathing, 104.10 transferring, mobility, and positioning. 104.11 (b) "Assessment" means a review and evaluation of a 104.12 recipient's need for home care services conducted in person. 104.13 Assessments for private duty nursing shall be conducted by a 104.14 registered private duty nurse. Assessments for home health 104.15 agency services shall be conducted by a home health agency 104.16 nurse. Assessments for personal care assistant services shall 104.17 be conducted by the county public health nurse or a certified 104.18 public health nurse under contract with the county. A 104.19 face-to-face assessment must include: documentation of health 104.20 status, determination of need, evaluation of service 104.21 effectiveness, identification of appropriate services, service 104.22 plan development or modification, coordination of services, 104.23 referrals and follow-up to appropriate payers and community 104.24 resources, completion of required reports, recommendation of 104.25 service authorization, and consumer education. Once the need 104.26 for personal care assistant services is determined under this 104.27 section, the county public health nurse or certified public 104.28 health nurse under contract with the county is responsible for 104.29 communicating this recommendation to the commissioner and the 104.30 recipient. A face-to-face assessment for personal 104.31 care assistant services is conducted on those recipients who 104.32 have never had a county public health nurse assessment. A 104.33 face-to-face assessment must occur at least annually or when 104.34 there is a significant change in the recipient's condition or 104.35 when there is a change in the need for personal care assistant 104.36 services. A service update may substitute for the annual 105.1 face-to-face assessment when there is not a significant change 105.2 in recipient condition or a change in the need for personal care 105.3 assistant service. A service update or review for temporary 105.4 increase includes a review of initial baseline data, evaluation 105.5 of service effectiveness, redetermination of service need, 105.6 modification of service plan and appropriate referrals, update 105.7 of initial forms, obtaining service authorization, and on going 105.8 consumer education. Assessments for medical assistance home 105.9 care services for mental retardation or related conditions and 105.10 alternative care services for developmentally disabled home and 105.11 community-based waivered recipients may be conducted by the 105.12 county public health nurse to ensure coordination and avoid 105.13 duplication. Assessments must be completed on forms provided by 105.14 the commissioner within 30 days of a request for home care 105.15 services by a recipient or responsible party. 105.16(b)(c) "Care plan" means a written description of personal 105.17 care assistant services developed by the qualified 105.18 professional or the recipient's physician with the recipient or 105.19 responsible party to be used by the personal care assistant with 105.20 a copy provided to the recipient or responsible party. 105.21 (d) "Complex and regular private duty nursing care" means: 105.22 (1) complex care is private duty nursing provided to 105.23 recipients who are ventilator dependent or for whom a physician 105.24 has certified that were it not for private duty nursing the 105.25 recipient would meet the criteria for inpatient hospital 105.26 intensive care unit (ICU) level of care; and 105.27 (2) regular care is private duty nursing provided to all 105.28 other recipients. 105.29 (e) "Health-related functions" means functions that can be 105.30 delegated or assigned by a licensed health care professional 105.31 under state law to be performed by a personal care attendant. 105.32(c)(f) "Home care services" means a health service, 105.33 determined by the commissioner as medically necessary, that is 105.34 ordered by a physician and documented in a service plan that is 105.35 reviewed by the physician at least once every6260 days for the 105.36 provision of home health services, or private duty nursing, or 106.1 at least once every 365 days for personal care. Home care 106.2 services are provided to the recipient at the recipient's 106.3 residence that is a place other than a hospital or long-term 106.4 care facility or as specified in section 256B.0625. 106.5 (g) "Instrumental activities of daily living" includes meal 106.6 planning and preparation, managing finances, shopping for food, 106.7 clothing, and other essential items, performing essential 106.8 household chores, communication by telephone and other media, 106.9 and getting around and participating in the community. 106.10(d)(h) "Medically necessary" has the meaning given in 106.11 Minnesota Rules, parts 9505.0170 to 9505.0475. 106.12(e)(i) "Personal care assistant" means a person who: 106.13 (1) is at least 18 years old, except for persons 16 to 18 106.14 years of age who participated in a related school-based job 106.15 training program or have completed a certified home health aide 106.16 competency evaluation; 106.17 (2) is able to effectively communicate with the recipient 106.18 and personal care provider organization; 106.19 (3) effective July 1, 1996, has completed one of the 106.20 training requirements as specified in Minnesota Rules, part 106.21 9505.0335, subpart 3, items A to D; 106.22 (4) has the ability to, and provides covered personal 106.23 care assistant services according to the recipient's care plan, 106.24 responds appropriately to recipient needs, and reports changes 106.25 in the recipient's condition to the supervising qualified 106.26 professional or physician; 106.27 (5) is not a consumer of personal care assistant services; 106.28 and 106.29 (6) is subject to criminal background checks and procedures 106.30 specified in section 245A.04. 106.31(f)(j) "Personal care provider organization" means an 106.32 organization enrolled to provide personal care assistant 106.33 services under the medical assistance program that complies with 106.34 the following: (1) owners who have a five percent interest or 106.35 more, and managerial officials are subject to a background study 106.36 as provided in section 245A.04. This applies to currently 107.1 enrolled personal care provider organizations and those agencies 107.2 seeking enrollment as a personal care provider organization. An 107.3 organization will be barred from enrollment if an owner or 107.4 managerial official of the organization has been convicted of a 107.5 crime specified in section 245A.04, or a comparable crime in 107.6 another jurisdiction, unless the owner or managerial official 107.7 meets the reconsideration criteria specified in section 245A.04; 107.8 (2) the organization must maintain a surety bond and liability 107.9 insurance throughout the duration of enrollment and provides 107.10 proof thereof. The insurer must notify the department of human 107.11 services of the cancellation or lapse of policy; and (3) the 107.12 organization must maintain documentation of services as 107.13 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 107.14 as evidence of compliance with personal care assistant training 107.15 requirements. 107.16(g)(k) "Responsible party" means an individual residing 107.17 with a recipient of personal care assistant services who is 107.18 capable of providing the supportive care necessary to assist the 107.19 recipient to live in the community, is at least 18 years old, 107.20 and is not a personal care assistant. Responsible parties who 107.21 are parents of minors or guardians of minors or incapacitated 107.22 persons may delegate the responsibility to another adult during 107.23 a temporary absence of at least 24 hours but not more than six 107.24 months. The person delegated as a responsible party must be 107.25 able to meet the definition of responsible party, except that 107.26 the delegated responsible party is required to reside with the 107.27 recipient only while serving as the responsible party. Foster 107.28 care license holders may be designated the responsible party for 107.29 residents of the foster care home if case management is provided 107.30 as required in section 256B.0625, subdivision 19a. For persons 107.31 who, as of April 1, 1992, are sharing personal care assistant 107.32 services in order to obtain the availability of 24-hour 107.33 coverage, an employee of the personal care provider organization 107.34 may be designated as the responsible party if case management is 107.35 provided as required in section 256B.0625, subdivision 19a. 107.36(h)(l) "Service plan" means a written description of the 108.1 services needed based on the assessment developed by the nurse 108.2 who conducts the assessment together with the recipient or 108.3 responsible party. The service plan shall include a description 108.4 of the covered home care services, frequency and duration of 108.5 services, and expected outcomes and goals. The recipient and 108.6 the provider chosen by the recipient or responsible party must 108.7 be given a copy of the completed service plan within 30 calendar 108.8 days of the request for home care services by the recipient or 108.9 responsible party. 108.10(i)(m) "Skilled nurse visits" are provided in a 108.11 recipient's residence under a plan of care or service plan that 108.12 specifies a level of care which the nurse is qualified to 108.13 provide. These services are: 108.14 (1) nursing services according to the written plan of care 108.15 or service plan and accepted standards of medical and nursing 108.16 practice in accordance with chapter 148; 108.17 (2) services which due to the recipient's medical condition 108.18 may only be safely and effectively provided by a registered 108.19 nurse or a licensed practical nurse; 108.20 (3) assessments performed only by a registered nurse; and 108.21 (4) teaching and training the recipient, the recipient's 108.22 family, or other caregivers requiring the skills of a registered 108.23 nurse or licensed practical nurse. 108.24 (n) "Telehomecare" means the use of telecommunications 108.25 technology by a home health care professional to deliver home 108.26 health care services, within the professional's scope of 108.27 practice, to a patient located at a site other than the site 108.28 where the practitioner is located. 108.29 Sec. 27. Minnesota Statutes 2000, section 256B.0627, 108.30 subdivision 2, is amended to read: 108.31 Subd. 2. [SERVICES COVERED.] Home care services covered 108.32 under this section include: 108.33 (1) nursing services under section 256B.0625, subdivision 108.34 6a; 108.35 (2) private duty nursing services under section 256B.0625, 108.36 subdivision 7; 109.1 (3) home healthaideservices under section 256B.0625, 109.2 subdivision 6a; 109.3 (4) personal care assistant services under section 109.4 256B.0625, subdivision 19a; 109.5 (5) supervision of personal care assistant services 109.6 provided by a qualified professional under section 256B.0625, 109.7 subdivision 19a; 109.8 (6)consultingqualified professional of personal care 109.9 assistant services under the fiscalagentintermediary option as 109.10 specified in subdivision 10; 109.11 (7) face-to-face assessments by county public health nurses 109.12 for services under section 256B.0625, subdivision 19a; and 109.13 (8) service updates and review of temporary increases for 109.14 personal care assistant services by the county public health 109.15 nurse for services under section 256B.0625, subdivision 19a. 109.16 Sec. 28. Minnesota Statutes 2000, section 256B.0627, 109.17 subdivision 4, is amended to read: 109.18 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 109.19 personal care assistant services that are eligible for payment 109.20 arethe following:services and supports furnished to an 109.21 individual, as needed, to assist in accomplishing activities of 109.22 daily living; instrumental activities of daily living; 109.23 health-related functions through hands-on assistance, 109.24 supervision, and cuing; and redirection and intervention for 109.25 behavior including observation and monitoring. 109.26 (b) Payment for services will be made within the limits 109.27 approved using the prior authorized process established in 109.28 subdivision 5. 109.29 (c) The amount and type of services authorized shall be 109.30 based on an assessment of the recipient's needs in these areas: 109.31 (1) bowel and bladder care; 109.32 (2) skin care to maintain the health of the skin; 109.33 (3) repetitive maintenance range of motion, muscle 109.34 strengthening exercises, and other tasks specific to maintaining 109.35 a recipient's optimal level of function; 109.36 (4) respiratory assistance; 110.1 (5) transfers and ambulation; 110.2 (6) bathing, grooming, and hairwashing necessary for 110.3 personal hygiene; 110.4 (7) turning and positioning; 110.5 (8) assistance with furnishing medication that is 110.6 self-administered; 110.7 (9) application and maintenance of prosthetics and 110.8 orthotics; 110.9 (10) cleaning medical equipment; 110.10 (11) dressing or undressing; 110.11 (12) assistance with eating and meal preparation and 110.12 necessary grocery shopping; 110.13 (13) accompanying a recipient to obtain medical diagnosis 110.14 or treatment; 110.15 (14) assisting, monitoring, or prompting the recipient to 110.16 complete the services in clauses (1) to (13); 110.17 (15) redirection, monitoring, and observation that are 110.18 medically necessary and an integral part of completing the 110.19 personal care assistant services described in clauses (1) to 110.20 (14); 110.21 (16) redirection and intervention for behavior, including 110.22 observation and monitoring; 110.23 (17) interventions for seizure disorders, including 110.24 monitoring and observation if the recipient has had a seizure 110.25 that requires intervention within the past three months; 110.26 (18) tracheostomy suctioning using a clean procedure if the 110.27 procedure is properly delegated by a registered nurse. Before 110.28 this procedure can be delegated to a personal care assistant, a 110.29 registered nurse must determine that the tracheostomy suctioning 110.30 can be accomplished utilizing a clean rather than a sterile 110.31 procedure and must ensure that the personal care assistant has 110.32 been taught the proper procedure; and 110.33 (19) incidental household services that are an integral 110.34 part of a personal care service described in clauses (1) to (18). 110.35 For purposes of this subdivision, monitoring and observation 110.36 means watching for outward visible signs that are likely to 111.1 occur and for which there is a covered personal care service or 111.2 an appropriate personal care intervention. For purposes of this 111.3 subdivision, a clean procedure refers to a procedure that 111.4 reduces the numbers of microorganisms or prevents or reduces the 111.5 transmission of microorganisms from one person or place to 111.6 another. A clean procedure may be used beginning 14 days after 111.7 insertion. 111.8(b)(d) The personal care assistant services that are not 111.9 eligible for payment are the following: 111.10 (1) services not ordered by the physician; 111.11 (2) assessments by personal care assistant provider 111.12 organizations or by independently enrolled registered nurses; 111.13 (3) services that are not in the service plan; 111.14 (4) services provided by the recipient's spouse, legal 111.15 guardian for an adult or child recipient, or parent of a 111.16 recipient under age 18; 111.17 (5) services provided by a foster care provider of a 111.18 recipient who cannot direct the recipient's own care, unless 111.19 monitored by a county or state case manager under section 111.20 256B.0625, subdivision 19a; 111.21 (6) services provided by the residential or program license 111.22 holder in a residence for more than four persons; 111.23 (7) services that are the responsibility of a residential 111.24 or program license holder under the terms of a service agreement 111.25 and administrative rules; 111.26 (8) sterile procedures; 111.27 (9) injections of fluids into veins, muscles, or skin; 111.28 (10) services provided by parents of adult recipients, 111.29 adult children, or siblings of the recipient, unless these 111.30 relatives meet one of the following hardship criteria and the 111.31 commissioner waives this requirement: 111.32 (i) the relative resigns from a part-time or full-time job 111.33 to provide personal care for the recipient; 111.34 (ii) the relative goes from a full-time to a part-time job 111.35 with less compensation to provide personal care for the 111.36 recipient; 112.1 (iii) the relative takes a leave of absence without pay to 112.2 provide personal care for the recipient; 112.3 (iv) the relative incurs substantial expenses by providing 112.4 personal care for the recipient; or 112.5 (v) because of labor conditions, special language needs, or 112.6 intermittent hours of care needed, the relative is needed in 112.7 order to provide an adequate number of qualified personal care 112.8 assistants to meet the medical needs of the recipient; 112.9 (11) homemaker services that are not an integral part of a 112.10 personal care assistant services; 112.11 (12) home maintenance, or chore services; 112.12 (13) services not specified under paragraph (a); and 112.13 (14) services not authorized by the commissioner or the 112.14 commissioner's designee. 112.15 (e) The recipient or responsible party may choose to 112.16 supervise the personal care assistant or to have a qualified 112.17 professional, as defined in section 256B.0625, subdivision 19c, 112.18 provide the supervision. As required under section 256B.0625, 112.19 subdivision 19c, the county public health nurse, as a part of 112.20 the assessment, will assist the recipient or responsible party 112.21 to identify the most appropriate person to provide supervision 112.22 of the personal care assistant. Health-related delegated tasks 112.23 performed by the personal care assistant will be under the 112.24 supervision of a qualified professional or the direction of the 112.25 recipient's physician. If the recipient has a qualified 112.26 professional, Minnesota Rules, part 9505.0335, subpart 4, 112.27 applies. 112.28 Sec. 29. Minnesota Statutes 2000, section 256B.0627, 112.29 subdivision 5, is amended to read: 112.30 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 112.31 payments for home care services shall be limited according to 112.32 this subdivision. 112.33 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 112.34 recipient may receive the following home care services during a 112.35 calendar year: 112.36 (1) up to two face-to-face assessments to determine a 113.1 recipient's need for personal care assistant services; 113.2 (2) one service update done to determine a recipient's need 113.3 for personal care assistant services; and 113.4 (3) up tofivenine skilled nurse visits. 113.5 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 113.6 services above the limits in paragraph (a) must receive the 113.7 commissioner's prior authorization, except when: 113.8 (1) the home care services were required to treat an 113.9 emergency medical condition that if not immediately treated 113.10 could cause a recipient serious physical or mental disability, 113.11 continuation of severe pain, or death. The provider must 113.12 request retroactive authorization no later than five working 113.13 days after giving the initial service. The provider must be 113.14 able to substantiate the emergency by documentation such as 113.15 reports, notes, and admission or discharge histories; 113.16 (2) the home care services were provided on or after the 113.17 date on which the recipient's eligibility began, but before the 113.18 date on which the recipient was notified that the case was 113.19 opened. Authorization will be considered if the request is 113.20 submitted by the provider within 20 working days of the date the 113.21 recipient was notified that the case was opened; 113.22 (3) a third-party payor for home care services has denied 113.23 or adjusted a payment. Authorization requests must be submitted 113.24 by the provider within 20 working days of the notice of denial 113.25 or adjustment. A copy of the notice must be included with the 113.26 request; 113.27 (4) the commissioner has determined that a county or state 113.28 human services agency has made an error; or 113.29 (5) the professional nurse determines an immediate need for 113.30 up to 40 skilled nursing or home health aide visits per calendar 113.31 year and submits a request for authorization within 20 working 113.32 days of the initial service date, and medical assistance is 113.33 determined to be the appropriate payer. 113.34 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 113.35 authorization will be evaluated according to the same criteria 113.36 applied to prior authorization requests. 114.1 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 114.2 section 256B.0627, subdivision 1, paragraph (a), shall be 114.3 conducted initially, and at least annually thereafter, in person 114.4 with the recipient and result in a completed service plan using 114.5 forms specified by the commissioner. Within 30 days of 114.6 recipient or responsible party request for home care services, 114.7 the assessment, the service plan, and other information 114.8 necessary to determine medical necessity such as diagnostic or 114.9 testing information, social or medical histories, and hospital 114.10 or facility discharge summaries shall be submitted to the 114.11 commissioner. Notwithstanding the provisions of section 114.12 256B.0627, subdivision 12, the commissioner shall maximize 114.13 federal financial participation to pay for public health nurse 114.14 assessments for personal care services. For personal care 114.15 assistant services: 114.16 (1) The amount and type of service authorized based upon 114.17 the assessment and service plan will follow the recipient if the 114.18 recipient chooses to change providers. 114.19 (2) If the recipient's medical need changes, the 114.20 recipient's provider may assess the need for a change in service 114.21 authorization and request the change from the county public 114.22 health nurse. Within 30 days of the request, the public health 114.23 nurse will determine whether to request the change in services 114.24 based upon the provider assessment, or conduct a home visit to 114.25 assess the need and determine whether the change is appropriate. 114.26 (3) To continue to receive personal care assistant services 114.27 after the first year, the recipient or the responsible party, in 114.28 conjunction with the public health nurse, may complete a service 114.29 update on forms developed by the commissioner according to 114.30 criteria and procedures in subdivision 1. 114.31 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 114.32 commissioner's designee, shall review the assessment, service 114.33 update, request for temporary services, service plan, and any 114.34 additional information that is submitted. The commissioner 114.35 shall, within 30 days after receiving a complete request, 114.36 assessment, and service plan, authorize home care services as 115.1 follows: 115.2 (1) [HOME HEALTH SERVICES.] All home health services 115.3 provided by alicensed nurse or ahome health aide must be prior 115.4 authorized by the commissioner or the commissioner's designee. 115.5 Prior authorization must be based on medical necessity and 115.6 cost-effectiveness when compared with other care options. When 115.7 home health services are used in combination with personal care 115.8 and private duty nursing, the cost of all home care services 115.9 shall be considered for cost-effectiveness. The commissioner 115.10 shall limitnurse andhome health aide visits to no more than 115.11 one visit each per day. The commissioner, or the commissioner's 115.12 designee, may authorize up to two skilled nurse visits per day. 115.13 (2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 115.14 care assistant services and supervision by a qualified 115.15 professional, if requested by the recipient, must be prior 115.16 authorized by the commissioner or the commissioner's designee 115.17 except for the assessments established in paragraph (a). The 115.18 amount of personal care assistant services authorized must be 115.19 based on the recipient's home care rating. A child may not be 115.20 found to be dependent in an activity of daily living if because 115.21 of the child's age an adult would either perform the activity 115.22 for the child or assist the child with the activity and the 115.23 amount of assistance needed is similar to the assistance 115.24 appropriate for a typical child of the same age. Based on 115.25 medical necessity, the commissioner may authorize: 115.26 (A) up to two times the average number of direct care hours 115.27 provided in nursing facilities for the recipient's comparable 115.28 case mix level; or 115.29 (B) up to three times the average number of direct care 115.30 hours provided in nursing facilities for recipients who have 115.31 complex medical needs or are dependent in at least seven 115.32 activities of daily living and need physical assistance with 115.33 eating or have a neurological diagnosis; or 115.34 (C) up to 60 percent of the average reimbursement rate, as 115.35 of July 1, 1991, for care provided in a regional treatment 115.36 center for recipients who have Level I behavior, plus any 116.1 inflation adjustment as provided by the legislature for personal 116.2 care service; or 116.3 (D) up to the amount the commissioner would pay, as of July 116.4 1, 1991, plus any inflation adjustment provided for home care 116.5 services, for care provided in a regional treatment center for 116.6 recipients referred to the commissioner by a regional treatment 116.7 center preadmission evaluation team. For purposes of this 116.8 clause, home care services means all services provided in the 116.9 home or community that would be included in the payment to a 116.10 regional treatment center; or 116.11 (E) up to the amount medical assistance would reimburse for 116.12 facility care for recipients referred to the commissioner by a 116.13 preadmission screening team established under section 256B.0911 116.14 or 256B.092; and 116.15 (F) a reasonable amount of time for the provision of 116.16 supervision by a qualified professional of personal 116.17 care assistant services, if a qualified professional is 116.18 requested by the recipient or responsible party. 116.19 (ii) The number of direct care hours shall be determined 116.20 according to the annual cost report submitted to the department 116.21 by nursing facilities. The average number of direct care hours, 116.22 as established by May 1, 1992, shall be calculated and 116.23 incorporated into the home care limits on July 1, 1992. These 116.24 limits shall be calculated to the nearest quarter hour. 116.25 (iii) The home care rating shall be determined by the 116.26 commissioner or the commissioner's designee based on information 116.27 submitted to the commissioner by the county public health nurse 116.28 on forms specified by the commissioner. The home care rating 116.29 shall be a combination of current assessment tools developed 116.30 under sections 256B.0911 and 256B.501 with an addition for 116.31 seizure activity that will assess the frequency and severity of 116.32 seizure activity and with adjustments, additions, and 116.33 clarifications that are necessary to reflect the needs and 116.34 conditions of recipients who need home care including children 116.35 and adults under 65 years of age. The commissioner shall 116.36 establish these forms and protocols under this section and shall 117.1 use an advisory group, including representatives of recipients, 117.2 providers, and counties, for consultation in establishing and 117.3 revising the forms and protocols. 117.4 (iv) A recipient shall qualify as having complex medical 117.5 needs if the care required is difficult to perform and because 117.6 of recipient's medical condition requires more time than 117.7 community-based standards allow or requires more skill than 117.8 would ordinarily be required and the recipient needs or has one 117.9 or more of the following: 117.10 (A) daily tube feedings; 117.11 (B) daily parenteral therapy; 117.12 (C) wound or decubiti care; 117.13 (D) postural drainage, percussion, nebulizer treatments, 117.14 suctioning, tracheotomy care, oxygen, mechanical ventilation; 117.15 (E) catheterization; 117.16 (F) ostomy care; 117.17 (G) quadriplegia; or 117.18 (H) other comparable medical conditions or treatments the 117.19 commissioner determines would otherwise require institutional 117.20 care. 117.21 (v) A recipient shall qualify as having Level I behavior if 117.22 there is reasonable supporting evidence that the recipient 117.23 exhibits, or that without supervision, observation, or 117.24 redirection would exhibit, one or more of the following 117.25 behaviors that cause, or have the potential to cause: 117.26 (A) injury to the recipient's own body; 117.27 (B) physical injury to other people; or 117.28 (C) destruction of property. 117.29 (vi) Time authorized for personal care relating to Level I 117.30 behavior in subclause (v), items (A) to (C), shall be based on 117.31 the predictability, frequency, and amount of intervention 117.32 required. 117.33 (vii) A recipient shall qualify as having Level II behavior 117.34 if the recipient exhibits on a daily basis one or more of the 117.35 following behaviors that interfere with the completion of 117.36 personal care assistant services under subdivision 4, paragraph 118.1 (a): 118.2 (A) unusual or repetitive habits; 118.3 (B) withdrawn behavior; or 118.4 (C) offensive behavior. 118.5 (viii) A recipient with a home care rating of Level II 118.6 behavior in subclause (vii), items (A) to (C), shall be rated as 118.7 comparable to a recipient with complex medical needs under 118.8 subclause (iv). If a recipient has both complex medical needs 118.9 and Level II behavior, the home care rating shall be the next 118.10 complex category up to the maximum rating under subclause (i), 118.11 item (B). 118.12 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 118.13 nursing services shall be prior authorized by the commissioner 118.14 or the commissioner's designee. Prior authorization for private 118.15 duty nursing services shall be based on medical necessity and 118.16 cost-effectiveness when compared with alternative care options. 118.17 The commissioner may authorize medically necessary private duty 118.18 nursing services in quarter-hour units when: 118.19 (i) the recipient requires more individual and continuous 118.20 care than can be provided during a nurse visit; or 118.21 (ii) the cares are outside of the scope of services that 118.22 can be provided by a home health aide or personal care assistant. 118.23 The commissioner may authorize: 118.24 (A) up to two times the average amount of direct care hours 118.25 provided in nursing facilities statewide for case mix 118.26 classification "K" as established by the annual cost report 118.27 submitted to the department by nursing facilities in May 1992; 118.28 (B) private duty nursing in combination with other home 118.29 care services up to the total cost allowed under clause (2); 118.30 (C) up to 16 hours per day if the recipient requires more 118.31 nursing than the maximum number of direct care hours as 118.32 established in item (A) and the recipient meets the hospital 118.33 admission criteria established under Minnesota Rules, parts 118.349505.05009505.0501 to 9505.0540. 118.35 The commissioner may authorize up to 16 hours per day of 118.36 medically necessary private duty nursing services or up to 24 119.1 hours per day of medically necessary private duty nursing 119.2 services until such time as the commissioner is able to make a 119.3 determination of eligibility for recipients who are 119.4 cooperatively applying for home care services under the 119.5 community alternative care program developed under section 119.6 256B.49, or until it is determined by the appropriate regulatory 119.7 agency that a health benefit plan is or is not required to pay 119.8 for appropriate medically necessary health care services. 119.9 Recipients or their representatives must cooperatively assist 119.10 the commissioner in obtaining this determination. Recipients 119.11 who are eligible for the community alternative care program may 119.12 not receive more hours of nursing under this section than would 119.13 otherwise be authorized under section 256B.49. 119.14 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 119.15 ventilator-dependent, the monthly medical assistance 119.16 authorization for home care services shall not exceed what the 119.17 commissioner would pay for care at the highest cost hospital 119.18 designated as a long-term hospital under the Medicare program. 119.19 For purposes of this clause, home care services means all 119.20 services provided in the home that would be included in the 119.21 payment for care at the long-term hospital. 119.22 "Ventilator-dependent" means an individual who receives 119.23 mechanical ventilation for life support at least six hours per 119.24 day and is expected to be or has been dependent for at least 30 119.25 consecutive days. 119.26 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 119.27 or the commissioner's designee shall determine the time period 119.28 for which a prior authorization shall be effective. If the 119.29 recipient continues to require home care services beyond the 119.30 duration of the prior authorization, the home care provider must 119.31 request a new prior authorization. Under no circumstances, 119.32 other than the exceptions in paragraph (b), shall a prior 119.33 authorization be valid prior to the date the commissioner 119.34 receives the request or for more than 12 months. A recipient 119.35 who appeals a reduction in previously authorized home care 119.36 services may continue previously authorized services, other than 120.1 temporary services under paragraph (h), pending an appeal under 120.2 section 256.045. The commissioner must provide a detailed 120.3 explanation of why the authorized services are reduced in amount 120.4 from those requested by the home care provider. 120.5 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 120.6 the commissioner's designee shall determine the medical 120.7 necessity of home care services, the level of caregiver 120.8 according to subdivision 2, and the institutional comparison 120.9 according to this subdivision, the cost-effectiveness of 120.10 services, and the amount, scope, and duration of home care 120.11 services reimbursable by medical assistance, based on the 120.12 assessment, primary payer coverage determination information as 120.13 required, the service plan, the recipient's age, the cost of 120.14 services, the recipient's medical condition, and diagnosis or 120.15 disability. The commissioner may publish additional criteria 120.16 for determining medical necessity according to section 256B.04. 120.17 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 120.18 The agency nurse, the independently enrolled private duty nurse, 120.19 or county public health nurse may request a temporary 120.20 authorization for home care services by telephone. The 120.21 commissioner may approve a temporary level of home care services 120.22 based on the assessment, and service or care plan information, 120.23 and primary payer coverage determination information as required. 120.24 Authorization for a temporary level of home care services 120.25 including nurse supervision is limited to the time specified by 120.26 the commissioner, but shall not exceed 45 days, unless extended 120.27 because the county public health nurse has not completed the 120.28 required assessment and service plan, or the commissioner's 120.29 determination has not been made. The level of services 120.30 authorized under this provision shall have no bearing on a 120.31 future prior authorization. 120.32 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 120.33 Home care services provided in an adult or child foster care 120.34 setting must receive prior authorization by the department 120.35 according to the limits established in paragraph (a). 120.36 The commissioner may not authorize: 121.1 (1) home care services that are the responsibility of the 121.2 foster care provider under the terms of the foster care 121.3 placement agreement and administrative rules; 121.4 (2) personal care assistant services when the foster care 121.5 license holder is also the personal care provider or personal 121.6 care assistant unless the recipient can direct the recipient's 121.7 own care, or case management is provided as required in section 121.8 256B.0625, subdivision 19a; 121.9 (3) personal care assistant services when the responsible 121.10 party is an employee of, or under contract with, or has any 121.11 direct or indirect financial relationship with the personal care 121.12 provider or personal care assistant, unless case management is 121.13 provided as required in section 256B.0625, subdivision 19a; or 121.14 (4) personal care assistant and private duty nursing 121.15 services when the number of foster care residents is greater 121.16 than four unless the county responsible for the recipient's 121.17 foster placement made the placement prior to April 1, 1992, 121.18 requests that personal care assistant and private duty nursing 121.19 services be provided, and case management is provided as 121.20 required in section 256B.0625, subdivision 19a. 121.21 Sec. 30. Minnesota Statutes 2000, section 256B.0627, 121.22 subdivision 7, is amended to read: 121.23 Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following 121.24 home care services are not eligible for payment under medical 121.25 assistance: 121.26 (1) skilled nurse visits for the sole purpose of 121.27 supervision of the home health aide; 121.28 (2) a skilled nursing visit: 121.29 (i) only for the purpose of monitoring medication 121.30 compliance with an established medication program for a 121.31 recipient; or 121.32 (ii) to administer or assist with medication 121.33 administration, including injections, prefilling syringes for 121.34 injections, or oral medication set-up of an adult recipient, 121.35 when as determined and documented by the registered nurse, the 121.36 need can be met by an available pharmacy or the recipient is 122.1 physically and mentally able to self-administer or prefill a 122.2 medication; 122.3 (3) home care services to a recipient who is eligible for 122.4 covered servicesincluding hospice, if elected by the recipient,122.5 under the Medicare program or any other insurance held by the 122.6 recipient; 122.7 (4) services to other members of the recipient's household; 122.8 (5) a visit made by a skilled nurse solely to train other 122.9 home health agency workers; 122.10 (6) any home care service included in the daily rate of the 122.11 community-based residential facility where the recipient is 122.12 residing; 122.13 (7) nursing and rehabilitation therapy services that are 122.14 reasonably accessible to a recipient outside the recipient's 122.15 place of residence, excluding the assessment, counseling and 122.16 education, and personal assistant care; 122.17 (8) any home health agency service, excluding personal care 122.18 assistant services and private duty nursing services, which are 122.19 performed in a place other than the recipient's residence; and 122.20 (9) Medicare evaluation or administrative nursing visits on 122.21 dual-eligible recipients that do not qualify for Medicare visit 122.22 billing. 122.23 Sec. 31. Minnesota Statutes 2000, section 256B.0627, 122.24 subdivision 8, is amended to read: 122.25 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 122.26 Medical assistance payments for shared personal care assistance 122.27 services shall be limited according to this subdivision. 122.28 (b) Recipients of personal care assistant services may 122.29 share staff and the commissioner shall provide a rate system for 122.30 shared personal care assistant services. For two persons 122.31 sharing services, the rate paid to a provider shall not exceed 122.32 1-1/2 times the rate paid for serving a single individual, and 122.33 for three persons sharing services, the rate paid to a provider 122.34 shall not exceed twice the rate paid for serving a single 122.35 individual. These rates apply only to situations in which all 122.36 recipients were present and received shared services on the date 123.1 for which the service is billed. No more than three persons may 123.2 receive shared services from a personal care assistant in a 123.3 single setting. 123.4 (c) Shared service is the provision of personal 123.5 care assistant services by a personal care assistant to two or 123.6 three recipients at the same time and in the same setting. For 123.7 the purposes of this subdivision, "setting" means: 123.8 (1) the home or foster care home of one of the individual 123.9 recipients; or 123.10 (2) a child care program in which all recipients served by 123.11 one personal care assistant are participating, which is licensed 123.12 under chapter 245A or operated by a local school district or 123.13 private school; or 123.14 (3) outside the home or foster care home of one of the 123.15 recipients when normal life activities take the recipients 123.16 outside the home. 123.17 The provisions of this subdivision do not apply when a 123.18 personal care assistant is caring for multiple recipients in 123.19 more than one setting. 123.20 (d) The recipient or the recipient's responsible party, in 123.21 conjunction with the county public health nurse, shall determine: 123.22 (1) whether shared personal care assistant services is an 123.23 appropriate option based on the individual needs and preferences 123.24 of the recipient; and 123.25 (2) the amount of shared services allocated as part of the 123.26 overall authorization of personal care assistant services. 123.27 The recipient or the responsible party, in conjunction with 123.28 the supervising qualified professional, if a qualified 123.29 professional is requested by any one of the recipients or 123.30 responsible parties, shall arrange the setting and grouping of 123.31 shared services based on the individual needs and preferences of 123.32 the recipients. Decisions on the selection of recipients to 123.33 share services must be based on the ages of the recipients, 123.34 compatibility, and coordination of their care needs. 123.35 (e) The following items must be considered by the recipient 123.36 or the responsible party and the supervising qualified 124.1 professional, if a qualified professional has been requested by 124.2 any one of the recipients or responsible parties, and documented 124.3 in the recipient's health service record: 124.4 (1) the additional qualifications needed by the personal 124.5 care assistant to provide care to several recipients in the same 124.6 setting; 124.7 (2) the additional training and supervision needed by the 124.8 personal care assistant to ensure that the needs of the 124.9 recipient are met appropriately and safely. The provider must 124.10 provide on-site supervision by a qualified professional within 124.11 the first 14 days of shared services, and monthly thereafter, if 124.12 supervision by a qualified provider has been requested by any 124.13 one of the recipients or responsible parties; 124.14 (3) the setting in which the shared services will be 124.15 provided; 124.16 (4) the ongoing monitoring and evaluation of the 124.17 effectiveness and appropriateness of the service and process 124.18 used to make changes in service or setting; and 124.19 (5) a contingency plan which accounts for absence of the 124.20 recipient in a shared services setting due to illness or other 124.21 circumstances and staffing contingencies. 124.22 (f) The provider must offer the recipient or the 124.23 responsible party the option of shared or one-on-one personal 124.24 care assistant services. The recipient or the responsible party 124.25 can withdraw from participating in a shared services arrangement 124.26 at any time. 124.27 (g) In addition to documentation requirements under 124.28 Minnesota Rules, part 9505.2175, a personal care provider must 124.29 meet documentation requirements for shared personal care 124.30 assistant services and must document the following in the health 124.31 service record for each individual recipient sharing services: 124.32 (1) permission by the recipient or the recipient's 124.33 responsible party, if any, for the maximum number of shared 124.34 services hours per week chosen by the recipient; 124.35 (2) permission by the recipient or the recipient's 124.36 responsible party, if any, for personal care assistant services 125.1 provided outside the recipient's residence; 125.2 (3) permission by the recipient or the recipient's 125.3 responsible party, if any, for others to receive shared services 125.4 in the recipient's residence; 125.5 (4) revocation by the recipient or the recipient's 125.6 responsible party, if any, of the shared service authorization, 125.7 or the shared service to be provided to others in the 125.8 recipient's residence, or the shared service to be provided 125.9 outside the recipient's residence; 125.10 (5) supervision of the shared personal care assistant 125.11 services by the qualified professional, if a qualified 125.12 professional is requested by one of the recipients or 125.13 responsible parties, including the date, time of day, number of 125.14 hours spent supervising the provision of shared services, 125.15 whether the supervision was face-to-face or another method of 125.16 supervision, changes in the recipient's condition, shared 125.17 services scheduling issues and recommendations; 125.18 (6) documentation by the qualified professional, if a 125.19 qualified professional is requested by one of the recipients or 125.20 responsible parties, of telephone calls or other discussions 125.21 with the personal care assistant regarding services being 125.22 provided to the recipient who has requested the supervision; and 125.23 (7) daily documentation of the shared services provided by 125.24 each identified personal care assistant including: 125.25 (i) the names of each recipient receiving shared services 125.26 together; 125.27 (ii) the setting for the shared services, including the 125.28 starting and ending times that the recipient received shared 125.29 services; and 125.30 (iii) notes by the personal care assistant regarding 125.31 changes in the recipient's condition, problems that may arise 125.32 from the sharing of services, scheduling issues, care issues, 125.33 and other notes as required by the qualified professional, if a 125.34 qualified professional is requested by one of the recipients or 125.35 responsible parties. 125.36 (h) Unless otherwise provided in this subdivision, all 126.1 other statutory and regulatory provisions relating to personal 126.2 care assistant services apply to shared services. 126.3 (i) In the event that supervision by a qualified 126.4 professional has been requested by one or more recipients, but 126.5 not by all of the recipients, the supervision duties of the 126.6 qualified professional shall be limited to only those recipients 126.7 who have requested the supervision. 126.8 Nothing in this subdivision shall be construed to reduce 126.9 the total number of hours authorized for an individual recipient. 126.10 Sec. 32. Minnesota Statutes 2000, section 256B.0627, 126.11 subdivision 10, is amended to read: 126.12 Subd. 10. [FISCALAGENTINTERMEDIARY OPTION AVAILABLE FOR 126.13 PERSONAL CARE ASSISTANT SERVICES.] (a)"Fiscal agent option" is126.14an option that allows the recipient to:126.15(1) use a fiscal agent instead of a personal care provider126.16organization;126.17(2) supervise the personal care assistant; and126.18(3) use a consulting professional.126.19 The commissioner may allow a recipient of personal care 126.20 assistant services to use a fiscalagentintermediary to assist 126.21 the recipient in paying and accounting for medically necessary 126.22 covered personal care assistant services authorized in 126.23 subdivision 4 and within the payment parameters of subdivision 126.24 5. Unless otherwise provided in this subdivision, all other 126.25 statutory and regulatory provisions relating to personal care 126.26 assistant services apply to a recipient using the fiscalagent126.27 intermediary option. 126.28 (b) The recipient or responsible party shall: 126.29 (1)hire, and terminate the personal care assistant and126.30consulting professional, with the fiscal agentrecruit, hire, 126.31 and terminate a qualified professional, if a qualified 126.32 professional is requested by the recipient or responsible party; 126.33 (2)recruit the personal care assistant and consulting126.34professional and orient and train the personal care assistant in126.35areas that do not require professional delegation as determined126.36by the county public health nurseverify and document the 127.1 credentials of the qualified professional, if a qualified 127.2 professional is requested by the recipient or responsible party; 127.3 (3)supervise and evaluate the personal care assistant in127.4areas that do not require professional delegation as determined127.5in the assessment;127.6(4) cooperate with a consultingdevelop a service plan 127.7 based on physician orders and public health nurse assessment 127.8 with the assistance of a qualified professionaland implement127.9recommendations pertaining to the health and safety of the127.10recipient, if a qualified professional is requested by the 127.11 recipient or responsible party, that addresses the health and 127.12 safety of the recipient; 127.13(5) hire a qualified professional to train and supervise127.14the performance of delegated tasks done by(4) recruit, hire, 127.15 and terminate the personal care assistant; 127.16(6) monitor services and verify in writing the hours worked127.17by the personal care assistant and the consulting(5) orient and 127.18 train the personal care assistant with assistance as needed from 127.19 the qualified professional; 127.20(7) develop and revise a care plan with assistance from a127.21consulting(6) supervise and evaluate the personal care 127.22 assistant with assistance as needed from the recipient's 127.23 physician or the qualified professional; 127.24(8) verify and document the credentials of the consulting127.25 (7) monitor and verify in writing and report to the fiscal 127.26 intermediary the number of hours worked by the personal care 127.27 assistant and the qualified professional; and 127.28(9)(8) enter into a written agreement, as specified in 127.29 paragraph (f). 127.30 (c) The duties of the fiscalagentintermediary shall be to: 127.31 (1) bill the medical assistance program for personal care 127.32 assistant andconsultingqualified professional services; 127.33 (2) request and secure background checks on personal care 127.34 assistants andconsultingqualified professionals according to 127.35 section 245A.04; 127.36 (3) pay the personal care assistant andconsulting128.1 qualified professional based on actual hours of services 128.2 provided; 128.3 (4) withhold and pay all applicable federal and state 128.4 taxes; 128.5 (5) verify anddocumentkeep records of hours worked by the 128.6 personal care assistant andconsultingqualified professional; 128.7 (6) make the arrangements and pay unemployment insurance, 128.8 taxes, workers' compensation, liability insurance, and other 128.9 benefits, if any; 128.10 (7) enroll in the medical assistance program as a fiscal 128.11agentintermediary; and 128.12 (8) enter into a written agreement as specified in 128.13 paragraph (f) before services are provided. 128.14 (d) The fiscalagentintermediary: 128.15 (1) may not be related to the recipient,consulting128.16 qualified professional, or the personal care assistant; 128.17 (2) must ensure arm's length transactions with the 128.18 recipient and personal care assistant; and 128.19 (3) shall be considered a joint employer of the personal 128.20 care assistant andconsultingqualified professional to the 128.21 extent specified in this section. 128.22 The fiscalagentintermediary or owners of the entity that 128.23 provides fiscalagentintermediary services under this 128.24 subdivision must pass a criminal background check as required in 128.25 section 256B.0627, subdivision 1, paragraph (e). 128.26 (e) If the recipient or responsible party requests a 128.27 qualified professional, theconsultingqualified professional 128.28 providing assistance to the recipient shall meet the 128.29 qualifications specified in section 256B.0625, subdivision 19c. 128.30 Theconsultingqualified professional shall assist the recipient 128.31 in developing and revising a plan to meet the 128.32 recipient'sassessedneeds,and supervise the performance of128.33delegated tasks, as determined by the public health nurseas 128.34 assessed by the public health nurse. In performing this 128.35 function, theconsultingqualified professional must visit the 128.36 recipient in the recipient's home at least once annually. 129.1 Theconsultingqualified professional must reportto the local129.2county public health nurse concerns relating to the health and129.3safety of the recipient, andany suspected abuse, neglect, or 129.4 financial exploitation of the recipient to the appropriate 129.5 authorities. 129.6 (f) The fiscalagentintermediary, recipient or responsible 129.7 party, personal care assistant, andconsultingqualified 129.8 professional shall enter into a written agreement before 129.9 services are started. The agreement shall include: 129.10 (1) the duties of the recipient, qualified professional, 129.11 personal care assistant, and fiscal agent based on paragraphs 129.12 (a) to (e); 129.13 (2) the salary and benefits for the personal care assistant 129.14 andthose providing professional consultationthe qualified 129.15 professional; 129.16 (3) the administrative fee of the fiscalagentintermediary 129.17 and services paid for with that fee, including background check 129.18 fees; 129.19 (4) procedures to respond to billing or payment complaints; 129.20 and 129.21 (5) procedures for hiring and terminating the personal care 129.22 assistant andthose providing professional consultationthe 129.23 qualified professional. 129.24 (g) The rates paid for personal care assistant services, 129.25 qualified professionalassistanceservices, and fiscalagency129.26 intermediary services under this subdivision shall be the same 129.27 rates paid for personal care assistant services and qualified 129.28 professional services under subdivision 2 respectively. Except 129.29 for the administrative fee of the fiscalagentintermediary 129.30 specified in paragraph (f), the remainder of the rates paid to 129.31 the fiscalagentintermediary must be used to pay for the salary 129.32 and benefits for the personal care assistant orthose providing129.33professional consultationthe qualified professional. 129.34 (h) As part of the assessment defined in subdivision 1, the 129.35 following conditions must be met to use or continue use of a 129.36 fiscalagentintermediary: 130.1 (1) the recipient must be able to direct the recipient's 130.2 own care, or the responsible party for the recipient must be 130.3 readily available to direct the care of the personal care 130.4 assistant; 130.5 (2) the recipient or responsible party must be 130.6 knowledgeable of the health care needs of the recipient and be 130.7 able to effectively communicate those needs; 130.8 (3) a face-to-face assessment must be conducted by the 130.9 local county public health nurse at least annually, or when 130.10 there is a significant change in the recipient's condition or 130.11 change in the need for personal care assistant services. The130.12county public health nurse shall determine the services that130.13require professional delegation, if any, and the amount and130.14frequency of related supervision; 130.15 (4) the recipient cannot select the shared services option 130.16 as specified in subdivision 8; and 130.17 (5) parties must be in compliance with the written 130.18 agreement specified in paragraph (f). 130.19 (i) The commissioner shall deny, revoke, or suspend the 130.20 authorization to use the fiscalagentintermediary option if: 130.21 (1) it has been determined by theconsultingqualified 130.22 professional or local county public health nurse that the use of 130.23 this option jeopardizes the recipient's health and safety; 130.24 (2) the parties have failed to comply with the written 130.25 agreement specified in paragraph (f); or 130.26 (3) the use of the option has led to abusive or fraudulent 130.27 billing for personal care assistant services. 130.28 The recipient or responsible party may appeal the 130.29 commissioner's action according to section 256.045. The denial, 130.30 revocation, or suspension to use the fiscalagentintermediary 130.31 option shall not affect the recipient's authorized level of 130.32 personal care assistant services as determined in subdivision 5. 130.33 Sec. 33. Minnesota Statutes 2000, section 256B.0627, 130.34 subdivision 11, is amended to read: 130.35 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 130.36 Medical assistance payments for shared private duty nursing 131.1 services by a private duty nurse shall be limited according to 131.2 this subdivision. For the purposes of this section, "private 131.3 duty nursing agency" means an agency licensed under chapter 144A 131.4 to provide private duty nursing services. 131.5 (b) Recipients of private duty nursing services may share 131.6 nursing staff and the commissioner shall provide a rate 131.7 methodology for shared private duty nursing. For two persons 131.8 sharing nursing care, the rate paid to a provider shall not 131.9 exceed 1.5 times thenonwaiveredregular private duty nursing 131.10 rates paid for serving a single individualwho is not ventilator131.11dependent,by a registered nurse or licensed practical nurse. 131.12 These rates apply only to situations in which both recipients 131.13 are present and receive shared private duty nursing care on the 131.14 date for which the service is billed. No more than two persons 131.15 may receive shared private duty nursing services from a private 131.16 duty nurse in a single setting. 131.17 (c) Shared private duty nursing care is the provision of 131.18 nursing services by a private duty nurse to two recipients at 131.19 the same time and in the same setting. For the purposes of this 131.20 subdivision, "setting" means: 131.21 (1) the home or foster care home of one of the individual 131.22 recipients; or 131.23 (2) a child care program licensed under chapter 245A or 131.24 operated by a local school district or private school; or 131.25 (3) an adult day care service licensed under chapter 245A; 131.26 or 131.27 (4) outside the home or foster care home of one of the 131.28 recipients when normal life activities take the recipients 131.29 outside the home. 131.30 This subdivision does not apply when a private duty nurse 131.31 is caring for multiple recipients in more than one setting. 131.32 (d) The recipient or the recipient's legal representative, 131.33 and the recipient's physician, in conjunction with the home 131.34 health care agency, shall determine: 131.35 (1) whether shared private duty nursing care is an 131.36 appropriate option based on the individual needs and preferences 132.1 of the recipient; and 132.2 (2) the amount of shared private duty nursing services 132.3 authorized as part of the overall authorization of nursing 132.4 services. 132.5 (e) The recipient or the recipient's legal representative, 132.6 in conjunction with the private duty nursing agency, shall 132.7 approve the setting, grouping, and arrangement of shared private 132.8 duty nursing care based on the individual needs and preferences 132.9 of the recipients. Decisions on the selection of recipients to 132.10 share services must be based on the ages of the recipients, 132.11 compatibility, and coordination of their care needs. 132.12 (f) The following items must be considered by the recipient 132.13 or the recipient's legal representative and the private duty 132.14 nursing agency, and documented in the recipient's health service 132.15 record: 132.16 (1) the additional training needed by the private duty 132.17 nurse to provide care to two recipients in the same setting and 132.18 to ensure that the needs of the recipients are met appropriately 132.19 and safely; 132.20 (2) the setting in which the shared private duty nursing 132.21 care will be provided; 132.22 (3) the ongoing monitoring and evaluation of the 132.23 effectiveness and appropriateness of the service and process 132.24 used to make changes in service or setting; 132.25 (4) a contingency plan which accounts for absence of the 132.26 recipient in a shared private duty nursing setting due to 132.27 illness or other circumstances; 132.28 (5) staffing backup contingencies in the event of employee 132.29 illness or absence; and 132.30 (6) arrangements for additional assistance to respond to 132.31 urgent or emergency care needs of the recipients. 132.32 (g) The provider must offer the recipient or responsible 132.33 party the option of shared or one-on-one private duty nursing 132.34 services. The recipient or responsible party can withdraw from 132.35 participating in a shared service arrangement at any time. 132.36 (h) The private duty nursing agency must document the 133.1 following in the health service record for each individual 133.2 recipient sharing private duty nursing care: 133.3 (1) permission by the recipient or the recipient's legal 133.4 representative for the maximum number of shared nursing care 133.5 hours per week chosen by the recipient; 133.6 (2) permission by the recipient or the recipient's legal 133.7 representative for shared private duty nursing services provided 133.8 outside the recipient's residence; 133.9 (3) permission by the recipient or the recipient's legal 133.10 representative for others to receive shared private duty nursing 133.11 services in the recipient's residence; 133.12 (4) revocation by the recipient or the recipient's legal 133.13 representative of the shared private duty nursing care 133.14 authorization, or the shared care to be provided to others in 133.15 the recipient's residence, or the shared private duty nursing 133.16 services to be provided outside the recipient's residence; and 133.17 (5) daily documentation of the shared private duty nursing 133.18 services provided by each identified private duty nurse, 133.19 including: 133.20 (i) the names of each recipient receiving shared private 133.21 duty nursing services together; 133.22 (ii) the setting for the shared services, including the 133.23 starting and ending times that the recipient received shared 133.24 private duty nursing care; and 133.25 (iii) notes by the private duty nurse regarding changes in 133.26 the recipient's condition, problems that may arise from the 133.27 sharing of private duty nursing services, and scheduling and 133.28 care issues. 133.29 (i) Unless otherwise provided in this subdivision, all 133.30 other statutory and regulatory provisions relating to private 133.31 duty nursing services apply to shared private duty nursing 133.32 services. 133.33 Nothing in this subdivision shall be construed to reduce 133.34 the total number of private duty nursing hours authorized for an 133.35 individual recipient under subdivision 5. 133.36 Sec. 34. Minnesota Statutes 2000, section 256B.0627, is 134.1 amended by adding a subdivision to read: 134.2 Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 134.3 PROJECT.] (a) Upon the receipt of federal waiver authority, the 134.4 commissioner shall implement a consumer-directed home care 134.5 demonstration project. The consumer-directed home care 134.6 demonstration project must demonstrate and evaluate the outcomes 134.7 of a consumer-directed service delivery alternative to improve 134.8 access, increase consumer control and accountability over 134.9 available resources, and enable the use of supports that are 134.10 more individualized and cost-effective for eligible medical 134.11 assistance recipients receiving certain medical assistance home 134.12 care services. The consumer-directed home care demonstration 134.13 project will be administered locally by county agencies, tribal 134.14 governments, or administrative entities under contract with the 134.15 state in regions where counties choose not to provide this 134.16 service. 134.17 (b) Grant awards for persons who have been receiving 134.18 medical assistance covered personal care, home health aide, or 134.19 private duty nursing services for a period of 12 consecutive 134.20 months or more prior to enrollment in the consumer-directed home 134.21 care demonstration project will be established on a case-by-case 134.22 basis using historical service expenditure data. An average 134.23 monthly expenditure for each continuing enrollee will be 134.24 calculated based on historical expenditures made on behalf of 134.25 the enrollee for personal care, home health aide, or private 134.26 duty nursing services during the 12 month period directly prior 134.27 to enrollment in the project. The grant award will equal 90 134.28 percent of the average monthly expenditure. 134.29 (c) Grant awards for project enrollees who have been 134.30 receiving medical assistance covered personal care, home health 134.31 aide, or private duty nursing services for a period of less than 134.32 12 consecutive months prior to project enrollment will be 134.33 calculated on a case-by-case basis using the service 134.34 authorization in place at the time of enrollment. The total 134.35 number of units of personal care, home health aide, or private 134.36 duty nursing services the enrollee has been authorized to 135.1 receive will be converted to the total cost of the authorized 135.2 services in a given month using the statewide average service 135.3 payment rates. To determine an estimated monthly expenditure, 135.4 the total authorized monthly personal care, home health aide or 135.5 private duty nursing service costs will be reduced by a 135.6 percentage rate equivalent to the difference between the 135.7 statewide average service authorization and the statewide 135.8 average utilization rate for each of the services by medical 135.9 assistance eligibles during the most recent fiscal year for 135.10 which 12 months of data is available. The grant award will 135.11 equal 90 percent of the estimated monthly expenditure. 135.12 (d) The state of Minnesota, county agencies, tribal 135.13 governments, or administrative entities under contract with the 135.14 state that participate in the implementation and administration 135.15 of the consumer-directed home care demonstration project, shall 135.16 not be liable for damages, injuries, or liabilities sustained 135.17 through the purchase of support by the individual, the 135.18 individual's family, legal representative, or the authorized 135.19 representative under this section with funds received through 135.20 the consumer-directed home care demonstration project. 135.21 Liabilities include but are not limited to: workers' 135.22 compensation liability, the Federal Insurance Contributions Act 135.23 (FICA), or the Federal Unemployment Tax Act (FUTA). 135.24 (e) With federal approval, the commissioner may adjust 135.25 methodologies in paragraphs (b) and (c) to simplify program 135.26 administration, improve consistency between state and federal 135.27 programs, and maximize federal financial participation. 135.28 Sec. 35. Minnesota Statutes 2000, section 256B.0627, is 135.29 amended by adding a subdivision to read: 135.30 Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 135.31 assistance covers skilled nurse visits according to section 135.32 256B.0625, subdivision 6a, provided via telehomecare, for 135.33 services which do not require hands-on care between the home 135.34 care nurse and recipient. The provision of telehomecare must be 135.35 made via live, two-way interactive audiovisual technology and 135.36 may be augmented by utilizing store-and-forward technologies. 136.1 Store-and-forward technology includes telehomecare services that 136.2 do not occur in real time via synchronous transmissions, and 136.3 that do not require a face-to-face encounter with the recipient 136.4 for all or any part of any such telehomecare visit. 136.5 Individually identifiable patient data obtained through 136.6 real-time or store-and-forward technology must be maintained as 136.7 health records according to section 144.335. If the video is 136.8 used for research, training, or other purposes unrelated to the 136.9 care of the patient, the identity of the patient must be 136.10 concealed. A communication between the home care nurse and 136.11 recipient that consists solely of a telephone conversation, 136.12 facsimile, electronic mail, or a consultation between two health 136.13 care practitioners, is not to be considered a telehomecare visit. 136.14 Multiple daily skilled nurse visits provided via telehomecare 136.15 are allowed. Coverage of telehomecare is limited to two visits 136.16 per day. All skilled nurse visits provided via telehomecare 136.17 must be prior authorized by the commissioner or the 136.18 commissioner's designee and will be covered at the same 136.19 allowable rate as skilled nurse visits provided in-person. 136.20 Sec. 36. Minnesota Statutes 2000, section 256B.0627, is 136.21 amended by adding a subdivision to read: 136.22 Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a) 136.23 [PHYSICAL THERAPY.] Medical assistance covers physical therapy 136.24 and related services, including specialized maintenance 136.25 therapy. Services provided by a physical therapy assistant 136.26 shall be reimbursed at the same rate as services performed by a 136.27 physical therapist when the services of the physical therapy 136.28 assistant are provided under the direction of a physical 136.29 therapist who is on the premises. Services provided by a 136.30 physical therapy assistant that are provided under the direction 136.31 of a physical therapist who is not on the premises shall be 136.32 reimbursed at 65 percent of the physical therapist rate. 136.33 Direction of the physical therapy assistant must be provided by 136.34 the physical therapist as described in Minnesota Rules, part 136.35 9505.0390, subpart 1, item B. The physical therapist and 136.36 physical therapist assistant may not both bill for services 137.1 provided to a recipient on the same day. 137.2 (b) [OCCUPATIONAL THERAPY.] Medical assistance covers 137.3 occupational therapy and related services, including specialized 137.4 maintenance therapy. Services provided by an occupational 137.5 therapy assistant shall be reimbursed at the same rate as 137.6 services performed by an occupational therapist when the 137.7 services of the occupational therapy assistant are provided 137.8 under the direction of the occupational therapist who is on the 137.9 premises. Services provided by an occupational therapy 137.10 assistant under the direction of an occupational therapist who 137.11 is not on the premises shall be reimbursed at 65 percent of the 137.12 occupational therapist rate. Direction of the occupational 137.13 therapy assistant must be provided by the occupational therapist 137.14 as described in Minnesota Rules, part 9505.0390, subpart 1, item 137.15 B. The occupational therapist and occupational therapist 137.16 assistant may not both bill for services provided to a recipient 137.17 on the same day. 137.18 Sec. 37. Minnesota Statutes 2000, section 256B.0627, is 137.19 amended by adding a subdivision to read: 137.20 Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 137.21 Payment is allowed for extraordinary services that require 137.22 specialized nursing skills and are provided by parents of minor 137.23 children, spouses, and legal guardians who are providing private 137.24 duty nursing care under the following conditions: 137.25 (1) the provision of these services is not legally required 137.26 of the parents, spouses, or legal guardians; 137.27 (2) the services are necessary to prevent hospitalization 137.28 of the recipient; and 137.29 (3) the recipient is eligible for state plan home care or a 137.30 home and community-based waiver and one of the following 137.31 hardship criteria are met: 137.32 (i) the parent, spouse, or legal guardian resigns from a 137.33 part-time or full-time job to provide nursing care for the 137.34 recipient; or 137.35 (ii) the parent, spouse, or legal guardian goes from a 137.36 full-time to a part-time job with less compensation to provide 138.1 nursing care for the recipient; or 138.2 (iii) the parent, spouse, or legal guardian takes a leave 138.3 of absence without pay to provide nursing care for the 138.4 recipient; or 138.5 (iv) because of labor conditions, special language needs, 138.6 or intermittent hours of care needed, the parent, spouse, or 138.7 legal guardian is needed in order to provide adequate private 138.8 duty nursing services to meet the medical needs of the recipient. 138.9 (b) Private duty nursing may be provided by a parent, 138.10 spouse, or legal guardian who is a nurse licensed in Minnesota. 138.11 Private duty nursing services provided by a parent, spouse, or 138.12 legal guardian cannot be used in lieu of nursing services 138.13 covered and available under liable third-party payors, including 138.14 Medicare. The private duty nursing provided by a parent, 138.15 spouse, or legal guardian must be included in the service plan. 138.16 Authorized skilled nursing services provided by the parent, 138.17 spouse, or legal guardian may not exceed 50 percent of the total 138.18 approved nursing hours, or eight hours per day, whichever is 138.19 less, up to a maximum of 40 hours per week. Nothing in this 138.20 subdivision precludes the parent's, spouse's, or legal 138.21 guardian's obligation of assuming the nonreimbursed family 138.22 responsibilities of emergency backup caregiver and primary 138.23 caregiver. 138.24 (c) A parent or a spouse may not be paid to provide private 138.25 duty nursing care if the parent or spouse fails to pass a 138.26 criminal background check according to section 245A.04, or if it 138.27 has been determined by the home health agency, the case manager, 138.28 or the physician that the private duty nursing care provided by 138.29 the parent, spouse, or legal guardian is unsafe. 138.30 Sec. 38. Minnesota Statutes 2000, section 256B.0627, is 138.31 amended by adding a subdivision to read: 138.32 Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 138.33 ASSISTANT SERVICES.] The commissioner shall establish a quality 138.34 assurance plan for personal care assistant services that 138.35 includes: 138.36 (1) performance-based provider agreements; 139.1 (2) meaningful consumer input, which may include consumer 139.2 surveys, that measure the extent to which participants receive 139.3 the services and supports described in the individual plan and 139.4 participant satisfaction with such services and supports; 139.5 (3) ongoing monitoring of the health and well-being of 139.6 consumers; and 139.7 (4) an ongoing public process for development, 139.8 implementation, and review of the quality assurance plan. 139.9 Sec. 39. Minnesota Statutes 2000, section 256B.0911, is 139.10 amended by adding a subdivision to read: 139.11 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 139.12 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 139.13 ensure that individuals with disabilities or chronic illness are 139.14 served in the most integrated setting appropriate to their needs 139.15 and have the necessary information to make informed choices 139.16 about home and community-based service options. 139.17 (b) Individuals under 65 years of age who are admitted to a 139.18 nursing facility from a hospital must be screened prior to 139.19 admission as outlined in subdivisions 4a through 4c. 139.20 (c) Individuals under 65 years of age who are admitted to 139.21 nursing facilities with only a telephone screening must receive 139.22 a face-to-face assessment from the long-term care consultation 139.23 team member of the county in which the facility is located or 139.24 from the recipient's county case manager within 20 working days 139.25 of admission. 139.26 (d) At the face-to-face assessment, the long-term care 139.27 consultation team member or county case manager must perform the 139.28 activities required under subdivision 3b. 139.29 (e) For individuals under 21 years of age, a screening 139.30 interview which recommends nursing facility admission must be 139.31 face-to-face and approved by the commissioner before the 139.32 individual is admitted to the nursing facility. 139.33 (f) In the event that an individual under 65 years of age 139.34 is admitted to a nursing facility on an emergency basis, the 139.35 county must be notified of the admission on the next working 139.36 day, and a face-to-face assessment as described in paragraph (c) 140.1 must be conducted within 20 working days of admission. 140.2 (g) At the face-to-face assessment, the long-term care 140.3 consultation team member or the case manager must present 140.4 information about home and community-based options so the 140.5 individual can make informed choices. If the individual chooses 140.6 home and community-based services, the long-term care 140.7 consultation team member or case manager must complete a written 140.8 relocation plan within 20 working days of the visit. The plan 140.9 shall describe the services needed to move out of the facility 140.10 and a time line for the move which is designed to ensure a 140.11 smooth transition to the individual's home and community. 140.12 (h) An individual under 65 years of age residing in a 140.13 nursing facility shall receive a face-to-face assessment at 140.14 least every 12 months to review the person's service choices and 140.15 available alternatives unless the individual indicates, in 140.16 writing, that annual visits are not desired. In this case, the 140.17 individual must receive a face-to-face assessment at least once 140.18 every 36 months for the same purposes. 140.19 (i) Notwithstanding the provisions of subdivision 6, the 140.20 commissioner may pay county agencies directly for face-to-face 140.21 assessments for individuals under 65 years of age who are being 140.22 considered for placement or residing in a nursing facility. 140.23 Sec. 40. Minnesota Statutes 2000, section 256B.0916, is 140.24 amended by adding a subdivision to read: 140.25 Subd. 6a. [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED 140.26 COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit 140.27 to the federal Health Care Financing Administration by August 1, 140.28 2001, an amendment to the home and community-based waiver for 140.29 persons with mental retardation or related conditions to make 140.30 consumer-directed community support services available in every 140.31 county of the state by January 1, 2002. 140.32 (b) If a county declines to meet the requirements for 140.33 provision of consumer-directed community supports, the 140.34 commissioner shall contract with another county, a group of 140.35 counties, or a private agency to plan for and administer 140.36 consumer-directed community supports in that county. 141.1 (c) The state of Minnesota, county agencies, tribal 141.2 governments, or administrative entities under contract to 141.3 participate in the implementation and administration of the home 141.4 and community-based waiver for persons with mental retardation 141.5 or a related condition, shall not be liable for damages, 141.6 injuries, or liabilities sustained through the purchase of 141.7 support by the individual, the individual's family, legal 141.8 representative, or the authorized representative with funds 141.9 received through the consumer-directed community support service 141.10 under this section. Liabilities include but are not limited 141.11 to: workers' compensation liability, the Federal Insurance 141.12 Contributions Act (FICA), or the Federal Unemployment Tax Act 141.13 (FUTA). 141.14 Sec. 41. Minnesota Statutes 2000, section 256B.0916, 141.15 subdivision 7, is amended to read: 141.16 Subd. 7. [ANNUAL REPORT BY COMMISSIONER.] Beginning 141.17October 1, 1999, and each October 1November 1, 2001, and each 141.18 November 1 thereafter, the commissioner shall issue an annual 141.19 report on county and state use of available resources for the 141.20 home and community-based waiver for persons with mental 141.21 retardation or related conditions. For each county or county 141.22 partnership, the report shall include: 141.23 (1) the amount of funds allocated but not used; 141.24 (2) the county specific allowed reserve amount approved and 141.25 used; 141.26 (3) the number, ages, and living situations of individuals 141.27 screened and waiting for services; 141.28 (4) the urgency of need for services to begin within one, 141.29 two, or more than two years for each individual; 141.30 (5) the services needed; 141.31 (6) the number of additional persons served by approval of 141.32 increased capacity within existing allocations; 141.33 (7) results of action by the commissioner to streamline 141.34 administrative requirements and improve county resource 141.35 management; and 141.36 (8) additional action that would decrease the number of 142.1 those eligible and waiting for waivered services. 142.2 The commissioner shall specify intended outcomes for the program 142.3 and the degree to which these specified outcomes are attained. 142.4 Sec. 42. Minnesota Statutes 2000, section 256B.0916, 142.5 subdivision 9, is amended to read: 142.6 Subd. 9. [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.] 142.7 The commissioner, in cooperation with representatives of 142.8 counties, service providers, service recipients, family members, 142.9 legal representatives and advocates, shall develop criteria to 142.10 allow legal representatives to be reimbursed for providing 142.11 specific support services to meet the person's needs when a plan 142.12 which assures health and safety has been agreed upon and carried 142.13 out by the legal representative, the person, and the county. 142.14 Legal representatives providing support underconsumer-directed142.15community support services pursuant to section 256B.092,142.16subdivision 4,the home and community-based waiver for persons 142.17 with mental retardation or related conditions or the consumer 142.18 support grant program pursuant to section256B.092, subdivision142.197256.476, shall not be considered to have a direct or indirect 142.20 service provider interest under section 256B.092, subdivision 7, 142.21 if a health and safety plan which meets the criteria established 142.22 has been agreed upon and implemented. ByOctober 1, 1999August 142.23 1, 2001, the commissioner shall submit, for federal approval, 142.24 amendments to allow legal representatives to provide support and 142.25 receive reimbursement under theconsumer-directed community142.26support services section of thehome and community-based waiver 142.27 plan. 142.28 Sec. 43. Minnesota Statutes 2000, section 256B.092, 142.29 subdivision 5, is amended to read: 142.30 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 142.31 apply for any federal waivers necessary to secure, to the extent 142.32 allowed by law, federal financial participation under United 142.33 States Code, title 42, sections 1396 et seq., as amended, for 142.34 the provision of services to persons who, in the absence of the 142.35 services, would need the level of care provided in a regional 142.36 treatment center or a community intermediate care facility for 143.1 persons with mental retardation or related conditions. The 143.2 commissioner may seek amendments to the waivers or apply for 143.3 additional waivers under United States Code, title 42, sections 143.4 1396 et seq., as amended, to contain costs. The commissioner 143.5 shall ensure that payment for the cost of providing home and 143.6 community-based alternative services under the federal waiver 143.7 plan shall not exceed the cost of intermediate care services 143.8 including day training and habilitation services that would have 143.9 been provided without the waivered services. 143.10 (b) The commissioner, in administering home and 143.11 community-based waivers for persons with mental retardation and 143.12 related conditions, shall ensure that day services for eligible 143.13 persons are not provided by the person's residential service 143.14 provider, unless the person or the person's legal representative 143.15 is offered a choice of providers and agrees in writing to 143.16 provision of day services by the residential service provider. 143.17 The individual service plan for individuals who choose to have 143.18 their residential service provider provide their day services 143.19 must describe how health, safety, and protection needs will be 143.20 met by frequent and regular contact with persons other than the 143.21 residential service provider. 143.22 Sec. 44. Minnesota Statutes 2000, section 256B.093, 143.23 subdivision 3, is amended to read: 143.24 Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 143.25 department shall fund administrative case management under this 143.26 subdivision using medical assistance administrative funds. The 143.27 traumatic brain injury program duties include: 143.28 (1) recommending to the commissioner in consultation with 143.29 the medical review agent according to Minnesota Rules, parts 143.30 9505.0500 to 9505.0540, the approval or denial of medical 143.31 assistance funds to pay for out-of-state placements for 143.32 traumatic brain injury services and in-state traumatic brain 143.33 injury services provided by designated Medicare long-term care 143.34 hospitals; 143.35 (2) coordinating the traumatic brain injury home and 143.36 community-based waiver; 144.1 (3)approving traumatic brain injury waiver eligibility or144.2care plans or both;144.3(4)providing ongoing technical assistance and consultation 144.4 to county and facility case managers to facilitate care plan 144.5 development for appropriate, accessible, and cost-effective 144.6 medical assistance services; 144.7(5)(4) providing technical assistance to promote statewide 144.8 development of appropriate, accessible, and cost-effective 144.9 medical assistance services and related policy; 144.10(6)(5) providing training and outreach to facilitate 144.11 access to appropriate home and community-based services to 144.12 prevent institutionalization; 144.13(7)(6) facilitating appropriate admissions, continued stay 144.14 review, discharges, and utilization review for neurobehavioral 144.15 hospitals and other specialized institutions; 144.16(8)(7) providing technical assistance on the use of prior 144.17 authorization of home care services and coordination of these 144.18 services with other medical assistance services; 144.19(9)(8) developing a system for identification of nursing 144.20 facility and hospital residents with traumatic brain injury to 144.21 assist in long-term planning for medical assistance services. 144.22 Factors will include, but are not limited to, number of 144.23 individuals served, length of stay, services received, and 144.24 barriers to community placement; and 144.25(10)(9) providing information, referral, and case 144.26 consultation to access medical assistance services for 144.27 recipients without a county or facility case manager. Direct 144.28 access to this assistance may be limited due to the structure of 144.29 the program. 144.30 Sec. 45. Minnesota Statutes 2000, section 256B.49, is 144.31 amended by adding a subdivision to read: 144.32 Subd. 11. [AUTHORITY.] (a) The commissioner is authorized 144.33 to apply for home and community-based service waivers, as 144.34 authorized under section 1915(c) of the Social Security Act to 144.35 serve persons under the age of 65 who are determined to require 144.36 the level of care provided in a nursing home and persons who 145.1 require the level of care provided in a hospital. The 145.2 commissioner shall apply for the home and community-based 145.3 waivers in order to: (i) promote the support of persons with 145.4 disabilities in the most integrated settings; (ii) expand the 145.5 availability of services for persons who are eligible for 145.6 medical assistance; (iii) promote cost-effective options to 145.7 institutional care; and (iv) obtain federal financial 145.8 participation. 145.9 (b) The provision of waivered services to medical 145.10 assistance recipients with disabilities shall comply with the 145.11 requirements outlined in the federally approved applications for 145.12 home and community-based services and subsequent amendments, 145.13 including provision of services according to a service plan 145.14 designed to meet the needs of the individual. For purposes of 145.15 this section, the approved home and community-based application 145.16 is considered the necessary federal requirement. 145.17 (c) The commissioner shall provide interested persons 145.18 serving on agency advisory committees and task forces, and 145.19 others upon request, with notice of, and an opportunity to 145.20 comment on, any changes or amendments to the federally approved 145.21 applications for home and community-based waivers, prior to 145.22 their submission to the federal health care financing 145.23 administration. 145.24 (d) The commissioner shall seek approval, as authorized 145.25 under section 1915(c) of the Social Security Act, to allow 145.26 medical assistance eligibility under this section for children 145.27 under age 21 without deeming of parental income or assets. 145.28 (e) The commissioner shall seek approval, as authorized 145.29 under section 1915(c) of the Social Act, to allow medical 145.30 assistance eligibility under this section for individuals under 145.31 age 65 without deeming the spouse's income or assets. 145.32 Sec. 46. Minnesota Statutes 2000, section 256B.49, is 145.33 amended by adding a subdivision to read: 145.34 Subd. 12. [INFORMED CHOICE.] Persons who are determined 145.35 likely to require the level of care provided in a nursing 145.36 facility or hospital shall be informed of the home and 146.1 community-based support alternatives to the provision of 146.2 inpatient hospital services or nursing facility services. Each 146.3 person must be given the choice of either institutional or home 146.4 and community-based services using the provisions described in 146.5 section 256B.77, subdivision 2, paragraph (p). 146.6 Sec. 47. Minnesota Statutes 2000, section 256B.49, is 146.7 amended by adding a subdivision to read: 146.8 Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home 146.9 and community-based waiver shall be provided case management 146.10 services by qualified vendors as described in the federally 146.11 approved waiver application. The case management service 146.12 activities provided will include: 146.13 (1) assessing the needs of the individual within 20 working 146.14 days of a recipient's request; 146.15 (2) developing the written individual service plan within 146.16 ten working days after the assessment is completed; 146.17 (3) informing the recipient or the recipient's legal 146.18 guardian or conservator of service options; 146.19 (4) assisting the recipient in the identification of 146.20 potential service providers; 146.21 (5) assisting the recipient to access services; 146.22 (6) coordinating, evaluating, and monitoring of the 146.23 services identified in the service plan; 146.24 (7) completing the annual reviews of the service plan; and 146.25 (8) informing the recipient or legal representative of the 146.26 right to have assessments completed and service plans developed 146.27 within specified time periods, and to appeal county action or 146.28 inaction under section 256.045, subdivision 3. 146.29 (b) The case manager may delegate certain aspects of the 146.30 case management service activities to another individual 146.31 provided there is oversight by the case manager. The case 146.32 manager may not delegate those aspects which require 146.33 professional judgment including assessments, reassessments, and 146.34 care plan development. 146.35 Sec. 48. Minnesota Statutes 2000, section 256B.49, is 146.36 amended by adding a subdivision to read: 147.1 Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments 147.2 of each recipient's strengths, informal support systems, and 147.3 need for services shall be completed within 20 working days of 147.4 the recipient's request. Reassessment of each recipient's 147.5 strengths, support systems, and need for services shall be 147.6 conducted at least every 12 months and at other times when there 147.7 has been a significant change in the recipient's functioning. 147.8 (b) Persons with mental retardation or a related condition 147.9 who apply for services under the nursing facility level waiver 147.10 programs shall be screened for the appropriate level of care 147.11 according to section 256B.092. 147.12 (c) Recipients who are found eligible for home and 147.13 community-based services under this section before their 65th 147.14 birthday may remain eligible for these services after their 65th 147.15 birthday if they continue to meet all other eligibility factors. 147.16 Sec. 49. Minnesota Statutes 2000, section 256B.49, is 147.17 amended by adding a subdivision to read: 147.18 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 147.19 home and community-based waivered services shall be provided a 147.20 copy of the written service plan which: 147.21 (1) is developed and signed by the recipient within ten 147.22 working days of the completion of the assessment; 147.23 (2) meets the assessed needs of the recipient; 147.24 (3) reasonably ensures the health and safety of the 147.25 recipient; 147.26 (4) promotes independence; 147.27 (5) allows for services to be provided in the most 147.28 integrated settings; and 147.29 (6) provides for an informed choice, as defined in section 147.30 256B.77, subdivision 2, paragraph (p), of service and support 147.31 providers. 147.32 Sec. 50. Minnesota Statutes 2000, section 256B.49, is 147.33 amended by adding a subdivision to read: 147.34 Subd. 16. [SERVICES AND SUPPORTS.] (a) Services and 147.35 supports included in the home and community-based waivers for 147.36 persons with disabilities shall meet the requirements set out in 148.1 United States Code, title 42, section 1396n. The services and 148.2 supports, which are offered as alternatives to institutional 148.3 care, shall promote consumer choice, community inclusion, 148.4 self-sufficiency, and self-determination. 148.5 (b) Beginning January 1, 2003, the commissioner shall 148.6 simplify and improve access to home and community-based waivered 148.7 services, to the extent possible, through the establishment of a 148.8 common service menu that is available to eligible recipients 148.9 regardless of age, disability type, or waiver program. 148.10 (c) Consumer directed community support services shall be 148.11 offered as an option to all persons eligible for services under 148.12 subdivision 11, by January 1, 2002. 148.13 (d) Services and supports shall be arranged and provided 148.14 consistent with individualized written plans of care for 148.15 eligible waiver recipients. 148.16 (e) The state of Minnesota and county agencies that 148.17 administer home and community-based waivered services for 148.18 persons with disabilities, shall not be liable for damages, 148.19 injuries, or liabilities sustained through the purchase of 148.20 supports by the individual, the individual's family, legal 148.21 representative, or the authorized representative with funds 148.22 received through the consumer-directed community support service 148.23 under this section. Liabilities include but are not limited 148.24 to: workers' compensation liability, the Federal Insurance 148.25 Contributions Act (FICA), or the Federal Unemployment Tax Act 148.26 (FUTA). 148.27 Sec. 51. Minnesota Statutes 2000, section 256B.49, is 148.28 amended by adding a subdivision to read: 148.29 Subd. 18. [PAYMENTS.] The commissioner shall reimburse 148.30 approved vendors from the medical assistance account for the 148.31 costs of providing home and community-based services to eligible 148.32 recipients using the invoice processing procedures of the 148.33 Medicaid management information system (MMIS). Recipients will 148.34 be screened and authorized for services according to the 148.35 federally approved waiver application and its subsequent 148.36 amendments. 149.1 Sec. 52. Minnesota Statutes 2000, section 256B.49, is 149.2 amended by adding a subdivision to read: 149.3 Subd. 19. [HEALTH AND WELFARE.] The commissioner of human 149.4 services shall take the necessary safeguards to protect the 149.5 health and welfare of individuals provided services under the 149.6 waiver. 149.7 Sec. 53. Minnesota Statutes 2000, section 256D.35, is 149.8 amended by adding a subdivision to read: 149.9 Subd. 11a. [INSTITUTION.] "Institution" means a hospital, 149.10 consistent with Code of Federal Regulations, title 42, section 149.11 440.10; regional treatment center inpatient services, consistent 149.12 with section 245.474; a nursing facility; and an intermediate 149.13 care facility for persons with mental retardation. 149.14 Sec. 54. Minnesota Statutes 2000, section 256D.35, is 149.15 amended by adding a subdivision to read: 149.16 Subd. 18a. [SHELTER COSTS.] "Shelter costs" means rent, 149.17 manufactured home lot rentals; monthly principal, interest, 149.18 insurance premiums, and property taxes due for mortgages or 149.19 contract for deed costs; costs for utilities, including heating, 149.20 cooling, electricity, water, and sewerage; garbage collection 149.21 fees; and the basic service fee for one telephone. 149.22 Sec. 55. Minnesota Statutes 2000, section 256D.44, 149.23 subdivision 5, is amended to read: 149.24 Subd. 5. [SPECIAL NEEDS.] In addition to the state 149.25 standards of assistance established in subdivisions 1 to 4, 149.26 payments are allowed for the following special needs of 149.27 recipients of Minnesota supplemental aid who are not residents 149.28 of a nursing home, a regional treatment center, or a group 149.29 residential housing facility. 149.30 (a) The county agency shall pay a monthly allowance for 149.31 medically prescribed diets payable under the Minnesota family 149.32 investment program if the cost of those additional dietary needs 149.33 cannot be met through some other maintenance benefit. 149.34 (b) Payment for nonrecurring special needs must be allowed 149.35 for necessary home repairs or necessary repairs or replacement 149.36 of household furniture and appliances using the payment standard 150.1 of the AFDC program in effect on July 16, 1996, for these 150.2 expenses, as long as other funding sources are not available. 150.3 (c) A fee for guardian or conservator service is allowed at 150.4 a reasonable rate negotiated by the county or approved by the 150.5 court. This rate shall not exceed five percent of the 150.6 assistance unit's gross monthly income up to a maximum of $100 150.7 per month. If the guardian or conservator is a member of the 150.8 county agency staff, no fee is allowed. 150.9 (d) The county agency shall continue to pay a monthly 150.10 allowance of $68 for restaurant meals for a person who was 150.11 receiving a restaurant meal allowance on June 1, 1990, and who 150.12 eats two or more meals in a restaurant daily. The allowance 150.13 must continue until the person has not received Minnesota 150.14 supplemental aid for one full calendar month or until the 150.15 person's living arrangement changes and the person no longer 150.16 meets the criteria for the restaurant meal allowance, whichever 150.17 occurs first. 150.18 (e) A fee of ten percent of the recipient's gross income or 150.19 $25, whichever is less, is allowed for representative payee 150.20 services provided by an agency that meets the requirements under 150.21 SSI regulations to charge a fee for representative payee 150.22 services. This special need is available to all recipients of 150.23 Minnesota supplemental aid regardless of their living 150.24 arrangement. 150.25 (f) Notwithstanding the language in this subdivision, an 150.26 amount equal to the maximum allotment authorized by the federal 150.27 Food Stamp Program for a single individual which is in effect on 150.28 the first day of January of the previous year will be added to 150.29 the standards of assistance established in subdivisions 1 to 4 150.30 for individuals under the age of 65 who are relocating from an 150.31 institution and who are shelter needy. An eligible individual 150.32 who receives this benefit prior to age 65 may continue to 150.33 receive the benefit after the age of 65. 150.34 "Shelter needy" means that the assistance unit incurs 150.35 monthly shelter costs that exceed 40 percent of the assistance 150.36 unit's gross income before the application of this special needs 151.1 standard. "Gross income" for the purposes of this section is 151.2 the applicant's or recipient's income as defined in section 151.3 256D.35, subdivision 10, or the standard specified in 151.4 subdivision 3, whichever is greater. A recipient of a federal 151.5 or state housing subsidy, that limits shelter costs to a 151.6 percentage of gross income, shall not be considered shelter 151.7 needy for purposes of this paragraph. 151.8 Sec. 56. Laws 1999, chapter 152, section 1, is amended to 151.9 read: 151.10 Section 1. [TASK FORCE.] 151.11 A day training and habilitation task force is established. 151.12 Task force membership shall consist of representatives of the 151.13 commissioner of human services, counties, service consumers, and 151.14 vendors of day training and habilitation as defined in Minnesota 151.15 Statutes, section 252.41, subdivision 9, including at least one 151.16 representative from each association representing day training 151.17 and habilitation vendors. Appointments to the task force shall 151.18 be made by the commissioner of human services and technical 151.19 assistance shall be provided by the department of human services. 151.20 Sec. 57. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 151.21 The commissioner of human services, in consultation with 151.22 county representatives and other interested persons, shall 151.23 develop recommendations revising the funding methodology for 151.24 SILS as defined in Minnesota Statutes, section 252.275, 151.25 subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002, 151.26 to the chair of the house of representatives health and human 151.27 services finance committee and the chair of the senate health, 151.28 human services and corrections budget division. 151.29 Sec. 58. [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 151.30 By September 1, 2001, the commissioner of human services 151.31 shall seek federal approval to allow recipients of home and 151.32 community-based waivers authorized under Minnesota Statutes, 151.33 section 256B.49, to choose either a waiver of deeming of spousal 151.34 income or the spousal impoverishment protections authorized 151.35 under United States Code, title 42, section 1396r-5, with the 151.36 addition of a recipient's maintenance needs in an amount equal 152.1 to the Minnesota supplemental aid equivalent rate as defined in 152.2 Minnesota Statutes, section 256I.03, subdivision 5, plus the 152.3 personal needs allowance as defined in Minnesota Statutes, 152.4 section 256B.35, subdivision 1, paragraph (a). Recipient 152.5 maintenance needs shall be adjusted under this provision each 152.6 July 1. 152.7 Sec. 59. [FEDERAL WAIVER REQUESTS.] 152.8 The commissioner of human services shall submit to the 152.9 federal Health Care Financing Administration by September 1, 152.10 2001, a request for a home and community-based services waiver 152.11 for day services, including: community inclusion, supported 152.12 employment, and day training and habilitation services defined 152.13 in Minnesota Statutes, section 252.41, subdivision 3, clause 152.14 (1), for persons eligible for the waiver under Minnesota 152.15 Statutes, section 256B.092. 152.16 ARTICLE 4 152.17 CONSUMER INFORMATION 152.18 Section 1. Minnesota Statutes 2000, section 256B.0911, 152.19 subdivision 1, is amended to read: 152.20 Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose ofthe152.21preadmission screening programlong-term care consultation 152.22 services is to assist persons with long-term or chronic care 152.23 needs in making long-term care decisions and selecting options 152.24 that meet their needs and reflect their preferences. The 152.25 availability of, and access to, information and other types of 152.26 assistance is also intended to prevent or delay certified 152.27 nursing facility placementsby assessing applicants and152.28residents and offering cost-effective alternatives appropriate152.29for the person's needsand to provide transition assistance 152.30 after admission. Further, the goal ofthe programthese 152.31 services is to contain costs associated with unnecessary 152.32 certified nursing facility admissions. The commissioners of 152.33 human services and health shall seek to maximize use of 152.34 available federal and state funds and establish the broadest 152.35 program possible within the funding available. 152.36 (b) These services must be coordinated with services 153.1 provided under sections 256.975, subdivision 7, and 256.9772, 153.2 and with services provided by other public and private agencies 153.3 in the community to offer a variety of cost-effective 153.4 alternatives to persons with disabilities and elderly persons. 153.5 The county agency providing long-term care consultation services 153.6 shall encourage the use of volunteers from families, religious 153.7 organizations, social clubs, and similar civic and service 153.8 organizations to provide community-based services. 153.9 Sec. 2. Minnesota Statutes 2000, section 256B.0911, is 153.10 amended by adding a subdivision to read: 153.11 Subd. 1a. [DEFINITIONS.] For purposes of this section, the 153.12 following definitions apply: 153.13 (a) "Long-term care consultation services" means: 153.14 (1) providing information and education to the general 153.15 public regarding availability of the services authorized under 153.16 this section; 153.17 (2) an intake process that provides access to the services 153.18 described in this section; 153.19 (3) assessment of the health, psychological, and social 153.20 needs of referred individuals; 153.21 (4) assistance in identifying services needed to maintain 153.22 an individual in the least restrictive environment; 153.23 (5) providing recommendations on cost-effective community 153.24 services that are available to the individual; 153.25 (6) development of an individual's community support plan; 153.26 (7) providing information regarding eligibility for 153.27 Minnesota health care programs; 153.28 (8) preadmission screening to determine the need for a 153.29 nursing facility level of care; 153.30 (9) preliminary determination of Minnesota health care 153.31 programs eligibility for individuals who need a nursing facility 153.32 level of care, with appropriate referrals for final 153.33 determination; 153.34 (10) providing recommendations for nursing facility 153.35 placement when there are no cost-effective community services 153.36 available; and 154.1 (11) assistance to transition people back to community 154.2 settings after facility admission. 154.3 (b) "Minnesota health care programs" means the medical 154.4 assistance program under chapter 256B, the alternative care 154.5 program under section 256B.0913, and the prescription drug 154.6 program under section 256.955. 154.7 Sec. 3. Minnesota Statutes 2000, section 256B.0911, 154.8 subdivision 3, is amended to read: 154.9 Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE154.10PREADMISSION SCREENINGLONG-TERM CARE CONSULTATION TEAM.] (a) A 154.11local screeninglong-term care consultation team shall be 154.12 established by the county board of commissioners. Each local 154.13screeningconsultation team shall consist ofscreeners who are a154.14 at least one social worker andaat least one public health 154.15 nurse from their respective county agencies. The board may 154.16 designate public health or social services as the lead agency 154.17 for long-term care consultation services. If a county does not 154.18 have a public health nurse available, it may request approval 154.19 from the commissioner to assign a county registered nurse with 154.20 at least one year experience in home care to participate on the 154.21 team.The screening team members must confer regarding the most154.22appropriate care for each individual screened.Two or more 154.23 counties may collaborate to establish a joint localscreening154.24 consultation team or teams. 154.25 (b)In assessing a person's needs, screeners shall have a154.26physician available for consultation and shall consider the154.27assessment of the individual's attending physician, if any. The154.28individual's physician shall be included if the physician154.29chooses to participate. Other personnel may be included on the154.30team as deemed appropriate by the county agencies.The team is 154.31 responsible for providing long-term care consultation services 154.32 to all persons located in the county who request the services, 154.33 regardless of eligibility for Minnesota health care programs. 154.34 Sec. 4. Minnesota Statutes 2000, section 256B.0911, is 154.35 amended by adding a subdivision to read: 154.36 Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 155.1 requesting assessment, services planning, or other assistance 155.2 intended to support community-based living must be visited by a 155.3 long-term care consultation team within ten working days after 155.4 the date on which an assessment was requested or recommended. 155.5 Assessments must be conducted according to paragraphs (b) to (g). 155.6 (b) The county may utilize a team of either the social 155.7 worker or public health nurse, or both, to conduct the 155.8 assessment in a face-to-face interview. The consultation team 155.9 members must confer regarding the most appropriate care for each 155.10 individual screened or assessed. 155.11 (c) The long-term care consultation team must assess the 155.12 health and social needs of the person, using an assessment form 155.13 provided by the commissioner. 155.14 (d) The team must conduct the assessment in a face-to-face 155.15 interview with the person being assessed and the person's legal 155.16 representative, if applicable. 155.17 (e) The team must provide the person, or the person's legal 155.18 representative, with written recommendations for facility- or 155.19 community-based services. The team must document that the most 155.20 cost-effective alternatives available were offered to the 155.21 individual. For purposes of this requirement, "cost-effective 155.22 alternatives" means community services and living arrangements 155.23 that cost the same as or less than nursing facility care. 155.24 (f) If the person chooses to use community-based services, 155.25 the team must provide the person or the person's legal 155.26 representative with a written community support plan, regardless 155.27 of whether the individual is eligible for Minnesota health care 155.28 programs. The person may request assistance in developing a 155.29 community support plan without participating in a complete 155.30 assessment. 155.31 (g) The team must give the person receiving assessment or 155.32 support planning, or the person's legal representative, 155.33 materials supplied by the commissioner containing the following 155.34 information: 155.35 (1) the purpose of preadmission screening and assessment; 155.36 (2) information about Minnesota health care programs; 156.1 (3) the person's freedom to accept or reject the 156.2 recommendations of the team; 156.3 (4) the person's right to confidentiality under the 156.4 Minnesota Government Data Practices Act, chapter 13; and 156.5 (5) the person's right to appeal the decision regarding the 156.6 need for nursing facility level of care or the county's final 156.7 decisions regarding public programs eligibility according to 156.8 section 256.045, subdivision 3. 156.9 Sec. 5. Minnesota Statutes 2000, section 256B.0911, is 156.10 amended by adding a subdivision to read: 156.11 Subd. 3b. [TRANSITION ASSISTANCE.] (a) A long-term care 156.12 consultation team shall provide assistance to persons residing 156.13 in a nursing facility, hospital, regional treatment center, or 156.14 intermediate care facility for persons with mental retardation 156.15 who request or are referred for assistance. Transition 156.16 assistance must include assessment, community support plan 156.17 development, referrals to Minnesota health care programs, and 156.18 referrals to programs that provide assistance with housing. 156.19 (b) The county shall develop transition processes with 156.20 institutional social workers and discharge planners to ensure 156.21 that: 156.22 (1) persons admitted to facilities receive information 156.23 about transition assistance that is available; 156.24 (2) the assessment is completed for persons within ten 156.25 working days of the date of request or recommendation for 156.26 assessment; and 156.27 (3) there is a plan for transition and follow-up for the 156.28 individual's return to the community. The plan must require 156.29 notification of other local agencies when a person who may 156.30 require assistance is screened by one county for admission to a 156.31 facility located in another county. 156.32 (c) If a person who is eligible for a Minnesota health care 156.33 program is admitted to a nursing facility, the nursing facility 156.34 must include a consultation team member or the case manager in 156.35 the discharge planning process. 156.36 Sec. 6. Minnesota Statutes 2000, section 256B.0911, is 157.1 amended by adding a subdivision to read: 157.2 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO 157.3 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 157.4 certified nursing facilities, including certified boarding care 157.5 facilities, must be screened prior to admission regardless of 157.6 income, assets, or funding sources for nursing facility care, 157.7 except as described in subdivision 4b. The purpose of the 157.8 screening is to determine the need for nursing facility level of 157.9 care as described in paragraph (d) and to complete activities 157.10 required under federal law related to mental illness and mental 157.11 retardation as outlined in paragraph (b). 157.12 (b) A person who has a diagnosis or possible diagnosis of 157.13 mental illness, mental retardation, or a related condition must 157.14 receive a preadmission screening before admission regardless of 157.15 the exemptions outlined in subdivision 4b, paragraph (b), to 157.16 identify the need for further evaluation and specialized 157.17 services, unless the admission prior to screening is authorized 157.18 by the local mental health authority or the local developmental 157.19 disabilities case manager, or unless authorized by the county 157.20 agency according to Public Law Number 100-508. 157.21 The following criteria apply to the preadmission screening: 157.22 (1) the county must use forms and criteria developed by the 157.23 commissioner to identify persons who require referral for 157.24 further evaluation and determination of the need for specialized 157.25 services; and 157.26 (2) the evaluation and determination of the need for 157.27 specialized services must be done by: 157.28 (i) a qualified independent mental health professional, for 157.29 persons with a primary or secondary diagnosis of a serious 157.30 mental illness; or 157.31 (ii) a qualified mental retardation professional, for 157.32 persons with a primary or secondary diagnosis of mental 157.33 retardation or related conditions. For purposes of this 157.34 requirement, a qualified mental retardation professional must 157.35 meet the standards for a qualified mental retardation 157.36 professional under Code of Federal Regulations, title 42, 158.1 section 483.430. 158.2 (c) The local county mental health authority or the state 158.3 mental retardation authority under Public Law Numbers 100-203 158.4 and 101-508 may prohibit admission to a nursing facility if the 158.5 individual does not meet the nursing facility level of care 158.6 criteria or needs specialized services as defined in Public Law 158.7 Numbers 100-203 and 101-508. For purposes of this section, 158.8 "specialized services" for a person with mental retardation or a 158.9 related condition means active treatment as that term is defined 158.10 under Code of Federal Regulations, title 42, section 483.440 158.11 (a)(1). 158.12 (d) The determination of the need for nursing facility 158.13 level of care must be made according to criteria developed by 158.14 the commissioner. In assessing a person's needs, consultation 158.15 team members shall have a physician available for consultation 158.16 and shall consider the assessment of the individual's attending 158.17 physician, if any. The individual's physician must be included 158.18 if the physician chooses to participate. Other personnel may be 158.19 included on the team as deemed appropriate by the county. 158.20 Sec. 7. Minnesota Statutes 2000, section 256B.0911, is 158.21 amended by adding a subdivision to read: 158.22 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 158.23 Exemptions from the federal screening requirements outlined in 158.24 subdivision 4a, paragraphs (b) and (c), are limited to: 158.25 (1) a person who, having entered an acute care facility 158.26 from a certified nursing facility, is returning to a certified 158.27 nursing facility; and 158.28 (2) a person transferring from one certified nursing 158.29 facility in Minnesota to another certified nursing facility in 158.30 Minnesota. 158.31 (b) Persons who are exempt from preadmission screening for 158.32 purposes of level of care determination include: 158.33 (1) persons described in paragraph (a); 158.34 (2) an individual who has a contractual right to have 158.35 nursing facility care paid for indefinitely by the veterans' 158.36 administration; 159.1 (3) an individual enrolled in a demonstration project under 159.2 section 256B.69, subdivision 8, at the time of application to a 159.3 nursing facility; 159.4 (4) an individual currently being served under the 159.5 alternative care program or under a home and community-based 159.6 services waiver authorized under section 1915(c) of the federal 159.7 Social Security Act; and 159.8 (5) individuals admitted to a certified nursing facility 159.9 for a short-term stay, which is expected to be 14 days or less 159.10 in duration based upon a physician's certification, and who have 159.11 been assessed and approved for nursing facility admission within 159.12 the previous six months. This exemption applies only if the 159.13 consultation team member determines at the time of the initial 159.14 assessment of the six-month period that it is appropriate to use 159.15 the nursing facility for short-term stays and that there is an 159.16 adequate plan of care for return to the home or community-based 159.17 setting. If a stay exceeds 14 days, the individual must be 159.18 referred no later than the first county working day following 159.19 the 14th resident day for a screening, which must be completed 159.20 within five working days of the referral. The payment 159.21 limitations in subdivision 7 apply to an individual found at 159.22 screening to not meet the level of care criteria for admission 159.23 to a certified nursing facility. 159.24 (c) Persons admitted to a Medicaid-certified nursing 159.25 facility from the community on an emergency basis as described 159.26 in paragraph (d) or from an acute care facility on a nonworking 159.27 day must be screened the first working day after admission. 159.28 (d) Emergency admission to a nursing facility prior to 159.29 screening is permitted when all of the following conditions are 159.30 met: 159.31 (1) a person is admitted from the community to a certified 159.32 nursing or certified boarding care facility during county 159.33 nonworking hours; 159.34 (2) a physician has determined that delaying admission 159.35 until preadmission screening is completed would adversely affect 159.36 the person's health and safety; 160.1 (3) there is a recent precipitating event that precludes 160.2 the client from living safely in the community, such as 160.3 sustaining an injury, sudden onset of acute illness, or a 160.4 caregiver's inability to continue to provide care; 160.5 (4) the attending physician has authorized the emergency 160.6 placement and has documented the reason that the emergency 160.7 placement is recommended; and 160.8 (5) the county is contacted on the first working day 160.9 following the emergency admission. 160.10 Transfer of a patient from an acute care hospital to a nursing 160.11 facility is not considered an emergency except for a person who 160.12 has received hospital services in the following situations: 160.13 hospital admission for observation, care in an emergency room 160.14 without hospital admission, or following hospital 24-hour bed 160.15 care. 160.16 Sec. 8. Minnesota Statutes 2000, section 256B.0911, is 160.17 amended by adding a subdivision to read: 160.18 Subd. 4c. [SCREENING REQUIREMENTS.] (a) A person may be 160.19 screened for nursing facility admission by telephone or in a 160.20 face-to-face screening interview. Consultation team members 160.21 shall identify each individual's needs using the following 160.22 categories: 160.23 (1) the person needs no face-to-face screening interview to 160.24 determine the need for nursing facility level of care based on 160.25 information obtained from other health care professionals; 160.26 (2) the person needs an immediate face-to-face screening 160.27 interview to determine the need for nursing facility level of 160.28 care and complete activities required under subdivision 4a; or 160.29 (3) the person may be exempt from screening requirements as 160.30 outlined in subdivision 4b, but will need transitional 160.31 assistance after admission or in-person follow-along after a 160.32 return home. 160.33 (b) Persons admitted on a nonemergency basis to a 160.34 Medicaid-certified nursing facility must be screened prior to 160.35 admission. 160.36 (c) The long-term care consultation team shall recommend a 161.1 case mix classification for persons admitted to a certified 161.2 nursing facility when sufficient information is received to make 161.3 that classification. The nursing facility is authorized to 161.4 conduct all case mix assessments for persons who have been 161.5 screened prior to admission for whom the county did not 161.6 recommend a case mix classification. The nursing facility is 161.7 authorized to conduct all case mix assessments for persons 161.8 admitted to the facility prior to a preadmission screening. The 161.9 county retains the responsibility of distributing appropriate 161.10 case mix forms to the nursing facility. 161.11 (d) The county screening or intake activity must include 161.12 processes to identify persons who may require transition 161.13 assistance as described in subdivision 3b. 161.14 Sec. 9. Minnesota Statutes 2000, section 256B.0911, 161.15 subdivision 5, is amended to read: 161.16 Subd. 5. [SIMPLIFICATION OF FORMSADMINISTRATIVE 161.17 ACTIVITY.] The commissioner shall minimize the number of forms 161.18 required in thepreadmission screening processprovision of 161.19 long-term care consultation services and shall limit the 161.20 screening document to items necessary forcarecommunity support 161.21 plan approval, reimbursement, program planning, evaluation, and 161.22 policy development. 161.23 Sec. 10. Minnesota Statutes 2000, section 256B.0911, 161.24 subdivision 6, is amended to read: 161.25 Subd. 6. [PAYMENT FORPREADMISSION SCREENINGLONG-TERM 161.26 CARE CONSULTATION SERVICES.] (a) The totalscreeningpayment for 161.27 each county must be paid monthly by certified nursing facilities 161.28 in the county. The monthly amount to be paid by each nursing 161.29 facility for each fiscal year must be determined by dividing the 161.30 county's annual allocation forscreeningslong-term care 161.31 consultation services by 12 to determine the monthly payment and 161.32 allocating the monthly payment to each nursing facility based on 161.33 the number of licensed beds in the nursing facility. Payments 161.34 to counties in which there is no certified nursing facility must 161.35 be made by increasing the payment rate of the two facilities 161.36 located nearest to the county seat. 162.1 (b) The commissioner shall include the total annual payment 162.2for screeningdetermined under paragraph (a) for each nursing 162.3 facility reimbursed under section 256B.431 or 256B.434 according 162.4 to section 256B.431, subdivision 2b, paragraph (g), or 256B.435. 162.5 (c) In the event of the layaway, delicensure and 162.6 decertification, or removal from layaway of 25 percent or more 162.7 of the beds in a facility, the commissioner may adjust the per 162.8 diem payment amount in paragraph (b) and may adjust the monthly 162.9 payment amount in paragraph (a). The effective date of an 162.10 adjustment made under this paragraph shall be on or after the 162.11 first day of the month following the effective date of the 162.12 layaway, delicensure and decertification, or removal from 162.13 layaway. 162.14 (d) Payments forscreening activitieslong-term care 162.15 consultation services are available to the county or counties to 162.16 cover staff salaries and expenses to provide thescreening162.17functionservices described in subdivision 1a. Thelead agency162.18 county shall employ, or contract with other agencies to employ, 162.19 within the limits of available funding, sufficient personnel 162.20 toconduct the preadmission screening activityprovide long-term 162.21 care consultation services while meeting the state's long-term 162.22 care outcomes and objectives as defined in section 256B.0917, 162.23 subdivision 1. Thelocal agencycounty shall be accountable for 162.24 meeting local objectives as approved by the commissioner in the 162.25 CSSA biennial plan. 162.26(d)(e) Notwithstanding section 256B.0641, overpayments 162.27 attributable to payment of the screening costs under the medical 162.28 assistance program may not be recovered from a facility. 162.29(e)(f) The commissioner of human services shall amend the 162.30 Minnesota medical assistance plan to include reimbursement for 162.31 the localscreeningconsultation teams. 162.32 (g) The county may bill, as case management services, 162.33 assessments, support planning, and follow-along provided to 162.34 persons determined to be eligible for case management under 162.35 Minnesota health care programs. No individual or family member 162.36 shall be charged for an initial assessment or initial support 163.1 plan development provided under subdivision 3a or 3b. 163.2 Sec. 11. Minnesota Statutes 2000, section 256B.0911, 163.3 subdivision 7, is amended to read: 163.4 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 163.5 (a) Medical assistance reimbursement for nursing facilities 163.6 shall be authorized for a medical assistance recipient only if a 163.7 preadmission screening has been conducted prior to admission or 163.8 thelocalcountyagencyhas authorized an exemption. Medical 163.9 assistance reimbursement for nursing facilities shall not be 163.10 provided for any recipient who the local screener has determined 163.11 does not meet the level of care criteria for nursing facility 163.12 placement or, if indicated, has not had a level IIPASARROBRA 163.13 evaluation as required under the federal Omnibus Budget 163.14 Reconciliation Act of 1987 completed unless an admission for a 163.15 recipient with mental illness is approved by the local mental 163.16 health authority or an admission for a recipient with mental 163.17 retardation or related condition is approved by the state mental 163.18 retardation authority. 163.19 (b) The nursing facility must not bill a person who is not 163.20 a medical assistance recipient for resident days that preceded 163.21 the date of completion of screening activities as required under 163.22 subdivisions 4a, 4b, and 4c. The nursing facility must include 163.23 unreimbursed resident days in the nursing facility resident day 163.24 totals reported to the commissioner. 163.25 (c) The commissioner shall make a request to the health 163.26 care financing administration for a waiver allowingscreening163.27 team approval of Medicaid payments for certified nursing 163.28 facility care. An individual has a choice and makes the final 163.29 decision between nursing facility placement and community 163.30 placement after the screening team's recommendation, except as 163.31 provided inparagraphs (b) and (c)subdivision 4a, paragraph (c). 163.32(c) The local county mental health authority or the state163.33mental retardation authority under Public Law Numbers 100-203163.34and 101-508 may prohibit admission to a nursing facility, if the163.35individual does not meet the nursing facility level of care163.36criteria or needs specialized services as defined in Public Law164.1Numbers 100-203 and 101-508. For purposes of this section,164.2"specialized services" for a person with mental retardation or a164.3related condition means "active treatment" as that term is164.4defined in Code of Federal Regulations, title 42, section164.5483.440(a)(1).164.6(e) Appeals from the screening team's recommendation or the164.7county agency's final decision shall be made according to164.8section 256.045, subdivision 3.164.9 Sec. 12. Minnesota Statutes 2000, section 256B.0913, 164.10 subdivision 1, is amended to read: 164.11 Subdivision 1. [PURPOSE AND GOALS.] The purpose of the 164.12 alternative care program is to provide funding foror access to164.13 home and community-based services forfrailelderly persons, in 164.14 order to limit nursing facility placements. The program is 164.15 designed to supportfrailelderly persons in their desire to 164.16 remain in the community as independently and as long as possible 164.17 and to support informal caregivers in their efforts to provide 164.18 care forfrailelderly people. Further, the goals of the 164.19 program are: 164.20 (1) to contain medical assistance expenditures byproviding164.21 funding care in the communityat a cost the same or less than164.22nursing facility costs; and 164.23 (2) to maintain the moratorium on new construction of 164.24 nursing home beds. 164.25 Sec. 13. Minnesota Statutes 2000, section 256B.0913, 164.26 subdivision 2, is amended to read: 164.27 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 164.28 services are available toall frail olderMinnesotans. This164.29includes:164.30(1) persons who are receiving medical assistance and served164.31under the medical assistance program or the Medicaid waiver164.32program;164.33(2) personsage 65 or older who are not eligible for 164.34 medical assistance without a spenddown or waiver obligation but 164.35 who would be eligible for medical assistance within 180 days of 164.36 admission to a nursing facility andserved undersubject to 165.1 subdivisions 4 to 13; and165.2(3) persons who are paying for their services out-of-pocket. 165.3 Sec. 14. Minnesota Statutes 2000, section 256B.0913, 165.4 subdivision 4, is amended to read: 165.5 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 165.6 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 165.7 under the alternative care program is available to persons who 165.8 meet the following criteria: 165.9 (1) the person has beenscreened by the county screening165.10team or, if previously screened and served under the alternative165.11care program, assessed by the local county social worker or165.12public health nursedetermined by a community assessment under 165.13 section 256B.0911, to be a person who would require the level of 165.14 care provided in a nursing facility, but for the provision of 165.15 services under the alternative care program; 165.16 (2) the person is age 65 or older; 165.17 (3) the person would befinanciallyeligible for medical 165.18 assistance within 180 days of admission to a nursing facility; 165.19 (4) the personmeets the asset transfer requirements ofis 165.20 not ineligible for the medical assistance program due to an 165.21 asset transfer penalty; 165.22 (5)the screening team would recommend nursing facility165.23admission or continued stay for the person if alternative care165.24services were not available;165.25(6)the person needs services that are notavailable at165.26that time in the countyfunded through othercounty,state,or 165.27 federal fundingsources; and 165.28(7)(6) the monthly cost of the alternative care services 165.29 funded by the program for this person does not exceed 75 percent 165.30 of the statewideaverage monthly medical assistance payment for165.31nursing facility care at the individual's case mix165.32classificationweighted average monthly nursing facility rate of 165.33 the case mix resident class to which the individual alternative 165.34 care client would be assigned under Minnesota Rules, parts 165.35 9549.0050 to 9549.0059, less the recipient's maintenance needs 165.36 allowance as described in section 256B.0915, subdivision 1d, 166.1 paragraph (a), until the first day of the state fiscal year in 166.2 which the resident assessment system, under section 256B.437, 166.3 for nursing home rate determination is implemented. Effective 166.4 on the first day of the state fiscal year in which a resident 166.5 assessment system, under section 256B.437, for nursing home rate 166.6 determination is implemented and the first day of each 166.7 subsequent state fiscal year, the monthly cost of alternative 166.8 care services for this person shall not exceed the alternative 166.9 care monthly cap for the case mix resident class to which the 166.10 alternative care client would be assigned under Minnesota Rules, 166.11 parts 9549.0050 to 9549.0059, which was in effect on the last 166.12 day of the previous state fiscal year, and adjusted by the 166.13 greater of any legislatively adopted home and community-based 166.14 services cost-of-living percentage increase or any legislatively 166.15 adopted statewide percent rate increase for nursing facilities. 166.16 This monthly limit does not prohibit the alternative care client 166.17 from payment for additional services, but in no case may the 166.18 cost of additional services purchased under this section exceed 166.19 the difference between the client's monthly service limit 166.20 defined under section 256B.0915, subdivision 3, and the 166.21 alternative care program monthly service limit defined in this 166.22 paragraph. If medical supplies and equipment oradaptations166.23 environmental modifications are or will be purchased for an 166.24 alternative care services recipient, the costs may be prorated 166.25 on a monthly basisthroughout the year in which they are166.26purchasedfor up to 12 consecutive months beginning with the 166.27 month of purchase. If the monthly cost of a recipient's other 166.28 alternative care services exceeds the monthly limit established 166.29 in this paragraph, the annual cost of the alternative care 166.30 services shall be determined. In this event, the annual cost of 166.31 alternative care services shall not exceed 12 times the monthly 166.32 limitcalculateddescribed in this paragraph. 166.33 (b)Individuals who meet the criteria in paragraph (a) and166.34who have been approved for alternative care funding are called166.35180-day eligible clients.166.36(c) The statewide average payment for nursing facility care167.1is the statewide average monthly nursing facility rate in effect167.2on July 1 of the fiscal year in which the cost is incurred, less167.3the statewide average monthly income of nursing facility167.4residents who are age 65 or older and who are medical assistance167.5recipients in the month of March of the previous fiscal year.167.6This monthly limit does not prohibit the 180-day eligible client167.7from paying for additional services needed or desired.167.8(d) In determining the total costs of alternative care167.9services for one month, the costs of all services funded by the167.10alternative care program, including supplies and equipment, must167.11be included.167.12(e)Alternative care funding under this subdivision is not 167.13 available for a person who is a medical assistance recipient or 167.14 who would be eligible for medical assistance without a 167.15 spenddown, unless authorized by the commissioneror waiver 167.16 obligation. A person whose initial application for medical 167.17 assistance is being processed may be served under the 167.18 alternative care program for a period up to 60 days. If the 167.19 individual is found to be eligible for medical assistance,the167.20county must billmedical assistance must be billed for services 167.21 payable under the federally approved elderly waiver plan and 167.22 delivered from the date the individual was found eligible 167.23 forservices reimbursable underthe federally approved elderly 167.24 waiverprogramplan. Notwithstanding this provision, upon 167.25 federal approval, alternative care funds may not be used to pay 167.26 for any service the cost of which is payable by medical 167.27 assistance or which is used by a recipient to meet a medical 167.28 assistance income spenddown or waiver obligation. 167.29(f)(c) Alternative care funding is not available for a 167.30 person who resides in a licensed nursing homeor, certified 167.31 boarding care home, hospital, or intermediate care facility, 167.32 except for case management services which arebeingprovided in 167.33 support of the discharge planning process to a nursing home 167.34 resident or certified boarding care home resident who is 167.35 ineligible for case management funded by medical assistance. 167.36 Sec. 15. Minnesota Statutes 2000, section 256B.0913, 168.1 subdivision 5, is amended to read: 168.2 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 168.3 Alternative care funding may be used for payment of costs of: 168.4 (1) adult foster care; 168.5 (2) adult day care; 168.6 (3) home health aide; 168.7 (4) homemaker services; 168.8 (5) personal care; 168.9 (6) case management; 168.10 (7) respite care; 168.11 (8) assisted living; 168.12 (9) residential care services; 168.13 (10) care-related supplies and equipment; 168.14 (11) meals delivered to the home; 168.15 (12) transportation; 168.16 (13) skilled nursing; 168.17 (14) chore services; 168.18 (15) companion services; 168.19 (16) nutrition services; 168.20 (17) training for direct informal caregivers; 168.21 (18) telemedicine devices to monitor recipients in their 168.22 own homes as an alternative to hospital care, nursing home care, 168.23 or home visits;and168.24 (19) other servicesincludingwhich includes discretionary 168.25 funds and direct cash payments to clients,approved by the168.26county agencyfollowing approval by the commissioner, subject to 168.27 the provisions of paragraph(m)(j). Total annual payments for " 168.28 other services" for all clients within a county may not exceed 168.29 either ten percent of that county's annual alternative care 168.30 program base allocation or $5,000, whichever is greater. In no 168.31 case shall this amount exceed the county's total annual 168.32 alternative care program base allocation; and 168.33 (20) environmental modifications. 168.34 (b) The county agency must ensure that the funds are not 168.35 usedonly to supplement and notto supplant services available 168.36 through other public assistance or services programs. 169.1 (c) Unless specified in statute, the service definitions 169.2 and standards for alternative care services shall be the same as 169.3 the service definitions and standardsdefinedspecified in the 169.4 federally approved elderly waiver plan. Except for the county 169.5 agencies' approval of direct cash payments to clients as 169.6 described in paragraph (j) or for a provider of supplies and 169.7 equipment when the monthly cost of the supplies and equipment is 169.8 less than $250, persons or agencies must be employed by or under 169.9 a contract with the county agency or the public health nursing 169.10 agency of the local board of health in order to receive funding 169.11 under the alternative care program. Supplies and equipment may 169.12 be purchased from a vendor not certified to participate in the 169.13 Medicaid program if the cost for the item is less than that of a 169.14 Medicaid vendor. 169.15 (d) The adult foster care rate shall be considered a 169.16 difficulty of care payment and shall not include room and 169.17 board. The adult foster caredailyrate shall be negotiated 169.18 between the county agency and the foster care provider.The169.19rate established under this section shall not exceed 75 percent169.20of the state average monthly nursing home payment for the case169.21mix classification to which the individual receiving foster care169.22is assigned, and it must allow for other alternative care169.23services to be authorized by the case manager.The alternative 169.24 care payment for the foster care service in combination with the 169.25 payment for other alternative care services, including case 169.26 management, must not exceed the limit specified in subdivision 169.27 4, paragraph (a), clause (6). 169.28 (e) Personal care servicesmay be provided by a personal169.29care provider organization.must meet the service standards 169.30 defined in the federally approved elderly waiver plan, except 169.31 that a county agency may contract with a client's relativeof169.32the clientwho meets the relative hardship waiver requirement as 169.33 defined in section 256B.0627, subdivision 4, paragraph (b), 169.34 clause (10), to provide personal care services, but must ensure169.35nursingif the county agency ensures supervision of this service 169.36 by a registered nurse or mental health practitioner.Covered170.1personal care services defined in section 256B.0627, subdivision170.24, must meet applicable standards in Minnesota Rules, part170.39505.0335.170.4 (f)A county may use alternative care funds to purchase170.5medical supplies and equipment without prior approval from the170.6commissioner when: (1) there is no other funding source; (2)170.7the supplies and equipment are specified in the individual's170.8care plan as medically necessary to enable the individual to170.9remain in the community according to the criteria in Minnesota170.10Rules, part 9505.0210, item A; and (3) the supplies and170.11equipment represent an effective and appropriate use of170.12alternative care funds. A county may use alternative care funds170.13to purchase supplies and equipment from a non-Medicaid certified170.14vendor if the cost for the items is less than that of a Medicaid170.15vendor. A county is not required to contract with a provider of170.16supplies and equipment if the monthly cost of the supplies and170.17equipment is less than $250.170.18(g)For purposes of this section, residential care services 170.19 are services which are provided to individuals living in 170.20 residential care homes. Residential care homes are currently 170.21 licensed as board and lodging establishments and are registered 170.22 with the department of health as providing special 170.23 services under section 157.17 and are not subject to 170.24 registration under chapter 144D. Residential care services are 170.25 defined as "supportive services" and "health-related services." 170.26 "Supportive services" means the provision of up to 24-hour 170.27 supervision and oversight. Supportive services includes: (1) 170.28 transportation, when provided by the residential carecenter170.29 home only; (2) socialization, when socialization is part of the 170.30 plan of care, has specific goals and outcomes established, and 170.31 is not diversional or recreational in nature; (3) assisting 170.32 clients in setting up meetings and appointments; (4) assisting 170.33 clients in setting up medical and social services; (5) providing 170.34 assistance with personal laundry, such as carrying the client's 170.35 laundry to the laundry room. Assistance with personal laundry 170.36 does not include any laundry, such as bed linen, that is 171.1 included in the room and board rate. "Health-related services" 171.2 are limited to minimal assistance with dressing, grooming, and 171.3 bathing and providing reminders to residents to take medications 171.4 that are self-administered or providing storage for medications, 171.5 if requested. Individuals receiving residential care services 171.6 cannot receive homemaking services funded under this section. 171.7(h)(g) For the purposes of this section, "assisted living" 171.8 refers to supportive services provided by a single vendor to 171.9 clients who reside in the same apartment building of three or 171.10 more units which are not subject to registration under chapter 171.11 144D and are licensed by the department of health as a class A 171.12 home care provider or a class E home care provider. Assisted 171.13 living services are defined as up to 24-hour supervision, and 171.14 oversight, supportive services as defined in clause (1), 171.15 individualized home care aide tasks as defined in clause (2), 171.16 and individualized home management tasks as defined in clause 171.17 (3) provided to residents of a residential center living in 171.18 their units or apartments with a full kitchen and bathroom. A 171.19 full kitchen includes a stove, oven, refrigerator, food 171.20 preparation counter space, and a kitchen utensil storage 171.21 compartment. Assisted living services must be provided by the 171.22 management of the residential center or by providers under 171.23 contract with the management or with the county. 171.24 (1) Supportive services include: 171.25 (i) socialization, when socialization is part of the plan 171.26 of care, has specific goals and outcomes established, and is not 171.27 diversional or recreational in nature; 171.28 (ii) assisting clients in setting up meetings and 171.29 appointments; and 171.30 (iii) providing transportation, when provided by the 171.31 residential center only. 171.32Individuals receiving assisted living services will not171.33receive both assisted living services and homemaking services.171.34Individualized means services are chosen and designed171.35specifically for each resident's needs, rather than provided or171.36offered to all residents regardless of their illnesses,172.1disabilities, or physical conditions.172.2 (2) Home care aide tasks means: 172.3 (i) preparing modified diets, such as diabetic or low 172.4 sodium diets; 172.5 (ii) reminding residents to take regularly scheduled 172.6 medications or to perform exercises; 172.7 (iii) household chores in the presence of technically 172.8 sophisticated medical equipment or episodes of acute illness or 172.9 infectious disease; 172.10 (iv) household chores when the resident's care requires the 172.11 prevention of exposure to infectious disease or containment of 172.12 infectious disease; and 172.13 (v) assisting with dressing, oral hygiene, hair care, 172.14 grooming, and bathing, if the resident is ambulatory, and if the 172.15 resident has no serious acute illness or infectious disease. 172.16 Oral hygiene means care of teeth, gums, and oral prosthetic 172.17 devices. 172.18 (3) Home management tasks means: 172.19 (i) housekeeping; 172.20 (ii) laundry; 172.21 (iii) preparation of regular snacks and meals; and 172.22 (iv) shopping. 172.23 Individuals receiving assisted living services shall not 172.24 receive both assisted living services and homemaking services. 172.25 Individualized means services are chosen and designed 172.26 specifically for each resident's needs, rather than provided or 172.27 offered to all residents regardless of their illnesses, 172.28 disabilities, or physical conditions. Assisted living services 172.29 as defined in this section shall not be authorized in boarding 172.30 and lodging establishments licensed according to sections 172.31 157.011 and 157.15 to 157.22. 172.32(i)(h) For establishments registered under chapter 144D, 172.33 assisted living services under this section means either the 172.34 services describedand licensedin paragraph (g) and delivered 172.35 by a class E home care provider licensed by the department of 172.36 health or the services described under section 144A.4605 and 173.1 delivered by an assisted living home care provider or a class A 173.2 home care provider licensed by the commissioner of health. 173.3(j) For the purposes of this section, reimbursement(i) 173.4 Payment for assisted living services and residential care 173.5 services shall be a monthly rate negotiated and authorized by 173.6 the county agency based on an individualized service plan for 173.7 each resident and may not cover direct rent or food costs.The173.8rate173.9 (1) The individualized monthly negotiated payment for 173.10 assisted living services as described in paragraph (g) or (h), 173.11 and residential care services as described in paragraph (f), 173.12 shall not exceed the nonfederal share in effect on July 1 of the 173.13 state fiscal year for which the rate limit is being calculated 173.14 of the greater of either the statewide or any of the geographic 173.15 groups' weighted average monthlymedical assistancenursing 173.16 facility payment rate of the case mix resident class to which 173.17 the180-dayalternative care eligible client would be assigned 173.18 under Minnesota Rules, parts 9549.0050 to 9549.0059,unless the173.19 less the maintenance needs allowance as described in section 173.20 256B.0915, subdivision 1d, paragraph (a), until the first day of 173.21 the state fiscal year in which a resident assessment system, 173.22 under section 256B.437, of nursing home rate determination is 173.23 implemented. Effective on the first day of the state fiscal 173.24 year in which a resident assessment system, under section 173.25 256B.437, of nursing home rate determination is implemented and 173.26 the first day of each subsequent state fiscal year, the 173.27 individualized monthly negotiated payment for the services 173.28 described in this clause shall not exceed the limit described in 173.29 this clause which was in effect on the last day of the previous 173.30 state fiscal year and which has been adjusted by the greater of 173.31 any legislatively adopted home and community-based services 173.32 cost-of-living percentage increase or any legislatively adopted 173.33 statewide percent rate increase for nursing facilities. 173.34 (2) The individualized monthly negotiated payment for 173.35 assisted living servicesare provided by a home caredescribed 173.36 under section 144A.4605 and delivered by a provider licensed by 174.1 the department of health as a class A home care provider or an 174.2 assisted living home care provider andareprovided in a 174.3 building that is registered as a housing with services 174.4 establishment under chapter 144D and that provides 24-hour 174.5 supervision in combination with the payment for other 174.6 alternative care services, including case management, must not 174.7 exceed the limit specified in subdivision 4, paragraph (a), 174.8 clause (6). 174.9(k) For purposes of this section, companion services are174.10defined as nonmedical care, supervision and oversight, provided174.11to a functionally impaired adult. Companions may assist the174.12individual with such tasks as meal preparation, laundry and174.13shopping, but do not perform these activities as discrete174.14services. The provision of companion services does not entail174.15hands-on medical care. Providers may also perform light174.16housekeeping tasks which are incidental to the care and174.17supervision of the recipient. This service must be approved by174.18the case manager as part of the care plan. Companion services174.19must be provided by individuals or organizations who are under174.20contract with the local agency to provide the service. Any174.21person related to the waiver recipient by blood, marriage or174.22adoption cannot be reimbursed under this service. Persons174.23providing companion services will be monitored by the case174.24manager.174.25(l) For purposes of this section, training for direct174.26informal caregivers is defined as a classroom or home course of174.27instruction which may include: transfer and lifting skills,174.28nutrition, personal and physical cares, home safety in a home174.29environment, stress reduction and management, behavioral174.30management, long-term care decision making, care coordination174.31and family dynamics. The training is provided to an informal174.32unpaid caregiver of a 180-day eligible client which enables the174.33caregiver to deliver care in a home setting with high levels of174.34quality. The training must be approved by the case manager as174.35part of the individual care plan. Individuals, agencies, and174.36educational facilities which provide caregiver training and175.1education will be monitored by the case manager.175.2(m)(j) A county agency may make payment from their 175.3 alternative care program allocation for "other services" 175.4provided to an alternative care program recipient if those175.5services prevent, shorten, or delay institutionalization. These175.6services maywhich include use of "discretionary funds" for 175.7 services that are not otherwise defined in this section and 175.8 direct cash payments to therecipientclient for the purpose of 175.9 purchasing therecipient'sservices. The following provisions 175.10 apply to payments under this paragraph: 175.11 (1) a cash payment to a client under this provision cannot 175.12 exceed 80 percent of the monthly payment limit for that client 175.13 as specified in subdivision 4, paragraph (a), clause(7)(6); 175.14 (2) a county may not approve any cash payment for a client 175.15 who meets either of the following: 175.16 (i) has been assessed as having a dependency in 175.17 orientation, unless the client has an authorized 175.18 representativeunder section 256.476, subdivision 2, paragraph175.19(g), or for a client who. An "authorized representative" means 175.20 an individual who is at least 18 years of age and is designated 175.21 by the person or the person's legal representative to act on the 175.22 person's behalf. This individual may be a family member, 175.23 guardian, representative payee, or other individual designated 175.24 by the person or the person's legal representative, if any, to 175.25 assist in purchasing and arranging for supports; or 175.26 (ii) is concurrently receiving adult foster care, 175.27 residential care, or assisted living services; 175.28 (3)any service approved under this section must be a175.29service which meets the purpose and goals of the program as175.30listed in subdivision 1;175.31(4) cash payments must also meet the criteria of and are175.32governed by the procedures and liability protection established175.33in section 256.476, subdivision 4, paragraphs (b) through (h),175.34and recipients of cash grants must meet the requirements in175.35section 256.476, subdivision 10; andcash payments to a person 175.36 or a person's family will be provided through a monthly payment 176.1 and be in the form of cash, voucher, or direct county payment to 176.2 a vendor. Fees or premiums assessed to the person for 176.3 eligibility for health and human services are not reimbursable 176.4 through this service option. Services and goods purchased 176.5 through cash payments must be identified in the person's 176.6 individualized care plan and must meet all of the following 176.7 criteria: 176.8 (i) they must be over and above the normal cost of caring 176.9 for the person if the person did not have functional 176.10 limitations; 176.11 (ii) they must be directly attributable to the person's 176.12 functional limitations; 176.13 (iii) they must have the potential to be effective at 176.14 meeting the goals of the program; 176.15 (iv) they must be consistent with the needs identified in 176.16 the individualized service plan. The service plan shall specify 176.17 the needs of the person and family, the form and amount of 176.18 payment, the items and services to be reimbursed, and the 176.19 arrangements for management of the individual grant; and 176.20 (v) the person, the person's family, or the legal 176.21 representative shall be provided sufficient information to 176.22 ensure an informed choice of alternatives. The local agency 176.23 shall document this information in the person's care plan, 176.24 including the type and level of expenditures to be reimbursed; 176.25 (4) the county, lead agency under contract, or tribal 176.26 government under contract to administer the alternative care 176.27 program shall not be liable for damages, injuries, or 176.28 liabilities sustained through the purchase of direct supports or 176.29 goods by the person, the person's family, or the authorized 176.30 representative with funds received through the cash payments 176.31 under this section. Liabilities include, but are not limited 176.32 to, workers' compensation, the Federal Insurance Contributions 176.33 Act (FICA), or the Federal Unemployment Tax Act (FUTA); 176.34 (5) persons receiving grants under this section shall have 176.35 the following responsibilities: 176.36 (i) spend the grant money in a manner consistent with their 177.1 individualized service plan with the local agency; 177.2 (ii) notify the local agency of any necessary changes in 177.3 the grant-expenditures; 177.4 (iii) arrange and pay for supports; and 177.5 (iv) inform the local agency of areas where they have 177.6 experienced difficulty securing or maintaining supports; and 177.7(5)(6) the county shall report client outcomes, services, 177.8 and costs under this paragraph in a manner prescribed by the 177.9 commissioner. 177.10 (k) Upon implementation of direct cash payments to clients 177.11 under this section, any person determined eligible for the 177.12 alternative care program who chooses a cash payment approved by 177.13 the county agency shall receive the cash payment under this 177.14 section and not under section 256.476 unless the person was 177.15 receiving a consumer support grant under section 256.476 before 177.16 implementation of direct cash payments under this section. 177.17 Sec. 16. Minnesota Statutes 2000, section 256B.0913, 177.18 subdivision 6, is amended to read: 177.19 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 177.20 alternative care program is administered by the county agency. 177.21 This agency is the lead agency responsible for the local 177.22 administration of the alternative care program as described in 177.23 this section. However, it may contract with the public health 177.24 nursing service to be the lead agency. The commissioner may 177.25 contract with federally recognized Indian tribes with a 177.26 reservation in Minnesota to serve as the lead agency responsible 177.27 for the local administration of the alternative care program as 177.28 described in the contract. 177.29 Sec. 17. Minnesota Statutes 2000, section 256B.0913, 177.30 subdivision 7, is amended to read: 177.31 Subd. 7. [CASE MANAGEMENT.] Providers of case management 177.32 services for persons receiving services funded by the 177.33 alternative care program must meet the qualification 177.34 requirements and standards specified in section 256B.0915, 177.35 subdivision 1b. The case manager mustensure the health and177.36safety of the individual client andnot approve alternative care 178.1 funding for a client in any setting in which the case manager 178.2 cannot reasonably ensure the client's health and safety. The 178.3 case manager is responsible for the cost-effectiveness of the 178.4 alternative care individual care plan and must not approve any 178.5 care plan in which the cost of services funded by alternative 178.6 care and client contributions exceeds the limit specified in 178.7 section 256B.0915, subdivision 3, paragraph (b). The county may 178.8 allow a case manager employed by the county to delegate certain 178.9 aspects of the case management activity to another individual 178.10 employed by the county provided there is oversight of the 178.11 individual by the case manager. The case manager may not 178.12 delegate those aspects which require professional judgment 178.13 including assessments, reassessments, and care plan development. 178.14 Sec. 18. Minnesota Statutes 2000, section 256B.0913, 178.15 subdivision 8, is amended to read: 178.16 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 178.17 case manager shall implement the plan of care for each180-day178.18eligiblealternative care client and ensure that a client's 178.19 service needs and eligibility are reassessed at least every 12 178.20 months. The plan shall include any services prescribed by the 178.21 individual's attending physician as necessary to allow the 178.22 individual to remain in a community setting. In developing the 178.23 individual's care plan, the case manager should include the use 178.24 of volunteers from families and neighbors, religious 178.25 organizations, social clubs, and civic and service organizations 178.26 to support the formal home care services. The county shall be 178.27 held harmless for damages or injuries sustained through the use 178.28 of volunteers under this subdivision including workers' 178.29 compensation liability.The lead agency shall provide178.30documentation to the commissioner verifying that the178.31individual's alternative care is not available at that time178.32through any other public assistance or service program.The 178.33 lead agency shall provide documentation in each individual's 178.34 plan of care and, if requested, to the commissioner that the 178.35 most cost-effective alternatives available have been offered to 178.36 the individual and that the individual was free to choose among 179.1 available qualified providers, both public and private. The 179.2 case manager must give the individual a ten-day written notice 179.3 of any decrease in or termination of alternative care services. 179.4 (b) If the county administering alternative care services 179.5 is different than the county of financial responsibility, the 179.6 care plan may be implemented without the approval of the county 179.7 of financial responsibility. 179.8 Sec. 19. Minnesota Statutes 2000, section 256B.0913, 179.9 subdivision 9, is amended to read: 179.10 Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.]The lead179.11agency shall document to the commissioner that the agency made179.12reasonable efforts to inform potential providers of the179.13anticipated need for services under the alternative care program179.14or waiver programs under sections 256B.0915 and 256B.49,179.15including a minimum of 14 days' written advance notice of the179.16opportunity to be selected as a service provider and an annual179.17public meeting with providers to explain and review the criteria179.18for selection. The lead agency shall also document to the179.19commissioner that the agency allowed potential providers an179.20opportunity to be selected to contract with the county agency.179.21Funds reimbursed to counties under this subdivisionAlternative 179.22 care funds paid to service providers are subject to audit by the 179.23 commissioner for fiscal and utilization control. 179.24 The lead agency must select providers for contracts or 179.25 agreements using the following criteria and other criteria 179.26 established by the county: 179.27 (1) the need for the particular services offered by the 179.28 provider; 179.29 (2) the population to be served, including the number of 179.30 clients, the length of time services will be provided, and the 179.31 medical condition of clients; 179.32 (3) the geographic area to be served; 179.33 (4) quality assurance methods, including appropriate 179.34 licensure, certification, or standards, and supervision of 179.35 employees when needed; 179.36 (5) rates for each service and unit of service exclusive of 180.1 county administrative costs; 180.2 (6) evaluation of services previously delivered by the 180.3 provider; and 180.4 (7) contract or agreement conditions, including billing 180.5 requirements, cancellation, and indemnification. 180.6 The county must evaluate its own agency services under the 180.7 criteria established for other providers.The county shall180.8provide a written statement of the reasons for not selecting180.9providers.180.10 Sec. 20. Minnesota Statutes 2000, section 256B.0913, 180.11 subdivision 10, is amended to read: 180.12 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 180.13 appropriation for fiscal years 1992 and beyond shall cover 180.14 only180-dayalternative care eligible clients. Prior to July 1 180.15 of each year, the commissioner shall allocate to county agencies 180.16 the state funds available for alternative care for persons 180.17 eligible under subdivision 2. 180.18 (b)Prior to July 1 of each year, the commissioner shall180.19allocate to county agencies the state funds available for180.20alternative care for persons eligible under subdivision 2. The180.21allocation for fiscal year 1992 shall be calculated using a base180.22that is adjusted to exclude the medical assistance share of180.23alternative care expenditures. The adjusted base is calculated180.24by multiplying each county's allocation for fiscal year 1991 by180.25the percentage of county alternative care expenditures for180.26180-day eligible clients. The percentage is determined based on180.27expenditures for services rendered in fiscal year 1989 or180.28calendar year 1989, whichever is greater.The adjusted base for 180.29 each county is the county's current fiscal year base allocation 180.30 plus any targeted funds approved during the current fiscal 180.31 year. Calculations for paragraphs (c) and (d) are to be made as 180.32 follows: for each county, the determination of alternative care 180.33 program expenditures shall be based on payments for services 180.34 rendered from April 1 through March 31 in the base year, to the 180.35 extent that claims have been submitted and paid by June 1 of 180.36 that year. 181.1 (c) If thecountyalternative care program expendituresfor181.2180-day eligible clientsas defined in paragraph (b) are 95 181.3 percent or more ofitsthe county's adjusted base allocation, 181.4 the allocation for the next fiscal year is 100 percent of the 181.5 adjusted base, plus inflation to the extent that inflation is 181.6 included in the state budget. 181.7 (d) If thecountyalternative care program expendituresfor181.8180-day eligible clientsas defined in paragraph (b) are less 181.9 than 95 percent ofitsthe county's adjusted base allocation, 181.10 the allocation for the next fiscal year is the adjusted base 181.11 allocation less the amount of unspent funds below the 95 percent 181.12 level. 181.13 (e)For fiscal year 1992 only, a county may receive an181.14increased allocation if annualized service costs for the month181.15of May 1991 for 180-day eligible clients are greater than the181.16allocation otherwise determined. A county may apply for this181.17increase by reporting projected expenditures for May to the181.18commissioner by June 1, 1991. The amount of the allocation may181.19exceed the amount calculated in paragraph (b). The projected181.20expenditures for May must be based on actual 180-day eligible181.21client caseload and the individual cost of clients' care plans.181.22If a county does not report its expenditures for May, the amount181.23in paragraph (c) or (d) shall be used.181.24(f) Calculations for paragraphs (c) and (d) are to be made181.25as follows: for each county, the determination of expenditures181.26shall be based on payments for services rendered from April 1181.27through March 31 in the base year, to the extent that claims181.28have been submitted by June 1 of that year. Calculations for181.29paragraphs (c) and (d) must also include the funds transferred181.30to the consumer support grant program for clients who have181.31transferred to that program from April 1 through March 31 in the181.32base year.181.33(g) For the biennium ending June 30, 2001, the allocation181.34of state funds to county agencies shall be calculated as181.35described in paragraphs (c) and (d).If the annual legislative 181.36 appropriation for the alternative care program is inadequate to 182.1 fund the combined county allocations forfiscal year 2000 or182.22001a biennium, the commissioner shall distribute to each 182.3 county the entire annual appropriation as that county's 182.4 percentage of the computed base as calculated inparagraph182.5(f)paragraphs (c) and (d). 182.6 Sec. 21. Minnesota Statutes 2000, section 256B.0913, 182.7 subdivision 11, is amended to read: 182.8 Subd. 11. [TARGETED FUNDING.] (a) The purpose of targeted 182.9 funding is to make additional money available to counties with 182.10 the greatest need. Targeted funds are not intended to be 182.11 distributed equitably among all counties, but rather, allocated 182.12 to those with long-term care strategies that meet state goals. 182.13 (b) The funds available for targeted funding shall be the 182.14 total appropriation for each fiscal year minus county 182.15 allocations determined under subdivision 10 as adjusted for any 182.16 inflation increases provided in appropriations for the biennium. 182.17 (c) The commissioner shall allocate targeted funds to 182.18 counties that demonstrate to the satisfaction of the 182.19 commissioner that they have developed feasible plans to increase 182.20 alternative care spending. In making targeted funding 182.21 allocations, the commissioner shall use the following priorities: 182.22 (1) counties that received a lower allocation in fiscal 182.23 year 1991 than in fiscal year 1990. Counties remain in this 182.24 priority until they have been restored to their fiscal year 1990 182.25 level plus inflation; 182.26 (2) counties that sustain a base allocation reduction for 182.27 failure to spend 95 percent of the allocation if they 182.28 demonstrate that the base reduction should be restored; 182.29 (3) counties that propose projects to divert community 182.30 residents from nursing home placement or convert nursing home 182.31 residents to community living; and 182.32 (4) counties that can otherwise justify program growth by 182.33 demonstrating the existence of waiting lists, demographically 182.34 justified needs, or other unmet needs. 182.35 (d) Counties that would receive targeted funds according to 182.36 paragraph (c) must demonstrate to the commissioner's 183.1 satisfaction that the funds would be appropriately spent by 183.2 showing how the funds would be used to further the state's 183.3 alternative care goals as described in subdivision 1, and that 183.4 the county has the administrative and service delivery 183.5 capability to use them. 183.6 (e) The commissioner shall request applicationsby June 1183.7each year, for county agencies to applyfor targeted funds by 183.8 November 1 of each year. The counties selected for targeted 183.9 funds shall be notified of the amount of their additional 183.10 fundingby August 1 of each year. Targeted funds allocated to a 183.11 county agency in one year shall be treated as part of the 183.12 county's base allocation for that year in determining 183.13 allocations for subsequent years. No reallocations between 183.14 counties shall be made. 183.15(f) The allocation for each year after fiscal year 1992183.16shall be determined using the previous fiscal year's allocation,183.17including any targeted funds, as the base and then applying the183.18criteria under subdivision 10, paragraphs (c), (d), and (f), to183.19the current year's expenditures.183.20 Sec. 22. Minnesota Statutes 2000, section 256B.0913, 183.21 subdivision 13, is amended to read: 183.22 Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan 183.23 forthe preadmission screening programlong-term care 183.24 consultation services under section 256B.0911, the alternative 183.25 care program under this section, and waivers for the elderly 183.26 under section 256B.0915,and waivers for the disabled under183.27section 256B.49,shall be incorporated into the biennial 183.28 Community Social Services Act plan and shall meet the 183.29 regulations and timelines of that plan.This county biennial183.30plan shall include:183.31(1) information on the administration of the preadmission183.32screening program;183.33(2) information on the administration of the home and183.34community-based services waivers for the elderly under section183.35256B.0915, and for the disabled under section 256B.49; and183.36(3) information on the administration of the alternative184.1care program.184.2 Sec. 23. Minnesota Statutes 2000, section 256B.0913, 184.3 subdivision 14, is amended to read: 184.4 Subd. 14. [REIMBURSEMENTPAYMENT AND RATE ADJUSTMENTS.] (a) 184.5ReimbursementPayment forexpenditures for theprovided 184.6 alternative care services as approved by the client's case 184.7 manager shall be through the invoice processing procedures of 184.8 the department's Medicaid Management Information System (MMIS). 184.9 To receivereimbursementpayment, the county or vendor must 184.10 submit invoices within 12 months following the date of service. 184.11 The county agency and its vendors under contract shall not be 184.12 reimbursed for services which exceed the county allocation. 184.13 (b)If a county collects less than 50 percent of the client184.14premiums due under subdivision 12, the commissioner may withhold184.15up to three percent of the county's final alternative care184.16program allocation determined under subdivisions 10 and 11.184.17(c)The county shall negotiate individual rates with 184.18 vendors and maybe reimbursedauthorize service payment for 184.19 actual costs up tothe greater ofthe county's current approved 184.20 rateor 60 percent of the maximum rate in fiscal year 1994 and184.2165 percent of the maximum rate in fiscal year 1995 for each184.22alternative care service. Notwithstanding any other rule or 184.23 statutory provision to the contrary, the commissioner shall not 184.24 be authorized to increase rates by an annual inflation factor, 184.25 unless so authorized by the legislature. 184.26(d) On July 1, 1993, the commissioner shall increase the184.27maximum rate for home delivered meals to $4.50 per meal.To 184.28 Sec. 24. Minnesota Statutes 2000, section 256B.0915, 184.29 subdivision 1d, is amended to read: 184.30 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 184.31 RESOURCES FOR ELDERLY WAIVER.](a)Notwithstanding the 184.32 provisions of section 256B.056, the commissioner shall make the 184.33 following amendment to the medical assistance elderly waiver 184.34 program effective July 1, 1999, or upon federal approval, 184.35 whichever is later. 184.36 A recipient's maintenance needs will be an amount equal to 185.1 the Minnesota supplemental aid equivalent rate as defined in 185.2 section 256I.03, subdivision 5, plus the medical assistance 185.3 personal needs allowance as defined in section 256B.35, 185.4 subdivision 1, paragraph (a), when applying posteligibility 185.5 treatment of income rules to the gross income of elderly waiver 185.6 recipients, except for individuals whose income is in excess of 185.7 the special income standard according to Code of Federal 185.8 Regulations, title 42, section 435.236. Recipient maintenance 185.9 needs shall be adjusted under this provision each July 1. 185.10(b) The commissioner of human services shall secure185.11approval of additional elderly waiver slots sufficient to serve185.12persons who will qualify under the revised income standard185.13described in paragraph (a) before implementing section185.14256B.0913, subdivision 16.185.15(c) In implementing this subdivision, the commissioner185.16shall consider allowing persons who would otherwise be eligible185.17for the alternative care program but would qualify for the185.18elderly waiver with a spenddown to remain on the alternative185.19care program.185.20 Sec. 25. Minnesota Statutes 2000, section 256B.0915, 185.21 subdivision 3, is amended to read: 185.22 Subd. 3. [LIMITS OF CASES, RATES,REIMBURSEMENTPAYMENTS, 185.23 AND FORECASTING.] (a) The number of medical assistance waiver 185.24 recipients that a county may serve must be allocated according 185.25 to the number of medical assistance waiver cases open on July 1 185.26 of each fiscal year. Additional recipients may be served with 185.27 the approval of the commissioner. 185.28 (b) The monthly limit for the cost of waivered services to 185.29 an individual elderly waiver client shall be thestatewide185.30average paymentweighted average monthly nursing facility rate 185.31 of the case mix resident class to which the elderly waiver 185.32 client would be assigned underthe medical assistance case mix185.33reimbursement system.Minnesota Rules, parts 9549.0050 to 185.34 9549.0059, less the recipient's maintenance needs allowance as 185.35 described in subdivision 1d, paragraph (a), until the first day 185.36 of the state fiscal year in which the resident assessment system 186.1 as described in section 256B.437 for nursing home rate 186.2 determination is implemented. Effective on the first day of the 186.3 state fiscal year in which the resident assessment system as 186.4 described in section 256B.437 for nursing home rate 186.5 determination is implemented and the first day of each 186.6 subsequent state fiscal year, the monthly limit for the cost of 186.7 waivered services to an individual elderly waiver client shall 186.8 be the rate of the case mix resident class to which the waiver 186.9 client would be assigned under Minnesota Rules, parts 9549.0050 186.10 to 9549.0059, in effect on the last day of the previous state 186.11 fiscal year, adjusted by the greater of any legislatively 186.12 adopted home and community-based services cost-of-living 186.13 percentage increase or any legislatively adopted statewide 186.14 percent rate increase for nursing facilities. 186.15 (c) If extended medical supplies and equipment or 186.16adaptationsenvironmental modifications are or will be purchased 186.17 for an elderly waiverservices recipientclient, the costs may 186.18 be proratedon a monthly basis throughout the year in which they186.19are purchasedfor up to 12 consecutive months beginning with the 186.20 month of purchase. If the monthly cost of a recipient'sother186.21 waivered services exceeds the monthly limit established inthis186.22 paragraph (b), the annual cost oftheall waivered services 186.23 shall be determined. In this event, the annual cost of all 186.24 waivered services shall not exceed 12 times the monthly 186.25 limitcalculated in this paragraph. The statewide average186.26payment rate is calculated by determining the statewide average186.27monthly nursing home rate, effective July 1 of the fiscal year186.28in which the cost is incurred, less the statewide average186.29monthly income of nursing home residents who are age 65 or186.30older, and who are medical assistance recipients in the month of186.31March of the previous state fiscal year. The annual cost186.32divided by 12 of elderly or disabled waivered servicesof 186.33 waivered services as described in paragraph (b). 186.34 (d) For a person who is a nursing facility resident at the 186.35 time of requesting a determination of eligibility for elderlyor186.36disabledwaivered servicesshall be the greater of the monthly187.1payment for: (i), a monthly conversion limit for the cost of 187.2 elderly waivered services may be requested. The monthly 187.3 conversion limit for the cost of elderly waiver services shall 187.4 be the resident class assigned under Minnesota Rules, parts 187.5 9549.0050 to 9549.0059, for that resident in the nursing 187.6 facility where the resident currently resides; or (ii) the187.7statewide average payment of the case mix resident class to187.8which the resident would be assigned under the medical187.9assistance case mix reimbursement system, provided thatuntil 187.10 July 1 of the state fiscal year in which the resident assessment 187.11 system as described in section 256B.437 for nursing home rate 187.12 determination is implemented. Effective on July 1 of the state 187.13 fiscal year in which the resident assessment system as described 187.14 in section 256B.437 for nursing home rate determination is 187.15 implemented, the monthly conversion limit for the cost of 187.16 elderly waiver services shall be the per diem nursing facility 187.17 rate as determined by the resident assessment system as 187.18 described in section 256B.437 for that resident in the nursing 187.19 facility where the resident currently resides multiplied by 365 187.20 and divided by 12, less the recipient's maintenance needs 187.21 allowance as described in subdivision 1d. The limit under this 187.22 clause only applies to persons discharged from a nursing 187.23 facility after a minimum 30-day stay and found eligible for 187.24 waivered services on or after July 1, 1997. The following costs 187.25 must be included in determining the total monthly costs for the 187.26 waiver client: 187.27 (1) cost of all waivered services, including extended 187.28 medical supplies and equipment and environmental modifications; 187.29 and 187.30 (2) cost of skilled nursing, home health aide, and personal 187.31 care services reimbursable by medical assistance. 187.32(c)(e) Medical assistance funding for skilled nursing 187.33 services, private duty nursing, home health aide, and personal 187.34 care services for waiver recipients must be approved by the case 187.35 manager and included in the individual care plan. 187.36(d) For both the elderly waiver and the nursing facility188.1disabled waiver, a county may purchase extended supplies and188.2equipment without prior approval from the commissioner when188.3there is no other funding source and the supplies and equipment188.4are specified in the individual's care plan as medically188.5necessary to enable the individual to remain in the community188.6according to the criteria in Minnesota Rules, part 9505.0210,188.7items A and B.(f) A county is not required to contract with a 188.8 provider of supplies and equipment if the monthly cost of the 188.9 supplies and equipment is less than $250. 188.10(e)(g) The adult foster caredailyratefor the elderly188.11and disabled waiversshall be considered a difficulty of care 188.12 payment and shall not include room and board. The adult foster 188.13 care service rate shall be negotiated between the county agency 188.14 and the foster care provider.The rate established under this188.15section shall not exceed the state average monthly nursing home188.16payment for the case mix classification to which the individual188.17receiving foster care is assigned; the rate must allow for other188.18waiver and medical assistance home care services to be188.19authorized by the case manager.The elderly waiver payment for 188.20 the foster care service in combination with the payment for all 188.21 other elderly waiver services, including case management, must 188.22 not exceed the limit specified in paragraph (b). 188.23(f) The assisted living and residential care service rates188.24for elderly and community alternatives for disabled individuals188.25(CADI) waivers shall be made to the vendor as a monthly rate188.26negotiated with the county agency based on an individualized188.27service plan for each resident. The rate shall not exceed the188.28nonfederal share of the greater of either the statewide or any188.29of the geographic groups' weighted average monthly medical188.30assistance nursing facility payment rate of the case mix188.31resident class to which the elderly or disabled client would be188.32assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,188.33unless the services are provided by a home care provider188.34licensed by the department of health and are provided in a188.35building that is registered as a housing with services188.36establishment under chapter 144D and that provides 24-hour189.1supervision. For alternative care assisted living projects189.2established under Laws 1988, chapter 689, article 2, section189.3256, monthly rates may not exceed 65 percent of the greater of189.4either the statewide or any of the geographic groups' weighted189.5average monthly medical assistance nursing facility payment rate189.6for the case mix resident class to which the elderly or disabled189.7client would be assigned under Minnesota Rules, parts 9549.0050189.8to 9549.0059. The rate may not cover direct rent or food costs.189.9 (h) Payment for assisted living service shall be a monthly 189.10 rate negotiated and authorized by the county agency based on an 189.11 individualized service plan for each resident and may not cover 189.12 direct rent or food costs. 189.13 (1) The individualized monthly negotiated payment for 189.14 assisted living services as described in section 256B.0913, 189.15 subdivision 5, paragraph (g) or (h), and residential care 189.16 services as described in section 256B.0913, subdivision 5, 189.17 paragraph (f), shall not exceed the nonfederal share, in effect 189.18 on July 1 of the state fiscal year for which the rate limit is 189.19 being calculated, of the greater of either the statewide or any 189.20 of the geographic groups' weighted average monthly nursing 189.21 facility rate of the case mix resident class to which the 189.22 elderly waiver eligible client would be assigned under Minnesota 189.23 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 189.24 allowance as described in subdivision 1d, paragraph (a), until 189.25 the July 1 of the state fiscal year in which the resident 189.26 assessment system as described in section 256B.437 for nursing 189.27 home rate determination is implemented. Effective on July 1 of 189.28 the state fiscal year in which the resident assessment system as 189.29 described in section 256B.437 for nursing home rate 189.30 determination is implemented and July 1 of each subsequent state 189.31 fiscal year, the individualized monthly negotiated payment for 189.32 the services described in this clause shall not exceed the limit 189.33 described in this clause which was in effect on June 30 of the 189.34 previous state fiscal year and which has been adjusted by the 189.35 greater of any legislatively adopted home and community-based 189.36 services cost-of-living percentage increase or any legislatively 190.1 adopted statewide percent rate increase for nursing facilities. 190.2 (2) The individualized monthly negotiated payment for 190.3 assisted living services described in section 144A.4605 and 190.4 delivered by a provider licensed by the department of health as 190.5 a class A home care provider or an assisted living home care 190.6 provider and provided in a building that is registered as a 190.7 housing with services establishment under chapter 144D and that 190.8 provides 24-hour supervision in combination with the payment for 190.9 other elderly waiver services, including case management, must 190.10 not exceed the limit specified in paragraph (b). 190.11(g)(i) The county shall negotiate individual service rates 190.12 with vendors and maybe reimbursedauthorize payment for actual 190.13 costs up to thegreater of thecounty's current approved rateor190.1460 percent of the maximum rate in fiscal year 1994 and 65190.15percent of the maximum rate in fiscal year 1995 for each service190.16within each program. Persons or agencies must be employed by or 190.17 under a contract with the county agency or the public health 190.18 nursing agency of the local board of health in order to receive 190.19 funding under the elderly waiver program, except as a provider 190.20 of supplies and equipment when the monthly cost of the supplies 190.21 and equipment is less than $250. 190.22(h) On July 1, 1993, the commissioner shall increase the190.23maximum rate for home-delivered meals to $4.50 per meal.190.24(i)(j) Reimbursement for the medical assistance recipients 190.25 under the approved waiver shall be made from the medical 190.26 assistance account through the invoice processing procedures of 190.27 the department's Medicaid Management Information System (MMIS), 190.28 only with the approval of the client's case manager. The budget 190.29 for the state share of the Medicaid expenditures shall be 190.30 forecasted with the medical assistance budget, and shall be 190.31 consistent with the approved waiver. 190.32 (k) To improve access to community services and eliminate 190.33 payment disparities between the alternative care program and the 190.34 elderly waiver, the commissioner shall establish statewide 190.35 maximum service rate limits and eliminate county-specific 190.36 service rate limits. 191.1 (1) Effective July 1, 2001, for service rate limits, except 191.2 those described or defined in paragraphs (g) and (h), the rate 191.3 limit for each service shall be the greater of the alternative 191.4 care statewide maximum rate or the elderly waiver statewide 191.5 maximum rate. 191.6 (2) Counties may negotiate individual service rates with 191.7 vendors for actual costs up to the statewide maximum service 191.8 rate limit. 191.9(j)(l) Beginning July 1, 1991, the state shall reimburse 191.10 counties according to the payment schedule in section 256.025 191.11 for the county share of costs incurred under this subdivision on 191.12 or after January 1, 1991, for individuals who are receiving 191.13 medical assistance. 191.14(k) For the community alternatives for disabled individuals191.15waiver, and nursing facility disabled waivers, county may use191.16waiver funds for the cost of minor adaptations to a client's191.17residence or vehicle without prior approval from the191.18commissioner if there is no other source of funding and the191.19adaptation:191.20(1) is necessary to avoid institutionalization;191.21(2) has no utility apart from the needs of the client; and191.22(3) meets the criteria in Minnesota Rules, part 9505.0210,191.23items A and B.191.24For purposes of this subdivision, "residence" means the client's191.25own home, the client's family residence, or a family foster191.26home. For purposes of this subdivision, "vehicle" means the191.27client's vehicle, the client's family vehicle, or the client's191.28family foster home vehicle.191.29(l) The commissioner shall establish a maximum rate unit191.30for baths provided by an adult day care provider that are not191.31included in the provider's contractual daily or hourly rate.191.32This maximum rate must equal the home health aide extended rate191.33and shall be paid for baths provided to clients served under the191.34elderly and disabled waivers.191.35 Sec. 26. Minnesota Statutes 2000, section 256B.0915, 191.36 subdivision 5, is amended to read: 192.1 Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A 192.2 reassessment of a client served under the elderlyor disabled192.3 waiver must be conducted at least every 12 months and at other 192.4 times when the case manager determines that there has been 192.5 significant change in the client's functioning. This may 192.6 include instances where the client is discharged from the 192.7 hospital. 192.8 Sec. 27. Minnesota Statutes 2000, section 256B.0917, 192.9 subdivision 7, is amended to read: 192.10 Subd. 7. [CONTRACT.] (a) The commissioner of human 192.11 services shall execute a contract with Living at Home/Block 192.12 Nurse Program, Inc. (LAH/BN, Inc.). The contract shall require 192.13 LAH/BN, Inc. to: 192.14 (1) develop criteria for and award grants to establish 192.15 community-based organizations that will implement 192.16 living-at-home/block nurse programs throughout the state; 192.17 (2) award grants to enablecurrentliving-at-home/block 192.18 nurse programs to continue to implement the combined 192.19 living-at-home/block nurse program model; 192.20 (3) serve as a state technical assistance center to assist 192.21 and coordinate the living-at-home/block nurse programs 192.22 established; and 192.23 (4) manage contracts with individual living-at-home/block 192.24 nurse programs. 192.25 (b) The contract shall be effective July 1, 1997, and 192.26 section 16B.17 shall not apply. 192.27 Sec. 28. [RESPITE CARE.] 192.28 The Minnesota board on aging shall report to the 192.29 legislature by February 1, 2002, on the provision of in-home and 192.30 out-of-home respite care services on a sliding scale basis under 192.31 the federal Older Americans Act. 192.32 Sec. 29. [REPEALER.] 192.33 (a) Minnesota Statutes 2000, sections 256B.0911, 192.34 subdivisions 2, 2a, 4, and 9; 256B.0913, subdivisions 3, 15a, 192.35 15b, 15c, and 16; and 256B.0915, subdivisions 3a, 3b, and 3c, 192.36 are repealed. 193.1 (b) Minnesota Rules, parts 9505.2390; 9505.2395; 9505.2396; 193.2 9505.2400; 9505.2405; 9505.2410; 9505.2413; 9505.2415; 193.3 9505.2420; 9505.2425; 9505.2426; 9505.2430; 9505.2435; 193.4 9505.2440; 9505.2445; 9505.2450; 9505.2455; 9505.2458; 193.5 9505.2460; 9505.2465; 9505.2470; 9505.2473; 9505.2475; 193.6 9505.2480; 9505.2485; 9505.2486; 9505.2490; 9505.2495; 193.7 9505.2496; and 9505.2500, are repealed. 193.8 ARTICLE 5 193.9 LONG-TERM CARE SYSTEM REFORM AND REIMBURSEMENT 193.10 Section 1. Minnesota Statutes 2000, section 144.0721, 193.11 subdivision 1, is amended to read: 193.12 Subdivision 1. [APPROPRIATENESS AND QUALITY.] Until the 193.13 date of implementation of the revised case mix system based on 193.14 the minimum data set, the commissioner of health shall assess 193.15 the appropriateness and quality of care and services furnished 193.16 to private paying residents in nursing homes and boarding care 193.17 homes that are certified for participation in the medical 193.18 assistance program under United States Code, title 42, sections 193.19 1396-1396p. These assessments shall be conducted until the date 193.20 of implementation of the revised case mix system based on the 193.21 minimum data set, in accordance with section 144.072, with the 193.22 exception of provisions requiring recommendations for changes in 193.23 the level of care provided to the private paying residents. 193.24 Sec. 2. [144.0724] [RESIDENT REIMBURSEMENT 193.25 CLASSIFICATION.] 193.26 Subdivision 1. [RESIDENT REIMBURSEMENT 193.27 CLASSIFICATIONS.] The commissioner of health shall establish 193.28 resident reimbursement classifications based upon the 193.29 assessments of residents of nursing homes and boarding care 193.30 homes conducted under this section and according to section 193.31 256B.438. The reimbursement classifications established under 193.32 this section shall be implemented after June 30, 2002, but no 193.33 later than January 1, 2003. 193.34 Subd. 2. [DEFINITIONS.] For purposes of this section, the 193.35 following terms have the meanings given. 193.36 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 194.1 date" means the last day of the minimum data set observation 194.2 period. The date sets the designated endpoint of the common 194.3 observation period, and all minimum data set items refer back in 194.4 time from that point. 194.5 (b) [CASE MIX INDEX.] "Case mix index" means the weighting 194.6 factors assigned to the RUG-III classifications. 194.7 (c) [INDEX MAXIMIZATION.] "Index maximization" means 194.8 classifying a resident who could be assigned to more than one 194.9 category, to the category with the highest case mix index. 194.10 (d) [MINIMUM DATA SET.] "Minimum data set" means the 194.11 assessment instrument specified by the Health Care Financing 194.12 Administration and designated by the Minnesota department of 194.13 health. 194.14 (e) [REPRESENTATIVE.] "Representative" means a person who 194.15 is the resident's guardian or conservator, the person authorized 194.16 to pay the nursing home expenses of the resident, a 194.17 representative of the nursing home ombudsman's office whose 194.18 assistance has been requested, or any other individual 194.19 designated by the resident. 194.20 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 194.21 utilization groups" or "RUG" means the system for grouping a 194.22 nursing facility's residents according to their clinical and 194.23 functional status identified in data supplied by the facility's 194.24 minimum data set. 194.25 Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 194.26 Resident reimbursement classifications shall be based on the 194.27 minimum data set, version 2.0 assessment instrument, or its 194.28 successor version mandated by the Health Care Financing 194.29 Administration that nursing facilities are required to complete 194.30 for all residents. The commissioner of health shall establish 194.31 resident classes according to the 34 group, resource utilization 194.32 groups, version III or RUG-III model. Resident classes must be 194.33 established based on the individual items on the minimum data 194.34 set and must be completed according to the facility manual for 194.35 case mix classification issued by the Minnesota department of 194.36 health. The facility manual for case mix classification shall 195.1 be drafted by the Minnesota department of health and presented 195.2 to the chairs of health and human services legislative 195.3 committees by December 31, 2001. 195.4 (b) Each resident must be classified based on the 195.5 information from the minimum data set according to general 195.6 domains in clauses (1) to (7): 195.7 (1) extensive services where a resident requires 195.8 intravenous feeding or medications, suctioning, tracheostomy 195.9 care, or is on a ventilator or respirator; 195.10 (2) rehabilitation where a resident requires physical, 195.11 occupational, or speech therapy; 195.12 (3) special care where a resident has cerebral palsy; 195.13 quadriplegia; multiple sclerosis; pressure ulcers; fever with 195.14 vomiting, weight loss, or dehydration; tube feeding and aphasia; 195.15 or is receiving radiation therapy; 195.16 (4) clinically complex status where a resident has burns, 195.17 coma, septicemia, pneumonia, internal bleeding, chemotherapy, 195.18 wounds, kidney failure, urinary tract infections, oxygen, or 195.19 transfusions; 195.20 (5) impaired cognition where a resident has poor cognitive 195.21 performance; 195.22 (6) behavior problems where a resident exhibits wandering, 195.23 has hallucinations, or is physically or verbally abusive toward 195.24 others, unless the resident's other condition would place the 195.25 resident in other categories; and 195.26 (7) reduced physical functioning where a resident has no 195.27 special clinical conditions. 195.28 (c) The commissioner of health shall establish resident 195.29 classification according to a 34 group model based on the 195.30 information on the minimum data set and within the general 195.31 domains listed in paragraph (b), clauses (1) to (7). Detailed 195.32 descriptions of each resource utilization group shall be defined 195.33 in the facility manual for case mix classification issued by the 195.34 Minnesota department of health. The 34 groups are described as 195.35 follows: 195.36 (1) SE3: requires four or five extensive services; 196.1 (2) SE2: requires two or three extensive services; 196.2 (3) SE1: requires one extensive service; 196.3 (4) RAD: requires rehabilitation services and is dependent 196.4 in activity of daily living (ADL) at a count of 17 or 18; 196.5 (5) RAC: requires rehabilitation services and ADL count is 196.6 14 to 16; 196.7 (6) RAB: requires rehabilitation services and ADL count is 196.8 ten to 13; 196.9 (7) RAA: requires rehabilitation services and ADL count is 196.10 four to nine; 196.11 (8) SSC: requires special care and ADL count is 17 or 18; 196.12 (9) SSB: requires special care and ADL count is 15 or 16; 196.13 (10) SSA: requires special care and ADL count is seven to 196.14 14; 196.15 (11) CC2: clinically complex with depression and ADL count 196.16 is 17 or 18; 196.17 (12) CC1: clinically complex with no depression and ADL 196.18 count is 17 or 18; 196.19 (13) CB2: clinically complex with depression and ADL count 196.20 is 12 to 16; 196.21 (14) CB1: clinically complex with no depression and ADL 196.22 count is 12 to 16; 196.23 (15) CA2: clinically complex with depression and ADL count 196.24 is four to 11; 196.25 (16) CA1: clinically complex with no depression and ADL 196.26 count is four to 11; 196.27 (17) IB2: impaired cognition with nursing rehabilitation 196.28 and ADL count is six to ten; 196.29 (18) IB1: impaired cognition with no nursing 196.30 rehabilitation and ADL count is six to ten; 196.31 (19) IA2: impaired cognition with nursing rehabilitation 196.32 and ADL count is four or five; 196.33 (20) IA1: impaired cognition with no nursing 196.34 rehabilitation and ADL count is four or five; 196.35 (21) BB2: behavior problems with nursing rehabilitation 196.36 and ADL count is six to ten; 197.1 (22) BB1: behavior problems with no nursing rehabilitation 197.2 and ADL count is six to ten; 197.3 (23) BA2: behavior problems with nursing rehabilitation 197.4 and ADL count is four to five; 197.5 (24) BA1: behavior problems with no nursing rehabilitation 197.6 and ADL count is four to five; 197.7 (25) PE2: reduced physical functioning with nursing 197.8 rehabilitation and ADL count is 16 to 18; 197.9 (26) PE1: reduced physical functioning with no nursing 197.10 rehabilitation and ADL count is 16 to 18; 197.11 (27) PD2: reduced physical functioning with nursing 197.12 rehabilitation and ADL count is 11 to 15; 197.13 (28) PD1: reduced physical functioning with no nursing 197.14 rehabilitation and ADL count is 11 to 15; 197.15 (29) PC2: reduced physical functioning with nursing 197.16 rehabilitation and ADL count is nine or ten; 197.17 (30) PC1: reduced physical functioning with no nursing 197.18 rehabilitation and ADL count is nine or ten; 197.19 (31) PB2: reduced physical functioning with nursing 197.20 rehabilitation and ADL count is six to eight; 197.21 (32) PB1: reduced physical functioning with no nursing 197.22 rehabilitation and ADL count is six to eight; 197.23 (33) PA2: reduced physical functioning with nursing 197.24 rehabilitation and ADL count is four or five; and 197.25 (34) PA1: reduced physical functioning with no nursing 197.26 rehabilitation and ADL count is four or five. 197.27 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 197.28 must conduct and electronically submit to the commissioner of 197.29 health case mix assessments that conform with the assessment 197.30 schedule defined by the Code of Federal Regulations, title 42, 197.31 section 483.20, and published by the United States Department of 197.32 Health and Human Services, Health Care Financing Administration, 197.33 in the Long Term Care Assessment Instrument User's Manual, 197.34 version 2.0, October 1995, and subsequent clarifications made in 197.35 the Long-Term Care Assessment Instrument Questions and Answers, 197.36 version 2.0, August 1996. The commissioner of health may 198.1 substitute successor manuals or question and answer documents 198.2 published by the United States Department of Health and Human 198.3 Services, Health Care Financing Administration, to replace or 198.4 supplement the current version of the manual or document. 198.5 (b) The assessments used to determine a case mix 198.6 classification for reimbursement include the following: 198.7 (1) a new admission assessment must be completed by day 14 198.8 following admission; 198.9 (2) an annual assessment must be completed within 366 days 198.10 of the last comprehensive assessment; 198.11 (3) a significant change assessment must be completed 198.12 within 14 days of the identification of a significant change; 198.13 and 198.14 (4) the second quarterly assessment following either a new 198.15 admission assessment, an annual assessment, or a significant 198.16 change assessment. Each quarterly assessment must be completed 198.17 within 92 days of the previous assessment. 198.18 Subd. 5. [SHORT STAYS.] (a) A facility must submit to the 198.19 commissioner of health an initial admission assessment for all 198.20 residents who stay in the facility less than 14 days. 198.21 (b) Notwithstanding the admission assessment requirements 198.22 of paragraph (a), a facility may elect to accept a default rate 198.23 with a case mix index of 1.0 for all facility residents who stay 198.24 less than 14 days in lieu of submitting an initial assessment. 198.25 Facilities may make this election to be effective on the day of 198.26 implementation of the revised case mix system. 198.27 (c) After implementation of the revised case mix system, 198.28 nursing facilities must elect one of the options described in 198.29 paragraphs (a) and (b) on the annual report to the commissioner 198.30 of human services filed for each report year ending September 198.31 30. The election shall be effective on the following July 1. 198.32 (d) For residents who are admitted or readmitted and leave 198.33 the facility on a frequent basis and for whom readmission is 198.34 expected, the resident may be discharged on an extended leave 198.35 status. This status does not require reassessment each time the 198.36 resident returns to the facility unless a significant change in 199.1 the resident's status has occurred since the last assessment. 199.2 The case mix classification for these residents is determined by 199.3 the facility election made in paragraphs (a) and (b). 199.4 Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 199.5 that fails to complete or submit an assessment for a RUG-III 199.6 classification within seven days of the time requirements in 199.7 subdivisions 4 and 5 is subject to a reduced rate for that 199.8 resident. The reduced rate shall be the lowest rate for that 199.9 facility. The reduced rate is effective on the day of admission 199.10 for new admission assessments or on the day that the assessment 199.11 was due for all other assessments and continues in effect until 199.12 the first day of the month following the date of submission of 199.13 the resident's assessment. 199.14 Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT 199.15 CLASSIFICATION.] (a) A facility must elect between the options 199.16 in clauses (1) and (2) to provide notice to a resident of the 199.17 resident's case mix classification. 199.18 (1) The commissioner of health shall provide to a nursing 199.19 facility a notice for each resident of the reimbursement 199.20 classification established under subdivision 1. The notice must 199.21 inform the resident of the classification that was assigned, the 199.22 opportunity to review the documentation supporting the 199.23 classification, the opportunity to obtain clarification from the 199.24 commissioner, and the opportunity to request a reconsideration 199.25 of the classification. The commissioner must send notice of 199.26 resident classification by first class mail. A nursing facility 199.27 is responsible for the distribution of the notice to each 199.28 resident, to the person responsible for the payment of the 199.29 resident's nursing home expenses, or to another person 199.30 designated by the resident. This notice must be distributed 199.31 within three working days after the facility's receipt of the 199.32 notice from the commissioner of health. 199.33 (2) A facility may choose to provide a classification 199.34 notice, as prescribed by the commissioner of health, to a 199.35 resident upon receipt of the confirmation of the case mix 199.36 classification calculated by a facility or a corrected case mix 200.1 classification as indicated on the final validation report from 200.2 the commissioner. A nursing facility is responsible for the 200.3 distribution of the notice to each resident, to the person 200.4 responsible for the payment of the resident's nursing home 200.5 expenses, or to another person designated by the resident. This 200.6 notice must be distributed within three working days after the 200.7 facility's receipt of the validation report from the 200.8 commissioner. If a facility elects this option, the 200.9 commissioner of health shall provide the facility with a list of 200.10 residents and their case mix classifications as determined by 200.11 the commissioner. A nursing facility may make this election to 200.12 be effective on the day of implementation of the revised case 200.13 mix system. 200.14 (3) After implementation of the revised case mix system, a 200.15 nursing facility shall elect a notice of resident reimbursement 200.16 classification procedure as described in clause (1) or (2) on 200.17 the annual report to the commissioner of human services filed 200.18 for each report year ending September 30. The election will be 200.19 effective the following July 1. 200.20 (b) If a facility submits a correction to an assessment 200.21 conducted under subdivision 3 that results in a change in case 200.22 mix classification, the facility shall give written notice to 200.23 the resident or the resident's representative about the item 200.24 that was corrected and the reason for the correction. The 200.25 notice of corrected assessment may be provided at the same time 200.26 that the resident or resident's representative is provided the 200.27 resident's corrected notice of classification. 200.28 Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT 200.29 CLASSIFICATIONS.] (a) The resident, or resident's 200.30 representative, or the nursing facility or boarding care home 200.31 may request that the commissioner of health reconsider the 200.32 assigned reimbursement classification. The request for 200.33 reconsideration must be submitted in writing to the commissioner 200.34 within 30 days of the day the resident or the resident's 200.35 representative receives the resident classification notice. The 200.36 request for reconsideration must include the name of the 201.1 resident, the name and address of the facility in which the 201.2 resident resides, the reasons for the reconsideration, the 201.3 requested classification changes, and documentation supporting 201.4 the requested classification. The documentation accompanying 201.5 the reconsideration request is limited to documentation which 201.6 establishes that the needs of the resident at the time of the 201.7 assessment justify a classification which is different than the 201.8 classification established by the commissioner of health. 201.9 (b) Upon request, the nursing facility must give the 201.10 resident or the resident's representative a copy of the 201.11 assessment form and the other documentation that was given to 201.12 the commissioner of health to support the assessment findings. 201.13 The nursing facility shall also provide access to and a copy of 201.14 other information from the resident's record that has been 201.15 requested by or on behalf of the resident to support a 201.16 resident's reconsideration request. A copy of any requested 201.17 material must be provided within three working days of receipt 201.18 of a written request for the information. If a facility fails 201.19 to provide the material within this time, it is subject to the 201.20 issuance of a correction order and penalty assessment under 201.21 sections 144.653 and 144A.10. Notwithstanding those sections, 201.22 any correction order issued under this subdivision must require 201.23 that the nursing facility immediately comply with the request 201.24 for information and that as of the date of the issuance of the 201.25 correction order, the facility shall forfeit to the state a $100 201.26 fine for the first day of noncompliance, and an increase in the 201.27 $100 fine by $50 increments for each day the noncompliance 201.28 continues. 201.29 (c) In addition to the information required under 201.30 paragraphs (a) and (b), a reconsideration request from a nursing 201.31 facility must contain the following information: (i) the date 201.32 the reimbursement classification notices were received by the 201.33 facility; (ii) the date the classification notices were 201.34 distributed to the resident or the resident's representative; 201.35 and (iii) a copy of a notice sent to the resident or to the 201.36 resident's representative. This notice must inform the resident 202.1 or the resident's representative that a reconsideration of the 202.2 resident's classification is being requested, the reason for the 202.3 request, that the resident's rate will change if the request is 202.4 approved by the commissioner, the extent of the change, that 202.5 copies of the facility's request and supporting documentation 202.6 are available for review, and that the resident also has the 202.7 right to request a reconsideration. If the facility fails to 202.8 provide the required information with the reconsideration 202.9 request, the request must be denied, and the facility may not 202.10 make further reconsideration requests on that specific 202.11 reimbursement classification. 202.12 (d) Reconsideration by the commissioner must be made by 202.13 individuals not involved in reviewing the assessment, audit, or 202.14 reconsideration that established the disputed classification. 202.15 The reconsideration must be based upon the initial assessment 202.16 and upon the information provided to the commissioner under 202.17 paragraphs (a) and (b). If necessary for evaluating the 202.18 reconsideration request, the commissioner may conduct on-site 202.19 reviews. Within 15 working days of receiving the request for 202.20 reconsideration, the commissioner shall affirm or modify the 202.21 original resident classification. The original classification 202.22 must be modified if the commissioner determines that the 202.23 assessment resulting in the classification did not accurately 202.24 reflect the needs or assessment characteristics of the resident 202.25 at the time of the assessment. The resident and the nursing 202.26 facility or boarding care home shall be notified within five 202.27 working days after the decision is made. A decision by the 202.28 commissioner under this subdivision is the final administrative 202.29 decision of the agency for the party requesting reconsideration. 202.30 (e) The resident classification established by the 202.31 commissioner shall be the classification that applies to the 202.32 resident while the request for reconsideration is pending. 202.33 (f) The commissioner may request additional documentation 202.34 regarding a reconsideration necessary to make an accurate 202.35 reconsideration determination. 202.36 Subd. 9. [AUDIT AUTHORITY.] (a) The commissioner shall 203.1 audit the accuracy of resident assessments performed under 203.2 section 256B.438 through desk audits, on-site review of 203.3 residents and their records, and interviews with staff and 203.4 families. The commissioner shall reclassify a resident if the 203.5 commissioner determines that the resident was incorrectly 203.6 classified. 203.7 (b) The commissioner is authorized to conduct on-site 203.8 audits on an unannounced basis. 203.9 (c) A facility must grant the commissioner access to 203.10 examine the medical records relating to the resident assessments 203.11 selected for audit under this subdivision. The commissioner may 203.12 also observe and speak to facility staff and residents. 203.13 (d) The commissioner shall consider documentation under the 203.14 time frames for coding items on the minimum data set as set out 203.15 in the Resident Assessment Instrument Manual published by the 203.16 Health Care Financing Administration. 203.17 (e) The commissioner shall develop an audit selection 203.18 procedure that includes the following factors: 203.19 (1) The commissioner may target facilities that demonstrate 203.20 an atypical pattern of scoring minimum data set items, 203.21 nonsubmission of assessments, late submission of assessments, or 203.22 a previous history of audit changes of greater than 35 percent. 203.23 The commissioner shall select at least 20 percent of the most 203.24 current assessments submitted to the state for audit. Audits of 203.25 assessments selected in the targeted facilities must focus on 203.26 the factors leading to the audit. If the number of targeted 203.27 assessments selected does not meet the threshold of 20 percent 203.28 of the facility residents, then a stratified sample of the 203.29 remainder of assessments shall be drawn to meet the quota. If 203.30 the total change exceeds 35 percent, the commissioner may 203.31 conduct an expanded audit up to 100 percent of the remaining 203.32 current assessments. 203.33 (2) Facilities that are not a part of the targeted group 203.34 shall be placed in a general pool from which facilities will be 203.35 selected on a random basis for audit. Every facility shall be 203.36 audited annually. If a facility has two successive audits in 204.1 which the percentage of change is five percent or less and the 204.2 facility has not been the subject of a targeted audit in the 204.3 past 36 months, the facility may be audited biannually. A 204.4 stratified sample of 15 percent of the most current assessments 204.5 shall be selected for audit. If more than 20 percent of the 204.6 RUGS-III classifications after the audit are changed, the audit 204.7 shall be expanded to a second 15 percent sample. If the total 204.8 change between the first and second samples exceed 35 percent, 204.9 the commissioner may expand the audit to all of the remaining 204.10 assessments. 204.11 (3) If a facility qualifies for an expanded audit, the 204.12 commissioner may audit the facility again within six months. If 204.13 a facility has two expanded audits within a 24-month period, 204.14 that facility will be audited at least every six months for the 204.15 next 18 months. 204.16 (4) The commissioner may conduct special audits if the 204.17 commissioner determines that circumstances exist that could 204.18 alter or affect the validity of case mix classifications of 204.19 residents. These circumstances include, but are not limited to, 204.20 the following: 204.21 (i) frequent changes in the administration or management of 204.22 the facility; 204.23 (ii) an unusually high percentage of residents in a 204.24 specific case mix classification; 204.25 (iii) a high frequency in the number of reconsideration 204.26 requests received from a facility; 204.27 (iv) frequent adjustments of case mix classifications as 204.28 the result of reconsiderations or audits; 204.29 (v) a criminal indictment alleging provider fraud; or 204.30 (vi) other similar factors that relate to a facility's 204.31 ability to conduct accurate assessments. 204.32 (f) Within 15 working days of completing the audit process, 204.33 the commissioner shall mail the written results of the audit to 204.34 the facility, along with a written notice for each resident 204.35 affected to be forwarded by the facility. The notice must 204.36 contain the resident's classification and a statement informing 205.1 the resident, the resident's authorized representative, and the 205.2 facility of their right to review the commissioner's documents 205.3 supporting the classification and to request a reconsideration 205.4 of the classification. This notice must also include the 205.5 address and telephone number of the area nursing home ombudsman. 205.6 Subd. 10. [TRANSITION.] After implementation of this 205.7 section, reconsiderations requested for classifications made 205.8 under section 144.0722, subdivision 1, shall be determined under 205.9 section 144.0722, subdivision 3. 205.10 Sec. 3. Minnesota Statutes 2000, section 144A.071, 205.11 subdivision 1, is amended to read: 205.12 Subdivision 1. [FINDINGS.] The legislature declares that a 205.13 moratorium on the licensure and medical assistance certification 205.14 of new nursing home beds and construction projects that 205.15 exceed$750,000$1,000,000 is necessary to control nursing home 205.16 expenditure growth and enable the state to meet the needs of its 205.17 elderly by providing high quality services in the most 205.18 appropriate manner along a continuum of care. 205.19 Sec. 4. Minnesota Statutes 2000, section 144A.071, 205.20 subdivision 1a, is amended to read: 205.21 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 205.22 to 144A.073, the following terms have the meanings given them: 205.23 (a) "attached fixtures" has the meaning given in Minnesota 205.24 Rules, part 9549.0020, subpart 6. 205.25 (b) "buildings" has the meaning given in Minnesota Rules, 205.26 part 9549.0020, subpart 7. 205.27 (c) "capital assets" has the meaning given in section 205.28 256B.421, subdivision 16. 205.29 (d) "commenced construction" means that all of the 205.30 following conditions were met: the final working drawings and 205.31 specifications were approved by the commissioner of health; the 205.32 construction contracts were let; a timely construction schedule 205.33 was developed, stipulating dates for beginning, achieving 205.34 various stages, and completing construction; and all zoning and 205.35 building permits were applied for. 205.36 (e) "completion date" means the date on which a certificate 206.1 of occupancy is issued for a construction project, or if a 206.2 certificate of occupancy is not required, the date on which the 206.3 construction project is available for facility use. 206.4 (f) "construction" means any erection, building, 206.5 alteration, reconstruction, modernization, or improvement 206.6 necessary to comply with the nursing home licensure rules. 206.7 (g) "construction project" means: 206.8 (1) a capital asset addition to, or replacement of a 206.9 nursing home or certified boarding care home that results in new 206.10 space or the remodeling of or renovations to existing facility 206.11 space; 206.12 (2) the remodeling or renovation of existing facility space 206.13 the use of which is modified as a result of the project 206.14 described in clause (1). This existing space and the project 206.15 described in clause (1) must be used for the functions as 206.16 designated on the construction plans on completion of the 206.17 project described in clause (1) for a period of not less than 24 206.18 months; or 206.19 (3) capital asset additions or replacements that are 206.20 completed within 12 months before or after the completion date 206.21 of the project described in clause (1). 206.22 (h) "new licensed" or "new certified beds" means: 206.23 (1) newly constructed beds in a facility or the 206.24 construction of a new facility that would increase the total 206.25 number of licensed nursing home beds or certified boarding care 206.26 or nursing home beds in the state; or 206.27 (2) newly licensed nursing home beds or newly certified 206.28 boarding care or nursing home beds that result from remodeling 206.29 of the facility that involves relocation of beds but does not 206.30 result in an increase in the total number of beds, except when 206.31 the project involves the upgrade of boarding care beds to 206.32 nursing home beds, as defined in section 144A.073, subdivision 206.33 1. "Remodeling" includes any of the type of conversion, 206.34 renovation, replacement, or upgrading projects as defined in 206.35 section 144A.073, subdivision 1. 206.36 (i) "project construction costs" means the cost of the 207.1 facility capital asset additions, replacements, renovations, or 207.2 remodeling projects, construction site preparation costs, and 207.3 related soft costs. Project construction costsalsoinclude the 207.4 cost of any remodeling or renovation of existing facility space 207.5 which is modified as a result of the construction 207.6 project. Project construction costs also includes the cost of 207.7 new technology implemented as part of the construction project. 207.8 (j) "technology" means information systems or devices that 207.9 make documentation, charting, and staff time more efficient or 207.10 encourage and allow for care through alternative settings 207.11 including, but not limited to, touch screens, monitors, 207.12 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 207.13 medication dispensers, and equipment to monitor vital signs and 207.14 self-injections, and to observe skin and other conditions. 207.15 Sec. 5. Minnesota Statutes 2000, section 144A.071, 207.16 subdivision 2, is amended to read: 207.17 Subd. 2. [MORATORIUM.] The commissioner of health, in 207.18 coordination with the commissioner of human services, shall deny 207.19 each request for new licensed or certified nursing home or 207.20 certified boarding care beds except as provided in subdivision 3 207.21 or 4a, or section 144A.073. "Certified bed" means a nursing 207.22 home bed or a boarding care bed certified by the commissioner of 207.23 health for the purposes of the medical assistance program, under 207.24 United States Code, title 42, sections 1396 et seq. 207.25 The commissioner of human services, in coordination with 207.26 the commissioner of health, shall deny any request to issue a 207.27 license under section 252.28 and chapter 245A to a nursing home 207.28 or boarding care home, if that license would result in an 207.29 increase in the medical assistance reimbursement amount. 207.30 In addition, the commissioner of health must not approve 207.31 any construction project whose cost exceeds$750,000$1,000,000, 207.32 unless: 207.33 (a) any construction costs exceeding$750,000$1,000,000 207.34 are not added to the facility's appraised value and are not 207.35 included in the facility's payment rate for reimbursement under 207.36 the medical assistance program; or 208.1 (b) the project: 208.2 (1) has been approved through the process described in 208.3 section 144A.073; 208.4 (2) meets an exception in subdivision 3 or 4a; 208.5 (3) is necessary to correct violations of state or federal 208.6 law issued by the commissioner of health; 208.7 (4) is necessary to repair or replace a portion of the 208.8 facility that was damaged by fire, lightning, groundshifts, or 208.9 other such hazards, including environmental hazards, provided 208.10 that the provisions of subdivision 4a, clause (a), are met; 208.11 (5) as of May 1, 1992, the facility has submitted to the 208.12 commissioner of health written documentation evidencing that the 208.13 facility meets the "commenced construction" definition as 208.14 specified in subdivision 1a, clause (d), or that substantial 208.15 steps have been taken prior to April 1, 1992, relating to the 208.16 construction project. "Substantial steps" require that the 208.17 facility has made arrangements with outside parties relating to 208.18 the construction project and include the hiring of an architect 208.19 or construction firm, submission of preliminary plans to the 208.20 department of health or documentation from a financial 208.21 institution that financing arrangements for the construction 208.22 project have been made; or 208.23 (6) is being proposed by a licensed nursing facility that 208.24 is not certified to participate in the medical assistance 208.25 program and will not result in new licensed or certified beds. 208.26 Prior to the final plan approval of any construction 208.27 project, the commissioner of health shall be provided with an 208.28 itemized cost estimate for the project construction costs. If a 208.29 construction project is anticipated to be completed in phases, 208.30 the total estimated cost of all phases of the project shall be 208.31 submitted to the commissioner and shall be considered as one 208.32 construction project. Once the construction project is 208.33 completed and prior to the final clearance by the commissioner, 208.34 the total project construction costs for the construction 208.35 project shall be submitted to the commissioner. If the final 208.36 project construction cost exceeds the dollar threshold in this 209.1 subdivision, the commissioner of human services shall not 209.2 recognize any of the project construction costs or the related 209.3 financing costs in excess of this threshold in establishing the 209.4 facility's property-related payment rate. 209.5 The dollar thresholds for construction projects are as 209.6 follows: for construction projects other than those authorized 209.7 in clauses (1) to (6), the dollar threshold 209.8 is$750,000$1,000,000. For projects authorized after July 1, 209.9 1993, under clause (1), the dollar threshold is the cost 209.10 estimate submitted with a proposal for an exception under 209.11 section 144A.073, plus inflation as calculated according to 209.12 section 256B.431, subdivision 3f, paragraph (a). For projects 209.13 authorized under clauses (2) to (4), the dollar threshold is the 209.14 itemized estimate project construction costs submitted to the 209.15 commissioner of health at the time of final plan approval, plus 209.16 inflation as calculated according to section 256B.431, 209.17 subdivision 3f, paragraph (a). 209.18 The commissioner of health shall adopt rules to implement 209.19 this section or to amend the emergency rules for granting 209.20 exceptions to the moratorium on nursing homes under section 209.21 144A.073. 209.22 Sec. 6. Minnesota Statutes 2000, section 144A.073, 209.23 subdivision 4, is amended to read: 209.24 Subd. 4. [CRITERIA FOR REVIEW.] The following criteria 209.25 shall be used in a consistent manner to compare, evaluate, and 209.26 rank all proposals submitted. Except for the criteria specified 209.27 in clause (3), the application of criteria listed under this 209.28 subdivision shall not reflect any distinction based on the 209.29 geographic location of the proposed project: 209.30 (1) the extent to which the proposal furthers state 209.31 long-term care goals,including the goals stated in section209.32144A.31, andincluding the goal of enhancing the availability 209.33 and use of alternative care services and the goal of reducing 209.34 the number of long-term care resident rooms with more than two 209.35 beds; 209.36 (2) the proposal's long-term effects on state costs 210.1 including the cost estimate of the project according to section 210.2 144A.071, subdivision 5a; 210.3 (3) the extent to which the proposal promotes equitable 210.4 access to long-term care services in nursing homes through 210.5 redistribution of the nursing home bed supply, as measured by 210.6 the number of beds relative to the population 85 or older, 210.7 projected to the year 2000 by the state demographer, and 210.8 according to items (i) to (iv): 210.9 (i) reduce beds in counties where the supply is high, 210.10 relative to the statewide mean, and increase beds in counties 210.11 where the supply is low, relative to the statewide mean; 210.12 (ii) adjust the bed supply so as to create the greatest 210.13 benefits in improving the distribution of beds; 210.14 (iii) adjust the existing bed supply in counties so that 210.15 the bed supply in a county moves toward the statewide mean; and 210.16 (iv) adjust the existing bed supply so that the 210.17 distribution of beds as projected for the year 2020 would be 210.18 consistent with projected need, based on the methodology 210.19 outlined in the interagency long-term care committee's1993210.20 nursing home bed distribution study; 210.21 (4) the extent to which the project improves conditions 210.22 that affect the health or safety of residents, such as narrow 210.23 corridors, narrow door frames, unenclosed fire exits, and wood 210.24 frame construction, and similar provisions contained in fire and 210.25 life safety codes and licensure and certification rules; 210.26 (5) the extent to which the project improves conditions 210.27 that affect the comfort or quality of life of residents in a 210.28 facility or the ability of the facility to provide efficient 210.29 care, such as a relatively high number of residents in a room; 210.30 inadequate lighting or ventilation; poor access to bathing or 210.31 toilet facilities; a lack of available ancillary space for 210.32 dining rooms, day rooms, or rooms used for other activities; 210.33 problems relating to heating, cooling, or energy efficiency; 210.34 inefficient location of nursing stations; narrow corridors; or 210.35 other provisions contained in the licensure and certification 210.36 rules; 211.1 (6) the extent to which the applicant demonstrates the 211.2 delivery of quality care, as defined in state and federal 211.3 statutes and rules, to residents as evidenced by the two most 211.4 recent state agency certification surveys and the applicants' 211.5 response to those surveys; 211.6 (7) the extent to which the project removes the need for 211.7 waivers or variances previously granted by either the licensing 211.8 agency, certifying agency, fire marshal, or local government 211.9 entity;and211.10 (8) the extent to which the project increases the number of 211.11 private or single bed rooms; and 211.12 (9) other factors that may be developed in permanent rule 211.13 by the commissioner of health that evaluate and assess how the 211.14 proposed project will further promote or protect the health, 211.15 safety, comfort, treatment, or well-being of the facility's 211.16 residents. 211.17 Sec. 7. [144A.1888] [REUSE OF FACILITIES.] 211.18 Notwithstanding any local ordinance related to development, 211.19 planning, or zoning to the contrary, the conversion or reuse of 211.20 a nursing home that closes or that curtails, reduces, or changes 211.21 operations shall be considered a conforming use permitted under 211.22 local law, provided that the facility is converted to another 211.23 long-term care service approved by a regional planning group 211.24 under section 256B.437 that serves a smaller number of persons 211.25 than the number of persons served before the closure or 211.26 curtailment, reduction, or change in operations. 211.27 Sec. 8. Minnesota Statutes 2000, section 256B.431, is 211.28 amended by adding a subdivision to read: 211.29 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 211.30 years beginning on or after July 1, 2001, the total payment rate 211.31 for a facility reimbursed under this section, section 256B.434, 211.32 or any other section for the first 90 paid days after admission 211.33 shall be: 211.34 (1) for the first 30 paid days, the rate shall be 120 211.35 percent of the facility's medical assistance rate for each case 211.36 mix class; and 212.1 (2) for the next 60 paid days after the first 30 paid days, 212.2 the rate shall be 110 percent of the facility's medical 212.3 assistance rate for each case mix class. 212.4 (b) Beginning with the 91st paid day after admission, the 212.5 payment rate shall be the rate otherwise determined under this 212.6 section, section 256B.434, or any other section. 212.7 (c) This subdivision applies to admissions occurring on or 212.8 after July 1, 2001. 212.9 Sec. 9. Minnesota Statutes 2000, section 256B.431, is 212.10 amended by adding a subdivision to read: 212.11 Subd. 35. [EXCLUSION OF RAW FOOD COST ADJUSTMENT.] For 212.12 rate years beginning on or after July 1, 2001, in calculating a 212.13 nursing facility's operating cost per diem for the purposes of 212.14 constructing an array, determining a median, or otherwise 212.15 performing a statistical measure of nursing facility payment 212.16 rates to be used to determine future rate increases under this 212.17 section, section 256B.434, or any other section, the 212.18 commissioner shall exclude adjustments for raw food costs under 212.19 subdivision 2b, paragraph (h), that are related to providing 212.20 special diets based on religious beliefs. 212.21 Sec. 10. Minnesota Statutes 2000, section 256B.433, 212.22 subdivision 3a, is amended to read: 212.23 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 212.24 BILLING.] The provisions of subdivision 3 do not apply to 212.25 nursing facilities that are reimbursed according to the 212.26 provisions of section 256B.431and are located in a county212.27participating in the prepaid medical assistance program. 212.28 Nursing facilities that are reimbursed according to the 212.29 provisions of section 256B.434 and are located in a county 212.30 participating in the prepaid medical assistance program are 212.31 exempt from the maximum therapy rent revenue provisions of 212.32 subdivision 3, paragraph (c). 212.33 [EFFECTIVE DATE.] This section is effective the day 212.34 following final enactment. 212.35 Sec. 11. [256B.438] [IMPLEMENTATION OF A CASE MIX SYSTEM 212.36 FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 213.1 Subdivision 1. [SCOPE.] This section establishes the 213.2 method and criteria used to determine resident reimbursement 213.3 classifications based upon the assessments of residents of 213.4 nursing homes and boarding care homes whose payment rates are 213.5 established under section 256B.431, 256B.434, or 256B.435. 213.6 Resident reimbursement classifications shall be established 213.7 according to the 34 group, resource utilization groups, version 213.8 III or RUG-III model as described in section 144.0724. 213.9 Reimbursement classifications established under this section 213.10 shall be implemented after June 30, 2002, but no later than 213.11 January 1, 2003. 213.12 Subd. 2. [DEFINITIONS.] For purposes of this section, the 213.13 following terms have the meanings given. 213.14 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 213.15 date" has the meaning given in section 144.0724, subdivision 2, 213.16 paragraph (a). 213.17 (b) [CASE MIX INDEX.] "Case mix index" has the meaning 213.18 given in section 144.0724, subdivision 2, paragraph (b). 213.19 (c) [INDEX MAXIMIZATION.] "Index maximization" has the 213.20 meaning given in section 144.0724, subdivision 2, paragraph (c). 213.21 (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 213.22 given in section 144.0724, subdivision 2, paragraph (d). 213.23 (e) [REPRESENTATIVE.] "Representative" has the meaning 213.24 given in section 144.0724, subdivision 2, paragraph (e). 213.25 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 213.26 utilization groups" or "RUG" has the meaning given in section 213.27 144.0724, subdivision 2, paragraph (f). 213.28 Subd. 3. [CASE MIX INDICES.] (a) The commissioner of human 213.29 services shall assign a case mix index to each resident class 213.30 based on the Health Care Financing Administration's staff time 213.31 measurement study and adjusted for Minnesota-specific wage 213.32 indices. The case mix indices assigned to each resident class 213.33 shall be published in the Minnesota State Register at least 120 213.34 days prior to the implementation of the 34 group, RUG-III 213.35 resident classification system. 213.36 (b) An index maximization approach shall be used to 214.1 classify residents. 214.2 (c) After implementation of the revised case mix system, 214.3 the commissioner of human services may annually rebase case mix 214.4 indices and base rates using more current data on average wage 214.5 rates and staff time measurement studies. This rebasing shall 214.6 be calculated under subdivision 7, paragraph (b). The 214.7 commissioner shall publish in the Minnesota State Register 214.8 adjusted case mix indices at least 45 days prior to the 214.9 effective date of the adjusted case mix indices. 214.10 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 214.11 facilities shall conduct and submit case mix assessments 214.12 according to the schedule established by the commissioner of 214.13 health under section 144.0724, subdivisions 4 and 5. 214.14 (b) The resident reimbursement classifications established 214.15 under section 144.0724, subdivision 3, shall be effective the 214.16 day of admission for new admission assessments. The effective 214.17 date for significant change assessments shall be the assessment 214.18 reference date. The effective date for annual and second 214.19 quarterly assessments shall be the first day of the month 214.20 following assessment reference date. 214.21 Subd. 5. [NOTICE OF RESIDENT REIMBURSEMENT 214.22 CLASSIFICATION.] Nursing facilities shall provide notice to a 214.23 resident of the resident's case mix classification according to 214.24 procedures established by the commissioner of health under 214.25 section 144.0724, subdivision 7. 214.26 Subd. 6. [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 214.27 request for reconsideration of a resident classification must be 214.28 made under section 144.0724, subdivision 8. 214.29 Subd. 7. [RATE DETERMINATION UPON TRANSITION TO RUG-III 214.30 PAYMENT RATES.] (a) The commissioner of human services shall 214.31 determine payment rates at the time of transition to the RUG 214.32 based payment model in a facility-specific, budget-neutral 214.33 manner. The case mix indices as defined in subdivision 3 shall 214.34 be used to allocate the case mix adjusted component of total 214.35 payment across all case mix groups. To transition from the 214.36 current calculation methodology to the RUG based methodology, 215.1 the commissioner of health shall report to the commissioner of 215.2 human services the resident days classified according to the 215.3 categories defined in subdivision 3 for the 12-month reporting 215.4 period ending September 30, 2001, for each nursing facility. 215.5 The commissioner of human services shall use this data to 215.6 compute the standardized days for the reporting period under the 215.7 RUG system. 215.8 (b) The commissioner of human services shall determine the 215.9 case mix adjusted component of the rate as follows: 215.10 (1) determine the case mix portion of the 11 case mix rates 215.11 in effect on June 30, 2002, or the 34 case mix rates in effect 215.12 on or after June 30, 2003; 215.13 (2) multiply each amount in clause (1) by the number of 215.14 resident days assigned to each group for the reporting period 215.15 ending September 30, 2001, or the most recent year for which 215.16 data is available; 215.17 (3) compute the sum of the amounts in clause (2); 215.18 (4) determine the total RUG standardized days for the 215.19 reporting period ending September 30, 2001, or the most recent 215.20 year for which data is available using the new indices 215.21 calculated under subdivision 3, paragraph (c); 215.22 (5) divide the amount in clause (3) by the amount in clause 215.23 (4) which shall be the average case mix adjusted component of 215.24 the rate under the RUG method; and 215.25 (6) multiply this average rate by the case mix weight in 215.26 subdivision 3 for each RUG group. 215.27 (c) The noncase mix component will be allocated to each RUG 215.28 group as a constant amount to determine the transition payment 215.29 rate. Any other rate adjustments that are effective on or after 215.30 July 1, 2002, shall be applied to the transition rates 215.31 determined under this section. 215.32 Sec. 12. Minnesota Statutes 2000, section 626.557, 215.33 subdivision 12b, is amended to read: 215.34 Subd. 12b. [DATA MANAGEMENT.] (a) [COUNTY DATA.] In 215.35 performing any of the duties of this section as a lead agency, 215.36 the county social service agency shall maintain appropriate 216.1 records. Data collected by the county social service agency 216.2 under this section are welfare data under section 13.46. 216.3 Notwithstanding section 13.46, subdivision 1, paragraph (a), 216.4 data under this paragraph that are inactive investigative data 216.5 on an individual who is a vendor of services are private data on 216.6 individuals, as defined in section 13.02. The identity of the 216.7 reporter may only be disclosed as provided in paragraph (c). 216.8 Data maintained by the common entry point are confidential 216.9 data on individuals or protected nonpublic data as defined in 216.10 section 13.02. Notwithstanding section 138.163, the common 216.11 entry point shall destroy data three calendar years after date 216.12 of receipt. 216.13 (b) [LEAD AGENCY DATA.] The commissioners of health and 216.14 human services shall prepare an investigation memorandum for 216.15 each report alleging maltreatment investigated under this 216.16 section. During an investigation by the commissioner of health 216.17 or the commissioner of human services, data collected under this 216.18 section are confidential data on individuals or protected 216.19 nonpublic data as defined in section 13.02. Upon completion of 216.20 the investigation, the data are classified as provided in 216.21 clauses (1) to (3) and paragraph (c). 216.22 (1) The investigation memorandum must contain the following 216.23 data, which are public: 216.24 (i) the name of the facility investigated; 216.25 (ii) a statement of the nature of the alleged maltreatment; 216.26 (iii) pertinent information obtained from medical or other 216.27 records reviewed; 216.28 (iv) the identity of the investigator; 216.29 (v) a summary of the investigation's findings; 216.30 (vi) statement of whether the report was found to be 216.31 substantiated, inconclusive, false, or that no determination 216.32 will be made; 216.33 (vii) a statement of any action taken by the facility; 216.34 (viii) a statement of any action taken by the lead agency; 216.35 and 216.36 (ix) when a lead agency's determination has substantiated 217.1 maltreatment, a statement of whether an individual, individuals, 217.2 or a facility were responsible for the substantiated 217.3 maltreatment, if known. 217.4 The investigation memorandum must be written in a manner 217.5 which protects the identity of the reporter and of the 217.6 vulnerable adult and may not contain the names or, to the extent 217.7 possible, data on individuals or private data listed in clause 217.8 (2). 217.9 (2) Data on individuals collected and maintained in the 217.10 investigation memorandum are private data, including: 217.11 (i) the name of the vulnerable adult; 217.12 (ii) the identity of the individual alleged to be the 217.13 perpetrator; 217.14 (iii) the identity of the individual substantiated as the 217.15 perpetrator; and 217.16 (iv) the identity of all individuals interviewed as part of 217.17 the investigation. 217.18 (3) Other data on individuals maintained as part of an 217.19 investigation under this section are private data on individuals 217.20 upon completion of the investigation. 217.21 (c) [IDENTITY OF REPORTER.] The subject of the report may 217.22 compel disclosure of the name of the reporter only with the 217.23 consent of the reporter or upon a written finding by a court 217.24 that the report was false and there is evidence that the report 217.25 was made in bad faith. This subdivision does not alter 217.26 disclosure responsibilities or obligations under the rules of 217.27 criminal procedure, except that where the identity of the 217.28 reporter is relevant to a criminal prosecution, the district 217.29 court shall do an in-camera review prior to determining whether 217.30 to order disclosure of the identity of the reporter. 217.31 (d) [DESTRUCTION OF DATA.] Notwithstanding section 217.32 138.163, data maintained under this section by the commissioners 217.33 of health and human services must be destroyed under the 217.34 following schedule: 217.35 (1) data from reports determined to be false, two years 217.36 after the finding was made; 218.1 (2) data from reports determined to be inconclusive, four 218.2 years after the finding was made; 218.3 (3) data from reports determined to be substantiated, seven 218.4 years after the finding was made; and 218.5 (4) data from reports which were not investigated by a lead 218.6 agency and for which there is no final disposition, two years 218.7 from the date of the report. 218.8 (e) [SUMMARY OF REPORTS.] The commissioners of health and 218.9 human services shall each annuallyprepare a summary ofreport 218.10 to the legislature and the governor on the number and type of 218.11 reports of alleged maltreatment involving licensed facilities 218.12 reported under this section, the number of those requiring 218.13 investigation under this section, and the resolution of those 218.14 investigations. The report shall identify: 218.15 (1) whether and where backlogs of cases result in a failure 218.16 to conform with statutory time frames; 218.17 (2) where adequate coverage requires additional 218.18 appropriations and staffing; and 218.19 (3) any other trends that affect the safety of vulnerable 218.20 adults. 218.21 (f) [RECORD RETENTION POLICY.] Each lead agency must have 218.22 a record retention policy. 218.23 (g) [EXCHANGE OF INFORMATION.] Lead agencies, prosecuting 218.24 authorities, and law enforcement agencies may exchange not 218.25 public data, as defined in section 13.02, if the agency or 218.26 authority requesting the data determines that the data are 218.27 pertinent and necessary to the requesting agency in initiating, 218.28 furthering, or completing an investigation under this section. 218.29 Data collected under this section must be made available to 218.30 prosecuting authorities and law enforcement officials, local 218.31 county agencies, and licensing agencies investigating the 218.32 alleged maltreatment under this section. The lead agency shall 218.33 exchange not public data with the vulnerable adult maltreatment 218.34 review panel established in section 256.021 if the data are 218.35 pertinent and necessary for a review requested under that 218.36 section. Upon completion of the review, not public data 219.1 received by the review panel must be returned to the lead agency. 219.2 (h) [COMPLETION TIME.] Each lead agency shall keep records 219.3 of the length of time it takes to complete its investigations. 219.4 (i) [NOTIFICATION OF OTHER AFFECTED PARTIES.] A lead 219.5 agency may notify other affected parties and their authorized 219.6 representative if the agency has reason to believe maltreatment 219.7 has occurred and determines the information will safeguard the 219.8 well-being of the affected parties or dispel widespread rumor or 219.9 unrest in the affected facility. 219.10 (j) [FEDERAL REQUIREMENTS.] Under any notification 219.11 provision of this section, where federal law specifically 219.12 prohibits the disclosure of patient identifying information, a 219.13 lead agency may not provide any notice unless the vulnerable 219.14 adult has consented to disclosure in a manner which conforms to 219.15 federal requirements. 219.16 Sec. 13. Laws 1999, chapter 245, article 3, section 45, as 219.17 amended by Laws 2000, chapter 312, section 3, is amended to read: 219.18 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 219.19 REGULATIONS.] 219.20 (a) Notwithstanding the provisions of Minnesota Rules, part 219.21 4658.0520, an incontinent resident must be checked according to 219.22 a specific time interval written in the resident's care plan. 219.23 The resident's attending physician must authorize in writing any 219.24 interval longer than two hours unless the resident, if 219.25 competent, or a family member or legally appointed conservator, 219.26 guardian, or health care agent of a resident who is not 219.27 competent, agrees in writing to waive physician involvement in 219.28 determining this interval. 219.29 (b) This section expires July 1,20012003. 219.30 Sec. 14. Laws 2000, chapter 364, section 2, is amended to 219.31 read: 219.32 Sec. 2. [MORATORIUM EXCEPTION PROCESS.] 219.33 Forfiscal yearthe biennium beginning July 1,20002001, 219.34 when approving nursing home moratorium exception projects under 219.35 Minnesota Statutes, section 144A.073, the commissioner of health 219.36 shall give priority toproposalsa proposal to build a 220.1 replacementfacilitiesfacility in the city of Anoka or within 220.2 ten miles of the city of Anoka. 220.3 Sec. 15. [MINIMUM STAFFING STANDARDS REPORT.] 220.4 By January 15, 2002, the commissioner of health and the 220.5 commissioner of human services shall report to the legislature 220.6 on whether they should translate the minimum nurse staffing 220.7 requirement in Minnesota Statutes, section 144A.04, subdivision 220.8 7, paragraph (a), upon the transition to the RUG-III 220.9 classification system, or whether they should establish 220.10 different time-based standards, and how to accomplish either. 220.11 Sec. 16. [REGULATORY FLEXIBILITY.] 220.12 (a) By July 1, 2001, the commissioners of health and human 220.13 services shall: 220.14 (1) develop a summary of federal nursing facility and 220.15 community long-term care regulations that hamper state 220.16 flexibility and place burdens on the goal of achieving 220.17 high-quality care and optimum outcomes for consumers of 220.18 services; and 220.19 (2) share this summary with the legislature, other states, 220.20 national groups that advocate for state interests with Congress, 220.21 and the Minnesota congressional delegation. 220.22 (b) The commissioners shall conduct ongoing follow-up with 220.23 the entities to which this summary is provided and with the 220.24 health care financing administration to achieve maximum 220.25 regulatory flexibility, including the possibility of pilot 220.26 projects to demonstrate regulatory flexibility on less than a 220.27 statewide basis. 220.28 [EFFECTIVE DATE.] This section is effective the day 220.29 following final enactment. 220.30 Sec. 17. [REPORT.] 220.31 By January 15, 2003, the commissioner of health and the 220.32 commissioner of human services shall report to the senate health 220.33 and family security committee and the house health and human 220.34 services policy committee on the number of closures that have 220.35 taken place under Minnesota Statutes, section 256B.437, and any 220.36 other nursing facility closures that may have taken place, 221.1 alternatives to nursing facility care that have been developed, 221.2 any problems with access to long-term care services that have 221.3 resulted, and any recommendations for continuation of the 221.4 regional long-term care planning process and the closure process 221.5 after June 30, 2003. 221.6 Sec. 18. [REVISOR INSTRUCTION.] 221.7 The revisor of statutes shall delete any reference to 221.8 Minnesota Statutes, section 144A.16, in Minnesota Statutes and 221.9 Minnesota Rules. 221.10 Sec. 19. [REPEALER.] 221.11 (a) Minnesota Statutes 2000, sections 144A.16; and 221.12 256B.434, subdivision 5, are repealed. 221.13 (b) Minnesota Rules, parts 4655.6810; 4655.6820; 4655.6830; 221.14 4658.1600; 4658.1605; 4658.1610; 4658.1690; 9546.0010; 221.15 9546.0020; 9546.0030; 9546.0040; 9546.0050; and 9546.0060, are 221.16 repealed. 221.17 ARTICLE 6 221.18 WORKFORCE RECRUITMENT AND RETENTION 221.19 Section 1. Minnesota Statutes 2000, section 116L.11, 221.20 subdivision 4, is amended to read: 221.21 Subd. 4. [QUALIFYING CONSORTIUM.] "Qualifying consortium" 221.22 means an entity thatmay includeincludes a public or private 221.23 institution of higher education, work force center, county,and 221.24 oneor moreeligibleemployers, but must include a public or221.25private institution of higher education and one or more eligible221.26employersemployer. 221.27 Sec. 2. Minnesota Statutes 2000, section 116L.12, 221.28 subdivision 4, is amended to read: 221.29 Subd. 4. [GRANTS.] Within the limits of available 221.30 appropriations, the board shall make grants not to exceed 221.31 $400,000 each to qualifying consortia to operate local, 221.32 regional, or statewide training and retention programs. Grants 221.33 may be made from TANF funds, general fund appropriations, and 221.34 any other funding sources available to the board, provided the 221.35 requirements of those funding sources are satisfied. Grant 221.36 awards must establish specific, measurable outcomes and 222.1 timelines for achieving those outcomes. 222.2 Sec. 3. Minnesota Statutes 2000, section 116L.12, 222.3 subdivision 5, is amended to read: 222.4 Subd. 5. [LOCAL MATCH REQUIREMENTS.] A consortium must 222.5provide at least a 50 percent match from local resources for222.6money appropriated under this section. The local match222.7requirement must be satisfied on an overall program basis but222.8need not be satisfied for each particular client. The local222.9match requirement may be reduced for consortia that include a222.10relatively large number of small employers whose financial222.11contribution has been reduced in accordance with section 116L.15.222.12In-kind services and expenditures under section 116L.13,222.13subdivision 2, may be used to meet this local match222.14requirement. The grant application must specify the financial222.15contribution from each member of the consortiumsatisfy the 222.16 match requirements established in section 116L.02, paragraph (a). 222.17 Sec. 4. Minnesota Statutes 2000, section 116L.13, 222.18 subdivision 1, is amended to read: 222.19 Subdivision 1. [MARKETING AND RECRUITMENT.] A qualifying 222.20 consortium must implement a marketing and outreach strategy to 222.21 recruit into the health care and human services fields persons 222.22 from one or more of the potential employee target groups. 222.23 Recruitment strategies must include: 222.24 (1) a screening process to evaluate whether potential 222.25 employees may be disqualified as the result of a required 222.26 background check or are otherwise unlikely to succeed in the 222.27 position for which they are being recruited; and 222.28 (2) a process for modifying course work to meet the 222.29 training needs of non-English-speaking persons, when appropriate. 222.30 Sec. 5. [116L.146] [EXPEDITED GRANT PROCESS.] 222.31 (a) The board may authorize grants not to exceed $50,000 222.32 each through an expedited grant approval process to: 222.33 (1) eligible employers to provide training programs for up 222.34 to 50 workers; or 222.35 (2) a public or private institution of higher education to: 222.36 (i) do predevelopment or curriculum development for 223.1 training programs prior to submission for program funding under 223.2 section 116L.12; 223.3 (ii) convert an existing curriculum for distance learning 223.4 through interactive television or other communication methods; 223.5 or 223.6 (iii) enable a training program to be offered when it would 223.7 otherwise be canceled due to an enrollment shortfall of one or 223.8 two students when the program is offered in a health-related 223.9 field with a documented worker shortage and is part of a 223.10 training program not exceeding two years in length. 223.11 (b) The board shall develop application procedures and 223.12 evaluation policies for grants made under this section. 223.13 Sec. 6. [REPEALER.] 223.14 Minnesota Statutes 2000, section 116L.12, subdivisions 2 223.15 and 7, are repealed. 223.16 ARTICLE 7 223.17 REGULATION OF SUPPLEMENTAL 223.18 NURSING SERVICES AGENCIES 223.19 Section 1. [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 223.20 SERVICES AGENCIES; DEFINITIONS.] 223.21 Subdivision 1. [SCOPE.] As used in sections 144A.70 to 223.22 144A.74, the terms defined in this section have the meanings 223.23 given them. 223.24 Subd. 2. [COMMISSIONER.] "Commissioner" means the 223.25 commissioner of health. 223.26 Subd. 3. [CONTROLLING PERSON.] "Controlling person" means 223.27 a business entity, officer, program administrator, or director 223.28 whose responsibilities include the direction of the management 223.29 or policies of a supplemental nursing services agency. 223.30 Controlling person also means an individual who, directly or 223.31 indirectly, beneficially owns an interest in a corporation, 223.32 partnership, or other business association that is a controlling 223.33 person. 223.34 Subd. 4. [HEALTH CARE FACILITY.] "Health care facility" 223.35 means a hospital, boarding care home, or outpatient surgical 223.36 center licensed under sections 144.50 to 144.58; a nursing home 224.1 or home care agency licensed under this chapter; a housing with 224.2 services establishment registered under chapter 144D; or a board 224.3 and lodging establishment that is registered to provide 224.4 supportive or health supervision services under section 157.17. 224.5 Subd. 5. [PERSON.] "Person" includes an individual, firm, 224.6 corporation, partnership, or association. 224.7 Subd. 6. [SUPPLEMENTAL NURSING SERVICES 224.8 AGENCY.] "Supplemental nursing services agency" means a person, 224.9 firm, corporation, partnership, or association engaged for hire 224.10 in the business of providing or procuring temporary employment 224.11 in health care facilities for nurses, nursing assistants, nurse 224.12 aides, and orderlies. Supplemental nursing services agency does 224.13 not include an individual who only engages in providing the 224.14 individual's services on a temporary basis to health care 224.15 facilities. Supplemental nursing services agency also does not 224.16 include any nursing service agency that is limited to providing 224.17 temporary nursing personnel solely to one or more health care 224.18 facilities owned or operated by the same person, firm, 224.19 corporation, or partnership. 224.20 Sec. 2. [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 224.21 REGISTRATION.] 224.22 Subdivision 1. [DUTY TO REGISTER.] A person who operates a 224.23 supplemental nursing services agency shall register the agency 224.24 with the commissioner. Each separate location of the business 224.25 of a supplemental nursing services agency shall register the 224.26 agency with the commissioner. Each separate location of the 224.27 business of a supplemental nursing services agency shall have a 224.28 separate registration. 224.29 Subd. 2. [APPLICATION INFORMATION AND FEE.] The 224.30 commissioner shall establish forms and procedures for processing 224.31 each supplemental nursing services agency registration 224.32 application. An application for a supplemental nursing services 224.33 agency registration must include at least the following: 224.34 (1) the names and addresses of the owner or owners of the 224.35 supplemental nursing services agency; 224.36 (2) if the owner is a corporation, copies of its articles 225.1 of incorporation and current bylaws, together with the names and 225.2 addresses of its officers and directors; 225.3 (3) any other relevant information that the commissioner 225.4 determines is necessary to properly evaluate an application for 225.5 registration; and 225.6 (4) the annual registration fee for a supplemental nursing 225.7 services agency, which is $891. 225.8 Subd. 3. [REGISTRATION NOT TRANSFERABLE.] A registration 225.9 issued by the commissioner according to this section is 225.10 effective for a period of one year from the date of its issuance 225.11 unless the registration is revoked or suspended under section 225.12 144A.72, subdivision 2, or unless the supplemental nursing 225.13 services agency is sold or ownership or management is 225.14 transferred. When a supplemental nursing services agency is 225.15 sold or ownership or management is transferred, the registration 225.16 of the agency must be voided and the new owner or operator may 225.17 apply for a new registration. 225.18 Sec. 3. [144A.72] [REGISTRATION REQUIREMENTS; PENALTIES.] 225.19 Subdivision 1. [MINIMUM CRITERIA.] The commissioner shall 225.20 require that, as a condition of registration: 225.21 (1) the supplemental nursing services agency shall document 225.22 that each temporary employee provided to health care facilities 225.23 currently meets the minimum licensing, training, and continuing 225.24 education standards for the position in which the employee will 225.25 be working; 225.26 (2) the supplemental nursing services agency shall comply 225.27 with all pertinent requirements relating to the health and other 225.28 qualifications of personnel employed in health care facilities; 225.29 (3) the supplemental nursing services agency must not 225.30 restrict in any manner the employment opportunities of its 225.31 employees; 225.32 (4) the supplemental nursing services agency, when 225.33 supplying temporary employees to a health care facility, and 225.34 when requested by the facility to do so, shall agree that at 225.35 least 30 percent of the total personnel hours supplied are 225.36 during night, holiday, or weekend shifts; 226.1 (5) the supplemental nursing services agency shall carry 226.2 medical malpractice insurance to insure against the loss, 226.3 damage, or expense incident to a claim arising out of the death 226.4 or injury of any person as the result of negligence or 226.5 malpractice in the provision of health care services by the 226.6 supplemental nursing services agency or by any employee of the 226.7 agency; and 226.8 (6) the supplemental nursing services agency must not, in 226.9 any contract with any employee or health care facility, require 226.10 the payment of liquidated damages, employment fees, or other 226.11 compensation should the employee be hired as a permanent 226.12 employee of a health care facility. 226.13 Subd. 2. [PENALTIES.] A pattern of failure to comply with 226.14 this section shall subject the supplemental nursing services 226.15 agency to revocation or nonrenewal of its registration. 226.16 Violations of section 144A.74 are subject to a fine equal to 200 226.17 percent of the amount billed or received in excess of the 226.18 maximum permitted under that section. 226.19 Sec. 4. [144A.73] [COMPLAINT SYSTEM.] 226.20 The commissioner shall establish a system for reporting 226.21 complaints against a supplemental nursing services agency or its 226.22 employees. Complaints may be made by any member of the public. 226.23 Written complaints must be forwarded to the employer of each 226.24 person against whom a complaint is made. The employer shall 226.25 promptly report to the commissioner any corrective action taken. 226.26 Sec. 5. [144A.74] [MAXIMUM CHARGES.] 226.27 A supplemental nursing services agency must not bill or 226.28 receive payments from a nursing home licensed under this chapter 226.29 at a rate higher than 150 percent of the weighted average wage 226.30 rate for the applicable employee classification for the 226.31 geographic group to which the nursing home is assigned under 226.32 Minnesota Rules, part 9549.0052. The weighted average wage 226.33 rates must be determined by the commissioner of human services 226.34 and reported to the commissioner of health on an annual basis. 226.35 Facilities shall provide information necessary to determine 226.36 weighted average wage rates to the commissioner of human 227.1 services in a format requested by the commissioner. The maximum 227.2 rate must include all charges for administrative fees, contract 227.3 fees, or other special charges in addition to the hourly rates 227.4 for the temporary nursing pool personnel supplied to a nursing 227.5 home. 227.6 Sec. 6. [256B.039] [REPORTING OF SUPPLEMENTAL NURSING 227.7 SERVICES AGENCY USE.] 227.8 Beginning March 1, 2002, the commissioner shall to report 227.9 to the legislature annually on the use of supplemental nursing 227.10 services, including the number of hours worked by supplemental 227.11 nursing services agency personnel and payments to supplemental 227.12 nursing services agencies. 227.13 ARTICLE 8 227.14 LONG-TERM CARE INSURANCE 227.15 Section 1. Minnesota Statutes 2000, section 62A.48, 227.16 subdivision 4, is amended to read: 227.17 Subd. 4. [LOSS RATIO.] The anticipated loss ratio for 227.18 long-term care policies must not be less than 65 percent for 227.19 policies issued on a group basis or 60 percent for policies 227.20 issued on an individual or mass-market basis. This subdivision 227.21 does not apply to policies issued on or after January 1, 2002, 227.22 that comply with sections 62S.021 and 62S.081. 227.23 [EFFECTIVE DATE.] This section is effective the day 227.24 following final enactment. 227.25 Sec. 2. Minnesota Statutes 2000, section 62A.48, is 227.26 amended by adding a subdivision to read: 227.27 Subd. 10. [REGULATION OF PREMIUMS AND PREMIUM 227.28 INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 227.29 or after January 1, 2002, must comply with sections 62S.021, 227.30 62S.081, 62S.265, and 62S.266 to the same extent as policies 227.31 issued under chapter 62S. 227.32 [EFFECTIVE DATE.] This section is effective the day 227.33 following final enactment. 227.34 Sec. 3. Minnesota Statutes 2000, section 62A.48, is 227.35 amended by adding a subdivision to read: 227.36 Subd. 11. [NONFORFEITURE BENEFITS.] Policies issued under 228.1 sections 62A.46 to 62A.56 on or after January 1, 2002, must 228.2 comply with section 62S.02, subdivision 2, to the same extent as 228.3 policies issued under chapter 62S. 228.4 [EFFECTIVE DATE.] This section is effective the day 228.5 following final enactment. 228.6 Sec. 4. Minnesota Statutes 2000, section 62S.01, is 228.7 amended by adding a subdivision to read: 228.8 Subd. 13a. [EXCEPTIONAL INCREASE.] (a) "Exceptional 228.9 increase" means only those premium rate increases filed by an 228.10 insurer as exceptional for which the commissioner determines 228.11 that the need for the premium rate increase is justified due to 228.12 changes in laws or rules applicable to long-term care coverage 228.13 in this state, or due to increased and unexpected utilization 228.14 that affects the majority of insurers of similar products. 228.15 (b) Except as provided in section 62S.265, exceptional 228.16 increases are subject to the same requirements as other premium 228.17 rate schedule increases. The commissioner may request a review 228.18 by an independent actuary or a professional actuarial body of 228.19 the basis for a request that an increase be considered an 228.20 exceptional increase. The commissioner, in determining that the 228.21 necessary basis for an exceptional increase exists, shall also 228.22 determine any potential offsets to higher claims costs. 228.23 [EFFECTIVE DATE.] This section is effective the day 228.24 following final enactment. 228.25 Sec. 5. Minnesota Statutes 2000, section 62S.01, is 228.26 amended by adding a subdivision to read: 228.27 Subd. 17a. [INCIDENTAL.] "Incidental," as used in section 228.28 62S.265, subdivision 10, means that the value of the long-term 228.29 care benefits provided is less than ten percent of the total 228.30 value of the benefits provided over the life of the policy. 228.31 These values must be measured as of the date of issue. 228.32 [EFFECTIVE DATE.] This section is effective the day 228.33 following final enactment. 228.34 Sec. 6. Minnesota Statutes 2000, section 62S.01, is 228.35 amended by adding a subdivision to read: 228.36 Subd. 23a. [QUALIFIED ACTUARY.] "Qualified actuary" means 229.1 a member in good standing of the American Academy of Actuaries. 229.2 [EFFECTIVE DATE.] This section is effective the day 229.3 following final enactment. 229.4 Sec. 7. Minnesota Statutes 2000, section 62S.01, is 229.5 amended by adding a subdivision to read: 229.6 Subd. 25a. [SIMILAR POLICY FORMS.] "Similar policy forms" 229.7 means all of the long-term care insurance policies and 229.8 certificates issued by an insurer in the same long-term care 229.9 benefit classification as the policy form being considered. 229.10 Certificates of groups that meet the definition in section 229.11 62S.01, subdivision 15, clause (1), are not considered similar 229.12 to certificates or policies otherwise issued as long-term care 229.13 insurance, but are similar to other comparable certificates with 229.14 the same long-term care benefit classifications. For purposes 229.15 of determining similar policy forms, long-term care benefit 229.16 classifications are defined as follows: institutional long-term 229.17 care benefits only, noninstitutional long-term care benefits 229.18 only, or comprehensive long-term care benefits. 229.19 [EFFECTIVE DATE.] This section is effective the day 229.20 following final enactment. 229.21 Sec. 8. [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 229.22 FILING.] 229.23 Subdivision 1. [APPLICABILITY.] This section applies to 229.24 any long-term care policy issued in this state on or after 229.25 January 1, 2002, under this chapter or sections 62A.46 to 62A.56. 229.26 Subd. 2. [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 229.27 shall provide the following information to the commissioner 30 229.28 days prior to making a long-term care insurance form available 229.29 for sale: 229.30 (1) a copy of the disclosure documents required in section 229.31 62S.081; and 229.32 (2) an actuarial certification consisting of at least the 229.33 following: 229.34 (i) a statement that the initial premium rate schedule is 229.35 sufficient to cover anticipated costs under moderately adverse 229.36 experience and that the premium rate schedule is reasonably 230.1 expected to be sustainable over the life of the form with no 230.2 future premium increases anticipated; 230.3 (ii) a statement that the policy design and coverage 230.4 provided have been reviewed and taken into consideration; 230.5 (iii) a statement that the underwriting and claims 230.6 adjudication processes have been reviewed and taken into 230.7 consideration; and 230.8 (iv) a complete description of the basis for contract 230.9 reserves that are anticipated to be held under the form, to 230.10 include: 230.11 (A) sufficient detail or sample calculations provided so as 230.12 to have a complete depiction of the reserve amounts to be held; 230.13 (B) a statement that the assumptions used for reserves 230.14 contain reasonable margins for adverse experience; 230.15 (C) a statement that the net valuation premium for renewal 230.16 years does not increase, except for attained age rating where 230.17 permitted; 230.18 (D) a statement that the difference between the gross 230.19 premium and the net valuation premium for renewal years is 230.20 sufficient to cover expected renewal expenses, or if such a 230.21 statement cannot be made, a complete description of the 230.22 situations in which this does not occur. An aggregate 230.23 distribution of anticipated issues may be used as long as the 230.24 underlying gross premiums maintain a reasonably consistent 230.25 relationship. If the gross premiums for certain age groups 230.26 appear to be inconsistent with this requirement, the 230.27 commissioner may request a demonstration under item (i) based on 230.28 a standard age distribution; and 230.29 (E) either a statement that the premium rate schedule is 230.30 not less than the premium rate schedule for existing similar 230.31 policy forms also available from the insurer except for 230.32 reasonable differences attributable to benefits, or a comparison 230.33 of the premium schedules for similar policy forms that are 230.34 currently available from the insurer with an explanation of the 230.35 differences. 230.36 Subd. 3. [ACTUARIAL DEMONSTRATION.] The commissioner may 231.1 request an actuarial demonstration that benefits are reasonable 231.2 in relation to premiums. The actuarial demonstration must 231.3 include either premium and claim experience on similar policy 231.4 forms, adjusted for any premium or benefit differences, relevant 231.5 and credible data from other studies, or both. If the 231.6 commissioner asks for additional information under this 231.7 subdivision, the 30-day time limit in subdivision 2 does not 231.8 include the time during which the insurer is preparing the 231.9 requested information. 231.10 [EFFECTIVE DATE.] This section is effective the day 231.11 following final enactment. 231.12 Sec. 9. [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 231.13 TO CONSUMERS.] 231.14 Subdivision 1. [APPLICATION.] This section applies as 231.15 follows: 231.16 (a) Except as provided in paragraph (b), this section 231.17 applies to any long-term care policy or certificate issued in 231.18 this state on or after January 1, 2002. 231.19 (b) For certificates issued on or after the effective date 231.20 of this section under a policy of group long-term care insurance 231.21 as defined in section 62S.01, subdivision 15, that was in force 231.22 on the effective date of this section, this section applies on 231.23 the policy anniversary following June 30, 2002. 231.24 Subd. 2. [REQUIRED DISCLOSURES.] Other than policies for 231.25 which no applicable premium rate or rate schedule increases can 231.26 be made, insurers shall provide all of the information listed in 231.27 this subdivision to the applicant at the time of application or 231.28 enrollment, unless the method of application does not allow for 231.29 delivery at that time; in this case, an insurer shall provide 231.30 all of the information listed in this subdivision to the 231.31 applicant no later than at the time of delivery of the policy or 231.32 certificate: 231.33 (1) a statement that the policy may be subject to rate 231.34 increases in the future; 231.35 (2) an explanation of potential future premium rate 231.36 revisions and the policyholder's or certificate holder's option 232.1 in the event of a premium rate revision; 232.2 (3) the premium rate or rate schedules applicable to the 232.3 applicant that will be in effect until a request is made for an 232.4 increase; 232.5 (4) a general explanation of applying premium rate or rate 232.6 schedule adjustments that must include: 232.7 (i) a description of when premium rate or rate schedule 232.8 adjustments will be effective, for example the next anniversary 232.9 date or the next billing date; and 232.10 (ii) the right to a revised premium rate or rate schedule 232.11 as provided in clause (3) if the premium rate or rate schedule 232.12 is changed; and 232.13 (5)(i) information regarding each premium rate increase on 232.14 this policy form or similar policy forms over the past ten years 232.15 for this state or any other state that, at a minimum, identifies: 232.16 (A) the policy forms for which premium rates have been 232.17 increased; 232.18 (B) the calendar years when the form was available for 232.19 purchase; and 232.20 (C) the amount or percent of each increase. The percentage 232.21 may be expressed as a percentage of the premium rate prior to 232.22 the increase and may also be expressed as minimum and maximum 232.23 percentages if the rate increase is variable by rating 232.24 characteristics; 232.25 (ii) the insurer may, in a fair manner, provide additional 232.26 explanatory information related to the rate increases; 232.27 (iii) an insurer has the right to exclude from the 232.28 disclosure premium rate increases that apply only to blocks of 232.29 business acquired from other nonaffiliated insurers or the 232.30 long-term care policies acquired from other nonaffiliated 232.31 insurers when those increases occurred prior to the acquisition; 232.32 (iv) if an acquiring insurer files for a rate increase on a 232.33 long-term care policy form acquired from nonaffiliated insurers 232.34 or a block of policy forms acquired from nonaffiliated insurers 232.35 on or before the later of the effective date of this section, or 232.36 the end of a 24-month period following the acquisition of the 233.1 block of policies, the acquiring insurer may exclude that rate 233.2 increase from the disclosure. However, the nonaffiliated 233.3 selling company must include the disclosure of that rate 233.4 increase according to item (i); and 233.5 (v) if the acquiring insurer in item (iv) files for a 233.6 subsequent rate increase, even within the 24-month period, on 233.7 the same policy form acquired from nonaffiliated insurers or 233.8 block of policy forms acquired from nonaffiliated insurers 233.9 referenced in item (iv), the acquiring insurer shall make all 233.10 disclosures required by this subdivision, including disclosure 233.11 of the earlier rate increase referenced in item (iv). 233.12 Subd. 3. [ACKNOWLEDGMENT.] An applicant shall sign an 233.13 acknowledgment at the time of application, unless the method of 233.14 application does not allow for signature at that time, that the 233.15 insurer made the disclosure required under subdivision 2. If, 233.16 due to the method of application, the applicant cannot sign an 233.17 acknowledgment at the time of application, the applicant shall 233.18 sign no later than at the time of delivery of the policy or 233.19 certificate. 233.20 Subd. 4. [FORMS.] An insurer shall use the forms in 233.21 Appendices B and F of the Long-term Care Insurance Model 233.22 Regulation adopted by the National Association of Insurance 233.23 Commissioners to comply with the requirements of subdivisions 1 233.24 and 2. 233.25 Subd. 5. [NOTICE OF INCREASE.] An insurer shall provide 233.26 notice of an upcoming premium rate schedule increase, after the 233.27 increase has been approved by the commissioner, to all 233.28 policyholders or certificate holders, if applicable, at least 45 233.29 days prior to the implementation of the premium rate schedule 233.30 increase by the insurer. The notice must include the 233.31 information required by subdivision 2 when the rate increase is 233.32 implemented. 233.33 [EFFECTIVE DATE.] This section is effective the day 233.34 following final enactment. 233.35 Sec. 10. Minnesota Statutes 2000, section 62S.26, is 233.36 amended to read: 234.1 62S.26 [LOSS RATIO.] 234.2 (a) The minimum loss ratio must be at least 60 percent, 234.3 calculated in a manner which provides for adequate reserving of 234.4 the long-term care insurance risk. In evaluating the expected 234.5 loss ratio, the commissioner shall give consideration to all 234.6 relevant factors, including: 234.7 (1) statistical credibility of incurred claims experience 234.8 and earned premiums; 234.9 (2) the period for which rates are computed to provide 234.10 coverage; 234.11 (3) experienced and projected trends; 234.12 (4) concentration of experience within early policy 234.13 duration; 234.14 (5) expected claim fluctuation; 234.15 (6) experience refunds, adjustments, or dividends; 234.16 (7) renewability features; 234.17 (8) all appropriate expense factors; 234.18 (9) interest; 234.19 (10) experimental nature of the coverage; 234.20 (11) policy reserves; 234.21 (12) mix of business by risk classification; and 234.22 (13) product features such as long elimination periods, 234.23 high deductibles, and high maximum limits. 234.24 (b) This section does not apply to policies or certificates 234.25 that are subject to sections 62S.021, 62S.081, and 62S.265, and 234.26 that comply with those sections. 234.27 [EFFECTIVE DATE.] This section is effective the day 234.28 following final enactment. 234.29 Sec. 11. [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 234.30 Subdivision 1. [APPLICABILITY.] (a) Except as provided in 234.31 paragraph (b), this section applies to any long-term care policy 234.32 or certificate issued in this state on or after January 1, 2002, 234.33 under this chapter or sections 62A.46 to 62A.56. 234.34 (b) For certificates issued on or after the effective date 234.35 of this section under a group long-term care insurance policy as 234.36 defined in section 62S.01, subdivision 15, issued under this 235.1 chapter, that was in force on the effective date of this 235.2 section, this section applies on the policy anniversary 235.3 following June 30, 2002. 235.4 Subd. 2. [NOTICE.] An insurer shall file a requested 235.5 premium rate schedule increase, including an exceptional 235.6 increase, to the commissioner for prior approval at least 60 235.7 days prior to the notice to the policyholders and shall include: 235.8 (1) all information required by section 62S.081; 235.9 (2) certification by a qualified actuary that: 235.10 (i) if the requested premium rate schedule increase is 235.11 implemented and the underlying assumptions, which reflect 235.12 moderately adverse conditions, are realized, no further premium 235.13 rate schedule increases are anticipated; and 235.14 (ii) the premium rate filing complies with this section; 235.15 (3) an actuarial memorandum justifying the rate schedule 235.16 change request that includes: 235.17 (i) lifetime projections of earned premiums and incurred 235.18 claims based on the filed premium rate schedule increase and the 235.19 method and assumptions used in determining the projected values, 235.20 including reflection of any assumptions that deviate from those 235.21 used for pricing other forms currently available for sale; 235.22 (A) annual values for the five years preceding and the 235.23 three years following the valuation date must be provided 235.24 separately; 235.25 (B) the projections must include the development of the 235.26 lifetime loss ratio, unless the rate increase is an exceptional 235.27 increase; 235.28 (C) the projections must demonstrate compliance with 235.29 subdivision 3; and 235.30 (D) for exceptional increases, the projected experience 235.31 must be limited to the increases in claims expenses attributable 235.32 to the approved reasons for the exceptional increase and, if the 235.33 commissioner determines that offsets to higher claim costs may 235.34 exist, the insurer shall use appropriate net projected 235.35 experience; 235.36 (ii) disclosure of how reserves have been incorporated in 236.1 this rate increase whenever the rate increase will trigger 236.2 contingent benefit upon lapse; 236.3 (iii) disclosure of the analysis performed to determine why 236.4 a rate adjustment is necessary, which pricing assumptions were 236.5 not realized and why, and what other actions taken by the 236.6 company have been relied upon by the actuary; 236.7 (iv) a statement that policy design, underwriting, and 236.8 claims adjudication practices have been taken into 236.9 consideration; and 236.10 (v) if it is necessary to maintain consistent premium rates 236.11 for new certificates and certificates receiving a rate increase, 236.12 the insurer shall file composite rates reflecting projections of 236.13 new certificates; 236.14 (4) a statement that renewal premium rate schedules are not 236.15 greater than new business premium rate schedules except for 236.16 differences attributable to benefits, unless sufficient 236.17 justification is provided to the commissioner; and 236.18 (5) sufficient information for review and approval of the 236.19 premium rate schedule increase by the commissioner. 236.20 Subd. 3. [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 236.21 premium rate schedule increases must be determined according to 236.22 the following requirements: 236.23 (1) exceptional increases must provide that 70 percent of 236.24 the present value of projected additional premiums from the 236.25 exceptional increase will be returned to policyholders in 236.26 benefits; 236.27 (2) premium rate schedule increases must be calculated so 236.28 that the sum of the accumulated value of incurred claims, 236.29 without the inclusion of active life reserves, and the present 236.30 value of future projected incurred claims, without the inclusion 236.31 of active life reserves, will not be less than the sum of the 236.32 following: 236.33 (i) the accumulated value of the initial earned premium 236.34 times 58 percent; 236.35 (ii) 85 percent of the accumulated value of prior premium 236.36 rate schedule increases on an earned basis; 237.1 (iii) the present value of future projected initial earned 237.2 premiums times 58 percent; and 237.3 (iv) 85 percent of the present value of future projected 237.4 premiums not in item (iii) on an earned basis; 237.5 (3) if a policy form has both exceptional and other 237.6 increases, the values in clause (2), items (ii) and (iv), must 237.7 also include 70 percent for exceptional rate increase amounts; 237.8 and 237.9 (4) all present and accumulated values used to determine 237.10 rate increases must use the maximum valuation interest rate for 237.11 contract reserves permitted for valuation of whole life 237.12 insurance policies issued in this state on the same date. The 237.13 actuary shall disclose as part of the actuarial memorandum the 237.14 use of any appropriate averages. 237.15 Subd. 4. [PROJECTIONS.] For each rate increase that is 237.16 implemented, the insurer shall file for approval by the 237.17 commissioner updated projections, as described in subdivision 2, 237.18 clause (3), item (i), annually for the next three years and 237.19 include a comparison of actual results to projected values. The 237.20 commissioner may extend the period to greater than three years 237.21 if actual results are not consistent with projected values from 237.22 prior projections. For group insurance policies that meet the 237.23 conditions in subdivision 11, the projections required by this 237.24 subdivision must be provided to the policyholder in lieu of 237.25 filing with the commissioner. 237.26 Subd. 5. [LIFETIME PROJECTIONS.] If any premium rate in 237.27 the revised premium rate schedule is greater than 200 percent of 237.28 the comparable rate in the initial premium schedule, lifetime 237.29 projections, as described in subdivision 2, clause (3), item 237.30 (i), must be filed for approval by the commissioner every five 237.31 years following the end of the required period in subdivision 237.32 4. For group insurance policies that meet the conditions in 237.33 subdivision 11, the projections required by this subdivision 237.34 must be provided to the policyholder in lieu of filing with the 237.35 commissioner. 237.36 Subd. 6. [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 238.1 commissioner has determined that the actual experience following 238.2 a rate increase does not adequately match the projected 238.3 experience and that the current projections under moderately 238.4 adverse conditions demonstrate that incurred claims will not 238.5 exceed proportions of premiums specified in subdivision 3, the 238.6 commissioner may require the insurer to implement any of the 238.7 following: 238.8 (1) premium rate schedule adjustments; or 238.9 (2) other measures to reduce the difference between the 238.10 projected and actual experience. 238.11 (b) In determining whether the actual experience adequately 238.12 matches the projected experience, consideration must be given to 238.13 subdivision 2, clause (3), item (v), if applicable. 238.14 Subd. 7. [CONTINGENT BENEFIT UPON LAPSE.] If the majority 238.15 of the policies or certificates to which the increase is 238.16 applicable are eligible for the contingent benefit upon lapse, 238.17 the insurer shall file: 238.18 (1) a plan, subject to commissioner approval, for improved 238.19 administration or claims processing designed to eliminate the 238.20 potential for further deterioration of the policy form requiring 238.21 further premium rate schedule increases, or both, or a 238.22 demonstration that appropriate administration and claims 238.23 processing have been implemented or are in effect; otherwise, 238.24 the commissioner may impose the condition in subdivision 8, 238.25 paragraph (b); and 238.26 (2) the original anticipated lifetime loss ratio, and the 238.27 premium rate schedule increase that would have been calculated 238.28 according to subdivision 3 had the greater of the original 238.29 anticipated lifetime loss ratio or 58 percent been used in the 238.30 calculations described in subdivision 3, clause (2), items (i) 238.31 and (iii). 238.32 Subd. 8. [PROJECTED LAPSE RATES.] (a) For a rate increase 238.33 filing that meets the following criteria, the commissioner shall 238.34 review, for all policies included in the filing, the projected 238.35 lapse rates and past lapse rates during the 12 months following 238.36 each increase to determine if significant adverse lapsation has 239.1 occurred or is anticipated: 239.2 (1) the rate increase is not the first rate increase 239.3 requested for the specific policy form or forms; 239.4 (2) the rate increase is not an exceptional increase; and 239.5 (3) the majority of the policies or certificates to which 239.6 the increase is applicable are eligible for the contingent 239.7 benefit upon lapse. 239.8 (b) If significant adverse lapsation has occurred, is 239.9 anticipated in the filing, or is evidenced in the actual results 239.10 as presented in the updated projections provided by the insurer 239.11 following the requested rate increase, the commissioner may 239.12 determine that a rate spiral exists. Following the 239.13 determination that a rate spiral exists, the commissioner may 239.14 require the insurer to offer, without underwriting, to all 239.15 in-force insureds subject to the rate increase, the option to 239.16 replace existing coverage with one or more reasonably comparable 239.17 products being offered by the insurer or its affiliates. The 239.18 offer must: 239.19 (1) be subject to the approval of the commissioner; 239.20 (2) be based upon actuarially sound principles, but not be 239.21 based upon attained age; and 239.22 (3) provide that maximum benefits under any new policy 239.23 accepted by an insured are reduced by comparable benefits 239.24 already paid under the existing policy. 239.25 (c) The insurer shall maintain the experience of all the 239.26 replacement insureds separate from the experience of insureds 239.27 originally issued the policy forms. In the event of a request 239.28 for a rate increase on the policy form, the rate increase must 239.29 be limited to the lesser of the maximum rate increase determined 239.30 based on the combined experience and the maximum rate increase 239.31 determined based only upon the experience of the insureds 239.32 originally issued the form plus ten percent. 239.33 Subd. 9. [PERSISTENT PRACTICE OF INADEQUATE INITIAL 239.34 RATES.] If the commissioner determines that the insurer has 239.35 exhibited a persistent practice of filing inadequate initial 239.36 premium rates for long-term care insurance, the commissioner 240.1 may, in addition to the provisions of subdivision 8, prohibit 240.2 the insurer from either of the following: 240.3 (1) filing and marketing comparable coverage for a period 240.4 of up to five years; or 240.5 (2) offering all other similar coverages and limiting 240.6 marketing of new applications to the products subject to recent 240.7 premium rate schedule increases. 240.8 Subd. 10. [INCIDENTAL LONG-TERM CARE 240.9 BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 240.10 which the long-term care benefits provided by the policy are 240.11 incidental, as defined in section 62S.01, subdivision 17a, if 240.12 the policy complies with all of the following provisions: 240.13 (1) the interest credited internally to determine cash 240.14 value accumulations, including long-term care, if any, are 240.15 guaranteed not to be less than the minimum guaranteed interest 240.16 rate for cash value accumulations without long-term care set 240.17 forth in the policy; 240.18 (2) the portion of the policy that provides insurance 240.19 benefits other than long-term care coverage meets the 240.20 nonforfeiture requirements as applicable in any of the following: 240.21 (i) for life insurance, section 61A.25; 240.22 (ii) for individual deferred annuities, section 61A.245; 240.23 and 240.24 (iii) for variable annuities, section 61A.21; 240.25 (3) the policy meets the disclosure requirements of 240.26 sections 62S.10 and 62S.11 if the policy is governed by chapter 240.27 62S and of section 62A.50 if the policy is governed by sections 240.28 62A.46 to 62A.56; 240.29 (4) the portion of the policy that provides insurance 240.30 benefits other than long-term care coverage meets the 240.31 requirements as applicable in the following: 240.32 (i) policy illustrations to the extent required by state 240.33 law applicable to life insurance; 240.34 (ii) disclosure requirements in state law applicable to 240.35 annuities; and 240.36 (iii) disclosure requirements applicable to variable 241.1 annuities; and 241.2 (5) an actuarial memorandum is filed with the commissioner 241.3 that includes: 241.4 (i) a description of the basis on which the long-term care 241.5 rates were determined; 241.6 (ii) a description of the basis for the reserves; 241.7 (iii) a summary of the type of policy, benefits, 241.8 renewability, general marketing method, and limits on ages of 241.9 issuance; 241.10 (iv) a description and a table of each actuarial assumption 241.11 used. For expenses, an insurer must include percent of premium 241.12 dollars per policy and dollars per unit of benefits, if any; 241.13 (v) a description and a table of the anticipated policy 241.14 reserves and additional reserves to be held in each future year 241.15 for active lives; 241.16 (vi) the estimated average annual premium per policy and 241.17 the average issue age; 241.18 (vii) a statement as to whether underwriting is performed 241.19 at the time of application. The statement must indicate whether 241.20 underwriting is used and, if used, the statement shall include a 241.21 description of the type or types of underwriting used, such as 241.22 medical underwriting or functional assessment underwriting. 241.23 Concerning a group policy, the statement must indicate whether 241.24 the enrollee or any dependent will be underwritten and when 241.25 underwriting occurs; and 241.26 (viii) a description of the effect of the long-term care 241.27 policy provision on the required premiums, nonforfeiture values, 241.28 and reserves on the underlying insurance policy, both for active 241.29 lives and those in long-term care claim status. 241.30 Subd. 11. [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 241.31 not apply to group long-term care insurance policies as defined 241.32 in section 62S.01, subdivision 15, where: 241.33 (1) the policies insure 250 or more persons, and the 241.34 policyholder has 5,000 or more eligible employees of a single 241.35 employer; or 241.36 (2) the policyholder, and not the certificate holders, pays 242.1 a material portion of the premium, which is not less than 20 242.2 percent of the total premium for the group in the calendar year 242.3 prior to the year in which a rate increase is filed. 242.4 [EFFECTIVE DATE.] This section is effective the day 242.5 following final enactment. 242.6 Sec. 12. [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 242.7 Subdivision 1. [APPLICABILITY.] This section does not 242.8 apply to life insurance policies or riders containing 242.9 accelerated long-term care benefits. 242.10 Subd. 2. [REQUIREMENT.] An insurer must offer each 242.11 prospective policyholder a nonforfeiture benefit in compliance 242.12 with the following requirements: 242.13 (1) a policy or certificate offered with nonforfeiture 242.14 benefits must have coverage elements, eligibility, benefit 242.15 triggers, and benefit length that are the same as coverage to be 242.16 issued without nonforfeiture benefits. The nonforfeiture 242.17 benefit included in the offer must be the benefit described in 242.18 subdivision 5; and 242.19 (2) the offer must be in writing if the nonforfeiture 242.20 benefit is not otherwise described in the outline of coverage or 242.21 other materials given to the prospective policyholder. 242.22 Subd. 3. [EFFECT OF REJECTION OF OFFER.] If the offer 242.23 required to be made under subdivision 2 is rejected, the insurer 242.24 shall provide the contingent benefit upon lapse described in 242.25 this section. 242.26 Subd. 4. [CONTINGENT BENEFIT UPON LAPSE.] (a) After 242.27 rejection of the offer required under subdivision 2, for 242.28 individual and group policies without nonforfeiture benefits 242.29 issued after the effective date of this section, the insurer 242.30 shall provide a contingent benefit upon lapse. 242.31 (b) If a group policyholder elects to make the 242.32 nonforfeiture benefit an option to the certificate holder, a 242.33 certificate shall provide either the nonforfeiture benefit or 242.34 the contingent benefit upon lapse. 242.35 (c) The contingent benefit on lapse must be triggered every 242.36 time an insurer increases the premium rates to a level which 243.1 results in a cumulative increase of the annual premium equal to 243.2 or exceeding the percentage of the insured's initial annual 243.3 premium based on the insured's issue age provided in this 243.4 paragraph, and the policy or certificate lapses within 120 days 243.5 of the due date of the premium increase. Unless otherwise 243.6 required, policyholders shall be notified at least 30 days prior 243.7 to the due date of the premium reflecting the rate increase. 243.8 Triggers for a Substantial Premium Increase 243.9 Percent Increase 243.10 Issue Age Over Initial Premium 243.11 29 and Under 200 243.12 30-34 190 243.13 35-39 170 243.14 40-44 150 243.15 45-49 130 243.16 50-54 110 243.17 55-59 90 243.18 60 70 243.19 61 66 243.20 62 62 243.21 63 58 243.22 64 54 243.23 65 50 243.24 66 48 243.25 67 46 243.26 68 44 243.27 69 42 243.28 70 40 243.29 71 38 243.30 72 36 243.31 73 34 243.32 74 32 243.33 75 30 243.34 76 28 243.35 77 26 243.36 78 24 244.1 79 22 244.2 80 20 244.3 81 19 244.4 82 18 244.5 83 17 244.6 84 16 244.7 85 15 244.8 86 14 244.9 87 13 244.10 88 12 244.11 89 11 244.12 90 and over 10 244.13 (d) On or before the effective date of a substantial 244.14 premium increase as defined in paragraph (c), the insurer shall: 244.15 (1) offer to reduce policy benefits provided by the current 244.16 coverage without the requirement of additional underwriting so 244.17 that required premium payments are not increased; 244.18 (2) offer to convert the coverage to a paid-up status with 244.19 a shortened benefit period according to the terms of subdivision 244.20 5. This option may be elected at any time during the 120-day 244.21 period referenced in paragraph (c); and 244.22 (3) notify the policyholder or certificate holder that a 244.23 default or lapse at any time during the 120-day period 244.24 referenced in paragraph (c) is deemed to be the election of the 244.25 offer to convert in clause (2). 244.26 Subd. 5. [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 244.27 Benefits continued as nonforfeiture benefits, including 244.28 contingent benefits upon lapse, must be as described in this 244.29 subdivision. 244.30 (b) For purposes of this subdivision, "attained age rating" 244.31 is defined as a schedule of premiums starting from the issue 244.32 date which increases with age at least one percent per year 244.33 prior to age 50, and at least three percent per year beyond age 244.34 50. 244.35 (c) For purposes of this subdivision, the nonforfeiture 244.36 benefit must be of a shortened benefit period providing paid-up, 245.1 long-term care insurance coverage after lapse. The same 245.2 benefits, amounts, and frequency in effect at the time of lapse, 245.3 but not increased thereafter, will be payable for a qualifying 245.4 claim, but the lifetime maximum dollars or days of benefits must 245.5 be determined as specified in paragraph (d). 245.6 (d) The standard nonforfeiture credit will be equal to 100 245.7 percent of the sum of all premiums paid, including the premiums 245.8 paid prior to any changes in benefits. The insurer may offer 245.9 additional shortened benefit period options, so long as the 245.10 benefits for each duration equal or exceed the standard 245.11 nonforfeiture credit for that duration. However, the minimum 245.12 nonforfeiture credit must not be less than 30 times the daily 245.13 nursing home benefit at the time of lapse. In either event, the 245.14 calculation of the nonforfeiture credit is subject to the 245.15 limitation of this subdivision. 245.16 (e) The nonforfeiture benefit must begin not later than the 245.17 end of the third year following the policy or certificate issue 245.18 date. The contingent benefit upon lapse must be effective 245.19 during the first three years as well as thereafter. 245.20 (f) Notwithstanding paragraph (e), for a policy or 245.21 certificate with attained age rating, the nonforfeiture benefit 245.22 must begin on the earlier of: 245.23 (1) the end of the tenth year following the policy or 245.24 certificate issue date; or 245.25 (2) the end of the second year following the date the 245.26 policy or certificate is no longer subject to attained age 245.27 rating. 245.28 (g) Nonforfeiture credits may be used for all care and 245.29 services qualifying for benefits under the terms of the policy 245.30 or certificate, up to the limits specified in the policy or 245.31 certificate. 245.32 Subd. 6. [BENEFIT LIMIT.] All benefits paid by the insurer 245.33 while the policy or certificate is in premium-paying status and 245.34 in the paid-up status will not exceed the maximum benefits which 245.35 would be payable if the policy or certificate had remained in 245.36 premium-paying status. 246.1 Subd. 7. [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 246.2 POLICIES.] There must be no difference in the minimum 246.3 nonforfeiture benefits as required under this section for group 246.4 and individual policies. 246.5 Subd. 8. [APPLICATION; EFFECTIVE DATES.] This section 246.6 becomes effective January 1, 2002, and applies as follows: 246.7 (a) Except as provided in paragraph (b), this section 246.8 applies to any long-term care policy issued in this state on or 246.9 after the effective date of this section. 246.10 (b) For certificates issued on or after the effective date 246.11 of this section, under a group long-term care insurance policy 246.12 that was in force on the effective date of this section, the 246.13 provisions of this section do not apply. 246.14 Subd. 9. [EFFECT ON LOSS RATIO.] Premiums charged for a 246.15 policy or certificate containing nonforfeiture benefits or a 246.16 contingent benefit on lapse are subject to the loss ratio 246.17 requirements of section 62A.48, subdivision 4, or 62S.26, 246.18 treating the policy as a whole, except for policies or 246.19 certificates that are subject to sections 62S.021, 62S.081, and 246.20 62S.265 and that comply with those sections. 246.21 Subd. 10. [PURCHASED BLOCKS OF BUSINESS.] To determine 246.22 whether contingent nonforfeiture upon lapse provisions are 246.23 triggered under subdivision 4, paragraph (c), a replacing 246.24 insurer that purchased or otherwise assumed a block or blocks of 246.25 long-term care insurance policies from another insurer shall 246.26 calculate the percentage increase based on the initial annual 246.27 premium paid by the insured when the policy was first purchased 246.28 from the original insurer. 246.29 Subd. 11. [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 246.30 benefit for qualified long-term care insurance contracts that 246.31 are level premium contracts must be offered that meets the 246.32 following requirements: 246.33 (1) the nonforfeiture provision must be appropriately 246.34 captioned; 246.35 (2) the nonforfeiture provision must provide a benefit 246.36 available in the event of a default in the payment of any 247.1 premiums and must state that the amount of the benefit may be 247.2 adjusted subsequent to being initially granted only as necessary 247.3 to reflect changes in claims, persistency, and interest as 247.4 reflected in changes in rates for premium paying contracts 247.5 approved by the commissioner for the same contract form; and 247.6 (3) the nonforfeiture provision must provide at least one 247.7 of the following: 247.8 (i) reduced paid-up insurance; 247.9 (ii) extended term insurance; 247.10 (iii) shortened benefit period; or 247.11 (iv) other similar offerings approved by the commissioner. 247.12 [EFFECTIVE DATE.] This section is effective the day 247.13 following final enactment. 247.14 Sec. 13. Minnesota Statutes 2000, section 256.975, is 247.15 amended by adding a subdivision to read: 247.16 Subd. 8. [PROMOTION OF LONG-TERM CARE INSURANCE.] Within 247.17 the limits of appropriations specifically for this purpose, the 247.18 Minnesota board on aging, either directly or through contract, 247.19 shall promote the provision of employer-sponsored, long-term 247.20 care insurance. The board shall encourage private and public 247.21 sector employers to make long-term care insurance available to 247.22 employees, provide interested employers with information on the 247.23 long-term care insurance product offered to state employees, and 247.24 provide technical assistance to employers in designing long-term 247.25 care insurance products and contacting companies offering 247.26 long-term care insurance products. 247.27 ARTICLE 9 247.28 MENTAL HEALTH AND CIVIL COMMITMENT 247.29 Section 1. [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS 247.30 PROHIBITED.] 247.31 (a) No health plan may exclude or reduce coverage for 247.32 health care for an enrollee that is otherwise covered under the 247.33 health plan, on the basis that the need for the health care 247.34 arose out of a suicide or suicide attempt by the enrollee. 247.35 (b) For purposes of this section, "health plan" has the 247.36 meaning given in section 62Q.01, subdivision 3, but includes the 248.1 coverages described in section 62A.011, clauses (7) and (10). 248.2 [EFFECTIVE DATE.] This section is effective January 1, 248.3 2002, and applies to contracts issued or renewed on or after 248.4 that date. 248.5 Sec. 2. [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR 248.6 MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.] 248.7 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 248.8 section, the following terms have the meanings given to them. 248.9 (b) "Emotional disturbance" has the meaning given in 248.10 section 245.4871, subdivision 15. 248.11 (c) "Mental illness" has the meaning given in section 248.12 245.462, subdivision 20, paragraph (a). 248.13 (d) "Health plan" has the meaning given in section 62Q.01, 248.14 subdivision 3, but includes the coverages described in section 248.15 62A.011, subdivision 3, clauses (7) and (10). 248.16 Subd. 2. [REQUIRED COVERAGE FOR ANTIPSYCHOTIC DRUGS.] (a) 248.17 A health plan that provides prescription drug coverage must 248.18 provide coverage for an antipsychotic drug prescribed to treat 248.19 emotional disturbance or mental illness regardless of whether 248.20 the drug is in the health plan's drug formulary, if the health 248.21 care provider prescribing the drug: 248.22 (1) indicates to the dispensing pharmacist, orally or in 248.23 writing according to section 151.21, that the prescription must 248.24 be dispensed as communicated; and 248.25 (2) certifies in writing to the health plan company that 248.26 the health care provider has considered all equivalent drugs in 248.27 the health plan's drug formulary and has determined that the 248.28 drug prescribed will best treat the patient's condition. 248.29 (b) The health plan is not required to provide coverage for 248.30 a drug if the drug was removed from the health plan's drug 248.31 formulary for safety reasons. 248.32 (c) For drugs covered under this section, no health plan 248.33 company that has received a certification from the health care 248.34 provider as described in paragraph (a), may: 248.35 (1) impose a special deductible, co-payment, coinsurance, 248.36 or other special payment requirement that the health plan does 249.1 not apply to drugs that are in the health plan's drug formulary; 249.2 or 249.3 (2) require written certification from the prescribing 249.4 provider each time a prescription is refilled or renewed that 249.5 the drug prescribed will best treat the patient's condition. 249.6 Subd. 3. [CONTINUING CARE.] (a) Enrollees receiving a 249.7 prescribed drug to treat a diagnosed mental illness or emotional 249.8 disturbance, may continue to receive the prescribed drug for up 249.9 to one year without the imposition of a special deductible, 249.10 co-payment, coinsurance, or other special payment requirements, 249.11 when a health plan's drug formulary changes or an enrollee 249.12 changes health plans and the medication has been shown to 249.13 effectively treat the patient's condition. In order to be 249.14 eligible for this continuing care benefit: 249.15 (1) the patient must have been treated with the drug for 90 249.16 days prior to a change in a health plan's drug formulary or a 249.17 change in the enrollee's health plan; 249.18 (2) the health care provider prescribing the drug indicates 249.19 to the dispensing pharmacist, orally or in writing according to 249.20 section 151.21, that the prescription must be dispensed as 249.21 communicated; and 249.22 (3) the health care provider prescribing the drug certifies 249.23 in writing to the health plan company that the drug prescribed 249.24 will best treat the patient's condition. 249.25 (b) The continuing care benefit shall be extended annually 249.26 when the health care provider prescribing the drug: 249.27 (1) indicates to the dispensing pharmacist, orally or in 249.28 writing according to section 151.21, that the prescription must 249.29 be dispensed as communicated; and 249.30 (2) certifies in writing to the health plan company that 249.31 the drug prescribed will best treat the patient's condition. 249.32 (c) The health plan company is not required to provide 249.33 coverage for a drug if the drug was removed from the health 249.34 plan's drug formulary for safety reasons. 249.35 Subd. 4. [EXCEPTION TO FORMULARY.] A health plan company 249.36 must promptly grant an exception to the health plan's drug 250.1 formulary for an enrollee when the health care provider 250.2 prescribing the drug indicates to the health plan company that: 250.3 (1) the formulary drug causes an adverse reaction in the 250.4 patient; 250.5 (2) the formulary drug is contraindicated for the patient; 250.6 or 250.7 (3) the health care provider demonstrates to the health 250.8 plan that the prescription drug must be dispensed as written to 250.9 provide maximum medical benefit to the patient. 250.10 [EFFECTIVE DATE.] This section is effective January 1, 250.11 2002, and applies to contracts issued or renewed on or after 250.12 that date. 250.13 Sec. 3. [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL 250.14 HEALTH SERVICES.] 250.15 Subdivision 1. [MENTAL HEALTH SERVICES.] For purposes of 250.16 this section, mental health services means all covered services 250.17 that are intended to treat or ameliorate an emotional, 250.18 behavioral, or psychiatric condition and that are covered by the 250.19 policy, contract, or certificate of coverage of the enrollee's 250.20 health plan company or by law. 250.21 Subd. 2. [COVERAGE REQUIRED.] (a) All health plan 250.22 companies that provide coverage for mental health services must 250.23 cover or provide mental health services ordered by a court of 250.24 competent jurisdiction under a court order that is issued on the 250.25 basis of a behavioral care evaluation performed by a licensed 250.26 psychiatrist or a doctoral level licensed psychologist, which 250.27 includes a diagnosis and an individual treatment plan for care 250.28 in the most appropriate, least restrictive environment. The 250.29 health plan company must be given a copy of the court order and 250.30 the behavioral care evaluation. The health plan company shall 250.31 be financially liable for the evaluation if performed by a 250.32 participating provider of the health plan company and shall be 250.33 financially liable for the care included in the court-ordered 250.34 individual treatment plan if the care is covered by the health 250.35 plan and ordered to be provided by a participating provider or 250.36 another provider as required by rule or law. This court-ordered 251.1 coverage must not be subject to a separate medical necessity 251.2 determination by a health plan company under its utilization 251.3 procedures. 251.4 (b) A party or interested person, including a health plan 251.5 company or its designee, may make a motion for modification of 251.6 the court-ordered plan of care pursuant to the applicable rules 251.7 of procedure for modification of the court's order. The motion 251.8 may include a request for a new behavioral care evaluation 251.9 according to this section. 251.10 [EFFECTIVE DATE.] This section is effective July 1, 2001, 251.11 and applies to contracts issued or renewed on or after that date. 251.12 Sec. 4. Minnesota Statutes 2000, section 245.462, 251.13 subdivision 8, is amended to read: 251.14 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 251.15 treatment services," or "day treatment program" means a 251.16 structured program of treatment and care provided to an adult in 251.17 or by: (1) a hospital accredited by the joint commission on 251.18 accreditation of health organizations and licensed under 251.19 sections 144.50 to 144.55; (2) a community mental health center 251.20 under section 245.62; or (3) an entity that is under contract 251.21 with the county board to operate a program that meets the 251.22 requirements of section 245.4712, subdivision 2, and Minnesota 251.23 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 251.24 group psychotherapy and other intensive therapeutic services 251.25 that are provided at least one day a week by a multidisciplinary 251.26 staff under the clinical supervision of a mental health 251.27 professional. Day treatment may include education and 251.28 consultation provided to families and other individuals as part 251.29 of the treatment process. The services are aimed at stabilizing 251.30 the adult's mental health status, providing mental health 251.31 services, and developing and improving the adult's independent 251.32 living and socialization skills. The goal of day treatment is 251.33 to reduce or relieve mental illness and to enable the adult to 251.34 live in the community. Day treatment services are not a part of 251.35 inpatient or residential treatment services. Day treatment 251.36 services are distinguished from day care by their structured 252.1 therapeutic program of psychotherapy services. The commissioner 252.2 may limit medical assistance reimbursement for day treatment to 252.3 15 hours per week per person instead of the three hours per day 252.4 per person specified in Minnesota Rules, part 9505.0323, subpart 252.5 15. 252.6 Sec. 5. Minnesota Statutes 2000, section 245.462, is 252.7 amended by adding a subdivision to read: 252.8 Subd. 14c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 252.9 crisis services" means crisis assessment, crisis intervention, 252.10 and crisis stabilization services. 252.11 Sec. 6. Minnesota Statutes 2000, section 245.462, 252.12 subdivision 18, is amended to read: 252.13 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 252.14 professional" means a person providing clinical services in the 252.15 treatment of mental illness who is qualified in at least one of 252.16 the following ways: 252.17 (1) in psychiatric nursing: a registered nurse who is 252.18 licensed under sections 148.171 to 148.285, and who is certified 252.19 as a clinical specialist in adult psychiatric and mental health 252.20 nursing by a national nurse certification organization or who 252.21 has a master's degree in nursing or one of the behavioral 252.22 sciences or related fields from an accredited college or 252.23 university or its equivalent, with at least 4,000 hours of 252.24 post-master's supervised experience in the delivery of clinical 252.25 services in the treatment of mental illness; 252.26 (2) in clinical social work: a person licensed as an 252.27 independent clinical social worker under section 148B.21, 252.28 subdivision 6, or a person with a master's degree in social work 252.29 from an accredited college or university, with at least 4,000 252.30 hours of post-master's supervised experience in the delivery of 252.31 clinical services in the treatment of mental illness; 252.32 (3) in psychology:a psychologistan individual licensed 252.33 by the board of psychology under sections 148.88 to 148.98 who 252.34 has stated to the board of psychology competencies in the 252.35 diagnosis and treatment of mental illness; 252.36 (4) in psychiatry: a physician licensed under chapter 147 253.1 and certified by the American board of psychiatry and neurology 253.2 or eligible for board certification in psychiatry; 253.3 (5) in marriage and family therapy: the mental health 253.4 professional must be a marriage and family therapist licensed 253.5 under sections 148B.29 to 148B.39 with at least two years of 253.6 post-master's supervised experience in the delivery of clinical 253.7 services in the treatment of mental illness; or 253.8 (6) in allied fields: a person with a master's degree from 253.9 an accredited college or university in one of the behavioral 253.10 sciences or related fields, with at least 4,000 hours of 253.11 post-master's supervised experience in the delivery of clinical 253.12 services in the treatment of mental illness. 253.13 Sec. 7. Minnesota Statutes 2000, section 245.462, is 253.14 amended by adding a subdivision to read: 253.15 Subd. 25a. [SIGNIFICANT IMPAIRMENT IN FUNCTIONING.] 253.16 "Significant impairment in functioning" means a condition, 253.17 including significant suicidal ideation or thoughts of harming 253.18 self or others, which harmfully affects, recurrently or 253.19 consistently, a person's activities of daily living in 253.20 employment, housing, family, and social relationships, or 253.21 education. 253.22 Sec. 8. Minnesota Statutes 2000, section 245.474, is 253.23 amended by adding a subdivision to read: 253.24 Subd. 4. [STAFF SAFETY TRAINING.] The commissioner shall 253.25 by rule require all staff in mental health and support units at 253.26 regional treatment centers who have contact with persons with 253.27 mental illness or severe emotional disturbance to be 253.28 appropriately trained in violence reduction and violence 253.29 prevention, and shall establish criteria for such training. 253.30 Training programs shall be developed with input from consumer 253.31 advocacy organizations, and shall employ violence prevention 253.32 techniques as preferable to physical interaction. 253.33 Sec. 9. Minnesota Statutes 2000, section 245.4871, 253.34 subdivision 10, is amended to read: 253.35 Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day 253.36 treatment services," or "day treatment program" means a 254.1 structured program of treatment and care provided to a child in: 254.2 (1) an outpatient hospital accredited by the joint 254.3 commission on accreditation of health organizations and licensed 254.4 under sections 144.50 to 144.55; 254.5 (2) a community mental health center under section 245.62; 254.6 (3) an entity that is under contract with the county board 254.7 to operate a program that meets the requirements of section 254.8 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 254.9 9505.0475; or 254.10 (4) an entity that operates a program that meets the 254.11 requirements of section 245.4884, subdivision 2, and Minnesota 254.12 Rules, parts 9505.0170 to 9505.0475, that is under contract with 254.13 an entity that is under contract with a county board. 254.14 Day treatment consists of group psychotherapy and other 254.15 intensive therapeutic services that are provided for a minimum 254.16 three-hour time block by a multidisciplinary staff under the 254.17 clinical supervision of a mental health professional. Day 254.18 treatment may include education and consultation provided to 254.19 families and other individuals as an extension of the treatment 254.20 process. The services are aimed at stabilizing the child's 254.21 mental health status, and developing and improving the child's 254.22 daily independent living and socialization skills. Day 254.23 treatment services are distinguished from day care by their 254.24 structured therapeutic program of psychotherapy services. Day 254.25 treatment services are not a part of inpatient hospital or 254.26 residential treatment services. Day treatment services for a 254.27 child are an integrated set of education, therapy, and family 254.28 interventions. 254.29 A day treatment service must be available to a child at 254.30 least five days a week throughout the year and must be 254.31 coordinated with, integrated with, or part of an education 254.32 program offered by the child's school. 254.33 Sec. 10. Minnesota Statutes 2000, section 245.4871, is 254.34 amended by adding a subdivision to read: 254.35 Subd. 24c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 254.36 crisis services" means crisis assessment, crisis intervention, 255.1 and crisis stabilization services. 255.2 Sec. 11. Minnesota Statutes 2000, section 245.4871, 255.3 subdivision 27, is amended to read: 255.4 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 255.5 professional" means a person providing clinical services in the 255.6 diagnosis and treatment of children's emotional disorders. A 255.7 mental health professional must have training and experience in 255.8 working with children consistent with the age group to which the 255.9 mental health professional is assigned. A mental health 255.10 professional must be qualified in at least one of the following 255.11 ways: 255.12 (1) in psychiatric nursing, the mental health professional 255.13 must be a registered nurse who is licensed under sections 255.14 148.171 to 148.285 and who is certified as a clinical specialist 255.15 in child and adolescent psychiatric or mental health nursing by 255.16 a national nurse certification organization or who has a 255.17 master's degree in nursing or one of the behavioral sciences or 255.18 related fields from an accredited college or university or its 255.19 equivalent, with at least 4,000 hours of post-master's 255.20 supervised experience in the delivery of clinical services in 255.21 the treatment of mental illness; 255.22 (2) in clinical social work, the mental health professional 255.23 must be a person licensed as an independent clinical social 255.24 worker under section 148B.21, subdivision 6, or a person with a 255.25 master's degree in social work from an accredited college or 255.26 university, with at least 4,000 hours of post-master's 255.27 supervised experience in the delivery of clinical services in 255.28 the treatment of mental disorders; 255.29 (3) in psychology, the mental health professional must bea255.30psychologistan individual licensed by the board of psychology 255.31 under sections 148.88 to 148.98 who has stated to the board of 255.32 psychology competencies in the diagnosis and treatment of mental 255.33 disorders; 255.34 (4) in psychiatry, the mental health professional must be a 255.35 physician licensed under chapter 147 and certified by the 255.36 American board of psychiatry and neurology or eligible for board 256.1 certification in psychiatry; 256.2 (5) in marriage and family therapy, the mental health 256.3 professional must be a marriage and family therapist licensed 256.4 under sections 148B.29 to 148B.39 with at least two years of 256.5 post-master's supervised experience in the delivery of clinical 256.6 services in the treatment of mental disorders or emotional 256.7 disturbances; or 256.8 (6) in allied fields, the mental health professional must 256.9 be a person with a master's degree from an accredited college or 256.10 university in one of the behavioral sciences or related fields, 256.11 with at least 4,000 hours of post-master's supervised experience 256.12 in the delivery of clinical services in the treatment of 256.13 emotional disturbances. 256.14 Sec. 12. Minnesota Statutes 2000, section 245.4876, 256.15 subdivision 1, is amended to read: 256.16 Subdivision 1. [CRITERIA.] Children's mental health 256.17 services required by sections 245.487 to 245.4888 must be: 256.18 (1) based, when feasible, on research findings; 256.19 (2) based on individual clinical, cultural, and ethnic 256.20 needs, and other special needs of the children being served; 256.21 (3) delivered in a manner that improves family functioning 256.22 when clinically appropriate; 256.23 (4) provided in the most appropriate, least restrictive 256.24 setting that meets the requirements in subdivision 1a, and that 256.25 is available to the county board to meet the child's treatment 256.26 needs; 256.27 (5) accessible to all age groups of children; 256.28 (6) appropriate to the developmental age of the child being 256.29 served; 256.30 (7) delivered in a manner that provides accountability to 256.31 the child for the quality of service delivered and continuity of 256.32 services to the child during the years the child needs services 256.33 from the local system of care; 256.34 (8) provided by qualified individuals as required in 256.35 sections 245.487 to 245.4888; 256.36 (9) coordinated with children's mental health services 257.1 offered by other providers; 257.2 (10) provided under conditions that protect the rights and 257.3 dignity of the individuals being served; and 257.4 (11) provided in a manner and setting most likely to 257.5 facilitate progress toward treatment goals. 257.6 Sec. 13. Minnesota Statutes 2000, section 245.4876, is 257.7 amended by adding a subdivision to read: 257.8 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 257.9 child must be provided with mental health services in the least 257.10 restrictive setting that is appropriate to the needs and current 257.11 condition of the individual child. For a child to receive 257.12 mental health services in a residential treatment or acute care 257.13 hospital inpatient setting, the family may not be required to 257.14 demonstrate that services were first provided in a less 257.15 restrictive setting and that the child failed to make progress 257.16 toward or meet treatment goals in the less restrictive setting. 257.17 Sec. 14. Minnesota Statutes 2000, section 245.4885, 257.18 subdivision 1, is amended to read: 257.19 Subdivision 1. [SCREENING REQUIRED.] The county board 257.20 shall, prior to admission, except in the case of emergency 257.21 admission, screen all children referred for treatment of severe 257.22 emotional disturbance to a residential treatment facility or 257.23 informally admitted to a regional treatment center if public 257.24 funds are used to pay for the services. The county board shall 257.25 also screen all children admitted to an acute care hospital for 257.26 treatment of severe emotional disturbance if public funds other 257.27 than reimbursement under chapters 256B and 256D are used to pay 257.28 for the services. If a child is admitted to a residential 257.29 treatment facility or acute care hospital for emergency 257.30 treatment or held for emergency care by a regional treatment 257.31 center under section 253B.05, subdivision 1, screening must 257.32 occur within three working days of admission. Screening shall 257.33 determine whether the proposed treatment: 257.34 (1) is necessary; 257.35 (2) is appropriate to the child's individual treatment 257.36 needs; 258.1 (3) cannot be effectively provided in the child's home; and 258.2 (4) provides a length of stay as short as possible 258.3 consistent with the individual child's need. 258.4 When a screening is conducted, the county board may not 258.5 determine that referral or admission to a residential treatment 258.6 facility or acute care hospital is not appropriate solely 258.7 because services were not first provided to the child in a less 258.8 restrictive setting and the child failed to make progress toward 258.9 or meet treatment goals in the less restrictive setting. 258.10 Screening shall include both a diagnostic assessment and a 258.11 functional assessment which evaluates family, school, and 258.12 community living situations. If a diagnostic assessment or 258.13 functional assessment has been completed by a mental health 258.14 professional within 180 days, a new diagnostic or functional 258.15 assessment need not be completed unless in the opinion of the 258.16 current treating mental health professional the child's mental 258.17 health status has changed markedly since the assessment was 258.18 completed. The child's parent shall be notified if an 258.19 assessment will not be completed and of the reasons. A copy of 258.20 the notice shall be placed in the child's file. Recommendations 258.21 developed as part of the screening process shall include 258.22 specific community services needed by the child and, if 258.23 appropriate, the child's family, and shall indicate whether or 258.24 not these services are available and accessible to the child and 258.25 family. 258.26 During the screening process, the child, child's family, or 258.27 child's legal representative, as appropriate, must be informed 258.28 of the child's eligibility for case management services and 258.29 family community support services and that an individual family 258.30 community support plan is being developed by the case manager, 258.31 if assigned. 258.32 Screening shall be in compliance with section 256F.07 or 258.33 260C.212, whichever applies. Wherever possible, the parent 258.34 shall be consulted in the screening process, unless clinically 258.35 inappropriate. 258.36 The screening process, and placement decision, and 259.1 recommendations for mental health services must be documented in 259.2 the child's record. 259.3 An alternate review process may be approved by the 259.4 commissioner if the county board demonstrates that an alternate 259.5 review process has been established by the county board and the 259.6 times of review, persons responsible for the review, and review 259.7 criteria are comparable to the standards in clauses (1) to (4). 259.8 Sec. 15. Minnesota Statutes 2000, section 245.4886, 259.9 subdivision 1, is amended to read: 259.10 Subdivision 1. [STATEWIDE PROGRAM; ESTABLISHMENT.] The 259.11 commissioner shall establish a statewide program to assist 259.12 counties in providing services to children with severe emotional 259.13 disturbance as defined in section 245.4871, subdivision 15, and 259.14 their families; and to young adults meeting the criteria for 259.15 transition services in section 245.4875, subdivision 8, and 259.16 their families. Services must be designed to help each child to 259.17 function and remain with the child's family in the community. 259.18 Transition services to eligible young adults must be designed to 259.19 foster independent living in the community. The commissioner 259.20 shall make grants to counties to establish, operate, or contract 259.21 with private providers to provide the following services in the 259.22 following order of priority when these cannot be reimbursed 259.23 under section 256B.0625: 259.24 (1) family community support services including crisis 259.25 placement and crisis respite care as specified in section 259.26 245.4871, subdivision 17; 259.27 (2) case management services as specified in section 259.28 245.4871, subdivision 3; 259.29 (3) day treatment services as specified in section 259.30 245.4871, subdivision 10; 259.31 (4) professional home-based family treatment as specified 259.32 in section 245.4871, subdivision 31; and 259.33 (5) therapeutic support of foster care as specified in 259.34 section 245.4871, subdivision 34. 259.35 Funding appropriated beginning July 1, 1991, must be used 259.36 by county boards to provide family community support services 260.1 and case management services. Additional services shall be 260.2 provided in the order of priority as identified in this 260.3 subdivision. 260.4 Sec. 16. Minnesota Statutes 2000, section 245.99, 260.5 subdivision 4, is amended to read: 260.6 Subd. 4. [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 260.7 The commissioner may contract with organizations or government 260.8 units experienced in housing assistance to operate the program 260.9 under this section. This program is not an entitlement. The 260.10 commissioner may take any of the following steps whenever the 260.11 commissioner projects that funds will be inadequate to meet 260.12 demand in a given fiscal year: 260.13 (1) transfer funds from mental health grants in the same 260.14 appropriation; and 260.15 (2) impose statewide restrictions as to the type and amount 260.16 of assistance available to each recipient under this program, 260.17 including reducing the income eligibility level, limiting 260.18 reimbursement to a percentage of each recipient's costs, 260.19 limiting housing assistance to 60 days per recipient, or closing 260.20 the program for the remainder of the fiscal year. 260.21 Sec. 17. Minnesota Statutes 2000, section 253B.02, 260.22 subdivision 10, is amended to read: 260.23 Subd. 10. [INTERESTED PERSON.] "Interested person" means: 260.24 (1) an adult, including but not limited to, a public 260.25 official, including a local welfare agency acting under section 260.26 626.5561, and the legal guardian, spouse, parent, legal counsel, 260.27 adult child, next of kin, or other person designated by a 260.28 proposed patient; or 260.29 (2) a health plan company that is providing coverage for a 260.30 proposed patient. 260.31 Sec. 18. Minnesota Statutes 2000, section 253B.03, 260.32 subdivision 5, is amended to read: 260.33 Subd. 5. [PERIODIC ASSESSMENT.] A patient has the right to 260.34 periodic medical assessment, including assessment of the medical 260.35 necessity of continuing care and, if the treatment facility 260.36 declines to provide continuing care, the right to receive 261.1 specific written reasons why continuing care is declined at the 261.2 time of the assessment. The treatment facility shall assess the 261.3 physical and mental condition of every patient as frequently as 261.4 necessary, but not less often than annually. If the patient 261.5 refuses to be examined, the facility shall document in the 261.6 patient's chart its attempts to examine the patient. If a 261.7 person is committed as mentally retarded for an indeterminate 261.8 period of time, the three-year judicial review must include the 261.9 annual reviews for each year as outlined in Minnesota Rules, 261.10 part 9525.0075, subpart 6. 261.11 Sec. 19. Minnesota Statutes 2000, section 253B.03, 261.12 subdivision 10, is amended to read: 261.13 Subd. 10. [NOTIFICATION.] All persons admitted or 261.14 committed to a treatment facility shall be notified in writing 261.15 of their rightsunder this chapterregarding hospitalization and 261.16 other treatment at the time of admission. This notification 261.17 must include: 261.18 (1) patient rights specified in this section and section 261.19 144.651, including nursing home discharge rights; 261.20 (2) the right to obtain treatment and services voluntarily 261.21 under this chapter; 261.22 (3) the right to voluntary admission and release under 261.23 section 253B.04; 261.24 (4) rights in case of an emergency admission under section 261.25 253B.05, including the right to documentation in support of an 261.26 emergency hold and the right to a summary hearing before a judge 261.27 if the patient believes an emergency hold is improper; 261.28 (5) the right to request expedited review under section 261.29 62M.05 if additional days of inpatient stay are denied; 261.30 (6) the right to continuing benefits pending appeal and to 261.31 an expedited administrative hearing under section 256.045 if the 261.32 patient is a recipient of medical assistance, general assistance 261.33 medical care, or MinnesotaCare; and 261.34 (7) the right to an external appeal process under section 261.35 62Q.73, including the right to a second opinion. 261.36 Sec. 20. Minnesota Statutes 2000, section 253B.03, is 262.1 amended by adding a subdivision to read: 262.2 Subd. 11. [PROXY.] A legally authorized health care proxy, 262.3 agent, guardian, or conservator may exercise the patient's 262.4 rights on the patient's behalf. 262.5 Sec. 21. Minnesota Statutes 2000, section 253B.04, 262.6 subdivision 1, is amended to read: 262.7 Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a) 262.8 Voluntary admission is preferred over involuntary commitment and 262.9 treatment. Any person 16 years of age or older may request to 262.10 be admitted to a treatment facility as a voluntary patient for 262.11 observation, evaluation, diagnosis, care and treatment without 262.12 making formal written application. Any person under the age of 262.13 16 years may be admitted as a patient with the consent of a 262.14 parent or legal guardian if it is determined by independent 262.15 examination that there is reasonable evidence that (1) the 262.16 proposed patient has a mental illness, or is mentally retarded 262.17 or chemically dependent; and (2) the proposed patient is 262.18 suitable for treatment. The head of the treatment facility 262.19 shall not arbitrarily refuse any person seeking admission as a 262.20 voluntary patient. In making decisions regarding admissions, 262.21 the facility shall use clinical admission criteria consistent 262.22 with the current applicable inpatient admission standards 262.23 established by the American Psychiatric Association or the 262.24 American Academy of Child and Adolescent Psychiatry. These 262.25 criteria must be no more restrictive than, and must be 262.26 consistent with, the requirements of section 62Q.53. The 262.27 facility may not refuse to admit a person voluntarily solely 262.28 because the person does not meet the criteria for involuntary 262.29 holds under section 253B.05 or the definition of mental illness 262.30 under section 253B.02, subdivision 13. 262.31 (b) In addition to the consent provisions of paragraph (a), 262.32 a person who is 16 or 17 years of age who refuses to consent 262.33 personally to admission may be admitted as a patient for mental 262.34 illness or chemical dependency treatment with the consent of a 262.35 parent or legal guardian if it is determined by an independent 262.36 examination that there is reasonable evidence that the proposed 263.1 patient is chemically dependent or has a mental illness and is 263.2 suitable for treatment. The person conducting the examination 263.3 shall notify the proposed patient and the parent or legal 263.4 guardian of this determination. 263.5 Sec. 22. Minnesota Statutes 2000, section 253B.04, 263.6 subdivision 1a, is amended to read: 263.7 Subd. 1a. [VOLUNTARY TREATMENT OR ADMISSION FOR PERSONS 263.8 WITH MENTAL ILLNESS.] (a) A person with a mental illness may 263.9 seek or voluntarily agree to accept treatment or admission to a 263.10 facility. If the mental health provider determines that the 263.11 person lacks the capacity to give informed consent for the 263.12 treatment or admission, and in the absence of a health care 263.13 power of attorney that authorizes consent, the designated agency 263.14 or its designee may give informed consent for mental health 263.15 treatment or admission to a treatment facility on behalf of the 263.16 person. 263.17 (b) The designated agency shall apply the following 263.18 criteria in determining the person's ability to give informed 263.19 consent: 263.20 (1) whether the person demonstrates an awareness of the 263.21 person's illness, and the reasons for treatment, its risks, 263.22 benefits and alternatives, and the possible consequences of 263.23 refusing treatment; and 263.24 (2) whether the person communicates verbally or nonverbally 263.25 a clear choice concerning treatment that is a reasoned one, not 263.26 based on delusion, even though it may not be in the person's 263.27 best interests. 263.28 (c) The basis for the designated agency's decision that the 263.29 person lacks the capacity to give informed consent for treatment 263.30 or admission, and that the patient has voluntarily accepted 263.31 treatment or admission, must be documented in writing. 263.32 (d) A mental health provider that provides treatment in 263.33 reliance on the written consent given by the designated agency 263.34 under this subdivision or by a substitute decision maker 263.35 appointed by the court is not civilly or criminally liable for 263.36 performing treatment without consent. This paragraph does not 264.1 affect any other liability that may result from the manner in 264.2 which the treatment is performed. 264.3 (e) A person who receives treatment or is admitted to a 264.4 facility under this subdivision or subdivision 1b has the right 264.5 to refuse treatment at any time or to be released from a 264.6 facility as provided under subdivision 2. The person or any 264.7 interested person acting on the person's behalf may seek court 264.8 review within five days for a determination of whether the 264.9 person's agreement to accept treatment or admission is 264.10 voluntary. At the time a person agrees to treatment or 264.11 admission to a facility under this subdivision, the designated 264.12 agency or its designee shall inform the person in writing of the 264.13 person's rights under this paragraph. 264.14 (f) This subdivision does not authorize the administration 264.15 of neuroleptic medications. Neuroleptic medications may be 264.16 administered only as provided in section 253B.092. 264.17 Sec. 23. Minnesota Statutes 2000, section 253B.04, is 264.18 amended by adding a subdivision to read: 264.19 Subd. 1b. [COURT APPOINTMENT OF SUBSTITUTE DECISION 264.20 MAKER.] If the designated agency or its designee declines or 264.21 refuses to give informed consent under subdivision 1a, the 264.22 person who is seeking treatment or admission, or an interested 264.23 person acting on behalf of the person, may petition the court 264.24 for appointment of a substitute decision maker who may give 264.25 informed consent for voluntary treatment and services. In 264.26 making this determination, the court shall apply the criteria in 264.27 subdivision 1a, paragraph (b). 264.28 Sec. 24. Minnesota Statutes 2000, section 253B.045, 264.29 subdivision 6, is amended to read: 264.30 Subd. 6. [COVERAGE.]A health plan company must provide264.31coverage, according to the terms of the policy, contract, or264.32certificate of coverage, for all medically necessary covered264.33services as determined by section 62Q.53 provided to an enrollee264.34that are ordered by the court under this chapter.(a) For 264.35 purposes of this section, "mental health services" means all 264.36 covered services that are intended to treat or ameliorate an 265.1 emotional, behavioral, or psychiatric condition and that are 265.2 covered by the policy, contract, or certificate of coverage of 265.3 the enrollee's health plan company or by law. 265.4 (b) All health plan companies that provide coverage for 265.5 mental health services must cover or provide mental health 265.6 services ordered by a court of competent jurisdiction under a 265.7 court order that is issued on the basis of a behavioral care 265.8 evaluation performed by a licensed psychiatrist or a doctoral 265.9 level licensed psychologist, which includes a diagnosis and an 265.10 individual treatment plan for care in the most appropriate, 265.11 least restrictive environment. The health plan company must be 265.12 given a copy of the court order and the behavioral care 265.13 evaluation. The health plan company shall be financially liable 265.14 for the evaluation if performed by a participating provider of 265.15 the health plan company and shall be financially liable for the 265.16 care included in the court-ordered individual treatment plan if 265.17 the care is covered by the health plan company and ordered to be 265.18 provided by a participating provider or another provider as 265.19 required by rule or law. This court-ordered coverage must not 265.20 be subject to a separate medical necessity determination by a 265.21 health plan company under its utilization procedures. 265.22 Sec. 25. Minnesota Statutes 2000, section 253B.05, 265.23 subdivision 1, is amended to read: 265.24 Subdivision 1. [EMERGENCY HOLD.] (a) Any person may be 265.25 admitted or held for emergency care and treatment in a treatment 265.26 facility with the consent of the head of the treatment facility 265.27 upon a written statement by an examiner that: 265.28 (1) the examiner has examined the person not more than 15 265.29 days prior to admission,; 265.30 (2) the examiner is of the opinion, for stated reasons, 265.31 that the person is mentally ill, mentally retarded or chemically 265.32 dependent, and is inimminentdanger of causing injury to self 265.33 or others if not immediatelyrestrained,detained; and 265.34 (3) an order of the court cannot be obtained in time to 265.35 prevent the anticipated injury. 265.36 (b) If the proposed patient has been brought to the 266.1 treatment facility by another person, the examiner shall make a 266.2 good faith effort to obtain a statement of information that is 266.3 available from that person, which must be taken into 266.4 consideration in deciding whether to place the proposed patient 266.5 on an emergency hold. The statement of information must 266.6 include, to the extent available, direct observations of the 266.7 proposed patient's behaviors, reliable knowledge of recent and 266.8 past behavior, and information regarding psychiatric history, 266.9 past treatment, and current mental health providers. The 266.10 examiner shall also inquire into the existence of health care 266.11 directives under chapter 145, and advance psychiatric directives 266.12 under section 253B.03, subdivision 6d. 266.13 (c) The examiner's statement shall be: (1) sufficient 266.14 authority for a peace or health officer to transport a patient 266.15 to a treatment facility, (2) stated in behavioral terms and not 266.16 in conclusory language, and (3) of sufficient specificity to 266.17 provide an adequate record for review. Ifimminentdanger to 266.18 specific individuals is a basis for the emergency hold, the 266.19 statement must identify those individuals, to the extent 266.20 practicable. A copy of the examiner's statement shall be 266.21 personally served on the person immediately upon admission and a 266.22 copy shall be maintained by the treatment facility. 266.23 Sec. 26. Minnesota Statutes 2000, section 253B.065, 266.24 subdivision 5, is amended to read: 266.25 Subd. 5. [EARLY INTERVENTION CRITERIA.] (a) A court shall 266.26 order early intervention treatment of a proposed patient who 266.27 meets the criteria under paragraph (b). The early intervention 266.28 treatment must be less intrusive than long-term inpatient 266.29 commitment and must be the least restrictive treatment program 266.30 available that can meet the patient's treatment needs. 266.31 (b) The court shall order early intervention treatment if 266.32 the court finds all of the elements of the following factors by 266.33 clear and convincing evidence: 266.34 (1) the proposed patient is mentally ill; 266.35 (2) the proposed patient refuses to accept appropriate 266.36 mental health treatment; and 267.1 (3) the proposed patient's mental illness is manifested by 267.2 instances of grossly disturbed behavior or faulty perceptions 267.3 and either: 267.4 (i) the grossly disturbed behavior or faulty perceptions 267.5 significantly interfere with the proposed patient's ability to 267.6 care for self and the proposed patient, when competent, would 267.7 have chosen substantially similar treatment under the same 267.8 circumstances; or 267.9 (ii) due to the mental illness, the proposed patient 267.10 received court-ordered inpatient treatment under section 253B.09 267.11 at least two times in the previous three years; the patient is 267.12 exhibiting symptoms or behavior substantially similar to those 267.13 that precipitated one or more of the court-ordered treatments; 267.14 and the patient is reasonably expected to physically or mentally 267.15 deteriorate to the point of meeting the criteria for commitment 267.16 under section 253B.09 unless treated. 267.17 For purposes of this paragraph, a proposed patient who was 267.18 released under section 253B.095 and whose release was not 267.19 revoked is not considered to have received court-ordered 267.20 inpatient treatment under section 253B.09. 267.21 (c) For purposes of paragraph (b), none of the following 267.22 constitute a refusal to accept appropriate mental health 267.23 treatment: 267.24 (1) a willingness to take medication but a reasonable 267.25 disagreement about type or dosage; 267.26 (2) a good-faith effort to follow a reasonable alternative 267.27 treatment plan, including treatment as specified in a valid 267.28 advance directive under chapter 145C or section 253B.03, 267.29 subdivision 6d; 267.30 (3) an inability to obtain access to appropriate treatment 267.31 because of inadequate health care coverage or an insurer's 267.32 refusal or delay in providing coverage for the treatment; or 267.33 (4) an inability to obtain access to needed mental health 267.34 services because the provider will only accept patients who are 267.35 under a court order or because the provider gives persons under 267.36 a court order a priority over voluntary patients in obtaining 268.1 treatment and services. 268.2 Sec. 27. Minnesota Statutes 2000, section 253B.066, 268.3 subdivision 1, is amended to read: 268.4 Subdivision 1. [TREATMENT ALTERNATIVES.] If the court 268.5 orders early intervention under section 253B.065, subdivision 5, 268.6 the court may include in its order a variety of treatment 268.7 alternatives including, but not limited to, day treatment, 268.8 medication compliance monitoring, and short-term hospitalization 268.9 not to exceedten21 days. 268.10 If the court orders short-term hospitalization and the 268.11 proposed patient will not go voluntarily, the court may direct a 268.12 health officer, peace officer, or other person to take the 268.13 person into custody and transport the person to the hospital. 268.14 Sec. 28. Minnesota Statutes 2000, section 253B.07, 268.15 subdivision 1, is amended to read: 268.16 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 268.17 filing a petition for commitment of or early intervention for a 268.18 proposed patient, an interested person shall apply to the 268.19 designated agency in the county of the proposed patient's 268.20 residence or presence for conduct of a preliminary 268.21 investigation, except when the proposed patient has been 268.22 acquitted of a crime under section 611.026 and the county 268.23 attorney is required to file a petition for commitment. The 268.24 designated agency shall appoint a screening team to conduct an 268.25 investigationwhich shall include. The petitioner may not be a 268.26 member of the screening team. The investigation must include: 268.27 (i) a personal interview with the proposed patient and 268.28 other individuals who appear to have knowledge of the condition 268.29 of the proposed patient. If the proposed patient is not 268.30 interviewed, specific reasons must be documented; 268.31 (ii) identification and investigation of specific alleged 268.32 conduct which is the basis for application; 268.33 (iii) identification, exploration, and listing of 268.34 the specific reasons for rejecting or recommending alternatives 268.35 to involuntary placement; 268.36 (iv) in the case of a commitment based on mental illness, 269.1 the following information, if it is known or available:269.2information, that may be relevant to the administration of 269.3 neuroleptic medications,if necessary,including the existence 269.4 of a declaration under section 253B.03, subdivision 6d, or a 269.5 health care directive under chapter 145C or a guardian, 269.6 conservator, proxy, or agent with authority to make health care 269.7 decisions for the proposed patient; information regarding the 269.8 capacity of the proposed patient to make decisions regarding 269.9 administration of neuroleptic medication; and whether the 269.10 proposed patient is likely to consent or refuse consent to 269.11 administration of the medication;and269.12 (v) seeking input from the proposed patient's health plan 269.13 company to provide the court with information about services the 269.14 enrollee needs and the least restrictive alternatives.; and 269.15 (vi) in the case of a commitment based on mental illness, 269.16 information listed in clause (iv) for other purposes relevant to 269.17 treatment. 269.18 (b) In conducting the investigation required by this 269.19 subdivision, the screening team shall have access to all 269.20 relevant medical records of proposed patients currently in 269.21 treatment facilities. The interviewer shall inform the proposed 269.22 patient that any information provided by the proposed patient 269.23 may be included in the prepetition screening report and may be 269.24 considered in the commitment proceedings. Data collected 269.25 pursuant to this clause shall be considered private data on 269.26 individuals. The prepetition screening report is not admissible 269.27 as evidence except by agreement of counsel or as permitted by 269.28 this chapter or the rules of court, and is not admissible in any 269.29 court proceedings unrelated to the commitment proceedings. 269.30 (c) The prepetition screening team shall provide a notice, 269.31 written in easily understood language, to the proposed patient, 269.32 the petitioner, persons named in a declaration under chapter 269.33 145C or section 253B.03, subdivision 6d, and, with the proposed 269.34 patient's consent, other interested parties. The team shall ask 269.35 the patient if the patient wants the notice read and shall read 269.36 the notice to the patient upon request. The notice must contain 270.1 information regarding the process, purpose, and legal effects of 270.2 civil commitment and early intervention. The notice must inform 270.3 the proposed patient that: 270.4 (1) if a petition is filed, the patient has certain rights, 270.5 including the right to a court-appointed attorney, the right to 270.6 request a second examiner, the right to attend hearings, and the 270.7 right to oppose the proceeding and to present and contest 270.8 evidence; and 270.9 (2) if the proposed patient is committed to a state 270.10 regional treatment center or group home, the patient may be 270.11 billed for the cost of care and the state has the right to make 270.12 a claim against the patient's estate for this cost. 270.13 The ombudsman for mental health and mental retardation 270.14 shall develop a form for the notice, which includes the 270.15 requirements of this paragraph. 270.16 (d) When the prepetition screening team recommends 270.17 commitment, a written report shall be sent to the county 270.18 attorney for the county in which the petition is to be 270.19 filed. The statement of facts contained in the written report 270.20 must meet the requirements of subdivision 2, paragraph (b). 270.21(d)(e) The prepetition screening team shall refuse to 270.22 support a petition if the investigation does not disclose 270.23 evidence sufficient to support commitment. Notice of the 270.24 prepetition screening team's decision shall be provided to the 270.25 prospective petitioner and to the proposed patient. 270.26(e)(f) If the interested person wishes to proceed with a 270.27 petition contrary to the recommendation of the prepetition 270.28 screening team, application may be made directly to the county 270.29 attorney, whomayshall determine whether or not to proceed with 270.30 the petition. Notice of the county attorney's determination 270.31 shall be provided to the interested party. 270.32(f)(g) If the proposed patient has been acquitted of a 270.33 crime under section 611.026, the county attorney shall apply to 270.34 the designated county agency in the county in which the 270.35 acquittal took place for a preliminary investigation unless 270.36 substantially the same information relevant to the proposed 271.1 patient's current mental condition, as could be obtained by a 271.2 preliminary investigation, is part of the court record in the 271.3 criminal proceeding or is contained in the report of a mental 271.4 examination conducted in connection with the criminal 271.5 proceeding. If a court petitions for commitment pursuant to the 271.6 rules of criminal or juvenile procedure or a county attorney 271.7 petitions pursuant to acquittal of a criminal charge under 271.8 section 611.026, the prepetition investigation, if required by 271.9 this section, shall be completed within seven days after the 271.10 filing of the petition. 271.11 Sec. 29. Minnesota Statutes 2000, section 253B.07, 271.12 subdivision 2, is amended to read: 271.13 Subd. 2. [THE PETITION.] (a) Any interested person, except 271.14 a member of the prepetition screening team, may file a petition 271.15 for commitment in the district court of the county of the 271.16 proposed patient's residence or presence. If the head of the 271.17 treatment facility believes that commitment is required and no 271.18 petition has been filed, the head of the treatment facility 271.19 shall petition for the commitment of the person. 271.20 (b) The petition shall set forth the name and address of 271.21 the proposed patient, the name and address of the patient's 271.22 nearest relatives, and the reasons for the petition. The 271.23 petition must contain factual descriptions of the proposed 271.24 patient's recent behavior, including a description of the 271.25 behavior, where it occurred, and the time period over which it 271.26 occurred. Each factual allegation must be supported by 271.27 observations of witnesses named in the petition. Petitions 271.28 shall be stated in behavioral terms and shall not contain 271.29 judgmental or conclusory statements. 271.30 (c) The petition shall be accompanied by a written 271.31 statement by an examiner stating that the examiner has examined 271.32 the proposed patient within the 15 days preceding the filing of 271.33 the petition and is of the opinion that the proposed patient is 271.34 suffering a designated disability and should be committed to a 271.35 treatment facility. The statement shall include the reasons for 271.36 the opinion. In the case of a commitment based on mental 272.1 illness, the petition and the examiner's statementmayshall 272.2 include, to the extent this information is available, a 272.3 statement and opinion regarding the proposed patient's need for 272.4 treatment with neuroleptic medication and the patient's capacity 272.5 to make decisions regarding the administration of neuroleptic 272.6 medications, and the reasons for the opinion. If use of 272.7 neuroleptic medications is recommended by the treating 272.8 physician, the petition for commitment must, if applicable, 272.9 include or be accompanied by a request for proceedings under 272.10 section 253B.092. Failure to include the required information 272.11 regarding neuroleptic medications in the examiner's statement, 272.12 or to include a request for an order regarding neuroleptic 272.13 medications with the commitment petition, is not a basis for 272.14 dismissing the commitment petition. If a petitioner has been 272.15 unable to secure a statement from an examiner, the petition 272.16 shall include documentation that a reasonable effort has been 272.17 made to secure the supporting statement. 272.18 Sec. 30. Minnesota Statutes 2000, section 253B.07, 272.19 subdivision 7, is amended to read: 272.20 Subd. 7. [PRELIMINARY HEARING.] (a) No proposed patient 272.21 may be held in a treatment facility under a judicial hold 272.22 pursuant to subdivision 6 longer than 72 hours, exclusive of 272.23 Saturdays, Sundays, and legal holidays, unless the court holds a 272.24 preliminary hearing and determines that the standard is met to 272.25 hold the person. 272.26 (b) The proposed patient, patient's counsel, the 272.27 petitioner, the county attorney, and any other persons as the 272.28 court directs shall be given at least 24 hours written notice of 272.29 the preliminary hearing. The notice shall include the alleged 272.30 grounds for confinement. The proposed patient shall be 272.31 represented at the preliminary hearing by counsel. The court 272.32 may admit reliable hearsay evidence, including written reports, 272.33 for the purpose of the preliminary hearing. 272.34 (c) The court, on its motion or on the motion of any party, 272.35 may exclude or excuse a proposed patient who is seriously 272.36 disruptive or who is incapable of comprehending and 273.1 participating in the proceedings. In such instances, the court 273.2 shall, with specificity on the record, state the behavior of the 273.3 proposed patient or other circumstances which justify proceeding 273.4 in the absence of the proposed patient. 273.5 (d) The court may continue the judicial hold of the 273.6 proposed patient if it finds, by a preponderance of the 273.7 evidence, that seriousimminentphysical harm to the proposed 273.8 patient or others is likely if the proposed patient is not 273.9 immediately confined. If a proposed patient was acquitted of a 273.10 crime against the person under section 611.026 immediately 273.11 preceding the filing of the petition, the court may presume that 273.12 seriousimminentphysical harm to the patient or others is 273.13 likely if the proposed patient is not immediately confined. 273.14 (e) Upon a showing that a person subject to a petition for 273.15 commitment may need treatment with neuroleptic medications and 273.16 that the person may lack capacity to make decisions regarding 273.17 that treatment, the court may appoint a substitute 273.18 decision-maker as provided in section 253B.092, subdivision 6. 273.19 The substitute decision-maker shall meet with the proposed 273.20 patient and provider and make a report to the court at the 273.21 hearing under section 253B.08 regarding whether the 273.22 administration of neuroleptic medications is appropriate under 273.23 the criteria of section 253B.092, subdivision 7. If the 273.24 substitute decision-maker consents to treatment with neuroleptic 273.25 medications and the proposed patient does not refuse the 273.26 medication, neuroleptic medication may be administered to the 273.27 patient. If the substitute decision-maker does not consent or 273.28 the patient refuses, neuroleptic medication may not be 273.29 administered without a court order, or in an emergency as set 273.30 forth in section 253B.092, subdivision 3. 273.31 Sec. 31. Minnesota Statutes 2000, section 253B.09, 273.32 subdivision 1, is amended to read: 273.33 Subdivision 1. [STANDARD OF PROOF.] (a) If the court finds 273.34 by clear and convincing evidence that the proposed patient is a 273.35 mentally ill, mentally retarded, or chemically dependent person 273.36 and after careful consideration of reasonable alternative 274.1 dispositions, including but not limited to, dismissal of 274.2 petition, voluntary outpatient care, voluntary admission to a 274.3 treatment facility, appointment of a guardian or conservator, or 274.4 release before commitment as provided for in subdivision 4, it 274.5 finds that there is no suitable alternative to judicial 274.6 commitment, the court shall commit the patient to the least 274.7 restrictive treatment program or alternative programs which can 274.8 meet the patient's treatment needs consistent with section 274.9 253B.03, subdivision 7. 274.10 (b) In deciding on the least restrictive program, the court 274.11 shall consider a range of treatment alternatives including, but 274.12 not limited to, community-based nonresidential treatment, 274.13 community residential treatment, partial hospitalization, acute 274.14 care hospital, and regional treatment center services. The 274.15 court shall also consider the proposed patient's treatment 274.16 preferences and willingness to participate voluntarily in the 274.17 treatment ordered. The court may not commit a patient to a 274.18 facility or program that is not capable of meeting the patient's 274.19 needs. 274.20 Sec. 32. Minnesota Statutes 2000, section 253B.10, 274.21 subdivision 4, is amended to read: 274.22 Subd. 4. [PRIVATE TREATMENT.] Patients or other 274.23 responsible persons are required to pay the necessary charges 274.24 for patients committed or transferred to private treatment 274.25 facilities. Private treatment facilities may not refuse to 274.26 accept a committed person solely based on the person's 274.27 court-ordered status. Insurers must provide treatment and 274.28 services as ordered by the court under section 253B.045, 274.29 subdivision 6, or as required under chapter 62M. 274.30 Sec. 33. Minnesota Statutes 2000, section 256B.0625, 274.31 subdivision 20, is amended to read: 274.32 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 274.33 extent authorized by rule of the state agency, medical 274.34 assistance covers case management services to persons with 274.35 serious and persistent mental illness and children with severe 274.36 emotional disturbance. Services provided under this section 275.1 must meet the relevant standards in sections 245.461 to 275.2 245.4888, the Comprehensive Adult and Children's Mental Health 275.3 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 275.4 9505.0322, excluding subpart 10. 275.5 (b) Entities meeting program standards set out in rules 275.6 governing family community support services as defined in 275.7 section 245.4871, subdivision 17, are eligible for medical 275.8 assistance reimbursement for case management services for 275.9 children with severe emotional disturbance when these services 275.10 meet the program standards in Minnesota Rules, parts 9520.0900 275.11 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 275.12 (c) Medical assistance and MinnesotaCare payment for mental 275.13 health case management shall be made on a monthly basis. In 275.14 order to receive payment for an eligible child, the provider 275.15 must document at least a face-to-face contact with the child, 275.16 the child's parents, or the child's legal representative. To 275.17 receive payment for an eligible adult, the provider must 275.18 document: 275.19 (1) at least a face-to-face contact with the adult or the 275.20 adult's legal representative; or 275.21 (2) at least a telephone contact with the adult or the 275.22 adult's legal representative and document a face-to-face contact 275.23 with the adult or the adult's legal representative within the 275.24 preceding two months. 275.25 (d) Payment for mental health case management provided by 275.26 county or state staff shall be based on the monthly rate 275.27 methodology under section 256B.094, subdivision 6, paragraph 275.28 (b), with separate rates calculated for child welfare and mental 275.29 health, and within mental health, separate rates for children 275.30 and adults. 275.31 (e) Payment for mental health case management provided by 275.32 Indian health services or by agencies operated by Indian tribes 275.33 may be made according to this section or other relevant 275.34 federally approved rate setting methodology. 275.35 (f) Payment for mental health case management provided by 275.36county-contractedvendors who contract with a county or Indian 276.1 tribe shall be based on a monthly rate negotiated by the host 276.2 county or tribe. The negotiated rate must not exceed the rate 276.3 charged by the vendor for the same service to other payers. If 276.4 the service is provided by a team of contracted vendors, the 276.5 county or tribe may negotiate a team rate with a vendor who is a 276.6 member of the team. The team shall determine how to distribute 276.7 the rate among its members. No reimbursement received by 276.8 contracted vendors shall be returned to the county or tribe, 276.9 except to reimburse the county or tribe for advance funding 276.10 provided by the county or tribe to the vendor. 276.11(f)(g) If the service is provided by a team which includes 276.12 contracted vendors, tribal staff, and county or state staff, the 276.13 costs for county or state staff participation in the team shall 276.14 be included in the rate for county-provided services. In this 276.15 case, the contracted vendor, the tribal agency, and the county 276.16 may each receive separate payment for services provided by each 276.17 entity in the same month. In order to prevent duplication of 276.18 services,the countyeach entity must document, in the 276.19 recipient's file, the need for team case management and a 276.20 description of the roles of the team members. 276.21(g)(h) The commissioner shall calculate the nonfederal 276.22 share of actual medical assistance and general assistance 276.23 medical care payments for each county, based on the higher of 276.24 calendar year 1995 or 1996, by service date, project that amount 276.25 forward to 1999, and transfer one-half of the result from 276.26 medical assistance and general assistance medical care to each 276.27 county's mental health grants under sections 245.4886 and 276.28 256E.12 for calendar year 1999. The annualized minimum amount 276.29 added to each county's mental health grant shall be $3,000 per 276.30 year for children and $5,000 per year for adults. The 276.31 commissioner may reduce the statewide growth factor in order to 276.32 fund these minimums. The annualized total amount transferred 276.33 shall become part of the base for future mental health grants 276.34 for each county. 276.35(h)(i) Any net increase in revenue to the county or tribe 276.36 as a result of the change in this section must be used to 277.1 provide expanded mental health services as defined in sections 277.2 245.461 to 245.4888, the Comprehensive Adult and Children's 277.3 Mental Health Acts, excluding inpatient and residential 277.4 treatment. For adults, increased revenue may also be used for 277.5 services and consumer supports which are part of adult mental 277.6 health projects approved under Laws 1997, chapter 203, article 277.7 7, section 25. For children, increased revenue may also be used 277.8 for respite care and nonresidential individualized 277.9 rehabilitation services as defined in section 245.492, 277.10 subdivisions 17 and 23. "Increased revenue" has the meaning 277.11 given in Minnesota Rules, part 9520.0903, subpart 3. 277.12(i)(j) Notwithstanding section 256B.19, subdivision 1, the 277.13 nonfederal share of costs for mental health case management 277.14 shall be provided by the recipient's county of responsibility, 277.15 as defined in sections 256G.01 to 256G.12, from sources other 277.16 than federal funds or funds used to match other federal 277.17 funds. If the service is provided by a tribal agency, the 277.18 nonfederal share, if any, shall be provided by the recipient's 277.19 tribe. 277.20(j)(k) The commissioner may suspend, reduce, or terminate 277.21 the reimbursement to a provider that does not meet the reporting 277.22 or other requirements of this section. The county of 277.23 responsibility, as defined in sections 256G.01 to 256G.12, or, 277.24 if applicable, the tribal agency, is responsible for any federal 277.25 disallowances. The county or tribe may share this 277.26 responsibility with its contracted vendors. 277.27(k)(l) The commissioner shall set aside a portion of the 277.28 federal funds earned under this section to repay the special 277.29 revenue maximization account under section 256.01, subdivision 277.30 2, clause (15). The repayment is limited to: 277.31 (1) the costs of developing and implementing this section; 277.32 and 277.33 (2) programming the information systems. 277.34(l)(m) Notwithstanding section 256.025, subdivision 2, 277.35 payments to counties and tribal agencies for case management 277.36 expenditures under this section shall only be made from federal 278.1 earnings from services provided under this section. Payments to 278.2contractedcounty-contracted vendors shall include both the 278.3 federal earnings and the county share. 278.4(m)(n) Notwithstanding section 256B.041, county payments 278.5 for the cost of mental health case management services provided 278.6 by county or state staff shall not be made to the state 278.7 treasurer. For the purposes of mental health case management 278.8 services provided by county or state staff under this section, 278.9 the centralized disbursement of payments to counties under 278.10 section 256B.041 consists only of federal earnings from services 278.11 provided under this section. 278.12(n)(o) Case management services under this subdivision do 278.13 not include therapy, treatment, legal, or outreach services. 278.14(o)(p) If the recipient is a resident of a nursing 278.15 facility, intermediate care facility, or hospital, and the 278.16 recipient's institutional care is paid by medical assistance, 278.17 payment for case management services under this subdivision is 278.18 limited to the last 30 days of the recipient's residency in that 278.19 facility and may not exceed more than two months in a calendar 278.20 year. 278.21(p)(q) Payment for case management services under this 278.22 subdivision shall not duplicate payments made under other 278.23 program authorities for the same purpose. 278.24(q)(r) By July 1, 2000, the commissioner shall evaluate 278.25 the effectiveness of the changes required by this section, 278.26 including changes in number of persons receiving mental health 278.27 case management, changes in hours of service per person, and 278.28 changes in caseload size. 278.29(r)(s) For each calendar year beginning with the calendar 278.30 year 2001, the annualized amount of state funds for each county 278.31 determined under paragraph(g)(h) shall be adjusted by the 278.32 county's percentage change in the average number of clients per 278.33 month who received case management under this section during the 278.34 fiscal year that ended six months prior to the calendar year in 278.35 question, in comparison to the prior fiscal year. 278.36(s)(t) For counties receiving the minimum allocation of 279.1 $3,000 or $5,000 described in paragraph(g)(h), the adjustment 279.2 in paragraph(r)(s) shall be determined so that the county 279.3 receives the higher of the following amounts: 279.4 (1) a continuation of the minimum allocation in paragraph 279.5(g)(h); or 279.6 (2) an amount based on that county's average number of 279.7 clients per month who received case management under this 279.8 section during the fiscal year that ended six months prior to 279.9 the calendar year in question,in comparison to the prior fiscal279.10year,times the average statewide grant per person per month for 279.11 counties not receiving the minimum allocation. 279.12(t)(u) The adjustments in paragraphs(r) and(s) and (t) 279.13 shall be calculated separately for children and adults. 279.14 Sec. 34. Minnesota Statutes 2000, section 256B.0625, is 279.15 amended by adding a subdivision to read: 279.16 Subd. 46. [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 279.17 assistance covers provider travel time if a recipient's 279.18 individual treatment plan requires the provision of mental 279.19 health services outside of the provider's normal place of 279.20 business. This does not include any travel time which is 279.21 included in other billable services, and is only covered when 279.22 the mental health service being provided to a recipient is 279.23 covered under medical assistance. 279.24 Sec. 35. [256B.81] [MENTAL HEALTH PROVIDER APPEAL 279.25 PROCESS.] 279.26 If a county contract or certification is required to enroll 279.27 as an authorized provider of mental health services under 279.28 medical assistance, and if a county refuses to grant the 279.29 necessary contract or certification, the provider may appeal the 279.30 county decision to the commissioner. A recipient may initiate 279.31 an appeal on behalf of a provider who has been denied 279.32 certification. The commissioner shall determine whether the 279.33 provider meets applicable standards under state laws and rules 279.34 based on an independent review of the facts, including comments 279.35 from the county review. If the commissioner finds that the 279.36 provider meets the applicable standards, the commissioner shall 280.1 enroll the provider as an authorized provider. The commissioner 280.2 shall develop procedures for providers and recipients to appeal 280.3 a county decision to refuse to enroll a provider. After the 280.4 commissioner makes a decision regarding an appeal, the county, 280.5 provider, or recipient may request that the commissioner 280.6 reconsider the commissioner's initial decision. The 280.7 commissioner's reconsideration decision is final and not subject 280.8 to further appeal. 280.9 Sec. 36. [256B.82] [PREPAID PLANS AND MENTAL HEALTH 280.10 REHABILITATIVE SERVICES.] 280.11 Medical assistance and MinnesotaCare prepaid health plans 280.12 may include coverage for adult mental health rehabilitative 280.13 services under section 256B.0623 and adult mental health crisis 280.14 response services under section 256B.0624, beginning January 1, 280.15 2004. 280.16 By January 15, 2003, the commissioner shall report to the 280.17 legislature how these services should be included in prepaid 280.18 plans. The commissioner shall consult with mental health 280.19 advocates, health plans, and counties in developing this 280.20 report. The report recommendations must include a plan to 280.21 ensure coordination of these services between health plans and 280.22 counties, assure recipient access to essential community 280.23 providers, and monitor the health plans' delivery of services 280.24 through utilization review and quality standards. 280.25 Sec. 37. [256B.83] [MAINTENANCE OF EFFORT FOR CERTAIN 280.26 MENTAL HEALTH SERVICES.] 280.27 Any net increase in revenue to the county as a result of 280.28 the change in section 256B.0623 or 256B.0624 must be used to 280.29 provide expanded mental health services as defined in sections 280.30 245.461 to 245.486, the Comprehensive Adult Mental Health Act, 280.31 excluding inpatient and residential treatment. Increased 280.32 revenue may also be used for services and consumer supports, 280.33 which are part of adult mental health projects approved under 280.34 section 245.4661. "Increased revenue" has the meaning given in 280.35 Minnesota Rules, part 9520.0903, subpart 3. 280.36 Sec. 38. Minnesota Statutes 2000, section 260C.201, 281.1 subdivision 1, as amended by Laws 2001, chapter 178, article 1, 281.2 section 16, is amended to read: 281.3 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 281.4 the child is in need of protection or services or neglected and 281.5 in foster care, it shall enter an order making any of the 281.6 following dispositions of the case: 281.7 (1) place the child under the protective supervision of the 281.8 responsible social services agency or child-placing agency in 281.9 the home of a parent of the child under conditions prescribed by 281.10 the court directed to the correction of the child's need for 281.11 protection or services: 281.12 (i) the court may order the child into the home of a parent 281.13 who does not otherwise have legal custody of the child, however, 281.14 an order under this section does not confer legal custody on 281.15 that parent; 281.16 (ii) if the court orders the child into the home of a 281.17 father who is not adjudicated, he must cooperate with paternity 281.18 establishment proceedings regarding the child in the appropriate 281.19 jurisdiction as one of the conditions prescribed by the court 281.20 for the child to continue in his home; 281.21 (iii) the court may order the child into the home of a 281.22 noncustodial parent with conditions and may also order both the 281.23 noncustodial and the custodial parent to comply with the 281.24 requirements of a case plan under subdivision 2; or 281.25 (2) transfer legal custody to one of the following: 281.26 (i) a child-placing agency; or 281.27 (ii) the responsible social services agency. In placing a 281.28 child whose custody has been transferred under this paragraph, 281.29 the agencies shall make an individualized determination of how 281.30 the placement is in the child's best interests using the 281.31 consideration for relatives and the best interest factors in 281.32 section 260C.212, subdivision 2, paragraph (b); or 281.33 (3) if the child has been adjudicated as a child in need of 281.34 protection or services because the child is in need of special 281.35treatment andservices or carefor reasons of physical or mental281.36healthto treat or ameliorate a physical or mental disability, 282.1 the court may order the child's parent, guardian, or custodian 282.2 to provide it. The court may order the child's health plan 282.3 company to provide mental health services to the child. Section 282.4 62!.535 applies to an order for mental health services directed 282.5 to the child's health plan company. If the health plan, parent, 282.6 guardian, or custodian fails or is unable to provide this 282.7 treatment or care, the court may order it provided. Absent 282.8 specific written findings by the court that the child's 282.9 disability is the result of abuse or neglect by the child's 282.10 parent or guardian, the court shall not transfer legal custody 282.11 of the child for the purpose of obtaining special treatment or 282.12 care solely because the parent is unable to provide the 282.13 treatment or care. If the court's order for mental health 282.14 treatment is based on a diagnosis made by a treatment 282.15 professional, the court may order that the diagnosing 282.16 professional not provide the treatment to the child if it finds 282.17 that such an order is in the child's best interests; or 282.18 (4) if the court believes that the child has sufficient 282.19 maturity and judgment and that it is in the best interests of 282.20 the child, the court may order a child 16 years old or older to 282.21 be allowed to live independently, either alone or with others as 282.22 approved by the court under supervision the court considers 282.23 appropriate, if the county board, after consultation with the 282.24 court, has specifically authorized this dispositional 282.25 alternative for a child. 282.26 (b) If the child was adjudicated in need of protection or 282.27 services because the child is a runaway or habitual truant, the 282.28 court may order any of the following dispositions in addition to 282.29 or as alternatives to the dispositions authorized under 282.30 paragraph (a): 282.31 (1) counsel the child or the child's parents, guardian, or 282.32 custodian; 282.33 (2) place the child under the supervision of a probation 282.34 officer or other suitable person in the child's own home under 282.35 conditions prescribed by the court, including reasonable rules 282.36 for the child's conduct and the conduct of the parents, 283.1 guardian, or custodian, designed for the physical, mental, and 283.2 moral well-being and behavior of the child; or with the consent 283.3 of the commissioner of corrections, place the child in a group 283.4 foster care facility which is under the commissioner's 283.5 management and supervision; 283.6 (3) subject to the court's supervision, transfer legal 283.7 custody of the child to one of the following: 283.8 (i) a reputable person of good moral character. No person 283.9 may receive custody of two or more unrelated children unless 283.10 licensed to operate a residential program under sections 245A.01 283.11 to 245A.16; or 283.12 (ii) a county probation officer for placement in a group 283.13 foster home established under the direction of the juvenile 283.14 court and licensed pursuant to section 241.021; 283.15 (4) require the child to pay a fine of up to $100. The 283.16 court shall order payment of the fine in a manner that will not 283.17 impose undue financial hardship upon the child; 283.18 (5) require the child to participate in a community service 283.19 project; 283.20 (6) order the child to undergo a chemical dependency 283.21 evaluation and, if warranted by the evaluation, order 283.22 participation by the child in a drug awareness program or an 283.23 inpatient or outpatient chemical dependency treatment program; 283.24 (7) if the court believes that it is in the best interests 283.25 of the child and of public safety that the child's driver's 283.26 license or instruction permit be canceled, the court may order 283.27 the commissioner of public safety to cancel the child's license 283.28 or permit for any period up to the child's 18th birthday. If 283.29 the child does not have a driver's license or permit, the court 283.30 may order a denial of driving privileges for any period up to 283.31 the child's 18th birthday. The court shall forward an order 283.32 issued under this clause to the commissioner, who shall cancel 283.33 the license or permit or deny driving privileges without a 283.34 hearing for the period specified by the court. At any time 283.35 before the expiration of the period of cancellation or denial, 283.36 the court may, for good cause, order the commissioner of public 284.1 safety to allow the child to apply for a license or permit, and 284.2 the commissioner shall so authorize; 284.3 (8) order that the child's parent or legal guardian deliver 284.4 the child to school at the beginning of each school day for a 284.5 period of time specified by the court; or 284.6 (9) require the child to perform any other activities or 284.7 participate in any other treatment programs deemed appropriate 284.8 by the court. 284.9 To the extent practicable, the court shall enter a 284.10 disposition order the same day it makes a finding that a child 284.11 is in need of protection or services or neglected and in foster 284.12 care, but in no event more than 15 days after the finding unless 284.13 the court finds that the best interests of the child will be 284.14 served by granting a delay. If the child was under eight years 284.15 of age at the time the petition was filed, the disposition order 284.16 must be entered within ten days of the finding and the court may 284.17 not grant a delay unless good cause is shown and the court finds 284.18 the best interests of the child will be served by the delay. 284.19 (c) If a child who is 14 years of age or older is 284.20 adjudicated in need of protection or services because the child 284.21 is a habitual truant and truancy procedures involving the child 284.22 were previously dealt with by a school attendance review board 284.23 or county attorney mediation program under section 260A.06 or 284.24 260A.07, the court shall order a cancellation or denial of 284.25 driving privileges under paragraph (b), clause (7), for any 284.26 period up to the child's 18th birthday. 284.27 (d) In the case of a child adjudicated in need of 284.28 protection or services because the child has committed domestic 284.29 abuse and been ordered excluded from the child's parent's home, 284.30 the court shall dismiss jurisdiction if the court, at any time, 284.31 finds the parent is able or willing to provide an alternative 284.32 safe living arrangement for the child, as defined in Laws 1997, 284.33 chapter 239, article 10, section 2. 284.34 (e) When a parent has complied with a case plan ordered 284.35 under subdivision 6 and the child is in the care of the parent, 284.36 the court may order the responsible social services agency to 285.1 monitor the parent's continued ability to maintain the child 285.2 safely in the home under such terms and conditions as the court 285.3 determines appropriate under the circumstances. 285.4 Sec. 39. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 285.5 RESIDENTIAL SERVICES GRANTS.] 285.6 The commissioner of human services shall review funding 285.7 methods for adult residential services grants under Minnesota 285.8 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 285.9 system that takes into account client difficulty of care as 285.10 manifested by client physical, mental, or behavioral 285.11 conditions. The payment system must provide reimbursement for 285.12 education, consultation, and support services provided to 285.13 families and other individuals as an extension of the treatment 285.14 process. The commissioner shall present recommendations and 285.15 draft legislation for an adult residential services payment 285.16 system to the legislature by January 15, 2002. The 285.17 recommendations must address whether additional funding for 285.18 adult residential services grants is necessary for the provision 285.19 of high quality services under a payment reimbursement system. 285.20 Sec. 40. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 285.21 CARE BENEFIT PROGRAM.] 285.22 When the continuing care benefit program for persons with 285.23 mental illness under Minnesota Statutes, section 256.9693 is 285.24 established, the commissioner of human services shall notify 285.25 counties, health plan companies with prepaid medical assistance 285.26 contracts, health care providers, and enrollees of the benefit 285.27 program through bulletins, workshops, and other meetings. 285.28 [EFFECTIVE DATE.] This section is effective July 1, 2002. 285.29 Sec. 41. [DATA REGARDING COUNTY COMMITMENT COSTS.] 285.30 Each county shall report data regarding all county costs 285.31 for civil commitments under Minnesota Statutes, section 253B.09, 285.32 beginning July 1, 2002, to the commissioner of human services. 285.33 This fiscal data must include but is not limited to court costs, 285.34 hold order costs under Minnesota Statutes, section 253B.05, the 285.35 county share of costs for placement in a regional treatment 285.36 center, costs for prepetition screening under Minnesota 286.1 Statutes, section 253B.07, case management costs, transportation 286.2 costs, and contract bed costs. The commissioner shall report 286.3 this information, including any increases or decreases in county 286.4 commitment costs that occur after the implementation of sections 286.5 in this article relating to civil commitment, to the legislature 286.6 by January 15, 2004. 286.7 ARTICLE 10 286.8 ASSISTANCE PROGRAMS 286.9 Section 1. Minnesota Statutes 2000, section 256.98, 286.10 subdivision 8, is amended to read: 286.11 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 286.12 found to be guilty of wrongfully obtaining assistance by a 286.13 federal or state court or by an administrative hearing 286.14 determination, or waiver thereof, through a disqualification 286.15 consent agreement, or as part of any approved diversion plan 286.16 under section 401.065, or any court-ordered stay which carries 286.17 with it any probationary or other conditions, in the Minnesota 286.18 familyassistanceinvestment program, the food stamp program, 286.19 the general assistance program, the group residential housing 286.20 program, or the Minnesota supplemental aid program shall be 286.21 disqualified from that program. In addition, any person 286.22 disqualified from the Minnesota family investment program shall 286.23 also be disqualified from the food stamp program. The needs of 286.24 that individual shall not be taken into consideration in 286.25 determining the grant level for that assistance unit: 286.26 (1) for one year after the first offense; 286.27 (2) for two years after the second offense; and 286.28 (3) permanently after the third or subsequent offense. 286.29 The period of program disqualification shall begin on the 286.30 date stipulated on the advance notice of disqualification 286.31 without possibility of postponement for administrative stay or 286.32 administrative hearing and shall continue through completion 286.33 unless and until the findings upon which the sanctions were 286.34 imposed are reversed by a court of competent jurisdiction. The 286.35 period for which sanctions are imposed is not subject to 286.36 review. The sanctions provided under this subdivision are in 287.1 addition to, and not in substitution for, any other sanctions 287.2 that may be provided for by law for the offense involved. A 287.3 disqualification established through hearing or waiver shall 287.4 result in the disqualification period beginning immediately 287.5 unless the person has become otherwise ineligible for 287.6 assistance. If the person is ineligible for assistance, the 287.7 disqualification period begins when the person again meets the 287.8 eligibility criteria of the program from which they were 287.9 disqualified and makes application for that program. 287.10 (b) A family receiving assistance through child care 287.11 assistance programs under chapter 119B with a family member who 287.12 is found to be guilty of wrongfully obtaining child care 287.13 assistance by a federal court, state court, or an administrative 287.14 hearing determination or waiver, through a disqualification 287.15 consent agreement, as part of an approved diversion plan under 287.16 section 401.065, or a court-ordered stay with probationary or 287.17 other conditions, is disqualified from child care assistance 287.18 programs. The disqualifications must be for periods of three 287.19 months, six months, and two years for the first, second, and 287.20 third offenses respectively. Subsequent violations must result 287.21 in permanent disqualification. During the disqualification 287.22 period, disqualification from any child care program must extend 287.23 to all child care programs and must be immediately applied. 287.24 Sec. 2. Minnesota Statutes 2000, section 256J.08, 287.25 subdivision 55a, is amended to read: 287.26 Subd. 55a. [MFIP STANDARD OF NEED.] "MFIP standard of 287.27 need" means the appropriate standard used to determine MFIP 287.28 benefit payments for the MFIP unit and applies to: 287.29 (1) the transitional standard, sections 256J.08, 287.30 subdivision 85, and 256J.24, subdivision 5; and 287.31 (2) the shared household standard, section 256J.24, 287.32 subdivision 9; and287.33(3) the interstate transition standard, section 256J.43. 287.34 Sec. 3. Minnesota Statutes 2000, section 256J.08, is 287.35 amended by adding a subdivision to read: 287.36 Subd. 67a. [PERSON TRAINED IN DOMESTIC VIOLENCE.] "Person 288.1 trained in domestic violence" means an individual who works for 288.2 an organization that is designated by the Minnesota center for 288.3 crime victims services as providing services to victims of 288.4 domestic violence, or a county staff person who has received 288.5 similar specialized training, and includes any other person or 288.6 organization designated by a qualifying organization under this 288.7 section. 288.8 [EFFECTIVE DATE.] This section is effective October 1, 2001. 288.9 Sec. 4. Minnesota Statutes 2000, section 256J.09, 288.10 subdivision 1, is amended to read: 288.11 Subdivision 1. [WHERE TO APPLY.] To apply for assistance a 288.12 person mustapply for assistance atsubmit a signed application 288.13 to the county agency in the county where that person lives. 288.14 Sec. 5. Minnesota Statutes 2000, section 256J.09, 288.15 subdivision 2, is amended to read: 288.16 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 288.17 INFORMATION.] When a person inquires about assistance, a county 288.18 agency mustinform a person who inquires about assistance about: 288.19 (1) explain the eligibility requirementsfor assistanceof, 288.20 and how to apply for, diversionary assistance, including288.21diversionary assistance andas provided in section 256J.47; 288.22 emergency assistance.as provided in section 256J.48; MFIP as 288.23 provided in section 256J.10; or any other assistance for which 288.24 the person may be eligible; and 288.25A county agency must(2) offer the person brochures 288.26 developed or approved by the commissioner that describe how to 288.27 apply for assistance. 288.28 Sec. 6. Minnesota Statutes 2000, section 256J.09, 288.29 subdivision 3, is amended to read: 288.30 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 288.31 agency must offer, in person or by mail, the application forms 288.32 prescribed by the commissioner as soon as a person makes a 288.33 written or oral inquiry. At that time, the county agency must: 288.34 (1) inform the person that assistance begins with the date 288.35 the signed application is received by the county agency or the 288.36 date all eligibility criteria are met, whichever is later. The289.1county agency must; 289.2 (2) inform theapplicantperson that any delay in 289.3 submitting the application will reduce the amount of assistance 289.4 paid for the month of application. A county agency must; 289.5 (3) inform a person that the person may submit the 289.6 application before an interviewappointment. To apply for289.7assistance, a person must submit a signed application to the289.8county agency.; 289.9 (4) explain the information that will be verified during 289.10 the application process by the county agency as provided in 289.11 section 256J.32; 289.12 (5) inform a person about the county agency's average 289.13 application processing time and explain how the application will 289.14 be processed under subdivision 5; 289.15 (6) explain how to contact the county agency if a person's 289.16 application information changes and how to withdraw the 289.17 application; 289.18 (7) inform a person that the next step in the application 289.19 process is an interview and what a person must do if the 289.20 application is approved including, but not limited to, attending 289.21 orientation under section 256J.45 and complying with employment 289.22 and training services requirements in sections 256J.52 to 289.23 256J.55; 289.24 (8) explain the child care and transportation services that 289.25 are available under paragraph (c) to enable caregivers to attend 289.26 the interview, screening, and orientation; and 289.27 (9) identify any language barriers and arrange for 289.28 translation assistance during appointments, including, but not 289.29 limited to, screening under subdivision 3a, orientation under 289.30 section 256J.45, and the initial assessment under section 289.31 256J.52. 289.32 (b) Upon receipt of a signed application, the county agency 289.33 must stamp the date of receipt on the face of the application. 289.34 The county agency must process the application within the time 289.35 period required under subdivision 5. An applicant may withdraw 289.36 the application at any time by giving written or oral notice to 290.1 the county agency. The county agency must issue a written 290.2 notice confirming the withdrawal. The notice must inform the 290.3 applicant of the county agency's understanding that the 290.4 applicant has withdrawn the application and no longer wants to 290.5 pursue it. When, within ten days of the date of the agency's 290.6 notice, an applicant informs a county agency, in writing, that 290.7 the applicant does not wish to withdraw the application, the 290.8 county agency must reinstate the application and finish 290.9 processing the application. 290.10 (c) Upon a participant's request, the county agency must 290.11 arrange for transportation and child care or reimburse the 290.12 participant for transportation and child care expenses necessary 290.13 to enable participants to attend the screening under subdivision 290.14 3a and orientation under section 256J.45. 290.15 Sec. 7. Minnesota Statutes 2000, section 256J.09, is 290.16 amended by adding a subdivision to read: 290.17 Subd. 3a. [SCREENING.] The county agency, or at county 290.18 option, the county's employment and training service provider as 290.19 defined in section 256J.49, must screen each applicant to 290.20 determine immediate needs and to determine if the applicant may 290.21 be eligible for: 290.22 (1) another program that is not partially funded through 290.23 the federal temporary assistance to needy families block grant 290.24 under Title I of Public Law Number 104-193, including the 290.25 expedited issuance of food stamps under section 256J.28, 290.26 subdivision 1. If the applicant may be eligible for another 290.27 program, a county caseworker must provide the appropriate 290.28 referral to the program; 290.29 (2) the diversionary assistance program under section 290.30 256J.47; or 290.31 (3) the emergency assistance program under section 256J.48. 290.32 Sec. 8. Minnesota Statutes 2000, section 256J.09, is 290.33 amended by adding a subdivision to read: 290.34 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 290.35 If the applicant is not diverted from applying for MFIP, and if 290.36 the applicant meets the MFIP eligibility requirements, then a 291.1 county agency must: 291.2 (1) identify an applicant who is under the age of 20 and 291.3 explain to the applicant the assessment procedures and 291.4 employment plan requirements for minor parents under section 291.5 256J.54; 291.6 (2) explain to the applicant the eligibility criteria for 291.7 an exemption under the family violence provisions in section 291.8 256J.52, subdivision 6, and explain what an applicant should do 291.9 to develop an alternative employment plan; 291.10 (3) determine if an applicant qualifies for an exemption 291.11 under section 256J.56 from employment and training services 291.12 requirements, explain how a person should report to the county 291.13 agency any status changes, and explain that an applicant who is 291.14 exempt may volunteer to participate in employment and training 291.15 services; 291.16 (4) for applicants who are not exempt from the requirement 291.17 to attend orientation, arrange for an orientation under section 291.18 256J.45 and an initial assessment under section 256J.52; 291.19 (5) inform an applicant who is not exempt from the 291.20 requirement to attend orientation that failure to attend the 291.21 orientation is considered an occurrence of noncompliance with 291.22 program requirements and will result in an imposition of a 291.23 sanction under section 256J.46; and 291.24 (6) explain how to contact the county agency if an 291.25 applicant has questions about compliance with program 291.26 requirements. 291.27 Sec. 9. Minnesota Statutes 2000, section 256J.24, 291.28 subdivision 2, is amended to read: 291.29 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 291.30 for minor caregivers and their children who must be in a 291.31 separate assistance unit from the other persons in the 291.32 household, when the following individuals live together, they 291.33 must be included in the assistance unit: 291.34 (1) a minor child, including a pregnant minor; 291.35 (2) the minor child's minor siblings, minor half-siblings, 291.36 and minor step-siblings; 292.1 (3) the minor child's natural parents, adoptive parents, 292.2 and stepparents; and 292.3 (4) the spouse of a pregnant woman. 292.4 A minor child must have a caregiver for the child to be 292.5 included in the assistance unit. 292.6 Sec. 10. Minnesota Statutes 2000, section 256J.24, 292.7 subdivision 9, is amended to read: 292.8 Subd. 9. [SHARED HOUSEHOLD STANDARD; MFIP.] (a) Except as 292.9 prohibited in paragraph (b), the county agency must use the 292.10 shared household standard when the household includes one or 292.11 more unrelated members, as that term is defined in section 292.12 256J.08, subdivision 86a. The county agency must use the shared 292.13 household standard, unless a member of the assistance unit is a 292.14 victim ofdomesticfamily violence and has anapproved safety292.15 alternative employment plan, regardless of the number of 292.16 unrelated members in the household. 292.17 (b) The county agency must not use the shared household 292.18 standard when all unrelated members are one of the following: 292.19 (1) a recipient of public assistance benefits, including 292.20 food stamps, Supplemental Security Income, adoption assistance, 292.21 relative custody assistance, or foster care payments; 292.22 (2) a roomer or boarder, or a person to whom the assistance 292.23 unit is paying room or board; 292.24 (3) a minor child under the age of 18; 292.25 (4) a minor caregiver living with the minor caregiver's 292.26 parents or in an approved supervised living arrangement; 292.27 (5) a caregiver who is not the parent of the minor child in 292.28 the assistance unit; or 292.29 (6) an individual who provides child care to a child in the 292.30 MFIP assistance unit. 292.31 (c) The shared household standard must be discontinued if 292.32 it is not approved by the United States Department of 292.33 Agriculture under the MFIP waiver. 292.34 Sec. 11. Minnesota Statutes 2000, section 256J.24, 292.35 subdivision 10, is amended to read: 292.36 Subd. 10. [MFIP EXIT LEVEL.](a) In state fiscal years293.12000 and 2001,The commissioner shall adjust the MFIP earned 293.2 income disregard to ensure that most participants do not lose 293.3 eligibility for MFIP until their income reaches at least 120 293.4 percent of the federal poverty guidelines in effect in October 293.5 of each fiscal year. The adjustment to the disregard shall be 293.6 based on a household size of three, and the resulting earned 293.7 income disregard percentage must be applied to all household 293.8 sizes. The adjustment under this subdivision must be 293.9 implemented at the same time as the October food stamp 293.10 cost-of-living adjustment is reflected in the food portion of 293.11 MFIP transitional standard as required under subdivision 5a. 293.12(b) In state fiscal year 2002 and thereafter, the earned293.13income disregard percentage must be the same as the percentage293.14implemented in October 2000.293.15 Sec. 12. Minnesota Statutes 2000, section 256J.31, 293.16 subdivision 4, is amended to read: 293.17 Subd. 4. [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 293.18 must give a participant written notice of all adverse actions 293.19 affecting the participant including payment reductions, 293.20 suspensions, terminations, and use of protective, vendor, or 293.21 two-party payments. The notice of adverse action must be on a 293.22 form prescribed or approved by the commissioner, must be 293.23 understandable at a seventh grade reading level, and must be 293.24 mailed to the last known mailing address provided by the 293.25 participant. A notice written in English must include the 293.26 department of human services language block and must be sent to 293.27 every applicable participant. The county agency must state on 293.28 the notice of adverse action the action it intends to take, the 293.29 reasons for the action, the participant's right to appeal the 293.30 action, the conditions under which assistance can be continued 293.31 pending an appeal decision, and the related consequences of the 293.32 action. 293.33 Sec. 13. Minnesota Statutes 2000, section 256J.39, 293.34 subdivision 2, is amended to read: 293.35 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 293.36 paying assistance directly to a participant may be used when: 294.1 (1) a county agency determines that a vendor payment is the 294.2 most effective way to resolve an emergency situation pertaining 294.3 to basic needs; 294.4 (2) a caregiver makes a written request to the county 294.5 agency asking that part or all of the assistance payment be 294.6 issued by protective or vendor payments for shelter and utility 294.7 service only. The caregiver may withdraw this request in 294.8 writing at any time; 294.9 (3) the vendor payment is part of a sanction under section 294.10 256J.46; 294.11 (4) the vendor payment is required under section 256J.24, 294.12 subdivision 8, or 256J.26, or 256J.43; 294.13 (5) protective payments are required for minor parents 294.14 under section 256J.14; or 294.15 (6) a caregiver has exhibited a continuing pattern of 294.16 mismanaging funds as determined by the county agency. 294.17 The director of a county agency, or the director's 294.18 designee, must approve a proposal for protective or vendor 294.19 payment for money mismanagement when there is a pattern of 294.20 mismanagement under clause (6). During the time a protective or 294.21 vendor payment is being made, the county agency must provide 294.22 services designed to alleviate the causes of the mismanagement. 294.23 The continuing need for and method of payment must be 294.24 documented and reviewed every 12 months. The director of a 294.25 county agency or the director's designee must approve the 294.26 continuation of protective or vendor payments. When it appears 294.27 that the need for protective or vendor payments will continue or 294.28 is likely to continue beyond two years because the county 294.29 agency's efforts have not resulted in sufficiently improved use 294.30 of assistance on behalf of the minor child, judicial appointment 294.31 of a legal guardian or other legal representative must be sought 294.32 by the county agency. 294.33 Sec. 14. Minnesota Statutes 2000, section 256J.42, 294.34 subdivision 1, is amended to read: 294.35 Subdivision 1. [TIME LIMIT.] (a) Exceptfor the exemptions294.36 as otherwise provided for in this section, an assistance unit in 295.1 which any adult caregiver has received 60 months of cash 295.2 assistance funded in whole or in part by the TANF block grant in 295.3 this or any other state or United States territory, or from a 295.4 tribal TANF program, MFIP, the AFDC program formerly codified in 295.5 sections 256.72 to 256.87, or the family general assistance 295.6 program formerly codified in sections 256D.01 to 256D.23, funded 295.7 in whole or in part by state appropriations, is ineligible to 295.8 receive MFIP. Any cash assistance funded with TANF dollars in 295.9 this or any other state or United States territory, or from a 295.10 tribal TANF program, or MFIP assistance funded in whole or in 295.11 part by state appropriations, that was received by the unit on 295.12 or after the date TANF was implemented, including any assistance 295.13 received in states or United States territories of prior 295.14 residence, counts toward the 60-month limitation. The 60-month 295.15 limit applies to a minorwho is the head of a household or who295.16is married to the head of a householdcaregiver except under 295.17 subdivision 5. The 60-month time period does not need to be 295.18 consecutive months for this provision to apply. 295.19 (b) The months before July 1998 in which individuals 295.20 received assistance as part of the field trials as an MFIP, 295.21 MFIP-R, or MFIP or MFIP-R comparison group family are not 295.22 included in the 60-month time limit. 295.23 Sec. 15. Minnesota Statutes 2000, section 256J.42, 295.24 subdivision 3, is amended to read: 295.25 Subd. 3. [ADULTS LIVINGON ANIN INDIAN 295.26RESERVATIONCOUNTRY.] In determining the number of months for 295.27 which an adult has received assistance under MFIP-S, the county 295.28 agency must disregard any month during which the adult livedon295.29anin Indianreservationcountry if during the month at least 50 295.30 percent of the adults livingon the reservationin Indian 295.31 country were not employed. 295.32 Sec. 16. Minnesota Statutes 2000, section 256J.45, 295.33 subdivision 1, is amended to read: 295.34 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 295.35 county agency must provide a face-to-face orientation to each 295.36 MFIP caregiverwho is not exempt under section 256J.56,296.1paragraph (a), clause (6) or (8), with a face-to-face296.2orientationunless the caregiver is: 296.3 (1) a single parent, or one parent in a two-parent family, 296.4 employed at least 35 hours per week; or 296.5 (2) a second parent in a two-parent family who is employed 296.6 for 20 or more hours per week provided the first parent is 296.7 employed at least 35 hours per week. 296.8 The county agency must inform caregivers who are not exempt 296.9 undersection 256J.56, paragraph (a), clause (6) or (8),clause 296.10 (1) or (2) that failure to attend the orientation is considered 296.11 an occurrence of noncompliance with program requirements, and 296.12 will result in the imposition of a sanction under section 296.13 256J.46. If the client complies with the orientation 296.14 requirement prior to the first day of the month in which the 296.15 grant reduction is proposed to occur, the orientation sanction 296.16 shall be lifted. 296.17 Sec. 17. Minnesota Statutes 2000, section 256J.48, is 296.18 amended by adding a subdivision to read: 296.19 Subd. 1a. [PROCESSING EMERGENCY APPLICATIONS.] Within 296.20 seven days of receiving the application, or sooner if the 296.21 immediacy and severity of the situation warrants it, families 296.22 must be notified in writing whether their application was 296.23 approved, denied, or pended. 296.24 Sec. 18. Minnesota Statutes 2000, section 256J.49, is 296.25 amended by adding a subdivision to read: 296.26 Subd. 1a. [ALTERNATIVE EMPLOYMENT PLAN.] "Alternative 296.27 employment plan" means a plan that is based on an individualized 296.28 assessment of need and is developed with a person trained in 296.29 domestic violence and approved by the county or a job 296.30 counselor. The plan may address safety, legal or emotional 296.31 issues, and other demands on the family as a result of the 296.32 family violence. The information in section 256J.515, clauses 296.33 (1) to (8), must be included as part of the development of the 296.34 alternative employment plan. The primary goal of an alternative 296.35 employment plan is to ensure the safety of the caregiver and 296.36 children. To the extent it is consistent with ensuring safety, 297.1 an alternative employment plan shall also include activities 297.2 that are designed to lead to self-sufficiency. An activity is 297.3 inconsistent with ensuring safety if, in the opinion of a person 297.4 trained in domestic violence, the activity would endanger the 297.5 safety of the participant or children. An alternative 297.6 employment plan may not automatically include a provision that 297.7 requires a participant to obtain an order for protection or to 297.8 attend counseling. 297.9 [EFFECTIVE DATE.] This section is effective October 1, 2001. 297.10 Sec. 19. Minnesota Statutes 2000, section 256J.49, 297.11 subdivision 2, is amended to read: 297.12 Subd. 2. [DOMESTICFAMILY VIOLENCE.] "DomesticFamily 297.13 violence" means: 297.14 (1) physical acts that result, or threaten to result in, 297.15 physical injury to an individual; 297.16 (2) sexual abuse; 297.17 (3) sexual activity involving a minor child; 297.18 (4) being forced as the caregiver of a minor child to 297.19 engage in nonconsensual sexual acts or activities; 297.20 (5) threats of, or attempts at, physical or sexual abuse; 297.21 (6) mental abuse; or 297.22 (7) neglect or deprivation of medical care. 297.23 Claims of family violence must be documented by the applicant or 297.24 participant providing a sworn statement, which is supported by 297.25 collateral documentation. Collateral documentation may consist 297.26 of any one of the following: 297.27 (1) police, government agency, or court records; 297.28 (2) a statement from a battered woman's shelter staff with 297.29 knowledge of circumstances or credible evidence that supports 297.30 the sworn statement; 297.31 (3) a statement from a sexual assault or domestic violence 297.32 advocate with knowledge of the circumstances or credible 297.33 evidence that supports a sworn statement; 297.34 (4) a statement from professionals from whom the applicant 297.35 or recipient has sought assistance for the abuse; or 297.36 (5) a sworn statement from any other individual with 298.1 knowledge of circumstances or credible evidence that supports 298.2 the sworn statement. 298.3 [EFFECTIVE DATE.] This section is effective October 1, 2001. 298.4 Sec. 20. Minnesota Statutes 2000, section 256J.49, 298.5 subdivision 13, is amended to read: 298.6 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 298.7 activity in a participant's approved employment plan that is 298.8 tied to the participant's employment goal. For purposes of the 298.9 MFIP program, any activity that is included in a participant's 298.10 approved employment plan meets the definition of work activity 298.11 as counted under the federal participation standards. Work 298.12 activity includes, but is not limited to: 298.13 (1) unsubsidized employment; 298.14 (2) subsidized private sector or public sector employment, 298.15 including grant diversion as specified in section 256J.69; 298.16 (3) work experience, including CWEP as specified in section 298.17 256J.67, and including work associated with the refurbishing of 298.18 publicly assisted housing if sufficient private sector 298.19 employment is not available; 298.20 (4) on-the-job training as specified in section 256J.66; 298.21 (5) job search, either supervised or unsupervised; 298.22 (6) job readiness assistance; 298.23 (7) job clubs, including job search workshops; 298.24 (8) job placement; 298.25 (9) job development; 298.26 (10) job-related counseling; 298.27 (11) job coaching; 298.28 (12) job retention services; 298.29 (13) job-specific training or education; 298.30 (14) job skills training directly related to employment; 298.31 (15) the self-employment investment demonstration (SEID), 298.32 as specified in section 256J.65; 298.33 (16) preemployment activities, based on availability and 298.34 resources, such as volunteer work, literacy programs and related 298.35 activities, citizenship classes, English as a second language 298.36 (ESL) classes as limited by the provisions of section 256J.52, 299.1 subdivisions 3, paragraph (d), and 5, paragraph (c), or 299.2 participation in dislocated worker services, chemical dependency 299.3 treatment, mental health services, peer group networks, 299.4 displaced homemaker programs, strength-based resiliency 299.5 training, parenting education, or other programs designed to 299.6 help families reach their employment goals and enhance their 299.7 ability to care for their children; 299.8 (17) community service programs; 299.9 (18) vocational educational training or educational 299.10 programs that can reasonably be expected to lead to employment, 299.11 as limited by the provisions of section 256J.53; 299.12 (19) apprenticeships; 299.13 (20) satisfactory attendance in general educational 299.14 development diploma classes or an adult diploma program; 299.15 (21) satisfactory attendance at secondary school, if the 299.16 participant has not received a high school diploma; 299.17 (22) adult basic education classes; 299.18 (23) internships; 299.19 (24) bilingual employment and training services; 299.20 (25) providing child care services to a participant who is 299.21 working in a community service program; and 299.22 (26) activities included ina safetyan alternative 299.23 employment plan that is developed under section 256J.52, 299.24 subdivision 6. 299.25 [EFFECTIVE DATE.] This section is effective October 1, 2001. 299.26 Sec. 21. Minnesota Statutes 2000, section 256J.50, is 299.27 amended by adding a subdivision to read: 299.28 Subd. 12. [ACCESS TO PERSONS TRAINED IN DOMESTIC 299.29 VIOLENCE.] In a county where there is no staff person who is 299.30 trained in domestic violence, as that term is defined in section 299.31 256J.08, subdivision 67a, the county must work with the nearest 299.32 organization that is designated as providing services to victims 299.33 of domestic violence to develop a process, which ensures that 299.34 domestic violence victims have access to a person trained in 299.35 domestic violence. 299.36 [EFFECTIVE DATE.] This section is effective October 1, 2001. 300.1 Sec. 22. Minnesota Statutes 2000, section 256J.57, 300.2 subdivision 2, is amended to read: 300.3 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 300.4 participant fails without good cause to comply with the 300.5 requirements of sections 256J.52 to 256J.55, the job counselor 300.6 or the county agency must provide a notice of intent to sanction 300.7 to the participant specifying the program requirements that were 300.8 not complied with, informing the participant that the county 300.9 agency will impose the sanctions specified in section 256J.46, 300.10 and informing the participant of the opportunity to request a 300.11 conciliation conference as specified in paragraph (b). The 300.12 notice must also state that the participant's continuing 300.13 noncompliance with the specified requirements will result in 300.14 additional sanctions under section 256J.46, without the need for 300.15 additional notices or conciliation conferences under this 300.16 subdivision. The notice, written in English, must include the 300.17 department of human services language block, and must be sent to 300.18 every applicable participant. If the participant does not 300.19 request a conciliation conference within ten calendar days of 300.20 the mailing of the notice of intent to sanction, the job 300.21 counselor must notify the county agency that the assistance 300.22 payment should be reduced. The county must then send a notice 300.23 of adverse action to the participant informing the participant 300.24 of the sanction that will be imposed, the reasons for the 300.25 sanction, the effective date of the sanction, and the 300.26 participant's right to have a fair hearing under section 256J.40. 300.27 (b) The participant may request a conciliation conference 300.28 by sending a written request, by making a telephone request, or 300.29 by making an in-person request. The request must be received 300.30 within ten calendar days of the date the county agency mailed 300.31 the ten-day notice of intent to sanction. If a timely request 300.32 for a conciliation is received, the county agency's service 300.33 provider must conduct the conference within five days of the 300.34 request. The job counselor's supervisor, or a designee of the 300.35 supervisor, must review the outcome of the conciliation 300.36 conference. If the conciliation conference resolves the 301.1 noncompliance, the job counselor must promptly inform the county 301.2 agency and request withdrawal of the sanction notice. 301.3 (c) Upon receiving a sanction notice, the participant may 301.4 request a fair hearing under section 256J.40, without exercising 301.5 the option of a conciliation conference. In such cases, the 301.6 county agency shall not require the participant to engage in a 301.7 conciliation conference prior to the fair hearing. 301.8 (d) If the participant requests a fair hearing or a 301.9 conciliation conference, sanctions will not be imposed until 301.10 there is a determination of noncompliance. Sanctions must be 301.11 imposed as provided in section 256J.46. 301.12 Sec. 23. Minnesota Statutes 2000, section 256J.62, 301.13 subdivision 2a, is amended to read: 301.14 Subd. 2a. [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 301.15 state fiscal year 2000, and for all subsequent years, money 301.16 shall be allocated to counties and eligible tribal providers 301.17 based on their average number of MFIP cases as a proportion of 301.18 the statewide total number of MFIP cases: 301.19 (1) the average number of cases must be based upon counts 301.20 of MFIP or tribal TANF cases as of March 31, June 30, September 301.21 30, and December 31 of the previous calendar year, less the 301.22 number of child only cases and cases where all the caregivers 301.23 are age 60 or over. Two-parent cases, with the exception of 301.24 those with a caregiver age 60 or over, will be multiplied by a 301.25 factor of two; 301.26 (2) the MFIP or tribal TANF case count for each eligible 301.27 tribal provider shall be based upon the number of MFIP or tribal 301.28 TANF cases who are enrolled in, or are eligible for enrollment 301.29 in the tribe; and the case must be an active MFIP case; and the 301.30 case members must reside within the tribal program's service 301.31 delivery area; and 301.32 (3) MFIP or tribal TANF cases counted for determining 301.33 allocations to tribal providers shall be removed from the case 301.34 counts of the respective counties where they reside to prevent 301.35 duplicate counts;. 301.36(4) prior to allocating funds to counties and tribal302.1providers, $1,000,000 shall be set aside to allow the302.2commissioner to use these set-aside funds to provide funding to302.3county or tribal providers who experience an unforeseen influx302.4of participants or other emergent situations beyond their302.5control; and302.6(5) the commissioner shall use a portion of the funds in302.7clause (4) to offset a reduction in funds allocated to any302.8county between state fiscal year 1999 and state fiscal year 2000302.9that results from the adjustment in clause (3). The funding302.10provided under this clause must reduce by half the reduction for302.11state fiscal year 2000 that any county would otherwise302.12experience in the absence of this clause.302.13Any funds specified in this clause that remain unspent by March302.1431 of each year shall be reallocated out to county and tribal302.15providers using the funding formula detailed in clauses (1) to302.16(5).302.17 Sec. 24. Minnesota Statutes 2000, section 256J.645, is 302.18 amended to read: 302.19 256J.645 [INDIAN TRIBEMFIP-SMFIP EMPLOYMENTAND TRAINING302.20 SERVICES.] 302.21 Subdivision 1. [AUTHORIZATION TO ENTER INTO AGREEMENTS.] 302.22 Effective July 1, 1997, the commissioner may enter into 302.23 agreements with federally recognized Indian tribes with a 302.24 reservation in the state to provideMFIP-SMFIP employmentand302.25trainingservices to members of the Indian tribe and to other 302.26 caregivers who are a part of the tribal member'sMFIP-SMFIP 302.27 assistance unit. For purposes of this section, "Indian tribe" 302.28 means a tribe, band, nation, or other federally recognized group 302.29 or community of Indians. The commissioner may also enter into 302.30 an agreement with a consortium of Indian tribes providing the 302.31 governing body of each Indian tribe in the consortium complies 302.32 with the provisions of this section. 302.33 Subd. 2. [TRIBAL REQUIREMENTS.] The Indian tribe must: 302.34 (1) agree to fulfill the responsibilities provided under 302.35 the employmentand trainingservices component ofMFIP-SMFIP 302.36 regarding operation ofMFIP-SMFIP employmentand training303.1 services, as designated by the commissioner; 303.2 (2) operate its employmentand trainingservices program 303.3 within a geographic service area not to exceed the counties 303.4 within which a border of the reservation falls; 303.5 (3) operate its program in conformity with section 13.46 303.6 and any applicable federal regulations in the use of data about 303.7MFIP-SMFIP recipients; 303.8 (4) coordinate operation of its program with the county 303.9 agency,Job Training PartnershipWorkforce Investment Act 303.10 programs, and other support services or employment-related 303.11 programs in the counties in which the tribal unit's program 303.12 operates; 303.13 (5) provide financial and program participant activity 303.14 recordkeeping and reporting in the manner and using the forms 303.15 and procedures specified by the commissioner and permit 303.16 inspection of its program and records by representatives of the 303.17 state; and 303.18 (6) have the Indian tribe's employmentand trainingservice 303.19 provider certified by the commissioner of economic security, or 303.20 approved by the county. 303.21 Subd. 3. [FUNDING.] If the commissioner and an Indian 303.22 tribe are parties to an agreement under this subdivision, the 303.23 agreementmayshall annually provide to the Indian tribe the 303.24 fundingamount in clause (1) or (2):allocated in section 303.25 256J.62, subdivisions 1 and 2a. 303.26(1) if the Indian tribe operated a tribal STRIDE program303.27during state fiscal year 1997, the amount to be provided is the303.28amount the Indian tribe received from the state for operation of303.29its tribal STRIDE program in state fiscal year 1997, except that303.30the amount provided for a fiscal year may increase or decrease303.31in the same proportion that the total amount of state and303.32federal funds available for MFIP-S employment and training303.33services increased or decreased that fiscal year; or303.34(2) if the Indian tribe did not operate a tribal STRIDE303.35program during state fiscal year 1997, the commissioner may303.36provide to the Indian tribe for the first year of operations the304.1amount determined by multiplying the state allocation for MFIP-S304.2employment and training services to each county agency in the304.3Indian tribe's service delivery area by the percentage of MFIP-S304.4recipients in that county who were members of the Indian tribe304.5during the previous state fiscal year. The resulting amount304.6shall also be the amount that the commissioner may provide to304.7the Indian tribe annually thereafter through an agreement under304.8this subdivision, except that the amount provided for a fiscal304.9year may increase or decrease in the same proportion that the304.10total amount of state and federal funds available for MFIP-S304.11employment and training services increased or decreased that304.12fiscal year.304.13 Subd. 4. [COUNTY AGENCY REQUIREMENT.] Indian tribal 304.14 members receivingMFIP-SMFIP benefits and residing in the 304.15 service area of an Indian tribe operating employmentand304.16trainingservices under an agreement with the commissioner must 304.17 be referred by county agencies in the service area to the Indian 304.18 tribe for employmentand trainingservices. 304.19 Sec. 25. Minnesota Statutes 2000, section 268.0122, 304.20 subdivision 2, is amended to read: 304.21 Subd. 2. [SPECIFIC POWERS.] The commissioner of economic 304.22 security shall: 304.23 (1) administer and supervise all forms of unemployment 304.24 benefits provided for under federal and state laws that are 304.25 vested in the commissioner, including make investigations and 304.26 audits, secure and transmit information, and make available 304.27 services and facilities as the commissioner considers necessary 304.28 or appropriate to facilitate the administration of any other 304.29 states, or the federal Economic Security Law, and accept and use 304.30 information, services, and facilities made available by other 304.31 states or the federal government; 304.32 (2) administer and supervise all employment and training 304.33 services assigned to the department under federal or state law; 304.34 (3) review and comment on local service unit plans and 304.35 community investment program plans and approve or disapprove the 304.36 plans; 305.1 (4) establish and maintain administrative units necessary 305.2 to perform administrative functions common to all divisions of 305.3 the department; 305.4 (5) supervise the county boards of commissioners, local 305.5 service units, and any other units of government designated in 305.6 federal or state law as responsible for employment and training 305.7 programs; 305.8 (6) establish administrative standards and payment 305.9 conditions for providers of employment and training services; 305.10 (7) act as the agent of, and cooperate with, the federal 305.11 government in matters of mutual concern, including the 305.12 administration of any federal funds granted to the state to aid 305.13 in the performance of functions of the commissioner; 305.14 (8) obtain reports from local service units and service 305.15 providers for the purpose of evaluating the performance of 305.16 employment and training services;and305.17 (9) review and comment on plans for Indian tribe employment 305.18 and training services and approve or disapprove the plans; and 305.19 (10) require all general employment and training programs 305.20 that receive state funds to make available information about 305.21 opportunities for women in nontraditional careers in the trades 305.22 and technical occupations. 305.23 Sec. 26. [INSTRUCTION TO REVISOR.] 305.24 In the next edition of Minnesota Statutes and Minnesota 305.25 Rules, the revisor shall change all references to Minnesota 305.26 Family Investment Program-Statewide (MFIP-S) to Minnesota Family 305.27 Investment Program (MFIP). 305.28 ARTICLE 11 305.29 CHILD WELFARE AND FOSTER CARE 305.30 Section 1. Minnesota Statutes 2000, section 257.0725, is 305.31 amended to read: 305.32 257.0725 [ANNUAL REPORT.] 305.33 The commissioner of human services shall publish an annual 305.34 report on child maltreatment and on children in out-of-home 305.35 placement. The commissioner shall confer with counties, child 305.36 welfare organizations, child advocacy organizations, the courts, 306.1 and other groups on how to improve the content and utility of 306.2 the department's annual report. In regard to child 306.3 maltreatment, the report shall include the number and kinds of 306.4 maltreatment reports received and any other data that the 306.5 commissioner determines is appropriate to include in a report on 306.6 child maltreatment. In regard to children in out-of-home 306.7 placement, the report shall include, by county and statewide, 306.8 information on legal status, living arrangement, age, sex, race, 306.9 accumulated length of time in placement, reason for most recent 306.10 placement, race of family with whom placed, and other 306.11 information deemed appropriate on all children in out-of-home 306.12 placement. Out-of-home placement includes placement in any 306.13 facility by an authorized child-placing agency. 306.14 Sec. 2. Minnesota Statutes 2000, section 626.556, 306.15 subdivision 10, as amended by Laws 2001, chapter 178, article 2, 306.16 section 11, is amended to read: 306.17 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 306.18 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 306.19 alleges neglect, physical abuse, or sexual abuse by a parent, 306.20 guardian, or individual functioning within the family unit as a 306.21 person responsible for the child's care, the local welfare 306.22 agency shall immediately conduct an assessment including 306.23 gathering information on the existence of substance abuse and 306.24 offer protective social services for purposes of preventing 306.25 further abuses, safeguarding and enhancing the welfare of the 306.26 abused or neglected minor, and preserving family life whenever 306.27 possible. If the report alleges a violation of a criminal 306.28 statute involving sexual abuse, physical abuse, or neglect or 306.29 endangerment, under section 609.378, the local law enforcement 306.30 agency and local welfare agency shall coordinate the planning 306.31 and execution of their respective investigation and assessment 306.32 efforts to avoid a duplication of fact-finding efforts and 306.33 multiple interviews. Each agency shall prepare a separate 306.34 report of the results of its investigation. In cases of alleged 306.35 child maltreatment resulting in death, the local agency may rely 306.36 on the fact-finding efforts of a law enforcement investigation 307.1 to make a determination of whether or not maltreatment 307.2 occurred. When necessary the local welfare agency shall seek 307.3 authority to remove the child from the custody of a parent, 307.4 guardian, or adult with whom the child is living. In performing 307.5 any of these duties, the local welfare agency shall maintain 307.6 appropriate records. 307.7 If the assessment indicates there is a potential for abuse 307.8 of alcohol or other drugs by the parent, guardian, or person 307.9 responsible for the child's care, the local welfare agency shall 307.10 conduct a chemical use assessment pursuant to Minnesota Rules, 307.11 part 9530.6615. The local welfare agency shall report the 307.12 determination of the chemical use assessment, and the 307.13 recommendations and referrals for alcohol and other drug 307.14 treatment services to the state authority on alcohol and drug 307.15 abuse. 307.16 (b) When a local agency receives a report or otherwise has 307.17 information indicating that a child who is a client, as defined 307.18 in section 245.91, has been the subject of physical abuse, 307.19 sexual abuse, or neglect at an agency, facility, or program as 307.20 defined in section 245.91, it shall, in addition to its other 307.21 duties under this section, immediately inform the ombudsman 307.22 established under sections 245.91 to 245.97. The commissioner 307.23 of children, families, and learning shall inform the ombudsman 307.24 established under sections 245.91 to 245.97 of reports regarding 307.25 a child defined as a client in section 245.91 that maltreatment 307.26 occurred at a school as defined in sections 120A.05, 307.27 subdivisions 9, 11, and 13, and 124D.10. 307.28 (c) Authority of the local welfare agency responsible for 307.29 assessing the child abuse or neglect report, the agency 307.30 responsible for assessing or investigating the report, and of 307.31 the local law enforcement agency for investigating the alleged 307.32 abuse or neglect includes, but is not limited to, authority to 307.33 interview, without parental consent, the alleged victim and any 307.34 other minors who currently reside with or who have resided with 307.35 the alleged offender. The interview may take place at school or 307.36 at any facility or other place where the alleged victim or other 308.1 minors might be found or the child may be transported to, and 308.2 the interview conducted at, a place appropriate for the 308.3 interview of a child designated by the local welfare agency or 308.4 law enforcement agency. The interview may take place outside 308.5 the presence of the alleged offender or parent, legal custodian, 308.6 guardian, or school official. Except as provided in this 308.7 paragraph, the parent, legal custodian, or guardian shall be 308.8 notified by the responsible local welfare or law enforcement 308.9 agency no later than the conclusion of the investigation or 308.10 assessment that this interview has occurred. Notwithstanding 308.11 rule 49.02 of the Minnesota rules of procedure for juvenile 308.12 courts, the juvenile court may, after hearing on an ex parte 308.13 motion by the local welfare agency, order that, where reasonable 308.14 cause exists, the agency withhold notification of this interview 308.15 from the parent, legal custodian, or guardian. If the interview 308.16 took place or is to take place on school property, the order 308.17 shall specify that school officials may not disclose to the 308.18 parent, legal custodian, or guardian the contents of the 308.19 notification of intent to interview the child on school 308.20 property, as provided under this paragraph, and any other 308.21 related information regarding the interview that may be a part 308.22 of the child's school record. A copy of the order shall be sent 308.23 by the local welfare or law enforcement agency to the 308.24 appropriate school official. 308.25 (d) When the local welfare, local law enforcement agency, 308.26 or the agency responsible for assessing or investigating a 308.27 report of maltreatment determines that an interview should take 308.28 place on school property, written notification of intent to 308.29 interview the child on school property must be received by 308.30 school officials prior to the interview. The notification shall 308.31 include the name of the child to be interviewed, the purpose of 308.32 the interview, and a reference to the statutory authority to 308.33 conduct an interview on school property. For interviews 308.34 conducted by the local welfare agency, the notification shall be 308.35 signed by the chair of the local social services agency or the 308.36 chair's designee. The notification shall be private data on 309.1 individuals subject to the provisions of this paragraph. School 309.2 officials may not disclose to the parent, legal custodian, or 309.3 guardian the contents of the notification or any other related 309.4 information regarding the interview until notified in writing by 309.5 the local welfare or law enforcement agency that the 309.6 investigation or assessment has been concluded, unless a school 309.7 employee or agent is alleged to have maltreated the child. 309.8 Until that time, the local welfare or law enforcement agency or 309.9 the agency responsible for assessing or investigating a report 309.10 of maltreatment shall be solely responsible for any disclosures 309.11 regarding the nature of the assessment or investigation. 309.12 Except where the alleged offender is believed to be a 309.13 school official or employee, the time and place, and manner of 309.14 the interview on school premises shall be within the discretion 309.15 of school officials, but the local welfare or law enforcement 309.16 agency shall have the exclusive authority to determine who may 309.17 attend the interview. The conditions as to time, place, and 309.18 manner of the interview set by the school officials shall be 309.19 reasonable and the interview shall be conducted not more than 24 309.20 hours after the receipt of the notification unless another time 309.21 is considered necessary by agreement between the school 309.22 officials and the local welfare or law enforcement agency. 309.23 Where the school fails to comply with the provisions of this 309.24 paragraph, the juvenile court may order the school to comply. 309.25 Every effort must be made to reduce the disruption of the 309.26 educational program of the child, other students, or school 309.27 staff when an interview is conducted on school premises. 309.28 (e) Where the alleged offender or a person responsible for 309.29 the care of the alleged victim or other minor prevents access to 309.30 the victim or other minor by the local welfare agency, the 309.31 juvenile court may order the parents, legal custodian, or 309.32 guardian to produce the alleged victim or other minor for 309.33 questioning by the local welfare agency or the local law 309.34 enforcement agency outside the presence of the alleged offender 309.35 or any person responsible for the child's care at reasonable 309.36 places and times as specified by court order. 310.1 (f) Before making an order under paragraph (e), the court 310.2 shall issue an order to show cause, either upon its own motion 310.3 or upon a verified petition, specifying the basis for the 310.4 requested interviews and fixing the time and place of the 310.5 hearing. The order to show cause shall be served personally and 310.6 shall be heard in the same manner as provided in other cases in 310.7 the juvenile court. The court shall consider the need for 310.8 appointment of a guardian ad litem to protect the best interests 310.9 of the child. If appointed, the guardian ad litem shall be 310.10 present at the hearing on the order to show cause. 310.11 (g) The commissioner of human services, the ombudsman for 310.12 mental health and mental retardation, the local welfare agencies 310.13 responsible for investigating reports, the commissioner of 310.14 children, families, and learning, and the local law enforcement 310.15 agencies have the right to enter facilities as defined in 310.16 subdivision 2 and to inspect and copy the facility's records, 310.17 including medical records, as part of the investigation. 310.18 Notwithstanding the provisions of chapter 13, they also have the 310.19 right to inform the facility under investigation that they are 310.20 conducting an investigation, to disclose to the facility the 310.21 names of the individuals under investigation for abusing or 310.22 neglecting a child, and to provide the facility with a copy of 310.23 the report and the investigative findings. 310.24 (h) The local welfare agency or the agency responsible for 310.25 assessing or investigating the report shall collect available 310.26 and relevant information to ascertain whether maltreatment 310.27 occurred and whether protective services are needed. 310.28 Information collected includes, when relevant, information with 310.29 regard to the person reporting the alleged maltreatment, 310.30 including the nature of the reporter's relationship to the child 310.31 and to the alleged offender, and the basis of the reporter's 310.32 knowledge for the report; the child allegedly being maltreated; 310.33 the alleged offender; the child's caretaker; and other 310.34 collateral sources having relevant information related to the 310.35 alleged maltreatment. The local welfare agency or the agency 310.36 responsible for assessing or investigating the report may make a 311.1 determination of no maltreatment early in an assessment, and 311.2 close the case and retain immunity, if the collected information 311.3 shows no basis for a full assessment or investigation. 311.4 Information relevant to the assessment or investigation 311.5 must be asked for, and may include: 311.6 (1) the child's sex and age, prior reports of maltreatment, 311.7 information relating to developmental functioning, credibility 311.8 of the child's statement, and whether the information provided 311.9 under this clause is consistent with other information collected 311.10 during the course of the assessment or investigation; 311.11 (2) the alleged offender's age, a record check for prior 311.12 reports of maltreatment, and criminal charges and convictions. 311.13 The local welfare agency or the agency responsible for assessing 311.14 or investigating the report must provide the alleged offender 311.15 with an opportunity to make a statement. The alleged offender 311.16 may submit supporting documentation relevant to the assessment 311.17 or investigation; 311.18 (3) collateral source information regarding the alleged 311.19 maltreatment and care of the child. Collateral information 311.20 includes, when relevant: (i) a medical examination of the 311.21 child; (ii) prior medical records relating to the alleged 311.22 maltreatment or the care of the child maintained by any 311.23 facility, clinic, or health care professional and an interview 311.24 with the treating professionals; and (iii) interviews with the 311.25 child's caretakers, including the child's parent, guardian, 311.26 foster parent, child care provider, teachers, counselors, family 311.27 members, relatives, and other persons who may have knowledge 311.28 regarding the alleged maltreatment and the care of the child; 311.29 and 311.30 (4) information on the existence of domestic abuse and 311.31 violence in the home of the child, and substance abuse. 311.32 Nothing in this paragraph precludes the local welfare 311.33 agency, the local law enforcement agency, or the agency 311.34 responsible for assessing or investigating the report from 311.35 collecting other relevant information necessary to conduct the 311.36 assessment or investigation. Notwithstanding section 13.384 or 312.1 144.335, the local welfare agency has access to medical data and 312.2 records for purposes of clause (3). Notwithstanding the data's 312.3 classification in the possession of any other agency, data 312.4 acquired by the local welfare agency or the agency responsible 312.5 for assessing or investigating the report during the course of 312.6 the assessment or investigation are private data on individuals 312.7 and must be maintained in accordance with subdivision 11. Data 312.8 of the commissioner of children, families, and learning 312.9 collected or maintained during and for the purpose of an 312.10 investigation of alleged maltreatment in a school are governed 312.11 by this section, notwithstanding the data's classification as 312.12 educational, licensing, or personnel data under chapter 13. 312.13 In conducting an assessment or investigation involving a 312.14 school facility as defined in subdivision 2, paragraph (f), the 312.15 commissioner of children, families, and learning shall collect 312.16 investigative reports and data that are relevant to a report of 312.17 maltreatment and are from local law enforcement and the school 312.18 facility. 312.19 (i) In the initial stages of an assessment or 312.20 investigation, the local welfare agency shall conduct a 312.21 face-to-face observation of the child reported to be maltreated 312.22 and a face-to-face interview of the alleged offender. The 312.23 interview with the alleged offender may be postponed if it would 312.24 jeopardize an active law enforcement investigation. 312.25 (j) The local welfare agency shall use a question and 312.26 answer interviewing format with questioning as nondirective as 312.27 possible to elicit spontaneous responses. The following 312.28 interviewing methods and procedures must be used whenever 312.29 possible when collecting information: 312.30 (1) audio recordings of all interviews with witnesses and 312.31 collateral sources; and 312.32 (2) in cases of alleged sexual abuse, audio-video 312.33 recordings of each interview with the alleged victim and child 312.34 witnesses. 312.35 (k) In conducting an assessment or investigation involving 312.36 a school facility as defined in subdivision 2, paragraph (f), 313.1 the commissioner of children, families, and learning shall 313.2 collect available and relevant information and use the 313.3 procedures in paragraphs (h), (i), and (j), provided that the 313.4 commissioner may also base the assessment or investigation on 313.5 investigative reports and data received from the school facility 313.6 and local law enforcement, to the extent those investigations 313.7 satisfy the requirements of paragraphs (h), (i), and (j). 313.8 Sec. 3. Minnesota Statutes 2000, section 626.556, 313.9 subdivision 10d, as amended by Laws 2001, chapter 178, article 313.10 2, section 13, is amended to read: 313.11 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 313.12 (a) When a report is received that alleges neglect, physical 313.13 abuse,orsexual abuse, or maltreatment of a child while in the 313.14 care of a licensed or unlicensed day care facility, residential 313.15 facility, agency, hospital, sanitarium, or other facility or 313.16 institution required to be licensed according to sections 144.50 313.17 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B, or a 313.18 school as defined in sections 120A.05, subdivisions 9, 11, and 313.19 13; and 124D.10; or a nonlicensed personal care provider 313.20 organization as defined in section 256B.04, subdivision 16, and 313.21 256B.0625, subdivision 19a, the commissioner of the agency 313.22 responsible for assessing or investigating the report or local 313.23 welfare agency investigating the report shall provide the 313.24 following information to the parent, guardian, or legal 313.25 custodian of a child alleged to have been neglected, physically 313.26 abused,orsexually abused, or the victim of maltreatment of a 313.27 child in the facility: the name of the facility; the fact that 313.28 a report alleging neglect, physical abuse,orsexual abuse, or 313.29 maltreatment of a child in the facility has been received; the 313.30 nature of the alleged neglect, physical abuse,orsexual abuse, 313.31 or maltreatment of a child in the facility; that the agency is 313.32 conducting an assessment or investigation; any protective or 313.33 corrective measures being taken pending the outcome of the 313.34 investigation; and that a written memorandum will be provided 313.35 when the investigation is completed. 313.36 (b) The commissioner of the agency responsible for 314.1 assessing or investigating the report or local welfare agency 314.2 may also provide the information in paragraph (a) to the parent, 314.3 guardian, or legal custodian of any other child in the facility 314.4 if the investigative agency knows or has reason to believe the 314.5 alleged neglect, physical abuse,orsexual abuse, or 314.6 maltreatment of a child in the facility has occurred. In 314.7 determining whether to exercise this authority, the commissioner 314.8 of the agency responsible for assessing or investigating the 314.9 report or local welfare agency shall consider the seriousness of 314.10 the alleged neglect, physical abuse,orsexual abuse, or 314.11 maltreatment of a child in the facility; the number of children 314.12 allegedly neglected, physically abused,orsexually abused, or 314.13 victims of maltreatment of a child in the facility; the number 314.14 of alleged perpetrators; and the length of the investigation. 314.15 The facility shall be notified whenever this discretion is 314.16 exercised. 314.17 (c) When the commissioner of the agency responsible for 314.18 assessing or investigating the report or local welfare agency 314.19 has completed its investigation, every parent, guardian, or 314.20 legal custodian previously notified of the investigation by the 314.21 commissioner or local welfare agency shall be provided with the 314.22 following information in a written memorandum: the name of the 314.23 facility investigated; the nature of the alleged neglect, 314.24 physical abuse,orsexual abuse, or maltreatment of a child in 314.25 the facility; the investigator's name; a summary of the 314.26 investigation findings; a statement whether maltreatment was 314.27 found; and the protective or corrective measures that are being 314.28 or will be taken. The memorandum shall be written in a manner 314.29 that protects the identity of the reporter and the child and 314.30 shall not contain the name, or to the extent possible, reveal 314.31 the identity of the alleged perpetrator or of those interviewed 314.32 during the investigation. If maltreatment is determined to 314.33 exist, the commissioner or local welfare agency shall also 314.34 provide the written memorandum to the parent, guardian, or legal 314.35 custodian of each child in the facilityif maltreatment is314.36determined to existwho had contact with the individual 315.1 responsible for the maltreatment. When the facility is the 315.2 responsible party for maltreatment, the commissioner or local 315.3 welfare agency shall also provide the written memorandum to the 315.4 parent, guardian, or legal custodian of each child who received 315.5 services in the population of the facility where the 315.6 maltreatment occurred. This notification must be provided to 315.7 the parent, guardian, or legal custodian of each child receiving 315.8 services from the time the maltreatment occurred until either 315.9 the individual responsible for maltreatment is no longer in 315.10 contact with a child or children in the facility or the 315.11 conclusion of the investigation. In the case of maltreatment 315.12 within a school facility, as defined in sections 120A.05, 315.13 subdivisions 9, 11, and 13, and 124D.10, the commissioner of 315.14 children, families, and learning need not provide notification 315.15 to parents, guardians, or legal custodians of each child in the 315.16 facility, but may provide notification to the parent, guardian, 315.17 or legal custodian of any student alleged to have been 315.18 maltreated or involved as a witness to alleged maltreatment. 315.19 Sec. 4. Minnesota Statutes 2000, section 626.556, 315.20 subdivision 12, is amended to read: 315.21 Subd. 12. [DUTIES OF FACILITY OPERATORS.] Any operator, 315.22 employee, or volunteer worker at any facility who intentionally 315.23 neglects, physically abuses, or sexually abuses any child in the 315.24 care of that facility may be charged with a violation of section 315.25 609.255, 609.377, or 609.378. Any operator of a facility who 315.26 knowingly permits conditions to exist which result in neglect, 315.27 physical abuse,orsexual abuse, or maltreatment of a child in a 315.28 facility while in the care of that facility may be charged with 315.29 a violation of section 609.378. The facility operator shall 315.30 inform all mandated reporters employed by or otherwise 315.31 associated with the facility of the duties required of mandated 315.32 reporters and shall inform all mandatory reporters of the 315.33 prohibition against retaliation for reports made in good faith 315.34 under this section. 315.35 Sec. 5. Minnesota Statutes 2000, section 626.559, 315.36 subdivision 2, is amended to read: 316.1 Subd. 2. [JOINT TRAINING.] The commissioners of human 316.2 services and public safety shall cooperate in the development of 316.3 a joint program for training child abuse services professionals 316.4 in the appropriate techniques for child abuse assessment and 316.5 investigation. The program shall include but need not be 316.6 limited to the following areas: 316.7 (1) the public policy goals of the state as set forth in 316.8 section 260C.001 and the role of the assessment or investigation 316.9 in meeting these goals; 316.10 (2) the special duties of child protection workers and law 316.11 enforcement officers under section 626.556; 316.12 (3) the appropriate methods for directing and managing 316.13 affiliated professionals who may be utilized in providing 316.14 protective services and strengthening family ties; 316.15 (4) the appropriate methods for interviewing alleged 316.16 victims of child abuse and other minors in the course of 316.17 performing an assessment or an investigation; 316.18 (5) the dynamics of child abuse and neglect within family 316.19 systems and the appropriate methods for interviewing parents in 316.20 the course of the assessment or investigation, including 316.21 training in recognizing cases in which one of the parents is a 316.22 victim of domestic abuse and in need of special legal or medical 316.23 services; 316.24 (6) the legal, evidentiary considerations that may be 316.25 relevant to the conduct of an assessment or an investigation; 316.26 (7) the circumstances under which it is appropriate to 316.27 remove the alleged abuser or the alleged victim from the home; 316.28 (8) the protective social services that are available to 316.29 protect alleged victims from further abuse, to prevent child 316.30 abuse and domestic abuse, and to preserve the family unit, and 316.31 training in the preparation of case plans to coordinate services 316.32 for the alleged child abuse victim with services for any parents 316.33 who are victims of domestic abuse;and316.34 (9) the methods by which child protection workers and law 316.35 enforcement workers cooperate in conducting assessments and 316.36 investigations in order to avoid duplication of efforts; and 317.1 (10) appropriate methods for interviewing alleged victims 317.2 of child abuse and conducting investigations in cases where the 317.3 alleged victim is developmentally, physically, or mentally 317.4 disabled. 317.5 Sec. 6. [CHILD WELFARE COST CONSOLIDATION REPORT.] 317.6 By January 15, 2002, the commissioner of human services 317.7 shall report to the chairs and ranking minority members of 317.8 appropriate legislative committees the feasibility and cost of 317.9 creating a single benefit package for all children removed from 317.10 the care of a parent or guardian pursuant to a court order under 317.11 Minnesota Statutes, chapter 260C, regardless of a particular 317.12 child's legal status. Legal status includes any placement away 317.13 from the parent or guardian, including foster or other 317.14 residential care, guardianship with the commissioner, adoption, 317.15 or legal custody with a relative except a birth or adoptive 317.16 parent. The report shall be prepared after consultation with 317.17 public and private child-placing agencies, foster and adoptive 317.18 parents, relatives who are legal custodians, judges, county 317.19 attorneys, attorneys for children and parents, guardians ad 317.20 litem, representatives of the councils on Asian-Pacific, African 317.21 American, American Indian, and Spanish-speaking Minnesotans, and 317.22 other appropriate child protection system stakeholders. The 317.23 benefit package addressed in the report shall include the cost 317.24 of room and board, additional monthly payments associated with 317.25 special efforts a caretaker must make or special skills or 317.26 training a caretaker must have in order to adequately address 317.27 the daily needs of the child, the availability of respite care, 317.28 and any other costs associated with safely maintaining a 317.29 particular child in a legally secure home and adequately 317.30 addressing any special needs the child may have. 317.31 Sec. 7. [STUDY OF OUTCOMES FOR CHILDREN IN THE CHILD 317.32 PROTECTION SYSTEM.] 317.33 (a) The commissioner of human services, in consultation 317.34 with local social services agencies, councils of color, 317.35 representatives of communities of color, child advocates, 317.36 representatives of courts, and other interested parties, shall 318.1 study why African American children in Minnesota are 318.2 disproportionately represented in child welfare out-of-home 318.3 placements. The commissioner also shall study each stage of the 318.4 proceedings concerning children in need of protection or 318.5 services, including the point at which children enter the child 318.6 welfare system, each decision-making point in the child welfare 318.7 system, and the outcomes for children in the child welfare 318.8 system, to determine why outcomes for children differ by race. 318.9 The commissioner shall use child welfare performance and outcome 318.10 indicators and data and other available data as part of this 318.11 study. The commissioner also shall study and determine if there 318.12 are decision-making points in the child protection system that 318.13 lead to different outcomes for children and how those 318.14 decision-making points affect outcomes for children. The 318.15 commissioner shall report and make legislative recommendations 318.16 on the following: 318.17 (1) amend the child protection statutes to reduce any 318.18 identified disparities in the child protection system relating 318.19 to outcomes for children of color, as compared to white 318.20 children; 318.21 (2) reduce any identified bias in the child protection 318.22 system; 318.23 (3) reduce the number and duration of out-of-home 318.24 placements for African American children; and 318.25 (4) improve the long-term outcomes for African American 318.26 children in out-of-home placements. 318.27 (b) The commissioner of human services shall submit the 318.28 report and recommended legislation to the chairs and ranking 318.29 minority members of the committees in the house of 318.30 representatives and senate with jurisdiction over child 318.31 protection and out-of-home placement issues by January 15, 2002. 318.32 ARTICLE 12 318.33 CHILD SUPPORT 318.34 Section 1. Minnesota Statutes 2000, section 13B.06, 318.35 subdivision 7, is amended to read: 318.36 Subd. 7. [FEES.] A financial institution may charge and 319.1 collect a fee from the public authority for providing account 319.2 information to the public authority. The commissioner may pay a 319.3 financial institution up to $150 each quarter if the 319.4 commissioner and the financial institution have entered into a 319.5 signed agreement that complies with federal law. The 319.6 commissioner shall develop procedures for the financial 319.7 institutions to charge and collect the fee. Payment of the fee 319.8 is limited by the amount of the appropriation for this purpose. 319.9 If the appropriation is insufficient, or if fund availability in 319.10 the fourth quarter would allow payments for actual costs in 319.11 excess of $150, the commissioner shall prorate the available 319.12 funds among the financial institutions that have submitted a 319.13 claim for the fee. No financial institution shall charge or 319.14 collect a fee that exceeds its actual costs of complying with 319.15 this section. The commissioner, together with an advisory group 319.16 consisting of representatives of the financial institutions in 319.17 the state, shalldetermine a fee structure that minimizes the319.18cost to the state and reasonably meets the needs of the319.19financial institutions, and shall report to the chairs of the319.20judiciary committees in the house of representatives and the319.21senate by February 1, 1998, a recommended fee structure for319.22inclusion in this sectionevaluate whether the fee paid to 319.23 financial institutions compensates them for their actual costs, 319.24 including start-up costs, of complying with this section and 319.25 shall submit a report to the legislature by July 1, 2002, with a 319.26 recommendation for retaining or modifying the fee. 319.27 Sec. 2. Minnesota Statutes 2000, section 256.741, 319.28 subdivision 1, is amended to read: 319.29 Subdivision 1. [PUBLIC ASSISTANCE.] (a) The term "direct 319.30 support" as used in this chapter and chapters 257, 518, and 518C 319.31 refers to an assigned support payment from an obligor which is 319.32 paid directly to a recipient of TANF or MFIP. 319.33 (b) The term "public assistance" as used in this chapter 319.34 and chapters 257, 518, and 518C, includes any form of assistance 319.35 provided under the AFDC program formerly codified in sections 319.36 256.72 to 256.87, MFIP and MFIP-R formerly codified under 320.1 chapter 256, MFIP under chapter 256J, work first program under 320.2 chapter 256K; child care assistance provided through the child 320.3 care fund under chapter 119B; any form of medical assistance 320.4 under chapter 256B; MinnesotaCare under chapter 256L; and foster 320.5 care as provided under title IV-E of the Social Security Act. 320.6(b)(c) The term "child support agency" as used in this 320.7 section refers to the public authority responsible for child 320.8 support enforcement. 320.9(c)(d) The term "public assistance agency" as used in this 320.10 section refers to a public authority providing public assistance 320.11 to an individual. 320.12 Sec. 3. Minnesota Statutes 2000, section 256.741, 320.13 subdivision 5, is amended to read: 320.14 Subd. 5. [COOPERATION WITH CHILD SUPPORT ENFORCEMENT.] 320.15 After notification from a public assistance agency that an 320.16 individual has applied for or is receiving any form of public 320.17 assistance, the child support agency shall determine whether the 320.18 party is cooperating with the agency in establishing paternity, 320.19 child support, modification of an existing child support order, 320.20 or enforcement of an existing child support order. The public 320.21 assistance agency shall notify each applicant or recipient in 320.22 writing of the right to claim a good cause exemption from 320.23 cooperating with the requirements in this section. A copy of 320.24 the notice must be furnished to the applicant or recipient, and 320.25 the applicant or recipient and a representative from the public 320.26 authority shall acknowledge receipt of the notice by signing and 320.27 dating a copy of the notice. The individual shall cooperate 320.28 with the child support agency by: 320.29 (1) providing all known information regarding the alleged 320.30 father or obligor, including name, address, social security 320.31 number, telephone number, place of employment or school, and the 320.32 names and addresses of any relatives; 320.33 (2) appearing at interviews, hearings and legal 320.34 proceedings; 320.35 (3) submitting to genetic tests including genetic testing 320.36 of the child, under a judicial or administrative order; and 321.1 (4) providing additional information known by the 321.2 individual as necessary for cooperating in good faith with the 321.3 child support agency. 321.4 The caregiver of a minor child must cooperate with the 321.5 efforts of the public authority to collect support according to 321.6 this subdivision. A caregiver mustforward tonotify the public 321.7 authority of all support the caregiver receives during the 321.8 period the assignment of support required under subdivision 2 is 321.9 in effect.Support received by a caregiver and not forwarded to321.10the public authority must be repaid to the child support321.11enforcement unit for any month following the date on which321.12initial eligibility is determinedDirect support retained by a 321.13 caregiver must be counted as unearned income when determining 321.14 the amount of the assistance payment,except as provided under321.15subdivision 8, paragraph (b), clause (4)and repaid to the child 321.16 support agency for any month when the direct support retained is 321.17 greater than the court-ordered child support and the assistance 321.18 payment and the obligor owes support arrears. 321.19 Sec. 4. Minnesota Statutes 2000, section 256.741, 321.20 subdivision 8, is amended to read: 321.21 Subd. 8. [REFUSAL TO COOPERATE WITH SUPPORT REQUIREMENTS.] 321.22 (a) Failure by a caregiver to satisfy any of the requirements of 321.23 subdivision 5 constitutes refusal to cooperate, and the 321.24 sanctions under paragraph (b) apply. The IV-D agency must 321.25 determine whether a caregiver has refused to cooperate according 321.26 to subdivision 5. 321.27 (b) Determination by the IV-D agency that a caregiver has 321.28 refused to cooperate has the following effects: 321.29 (1) a caregiver is subject to the applicable sanctions 321.30 under section 256J.46; 321.31 (2) a caregiver who is not a parent of a minor child in an 321.32 assistance unit may choose to remove the child from the 321.33 assistance unit unless the child is required to be in the 321.34 assistance unit; and 321.35 (3) a parental caregiver who refuses to cooperate is 321.36 ineligible for medical assistance; and322.1(4) direct support retained by a caregiver must be counted322.2as unearned income when determining the amount of the assistance322.3payment. 322.4 Sec. 5. Minnesota Statutes 2000, section 256.979, 322.5 subdivision 5, is amended to read: 322.6 Subd. 5. [PATERNITY ESTABLISHMENT AND CHILD SUPPORT ORDER 322.7 ESTABLISHMENT AND MODIFICATION BONUS INCENTIVES.] (a) A bonus 322.8 incentive program is created to increase the number of paternity 322.9 establishments and establishment and modifications of child 322.10 support orders done by county child support enforcement agencies. 322.11 (b) A bonus must be awarded to a county child support 322.12 agency for eachcasechild for which the agency completes a 322.13 paternity or child support order establishment or modification 322.14 through judicial or administrative processes. 322.15 (c) The rate of bonus incentive is $100 per child for each 322.16 paternity or child support order establishment and modification 322.17 set in a specific dollar amount. 322.18 (d) No bonus shall be paid for a modification that is a 322.19 result of a termination of child care costs according to section 322.20 518.551, subdivision 5, paragraph (b), or due solely to a 322.21 reduction of child care expenses. 322.22 Sec. 6. Minnesota Statutes 2000, section 256.979, 322.23 subdivision 6, is amended to read: 322.24 Subd. 6. [CLAIMS FOR BONUS INCENTIVE.] (a) The 322.25 commissioner of human services and the county agency shall 322.26 develop procedures for the claims process and criteria using 322.27 automated systems where possible. 322.28 (b) Only one county agency may receive a bonus per 322.29 paternity establishment or child support order establishment or 322.30 modification for eachcasechild. The county agency completing 322.31 the action or procedure needed to establish paternity or a child 322.32 support order or modify an order is the county agency entitled 322.33 to claim the bonus incentive. 322.34 (c) Disputed claims must be submitted to the commissioner 322.35 of human services and the commissioner's decision is final. 322.36(d) For purposes of this section, "case" means a family323.1unit for whom the county agency is providing child support323.2enforcement services.323.3 Sec. 7. Minnesota Statutes 2000, section 393.07, is 323.4 amended by adding a subdivision to read: 323.5 Subd. 9a. [ADMINISTRATIVE PENALTIES.] (a) The public 323.6 authority, as defined in section 518.54, may sanction an 323.7 employer or payor of funds $25 per day, up to $500 per incident, 323.8 for failing to comply with section 518.5513, subdivision 5, 323.9 paragraph (a), clauses (5) and (8), if: 323.10 (1) the public authority mails the employer or payor of 323.11 funds by certified mail a notice of an administrative sanction, 323.12 at the employer's or payor's of funds last known address, which 323.13 includes the date the sanction will take effect, the amount of 323.14 the sanction, the reason for imposing the sanction, and the 323.15 corrective action that must be taken to avoid the sanction; and 323.16 (2) the employer or payor of funds fails to correct the 323.17 violation before the effective date of the sanction. 323.18 (b) The public authority shall include with the sanction 323.19 notice an additional notice of the right to appeal the sanction 323.20 and the process for making the appeal. 323.21 (c) Unless an appeal is made, the administrative 323.22 determination of the sanction is final and binding. 323.23 Sec. 8. Minnesota Statutes 2000, section 518.5513, 323.24 subdivision 5, is amended to read: 323.25 Subd. 5. [ADMINISTRATIVE AUTHORITY.] (a) The public 323.26 authority may take the following actions relating to 323.27 establishment of paternity or to establishment, modification, or 323.28 enforcement of support orders, without the necessity of 323.29 obtaining an order from any judicial or administrative tribunal: 323.30 (1) recognize and enforce orders of child support agencies 323.31 of other states; 323.32 (2) upon request for genetic testing by a child, parent, or 323.33 any alleged parent, and using the procedure in paragraph (b), 323.34 order the child, parent, or alleged parent to submit to blood or 323.35 genetic testing for the purpose of establishing paternity; 323.36 (3) subpoena financial or other information needed to 324.1 establish, modify, or enforce a child support order andrequest324.2sanctionssanction a party for failure to respond to a subpoena; 324.3 (4) upon notice to the obligor, obligee, and the 324.4 appropriate court, direct the obligor or other payor to change 324.5 the payee to the central collections unit under sections 324.6 518.5851 to 518.5853; 324.7 (5) order income withholding of child support under section 324.8 518.6111 and sanction an employer or payor of funds pursuant to 324.9 section 393.07, subdivision 9a, for failing to comply with an 324.10 income withholding notice; 324.11 (6) secure assets to satisfy the debt or arrearage in cases 324.12 in which there is a support debt or arrearage by: 324.13 (i) intercepting or seizing periodic or lump sum payments 324.14 from state or local agencies, including unemployment benefits, 324.15 workers' compensation payments, judgments, settlements, 324.16 lotteries, and other lump sum payments; 324.17 (ii) attaching and seizing assets of the obligor held in 324.18 financial institutions or public or private retirement funds; 324.19 and 324.20 (iii) imposing liens in accordance with section 548.091 324.21 and, in appropriate cases, forcing the sale of property and the 324.22 distribution of proceeds; 324.23 (7) for the purpose of securing overdue support, increase 324.24 the amount of the monthly support payments by an additional 324.25 amount equal to 20 percent of the monthly support payment to 324.26 include amounts for debts or arrearages; and 324.27 (8) subpoena an employer or payor of funds to provide 324.28 promptly information on the employment, compensation, and 324.29 benefits of an individual employed by that employer as an 324.30 employee or contractor, andto request sanctionssanction an 324.31 employer or payor of funds pursuant to section 393.07, 324.32 subdivision 9a, for failure to respond to the subpoenaas324.33provided by law. 324.34 (b) A request for genetic testing by a child, parent, or 324.35 alleged parent must be supported by a sworn statement by the 324.36 person requesting genetic testing alleging paternity, which sets 325.1 forth facts establishing a reasonable possibility of the 325.2 requisite sexual contact between the parties, or denying 325.3 paternity, and setting forth facts establishing a reasonable 325.4 possibility of the nonexistence of sexual contact between the 325.5 alleged parties. The order for genetic tests may be served 325.6 anywhere within the state and served outside the state in the 325.7 same manner as prescribed by law for service of subpoenas issued 325.8 by the district court of this state. If the child, parent, or 325.9 alleged parent fails to comply with the genetic testing order, 325.10 the public authority may seek to enforce that order in district 325.11 court through a motion to compel testing. No results obtained 325.12 through genetic testing done in response to an order issued 325.13 under this section may be used in any criminal proceeding. 325.14 (c) Subpoenas may be served anywhere within the state and 325.15 served outside the state in the same manner as prescribed by law 325.16 for service of process of subpoenas issued by the district court 325.17 of this state. When a subpoena under this subdivision is served 325.18 on a third-party recordkeeper, written notice of the subpoena 325.19 shall be mailed to the person who is the subject of the 325.20 subpoenaed material at the person's last known address within 325.21 three days of the day the subpoena is served. This notice 325.22 provision does not apply if there is reasonable cause to believe 325.23 the giving of the notice may lead to interference with the 325.24 production of the subpoenaed documents. 325.25 (d) A person served with a subpoena may make a written 325.26 objection to the public authority or court before the time 325.27 specified in the subpoena for compliance. The public authority 325.28 or the court shall cancel or modify the subpoena, if 325.29 appropriate. The public authority shall pay the reasonable 325.30 costs of producing the documents, if requested. 325.31 (e) Subpoenas are enforceable in the same manner as 325.32 subpoenas of the district court. Upon motion of the county 325.33 attorney, the court may issue an order directing the production 325.34 of the records. Failure to comply with the court order may 325.35 subject the person who fails to comply to civil or criminal 325.36 contempt of court. 326.1 (f) The administrative actions under this subdivision are 326.2 subject to due process safeguards, including requirements for 326.3 notice, opportunity to contest the action, and opportunity to 326.4 appeal the order to the judge, judicial officer, or child 326.5 support magistrate. 326.6 Sec. 9. Minnesota Statutes 2000, section 518.575, 326.7 subdivision 1, is amended to read: 326.8 Subdivision 1. [MAKING NAMES PUBLIC.] At least once each 326.9 year, the commissioner of human services, in consultation with 326.10 the attorney general,shallmay publish a list of the names and 326.11 other identifying information of no more than 25 persons who (1) 326.12 are child support obligors, (2) are at least $10,000 in arrears, 326.13 (3) are not in compliance with a written payment agreement 326.14 regarding both current support and arrearages approved by the 326.15 court, a child support magistrate, or the public authority, (4) 326.16 cannot currently be located by the public authority for the 326.17 purposes of enforcing a support order, and (5) have not made a 326.18 support payment except tax intercept payments, in the preceding 326.19 12 months. 326.20 Identifying information may include the obligor's name, 326.21 last known address, amount owed, date of birth, photograph, the 326.22 number of children for whom support is owed, and any additional 326.23 information about the obligor that would assist in identifying 326.24 or locating the obligor. The commissioner and attorney general 326.25 may use posters, media presentations, electronic technology, and 326.26 other means that the commissioner and attorney general determine 326.27 are appropriate for dissemination of the information, including 326.28 publication on the Internet. The commissioner and attorney 326.29 general may make any or all of the identifying information 326.30 regarding these persons public. Information regarding an 326.31 obligor who meets the criteria in this subdivision will only be 326.32 made public subsequent to that person's selection by the 326.33 commissioner and attorney general. 326.34 Before making public the name of the obligor, the 326.35 department of human services shall send a notice to the 326.36 obligor's last known address which states the department's 327.1 intention to make public information on the obligor. The notice 327.2 must also provide an opportunity to have the obligor's name 327.3 removed from the list by paying the arrearage or by entering 327.4 into an agreement to pay the arrearage, or by providing 327.5 information to the public authority that there is good cause not 327.6 to make the information public. The notice must include the 327.7 final date when the payment or agreement can be accepted. 327.8 The department of human services shall obtain the written 327.9 consent of the obligee to make the name of the obligor public. 327.10 Sec. 10. Minnesota Statutes 2000, section 518.5851, is 327.11 amended by adding a subdivision to read: 327.12 Subd. 7. [UNCLAIMED SUPPORT FUNDS.] "Unclaimed support 327.13 funds" means any support payments collected by the public 327.14 authority from the obligor, which have not been disbursed to the 327.15 obligee or public authority. 327.16 Sec. 11. Minnesota Statutes 2000, section 518.5853, is 327.17 amended by adding a subdivision to read: 327.18 Subd. 12. [UNCLAIMED SUPPORT FUNDS.] (a) If support 327.19 payments have not been disbursed to an obligee because the 327.20 obligee is not located, the public authority shall continue 327.21 locate efforts for one year from the date the public authority 327.22 determines that the obligee is not located. 327.23 (b) If the public authority is unable to locate the obligee 327.24 after one year, the public authority shall mail a written notice 327.25 to the obligee at the obligee's last known address. The notice 327.26 shall give the obligee 60 days to contact the public authority. 327.27 If the obligee does not contact the public authority within 60 327.28 days from the date of notice, the public authority shall: 327.29 (1) close the nonpublic assistance portion of the case; 327.30 (2) disburse unclaimed support funds to pay public 327.31 assistance arrears. If public assistance arrears remain after 327.32 disbursing the unclaimed support funds, the public authority may 327.33 continue enforcement and collection of child support until all 327.34 public assistance arrears have been paid. If there are no 327.35 public assistance arrears, or unclaimed support funds remain 327.36 after paying public assistance arrears, remaining unclaimed 328.1 support funds shall be returned to the obligor; and 328.2 (3) mail, when all public assistance arrears have been paid 328.3 the public authority, to the obligor at the obligor's last known 328.4 address a written notice of termination of income withholding 328.5 and case closure due to the public authority's inability to 328.6 locate the obligee. The notice must indicate that the obligor's 328.7 support or maintenance obligation will remain in effect until 328.8 further order of the court and must inform the obligor that the 328.9 obligor can contact the public authority for assistance to 328.10 modify the order. A copy of the form prepared by the state 328.11 court administrator's office under section 518.64, subdivision 328.12 5, must be included with the notice. 328.13 (c) If the obligor is not located when attempting to return 328.14 unclaimed support funds, the public authority shall continue 328.15 locate efforts for one year from the date the public authority 328.16 determines that the obligor is not located. If the public 328.17 authority is unable to locate the obligor after one year, the 328.18 funds shall be treated as unclaimed property according to 328.19 federal law and chapter 345. 328.20 Sec. 12. Minnesota Statutes 2000, section 518.6111, 328.21 subdivision 5, is amended to read: 328.22 Subd. 5. [PAYOR OF FUNDS RESPONSIBILITIES.] (a) An order 328.23 for or notice of withholding is binding on a payor of funds upon 328.24 receipt. Withholding must begin no later than the first pay 328.25 period that occurs after 14 days following the date of receipt 328.26 of the order for or notice of withholding. In the case of a 328.27 financial institution, preauthorized transfers must occur in 328.28 accordance with a court-ordered payment schedule. 328.29 (b) A payor of funds shall withhold from the income payable 328.30 to the obligor the amount specified in the order or notice of 328.31 withholding and amounts specified under subdivisions 6 and 9 and 328.32 shall remit the amounts withheld to the public authority within 328.33 seven business days of the date the obligor is paid the 328.34 remainder of the income. The payor of funds shall include with 328.35 the remittance the social security number of the obligor, the 328.36 case type indicator as provided by the public authority and the 329.1 date the obligor is paid the remainder of the income. The 329.2 obligor is considered to have paid the amount withheld as of the 329.3 date the obligor received the remainder of the income. A payor 329.4 of funds may combine all amounts withheld from one pay period 329.5 into one payment to each public authority, but shall separately 329.6 identify each obligor making payment. 329.7 (c) A payor of funds shall not discharge, or refuse to 329.8 hire, or otherwise discipline an employee as a result of wage or 329.9 salary withholding authorized by this section. A payor of funds 329.10 shall be liable to the obligee for any amounts required to be 329.11 withheld. A payor of funds that fails to withhold or transfer 329.12 funds in accordance with this section is also liable to the 329.13 obligee for interest on the funds at the rate applicable to 329.14 judgments under section 549.09, computed from the date the funds 329.15 were required to be withheld or transferred. A payor of funds 329.16 is liable for reasonable attorney fees of the obligee or public 329.17 authority incurred in enforcing the liability under this 329.18 paragraph. A payor of funds that has failed to comply with the 329.19 requirements of this section is subject to contempt sanctions 329.20 under section 518.615. If the payor of funds is an employer or 329.21 independent contractor and violates this subdivision, a court 329.22 may award the obligor twice the wages lost as a result of this 329.23 violation. If a court finds a payor of funds violated this 329.24 subdivision, the court shall impose a civil fine of not less 329.25 than $500. The liabilities in this paragraph apply to 329.26 intentional noncompliance with this section. 329.27 (d) If a single employee is subject to multiple withholding 329.28 orders or multiple notices of withholding for the support of 329.29 more than one child, the payor of funds shall comply with all of 329.30 the orders or notices to the extent that the total amount 329.31 withheld from the obligor's income does not exceed the limits 329.32 imposed under the Consumer Credit Protection Act, United States 329.33 Code, title 15, section 1673(b), giving priority to amounts 329.34 designated in each order or notice as current support as follows: 329.35 (1) if the total of the amounts designated in the orders 329.36 for or notices of withholding as current support exceeds the 330.1 amount available for income withholding, the payor of funds 330.2 shall allocate to each order or notice an amount for current 330.3 support equal to the amount designated in that order or notice 330.4 as current support, divided by the total of the amounts 330.5 designated in the orders or notices as current support, 330.6 multiplied by the amount of the income available for income 330.7 withholding; and 330.8 (2) if the total of the amounts designated in the orders 330.9 for or notices of withholding as current support does not exceed 330.10 the amount available for income withholding, the payor of funds 330.11 shall pay the amounts designated as current support, and shall 330.12 allocate to each order or notice an amount for past due support, 330.13 equal to the amount designated in that order or notice as past 330.14 due support, divided by the total of the amounts designated in 330.15 the orders or notices as past due support, multiplied by the 330.16 amount of income remaining available for income withholding 330.17 after the payment of current support. 330.18 (e) When an order for or notice of withholding is in effect 330.19 and the obligor's employment is terminated, the obligor and the 330.20 payor of funds shall notify the public authority of the 330.21 termination within ten days of the termination date. The 330.22 termination notice shall include the obligor's home address and 330.23 the name and address of the obligor's new payor of funds, if 330.24 known. 330.25 (f) A payor of funds may deduct one dollar from the 330.26 obligor's remaining salary for each payment made pursuant to an 330.27 order for or notice of withholding under this section to cover 330.28 the expenses of withholding. 330.29 Sec. 13. Minnesota Statutes 2000, section 518.6195, is 330.30 amended to read: 330.31 518.6195 [COLLECTION; ARREARS ONLY.] 330.32 (a) Remedies available for the collection and enforcement 330.33 of support in this chapter and chapters 256, 257, and 518C also 330.34 apply to cases in which the child or children for whom support 330.35 is owed are emancipated and the obligor owes past support or has 330.36 an accumulated arrearage as of the date of the youngest child's 331.1 emancipation. Child support arrearages under this section 331.2 include arrearages for child support, medical support, child 331.3 care, pregnancy and birth expenses, and unreimbursed medical 331.4 expenses as defined in section 518.171. 331.5 (b) This section applies retroactively to any support 331.6 arrearage that accrued on or before the date of enactment and to 331.7 all arrearages accruing after the date of enactment. 331.8 (c) Past support or pregnancy and confinement expenses 331.9 ordered for which the obligor has specific court ordered terms 331.10 for repayment may not be enforced using drivers' and 331.11 occupational or professional license suspension, credit bureau 331.12 reporting, and additional income withholding under section 331.13 518.6111, subdivision 10, paragraph (a), unless the obligor 331.14 fails to comply with the terms of the court order for repayment. 331.15 (d) If an arrearage exists at the time a support order 331.16 would otherwise terminate and section 518.6111, subdivision 10, 331.17 paragraph (c), does not apply to this section, the arrearage 331.18 shall be repaid in an amount equal to the current support order 331.19 until all arrears have been paid in full, absent a court order 331.20 to the contrary. 331.21 (e) If an arrearage exists according to a support order 331.22 which fails to establish a monthly support obligation in a 331.23 specific dollar amount, the public authority, if it provides 331.24 child support services, or the obligee, may establish a payment 331.25 agreement which shall equal what the obligor would pay for 331.26 current support after application of section 518.551, plus an 331.27 additional 20 percent of the current support obligation, until 331.28 all arrears have been paid in full. If the obligor fails to 331.29 enter into or comply with a payment agreement, the public 331.30 authority, if it provides child support services, or the 331.31 obligee, may move the district court or child support 331.32 magistrate, if section 484.702 applies, for an order 331.33 establishing repayment terms. 331.34 Sec. 14. Minnesota Statutes 2000, section 518.64, 331.35 subdivision 2, as amended by Laws 2001, chapter 51, section 16, 331.36 is amended to read: 332.1 Subd. 2. [MODIFICATION.] (a) The terms of an order 332.2 respecting maintenance or support may be modified upon a showing 332.3 of one or more of the following: (1) substantially increased or 332.4 decreased earnings of a party; (2) substantially increased or 332.5 decreased need of a party or the child or children that are the 332.6 subject of these proceedings; (3) receipt of assistance under 332.7 the AFDC program formerly codified under sections 256.72 to 332.8 256.87 or 256B.01 to 256B.40, or chapter 256J or 256K; (4) a 332.9 change in the cost of living for either party as measured by the 332.10 federal bureau of statistics, any of which makes the terms 332.11 unreasonable and unfair; (5) extraordinary medical expenses of 332.12 the child not provided for under section 518.171; or (6) the 332.13 addition of work-related or education-related child care 332.14 expenses of the obligee or a substantial increase or decrease in 332.15 existing work-related or education-related child care expenses. 332.16 On a motion to modify support, the needs of any child the 332.17 obligor has after the entry of the support order that is the 332.18 subject of a modification motion shall be considered as provided 332.19 by section 518.551, subdivision 5f. 332.20 (b) It is presumed that there has been a substantial change 332.21 in circumstances under paragraph (a) and the terms of a current 332.22 support order shall be rebuttably presumed to be unreasonable 332.23 and unfair if: 332.24 (1) the application of the child support guidelines in 332.25 section 518.551, subdivision 5, to the current circumstances of 332.26 the parties results in a calculated court order that is at least 332.27 20 percent and at least $50 per month higher or lower than the 332.28 current support order; 332.29 (2) the medical support provisions of the order established 332.30 under section 518.171 are not enforceable by the public 332.31 authority or the obligee; 332.32 (3) health coverage ordered under section 518.171 is not 332.33 available to the child for whom the order is established by the 332.34 parent ordered to provide; or 332.35 (4) the existing support obligation is in the form of a 332.36 statement of percentage and not a specific dollar amount. 333.1 (c) On a motion for modification of maintenance, including 333.2 a motion for the extension of the duration of a maintenance 333.3 award, the court shall apply, in addition to all other relevant 333.4 factors, the factors for an award of maintenance under section 333.5 518.552 that exist at the time of the motion. On a motion for 333.6 modification of support, the court: 333.7 (1) shall apply section 518.551, subdivision 5, and shall 333.8 not consider the financial circumstances of each party's spouse, 333.9 if any; and 333.10 (2) shall not consider compensation received by a party for 333.11 employment in excess of a 40-hour work week, provided that the 333.12 party demonstrates, and the court finds, that: 333.13 (i) the excess employment began after entry of the existing 333.14 support order; 333.15 (ii) the excess employment is voluntary and not a condition 333.16 of employment; 333.17 (iii) the excess employment is in the nature of additional, 333.18 part-time employment, or overtime employment compensable by the 333.19 hour or fractions of an hour; 333.20 (iv) the party's compensation structure has not been 333.21 changed for the purpose of affecting a support or maintenance 333.22 obligation; 333.23 (v) in the case of an obligor, current child support 333.24 payments are at least equal to the guidelines amount based on 333.25 income not excluded under this clause; and 333.26 (vi) in the case of an obligor who is in arrears in child 333.27 support payments to the obligee, any net income from excess 333.28 employment must be used to pay the arrearages until the 333.29 arrearages are paid in full. 333.30 (d) A modification of support or maintenance, including 333.31 interest that accrued pursuant to section 548.091, may be made 333.32 retroactive only with respect to any period during which the 333.33 petitioning party has pending a motion for modification but only 333.34 from the date of service of notice of the motion on the 333.35 responding party and on the public authority if public 333.36 assistance is being furnished or the county attorney is the 334.1 attorney of record. However, modification may be applied to an 334.2 earlier period if the court makes express findings that: 334.3 (1) the party seeking modification was precluded from 334.4 serving a motion by reason of a significant physical or mental 334.5 disability, a material misrepresentation of another party, or 334.6 fraud upon the court and that the party seeking modification, 334.7 when no longer precluded, promptly served a motion; 334.8 (2) the party seeking modification was a recipient of 334.9 federal Supplemental Security Income (SSI), Title II Older 334.10 Americans, Survivor's Disability Insurance (OASDI), other 334.11 disability benefits, or public assistance based upon need during 334.12 the period for which retroactive modification is sought;or334.13 (3) the order for which the party seeks amendment was 334.14 entered by default, the party shows good cause for not 334.15 appearing, and the record contains no factual evidence, or 334.16 clearly erroneous evidence regarding the individual obligor's 334.17 ability to pay.; or 334.18 (4) the party seeking modification was institutionalized or 334.19 incarcerated for an offense other than nonsupport of a child 334.20 during the period for which retroactive modification is sought 334.21 and lacked the financial ability to pay the support ordered 334.22 during that time period. In determining whether to allow the 334.23 retroactive modification, the court shall consider whether and 334.24 when a request was made to the public authority for support 334.25 modification. 334.26 The court may provide that a reduction in the amount allocated 334.27 for child care expenses based on a substantial decrease in the 334.28 expenses is effective as of the date the expenses decreased. 334.29 (e) Except for an award of the right of occupancy of the 334.30 homestead, provided in section 518.63, all divisions of real and 334.31 personal property provided by section 518.58 shall be final, and 334.32 may be revoked or modified only where the court finds the 334.33 existence of conditions that justify reopening a judgment under 334.34 the laws of this state, including motions under section 518.145, 334.35 subdivision 2. The court may impose a lien or charge on the 334.36 divided property at any time while the property, or subsequently 335.1 acquired property, is owned by the parties or either of them, 335.2 for the payment of maintenance or support money, or may 335.3 sequester the property as is provided by section 518.24. 335.4 (f) The court need not hold an evidentiary hearing on a 335.5 motion for modification of maintenance or support. 335.6 (g) Section 518.14 shall govern the award of attorney fees 335.7 for motions brought under this subdivision. 335.8 Sec. 15. Minnesota Statutes 2000, section 518.641, 335.9 subdivision 1, is amended to read: 335.10 Subdivision 1. [REQUIREMENT.] (a) An orderfor335.11 establishing, modifying, or enforcing maintenance or child 335.12 support shall provide for a biennial adjustment in the amount to 335.13 be paid based on a change in the cost of living. An order that 335.14 provides for a cost-of-living adjustment shall specify the 335.15 cost-of-living index to be applied and the date on which the 335.16 cost-of-living adjustment shall become effective. The court may 335.17 use the consumer price index for all urban consumers, 335.18 Minneapolis-St. Paul (CPI-U), the consumer price index for wage 335.19 earners and clerical, Minneapolis-St. Paul (CPI-W), or another 335.20 cost-of-living index published by the department of labor which 335.21 it specifically finds is more appropriate. Cost-of-living 335.22 increases under this section shall be compounded. The court may 335.23 also increase the amount by more than the cost-of-living 335.24 adjustment by agreement of the parties or by making further 335.25 findings. 335.26 (b) The adjustment becomes effective on the first of May of 335.27 the year in which it is made, for cases in which payment is made 335.28 to the public authority. For cases in which payment is not made 335.29 to the public authority, application for an adjustment may be 335.30 made in any month but no application for an adjustment may be 335.31 made sooner than two years after the date of the dissolution 335.32 decree. A court may waive the requirement of the cost-of-living 335.33 clause if it expressly finds that the obligor's occupation or 335.34 income, or both, does not provide for cost-of-living adjustment 335.35 or that the order for maintenance or child support has a 335.36 provision such as a step increase that has the effect of a 336.1 cost-of-living clause. The court may waive a cost-of-living 336.2 adjustment in a maintenance order if the parties so agree in 336.3 writing. The commissioner of human services may promulgate 336.4 rules for child support adjustments under this section in 336.5 accordance with the rulemaking provisions of chapter 14. Notice 336.6 of this statute must comply with section 518.68, subdivision 2. 336.7 Sec. 16. Minnesota Statutes 2000, section 518.641, 336.8 subdivision 2, is amended to read: 336.9 Subd. 2. [CONDITIONSNOTICE.] No adjustment under this 336.10 section may be made unless the order provides for it anduntil336.11the following conditions are met:336.12(a) the obligee serves notice of the application for336.13adjustment by mail on the obligor at the obligor's last known336.14address at least 20 days before the effective date of the336.15adjustment;336.16(b) the notice to the obligor informs the obligor of the336.17date on which the adjustment in payments will become effective;336.18(c) after receipt of notice and before the effective day of336.19the adjustment, the obligor fails to request a hearing on the336.20issue of whether the adjustment should take effect, and ex336.21parte, to stay imposition of the adjustment pending outcome of336.22the hearing; or336.23(d) the public authoritythe public authority or the 336.24 obligee, if the obligee is requesting the cost-of-living 336.25 adjustment, sends notice ofits application forthe intended 336.26 adjustment to the obligor at the obligor's last known address at 336.27 least 20 days before the effective date of the adjustment, and. 336.28 The noticeinformsshall inform the obligor of the date on which 336.29 the adjustment will become effective and the procedures for 336.30 contesting the adjustmentaccording to section 484.702. 336.31 Sec. 17. Minnesota Statutes 2000, section 518.641, is 336.32 amended by adding a subdivision to read: 336.33 Subd. 2a. [PROCEDURES FOR CONTESTING ADJUSTMENT.] (a) To 336.34 contest cost-of-living adjustments initiated by the public 336.35 authority or an obligee who has applied for or is receiving 336.36 child support and maintenance collection services from the 337.1 public authority, other than income withholding only services, 337.2 the obligor, before the effective date of the adjustment, must: 337.3 (1) file a motion contesting the cost-of-living adjustment 337.4 with the court administrator; and 337.5 (2) serve the motion by first-class mail on the public 337.6 authority and the obligee. 337.7 The hearing shall take place in the expedited child support 337.8 process as governed by section 484.702. 337.9 (b) To contest cost-of-living adjustments initiated by an 337.10 obligee who is not receiving child support and maintenance 337.11 collection services from the public authority, or for an obligee 337.12 who receives income withholding only services from the public 337.13 authority, the obligor must, before the effective date of the 337.14 adjustment: 337.15 (1) file a motion contesting the cost-of-living adjustment 337.16 with the court administrator; and 337.17 (2) serve the motion by first-class mail on the obligee. 337.18 The hearing shall take place in district court. 337.19 (c) Upon receipt of a motion contesting the cost-of-living 337.20 adjustment, the cost-of-living adjustment shall be stayed 337.21 pending further order of the court. 337.22 (d) The court administrator shall make available pro se 337.23 motion forms for contesting a cost-of-living adjustment under 337.24 this subdivision. 337.25 Sec. 18. Minnesota Statutes 2000, section 518.641, 337.26 subdivision 3, is amended to read: 337.27 Subd. 3. [RESULT OF HEARING.] If, at a hearing pursuant to 337.28 this section, the obligor establishes an insufficient cost of 337.29 living or other increase in income that prevents fulfillment of 337.30 the adjusted maintenance or child support obligation, the 337.31 court or child support magistrate may direct that all or part of 337.32 the adjustment not take effect. If, at the hearing, the obligor 337.33 does not establish this insufficient increase in income, the 337.34 adjustment shall take effect as of the date it would have become 337.35 effective had no hearing been requested. 337.36 Sec. 19. Minnesota Statutes 2000, section 548.091, 338.1 subdivision 1a, is amended to read: 338.2 Subd. 1a. [CHILD SUPPORT JUDGMENT BY OPERATION OF LAW.] 338.3 (a) Any payment or installment of support required by a judgment 338.4 or decree of dissolution or legal separation, determination of 338.5 parentage, an order under chapter 518C, an order under section 338.6 256.87, or an order under section 260B.331 or 260C.331, that is 338.7 not paid or withheld from the obligor's income as required under 338.8 section 518.6111, or which is ordered as child support by 338.9 judgment, decree, or order by a court in any other state, is a 338.10 judgment by operation of law on and after the date it is due, is 338.11 entitled to full faith and credit in this state and any other 338.12 state, and shall be entered and docketed by the court 338.13 administrator on the filing of affidavits as provided in 338.14 subdivision 2a. Except as otherwise provided by paragraph (b), 338.15 interest accrues from the date the unpaid amount due is greater 338.16 than the current support due at the annual rate provided in 338.17 section 549.09, subdivision 1, plus two percent, not to exceed 338.18 an annual rate of 18 percent. A payment or installment of 338.19 support that becomes a judgment by operation of law between the 338.20 date on which a party served notice of a motion for modification 338.21 under section 518.64, subdivision 2, and the date of the court's 338.22 order on modification may be modified under that subdivision. 338.23 (b) Notwithstanding the provisions of section 549.09, upon 338.24 motion to the court and upon proof by the obligor of 36 338.25 consecutive months of complete and timely payments of both 338.26 current support and court-ordered paybacks of a child support 338.27 debt or arrearage, the court may order interest on the remaining 338.28 debt or arrearage to stop accruing. Timely payments are those 338.29 made in the month in which they are due. If, after that time, 338.30 the obligor fails to make complete and timely payments of both 338.31 current support and court-ordered paybacks of child support debt 338.32 or arrearage, the public authority or the obligee may move the 338.33 court for the reinstatement of interest as of the month in which 338.34 the obligor ceased making complete and timely payments. 338.35 The court shall provide copies of all orders issued under 338.36 this section to the public authority. The commissioner of human 339.1 services shall prepare and make available to the court and the 339.2 parties forms to be submitted by the parties in support of a 339.3 motion under this paragraph. 339.4 (c) Notwithstanding the provisions of section 549.09, upon 339.5 motion to the court, the court may order interest on a child 339.6 support debt to stop accruing where the court finds that the 339.7 obligor is: 339.8 (1) unable to pay support because of a significant physical 339.9 or mental disability;or339.10 (2) a recipient of Supplemental Security Income (SSI), 339.11 Title II Older Americans Survivor's Disability Insurance 339.12 (OASDI), other disability benefits, or public assistance based 339.13 upon need; or 339.14 (3) institutionalized or incarcerated for at least 30 days 339.15 for an offense other than nonsupport of the child or children 339.16 involved, and is otherwise financially unable to pay support. 339.17 Sec. 20. [REPEALER.] 339.18 Minnesota Statutes 2000, section 518.641, subdivisions 4 339.19 and 5, are repealed. 339.20 ARTICLE 13 339.21 MISCELLANEOUS 339.22 Section 1. Minnesota Statutes 2000, section 144.1491, 339.23 subdivision 1, is amended to read: 339.24 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 339.25 program participant who fails to complete two years of obligated 339.26 service shall repay the amount paid, as well as a financial 339.27 penalty based upon the length of the service obligation not 339.28 fulfilled. If the participant has served at least one year, the 339.29 financial penalty is the number of unserved months multiplied by 339.30 $1,000. If the participant has served less than one year, the 339.31 financial penalty is the total number of obligated months 339.32 multiplied by $1,000. The commissioner shall report to the 339.33 appropriate health-related licensing board a participant who 339.34 fails to complete the service obligation and fails to repay the 339.35 amount paid or fails to pay any financial penalty owed under 339.36 this subdivision. 340.1 Sec. 2. Minnesota Statutes 2000, section 148.212, is 340.2 amended to read: 340.3 148.212 [TEMPORARY PERMIT.] 340.4 Upon receipt of the applicable licensure or reregistration 340.5 fee and permit fee, and in accordance with rules of the board, 340.6 the board may issue a nonrenewable temporary permit to practice 340.7 professional or practical nursing to an applicant for licensure 340.8 or reregistration who is not the subject of a pending 340.9 investigation or disciplinary action, nor disqualified for any 340.10 other reason, under the following circumstances: 340.11 (a) The applicant for licensure by examination under 340.12 section 148.211, subdivision 1, has graduated from an approved 340.13 nursing program within the 60 days preceding board receipt of an 340.14 affidavit of graduation or transcript and has been authorized by 340.15 the board to write the licensure examination for the first time 340.16 in the United States. The permit holder must practice 340.17 professional or practical nursing under the direct supervision 340.18 of a registered nurse. The permit is valid from the date of 340.19 issue until the date the board takes action on the application 340.20 or for 60 days whichever occurs first. 340.21 (b) The applicant for licensure by endorsement under 340.22 section 148.211, subdivision 2, is currently licensed to 340.23 practice professional or practical nursing in another state, 340.24 territory, or Canadian province. The permit is valid from 340.25 submission of a proper request until the date of board action on 340.26 the application. 340.27 (c) The applicant for licensure by endorsement under 340.28 section 148.211, subdivision 2, or for reregistration under 340.29 section 148.231, subdivision 5, is currently registered in a 340.30 formal, structured refresher course or its equivalent for nurses 340.31 that includes clinical practice. 340.32 (d) The applicant for licensure by examination under 340.33 section 148.211, subdivision 1, has been issued a Commission on 340.34 Graduates of Foreign Nursing Schools certificate, has completed 340.35 all requirements for licensure except the examination, and has 340.36 been authorized by the board to write the licensure examination 341.1 for the first time in the United States. The permit holder must 341.2 practice professional nursing under the direct supervision of a 341.3 registered nurse. The permit is valid from the date of issue 341.4 until the date the board takes action on the application or for 341.5 60 days, whichever occurs first. 341.6 Sec. 3. Minnesota Statutes 2000, section 148.284, is 341.7 amended to read: 341.8 148.284 [CERTIFICATION OF ADVANCED PRACTICE REGISTERED 341.9 NURSES.] 341.10 (a) No person shall practice advanced practice registered 341.11 nursing or use any title, abbreviation, or other designation 341.12 tending to imply that the person is an advanced practice 341.13 registered nurse, clinical nurse specialist, nurse anesthetist, 341.14 nurse-midwife, or nurse practitioner unless the person is 341.15 certified for such advanced practice registered nursing by a 341.16 national nurse certification organization. 341.17 (b) Paragraph (a) does not apply to an advanced practice 341.18 registered nurse who is within six months after completion of an 341.19 advanced practice registered nurse course of study and is 341.20 awaiting certification, provided that the person has not 341.21 previously failed the certification examination. 341.22 (c) An advanced practice registered nurse who has completed 341.23 a formal course of study as an advanced practice registered 341.24 nurse and has been certified by a national nurse certification 341.25 organization prior to January 1, 1999, may continue to practice 341.26 in the field of nursing in which the advanced practice 341.27 registered nurse is practicing as of July 1, 1999, regardless of 341.28 the type of certification held if the advanced practice 341.29 registered nurse is not eligible for the proper certification. 341.30 Sec. 4. Minnesota Statutes 2000, section 148B.21, 341.31 subdivision 6a, is amended to read: 341.32 Subd. 6a. [BACKGROUND CHECKS.] The board shall request a 341.33 criminal history background check from the superintendent of the 341.34 bureau of criminal apprehension on all applicants for initial 341.35 licensure. An application for a license under this section must 341.36 be accompanied by an executed criminal history consent form and 342.1 the fee for conducting the criminal history background 342.2 check. The board shall deposit all fees paid by applicants for 342.3 criminal history background checks under this subdivision into 342.4 the miscellaneous special revenue fund. The fees collected 342.5 under this subdivision are appropriated to the board for the 342.6 purpose of reimbursing the bureau of criminal apprehension for 342.7 the cost of the background checks upon their completion. 342.8 Sec. 5. Minnesota Statutes 2000, section 148B.22, 342.9 subdivision 3, is amended to read: 342.10 Subd. 3. [BACKGROUND CHECKS.] The board shall request a 342.11 criminal history background check from the superintendent of the 342.12 bureau of criminal apprehension on all licensees under its 342.13 jurisdiction who did not complete a criminal history background 342.14 check as part of an application for initial licensure. This 342.15 background check is a one-time requirement. An application for 342.16 a license under this section must be accompanied by an executed 342.17 criminal history consent form and the fee for conducting the 342.18 criminal history background check. The board shall deposit all 342.19 fees paid by licensees for criminal history background checks 342.20 under this subdivision into the miscellaneous special revenue 342.21 fund. The fees collected under this subdivision are 342.22 appropriated to the board for the purpose of reimbursing the 342.23 bureau of criminal apprehension for the cost of the background 342.24 checks upon their completion. 342.25 Sec. 6. [214.105] [HEALTH-RELATED LICENSING BOARDS; 342.26 DEFAULT ON FEDERAL LOANS OR SERVICE OBLIGATIONS.] 342.27 A health-related licensing board may refuse to grant a 342.28 license or may impose disciplinary action against a person 342.29 regulated by the board if the person is intentionally in 342.30 nonpayment, default, or breach of a repayment or service 342.31 obligation under any federal educational loan, loan repayment, 342.32 or service conditional scholarship program. The board shall 342.33 consider the reasons for nonpayment, default, or breach of a 342.34 repayment or service obligation and may not impose disciplinary 342.35 action against a person in cases of total and permanent 342.36 disability or long-term temporary disability lasting more than a 343.1 year. 343.2 Sec. 7. Minnesota Statutes 2000, section 252A.02, is 343.3 amended by adding a subdivision to read: 343.4 Subd. 3a. [GUARDIANSHIP SERVICE PROVIDERS.] "Guardianship 343.5 service providers" are individuals or agencies that meet the 343.6 ethical conduct and best practice standards of the National 343.7 Guardianship Association, meet the criminal background check 343.8 requirements of section 245A.04, and do not provide any other 343.9 services to the individuals for whom guardianship services are 343.10 provided. 343.11 Sec. 8. Minnesota Statutes 2000, section 252A.02, 343.12 subdivision 12, is amended to read: 343.13 Subd. 12. [COMPREHENSIVE EVALUATION.] "Comprehensive 343.14 evaluation" shall consist of: 343.15 (1) a medical report on the health status and physical 343.16 condition of the proposed ward, prepared under the direction of 343.17 a licensed physician; 343.18 (2) a report on the proposed ward's intellectual capacity 343.19 and functional abilities, specifying the tests and other data 343.20 used in reaching its conclusions, prepared by a psychologist who 343.21 is qualified in the diagnosis of mental retardation; and 343.22 (3) a report from the case manager that includes: 343.23 (i) the most current assessment of individual service needs 343.24 as described in rules of the commissioner; 343.25 (ii) the most current individual service planas described343.26in rules of the commissionerunder section 256B.092, subdivision 343.27 1b; and 343.28 (iii) a description of contacts with and responses of near 343.29 relatives of the proposed ward notifying them that a nomination 343.30 for public guardianship has been made and advising them that 343.31 they may seek private guardianship. 343.32 Each report shall contain recommendations as to the amount 343.33 of assistance and supervision required by the proposed ward to 343.34 function as independently as possible in society. To be 343.35 considered part of the comprehensive evaluation, reports must be 343.36 completed no more than one year before filing the petition under 344.1 section 252A.05. 344.2 Sec. 9. Minnesota Statutes 2000, section 252A.02, 344.3 subdivision 13, is amended to read: 344.4 Subd. 13. [CASE MANAGER.] "Case manager" means the person 344.5 designatedby the county board under rules of the commissioner344.6to provide case management servicesunder section 256B.092. 344.7 Sec. 10. Minnesota Statutes 2000, section 252A.111, 344.8 subdivision 6, is amended to read: 344.9 Subd. 6. [SPECIAL DUTIES.] In exercising powers and duties 344.10 under this chapter, the commissioner shall: 344.11 (1) maintain close contact with the ward, visiting at least 344.12 twice a year; 344.13 (2)prohibit filming a ward in any way that would reveal344.14the identity of the ward unless the commissioner determines the344.15filming to be in the best interests of the ward. The344.16commissioner may give written consent for filming of the ward344.17after permitting and encouraging input by the nearest relative344.18 protect and exercise the legal rights of the ward; 344.19 (3) take actions and make decisions on behalf of the ward 344.20 that encourage and allow the maximum level of independent 344.21 functioning in a manner least restrictive of the ward's personal 344.22 freedom consistent with the need for supervision and protection; 344.23 and 344.24 (4) permit and encourage maximum self-reliance on the part 344.25 of the ward and permit and encourage input by the nearest 344.26 relative of the ward in planning and decision making on behalf 344.27 of the ward. 344.28 Sec. 11. Minnesota Statutes 2000, section 252A.16, 344.29 subdivision 1, is amended to read: 344.30 Subdivision 1. [REVIEW REQUIRED.] The commissioner 344.31 shallproviderequire an annual review of the physical, mental, 344.32 and social adjustment and progress of every ward and 344.33 conservatee. A copy of this review shall be kept on file at the 344.34 department of human services and may be inspected by the ward or 344.35 conservatee, the ward's or conservatee's parents, spouse, or 344.36 relatives and other persons who receive the permission of the 345.1 commissioner. The review shall contain information required 345.2 underrules of the commissionerMinnesota Rules, part 9525.3065, 345.3 subpart 1. 345.4 Sec. 12. Minnesota Statutes 2000, section 252A.19, 345.5 subdivision 2, is amended to read: 345.6 Subd. 2. [PETITION.] The commissioner, ward, or any 345.7 interested person may petition the appointing court or the court 345.8 to which venue has been transferred for an order to remove the 345.9 guardianship or to limit or expand the powers of the 345.10 conservatorship or to appoint a guardian or conservator under 345.11 sections 525.539 to 525.705 or to restore the ward or 345.12 conservatee to full legal capacity or to review de novo any 345.13 decision made by the public guardian or public conservator for 345.14 or on behalf of a ward or conservatee or for any other order as 345.15 the court may deem just and equitable. Section 525.61, 345.16 subdivision 3, does not apply to a petition to remove a public 345.17 guardian. 345.18 Sec. 13. Minnesota Statutes 2000, section 252A.20, 345.19 subdivision 1, is amended to read: 345.20 Subdivision 1. [WITNESS AND ATTORNEY FEES.] In each 345.21 proceeding under sections 252A.01 to 252A.21, the court shall 345.22 allow and order paid to each witness subpoenaed the fees and 345.23 mileage prescribed by law; to each physician, psychologist, or 345.24 social worker who assists in the preparation of the 345.25 comprehensive evaluation and who is not in the employ of the 345.26 local agency,or the state department of human services,or area345.27mental health-mental retardation board,a reasonable sum for 345.28 services and for travel; and to the ward's counsel, when 345.29 appointed by the court, a reasonable sum for travel and for each 345.30 day or portion of a day actually employed in court or actually 345.31 consumed in preparing for the hearing. Upon order the county 345.32 auditor shall issue a warrant on the county treasurer for 345.33 payment of the amount allowed. 345.34 Sec. 14. [299A.76] [SUICIDE STATISTICS.] 345.35 (a) The commissioner of public safety shall not: 345.36 (1) include any statistics on committing suicide or 346.1 attempting suicide in any compilation of crime statistics 346.2 published by the commissioner; or 346.3 (2) label as a crime statistic, any data on committing 346.4 suicide or attempting suicide. 346.5 (b) This section does not apply to the crimes of aiding 346.6 suicide under section 609.215, subdivision 1, or aiding 346.7 attempted suicide under section 609.215, subdivision 2, or to 346.8 statistics on a suicide directly related to the commission of a 346.9 crime. 346.10 Sec. 15. [DEAF/BLIND SERVICES STUDY.] 346.11 The department of human services shall convene and lead an 346.12 interagency workgroup for the purpose of studying and developing 346.13 recommendations regarding: 346.14 (1) how the state can most effectively and efficiently use 346.15 state appropriations and other resources to provide needed 346.16 services to deaf/blind children, adults, and their families; 346.17 (2) how state agencies can work together to enhance and 346.18 ensure that a seamless service delivery system exists across 346.19 agency lines for persons who are deaf/blind; and 346.20 (3) how other existing barriers to the effective and 346.21 efficient delivery of service for deaf/blind Minnesotans can be 346.22 removed. 346.23 The workgroup shall include representatives from the 346.24 departments of human services, economic security, children, 346.25 families, and learning; the state academy for the deaf; the 346.26 state academy for the blind; the Minnesota commission serving 346.27 deaf and hard-of-hearing; a consumer who is deaf/blind; a parent 346.28 of a deaf/blind child from the metro area and a parent of a 346.29 deaf/blind child from greater Minnesota; and anyone else that 346.30 the workgroup finds necessary to complete its work. 346.31 The departments of human services, economic security, and 346.32 children, families, and learning shall share equally in the 346.33 costs of the workgroup. 346.34 The workgroup shall report its findings and recommendations 346.35 to the legislature by February 1, 2002. 346.36 Sec. 16. [PUBLIC GUARDIANSHIP ALTERNATIVES.] 347.1 The commissioner of human services shall provide county 347.2 agencies with funds up to the amount appropriated for public 347.3 guardianship alternatives based on proposals by the counties to 347.4 establish private alternatives. 347.5 Sec. 17. [REPEALER.] 347.6 Minnesota Statutes 2000, section 252A.111, subdivision 3, 347.7 is repealed. 347.8 ARTICLE 14 347.9 DHS LICENSING AND 347.10 LICENSING BACKGROUND STUDIES 347.11 Section 1. Minnesota Statutes 2000, section 13.46, 347.12 subdivision 4, is amended to read: 347.13 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 347.14 (1) "licensing data" means all data collected, maintained, 347.15 used, or disseminated by the welfare system pertaining to 347.16 persons licensed or registered or who apply for licensure or 347.17 registration or who formerly were licensed or registered under 347.18 the authority of the commissioner of human services; 347.19 (2) "client" means a person who is receiving services from 347.20 a licensee or from an applicant for licensure; and 347.21 (3) "personal and personal financial data" means social 347.22 security numbers, identity of and letters of reference, 347.23 insurance information, reports from the bureau of criminal 347.24 apprehension, health examination reports, and social/home 347.25 studies. 347.26 (b)(1) Except as provided in paragraph (c), the following 347.27 data on current and former licensees are public: name, address, 347.28 telephone number of licensees, date of receipt of a completed 347.29 application, dates of licensure, licensed capacity, type of 347.30 client preferred, variances granted, type of dwelling, name and 347.31 relationship of other family members, previous license history, 347.32 class of license, and the existence and status of complaints. 347.33 Whendisciplinary action has been taken against a licenseea 347.34 correction order or fine has been issued, a license is 347.35 suspended, immediately suspended, revoked, denied, or made 347.36 conditional, orthea complaint is resolved, the following data 348.1 on current and former licensees are public: the substance and 348.2 investigative findings of the complaint,the findings of the348.3investigation of the complaint,licensing violation, or 348.4 substantiated maltreatment; the record of informal resolution of 348.5 a licensing violation,; orders of hearing,; findings of 348.6 fact,; conclusions of law, and; specifications of the final 348.7disciplinary actioncorrection order, fine, suspension, 348.8 immediate suspension, revocation, denial, or conditional license 348.9 contained in the record ofdisciplinarylicensing action; and 348.10 the status of any appeal of these actions. When an individual 348.11 licensee is a substantiated perpetrator of maltreatment, and the 348.12 substantiated maltreatment is a reason for the licensing action, 348.13 the identity of the licensee as a perpetrator is public data. 348.14 For purposes of this clause, a person is a substantiated 348.15 perpetrator if the maltreatment determination has been upheld 348.16 under section 626.556, subdivision 10i, 626.557, subdivision 9d, 348.17 or 256.045, or an individual or facility has not timely 348.18 exercised appeal rights under these sections. 348.19 (2) For applicants who withdraw their application prior to 348.20 licensure or denial of a license, the following data are 348.21 public: the name of the applicant, the city and county in which 348.22 the applicant was seeking licensure, the dates of the 348.23 commissioner's receipt of the initial application and completed 348.24 application, the type of license sought, and the date of 348.25 withdrawal of the application. 348.26 (3) For applicants who are denied a license, the following 348.27 data are public: the name of the applicant, the city and county 348.28 in which the applicant was seeking licensure, the dates of the 348.29 commissioner's receipt of the initial application and completed 348.30 application, the type of license sought, the date of denial of 348.31 the application, the nature of the basis for the denial, and the 348.32 status of any appeal of the denial. 348.33 (4) The following data on persons subject to 348.34 disqualification under section 245A.04 in connection with a 348.35 license to provide family day care for children, child care 348.36 center services, foster care for children in the provider's 349.1 home, or foster care or day care services for adults in the 349.2 provider's home, are public: the nature of any disqualification 349.3 set aside under section 245A.04, subdivision 3b, and the reasons 349.4 for setting aside the disqualification; and the reasons for 349.5 granting any variance under section 245A.04, subdivision 9. 349.6 (5) When maltreatment is substantiated under section 349.7 626.556 or 626.557 and the victim and the substantiated 349.8 perpetrator are affiliated with a program licensed under chapter 349.9 245A, the commissioner of human services, local social services 349.10 agency, or county welfare agency may inform the license holder 349.11 where the maltreatment occurred of the identity of the 349.12 substantiated perpetrator and the victim. 349.13 (c) The following are private data on individuals under 349.14 section 13.02, subdivision 12, or nonpublic data under section 349.15 13.02, subdivision 9: personal and personal financial data on 349.16 family day care program and family foster care program 349.17 applicants and licensees and their family members who provide 349.18 services under the license. 349.19 (d) The following are private data on individuals: the 349.20 identity of persons who have made reports concerning licensees 349.21 or applicants that appear in inactive investigative data, and 349.22 the records of clients or employees of the licensee or applicant 349.23 for licensure whose records are received by the licensing agency 349.24 for purposes of review or in anticipation of a contested 349.25 matter. The names of reporters under sections 626.556 and 349.26 626.557 may be disclosed only as provided in section 626.556, 349.27 subdivision 11, or 626.557, subdivision 12b. 349.28 (e) Data classified as private, confidential, nonpublic, or 349.29 protected nonpublic under this subdivision become public data if 349.30 submitted to a court or administrative law judge as part of a 349.31 disciplinary proceeding in which there is a public hearing 349.32 concerningthe disciplinary actiona license which has been 349.33 suspended, immediately suspended, revoked, or denied. 349.34 (f) Data generated in the course of licensing 349.35 investigations that relate to an alleged violation of law are 349.36 investigative data under subdivision 3. 350.1 (g) Data that are not public data collected, maintained, 350.2 used, or disseminated under this subdivision that relate to or 350.3 are derived from a report as defined in section 626.556, 350.4 subdivision 2, or 626.5572, subdivision 18, are subject to the 350.5 destruction provisions ofsectionsections 626.556, subdivision 350.61111c, and 626.557, subdivision 12b. 350.7 (h) Upon request, not public data collected, maintained, 350.8 used, or disseminated under this subdivision that relate to or 350.9 are derived from a report of substantiated maltreatment as 350.10 defined in section 626.556 or 626.557 may be exchanged with the 350.11 department of health for purposes of completing background 350.12 studies pursuant to section 144.057. 350.13 (i) Data on individuals collected according to licensing 350.14 activities under chapter 245A, and data on individuals collected 350.15 by the commissioner of human services according to maltreatment 350.16 investigations under sections 626.556 and 626.557, may be shared 350.17 with the department of human rights, the department of health, 350.18 the department of corrections, the ombudsman for mental health 350.19 and retardation, and the individual's professional regulatory 350.20 board when there is reason to believe that laws or standards 350.21 under the jurisdiction of those agencies may have been violated. 350.22 (j) In addition to the notice of determinations required 350.23 under section 626.556, subdivision 10f, if the commissioner or 350.24 the local social services agency has determined that an 350.25 individual is a substantiated perpetrator of maltreatment of a 350.26 child based on sexual abuse, as defined in section 626.556, 350.27 subdivision 2, and the commissioner or local social services 350.28 agency knows that the individual is a person responsible for a 350.29 child's care in another facility, the commissioner or local 350.30 social services agency shall notify the head of that facility of 350.31 this determination. The notification must include an 350.32 explanation of the individual's available appeal rights and the 350.33 status of any appeal. If a notice is given under this 350.34 paragraph, the government entity making the notification shall 350.35 provide a copy of the notice to the individual who is the 350.36 subject of the notice. 351.1 Sec. 2. Minnesota Statutes 2000, section 144.057, is 351.2 amended to read: 351.3 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 351.4 NURSING SERVICES AGENCY PERSONNEL.] 351.5 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The 351.6 commissioner of health shall contract with the commissioner of 351.7 human services to conduct background studies of: 351.8 (1) individuals providing services which have direct 351.9 contact, as defined under section 245A.04, subdivision 3, with 351.10 patients and residents in hospitals, boarding care homes, 351.11 outpatient surgical centers licensed under sections 144.50 to 351.12 144.58; nursing homes and home care agencies licensed under 351.13 chapter 144A; residential care homes licensed under chapter 351.14 144B, and board and lodging establishments that are registered 351.15 to provide supportive or health supervision services under 351.16 section 157.17;and351.17 (2) individuals specified in section 245A.04, subdivision 351.18 3, paragraph (c), who perform direct contact services in a 351.19 nursing home or a home care agency licensed under chapter 144A 351.20 or a boarding care home licensed under sections 144.50 to 351.21 144.58, and if the individual under study resides outside 351.22 Minnesota, the study must be at least as comprehensive as that 351.23 of a Minnesota resident and include a search of information from 351.24 the criminal justice data communications network in the state 351.25 where the subject of the study resides; 351.26 (3) beginning July 1, 1999, all other employees in nursing 351.27 homes licensed under chapter 144A, and boarding care homes 351.28 licensed under sections 144.50 to 144.58. A disqualification of 351.29 an individual in this section shall disqualify the individual 351.30 from positions allowing direct contact or access to patients or 351.31 residents receiving services. "Access" means physical access to 351.32 a client or the client's personal property without continuous, 351.33 direct supervision as defined in section 245A.04, subdivision 3, 351.34 paragraph (b), clause (2), when the employee's employment 351.35 responsibilities do not include providing direct contact 351.36 services; 352.1 (4) individuals employed by a supplemental nursing services 352.2 agency, as defined under section 144A.70, who are providing 352.3 services in health care facilities; and 352.4 (5) controlling persons of a supplemental nursing services 352.5 agency, as defined under section 144A.70. 352.6 If a facility or program is licensed by the department of 352.7 human services and subject to the background study provisions of 352.8 chapter 245A and is also licensed by the department of health, 352.9 the department of human services is solely responsible for the 352.10 background studies of individuals in the jointly licensed 352.11 programs. 352.12 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 352.13 SERVICES.] The department of human services shall conduct the 352.14 background studies required by subdivision 1 in compliance with 352.15 the provisions of chapter 245Aand Minnesota Rules, parts352.169543.3000 to 9543.3090. For the purpose of this section, the 352.17 term "residential program" shall include all facilities 352.18 described in subdivision 1. The department of human services 352.19 shall provide necessary forms and instructions, shall conduct 352.20 the necessary background studies of individuals, and shall 352.21 provide notification of the results of the studies to the 352.22 facilities, supplemental nursing services agencies, individuals, 352.23 and the commissioner of health. Individuals shall be 352.24 disqualified under the provisions of chapter 245Aand Minnesota352.25Rules, parts 9543.3000 to 9543.3090. If an individual is 352.26 disqualified, the department of human services shall notify the 352.27 facility, the supplemental nursing services agency, and the 352.28 individual and shall inform the individual of the right to 352.29 request a reconsideration of the disqualification by submitting 352.30 the request to the department of health. 352.31 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 352.32 shall review and decide reconsideration requests, including the 352.33 granting of variances, in accordance with the procedures and 352.34 criteria contained in chapter 245Aand Minnesota Rules, parts352.359543.3000 to 9543.3090. The commissioner's decision shall be 352.36 provided to the individual and to the department of human 353.1 services. The commissioner's decision to grant or deny a 353.2 reconsideration of disqualification is the final administrative 353.3 agency action, except for the provisions under section 245A.04, 353.4 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a). 353.5 [EFFECTIVE DATE.] This subdivision is effective January 1, 353.6 2002. 353.7 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 353.8 Facilities and agencies described in subdivision 1 shall be 353.9 responsible for cooperating with the departments in implementing 353.10 the provisions of this section. The responsibilities imposed on 353.11 applicants and licensees under chapter 245Aand Minnesota Rules,353.12parts 9543.3000 to 9543.3090,shall apply to these facilities 353.13 and supplemental nursing services agencies. The provision of 353.14 section 245A.04, subdivision 3, paragraph (e), shall apply to 353.15 applicants, licensees, registrants, or an individual's refusal 353.16 to cooperate with the completion of the background 353.17 studies. Supplemental nursing services agencies subject to the 353.18 registration requirements in section 144A.71 must maintain 353.19 records verifying compliance with the background study 353.20 requirements under this section. 353.21 Sec. 3. Minnesota Statutes 2000, section 214.104, is 353.22 amended to read: 353.23 214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 353.24 REGARDINGDISQUALIFICATIONS FORMALTREATMENT.] 353.25 (a) A health-related licensing board shall make 353.26 determinations as to whetherlicenseesregulated persons who are 353.27 under the board's jurisdiction should bedisqualified under353.28section 245A.04, subdivision 3d, from positions allowing direct353.29contact with persons receiving servicesthe subject of 353.30 disciplinary or corrective action because of substantiated 353.31 maltreatment under section 626.556 or 626.557.A determination353.32under this section may be done as part of an investigation under353.33section 214.103.The board shall make a determinationwithin 90353.34days ofupon receipt, and after the review, of an investigation 353.35 memorandum or other notice of substantiated maltreatment under 353.36 section 626.556 or 626.557, or of a notice from the commissioner 354.1 of human services that a background study of alicensee354.2 regulated person shows substantiated maltreatment.The board354.3shall also make a determination under this section upon354.4consideration of the licensure of an individual who was subject354.5to disqualification before licensure because of substantiated354.6maltreatment.354.7(b) In making a determination under this section, the board354.8shall consider the nature and extent of any injury or harm354.9resulting from the conduct that would constitute grounds for354.10disqualification, the seriousness of the misconduct, the extent354.11that disqualification is necessary to protect persons receiving354.12services or the public, and other factors specified in section354.13245A.04, subdivision 3b, paragraph (b).354.14(c) The board shall determine the duration and extent of354.15the disqualification or may establish conditions under which the354.16licensee may hold a position allowing direct contact with354.17persons receiving services or in a licensed facility.354.18 (b) Upon completion of its review of a report of 354.19 substantiated maltreatment, the board shall notify the 354.20 commissioner of human servicesand the lead agency that354.21conducted an investigation under section 626.556 or 626.557, as354.22applicable,of its determination. The board shall notify the 354.23 commissioner of human services if, following a review of the 354.24 report of substantiated maltreatment, the board determines that 354.25 it does not have jurisdiction in the matter and the commissioner 354.26 shall make the appropriate disqualification decision regarding 354.27 the regulated person as otherwise provided in chapter 245A. The 354.28 board shall also notify the commissioner of health or the 354.29 commissioner of human services immediately upon receipt of 354.30 knowledge of a facility or program allowing a regulated person 354.31 to provide direct contact services at the facility or program 354.32 while not complying with requirements placed on the regulated 354.33 person. 354.34 (c) In addition to any other remedy provided by law, the 354.35 board may, through its designated board member, temporarily 354.36 suspend the license of a licensee; deny a credential to an 355.1 applicant; or require the regulated person to be continuously 355.2 supervised, if the board finds there is probable cause to 355.3 believe the regulated person referred to the board according to 355.4 paragraph (a) poses an immediate risk of harm to vulnerable 355.5 persons. The board shall consider all relevant information 355.6 available, which may include but is not limited to: 355.7 (1) the extent the action is needed to protect persons 355.8 receiving services or the public; 355.9 (2) the recency of the maltreatment; 355.10 (3) the number of incidents of maltreatment; 355.11 (4) the intrusiveness or violence of the maltreatment; and 355.12 (5) the vulnerability of the victim of maltreatment. 355.13 The action shall take effect upon written notice to the 355.14 regulated person, served by certified mail, specifying the 355.15 statute violated. The board shall notify the commissioner of 355.16 health or the commissioner of human services of the suspension 355.17 or denial of a credential. The action shall remain in effect 355.18 until the board issues a temporary stay or a final order in the 355.19 matter after a hearing or upon agreement between the board and 355.20 the regulated person. At the time the board issues the notice, 355.21 the regulated person shall inform the board of all settings in 355.22 which the regulated person is employed or practices. The board 355.23 shall inform all known employment and practice settings of the 355.24 board action and schedule a disciplinary hearing to be held 355.25 under chapter 14. The board shall provide the regulated person 355.26 with at least 30 days' notice of the hearing, unless the parties 355.27 agree to a hearing date that provides less than 30 days' notice, 355.28 and shall schedule the hearing to begin no later than 90 days 355.29 after issuance of the notice of hearing. 355.30 Sec. 4. Minnesota Statutes 2000, section 245A.02, 355.31 subdivision 1, is amended to read: 355.32 Subdivision 1. [SCOPE.] The terms used in this chapter and 355.33 chapter 245B have the meanings given them in this section. 355.34 Sec. 5. Minnesota Statutes 2000, section 245A.02, is 355.35 amended by adding a subdivision to read: 355.36 Subd. 3a. [CERTIFICATION.] "Certification" means the 356.1 commissioner's written authorization for a license holder 356.2 licensed by the commissioner of human services or the 356.3 commissioner of corrections to serve children in a residential 356.4 program and provide specialized services based on certification 356.5 standards in Minnesota Rules. The term "certification" and its 356.6 derivatives have the same meaning and may be substituted for the 356.7 term "licensure" and its derivatives in this chapter. 356.8 Sec. 6. Minnesota Statutes 2000, section 245A.02, 356.9 subdivision 9, is amended to read: 356.10 Subd. 9. [LICENSE HOLDER.] "License holder" means an 356.11 individual, corporation, partnership, voluntary association, or 356.12 other organization that is legally responsible for the operation 356.13 of the program, has been granted a license by the commissioner 356.14 under this chapter or chapter 245B and the rules of the 356.15 commissioner, and is a controlling individual. 356.16 Sec. 7. Minnesota Statutes 2000, section 245A.03, 356.17 subdivision 2, is amended to read: 356.18 Subd. 2. [EXCLUSION FROM LICENSURE.] This chapter does not 356.19 apply to: 356.20 (1) residential or nonresidential programs that are 356.21 provided to a person by an individual who is related unless the 356.22 residential program is a child foster care placement made by a 356.23 local social services agency or a licensed child-placing agency, 356.24 except as provided in subdivision 2a; 356.25 (2) nonresidential programs that are provided by an 356.26 unrelated individual to persons from a single related family; 356.27 (3) residential or nonresidential programs that are 356.28 provided to adults who do not abuse chemicals or who do not have 356.29 a chemical dependency, a mental illness, mental retardation or a 356.30 related condition, a functional impairment, or a physical 356.31 handicap; 356.32 (4) sheltered workshops or work activity programs that are 356.33 certified by the commissioner of economic security; 356.34 (5) programs for children enrolled in kindergarten to the 356.35 12th grade and prekindergarten special education in a school as 356.36 defined in section 120A.22, subdivision 4, and programs serving 357.1 children in combined special education and regular 357.2 prekindergarten programs that are operated or assisted by the 357.3 commissioner of children, families, and learning; 357.4 (6) nonresidential programs primarily for children that 357.5 provide care or supervision, without charge for ten or fewer 357.6 days a year, and for periods of less than three hours a day 357.7 while the child's parent or legal guardian is in the same 357.8 building as the nonresidential program or present within another 357.9 building that is directly contiguous to the building in which 357.10 the nonresidential program is located; 357.11 (7) nursing homes or hospitals licensed by the commissioner 357.12 of health except as specified under section 245A.02; 357.13 (8) board and lodge facilities licensed by the commissioner 357.14 of health that provide services for five or more persons whose 357.15 primary diagnosis is mental illness who have refused an 357.16 appropriate residential program offered by a county agency. 357.17 This exclusion expires on July 1, 1990; 357.18 (9) homes providing programs for persons placed there by a 357.19 licensed agency for legal adoption, unless the adoption is not 357.20 completed within two years; 357.21 (10) programs licensed by the commissioner of corrections; 357.22 (11) recreation programs for children or adults that 357.23 operate for fewer than 40 calendar days in a calendar year or 357.24 programs operated by a park and recreation board of a city of 357.25 the first class whose primary purpose is to provide social and 357.26 recreational activities to school age children, provided the 357.27 program is approved by the park and recreation board; 357.28 (12) programs operated by a school as defined in section 357.29 120A.22, subdivision 4, whose primary purpose is to provide 357.30 child care to school-age children, provided the program is 357.31 approved by the district's school board; 357.32 (13) Head Start nonresidential programs which operate for 357.33 less than 31 days in each calendar year; 357.34 (14) noncertified boarding care homes unless they provide 357.35 services for five or more persons whose primary diagnosis is 357.36 mental illness or mental retardation; 358.1 (15) nonresidential programs for nonhandicapped children 358.2 provided for a cumulative total of less than 30 days in any 358.3 12-month period; 358.4 (16) residential programs for persons with mental illness, 358.5 that are located in hospitals, until the commissioner adopts 358.6 appropriate rules; 358.7 (17) the religious instruction of school-age children; 358.8 Sabbath or Sunday schools; or the congregate care of children by 358.9 a church, congregation, or religious society during the period 358.10 used by the church, congregation, or religious society for its 358.11 regular worship; 358.12 (18) camps licensed by the commissioner of health under 358.13 Minnesota Rules, chapter 4630; 358.14 (19) mental health outpatient services for adults with 358.15 mental illness or children with emotional disturbance; 358.16 (20) residential programs serving school-age children whose 358.17 sole purpose is cultural or educational exchange, until the 358.18 commissioner adopts appropriate rules; 358.19 (21) unrelated individuals who provide out-of-home respite 358.20 care services to persons with mental retardation or related 358.21 conditions from a single related family for no more than 90 days 358.22 in a 12-month period and the respite care services are for the 358.23 temporary relief of the person's family or legal representative; 358.24 (22) respite care services provided as a home and 358.25 community-based service to a person with mental retardation or a 358.26 related condition, in the person's primary residence; 358.27 (23) community support services programs as defined in 358.28 section 245.462, subdivision 6, and family community support 358.29 services as defined in section 245.4871, subdivision 17; 358.30 (24) the placement of a child by a birth parent or legal 358.31 guardian in a preadoptive home for purposes of adoption as 358.32 authorized by section 259.47;or358.33 (25) settings registered under chapter 144D which provide 358.34 home care services licensed by the commissioner of health to 358.35 fewer than seven adults.; or 358.36 (26) consumer-directed community support service funded 359.1 under the Medicaid waiver for persons with mental retardation 359.2 and related conditions when the individual who provided the 359.3 service is: 359.4 (i) the same individual who is the direct payee of these 359.5 specific waiver funds or paid by a fiscal agent, fiscal 359.6 intermediary, or employer of record; and 359.7 (ii) not otherwise under the control of a residential or 359.8 nonresidential program that is required to be licensed under 359.9 this chapter when providing the service. 359.10 For purposes of clause (6), a building is directly 359.11 contiguous to a building in which a nonresidential program is 359.12 located if it shares a common wall with the building in which 359.13 the nonresidential program is located or is attached to that 359.14 building by skyway, tunnel, atrium, or common roof. 359.15 Sec. 8. Minnesota Statutes 2000, section 245A.03, 359.16 subdivision 2b, is amended to read: 359.17 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 359.18 clause (2), does not apply to: 359.19 (1) a child care provider who as an applicant for licensure 359.20 or as a license holder has received a license denial under 359.21 section 245A.05, afineconditional license under section 359.22 245A.06, or a sanction under section 245A.07 from the 359.23 commissioner that has not been reversed on appeal; or 359.24 (2) a child care provider, or a child care provider who has 359.25 a household member who, as a result of a licensing process, has 359.26 a disqualification under this chapter that has not been set 359.27 aside by the commissioner. 359.28 Sec. 9. Minnesota Statutes 2000, section 245A.03, is 359.29 amended by adding a subdivision to read: 359.30 Subd. 6. [RIGHT TO SEEK CERTIFICATION.] Nothing in this 359.31 section shall prohibit a residential program licensed by the 359.32 commissioner of corrections to serve children, that is excluded 359.33 from licensure under subdivision 2, clause (10), from seeking 359.34 certification from the commissioner of human services under this 359.35 chapter for program services for which certification standards 359.36 have been adopted. 360.1 Sec. 10. Minnesota Statutes 2000, section 245A.035, 360.2 subdivision 1, is amended to read: 360.3 Subdivision 1. [GRANT OF EMERGENCY LICENSE.] 360.4 Notwithstanding section 245A.03, subdivision 2a, a county agency 360.5 may place a child for foster care with a relative who is not 360.6 licensed to provide foster care, provided the requirements of 360.7 subdivision 2 are met. As used in this section, the term 360.8 "relative" has the meaning given it under section260.181,360.9subdivision 3260C.007, subdivision 14. 360.10 Sec. 11. Minnesota Statutes 2000, section 245A.04, 360.11 subdivision 3, is amended to read: 360.12 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 360.13 (a)Before the commissioner issues a license, the commissioner360.14shall conduct a study of the individuals specified in paragraph360.15(c), clauses (1) to (5), according to rules of the commissioner.360.16Beginning January 1, 1997, the commissioner shall also360.17conduct a study of employees providing direct contact services360.18for nonlicensed personal care provider organizationsIndividuals 360.19 and organizations that are required in statute to initiate 360.20 background studies under this section shall comply with the 360.21 following requirements: 360.22 (1) Applicants for licensure, license holders, and other 360.23 entities as provided in this section must submit completed 360.24 background study forms to the commissioner before individuals 360.25 specified in paragraph (c), clauses (1) to (4), (6), and (7), 360.26 begin positions allowing direct contact in any licensed program. 360.27 (2) Applicants and license holders under the jurisdiction 360.28 of other state agencies who are required in other statutory 360.29 sections to initiate background studies under this section must 360.30 submit completed background study forms to the commissioner 360.31 prior to the background study subject beginning in a position 360.32 allowing direct contact in the licensed program, or where 360.33 applicable, prior to being employed. 360.34 (3) Organizations required to initiate background studies 360.35 under section 256B.0627 for individuals described in paragraph 360.36 (c), clause (5), must submit a completed background study form 361.1 to the commissioner before those individuals begin a position 361.2 allowing direct contact with persons served by the organization. 361.3 The commissioner shall recover the cost of these background 361.4 studies through a fee of no more than $12 per study charged to 361.5 thepersonal care providerorganization responsible for 361.6 submitting the background study form. The fees collected under 361.7 this paragraph are appropriated to the commissioner for the 361.8 purpose of conducting background studies. 361.9Beginning August 1, 1997,Upon receipt of the background 361.10 study forms from the entities in clauses (1) to (3), the 361.11 commissioner shallconduct all background studies required under361.12this chapter for adult foster care providers who are licensed by361.13the commissioner of human services and registered under chapter361.14144D. The commissioner shall conduct these background studies361.15in accordance with this chapter. The commissioner shall361.16initiate a pilot project to conduct up to 5,000 background361.17studies under this chaptercomplete the background study as 361.18 specified under this section and provide notices required in 361.19 subdivision 3a. Unless otherwise specified, the subject of a 361.20 background study may have direct contact with persons served by 361.21 a program after the background study form is mailed or submitted 361.22 to the commissioner pending notification of the study results 361.23 under subdivision 3a. A county agency may accept a background 361.24 study completed by the commissioner under this section in place 361.25 of the background study required under section 245A.16, 361.26 subdivision 3, in programs with joint licensure as home and 361.27 community-based services and adult foster care for people with 361.28 developmental disabilities when the license holder does not 361.29 reside in the foster care residence and the subject of the study 361.30 has been continuously affiliated with the license holder since 361.31 the date of the commissioner's study. 361.32 (b)Beginning July 1, 1998, the commissioner shall conduct361.33a background study on individuals specified in paragraph (c),361.34clauses (1) to (5), who perform direct contact services in a361.35nursing home or a home care agency licensed under chapter 144A361.36or a boarding care home licensed under sections 144.50 to362.1144.58, when the subject of the study resides outside Minnesota;362.2the study must be at least as comprehensive as that of a362.3Minnesota resident and include a search of information from the362.4criminal justice data communications network in the state where362.5the subject of the study residesThe definitions in this 362.6 paragraph apply only to subdivisions 3 to 3e. 362.7 (1) "Background study" means the review of records 362.8 conducted by the commissioner to determine whether a subject is 362.9 disqualified from direct contact with persons served by a 362.10 program, and where specifically provided in statutes, whether a 362.11 subject is disqualified from having access to persons served by 362.12 a program. 362.13 (2) "Continuous, direct supervision" means an individual is 362.14 within sight or hearing of the supervising person to the extent 362.15 that supervising person is capable at all times of intervening 362.16 to protect the health and safety of the persons served by the 362.17 program. 362.18 (3) "Contractor" means any person, regardless of employer, 362.19 who is providing program services for hire under the control of 362.20 the provider. 362.21 (4) "Direct contact" means providing face-to-face care, 362.22 training, supervision, counseling, consultation, or medication 362.23 assistance to persons served by the program. 362.24 (5) "Reasonable cause" means information or circumstances 362.25 exist which provide the commissioner with articulable suspicion 362.26 that further pertinent information may exist concerning a 362.27 subject. The commissioner has reasonable cause when, but not 362.28 limited to, the commissioner has received a report from the 362.29 subject, the license holder, or a third party indicating that 362.30 the subject has a history that would disqualify the person or 362.31 that may pose a risk to the health or safety of persons 362.32 receiving services. 362.33 (6) "Subject of a background study" means an individual on 362.34 whom a background study is required or completed. 362.35 (c) The applicant, license holder,theregistrant under 362.36 section 144A.71, subdivision 1, bureau of criminal apprehension, 363.1thecommissioner of health, and county agencies, after written 363.2 notice to the individual who is the subject of the study, shall 363.3 help with the study by giving the commissioner criminal 363.4 conviction data and reports about the maltreatment of adults 363.5 substantiated under section 626.557 and the maltreatment of 363.6 minors in licensed programs substantiated under section 363.7 626.556. The individuals to be studied shall include: 363.8 (1) the applicant; 363.9 (2) personsover theageof13 and over living in the 363.10 household where the licensed program will be provided; 363.11 (3) current employees or contractors of the applicant who 363.12 will have direct contact with persons served by the facility, 363.13 agency, or program; 363.14 (4) volunteers or student volunteers who have direct 363.15 contact with persons served by the program to provide program 363.16 services, if the contact is not directly supervised by the 363.17 individuals listed in clause (1) or (3);and363.18 (5) any personwho, as an individual or as a member of an363.19organization, exclusively offers, provides, or arranges for363.20personal care assistant services under the medical assistance363.21program as authorized under sections 256B.04, subdivision 16,363.22and 256B.0625, subdivision 19a.required under section 256B.0627 363.23 to have a background study completed under this section; 363.24 (6) persons age 10 to 12 living in the household where the 363.25 licensed services will be provided when the commissioner has 363.26 reasonable cause; and 363.27 (7) persons who, without providing direct contact services 363.28 at a licensed program, may have unsupervised access to children 363.29 or vulnerable adults receiving services from the program 363.30 licensed to provide family child care for children, foster care 363.31 for children in the provider's own home, or foster care or day 363.32 care services for adults in the provider's own home when the 363.33 commissioner has reasonable cause. 363.34 (d) According to paragraph (c), clauses (2) and (6), the 363.35 commissioner shall review records from the juvenile courts. For 363.36 persons under paragraph (c), clauses (1), (3), (4), (5), and 364.1 (7), who are ages 13 to 17, the commissioner shall review 364.2 records from the juvenile courts when the commissioner has 364.3 reasonable cause. The juvenile courts shallalsohelp with the 364.4 study by giving the commissioner existing juvenile court records 364.5 on individuals described inclauseparagraph (c), clauses (2), 364.6 (6), and (7), relating to delinquency proceedings held within 364.7 either the five years immediately preceding theapplication364.8 background study or the five years immediately preceding the 364.9 individual's 18th birthday, whichever time period is longer. 364.10 The commissioner shall destroy juvenile records obtained 364.11 pursuant to this subdivision when the subject of the records 364.12 reaches age 23. 364.13 (e) Beginning August 1, 2001, the commissioner shall 364.14 conduct all background studies required under this chapter and 364.15 initiated by supplemental nursing services agencies registered 364.16 under section 144A.71, subdivision 1. Studies for the agencies 364.17 must be initiated annually by each agency. The commissioner 364.18 shall conduct the background studies according to this chapter. 364.19 The commissioner shall recover the cost of the background 364.20 studies through a fee of no more than $8 per study, charged to 364.21 the supplemental nursing services agency. The fees collected 364.22 under this paragraph are appropriated to the commissioner for 364.23 the purpose of conducting background studies. 364.24 (f) For purposes of this sectionand Minnesota Rules, part364.259543.3070, a finding that a delinquency petition is proven in 364.26 juvenile court shall be considered a conviction in state 364.27 district court. 364.28For purposes of this subdivision, "direct contact" means364.29providing face-to-face care, training, supervision, counseling,364.30consultation, or medication assistance to persons served by a364.31program. For purposes of this subdivision, "directly supervised"364.32means an individual listed in clause (1), (3), or (5) is within364.33sight or hearing of a volunteer to the extent that the364.34individual listed in clause (1), (3), or (5) is capable at all364.35times of intervening to protect the health and safety of the364.36persons served by the program who have direct contact with the365.1volunteer.365.2 (g) A study of an individual in paragraph (c), clauses (1) 365.3 to(5)(7), shall be conducted at least upon application for 365.4 initial license for all license types or registration under 365.5 section 144A.71, subdivision 1, and at reapplication for a 365.6 license or registration for family child care, child foster 365.7 care, and adult foster care. The commissioner is not required 365.8 to conduct a study of an individual at the time of reapplication 365.9 for a license or if the individual has been continuously 365.10 affiliated with a foster care provider licensed by the 365.11 commissioner of human services and registered under chapter 365.12 144D, other than a family day care or foster care license, if: 365.13 (i) a study of the individual was conducted either at the time 365.14 of initial licensure or when the individual became affiliated 365.15 with the license holder; (ii) the individual has been 365.16 continuously affiliated with the license holder since the last 365.17 study was conducted; and (iii) the procedure described in 365.18 paragraph(d)(j) has been implemented and was in effect 365.19 continuously since the last study was conducted. For the 365.20 purposes of this section, a physician licensed under chapter 147 365.21 is considered to be continuously affiliated upon the license 365.22 holder's receipt from the commissioner of health or human 365.23 services of the physician's background study results. For 365.24 individuals who are required to have background studies 365.25 underclauses (1) to (5)paragraph (c) and who have been 365.26 continuously affiliated with a foster care provider that is 365.27 licensed in more than one county, criminal conviction data may 365.28 be shared among those counties in which the foster care programs 365.29 are licensed. A county agency's receipt of criminal conviction 365.30 data from another county agency shall meet the criminal data 365.31 background study requirements of this section. 365.32 (h) The commissioner may also conduct studies on 365.33 individuals specified in paragraph (c), clauses (3) and (4), 365.34 when the studies are initiated by: 365.35 (i) personnel pool agencies; 365.36 (ii) temporary personnel agencies; 366.1 (iii) educational programs that train persons by providing 366.2 direct contact services in licensed programs; and 366.3 (iv) professional services agencies that are not licensed 366.4 and which contract with licensed programs to provide direct 366.5 contact services or individuals who provide direct contact 366.6 services. 366.7 (i) Studies on individuals in paragraph (h), items (i) to 366.8 (iv), must be initiated annually by these agencies, programs, 366.9 and individuals. Exceptfor personal care provider366.10organizationsas provided in paragraph (a), clause (3), no 366.11 applicant, license holder, or individual who is the subject of 366.12 the study shall pay any fees required to conduct the study. 366.13 (1) At the option of the licensed facility, rather than 366.14 initiating another background study on an individual required to 366.15 be studied who has indicated to the licensed facility that a 366.16 background study by the commissioner was previously completed, 366.17 the facility may make a request to the commissioner for 366.18 documentation of the individual's background study status, 366.19 provided that: 366.20 (i) the facility makes this request using a form provided 366.21 by the commissioner; 366.22 (ii) in making the request the facility informs the 366.23 commissioner that either: 366.24 (A) the individual has been continuously affiliated with a 366.25 licensed facility since the individual's previous background 366.26 study was completed, or since October 1, 1995, whichever is 366.27 shorter; or 366.28 (B) the individual is affiliated only with a personnel pool 366.29 agency, a temporary personnel agency, an educational program 366.30 that trains persons by providing direct contact services in 366.31 licensed programs, or a professional services agency that is not 366.32 licensed and which contracts with licensed programs to provide 366.33 direct contact services or individuals who provide direct 366.34 contact services; and 366.35 (iii) the facility provides notices to the individual as 366.36 required in paragraphs (a) to(d)(j), and that the facility is 367.1 requesting written notification of the individual's background 367.2 study status from the commissioner. 367.3 (2) The commissioner shall respond to each request under 367.4 paragraph (1) with a written or electronic notice to the 367.5 facility and the study subject. If the commissioner determines 367.6 that a background study is necessary, the study shall be 367.7 completed without further request from a licensed agency or 367.8 notifications to the study subject. 367.9 (3) When a background study is being initiated by a 367.10 licensed facility or a foster care provider that is also 367.11 registered under chapter 144D, a study subject affiliated with 367.12 multiple licensed facilities may attach to the background study 367.13 form a cover letter indicating the additional facilities' names, 367.14 addresses, and background study identification numbers. When 367.15 the commissioner receives such notices, each facility identified 367.16 by the background study subject shall be notified of the study 367.17 results. The background study notice sent to the subsequent 367.18 agencies shall satisfy those facilities' responsibilities for 367.19 initiating a background study on that individual. 367.20(d)(j) If an individual who is affiliated with a program 367.21 or facility regulated by the department of human services or 367.22 department of health or who is affiliated witha nonlicensed367.23personal care provider organizationany type of home care agency 367.24 or provider of personal care assistance services, is convicted 367.25 of a crime constituting a disqualification under subdivision 3d, 367.26 the probation officer or corrections agent shall notify the 367.27 commissioner of the conviction. For the purpose of this 367.28 paragraph, "conviction" has the meaning given it in section 367.29 609.02, subdivision 5. The commissioner, in consultation with 367.30 the commissioner of corrections, shall develop forms and 367.31 information necessary to implement this paragraph and shall 367.32 provide the forms and information to the commissioner of 367.33 corrections for distribution to local probation officers and 367.34 corrections agents. The commissioner shall inform individuals 367.35 subject to a background study that criminal convictions for 367.36 disqualifying crimes will be reported to the commissioner by the 368.1 corrections system. A probation officer, corrections agent, or 368.2 corrections agency is not civilly or criminally liable for 368.3 disclosing or failing to disclose the information required by 368.4 this paragraph. Upon receipt of disqualifying information, the 368.5 commissioner shall provide the notifications required in 368.6 subdivision 3a, as appropriate to agencies on record as having 368.7 initiated a background study or making a request for 368.8 documentation of the background study status of the individual. 368.9 This paragraph does not apply to family day care and child 368.10 foster care programs. 368.11(e)(k) The individual who is the subject of the study must 368.12 provide the applicant or license holder with sufficient 368.13 information to ensure an accurate study including the 368.14 individual's first, middle, and last name and all other names by 368.15 which the individual has been known; home address, city, county, 368.16 and state of residence for the past five years; zip code; sex; 368.17 date of birth; and driver's license number or state 368.18 identification number. The applicant or license holder shall 368.19 provide this information about an individual in paragraph (c), 368.20 clauses (1) to(5)(7), on forms prescribed by the commissioner. 368.21 By January 1, 2000, for background studies conducted by the 368.22 department of human services, the commissioner shall implement a 368.23 system for the electronic transmission of: (1) background study 368.24 information to the commissioner; and (2) background study 368.25 results to the license holder. The commissioner may request 368.26 additional information of the individual, which shall be 368.27 optional for the individual to provide, such as the individual's 368.28 social security number or race. 368.29(f) Except for child foster care, adult foster care, and368.30family day care homes(l) For programs directly licensed by the 368.31 commissioner, a study must include information related to names 368.32 of substantiated perpetrators of maltreatment of vulnerable 368.33 adults that has been received by the commissioner as required 368.34 under section 626.557, subdivision 9c, paragraph (i), and the 368.35 commissioner's records relating to the maltreatment of minors in 368.36 licensed programs, information from juvenile courts as required 369.1 in paragraph (c) for persons listed in paragraph (c), 369.2clauseclauses (2), (6), and (7), and information from the 369.3 bureau of criminal apprehension. For child foster care, adult 369.4 foster care, and family day care homes, the study must include 369.5 information from the county agency's record of substantiated 369.6 maltreatment of adults, and the maltreatment of minors, 369.7 information from juvenile courts as required in paragraph (c) 369.8 for persons listed in paragraph (c),clauseclauses (2), (6), 369.9 and (7), and information from the bureau of criminal 369.10 apprehension. The commissioner may also review arrest and 369.11 investigative information from the bureau of criminal 369.12 apprehension, the commissioner of health, a county attorney, 369.13 county sheriff, county agency, local chief of police, other 369.14 states, the courts, or the Federal Bureau of Investigation if 369.15 the commissioner has reasonable cause to believe the information 369.16 is pertinent to the disqualification of an individual listed in 369.17 paragraph (c), clauses (1) to(5)(7). The commissioner is not 369.18 required to conduct more than one review of a subject's records 369.19 from the Federal Bureau of Investigation if a review of the 369.20 subject's criminal history with the Federal Bureau of 369.21 Investigation has already been completed by the commissioner and 369.22 there has been no break in the subject's affiliation with the 369.23 license holder who initiated the backgroundstudiesstudy. 369.24 (m) When the commissioner has reasonable cause to believe 369.25 that further pertinent information may exist on the subject, the 369.26 subject shall provide a set of classifiable fingerprints 369.27 obtained from an authorized law enforcement agency. For 369.28 purposes of requiring fingerprints, the commissioner shall be 369.29 considered to have reasonable cause under, but not limited to, 369.30 the following circumstances: 369.31 (1) information from the bureau of criminal apprehension 369.32 indicates that the subject is a multistate offender; 369.33 (2) information from the bureau of criminal apprehension 369.34 indicates that multistate offender status is undetermined; or 369.35 (3) the commissioner has received a report from the subject 369.36 or a third party indicating that the subject has a criminal 370.1 history in a jurisdiction other than Minnesota. 370.2(g)(n) The failure or refusal of anapplicant's or license370.3holder's failure or refusalapplicant, license holder, or 370.4 registrant under section 144A.71, subdivision 1, to cooperate 370.5 with the commissioner is reasonable cause to disqualify a 370.6 subject, deny a license application or immediately suspend, 370.7 suspend, or revoke a license or registration. Failure or 370.8 refusal of an individual to cooperate with the study is just 370.9 cause for denying or terminating employment of the individual if 370.10 the individual's failure or refusal to cooperate could cause the 370.11 applicant's application to be denied or the license holder's 370.12 license to be immediately suspended, suspended, or revoked. 370.13(h)(o) The commissioner shall not consider an application 370.14 to be complete until all of the information required to be 370.15 provided under this subdivision has been received. 370.16(i)(p) No person in paragraph (c),clauseclauses (1),370.17(2), (3), (4), or (5)to (7), who is disqualified as a result of 370.18 this section may be retained by the agency in a position 370.19 involving direct contact with persons served by the program.or 370.20 in a position allowing access to persons served by the program 370.21 as provided for in statutes, unless the commissioner has 370.22 provided written notice to the agency stating that: 370.23 (1) the individual may remain in direct contact during the 370.24 period in which the individual may request reconsideration as 370.25 provided in subdivision 3a, paragraph (b), clause (2) or (3); 370.26 (2) the individual's disqualification has been set aside 370.27 for that agency as provided in subdivision 3b, paragraph (b); or 370.28 (3) the license holder has been granted a variance for the 370.29 disqualified individual under subdivision 3e. 370.30(j)(q) Termination of persons in paragraph (c),clause370.31 clauses (1), (2), (3), (4), or (5)to (7), made in good faith 370.32 reliance on a notice of disqualification provided by the 370.33 commissioner shall not subject the applicant or license holder 370.34 to civil liability. 370.35(k)(r) The commissioner may establish records to fulfill 370.36 the requirements of this section. 371.1(l)(s) The commissioner may not disqualify an individual 371.2 subject to a study under this section because that person has, 371.3 or has had, a mental illness as defined in section 245.462, 371.4 subdivision 20. 371.5(m)(t) An individual subject to disqualification under 371.6 this subdivision has the applicable rights in subdivision 3a, 371.7 3b, or 3c. 371.8(n)(u) For the purposes of background studies completed by 371.9 tribal organizations performing licensing activities otherwise 371.10 required of the commissioner under this chapter, after obtaining 371.11 consent from the background study subject, tribal licensing 371.12 agencies shall have access to criminal history data in the same 371.13 manner as county licensing agencies and private licensing 371.14 agencies under this chapter. 371.15 Sec. 12. Minnesota Statutes 2000, section 245A.04, 371.16 subdivision 3a, is amended to read: 371.17 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 371.18 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15 371.19 working days, the commissioner shall notify the applicantor, 371.20 license holder, or registrant under section 144A.71, subdivision 371.21 1, and the individual who is the subject of the study, in 371.22 writing or by electronic transmission, of the results of the 371.23 study or that more time is needed to complete the study. When 371.24 the study is completed, a notice that the study was undertaken 371.25 and completed shall be maintained in the personnel files of the 371.26 program. For studies on individuals pertaining to a license to 371.27 provide family day care or group family day care, foster care 371.28 for children in the provider's own home, or foster care or day 371.29 care services for adults in the provider's own home, the 371.30 commissioner is not required to provide a separate notice of the 371.31 background study results to the individual who is the subject of 371.32 the study unless the study results in a disqualification of the 371.33 individual. 371.34 The commissioner shall notify the individual studied if the 371.35 information in the study indicates the individual is 371.36 disqualified from direct contact with persons served by the 372.1 program. The commissioner shall disclose the information 372.2 causing disqualification and instructions on how to request a 372.3 reconsideration of the disqualification to the individual 372.4 studied. An applicant or license holder who is not the subject 372.5 of the study shall be informed that the commissioner has found 372.6 information that disqualifies the subject from direct contact 372.7 with persons served by the program. However, only the 372.8 individual studied must be informed of the information contained 372.9 in the subject's background study unless theonlybasis for the 372.10 disqualification is failure to cooperate, substantiated 372.11 maltreatment under section 626.556 or 626.557, the Data 372.12 Practices Act provides for release of the information, or the 372.13 individual studied authorizes the release of the 372.14 information. When a disqualification is based on the subject's 372.15 failure to cooperate with the background study or substantiated 372.16 maltreatment under section 626.556 or 626.557, the agency that 372.17 initiated the study shall be informed by the commissioner of the 372.18 reason for the disqualification. 372.19 (b) Except as provided in subdivision 3d, paragraph (b), if 372.20 the commissioner determines that the individual studied has a 372.21 disqualifying characteristic, the commissioner shall review the 372.22 information immediately available and make a determination as to 372.23 the subject's immediate risk of harm to persons served by the 372.24 program where the individual studied will have direct contact. 372.25 The commissioner shall consider all relevant information 372.26 available, including the following factors in determining the 372.27 immediate risk of harm: the recency of the disqualifying 372.28 characteristic; the recency of discharge from probation for the 372.29 crimes; the number of disqualifying characteristics; the 372.30 intrusiveness or violence of the disqualifying characteristic; 372.31 the vulnerability of the victim involved in the disqualifying 372.32 characteristic; and the similarity of the victim to the persons 372.33 served by the program where the individual studied will have 372.34 direct contact. The commissioner may determine that the 372.35 evaluation of the information immediately available gives the 372.36 commissioner reason to believe one of the following: 373.1 (1) The individual poses an imminent risk of harm to 373.2 persons served by the program where the individual studied will 373.3 have direct contact. If the commissioner determines that an 373.4 individual studied poses an imminent risk of harm to persons 373.5 served by the program where the individual studied will have 373.6 direct contact, the individual and the license holder must be 373.7 sent a notice of disqualification. The commissioner shall order 373.8 the license holder to immediately remove the individual studied 373.9 from direct contact. The notice to the individual studied must 373.10 include an explanation of the basis of this determination. 373.11 (2) The individual poses a risk of harm requiring 373.12 continuous, direct supervision while providing direct contact 373.13 services during the period in which the subject may request a 373.14 reconsideration. If the commissioner determines that an 373.15 individual studied poses a risk of harm that requires 373.16 continuous, direct supervision, the individual and the license 373.17 holder must be sent a notice of disqualification. The 373.18 commissioner shall order the license holder to immediately 373.19 remove the individual studied from direct contact services or 373.20 assure that the individual studied is within sight or hearing of 373.21 another staff person when providing direct contact services 373.22 during the period in which the individual may request a 373.23 reconsideration of the disqualification. If the individual 373.24 studied does not submit a timely request for reconsideration, or 373.25 the individual submits a timely request for reconsideration, but 373.26 the disqualification is not set aside for that license holder, 373.27 the license holder will be notified of the disqualification and 373.28 ordered to immediately remove the individual from any position 373.29 allowing direct contact with persons receiving services from the 373.30 license holder. 373.31 (3) The individual does not pose an imminent risk of harm 373.32 or a risk of harm requiring continuous, direct supervision while 373.33 providing direct contact services during the period in which the 373.34 subject may request a reconsideration. If the commissioner 373.35 determines that an individual studied does not pose a risk of 373.36 harm that requires continuous, direct supervision, only the 374.1 individual must be sent a notice of disqualification. The 374.2 license holder must be sent a notice that more time is needed to 374.3 complete the individual's background study. If the individual 374.4 studied submits a timely request for reconsideration, and if the 374.5 disqualification is set aside for that license holder, the 374.6 license holder will receive the same notification received by 374.7 license holders in cases where the individual studied has no 374.8 disqualifying characteristic. If the individual studied does 374.9 not submit a timely request for reconsideration, or the 374.10 individual submits a timely request for reconsideration, but the 374.11 disqualification is not set aside for that license holder, the 374.12 license holder will be notified of the disqualification and 374.13 ordered to immediately remove the individual from any position 374.14 allowing direct contact with persons receiving services from the 374.15 license holder. 374.16 (c) County licensing agencies performing duties under this 374.17 subdivision may develop an alternative system for determining 374.18 the subject's immediate risk of harm to persons served by the 374.19 program, providing the notices under paragraph (b), and 374.20 documenting the action taken by the county licensing agency. 374.21 Each county licensing agency's implementation of the alternative 374.22 system is subject to approval by the commissioner. 374.23 Notwithstanding this alternative system, county licensing 374.24 agencies shall complete the requirements of paragraph (a). 374.25 Sec. 13. Minnesota Statutes 2000, section 245A.04, 374.26 subdivision 3b, is amended to read: 374.27 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 374.28 individual who is the subject of the disqualification may 374.29 request a reconsideration of the disqualification. 374.30 The individual must submit the request for reconsideration 374.31 to the commissioner in writing. A request for reconsideration 374.32 for an individual who has been sent a notice of disqualification 374.33 under subdivision 3a, paragraph (b), clause (1) or (2), must be 374.34 submitted within 30 calendar days of the disqualified 374.35 individual's receipt of the notice of disqualification. Upon 374.36 showing that the information in clause (1) or (2) cannot be 375.1 obtained within 30 days, the disqualified individual may request 375.2 additional time, not to exceed 30 days, to obtain that 375.3 information. A request for reconsideration for an individual 375.4 who has been sent a notice of disqualification under subdivision 375.5 3a, paragraph (b), clause (3), must be submitted within 15 375.6 calendar days of the disqualified individual's receipt of the 375.7 notice of disqualification. An individual who was determined to 375.8 have maltreated a child under section 626.556 or a vulnerable 375.9 adult under section 626.557, and who was disqualified under this 375.10 section on the basis of serious or recurring maltreatment, may 375.11 request reconsideration of both the maltreatment and the 375.12 disqualification determinations. The request for 375.13 reconsideration of the maltreatment determination and the 375.14 disqualification must be submitted within 30 calendar days of 375.15 the individual's receipt of the notice of disqualification. 375.16 Removal of a disqualified individual from direct contact shall 375.17 be ordered if the individual does not request reconsideration 375.18 within the prescribed time, and for an individual who submits a 375.19 timely request for reconsideration, if the disqualification is 375.20 not set aside. The individual must present information showing 375.21 that: 375.22 (1) the information the commissioner relied upon is 375.23 incorrect or inaccurate. If the basis of a reconsideration 375.24 request is that a maltreatment determination or disposition 375.25 under section 626.556 or 626.557 is incorrect, and the 375.26 commissioner has issued a final order in an appeal of that 375.27 determination or disposition under section 256.045 or 245A.08, 375.28 subdivision 5, the commissioner's order is conclusive on the 375.29 issue of maltreatment. If the individual did not request 375.30 reconsideration of the maltreatment determination, the 375.31 maltreatment determination is deemed conclusive; or 375.32 (2) the subject of the study does not pose a risk of harm 375.33 to any person served by the applicantor, license holder, or 375.34 registrant under section 144A.71, subdivision 1. 375.35 (b) The commissioner shall rescind the disqualification if 375.36 the commissioner finds that the information relied on to 376.1 disqualify the subject is incorrect. The commissioner may set 376.2 aside the disqualification under this section if the 376.3 commissioner finds that theinformation the commissioner relied376.4upon is incorrect or theindividual does not pose a risk of harm 376.5 to any person served by the applicantor, license holder, or 376.6 registrant under section 144A.71, subdivision 1. In determining 376.7 that an individual does not pose a risk of harm, the 376.8 commissioner shall consider the nature, severity, and 376.9 consequences of the event or events that lead to 376.10 disqualification, whether there is more than one disqualifying 376.11 event, the age and vulnerability of the victim at the time of 376.12 the event, the harm suffered by the victim, the similarity 376.13 between the victim and persons served by the program, the time 376.14 elapsed without a repeat of the same or similar event, 376.15 documentation of successful completion by the individual studied 376.16 of training or rehabilitation pertinent to the event, and any 376.17 other information relevant to reconsideration. In reviewing a 376.18 disqualification under this section, the commissioner shall give 376.19 preeminent weight to the safety of each person to be served by 376.20 the license holderor, applicant, or registrant under section 376.21 144A.71, subdivision 1, over the interests of the license holder 376.22or, applicant, or registrant under section 144A.71, subdivision 376.23 1. 376.24 (c) Unless the information the commissioner relied on in 376.25 disqualifying an individual is incorrect, the commissioner may 376.26 not set aside the disqualification of an individual in 376.27 connection with a license to provide family day care for 376.28 children, foster care for children in the provider's own home, 376.29 or foster care or day care services for adults in the provider's 376.30 own home if: 376.31 (1) less than ten years have passed since the discharge of 376.32 the sentence imposed for the offense; and the individual has 376.33 been convicted of a violation of any offense listed in sections 376.34 609.20 (manslaughter in the first degree), 609.205 (manslaughter 376.35 in the second degree), criminal vehicular homicide under 609.21 376.36 (criminal vehicular homicide and injury), 609.215 (aiding 377.1 suicide or aiding attempted suicide), felony violations under 377.2 609.221 to 609.2231 (assault in the first, second, third, or 377.3 fourth degree), 609.713 (terroristic threats), 609.235 (use of 377.4 drugs to injure or to facilitate crime), 609.24 (simple 377.5 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 377.6 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 377.7 first or second degree), 609.71 (riot), burglary in the first or 377.8 second degree under 609.582 (burglary), 609.66 (dangerous 377.9 weapon), 609.665 (spring guns), 609.67 (machine guns and 377.10 short-barreled shotguns), 609.749 (harassment; stalking), 377.11 152.021 or 152.022 (controlled substance crime in the first or 377.12 second degree), 152.023, subdivision 1, clause (3) or (4), or 377.13 subdivision 2, clause (4) (controlled substance crime in the 377.14 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 377.15 (controlled substance crime in the fourth degree), 609.224, 377.16 subdivision 2, paragraph (c) (fifth-degree assault by a 377.17 caregiver against a vulnerable adult), 609.228 (great bodily 377.18 harm caused by distribution of drugs), 609.23 (mistreatment of 377.19 persons confined), 609.231 (mistreatment of residents or 377.20 patients), 609.2325 (criminal abuse of a vulnerable adult), 377.21 609.233 (criminal neglect of a vulnerable adult), 609.2335 377.22 (financial exploitation of a vulnerable adult), 609.234 (failure 377.23 to report), 609.265 (abduction), 609.2664 to 609.2665 377.24 (manslaughter of an unborn child in the first or second degree), 377.25 609.267 to 609.2672 (assault of an unborn child in the first, 377.26 second, or third degree), 609.268 (injury or death of an unborn 377.27 child in the commission of a crime), 617.293 (disseminating or 377.28 displaying harmful material to minors), a felony level 377.29 conviction involving alcohol or drug use, a gross misdemeanor 377.30 offense under 609.324, subdivision 1 (other prohibited acts), a 377.31 gross misdemeanor offense under 609.378 (neglect or endangerment 377.32 of a child), a gross misdemeanor offense under 609.377 377.33 (malicious punishment of a child), 609.72, subdivision 3 377.34 (disorderly conduct against a vulnerable adult); or an attempt 377.35 or conspiracy to commit any of these offenses, as each of these 377.36 offenses is defined in Minnesota Statutes; or an offense in any 378.1 other state, the elements of which are substantially similar to 378.2 the elements of any of the foregoing offenses; 378.3 (2) regardless of how much time has passed since the 378.4 involuntary termination of parental rights under section 378.5 260C.301 or the discharge of the sentence imposed for the 378.6 offense, the individual was convicted of a violation of any 378.7 offense listed in sections 609.185 to 609.195 (murder in the 378.8 first, second, or third degree), 609.2661 to 609.2663 (murder of 378.9 an unborn child in the first, second, or third degree), a felony 378.10 offense under 609.377 (malicious punishment of a child), a 378.11 felony offense under 609.324, subdivision 1 (other prohibited 378.12 acts), a felony offense under 609.378 (neglect or endangerment 378.13 of a child), 609.322 (solicitation, inducement, and promotion of 378.14 prostitution), 609.342 to 609.345 (criminal sexual conduct in 378.15 the first, second, third, or fourth degree), 609.352 378.16 (solicitation of children to engage in sexual conduct), 617.246 378.17 (use of minors in a sexual performance), 617.247 (possession of 378.18 pictorial representations of a minor), 609.365 (incest), a 378.19 felony offense under sections 609.2242 and 609.2243 (domestic 378.20 assault), a felony offense of spousal abuse, a felony offense of 378.21 child abuse or neglect, a felony offense of a crime against 378.22 children, or an attempt or conspiracy to commit any of these 378.23 offenses as defined in Minnesota Statutes, or an offense in any 378.24 other state, the elements of which are substantially similar to 378.25 any of the foregoing offenses; 378.26 (3) within the seven years preceding the study, the 378.27 individual committed an act that constitutes maltreatment of a 378.28 child under section 626.556, subdivision 10e, and that resulted 378.29 in substantial bodily harm as defined in section 609.02, 378.30 subdivision 7a, or substantial mental or emotional harm as 378.31 supported by competent psychological or psychiatric evidence; or 378.32 (4) within the seven years preceding the study, the 378.33 individual was determined under section 626.557 to be the 378.34 perpetrator of a substantiated incident of maltreatment of a 378.35 vulnerable adult that resulted in substantial bodily harm as 378.36 defined in section 609.02, subdivision 7a, or substantial mental 379.1 or emotional harm as supported by competent psychological or 379.2 psychiatric evidence. 379.3 In the case of any ground for disqualification under 379.4 clauses (1) to (4), if the act was committed by an individual 379.5 other than the applicantor, license holder, or registrant under 379.6 section 144A.71, subdivision 1, residing in the applicant's or 379.7 license holder's home, or the home of a registrant under section 379.8 144A.71, subdivision 1, the applicantor, license holder, or 379.9 registrant under section 144A.71, subdivision 1, may seek 379.10 reconsideration when the individual who committed the act no 379.11 longer resides in the home. 379.12 The disqualification periods provided under clauses (1), 379.13 (3), and (4) are the minimum applicable disqualification 379.14 periods. The commissioner may determine that an individual 379.15 should continue to be disqualified from licensure or 379.16 registration under section 144A.71, subdivision 1, because the 379.17 license holderor, applicant, or registrant under section 379.18 144A.71, subdivision 1, poses a risk of harm to a person served 379.19 by that individual after the minimum disqualification period has 379.20 passed. 379.21 (d) The commissioner shall respond in writing or by 379.22 electronic transmission to all reconsideration requests for 379.23 which the basis for the request is that the information relied 379.24 upon by the commissioner to disqualify is incorrect or 379.25 inaccurate within 30 working days of receipt of a request and 379.26 all relevant information. If the basis for the request is that 379.27 the individual does not pose a risk of harm, the commissioner 379.28 shall respond to the request within 15 working days after 379.29 receiving the request for reconsideration and all relevant 379.30 information. If the request is based on both the correctness or 379.31 accuracy of the information relied on to disqualify the 379.32 individual and the risk of harm, the commissioner shall respond 379.33 to the request within 45 working days after receiving the 379.34 request for reconsideration and all relevant information. If 379.35 the disqualification is set aside, the commissioner shall notify 379.36 the applicant or license holder in writing or by electronic 380.1 transmission of the decision. 380.2 (e) Except as provided in subdivision 3c,the380.3commissioner's decision to disqualify an individual, including380.4the decision to grant or deny a rescission or set aside a380.5disqualification under this section, is the final administrative380.6agency action and shall not be subject to further review in a380.7contested case under chapter 14 involving a negative licensing380.8appeal taken in response to the disqualification or involving an380.9accuracy and completeness appeal under section 13.04.if a 380.10 disqualification is not set aside or is not rescinded, an 380.11 individual who was disqualified on the basis of a preponderance 380.12 of evidence that the individual committed an act or acts that 380.13 meet the definition of any of the crimes lists in subdivision 380.14 3d, paragraph (a), clauses (1) to (4); or for failure to make 380.15 required reports under section 626.556, subdivision 3, or 380.16 626.557, subdivision 3, pursuant to subdivision 3d, paragraph 380.17 (a), clause (4), may request a fair hearing under section 380.18 256.045. Except as provided under subdivision 3c, the 380.19 commissioner's final order for an individual under this 380.20 paragraph is conclusive on the issue of maltreatment and 380.21 disqualification, including for purposes of subsequent studies 380.22 conducted under subdivision 3, and is the only administrative 380.23 appeal of the final agency determination, specifically, 380.24 including a challenge to the accuracy and completeness of data 380.25 under section 13.04. 380.26 (f) Except as provided under subdivision 3c, if an 380.27 individual was disqualified on the basis of a determination of 380.28 maltreatment under section 626.556 or 626.557, which was serious 380.29 or recurring, and the individual has requested reconsideration 380.30 of the maltreatment determination under section 626.556, 380.31 subdivision 10i, or 626.557, subdivision 9d, and also requested 380.32 reconsideration of the disqualification under this subdivision, 380.33 reconsideration of the maltreatment determination and 380.34 reconsideration of the disqualification shall be consolidated 380.35 into a single reconsideration. For maltreatment and 380.36 disqualification determinations made by county agencies, the 381.1 consolidated reconsideration shall be conducted by the county 381.2 agency. Except as provided under subdivision 3c, if an 381.3 individual who was disqualified on the basis of serious or 381.4 recurring maltreatment requests a fair hearing on the 381.5 maltreatment determination under section 626.556, subdivision 381.6 10i, or 626.557, subdivision 9d, the scope of the fair hearing 381.7 under section 256.045 shall include the maltreatment 381.8 determination and the disqualification. Except as provided 381.9 under subdivision 3c, the commissioner's final order for an 381.10 individual under this paragraph is conclusive on the issue of 381.11 maltreatment and disqualification, including for purposes of 381.12 subsequent studies conducted under subdivision 3, and is the 381.13 only administrative appeal of the final agency determination, 381.14 specifically, including a challenge to the accuracy and 381.15 completeness of data under section 13.04. 381.16 Sec. 14. Minnesota Statutes 2000, section 245A.04, 381.17 subdivision 3c, is amended to read: 381.18 Subd. 3c. [CONTESTED CASE.] (a) Notwithstanding 381.19 subdivision 3b, paragraphs (e) and (f), if a disqualification is 381.20 not set aside, a person who is an employee of an employer, as 381.21 defined in section 179A.03, subdivision 15, may request a 381.22 contested case hearing under chapter 14. If the 381.23 disqualification which was not set aside or was not rescinded 381.24 was based on a maltreatment determination, the scope of the 381.25 contested case hearing shall include the maltreatment 381.26 determination and the disqualification. In such cases, a fair 381.27 hearing shall not be conducted under section 256.045. Rules 381.28 adopted under this chapter may not preclude an employee in a 381.29 contested case hearing for disqualification from submitting 381.30 evidence concerning information gathered under subdivision 3, 381.31 paragraph (e). 381.32 (b) If a disqualification for which reconsideration was 381.33 requested and which was not set aside or was not rescinded under 381.34 subdivision 3b is the basis for a denial of a license under 381.35 section 245A.05 or a licensing sanction under section 245A.07, 381.36 the license holder has the right to a contested case hearing 382.1 under chapter 14 and Minnesota Rules, parts 1400.8510 to 382.2 1400.8612 and successor rules. The appeal must be submitted in 382.3 accordance with section 245A.05 or 245A.07, subdivision 3. As 382.4 provided for under section 245A.08, subdivision 2a, the scope of 382.5 the consolidated contested case hearing shall include the 382.6 disqualification and the licensing sanction or denial of a 382.7 license. If the disqualification was based on a determination 382.8 of substantiated serious or recurring maltreatment under section 382.9 626.556 or 626.557, the appeal must be submitted in accordance 382.10 with sections 245A.07, subdivision 3, and 626.556, subdivision 382.11 10i, or 626.557, subdivision 9d. As provided for under section 382.12 245A.08, subdivision 2a, the scope of the contested case hearing 382.13 shall include the maltreatment determination, the 382.14 disqualification, and the licensing sanction or denial of a 382.15 license. In such cases, a fair hearing shall not be conducted 382.16 under section 256.045. 382.17 (c) If a maltreatment determination or disqualification, 382.18 which was not set aside or was not rescinded under subdivision 382.19 3b, is the basis for a denial of a license under section 245A.05 382.20 or a licensing sanction under section 245A.07, and the 382.21 disqualified subject is an individual other than the license 382.22 holder and upon whom a background study must be conducted under 382.23 subdivision 3, the hearing of all parties may be consolidated 382.24 into a single contested case hearing upon consent of all parties 382.25 and the administrative law judge. 382.26 (d) The commissioner's final order under section 245A.08, 382.27 subdivision 5, is conclusive on the issue of maltreatment and 382.28 disqualification, including for purposes of subsequent 382.29 background studies. The contested case hearing under this 382.30 subdivision is the only administrative appeal of the final 382.31 agency determination, specifically, including a challenge to the 382.32 accuracy and completeness of data under section 13.04. 382.33 [EFFECTIVE DATE.] This section is effective January 1, 2002. 382.34 Sec. 15. Minnesota Statutes 2000, section 245A.04, 382.35 subdivision 3d, is amended to read: 382.36 Subd. 3d. [DISQUALIFICATION.](a) Except as provided in383.1paragraph (b),Upon receipt of information showing, or when a 383.2 background study completed under subdivision 3 shows any of the 383.3 following: a conviction of one or more crimes listed in clauses 383.4 (1) to (4); the individual has admitted to or a preponderance of 383.5 the evidence indicates the individual has committed an act or 383.6 acts that meet the definition of any of the crimes listed in 383.7 clauses (1) to (4); or an investigation results in an 383.8 administrative determination listed under clause (4), the 383.9 individual shall be disqualified from any position allowing 383.10 direct contact with persons receiving services from the license 383.11 holder, entity identified in subdivision 3, paragraph (a), or 383.12 registrant under section 144A.71, subdivision 1, and for 383.13 individuals studied under section 245A.04, subdivision 3, 383.14 paragraph (c), clauses (2), (6), and (7), the individual shall 383.15 also be disqualified from access to a person receiving services 383.16 from the license holder: 383.17 (1) regardless of how much time has passed since the 383.18 involuntary termination of parental rights under section 383.19 260C.301 or the discharge of the sentence imposed for the 383.20 offense, and unless otherwise specified, regardless of the level 383.21 of the conviction, the individual was convicted of any of the 383.22 following offenses: sections 609.185 (murder in the first 383.23 degree); 609.19 (murder in the second degree); 609.195 (murder 383.24 in the third degree); 609.2661 (murder of an unborn child in the 383.25 first degree); 609.2662 (murder of an unborn child in the second 383.26 degree); 609.2663 (murder of an unborn child in the third 383.27 degree); 609.322 (solicitation, inducement, and promotion of 383.28 prostitution); 609.342 (criminal sexual conduct in the first 383.29 degree); 609.343 (criminal sexual conduct in the second degree); 383.30 609.344 (criminal sexual conduct in the third degree); 609.345 383.31 (criminal sexual conduct in the fourth degree); 609.352 383.32 (solicitation of children to engage in sexual conduct); 609.365 383.33 (incest); felony offense under 609.377 (malicious punishment of 383.34 a child); a felony offense under 609.378 (neglect or 383.35 endangerment of a child); a felony offense under 609.324, 383.36 subdivision 1 (other prohibited acts); 617.246 (use of minors in 384.1 sexual performance prohibited); 617.247 (possession of pictorial 384.2 representations of minors); a felony offense under sections 384.3 609.2242 and 609.2243 (domestic assault), a felony offense of 384.4 spousal abuse, a felony offense of child abuse or neglect, a 384.5 felony offense of a crime against children; or attempt or 384.6 conspiracy to commit any of these offenses as defined in 384.7 Minnesota Statutes, or an offense in any other state or country, 384.8 where the elements are substantially similar to any of the 384.9 offenses listed in this clause; 384.10 (2) if less than 15 years have passed since the discharge 384.11 of the sentence imposed for the offense; and the individual has 384.12 received a felony conviction for a violation of any of these 384.13 offenses: sections 609.20 (manslaughter in the first degree); 384.14 609.205 (manslaughter in the second degree); 609.21 (criminal 384.15 vehicular homicide and injury); 609.215 (suicide); 609.221 to 384.16 609.2231 (assault in the first, second, third, or fourth 384.17 degree); repeat offenses under 609.224 (assault in the fifth 384.18 degree); repeat offenses under 609.3451 (criminal sexual conduct 384.19 in the fifth degree); 609.713 (terroristic threats); 609.235 384.20 (use of drugs to injure or facilitate crime); 609.24 (simple 384.21 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 384.22 609.255 (false imprisonment); 609.561 (arson in the first 384.23 degree); 609.562 (arson in the second degree); 609.563 (arson in 384.24 the third degree); repeat offenses under 617.23 (indecent 384.25 exposure; penalties); repeat offenses under 617.241 (obscene 384.26 materials and performances; distribution and exhibition 384.27 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 384.28 609.67 (machine guns and short-barreled shotguns); 609.749 384.29 (harassment; stalking; penalties); 609.228 (great bodily harm 384.30 caused by distribution of drugs); 609.2325 (criminal abuse of a 384.31 vulnerable adult); 609.2664 (manslaughter of an unborn child in 384.32 the first degree); 609.2665 (manslaughter of an unborn child in 384.33 the second degree); 609.267 (assault of an unborn child in the 384.34 first degree); 609.2671 (assault of an unborn child in the 384.35 second degree); 609.268 (injury or death of an unborn child in 384.36 the commission of a crime); 609.52 (theft); 609.2335 (financial 385.1 exploitation of a vulnerable adult); 609.521 (possession of 385.2 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 385.3 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 385.4 forged check); 609.635 (obtaining signature by false pretense); 385.5 609.27 (coercion); 609.275 (attempt to coerce); 609.687 385.6 (adulteration); 260C.301 (grounds for termination of parental 385.7 rights);andchapter 152 (drugs; controlled substance); and a 385.8 felony level conviction involving alcohol or drug use. An 385.9 attempt or conspiracy to commit any of these offenses, as each 385.10 of these offenses is defined in Minnesota Statutes; or an 385.11 offense in any other state or country, the elements of which are 385.12 substantially similar to the elements of the offenses in this 385.13 clause. If the individual studied is convicted of one of the 385.14 felonies listed in this clause, but the sentence is a gross 385.15 misdemeanor or misdemeanor disposition, the lookback period for 385.16 the conviction is the period applicable to the disposition, that 385.17 is the period for gross misdemeanors or misdemeanors; 385.18 (3) if less than ten years have passed since the discharge 385.19 of the sentence imposed for the offense; and the individual has 385.20 received a gross misdemeanor conviction for a violation of any 385.21 of the following offenses: sections 609.224 (assault in the 385.22 fifth degree); 609.2242 and 609.2243 (domestic assault); 385.23 violation of an order for protection under 518B.01, subdivision 385.24 14; 609.3451 (criminal sexual conduct in the fifth degree); 385.25 repeat offenses under 609.746 (interference with privacy); 385.26 repeat offenses under 617.23 (indecent exposure); 617.241 385.27 (obscene materials and performances); 617.243 (indecent 385.28 literature, distribution); 617.293 (harmful materials; 385.29 dissemination and display to minors prohibited); 609.71 (riot); 385.30 609.66 (dangerous weapons); 609.749 (harassment; stalking; 385.31 penalties); 609.224, subdivision 2, paragraph (c) (assault in 385.32 the fifth degree by a caregiver against a vulnerable adult); 385.33 609.23 (mistreatment of persons confined); 609.231 (mistreatment 385.34 of residents or patients); 609.2325 (criminal abuse of a 385.35 vulnerable adult); 609.233 (criminal neglect of a vulnerable 385.36 adult); 609.2335 (financial exploitation of a vulnerable adult); 386.1 609.234 (failure to report maltreatment of a vulnerable adult); 386.2 609.72, subdivision 3 (disorderly conduct against a vulnerable 386.3 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 386.4 a child); 609.377 (malicious punishment of a child); 609.324, 386.5 subdivision 1a (other prohibited acts; minor engaged in 386.6 prostitution); 609.33 (disorderly house); 609.52 (theft); 386.7 609.582 (burglary); 609.631 (check forgery; offering a forged 386.8 check); 609.275 (attempt to coerce); or an attempt or conspiracy 386.9 to commit any of these offenses, as each of these offenses is 386.10 defined in Minnesota Statutes; or an offense in any other state 386.11 or country, the elements of which are substantially similar to 386.12 the elements of any of the offenses listed in this clause. If 386.13 the defendant is convicted of one of the gross misdemeanors 386.14 listed in this clause, but the sentence is a misdemeanor 386.15 disposition, the lookback period for the conviction is the 386.16 period applicable to misdemeanors; or 386.17 (4) if less than seven years have passed since the 386.18 discharge of the sentence imposed for the offense; and the 386.19 individual has received a misdemeanor conviction for a violation 386.20 of any of the following offenses: sections 609.224 (assault in 386.21 the fifth degree); 609.2242 (domestic assault); violation of an 386.22 order for protection under 518B.01 (Domestic Abuse Act); 386.23 violation of an order for protection under 609.3232 (protective 386.24 order authorized; procedures; penalties); 609.746 (interference 386.25 with privacy); 609.79 (obscene or harassing phone calls); 386.26 609.795 (letter, telegram, or package; opening; harassment); 386.27 617.23 (indecent exposure; penalties); 609.2672 (assault of an 386.28 unborn child in the third degree); 617.293 (harmful materials; 386.29 dissemination and display to minors prohibited); 609.66 386.30 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 386.31 exploitation of a vulnerable adult); 609.234 (failure to report 386.32 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 386.33 (coercion); or an attempt or conspiracy to commit any of these 386.34 offenses, as each of these offenses is defined in Minnesota 386.35 Statutes; or an offense in any other state or country, the 386.36 elements of which are substantially similar to the elements of 387.1 any of the offenses listed in this clause; a determination or 387.2 disposition of failure to make required reports under section 387.3 626.556, subdivision 3, or 626.557, subdivision 3, for incidents 387.4 in which: (i) the final disposition under section 626.556 or 387.5 626.557 was substantiated maltreatment, and (ii) the 387.6 maltreatment was recurring or serious; or a determination or 387.7 disposition of substantiated serious or recurring maltreatment 387.8 of a minor under section 626.556 or of a vulnerable adult under 387.9 section 626.557 for which there is a preponderance of evidence 387.10 that the maltreatment occurred, and that the subject was 387.11 responsible for the maltreatment. 387.12 For the purposes of this section, "serious maltreatment" 387.13 means sexual abuse; maltreatment resulting in death; or 387.14 maltreatment resulting in serious injury which reasonably 387.15 requires the care of a physician whether or not the care of a 387.16 physician was sought; or abuse resulting in serious injury. For 387.17 purposes of this section, "abuse resulting in serious injury" 387.18 means: bruises, bites, skin laceration or tissue damage; 387.19 fractures; dislocations; evidence of internal injuries; head 387.20 injuries with loss of consciousness; extensive second-degree or 387.21 third-degree burns and other burns for which complications are 387.22 present; extensive second-degree or third-degree frostbite, and 387.23 others for which complications are present; irreversible 387.24 mobility or avulsion of teeth; injuries to the eyeball; 387.25 ingestion of foreign substances and objects that are harmful; 387.26 near drowning; and heat exhaustion or sunstroke. For purposes 387.27 of this section, "care of a physician" is treatment received or 387.28 ordered by a physician, but does not include diagnostic testing, 387.29 assessment, or observation. For the purposes of this section, 387.30 "recurring maltreatment" means more than one incident of 387.31 maltreatment for which there is a preponderance of evidence that 387.32 the maltreatment occurred, and that the subject was responsible 387.33 for the maltreatment. For purposes of this section, "access" 387.34 means physical access to an individual receiving services or the 387.35 individual's personal property without continuous, direct 387.36 supervision as defined in section 245A.04, subdivision 3. 388.1 (b)IfExcept for background studies related to child 388.2 foster care, adult foster care, or family child care licensure, 388.3 when the subject of a background study islicensedregulated by 388.4 a health-related licensing board as defined in chapter 214, and 388.5 the regulated person has been determined to have been 388.6 responsible for substantiated maltreatment under section 626.556 388.7 or 626.557, instead of the commissioner making a decision 388.8 regarding disqualification, the board shall makethea 388.9 determinationregarding a disqualification under this388.10subdivision based on a finding of substantiated maltreatment388.11under section 626.556 or 626.557. The commissioner shall notify388.12the health-related licensing board if a background study shows388.13that a licensee would be disqualified because of substantiated388.14maltreatment and the board shall make a determination under388.15section 214.104.whether to impose disciplinary or corrective 388.16 action under chapter 214. 388.17 (1) The commissioner shall notify the health-related 388.18 licensing board: 388.19 (i) upon completion of a background study that produces a 388.20 record showing that the individual was determined to have been 388.21 responsible for substantiated maltreatment; 388.22 (ii) upon the commissioner's completion of an investigation 388.23 that determined the individual was responsible for substantiated 388.24 maltreatment; or 388.25 (iii) upon receipt from another agency of a finding of 388.26 substantiated maltreatment for which the individual was 388.27 responsible. 388.28 (2) The commissioner's notice shall indicate whether the 388.29 individual would have been disqualified by the commissioner for 388.30 the substantiated maltreatment if the individual were not 388.31 regulated by the board. The commissioner shall concurrently 388.32 send this notice to the individual. 388.33 (3) Notwithstanding the exclusion from this subdivision for 388.34 individuals who provide child foster care, adult foster care, or 388.35 family child care, when the commissioner or a local agency has 388.36 reason to believe that the direct contact services provided by 389.1 the individual may fall within the jurisdiction of a 389.2 health-related licensing board, a referral shall be made to the 389.3 board as provided in this section. 389.4 (4) If, upon review of the information provided by the 389.5 commissioner, a health-related licensing board informs the 389.6 commissioner that the board does not have jurisdiction to take 389.7 disciplinary or corrective action, the commissioner shall make 389.8 the appropriate disqualification decision regarding the 389.9 individual as otherwise provided in this chapter. 389.10 (5) The commissioner has the authority to monitor the 389.11 facility's compliance with any requirements that the 389.12 health-related licensing board places on regulated persons 389.13 practicing in a facility either during the period pending a 389.14 final decision on a disciplinary or corrective action or as a 389.15 result of a disciplinary or corrective action. The commissioner 389.16 has the authority to order the immediate removal of a regulated 389.17 person from direct contact or access when a board issues an 389.18 order of temporary suspension based on a determination that the 389.19 regulated person poses an immediate risk of harm to persons 389.20 receiving services in a licensed facility. 389.21 (6) A facility that allows a regulated person to provide 389.22 direct contact services while not complying with the 389.23 requirements imposed by the health-related licensing board is 389.24 subject to action by the commissioner as specified under 389.25 sections 245A.06 and 245A.07. 389.26 (7) The commissioner shall notify a health-related 389.27 licensing board immediately upon receipt of knowledge of 389.28 noncompliance with requirements placed on a facility or upon a 389.29 person regulated by the board. 389.30 Sec. 16. Minnesota Statutes 2000, section 245A.04, is 389.31 amended by adding a subdivision to read: 389.32 Subd. 3e. [VARIANCE FOR A DISQUALIFIED PERSON.] (a) When a 389.33 background study subject's disqualification has not been set 389.34 aside by the commissioner, and there are conditions under which 389.35 the disqualified individual may provide direct contact services 389.36 or have access to people receiving services that minimize the 390.1 risk of harm to people receiving services, the commissioner may 390.2 grant a time limited variance to a license holder that states 390.3 the reason for the disqualification, the services that may be 390.4 provided by the disqualified individual, and the conditions with 390.5 which the license holder or applicant must comply for the 390.6 variance to be effective. 390.7 (b) Except for programs licensed to provide family day care 390.8 for children, foster care for children in the provider's own 390.9 home, or foster care or day care services for adults in the 390.10 provider's own home, the commissioner may not grant a variance 390.11 for a disqualified person unless the applicant or license holder 390.12 has requested the variance and the disqualified individual has 390.13 provided written consent for the commissioner to disclose to the 390.14 applicant or license holder the reason for the disqualification. 390.15 (c) When a license holder permits a disqualified individual 390.16 to provide any services for which the subject is disqualified 390.17 without complying with the conditions of the variance, 390.18 termination of the variance is immediate and the license holder 390.19 may be subject to fines or sanctions under sections 245A.06 and 390.20 245A.07. 390.21 (d) The commissioner may terminate a variance for a 390.22 disqualified person at any time for cause. 390.23 (e) The commissioner's decision to grant or deny a variance 390.24 request is final and not subject to appeal under the provisions 390.25 of chapter 14. 390.26 Sec. 17. Minnesota Statutes 2000, section 245A.04, 390.27 subdivision 6, is amended to read: 390.28 Subd. 6. [COMMISSIONER'S EVALUATION.] Beforegranting390.29 issuing, denying, suspending, revoking, or making conditional a 390.30 license, the commissioner shall evaluate information gathered 390.31 under this section. The commissioner's evaluation shall 390.32 consider facts, conditions, or circumstances concerning the 390.33 program's operation, the well-being of persons served by the 390.34 program, available consumer evaluations of the program, and 390.35 information about the qualifications of the personnel employed 390.36 by the applicant or license holder. 391.1 The commissioner shall evaluate the results of the study 391.2 required in subdivision 3 and determine whether a risk of harm 391.3 to the persons served by the program exists. In conducting this 391.4 evaluation, the commissioner shall apply the disqualification 391.5 standards set forth in rules adopted under this chapter. 391.6 Sec. 18. Minnesota Statutes 2000, section 245A.04, 391.7 subdivision 11, is amended to read: 391.8 Subd. 11. [EDUCATION PROGRAM; ADDITIONAL REQUIREMENT.] (a) 391.9 The education program offered in a residential or nonresidential 391.10 program, except for child care, foster care, or services for 391.11 adults, must be approved by the commissioner of children, 391.12 families, and learning before the commissioner of human services 391.13 may grant a license to the program. 391.14 (b) A residential program licensed under Minnesota Rules, 391.15 parts 9545.0905 to 9545.1125 or 9545.1400 to 9545.1480, may 391.16 serve persons through the age of 19 when: 391.17 (1) the admission is necessary for a person to complete a 391.18 secondary school program or its equivalent, or it is necessary 391.19 to facilitate a transition period after completing the secondary 391.20 school program or its equivalent for up to four months in order 391.21 for the resident to obtain other living arrangements; 391.22 (2) the facility develops policies, procedures, and plans 391.23 required under section 245A.65; 391.24 (3) the facility documents an assessment of the 18- or 391.25 19-year-old person's risk of victimizing children residing in 391.26 the facility, and develops necessary risk reduction measures, 391.27 including sleeping arrangements, to minimize any risk of harm to 391.28 children; and 391.29 (4) notwithstanding the license holder's target population 391.30 age range, whenever persons age 18 or 19 years old are receiving 391.31 residential services, the age difference among residents may not 391.32 exceed five years. 391.33 (c) Nothing in this paragraph precludes the license holder 391.34 from seeking other variances under section 245A.04, subdivision 391.35 9. 391.36 Sec. 19. Minnesota Statutes 2000, section 245A.05, is 392.1 amended to read: 392.2 245A.05 [DENIAL OF APPLICATION.] 392.3 The commissioner may deny a license if an applicant fails 392.4 to comply with applicable laws or rules, or knowingly withholds 392.5 relevant information from or gives false or misleading 392.6 information to the commissioner in connection with an 392.7 application for a license or during an investigation. An 392.8 applicant whose application has been denied by the commissioner 392.9 must be given notice of the denial. Notice must be given by 392.10 certified mail. The notice must state the reasons the 392.11 application was denied and must inform the applicant of the 392.12 right to a contested case hearing under chapter 14 and Minnesota 392.13 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 392.14 applicant may appeal the denial by notifying the commissioner in 392.15 writing by certified mail within 20 calendar days after 392.16 receiving notice that the application was denied. Section 392.17 245A.08 applies to hearings held to appeal the commissioner's 392.18 denial of an application. 392.19 [EFFECTIVE DATE.] This section is effective January 1, 2002. 392.20 Sec. 20. Minnesota Statutes 2000, section 245A.06, is 392.21 amended to read: 392.22 245A.06 [CORRECTION ORDER ANDFINESCONDITIONAL LICENSE.] 392.23 Subdivision 1. [CONTENTS OF CORRECTION ORDERSOR FINESAND 392.24 CONDITIONAL LICENSES.] (a) If the commissioner finds that the 392.25 applicant or license holder has failed to comply with an 392.26 applicable law or rule and this failure does not imminently 392.27 endanger the health, safety, or rights of the persons served by 392.28 the program, the commissioner may issue a correction order and 392.29 an order of conditional license toor impose a fine onthe 392.30 applicant or license holder. When issuing a conditional 392.31 license, the commissioner shall consider the nature, chronicity, 392.32 or severity of the violation of law or rule and the effect of 392.33 the violation on the health, safety, or rights of persons served 392.34 by the program. The correction order orfineconditional 392.35 license must state: 392.36 (1) the conditions that constitute a violation of the law 393.1 or rule; 393.2 (2) the specific law or rule violated; 393.3 (3) the time allowed to correct each violation; and 393.4 (4) if afine is imposed, the amount of the finelicense is 393.5 made conditional, the length and terms of the conditional 393.6 license. 393.7 (b) Nothing in this section prohibits the commissioner from 393.8 proposing a sanction as specified in section 245A.07, prior to 393.9 issuing a correction order orfineconditional license. 393.10 Subd. 2. [RECONSIDERATION OF CORRECTION ORDERS.] If the 393.11 applicant or license holder believes that the contents of the 393.12 commissioner's correction order are in error, the applicant or 393.13 license holder may ask the department of human services to 393.14 reconsider the parts of the correction order that are alleged to 393.15 be in error. The request for reconsideration must be in writing 393.16 and received by the commissioner within 20 calendar days after 393.17 receipt of the correction order by the applicant or license 393.18 holder, and: 393.19 (1) specify the parts of the correction order that are 393.20 alleged to be in error; 393.21 (2) explain why they are in error; and 393.22 (3) include documentation to support the allegation of 393.23 error. 393.24 A request for reconsideration does not stay any provisions 393.25 or requirements of the correction order. The commissioner's 393.26 disposition of a request for reconsideration is final and not 393.27 subject to appeal under chapter 14. 393.28 Subd. 3. [FAILURE TO COMPLY.] If the commissioner finds 393.29 that the applicant or license holder has not corrected the 393.30 violations specified in the correction order or conditional 393.31 license, the commissioner may impose a fine and order other 393.32 licensing sanctions pursuant to section 245A.07.If a fine was393.33imposed and the violation was not corrected, the commissioner393.34may impose an additional fine. This section does not prohibit393.35the commissioner from seeking a court order, denying an393.36application, or suspending, revoking, or making conditional the394.1license in addition to imposing a fine.394.2 Subd. 4. [NOTICE OFFINECONDITIONAL LICENSE; 394.3 RECONSIDERATION OFFINECONDITIONAL LICENSE.]A license holder394.4who is ordered to pay a fineIf a license is made conditional, 394.5 the license holder must be notified of the order by certified 394.6 mail. The notice must be mailed to the address shown on the 394.7 application or the last known address of the license holder. 394.8 The notice must state the reasons thefineconditional license 394.9 was ordered and must inform the license holder of the 394.10responsibility for payment of fines in subdivision 7 and the394.11 right to request reconsideration of thefineconditional license 394.12 by the commissioner. The license holder may request 394.13 reconsideration of the orderto forfeit a fineof conditional 394.14 license by notifying the commissioner by certified mailwithin394.1520 calendar days after receiving the order. The request must be 394.16 in writing and must be received by the commissioner within ten 394.17 calendar days after the license holder received the order. The 394.18 license holder may submit with the request for reconsideration 394.19 written argument or evidence in support of the request for 394.20 reconsideration. A timely request for reconsideration shall 394.21 stayforfeiture of the fineimposition of the terms of the 394.22 conditional license until the commissioner issues a decision on 394.23 the request for reconsideration.The request for394.24reconsideration must be in writing and:394.25(1) specify the parts of the violation that are alleged to394.26be in error;394.27(2) explain why they are in error;394.28(3) include documentation to support the allegation of394.29error; and394.30(4) any other information relevant to the fine or the394.31amount of the fine.394.32 The commissioner's disposition of a request for 394.33 reconsideration is final and not subject to appeal under chapter 394.34 14. 394.35Subd. 5. [FORFEITURE OF FINES.] The license holder shall394.36pay the fines assessed on or before the payment date specified395.1in the commissioner's order. If the license holder fails to395.2fully comply with the order, the commissioner shall issue a395.3second fine or suspend the license until the license holder395.4complies. If the license holder receives state funds, the395.5state, county, or municipal agencies or departments responsible395.6for administering the funds shall withhold payments and recover395.7any payments made while the license is suspended for failure to395.8pay a fine.395.9Subd. 5a. [ACCRUAL OF FINES.] A license holder shall395.10promptly notify the commissioner of human services, in writing,395.11when a violation specified in an order to forfeit is corrected.395.12If upon reinspection the commissioner determines that a395.13violation has not been corrected as indicated by the order to395.14forfeit, the commissioner may issue a second fine. The395.15commissioner shall notify the license holder by certified mail395.16that a second fine has been assessed. The license holder may395.17request reconsideration of the second fine under the provisions395.18of subdivision 4.395.19Subd. 6. [AMOUNT OF FINES.] Fines shall be assessed as395.20follows:395.21(1) the license holder shall forfeit $1,000 for each395.22occurrence of violation of law or rule prohibiting the395.23maltreatment of children or the maltreatment of vulnerable395.24adults, including but not limited to corporal punishment,395.25illegal or unauthorized use of physical, mechanical, or chemical395.26restraints, and illegal or unauthorized use of aversive or395.27deprivation procedures;395.28(2) the license holder shall forfeit $200 for each395.29occurrence of a violation of law or rule governing matters of395.30health, safety, or supervision, including but not limited to the395.31provision of adequate staff to child or adult ratios; and395.32(3) the license holder shall forfeit $100 for each395.33occurrence of a violation of law or rule other than those395.34included in clauses (1) and (2).395.35For the purposes of this section, "occurrence" means each395.36violation identified in the commissioner's forfeiture order.396.1Subd. 7. [RESPONSIBILITY FOR PAYMENT OF FINES.] When a396.2fine has been assessed, the license holder may not avoid payment396.3by closing, selling, or otherwise transferring the licensed396.4program to a third party. In such an event, the license holder396.5will be personally liable for payment. In the case of a396.6corporation, each controlling individual is personally and396.7jointly liable for payment.396.8Fines for child care centers must be assessed according to396.9this section.396.10 Sec. 21. Minnesota Statutes 2000, section 245A.07, is 396.11 amended to read: 396.12 245A.07 [SANCTIONS.] 396.13 Subdivision 1. [SANCTIONS AVAILABLE.] In addition to 396.14ordering forfeiture of finesmaking a license conditional under 396.15 section 245A.06, the commissioner may propose to suspend,or 396.16 revoke, or make conditionalthe license, impose a fine, or 396.17 secure an injunction against the continuing operation of the 396.18 program of a license holder who does not comply with applicable 396.19 law or rule. When applying sanctions authorized under this 396.20 section, the commissioner shall consider the nature, chronicity, 396.21 or severity of the violation of law or rule and the effect of 396.22 the violation on the health, safety, or rights of persons served 396.23 by the program. 396.24 Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER396.25TO HEALTH, SAFETY, OR RIGHTSTEMPORARY IMMEDIATE SUSPENSION.] If 396.26 the license holder's actions or failure to comply with 396.27 applicable law or rulehas placedposes an imminent risk of harm 396.28 to the health, safety, or rights of persons served by the 396.29 programin imminent danger, the commissioner shall act 396.30 immediately to temporarily suspend the license. No state funds 396.31 shall be made available or be expended by any agency or 396.32 department of state, county, or municipal government for use by 396.33 a license holder regulated under this chapter while a license is 396.34 under immediate suspension. A notice stating the reasons for 396.35 the immediate suspension and informing the license holder of the 396.36 right toa contested casean expedited hearing under chapter 397.1 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 397.2 successor rules, must be delivered by personal service to the 397.3 address shown on the application or the last known address of 397.4 the license holder. The license holder may appeal an order 397.5 immediately suspending a license. The appeal of an order 397.6 immediately suspending a license must be made in writing by 397.7 certified mail and must be received by the commissioner within 397.8 five calendar days after the license holder receives notice that 397.9 the license has been immediately suspended. A license holder 397.10 and any controlling individual shall discontinue operation of 397.11 the program upon receipt of the commissioner's order to 397.12 immediately suspend the license. 397.13 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 397.14 Within five working days of receipt of the license holder's 397.15 timely appeal, the commissioner shall request assignment of an 397.16 administrative law judge. The request must include a proposed 397.17 date, time, and place of a hearing. A hearing must be conducted 397.18 by an administrative law judge within 30 calendar days of the 397.19 request for assignment, unless an extension is requested by 397.20 either party and granted by the administrative law judge for 397.21 good cause. The commissioner shall issue a notice of hearing by 397.22 certified mail at least ten working days before the hearing. 397.23 The scope of the hearing shall be limited solely to the issue of 397.24 whether the temporary immediate suspension should remain in 397.25 effect pending the commissioner's final order under section 397.26 245A.08, regarding a licensing sanction issued under subdivision 397.27 3 following the immediate suspension. The burden of proof in 397.28 expedited hearings under this subdivision shall be limited to 397.29 the commissioner's demonstration that reasonable cause exists to 397.30 believe that the license holder's actions or failure to comply 397.31 with applicable law or rule poses an imminent risk of harm to 397.32 the health, safety, or rights of persons served by the program. 397.33 (b) The administrative law judge shall issue findings of 397.34 fact, conclusions, and a recommendation within ten working days 397.35 from the date of hearing. The commissioner's final order shall 397.36 be issued within ten working days from receipt of the 398.1 recommendation of the administrative law judge. Within 90 398.2 calendar days after a final order affirming an immediate 398.3 suspension, the commissioner shall make a determination 398.4 regarding whether a final licensing sanction shall be issued 398.5 under subdivision 3. The license holder shall continue to be 398.6 prohibited from operation of the program during this 90-day 398.7 period. 398.8 Subd. 3. [LICENSE SUSPENSION, REVOCATION,DENIALOR 398.9CONDITIONAL LICENSEFINE.] The commissioner may suspend,or 398.10 revoke, make conditional, or denya license, or impose a fine if 398.11an applicant ora license holder fails to comply fully with 398.12 applicable laws or rules, or knowingly withholds relevant 398.13 information from or gives false or misleading information to the 398.14 commissioner in connection with an application for a license or 398.15 during an investigation. A license holder who has had a license 398.16 suspended, revoked, ormade conditionalhas been ordered to pay 398.17 a fine must be given notice of the action by certified mail. 398.18 The notice must be mailed to the address shown on the 398.19 application or the last known address of the license holder. 398.20 The notice must state the reasons the license was suspended, 398.21 revoked, ormade conditionala fine was ordered. 398.22 (a) If the license was suspended or revoked, the notice 398.23 must inform the license holder of the right to a contested case 398.24 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 398.25 1400.8612 and successor rules. The license holder may appeal an 398.26 order suspending or revoking a license. The appeal of an order 398.27 suspending or revoking a license must be made in writing by 398.28 certified mail and must be received by the commissioner within 398.29 ten calendar days after the license holder receives notice that 398.30 the license has been suspended or revoked. 398.31 (b)If the license was made conditional, the notice must398.32inform the license holder of the right to request a398.33reconsideration by the commissioner. The request for398.34reconsideration must be made in writing by certified mail and398.35must be received by the commissioner within ten calendar days398.36after the license holder receives notice that the license has399.1been made conditional. The license holder may submit with the399.2request for reconsideration written argument or evidence in399.3support of the request for reconsideration. The commissioner's399.4disposition of a request for reconsideration is final and is not399.5subject to appeal under chapter 14.(1) If the license holder 399.6 was ordered to pay a fine, the notice must inform the license 399.7 holder of the responsibility for payment of fines and the right 399.8 to a contested case hearing under chapter 14 and Minnesota 399.9 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 399.10 appeal of an order to pay a fine must be made in writing by 399.11 certified mail and must be received by the commissioner within 399.12 ten calendar days after the license holder receives notice that 399.13 the fine has been ordered. 399.14 (2) The license holder shall pay the fines assessed on or 399.15 before the payment date specified. If the license holder fails 399.16 to fully comply with the order, the commissioner may issue a 399.17 second fine or suspend the license until the license holder 399.18 complies. If the license holder receives state funds, the 399.19 state, county, or municipal agencies or departments responsible 399.20 for administering the funds shall withhold payments and recover 399.21 any payments made while the license is suspended for failure to 399.22 pay a fine. A timely appeal shall stay payment of the fine 399.23 until the commissioner issues a final order. 399.24 (3) A license holder shall promptly notify the commissioner 399.25 of human services, in writing, when a violation specified in the 399.26 order to forfeit a fine is corrected. If upon reinspection the 399.27 commissioner determines that a violation has not been corrected 399.28 as indicated by the order to forfeit a fine, the commissioner 399.29 may issue a second fine. The commissioner shall notify the 399.30 license holder by certified mail that a second fine has been 399.31 assessed. The license holder may appeal the second fine as 399.32 provided under this subdivision. 399.33 (4) Fines shall be assessed as follows: the license holder 399.34 shall forfeit $1,000 for each determination of maltreatment of a 399.35 child under section 626.556 or the maltreatment of a vulnerable 399.36 adult under section 626.557; the license holder shall forfeit 400.1 $200 for each occurrence of a violation of law or rule governing 400.2 matters of health, safety, or supervision, including but not 400.3 limited to the provision of adequate staff-to-child or adult 400.4 ratios, and failure to submit a background study; and the 400.5 license holder shall forfeit $100 for each occurrence of a 400.6 violation of law or rule other than those subject to a $1,000 or 400.7 $200 fine above. For purposes of this section, "occurrence" 400.8 means each violation identified in the commissioner's fine order. 400.9 (5) When a fine has been assessed, the license holder may 400.10 not avoid payment by closing, selling, or otherwise transferring 400.11 the licensed program to a third party. In such an event, the 400.12 license holder will be personally liable for payment. In the 400.13 case of a corporation, each controlling individual is personally 400.14 and jointly liable for payment. 400.15 Subd. 4. [ADOPTION AGENCY VIOLATIONS.] If a license holder 400.16 licensed to place children for adoption fails to provide 400.17 services as described in the disclosure form required by section 400.18 259.37, subdivision 2, the sanctions under this section may be 400.19 imposed. 400.20 [EFFECTIVE DATE.] This section is effective January 1, 2002. 400.21 Sec. 22. Minnesota Statutes 2000, section 245A.08, is 400.22 amended to read: 400.23 245A.08 [HEARINGS.] 400.24 Subdivision 1. [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 400.25 Upon receiving a timely appeal or petition pursuant to 400.26 section 245A.04, subdivision 3c, 245A.05, or 245A.07, 400.27 subdivision 3, the commissioner shall issue a notice of and 400.28 order for hearing to the appellant under chapter 14 and 400.29 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 400.30 rules. 400.31 Subd. 2. [CONDUCT OF HEARINGS.] At any hearing provided 400.32 for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 400.33 subdivision 3, the appellant may be represented by counsel and 400.34 has the right to call, examine, and cross-examine witnesses. 400.35 The administrative law judge may require the presence of 400.36 witnesses and evidence by subpoena on behalf of any party. 401.1 Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR 401.2 SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 401.3 DISQUALIFICATIONS.] (a) When a denial of a license under section 401.4 245A.05 or a licensing sanction under section 245A.07, 401.5 subdivision 3, is based on a disqualification for which 401.6 reconsideration was requested and which was not set aside or was 401.7 not rescinded under section 245A.04, subdivision 3b, the scope 401.8 of the contested case hearing shall include the disqualification 401.9 and the licensing sanction or denial of a license. When the 401.10 licensing sanction or denial of a license is based on a 401.11 determination of maltreatment under section 626.556 or 626.557, 401.12 or a disqualification for serious or recurring maltreatment 401.13 which was not set aside or was not rescinded, the scope of the 401.14 contested case hearing shall include the maltreatment 401.15 determination, disqualification, and the licensing sanction or 401.16 denial of a license. In such cases, a fair hearing under 401.17 section 256.045 shall not be conducted as provided for in 401.18 sections 626.556, subdivision 10i, and 626.557, subdivision 9d. 401.19 (b) In consolidated contested case hearings regarding 401.20 sanctions issued in family child care, child foster care, and 401.21 adult foster care, the county attorney shall defend the 401.22 commissioner's orders in accordance with section 245A.16, 401.23 subdivision 4. 401.24 (c) The commissioner's final order under subdivision 5 is 401.25 the final agency action on the issue of maltreatment and 401.26 disqualification, including for purposes of subsequent 401.27 background studies under section 245A.04, subdivision 3, and is 401.28 the only administrative appeal of the final agency 401.29 determination, specifically, including a challenge to the 401.30 accuracy and completeness of data under section 13.04. 401.31 (d) When consolidated hearings under this subdivision 401.32 involve a licensing sanction based on a previous maltreatment 401.33 determination for which the commissioner has issued a final 401.34 order in an appeal of that determination under section 256.045, 401.35 or the individual failed to exercise the right to appeal the 401.36 previous maltreatment determination under section 626.556, 402.1 subdivision 10i, or 626.557, subdivision 9d, the commissioner's 402.2 order is conclusive on the issue of maltreatment. In such 402.3 cases, the scope of the administrative law judge's review shall 402.4 be limited to the disqualification and the licensing sanction or 402.5 denial of a license. In the case of a denial of a license or a 402.6 licensing sanction issued to a facility based on a maltreatment 402.7 determination regarding an individual who is not the license 402.8 holder or a household member, the scope of the administrative 402.9 law judge's review includes the maltreatment determination. 402.10 (e) If a maltreatment determination or disqualification, 402.11 which was not set aside or was not rescinded under section 402.12 245A.04, subdivision 3b, is the basis for a denial of a license 402.13 under section 245A.05 or a licensing sanction under section 402.14 245A.07, and the disqualified subject is an individual other 402.15 than the license holder and upon whom a background study must be 402.16 conducted under section 245A.04, subdivision 3, the hearings of 402.17 all parties may be consolidated into a single contested case 402.18 hearing upon consent of all parties and the administrative law 402.19 judge. 402.20 Subd. 3. [BURDEN OF PROOF.] (a) At a hearing regarding 402.21suspension, immediate suspension, or revocation of a license for402.22family day care or foster carea licensing sanction under 402.23 section 245A.07, including consolidated hearings under 402.24 subdivision 2a, the commissioner may demonstrate reasonable 402.25 cause for action taken by submitting statements, reports, or 402.26 affidavits to substantiate the allegations that the license 402.27 holder failed to comply fully with applicable law or rule. If 402.28 the commissioner demonstrates that reasonable cause existed, the 402.29 burden of proofin hearings involving suspension, immediate402.30suspension, or revocation of a family day care or foster care402.31licenseshifts to the license holder to demonstrate by a 402.32 preponderance of the evidence that the license holder was in 402.33 full compliance with those laws or rules that the commissioner 402.34 alleges the license holder violated, at the time that the 402.35 commissioner alleges the violations of law or rules occurred. 402.36 (b) At a hearing on denial of an application, the applicant 403.1 bears the burden of proof to demonstrate by a preponderance of 403.2 the evidence that the appellant has complied fully withsections403.3245A.01 to 245A.15this chapter and other applicable law or rule 403.4 and that the application should be approved and a license 403.5 granted. 403.6(c) At all other hearings under this section, the403.7commissioner bears the burden of proof to demonstrate, by a403.8preponderance of the evidence, that the violations of law or403.9rule alleged by the commissioner occurred.403.10 Subd. 4. [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 403.11 administrative law judge shall recommend whether or not the 403.12 commissioner's order should be affirmed. The recommendations 403.13 must be consistent with this chapter and the rules of the 403.14 commissioner. The recommendations must be in writing and 403.15 accompanied by findings of fact and conclusions and must be 403.16 mailed to the parties by certified mail to their last known 403.17 addresses as shown on the license or application. 403.18 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 403.19 considering the findings of fact, conclusions, and 403.20 recommendations of the administrative law judge, the 403.21 commissioner shall issue a final order. The commissioner shall 403.22 consider, but shall not be bound by, the recommendations of the 403.23 administrative law judge. The appellant must be notified of the 403.24 commissioner's final order as required by chapter 14 and 403.25 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 403.26 rules. The notice must also contain information about the 403.27 appellant's rights under chapter 14 and Minnesota Rules, parts 403.28 1400.8510 to 1400.8612 and successor rules. The institution of 403.29 proceedings for judicial review of the commissioner's final 403.30 order shall not stay the enforcement of the final order except 403.31 as provided in section 14.65. A license holder and each 403.32 controlling individual of a license holder whose license has 403.33 been revoked because of noncompliance with applicable law or 403.34 rule must not be granted a license for five years following the 403.35 revocation. An applicant whose application was denied must not 403.36 be granted a license for two years following a denial, unless 404.1 the applicant's subsequent application contains new information 404.2 which constitutes a substantial change in the conditions that 404.3 caused the previous denial. 404.4 [EFFECTIVE DATE.] This section is effective January 1, 2002. 404.5 Sec. 23. [245A.144] [REDUCTION OF RISK OF SUDDEN INFANT 404.6 DEATH SYNDROME IN CHILD CARE PROGRAMS.] 404.7 License holders must ensure that before staff persons, 404.8 caregivers, and helpers assist in the care of infants, they 404.9 receive training on reducing the risk of sudden infant death 404.10 syndrome. The training on reducing the risk of sudden infant 404.11 death syndrome may be provided as orientation training under 404.12 Minnesota Rules, part 9503.0035, subpart 1, as initial training 404.13 under Minnesota Rules, part 9502.0385, subpart 2, as in-service 404.14 training under Minnesota Rules, part 9503.0035, subpart 4, or as 404.15 ongoing training under Minnesota Rules, part 9502.0385, subpart 404.16 3. Training required under this section must be completed at 404.17 least once every five years. 404.18 Sec. 24. Minnesota Statutes 2000, section 245A.16, 404.19 subdivision 1, is amended to read: 404.20 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 404.21 County agencies and private agencies that have been designated 404.22 or licensed by the commissioner to perform licensing functions 404.23 and activities under section 245A.04, to recommend denial of 404.24 applicants under section 245A.05, to issue correction orders, to 404.25 issue variances, and recommendfinesa conditional license under 404.26 section 245A.06, or to recommend suspending,or revoking, and404.27making licenses probationarya license or issuing a fine under 404.28 section 245A.07, shall comply with rules and directives of the 404.29 commissioner governing those functions and with this 404.30 section. The following variances are excluded from the 404.31 delegation of variance authority and may be issued only by the 404.32 commissioner: 404.33 (1) dual licensure of family child care and child foster 404.34 care, dual licensure of child and adult foster care, and adult 404.35 foster care and family child care; 404.36 (2) adult foster care maximum capacity; 405.1 (3) adult foster care minimum age requirement; 405.2 (4) child foster care maximum age requirement; 405.3 (5) variances regarding disqualified individuals; and 405.4 (6) the required presence of a caregiver in the adult 405.5 foster care residence during normal sleeping hours. 405.6 (b) For family day care programs, the commissioner may 405.7 authorize licensing reviews every two years after a licensee has 405.8 had at least one annual review. 405.9 Sec. 25. Minnesota Statutes 2000, section 245B.08, 405.10 subdivision 3, is amended to read: 405.11 Subd. 3. [SANCTIONS AVAILABLE.] Nothing in this 405.12 subdivision shall be construed to limit the commissioner's 405.13 authority to suspend,or revoke, or make conditionala license 405.14 or issue a fine at any timea licenseunder section 245A.07; 405.15 make correction orders andrequire finesmake a license 405.16 conditional for failure to comply with applicable laws or rules 405.17 under section 245A.06; or deny an application for license under 405.18 section 245A.05. 405.19 Sec. 26. Minnesota Statutes 2000, section 256.045, 405.20 subdivision 3, is amended to read: 405.21 Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency 405.22 hearings are available for the following: (1) any person 405.23 applying for, receiving or having received public assistance, 405.24 medical care, or a program of social services granted by the 405.25 state agency or a county agency or the federal Food Stamp Act 405.26 whose application for assistance is denied, not acted upon with 405.27 reasonable promptness, or whose assistance is suspended, 405.28 reduced, terminated, or claimed to have been incorrectly paid; 405.29 (2) any patient or relative aggrieved by an order of the 405.30 commissioner under section 252.27; (3) a party aggrieved by a 405.31 ruling of a prepaid health plan; (4) except as provided under 405.32 chapter 245A, any individual or facility determined by a lead 405.33 agency to have maltreated a vulnerable adult under section 405.34 626.557 after they have exercised their right to administrative 405.35 reconsideration under section 626.557; (5) any person whose 405.36 claim for foster care payment according to a placement of the 406.1 child resulting from a child protection assessment under section 406.2 626.556 is denied or not acted upon with reasonable promptness, 406.3 regardless of funding source; (6) any person to whom a right of 406.4 appeal according to this section is given by other provision of 406.5 law; (7) an applicant aggrieved by an adverse decision to an 406.6 application for a hardship waiver under section 406.7 256B.15;or(8) except as provided under chapter 245A, an 406.8 individual or facility determined to have maltreated a minor 406.9 under section 626.556, after the individual or facility has 406.10 exercised the right to administrative reconsideration under 406.11 section 626.556; or (9) except as provided under chapter 245A, 406.12 an individual disqualified under section 245A.04, subdivision 406.13 3d, on the basis of serious or recurring maltreatment; a 406.14 preponderance of the evidence that the individual has committed 406.15 an act or acts that meet the definition of any of the crimes 406.16 listed in section 245A.04, subdivision 3d, paragraph (a), 406.17 clauses (1) to (4); or for failing to make reports required 406.18 under section 626.556, subdivision 3, or 626.557, subdivision 406.19 3. Hearings regarding a maltreatment determination under clause 406.20 (4) or (8) and a disqualification under this clause in which the 406.21 basis for a disqualification is serious or recurring 406.22 maltreatment, which has not been set aside or rescinded under 406.23 section 245A.04, subdivision 3b, shall be consolidated into a 406.24 single fair hearing. In such cases, the scope of review by the 406.25 human services referee shall include both the maltreatment 406.26 determination and the disqualification. The failure to exercise 406.27 the right to an administrative reconsideration shall not be a 406.28 bar to a hearing under this section if federal law provides an 406.29 individual the right to a hearing to dispute a finding of 406.30 maltreatment. Individuals and organizations specified in this 406.31 section may contest the specified action, decision, or final 406.32 disposition before the state agency by submitting a written 406.33 request for a hearing to the state agency within 30 days after 406.34 receiving written notice of the action, decision, or final 406.35 disposition, or within 90 days of such written notice if the 406.36 applicant, recipient, patient, or relative shows good cause why 407.1 the request was not submitted within the 30-day time limit. 407.2 The hearing for an individual or facility under clause 407.3 (4)or, (8), or (9) is the only administrative appeal to the 407.4 final agency determination specifically, including a challenge 407.5 to the accuracy and completeness of data under section 13.04. 407.6 Hearings requested under clause (4) apply only to incidents of 407.7 maltreatment that occur on or after October 1, 1995. Hearings 407.8 requested by nursing assistants in nursing homes alleged to have 407.9 maltreated a resident prior to October 1, 1995, shall be held as 407.10 a contested case proceeding under the provisions of chapter 14. 407.11 Hearings requested under clause (8) apply only to incidents of 407.12 maltreatment that occur on or after July 1, 1997. A hearing for 407.13 an individual or facility under clause (8) is only available 407.14 when there is no juvenile court or adult criminal action 407.15 pending. If such action is filed in either court while an 407.16 administrative review is pending, the administrative review must 407.17 be suspended until the judicial actions are completed. If the 407.18 juvenile court action or criminal charge is dismissed or the 407.19 criminal action overturned, the matter may be considered in an 407.20 administrative hearing. 407.21 For purposes of this section, bargaining unit grievance 407.22 procedures are not an administrative appeal. 407.23 The scope of hearings involving claims to foster care 407.24 payments under clause (5) shall be limited to the issue of 407.25 whether the county is legally responsible for a child's 407.26 placement under court order or voluntary placement agreement 407.27 and, if so, the correct amount of foster care payment to be made 407.28 on the child's behalf and shall not include review of the 407.29 propriety of the county's child protection determination or 407.30 child placement decision. 407.31 (b) A vendor of medical care as defined in section 256B.02, 407.32 subdivision 7, or a vendor under contract with a county agency 407.33 to provide social services under section 256E.08, subdivision 4, 407.34 is not a party and may not request a hearing under this section, 407.35 except if assisting a recipient as provided in subdivision 4. 407.36 (c) An applicant or recipient is not entitled to receive 408.1 social services beyond the services included in the amended 408.2 community social services plan developed under section 256E.081, 408.3 subdivision 3, if the county agency has met the requirements in 408.4 section 256E.081. 408.5 (d) The commissioner may summarily affirm the county or 408.6 state agency's proposed action without a hearing when the sole 408.7 issue is an automatic change due to a change in state or federal 408.8 law. 408.9 Sec. 27. Minnesota Statutes 2000, section 256.045, 408.10 subdivision 3b, is amended to read: 408.11 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 408.12 DISQUALIFICATION HEARINGS.] The state human services referee 408.13 shall determine that maltreatment has occurred if a 408.14 preponderance of evidence exists to support the final 408.15 disposition under sections 626.556 and 626.557. For purposes of 408.16 hearings regarding disqualification, the state human services 408.17 referee shall affirm the proposed disqualification in an appeal 408.18 under subdivision 3, paragraph (a), clause (9), if a 408.19 preponderance of the evidence shows the individual has: 408.20 (1) committed maltreatment under section 626.556 or 408.21 626.557, which is serious or recurring; 408.22 (2) committed an act or acts meeting the definition of any 408.23 of the crimes listed in section 245A.04, subdivision 3d, 408.24 paragraph (a), clauses (1) to (4); or 408.25 (3) failed to make required reports under section 626.556 408.26 or 626.557, for incidents in which: 408.27 (i) the final disposition under section 626.556 or 626.557 408.28 was substantiated maltreatment; and 408.29 (ii) the maltreatment was recurring or serious; or 408.30 substantiated serious or recurring maltreatment of a minor under 408.31 section 626.556 or of a vulnerable adult under section 626.557 408.32 for which there is a preponderance of evidence that the 408.33 maltreatment occurred, and that the subject was responsible for 408.34 the maltreatment. If the disqualification is affirmed, the 408.35 state human services referee shall determine whether the 408.36 individual poses a risk of harm in accordance with the 409.1 requirements of section 245A.04, subdivision 3b. 409.2 The state human services referee shall recommend an order 409.3 to the commissioner of health or human services, as applicable, 409.4 who shall issue a final order. The commissioner shall affirm, 409.5 reverse, or modify the final disposition. Any order of the 409.6 commissioner issued in accordance with this subdivision is 409.7 conclusive upon the parties unless appeal is taken in the manner 409.8 provided in subdivision 7. Except as provided under section 409.9 245A.04, subdivisions 3b, paragraphs (e) and (f), and 3c, in any 409.10 licensing appeal under chapter 245A and sections 144.50 to 409.11 144.58 and 144A.02 to 144A.46, the commissioner's determination 409.12 as to maltreatment is conclusive. 409.13 Sec. 28. Minnesota Statutes 2000, section 256.045, 409.14 subdivision 4, is amended to read: 409.15 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 409.16 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 409.17 according to the provisions of the federal Social Security Act 409.18 and the regulations implemented in accordance with that act to 409.19 enable this state to qualify for federal grants-in-aid, and 409.20 according to the rules and written policies of the commissioner 409.21 of human services. County agencies shall install equipment 409.22 necessary to conduct telephone hearings. A state human services 409.23 referee may schedule a telephone conference hearing when the 409.24 distance or time required to travel to the county agency offices 409.25 will cause a delay in the issuance of an order, or to promote 409.26 efficiency, or at the mutual request of the parties. Hearings 409.27 may be conducted by telephone conferences unless the applicant, 409.28 recipient, former recipient, person, or facility contesting 409.29 maltreatment objects. The hearing shall not be held earlier 409.30 than five days after filing of the required notice with the 409.31 county or state agency. The state human services referee shall 409.32 notify all interested persons of the time, date, and location of 409.33 the hearing at least five days before the date of the hearing. 409.34 Interested persons may be represented by legal counsel or other 409.35 representative of their choice, including a provider of therapy 409.36 services, at the hearing and may appear personally, testify and 410.1 offer evidence, and examine and cross-examine witnesses. The 410.2 applicant, recipient, former recipient, person, or facility 410.3 contesting maltreatment shall have the opportunity to examine 410.4 the contents of the case file and all documents and records to 410.5 be used by the county or state agency at the hearing at a 410.6 reasonable time before the date of the hearing and during the 410.7 hearing. In hearings under subdivision 3, paragraph (a), 410.8 clauses (4)and, (8), and (9), either party may subpoena the 410.9 private data relating to the investigation prepared by the 410.10 agency under section 626.556 or 626.557 that is not otherwise 410.11 accessible under section 13.04, provided the identity of the 410.12 reporter may not be disclosed. 410.13 (b) The private data obtained by subpoena in a hearing 410.14 under subdivision 3, paragraph (a), clause (4)or, (8), or (9), 410.15 must be subject to a protective order which prohibits its 410.16 disclosure for any other purpose outside the hearing provided 410.17 for in this section without prior order of the district court. 410.18 Disclosure without court order is punishable by a sentence of 410.19 not more than 90 days imprisonment or a fine of not more than 410.20 $700, or both. These restrictions on the use of private data do 410.21 not prohibit access to the data under section 13.03, subdivision 410.22 6. Except for appeals under subdivision 3, paragraph (a), 410.23 clauses (4), (5),and(8), and (9), upon request, the county 410.24 agency shall provide reimbursement for transportation, child 410.25 care, photocopying, medical assessment, witness fee, and other 410.26 necessary and reasonable costs incurred by the applicant, 410.27 recipient, or former recipient in connection with the appeal. 410.28 All evidence, except that privileged by law, commonly accepted 410.29 by reasonable people in the conduct of their affairs as having 410.30 probative value with respect to the issues shall be submitted at 410.31 the hearing and such hearing shall not be "a contested case" 410.32 within the meaning of section 14.02, subdivision 3. The agency 410.33 must present its evidence prior to or at the hearing, and may 410.34 not submit evidence after the hearing except by agreement of the 410.35 parties at the hearing, provided the petitioner has the 410.36 opportunity to respond. 411.1 Sec. 29. Minnesota Statutes 2000, section 626.557, 411.2 subdivision 3, is amended to read: 411.3 Subd. 3. [TIMING OF REPORT.] (a) A mandated reporter who 411.4 has reason to believe that a vulnerable adult is being or has 411.5 been maltreated, or who has knowledge that a vulnerable adult 411.6 has sustained a physical injury which is not reasonably 411.7 explained shall immediately report the information to the common 411.8 entry point. If an individual is a vulnerable adult solely 411.9 because the individual is admitted to a facility, a mandated 411.10 reporter is not required to report suspected maltreatment of the 411.11 individual that occurred prior to admission, unless: 411.12 (1) the individual was admitted to the facility from 411.13 another facility and the reporter has reason to believe the 411.14 vulnerable adult was maltreated in the previous facility; or 411.15 (2) the reporter knows or has reason to believe that the 411.16 individual is a vulnerable adult as defined in section 626.5572, 411.17 subdivision 21, clause (4). 411.18 (b) A person not required to report under the provisions of 411.19 this section may voluntarily report as described above. 411.20 (c) Nothing in this section requires a report of known or 411.21 suspected maltreatment, if the reporter knows or has reason to 411.22 know that a report has been made to the common entry point. 411.23 (d) Nothing in this section shall preclude a reporter from 411.24 also reporting to a law enforcement agency. 411.25 (e) A mandated reporter who knows or has reason to believe 411.26 that an error under section 626.5572, subdivision 17, paragraph 411.27 (c), clause (5), occurred must make a report under this 411.28 subdivision. If the reporter or a facility, at any time 411.29 believes that an investigation by a lead agency will determine 411.30 or should determine that the reported error was not neglect 411.31 according to the criteria under section 626.5572, subdivision 411.32 17, paragraph (c), clause (5), the reporter or facility may 411.33 provide to the common entry point or directly to the lead agency 411.34 information explaining how the event meets the criteria under 411.35 section 626.5572, subdivision 17, paragraph (c), clause (5). 411.36 The lead agency shall consider this information when making an 412.1 initial disposition of the report under subdivision 9c. 412.2 [EFFECTIVE DATE.] This section is effective August 1, 2001. 412.3 Sec. 30. Minnesota Statutes 2000, section 626.557, 412.4 subdivision 9d, is amended to read: 412.5 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 412.6 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 412.7 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 412.8 provided under paragraph (e), any individual or facility which a 412.9 lead agency determines has maltreated a vulnerable adult, or the 412.10 vulnerable adult or an interested person acting on behalf of the 412.11 vulnerable adult, regardless of the lead agency's determination, 412.12 who contests the lead agency's final disposition of an 412.13 allegation of maltreatment, may request the lead agency to 412.14 reconsider its final disposition. The request for 412.15 reconsideration must be submitted in writing to the lead agency 412.16 within 15 calendar days after receipt of notice of final 412.17 disposition or, if the request is made by an interested person 412.18 who is not entitled to notice, within 15 days after receipt of 412.19 the notice by the vulnerable adult or the vulnerable adult's 412.20 legal guardian. An individual who was determined to have 412.21 maltreated a vulnerable adult under this section and who was 412.22 disqualified on the basis of serious or recurring maltreatment 412.23 under section 245A.04, subdivision 3d, may request 412.24 reconsideration of the maltreatment determination and the 412.25 disqualification. The request for reconsideration of the 412.26 maltreatment determination and the disqualification must be 412.27 submitted within 30 calendar days of the individual's receipt of 412.28 the notice of disqualification under section 245A.04, 412.29 subdivision 3a. 412.30 (b) Except as provided under paragraphs (e) and (f), if the 412.31 lead agency denies the request or fails to act upon the request 412.32 within 15 calendar days after receiving the request for 412.33 reconsideration, the person or facility entitled to a fair 412.34 hearing under section 256.045, may submit to the commissioner of 412.35 human services a written request for a hearing under that 412.36 statute. The vulnerable adult, or an interested person acting 413.1 on behalf of the vulnerable adult, may request a review by the 413.2 vulnerable adult maltreatment review panel under section 256.021 413.3 if the lead agency denies the request or fails to act upon the 413.4 request, or if the vulnerable adult or interested person 413.5 contests a reconsidered disposition. The lead agency shall 413.6 notify persons who request reconsideration of their rights under 413.7 this paragraph. The request must be submitted in writing to the 413.8 review panel and a copy sent to the lead agency within 30 413.9 calendar days of receipt of notice of a denial of a request for 413.10 reconsideration or of a reconsidered disposition. The request 413.11 must specifically identify the aspects of the agency 413.12 determination with which the person is dissatisfied. 413.13 (c) If, as a result of a reconsideration or review, the 413.14 lead agency changes the final disposition, it shall notify the 413.15 parties specified in subdivision 9c, paragraph (d). 413.16 (d) For purposes of this subdivision, "interested person 413.17 acting on behalf of the vulnerable adult" means a person 413.18 designated in writing by the vulnerable adult to act on behalf 413.19 of the vulnerable adult, or a legal guardian or conservator or 413.20 other legal representative, a proxy or health care agent 413.21 appointed under chapter 145B or 145C, or an individual who is 413.22 related to the vulnerable adult, as defined in section 245A.02, 413.23 subdivision 13. 413.24 (e) If an individual was disqualified under section 413.25 245A.04, subdivision 3d, on the basis of a determination of 413.26 maltreatment, which was serious or recurring, and the individual 413.27 has requested reconsideration of the maltreatment determination 413.28 under paragraph (a) and reconsideration of the disqualification 413.29 under section 245A.04, subdivision 3b, reconsideration of the 413.30 maltreatment determination and requested reconsideration of the 413.31 disqualification shall be consolidated into a single 413.32 reconsideration. If an individual who was disqualified on the 413.33 basis of serious or recurring maltreatment requests a fair 413.34 hearing under paragraph (b), the scope of the fair hearing shall 413.35 include the maltreatment determination and the disqualification. 413.36 (f) If a maltreatment determination or a disqualification 414.1 based on serious or recurring maltreatment is the basis for a 414.2 denial of a license under section 245A.05 or a licensing 414.3 sanction under section 245A.07, the license holder has the right 414.4 to a contested case hearing under chapter 14 and Minnesota 414.5 Rules, parts 1400.8510 to 1400.8612 and successor rules. As 414.6 provided for under section 245A.08, the scope of the contested 414.7 case hearing shall include the maltreatment determination, 414.8 disqualification, and licensing sanction or denial of a 414.9 license. In such cases, a fair hearing shall not be conducted 414.10 under paragraph (b). If the disqualified subject is an 414.11 individual other than the license holder and upon whom a 414.12 background study must be conducted under section 245A.04, 414.13 subdivision 3, the hearings of all parties may be consolidated 414.14 into a single contested case hearing upon consent of all parties 414.15 and the administrative law judge. 414.16 (g) Until August 1, 2002, an individual or facility that 414.17 was determined by the commissioner of human services or the 414.18 commissioner of health to be responsible for neglect under 414.19 section 626.5572, subdivision 17, after October 1, 1995, and 414.20 before August 1, 2001, that believes that the finding of neglect 414.21 does not meet an amended definition of neglect may request a 414.22 reconsideration of the determination of neglect. The 414.23 commissioner of human services or the commissioner of health 414.24 shall mail a notice to the last known address of individuals who 414.25 are eligible to seek this reconsideration. The request for 414.26 reconsideration must state how the established findings no 414.27 longer meet the elements of the definition of neglect. The 414.28 commissioner shall review the request for reconsideration and 414.29 make a determination within 15 calendar days. The 414.30 commissioner's decision on this reconsideration is the final 414.31 agency action. 414.32 (1) For purposes of compliance with the data destruction 414.33 schedule under subdivision 12b, paragraph (d), when a finding of 414.34 substantiated maltreatment has been changed as a result of a 414.35 reconsideration under this paragraph, the date of the original 414.36 finding of a substantiated maltreatment must be used to 415.1 calculate the destruction date. 415.2 (2) For purposes of any background studies under section 415.3 245A.04, when a determination of substantiated maltreatment has 415.4 been changed as a result of a reconsideration under this 415.5 paragraph, any prior disqualification of the individual under 415.6 section 245A.04 that was based on this determination of 415.7 maltreatment shall be rescinded, and for future background 415.8 studies under section 245A.04 the commissioner must not use the 415.9 previous determination of substantiated maltreatment as a basis 415.10 for disqualification or as a basis for referring the 415.11 individual's maltreatment history to a health-related licensing 415.12 board under section 245A.04, subdivision 3d, paragraph (b). 415.13 [EFFECTIVE DATE.] Paragraph (g) of this section is 415.14 effective the day following final enactment. Paragraphs (a), 415.15 (b), (e), and (f) are effective January 1, 2002. 415.16 Sec. 31. Minnesota Statutes 2000, section 626.5572, 415.17 subdivision 17, is amended to read: 415.18 Subd. 17. [NEGLECT.] "Neglect" means: 415.19 (a) The failure or omission by a caregiver to supply a 415.20 vulnerable adult with care or services, including but not 415.21 limited to, food, clothing, shelter, health care, or supervision 415.22 which is: 415.23 (1) reasonable and necessary to obtain or maintain the 415.24 vulnerable adult's physical or mental health or safety, 415.25 considering the physical and mental capacity or dysfunction of 415.26 the vulnerable adult; and 415.27 (2) which is not the result of an accident or therapeutic 415.28 conduct. 415.29 (b) The absence or likelihood of absence of care or 415.30 services, including but not limited to, food, clothing, shelter, 415.31 health care, or supervision necessary to maintain the physical 415.32 and mental health of the vulnerable adult which a reasonable 415.33 person would deem essential to obtain or maintain the vulnerable 415.34 adult's health, safety, or comfort considering the physical or 415.35 mental capacity or dysfunction of the vulnerable adult. 415.36 (c) For purposes of this section, a vulnerable adult is not 416.1 neglected for the sole reason that: 416.2 (1) the vulnerable adult or a person with authority to make 416.3 health care decisions for the vulnerable adult under sections 416.4 144.651, 144A.44, chapter 145B, 145C, or 252A, or section 416.5 253B.03, or 525.539 to 525.6199, refuses consent or withdraws 416.6 consent, consistent with that authority and within the boundary 416.7 of reasonable medical practice, to any therapeutic conduct, 416.8 including any care, service, or procedure to diagnose, maintain, 416.9 or treat the physical or mental condition of the vulnerable 416.10 adult, or, where permitted under law, to provide nutrition and 416.11 hydration parenterally or through intubation; this paragraph 416.12 does not enlarge or diminish rights otherwise held under law by: 416.13 (i) a vulnerable adult or a person acting on behalf of a 416.14 vulnerable adult, including an involved family member, to 416.15 consent to or refuse consent for therapeutic conduct; or 416.16 (ii) a caregiver to offer or provide or refuse to offer or 416.17 provide therapeutic conduct; or 416.18 (2) the vulnerable adult, a person with authority to make 416.19 health care decisions for the vulnerable adult, or a caregiver 416.20 in good faith selects and depends upon spiritual means or prayer 416.21 for treatment or care of disease or remedial care of the 416.22 vulnerable adult in lieu of medical care, provided that this is 416.23 consistent with the prior practice or belief of the vulnerable 416.24 adult or with the expressed intentions of the vulnerable adult; 416.25 (3) the vulnerable adult, who is not impaired in judgment 416.26 or capacity by mental or emotional dysfunction or undue 416.27 influence, engages in sexual contact with: 416.28 (i) a person including a facility staff person when a 416.29 consensual sexual personal relationship existed prior to the 416.30 caregiving relationship; or 416.31 (ii) a personal care attendant, regardless of whether the 416.32 consensual sexual personal relationship existed prior to the 416.33 caregiving relationship; or 416.34 (4) an individual makes an error in the provision of 416.35 therapeutic conduct to a vulnerable adult which: (i)does not 416.36 result in injury or harm which reasonably requires medical or 417.1 mental health care; or, if it reasonably requires care,417.2 (5) an individual makes an error in the provision of 417.3 therapeutic conduct to a vulnerable adult that results in injury 417.4 or harm, which reasonably requires the care of a physician; and: 417.5 (i) the necessary care issought andprovided in a timely 417.6 fashion as dictated by the condition of the vulnerable adult; 417.7and the injury or harm that required care does not result in417.8substantial acute, or chronic injury or illness, or permanent417.9disability above and beyond the vulnerable adult's preexisting417.10condition; 417.11 (ii) is after receiving care, the health status of the 417.12 vulnerable adult can be reasonably expected, as determined by 417.13 the attending physician, to be restored to the vulnerable 417.14 adult's preexisting condition; 417.15 (iii) the error is not part of a pattern of errors by the 417.16 individual; 417.17 (iv) if in a facility, the error is immediately reported as 417.18 required under section 626.557, and recorded internallyby the417.19employee or person providing servicesin the facilityin order417.20to evaluate and identify corrective action; 417.21 (v) if in a facility, the facility identifies and takes 417.22 corrective action and implements measures designed to reduce the 417.23 risk of further occurrence of this error and similar errors; and 417.24(iii) is(vi) if in a facility, the actions required under 417.25 items (iv) and (v) are sufficiently documented for review and 417.26 evaluation by the facility and any applicable licensing, 417.27 certification, and ombudsman agency; and417.28(iv) is not part of a pattern of errors by the individual. 417.29 (d) Nothing in this definition requires a caregiver, if 417.30 regulated, to provide services in excess of those required by 417.31 the caregiver's license, certification, registration, or other 417.32 regulation. 417.33 (e) If the findings of an investigation by a lead agency 417.34 result in a determination of substantiated maltreatment for the 417.35 sole reason that the actions required of a facility under 417.36 paragraph (c), clause (5), item (iv), (v), or (vi), were not 418.1 taken, then the facility is subject to a correction order. An 418.2 individual will not be found to have neglected or maltreated the 418.3 vulnerable adult based solely on the facility's not having taken 418.4 the actions required under paragraph (c), clause (5), item (iv), 418.5 (v), or (vi). This must not alter the lead agency's 418.6 determination of mitigating factors under section 626.557, 418.7 subdivision 9c, paragraph (c). 418.8 Sec. 32. [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 418.9 The commissioner of health or human services, whichever is 418.10 appropriate, shall pursue changes to federal law necessary to 418.11 allow greater discretion on disciplinary activities of 418.12 unlicensed health care workers, and apply for necessary federal 418.13 waivers or approval that would allow for a set-aside process 418.14 related to disqualifications for nurse aides in nursing homes by 418.15 July 1, 2002. 418.16 Sec. 33. [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 418.17 By January 2002, the commissioner of health shall work with 418.18 providers to examine federal rules and regulations prohibiting 418.19 neglect, abuse, and financial exploitation of residents in 418.20 licensed nursing facilities and shall apply for federal waivers 418.21 to: 418.22 (1) allow the use of Minnesota Statutes, section 626.5572, 418.23 to control the identification and prevention of maltreatment of 418.24 residents in licensed nursing facilities, rather than the 418.25 definitions under federal rules and regulations; and 418.26 (2) allow the use of Minnesota Statutes, sections 214.104, 418.27 245A.04, and 626.557 to control the disqualification or 418.28 discipline of any persons providing services to residents in 418.29 licensed nursing facilities, rather than the nurse aide registry 418.30 or other exclusionary provisions of federal rules and 418.31 regulations. 418.32 [EFFECTIVE DATE.] This section is effective July 1, 2001. 418.33 Sec. 34. [INSTRUCTION TO REVISOR.] 418.34 (a) The revisor of statutes shall replace any references to 418.35 "sections 245A.01 to 245A.16" in chapter 245A with "this 418.36 chapter." 419.1 (b) The revisor of statutes shall replace references in 419.2 Minnesota Rules and Minnesota Statutes to "parts 9543.3000 to 419.3 9543.3090" with "section 245A.04." 419.4 (c) The revisor of statutes shall replace references in 419.5 Minnesota Rules and Minnesota Statutes to "part 9543.3070" with 419.6 "section 245A.04, subdivision 3d." 419.7 (d) The revisor of statutes shall replace references in 419.8 Minnesota Rules and Minnesota Statutes to "part 9543.3080" with 419.9 "section 245A.04, subdivision 3b." 419.10 Sec. 35. [REPEALER.] 419.11 Minnesota Rules, parts 9543.3000; 9543.3010; 9543.3020; 419.12 9543.3030; 9543.3040; 9543.3050; 9543.3060; 9543.3080; and 419.13 9543.3090, are repealed. 419.14 ARTICLE 15 419.15 VITAL STATISTICS 419.16 Section 1. Minnesota Statutes 2000, section 144.212, 419.17 subdivision 2a, is amended to read: 419.18 Subd. 2a. [DELAYED REGISTRATION.] "Delayed registration" 419.19 means registration of acertificaterecord of birth or death 419.20 filed one or more years after the dateestablished by law for419.21filing a certificateof birth or death. 419.22 Sec. 2. Minnesota Statutes 2000, section 144.212, 419.23 subdivision 3, is amended to read: 419.24 Subd. 3. [FILE.] "File" means to present a vital record or 419.25 report for registration to the office of the state registrar and 419.26 to have the vital record or report accepted for registration by 419.27 the office of the state registrar. 419.28 Sec. 3. Minnesota Statutes 2000, section 144.212, 419.29 subdivision 5, is amended to read: 419.30 Subd. 5. [REGISTRATION.] "Registration" means the 419.31acceptance of a vital record for filing by a registrar of vital419.32statisticsprocess by which vital records are completed, filed, 419.33 and incorporated into the official records of the office of the 419.34 state registrar. 419.35 Sec. 4. Minnesota Statutes 2000, section 144.212, 419.36 subdivision 7, is amended to read: 420.1 Subd. 7. [SYSTEM OF VITAL STATISTICS.] "System of vital 420.2 statistics" includes the registration, collection, preservation, 420.3 amendment, and certification of vital records, the collection of 420.4 other reports required by sections 144.211 to 144.227, and 420.5 related activities including the tabulation, analysisand, 420.6 publication, and dissemination of vital statistics. 420.7 Sec. 5. Minnesota Statutes 2000, section 144.212, 420.8 subdivision 8, is amended to read: 420.9 Subd. 8. [VITAL RECORD.] "Vital record" meanscertificates420.10or reportsa record or report of birth, death, marriage, 420.11 dissolution and annulment, and data related thereto. The birth 420.12 record is not a medical record of the mother or the child. 420.13 Sec. 6. Minnesota Statutes 2000, section 144.212, 420.14 subdivision 9, is amended to read: 420.15 Subd. 9. [VITAL STATISTICS.] "Vital statistics" means the 420.16 data derived fromcertificates andrecords and reports of birth, 420.17 death, fetal death, induced abortion, marriage, dissolution and 420.18 annulment, and related reports. 420.19 Sec. 7. Minnesota Statutes 2000, section 144.212, 420.20 subdivision 11, is amended to read: 420.21 Subd. 11. [CONSENT TO DISCLOSURE.] "Consent to disclosure" 420.22 means an affidavit filed with the state registrar which sets 420.23 forth the following information: 420.24(a)(1) the current name and address of the affiant; 420.25(b)(2) any previous name by which the affiant was known; 420.26(c)(3) the original and adopted names, if known, of the 420.27 adopted child whose original birthcertificaterecord is to be 420.28 disclosed; 420.29(d)(4) the place and date of birth of the adopted child; 420.30(e)(5) the biological relationship of the affiant to the 420.31 adopted child; and 420.32(f)(6) the affiant's consent to disclosure of information 420.33 from the originalunalteredbirthcertificaterecord of the 420.34 adopted child. 420.35 Sec. 8. Minnesota Statutes 2000, section 144.214, 420.36 subdivision 1, is amended to read: 421.1 Subdivision 1. [DISTRICTS.]Each countyThe counties of 421.2 the state, and the city of St. Paul,shall constitute the8887 421.3 registration districts of the state.TheA local registrar in 421.4 each county shall bethe court administrator of district court421.5in that countydesignated by the county board of commissioners. 421.6 The local registrar in any city which maintains local 421.7 registration of vital statistics shall be the agent of a board 421.8 of health as authorized under section 145A.04. In addition, the 421.9 state registrar may establish registration districts on United 421.10 States government reservations,and may appoint a local 421.11 registrar for each registration district so established. 421.12 Sec. 9. Minnesota Statutes 2000, section 144.214, 421.13 subdivision 3, is amended to read: 421.14 Subd. 3. [DUTIES.]The local registrar shall examine each421.15certificate of birth and death received pursuant to the rules of421.16the commissioner. If the certificate is complete it shall be421.17registered.The local registrar shall enforce the provisions of 421.18 sections 144.211 to 144.227 and the rules promulgated thereunder 421.19 within the registration district,and shall promptly report 421.20 violations of the laws or rules to the state registrar. 421.21 Sec. 10. Minnesota Statutes 2000, section 144.214, 421.22 subdivision 4, is amended to read: 421.23 Subd. 4. [DESIGNATED MORTICIANS.] The state registrar may 421.24 designate licensed morticians to receive records of death for 421.25 filingcertificates of death, to issue burial permits, and to 421.26 issue permits for the transportation of dead bodies or dead 421.27 fetuses within a designated territory. The designated 421.28 morticians shall perform duties as prescribed by rule of the 421.29 commissioner. 421.30 Sec. 11. Minnesota Statutes 2000, section 144.215, 421.31 subdivision 1, is amended to read: 421.32 Subdivision 1. [WHEN AND WHERE TO FILE.] Acertificate421.33 record of birth for each live birth which occurs in this state 421.34 shall be filed with the state registraror the local registrar421.35of the district in which the birth occurred,within five days 421.36 after the birth. 422.1 Sec. 12. Minnesota Statutes 2000, section 144.215, 422.2 subdivision 3, is amended to read: 422.3 Subd. 3. [FATHER'S NAME; CHILD'S NAME.] In any case in 422.4 which paternity of a child is determined by a court of competent 422.5 jurisdiction, a declaration of parentage is executed under 422.6 section 257.34, or a recognition of parentage is executed under 422.7 section 257.75, the name of the father shall be entered on the 422.8 birthcertificaterecord. If the order of the court declares 422.9 the name of the child, it shall also be entered on the birth 422.10certificaterecord. If the order of the court does not declare 422.11 the name of the child, or there is no court order, then upon the 422.12 request of both parents in writing, the surname of the child 422.13 shall bethat of the fatherdefined by both parents. 422.14 Sec. 13. Minnesota Statutes 2000, section 144.215, 422.15 subdivision 4, is amended to read: 422.16 Subd. 4. [SOCIAL SECURITY NUMBER REGISTRATION.] (a) 422.17 Parents of a child born within this state shall givetheirthe 422.18 parents' social security numbers to the office ofvital422.19statisticsthe state registrar at the time of filing the birth 422.20certificaterecord, but the numbers shall not appear on the 422.21 certificate. 422.22 (b) The social security numbers are classified as private 422.23 data, as defined in section 13.02, subdivision 12, on 422.24 individuals, but the office ofvital statisticsthe state 422.25 registrar shall providethea social security number to the 422.26 public authority responsible for child support services upon 422.27 request by the public authority for use in the establishment of 422.28 parentage and the enforcement of child support obligations. 422.29 Sec. 14. Minnesota Statutes 2000, section 144.215, 422.30 subdivision 6, is amended to read: 422.31 Subd. 6. [BIRTHS OCCURRING OUTSIDE AN INSTITUTION.] When a 422.32 birth occurs outside of an institution as defined in subdivision 422.33 5, thecertificaterecord of birth shall beprepared andfiled 422.34 by one of the following persons, in the indicated order of 422.35 preference: 422.36 (1) the physician present at the time of the birth or 423.1 immediately thereafter; 423.2 (2) in the absence of a physician, a person, other than the 423.3 mother, present at the time of the birth or immediately 423.4 thereafter; 423.5 (3) the fatheror motherof the child;or423.6 (4) the mother of the child; or 423.7 (5) in the absence of the father and if the mother is 423.8 unable, the person with primary responsibility for the premises 423.9 where the child was born. 423.10 Sec. 15. Minnesota Statutes 2000, section 144.215, 423.11 subdivision 7, is amended to read: 423.12 Subd. 7. [EVIDENCE REQUIRED TO REGISTER A NONINSTITUTION 423.13 BIRTH WITHIN THE FIRST YEAR OF BIRTH.] When a birth occurs in 423.14 this state outside of an institution, as defined in subdivision 423.15 5, and the birthcertificaterecord is filed before the first 423.16 birthday, evidence in support of the facts of birth shall be 423.17 requiredwhen neither the state nor local registrar has personal423.18knowledge regarding the facts of birth. Evidence shall be 423.19 presented by the individual responsible for filing 423.20 thecertificatevital record under subdivision 6. Evidence 423.21 shall consist of proof that the child was born alive, proof of 423.22 pregnancy,orand evidence of the mother's presence in this 423.23 state on the date of the birth. If the evidence is not 423.24 acceptable, the state registrar shall advise the applicant of 423.25 the reason for not filing a birthcertificaterecord and shall 423.26 further advise the applicant of the right of appeal to a court 423.27 of competent jurisdiction. 423.28 Sec. 16. Minnesota Statutes 2000, section 144.217, is 423.29 amended to read: 423.30 144.217 [DELAYEDCERTIFICATESRECORDS OF BIRTH.] 423.31 Subdivision 1. [EVIDENCE REQUIRED FOR FILING.] Before a 423.32 delayedcertificaterecord of birth is registered, the person 423.33 presenting the delayedcertificatevital record for registration 423.34 shall offer evidence of the facts contained in thecertificate423.35 vital record, as required by the rules of the commissioner. In 423.36 the absence of the evidence required, the delayedcertificate424.1 vital record shall not be registered. No delayed record of 424.2 birth shall be registered for a deceased person. 424.3 Subd. 2. [COURT PETITION.] If a delayedcertificaterecord 424.4 of birth is rejected under subdivision 1, a person may petition 424.5 the appropriate court for an order establishing a record of the 424.6 date and place of the birth and the parentage of the person 424.7 whose birth is to be registered. The petition shall state: 424.8(a)(1) that the person for whom a delayed 424.9certificaterecord of birth is sought was born in this state; 424.10(b)(2) that nocertificaterecord of birth can be found in 424.11 the office of the stateor localregistrar; 424.12(c)(3) that diligent efforts by the petitioner have failed 424.13 to obtain the evidence required in subdivision 1; 424.14(d)(4) that the state registrar has refused to register a 424.15 delayedcertificaterecord of birth; and 424.16(e)(5) other information as may be required by the court. 424.17 Subd. 3. [COURT ORDER.] The court shall fix a time and 424.18 place for a hearing on the petition and shall give the state 424.19 registrar ten days' notice of the hearing. The state registrar 424.20 may appear and testify in the proceeding. If the court is 424.21 satisfied from the evidence received at the hearing of the truth 424.22 of the statements in the petition, the court shall order the 424.23 registration of the delayedcertificatevital record. 424.24Subd. 4. [FILING THE ORDER.] A certified copy of the order424.25shall be filed with the state registrar, who shall forward a424.26copy to the local registrar in the district of birth. Certified424.27copies of the order shall be evidence of the truth of their424.28contents and be admissible as birth certificates.424.29 Sec. 17. Minnesota Statutes 2000, section 144.218, is 424.30 amended to read: 424.31 144.218 [REPLACEMENTCERTIFICATES OFBIRTH RECORDS.] 424.32 Subdivision 1. [ADOPTION.] Upon receipt of a certified 424.33 copy of an order, decree, or certificate of adoption, the state 424.34 registrar shall register a replacementcertificatevital record 424.35 in the new name of the adopted person. The originalcertificate424.36 record of birthand the certified copy areis confidential 425.1 pursuant to section 13.02, subdivision 3, and shall not be 425.2 disclosed except pursuant to court order or section144.1761425.3 144.2252.A certified copy of the original birth certificate425.4from which the registration number has been deleted and which425.5has been marked "Not for Official Use," orThe information 425.6 contained on the original birthcertificate, except for the425.7registration number,record, except for the registration number, 425.8 shall be provided on request to a parent who is named on the 425.9 original birthcertificaterecord. Upon the receipt of a 425.10 certified copy of a court order of annulment of adoption the 425.11 state registrar shall restore the originalcertificatevital 425.12 record to its original place in the file. 425.13 Subd. 2. [ADOPTION OF FOREIGN PERSONS.] In proceedings for 425.14 the adoption of a person who was born in a foreign country, the 425.15 court, upon evidence presented by the commissioner of human 425.16 services from information secured at the port of entry,or upon 425.17 evidence from other reliable sources, may make findings of fact 425.18 as to the date and place of birth and parentage. Upon receipt 425.19 of certified copies of the court findings and the order or 425.20 decree of adoption, a certificate of adoption, or a certified 425.21 copy of a decree issued under section 259.60, the state 425.22 registrar shall register a birthcertificaterecord in the new 425.23 name of the adopted person. The certified copies of the court 425.24 findings and the order,or decree of adoption, certificate of 425.25 adoption, or decree issued under section 259.60 are 425.26 confidential, pursuant to section 13.02, subdivision 3, and 425.27 shall not be disclosed except pursuant to court order or section 425.28144.1761144.2252. The birthcertificaterecord shall state the 425.29 place of birth as specifically as possible,and that 425.30 thecertificatevital record is not evidence of United States 425.31 citizenship. 425.32 Subd. 3. [SUBSEQUENT MARRIAGE OF BIRTH PARENTS.] If, in 425.33 cases in which acertificaterecord of birth has been registered 425.34 pursuant to section 144.215 and the birth parents of the child 425.35 marry after the birth of the child, a replacementcertificate425.36 record of birth shall be registered upon presentation of a 426.1 certified copy of the marriage certificate of the birth parents, 426.2 and either a recognition of parentage or court adjudication of 426.3 paternity. Theinformation presented and theoriginal 426.4certificaterecord of birthareis confidential, pursuant to 426.5 section 13.02, subdivision 3, and shall not be disclosed except 426.6 pursuant to court order. 426.7 Subd. 4. [INCOMPLETE, INCORRECT, AND MODIFIEDCERTIFICATES426.8 VITAL RECORDS.] If a court finds that a birthcertificaterecord 426.9 is incomplete, inaccurate, or false,or if it is being issued 426.10 pursuant to section 259.10, subdivision 2,itthe court may 426.11 order the registration of a replacementcertificatevital 426.12 record, and, if necessary, set forth the correct information in 426.13 the order. Upon receipt of the order, thestateregistrar shall 426.14 register a replacementcertificatevital record containing the 426.15 findings of the court, and. The priorcertificatevital record 426.16 shall be confidential pursuant to section 13.02, subdivision 3, 426.17 and shall not be disclosed except pursuant to court order. 426.18 Subd. 5. [REPLACEMENT OF VITAL RECORDS.] Upon the order of 426.19 a court of this state, upon the request of a court of another 426.20 state, upon the filing of a declaration of parentage under 426.21 section 257.34, or upon the filing of a recognition of parentage 426.22 with a registrar, a replacement birth record must be registered 426.23 consistent with the findings of the court, the declaration of 426.24 parentage, or the recognition of parentage. 426.25 Sec. 18. Minnesota Statutes 2000, section 144.221, 426.26 subdivision 1, is amended to read: 426.27 Subdivision 1. [WHEN AND WHERE TO FILE.] A death 426.28certificaterecord for each death which occurs in the state 426.29 shall be filed with the state registrar or local registrarof426.30the district in which the death occurredor with a mortician 426.31appointeddesignated pursuant to section 144.214, subdivision 4, 426.32 within five days after death and prior to final disposition. 426.33 Sec. 19. Minnesota Statutes 2000, section 144.221, 426.34 subdivision 3, is amended to read: 426.35 Subd. 3. [WHEN NO BODY IS FOUND.] When circumstances 426.36 suggest that a death has occurred although a dead body cannot be 427.1 produced to confirm the fact of death, a deathcertificate427.2 record shall not be registered until a court has adjudicated the 427.3 fact of death.A certified copy of the court finding shall be427.4attached to the death certificate when it is registered.427.5 Sec. 20. Minnesota Statutes 2000, section 144.222, 427.6 subdivision 2, is amended to read: 427.7 Subd. 2. [SUDDEN INFANT DEATH.] Each infant death which is 427.8 diagnosed as sudden infant death syndrome shall be 427.9 reportedpromptlywithin five days to the state registrar. 427.10 Sec. 21. Minnesota Statutes 2000, section 144.223, is 427.11 amended to read: 427.12 144.223 [REPORT OF MARRIAGE.] 427.13 Data relating to certificates of marriage registered shall 427.14 be reported to the state registrar by the localregistrars427.15 registrar or designee of the county board in each of the 87 427.16 registration districts pursuant to the rules of the 427.17 commissioner. The information in clause (1) necessary to 427.18 compile the report shall be furnished by the applicant prior to 427.19 the issuance of the marriage license. The report shall contain 427.20 the followinginformation: 427.21A.(1) personal information on bride and groom: 427.221.(i) name; 427.232.(ii) residence; 427.243.(iii) date and place of birth; 427.254.(iv) race; 427.265.(v) if previously married, how terminated; and 427.276.(vi) signature of applicantand, date signed, and social 427.28 security number.; and 427.29B.(2) information concerning the marriage: 427.301.(i) date of marriage; 427.312.(ii) place of marriage; and 427.323.(iii) civil or religious ceremony. 427.33 Sec. 22. Minnesota Statutes 2000, section 144.225, 427.34 subdivision 1, is amended to read: 427.35 Subdivision 1. [PUBLIC INFORMATION; ACCESS TO VITAL 427.36 RECORDS.] Except as otherwise provided for in this section and 428.1 section144.1761144.2252, information contained in vital 428.2 records shall be public information. Physical access to vital 428.3 records shall be subject to the supervision and regulation of 428.4 state and local registrars and their employees pursuant to rules 428.5 promulgated by the commissioner in order to protect vital 428.6 records from loss, mutilation or destruction and to prevent 428.7 improper disclosure of vital records which are confidential or 428.8 private data on individuals, as defined in section 13.02, 428.9 subdivisions 3 and 12. 428.10 Sec. 23. Minnesota Statutes 2000, section 144.225, 428.11 subdivision 2, is amended to read: 428.12 Subd. 2. [DATA ABOUT BIRTHS.] (a) Except as otherwise 428.13 provided in this subdivision, data pertaining to the birth of a 428.14 child to a woman who was not married to the child's father when 428.15 the child was conceived nor when the child was born, including 428.16 the originalcertificaterecord of birth and the certified 428.17copyvital record, are confidential data. At the time of the 428.18 birth of a child to a woman who was not married to the child's 428.19 father when the child was conceived nor when the child was born, 428.20 the mother may designateon the birth registration form whether428.21 demographic data pertaining to the birthwill beas public 428.22data. Notwithstanding the designation of the data as 428.23 confidential, it may be disclosed: 428.24 (1) to a parent or guardian of the child; 428.25 (2) to the child when the child is1816 years of age or 428.26 older; 428.27 (3) under paragraph (b) or (e); or 428.28 (4) pursuant to a court order. For purposes of this 428.29 section, a subpoena does not constitute a court order. 428.30 (b) Unless the child is adopted, data pertaining to the 428.31 birth of a child that are not accessible to the public become 428.32 public data if 100 years have elapsed since the birth of the 428.33 child who is the subject of the data, or as provided under 428.34 section 13.10, whichever occurs first. 428.35 (c) If a child is adopted, data pertaining to the child's 428.36 birth are governed by the provisions relating to adoption 429.1 records, including sections 13.10, subdivision 5;144.1761;429.2 144.218, subdivision 1; 144.2252; and 259.89.The birth and429.3death records of the commissioner of health shall be open to429.4inspection by the commissioner of human services and it shall429.5not be necessary for the commissioner of human services to429.6obtain an order of the court in order to inspect records or to429.7secure certified copies of them.429.8 (d) The name and address of a mother under paragraph (a) 429.9 and the child's date of birth may be disclosed to the county 429.10 social services or public health member of a family services 429.11 collaborative for purposes of providing services under section 429.12 124D.23. 429.13 (e) The commissioner of human services shall have access to 429.14 birth records for: 429.15 (1) the purposes of administering medical assistance, 429.16 general assistance medical care, and the MinnesotaCare program; 429.17 (2) child support enforcement purposes; and 429.18 (3) other public health purposes as determined by the 429.19 commissioner of health. 429.20 Sec. 24. Minnesota Statutes 2000, section 144.225, 429.21 subdivision 2a, is amended to read: 429.22 Subd. 2a. [HEALTH DATA ASSOCIATED WITH BIRTH 429.23 REGISTRATION.] Information from which an identification of risk 429.24 for disease, disability, or developmental delay in a mother or 429.25 child can be made, that is collected in conjunction with birth 429.26 registration or fetal death reporting, is private data as 429.27 defined in section 13.02, subdivision 12. The commissioner may 429.28 disclose to a local board of health, as defined in section 429.29 145A.02, subdivision 2, health data associated with birth 429.30 registration which identifies a mother or child at high risk for 429.31 serious disease, disability, or developmental delay in order to 429.32 assure access to appropriate health, social, or educational 429.33 services. Notwithstanding the designation of the private data, 429.34 the commissioner of human services shall have access to health 429.35 data associated with birth registration for: 429.36 (1) purposes of administering medical assistance, general 430.1 assistance medical care, and the MinnesotaCare program; and 430.2 (2) for other public health purposes as determined by the 430.3 commissioner of health. 430.4 Sec. 25. Minnesota Statutes 2000, section 144.225, 430.5 subdivision 3, is amended to read: 430.6 Subd. 3. [LAWS AND RULES FOR PREPARINGCERTIFICATESVITAL 430.7 RECORDS.] No person shall prepare or issue anycertificatevital 430.8 record which purports to be an original, certified copy, or copy 430.9 of a vital record except as authorized in sections 144.211 to 430.10 144.227 or the rules of the commissioner. 430.11 Sec. 26. Minnesota Statutes 2000, section 144.225, 430.12 subdivision 7, as amended by Laws 2001, chapter 15, section 1, 430.13 is amended to read: 430.14 Subd. 7. [CERTIFIEDCOPY OFBIRTH OR DEATH 430.15CERTIFICATERECORD.] (a) The state or local registrar shall 430.16 issue a certifiedcopy of abirth or deathcertificaterecord or 430.17 a statement of no vital record found to an individual upon the 430.18 individual's proper completion of an attestation provided by the 430.19 commissioner: 430.20 (1) to a person who has a tangible interest in the 430.21 requestedcertificatevital record. A person who has a tangible 430.22 interest is: 430.23 (i) the subject of thecertificatevital record; 430.24 (ii) a child of the subject; 430.25 (iii) the spouse of the subject; 430.26 (iv) a parent of the subject; 430.27 (v) the grandparent or grandchild of the subject; 430.28 (vi) the party responsible for filing thecertificatevital 430.29 record; 430.30 (vii) the legal custodian or guardian or conservator of the 430.31 subject; 430.32 (viii) a personal representative, by sworn affidavit of the 430.33 fact that the certified copy is required for administration of 430.34 the estate; 430.35 (ix) a successor of the subject, as defined in section 430.36 524.1-201, if the subject is deceased, by sworn affidavit of the 431.1 fact that the certified copy is required for administration of 431.2 the estate; 431.3 (x) if the requested certificate is a death certificate, a 431.4 trustee of a trust by sworn affidavit of the fact that the 431.5 certified copy is needed for the proper administration of the 431.6 trust;or431.7 (xi) a person or entity who demonstrates that a 431.8 certifiedcopy of the certificatevital record is necessary for 431.9 the determination or protection of a personal or property right, 431.10 pursuant to rules adopted by the commissioner; or 431.11 (xii) adoption agencies in order to complete confidential 431.12 postadoption searches as required by section 259.83; 431.13 (2) to any local, state, or federal governmental agency 431.14 upon request if the certifiedcertificatevital record is 431.15 necessary for the governmental agency to perform its authorized 431.16 duties. An authorized governmental agency includes the 431.17 department of human services, the department of revenue, and the 431.18 United States Immigration and Naturalization Service; 431.19 (3) to an attorney upon evidence of the attorney's license; 431.20 (4) pursuant to a court order issued by a court of 431.21 competent jurisdiction. For purposes of this section, a 431.22 subpoena does not constitute a court order; or 431.23 (5) to a representative authorized by a person under 431.24 clauses (1) to (4). 431.25 (b) The state or local registrar shall also issue a 431.26 certified death record to an individual described in paragraph 431.27 (a), clause (1), items (ii) to (vii), if, on behalf of the 431.28 individual, a mortician designated to receive death certificates 431.29 under section 144.214, subdivision 4, furnishes the registrar 431.30 with a properly completed attestation in the form provided by 431.31 the commissioner within 180 days of the time of death of the 431.32 subject of the death record. This paragraph is not subject to 431.33 the requirements specified in Minnesota Rules, part 4601.2600, 431.34 subpart 5, item B. 431.35 Sec. 27. [144.2252] [ACCESS TO ORIGINAL BIRTH RECORD AFTER 431.36 ADOPTION.] 432.1 (a) Whenever an adopted person requests the state registrar 432.2 to disclose the information on the adopted person's original 432.3 birth record, the state registrar shall act according to section 432.4 259.89. 432.5 (b) The state registrar shall provide a transcript of an 432.6 adopted person's original birth record to an authorized 432.7 representative of a federally recognized American Indian tribe 432.8 for the sole purpose of determining the adopted person's 432.9 eligibility for enrollment or membership. Information contained 432.10 in the birth record may not be used to provide the adopted 432.11 person information about the person's birth parents, except as 432.12 provided in this section or section 259.83. 432.13 Sec. 28. Minnesota Statutes 2000, section 144.226, 432.14 subdivision 1, is amended to read: 432.15 Subdivision 1. [WHICH SERVICES ARE FOR FEE.] The fees for 432.16 the following services shall be the following or an amount 432.17 prescribed by rule of the commissioner: 432.18 (a) The fee for the issuance of a certifiedcopy or432.19certification of avital record,or a certification that the 432.20 vital record cannot be found is $8. No fee shall be charged for 432.21 a certified birth or death record that is reissued within one 432.22 year of the original issue, if an amendment is made to the vital 432.23 record and if the previously issued vital record is surrendered. 432.24 (b) The fee for the replacement of a birth record for all 432.25 events, exceptadoptionwhen filing a recognition of parentage 432.26 pursuant to section 257.73, subdivision 1, is $20. 432.27 (c) The fee for the filing of a delayed registration of 432.28 birth or death is $20. 432.29 (d) The fee for the amendment of any vital record when 432.30 requested more thanone year45 days after the filing of the 432.31 vital record is $20. No fee shall be charged for an amendment 432.32 requested withinone year45 days after the filing of the 432.33certificatevital record. 432.34 (e) The fee for the verification of information from vital 432.35 records is $8 when the applicant furnishes the specific 432.36 information to locate the vital record. When the applicant does 433.1 not furnish specific information, the fee is $20 per hour for 433.2 staff time expended. Specific informationshall include433.3 includes the correct date of the event and the correct name of 433.4 the registrant. Fees charged shall approximate the costs 433.5 incurred in searching and copying the vital records. The fee 433.6 shall be payable at the time of application. 433.7 (f) The fee for issuance of acertified or noncertified433.8 copy of any document on file pertaining to a vital record ora433.9certificationstatement thatthe recorda related document 433.10 cannot be found is $8. 433.11 Sec. 29. Minnesota Statutes 2000, section 144.226, 433.12 subdivision 3, is amended to read: 433.13 Subd. 3. [BIRTHCERTIFICATE COPYRECORD SURCHARGE.] In 433.14 addition to any fee prescribed under subdivision 1, there shall 433.15 be a nonrefundable surcharge of $3 for each certifiedcopy of a433.16 birthcertificate,record and for a certification that the vital 433.17 record cannot be found. The local or state registrar shall 433.18 forward this amount to the commissioner of finance for deposit 433.19 into the account for the children's trust fund for the 433.20 prevention of child abuse established under section 119A.12. 433.21 This surcharge shall not be charged under those circumstances in 433.22 which no fee for a certifiedcopy of abirthcertificaterecord 433.23 is permitted under subdivision 1, paragraph (a). Upon 433.24 certification by the commissioner of finance that the assets in 433.25 that fund exceed $20,000,000, this surcharge shall be 433.26 discontinued. 433.27 Sec. 30. Minnesota Statutes 2000, section 144.227, is 433.28 amended to read: 433.29 144.227 [PENALTIES.] 433.30 Subdivision 1. [FALSE STATEMENTS.]WhoeverA person who 433.31 intentionally makesanya false statement in a certificate, 433.32 vital record, or report required to be filed under sections 433.33 144.211 to 144.214 or 144.216 to 144.227, or in an application 433.34 for an amendment thereof, or in an application for a 433.35 certifiedcopy of avital record,or who supplies false 433.36 information intending that the information be used in the 434.1 preparation ofanya report, vital record, certificate, or 434.2 amendment thereof, is guilty of a misdemeanor. 434.3 Subd. 2. [FRAUD.]AnyA person who, without lawful 434.4 authority and with the intent to deceive, willfully and 434.5 knowingly makes, counterfeits, alters, obtains, possesses, uses, 434.6 or sellsanya certificate, vital record, or report required to 434.7 be filed under sections 144.211 to 144.227,or a certifiedcopy434.8of acertificate, vital record, or report, is guilty of a gross 434.9 misdemeanor. 434.10 Subd. 3. [BIRTH REGISTRATION.]WhoeverA person who 434.11 intentionally makes a false statement in a registration required 434.12 under section 144.215 or in an application for an amendment to 434.13 such a registration,or who intentionally supplies false 434.14 information intending that the information be used in the 434.15 preparation of a registration under section 144.215 is guilty of 434.16 a gross misdemeanor. This offense shall be prosecuted by the 434.17 county attorney. 434.18 Sec. 31. Minnesota Statutes 2000, section 260C.317, 434.19 subdivision 4, is amended to read: 434.20 Subd. 4. [RIGHTS OF TERMINATED PARENT.] Upon entry of an 434.21 order terminating the parental rights of any person who is 434.22 identified as a parent on the original birth certificate of the 434.23 child as to whom the parental rights are terminated, the court 434.24 shall cause written notice to be made to that person setting 434.25 forth: 434.26(a)(1) the right of the person to file at any time with 434.27 the state registrar of vital statistics a consent to disclosure, 434.28 as defined in section 144.212, subdivision 11; 434.29(b)(2) the right of the person to file at any time with 434.30 the state registrar of vital statistics an affidavit stating 434.31 that the information on the original birth certificate shall not 434.32 be disclosed as provided in section144.1761144.2252; and 434.33(c)(3) the effect of a failure to file either a consent to 434.34 disclosure, as defined in section 144.212, subdivision 11, or an 434.35 affidavit stating that the information on the original birth 434.36 certificate shall not be disclosed. 435.1 Sec. 32. [REVISOR'S INSTRUCTION.] 435.2 (a) The revisor of statutes shall change the terms 435.3 "certificate of birth," "birth certificate," or similar terms to 435.4 "record of birth," "birth record," or similar terms wherever 435.5 they appear in Minnesota Statutes and Minnesota Rules. 435.6 (b) The revisor of statutes shall change the terms 435.7 "certificate of death," "death certificate," or similar terms to 435.8 "record of death," "death record," or similar terms wherever 435.9 they appear in Minnesota Statutes and Minnesota Rules. 435.10 (c) The revisor of statutes shall change the term "office 435.11 of vital statistics" to "office of the state registrar" wherever 435.12 it appears in Minnesota Statutes and Minnesota Rules. 435.13 Sec. 33. [REPEALER.] 435.14 Minnesota Statutes 2000, sections 144.1761; 144.217, 435.15 subdivision 4; and 144.219, are repealed. 435.16 ARTICLE 16 435.17 APPROPRIATIONS 435.18 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 435.19 The sums shown in the columns marked "APPROPRIATIONS" are 435.20 appropriated from the general fund, or any other named fund, to 435.21 the agencies and for the purposes specified in the following 435.22 sections of this article, to be available for the fiscal years 435.23 indicated for each purpose. The figures "2002" and "2003" where 435.24 used in this article, mean that the appropriation or 435.25 appropriations listed under them are available for the fiscal 435.26 year ending June 30, 2002, or June 30, 2003, respectively. 435.27 Where a dollar amount appears in parentheses, it means a 435.28 reduction of an appropriation. 435.29 SUMMARY BY FUND 435.30 APPROPRIATIONS BIENNIAL 435.31 2002 2003 TOTAL 435.32 General $.,...,...,... $.,...,...,... $.,...,...,... 435.33 State Government 435.34 Special Revenue ..,...,... ..,...,... ..,...,... 435.35 Health Care 435.36 Access ...,...,... ...,...,... ...,...,... 435.37 Federal TANF ...,...,... ...,...,... ...,...,... 436.1 Lottery Cash Flow .,...,... .,...,... .,...,... 436.2 TOTAL $.,...,...,... $.,...,...,... $.,...,...,... 436.3 APPROPRIATIONS 436.4 Available for the Year 436.5 Ending June 30 436.6 2002 2003 436.7 Sec. 2. COMMISSIONER OF 436.8 HUMAN SERVICES 436.9 Subdivision 1. Total 436.10 Appropriation $.,...,...,... $.,...,...,... 436.11 Summary by Fund 436.12 General .,...,...,... .,...,...,... 436.13 State Government 436.14 Special Revenue ...,... ...,... 436.15 Health Care 436.16 Access ...,...,... ...,...,... 436.17 Federal TANF ...,...,... ...,...,... 436.18 Lottery Cash Flow .,...,... .,...,... 436.19 Subd. 2. Agency Management 436.20 General ..,...,... ..,...,... 436.21 State Government 436.22 Special Revenue ...,... ...,... 436.23 Health Care 436.24 Access .,...,... .,...,... 436.25 Federal TANF ...,... ...,... 436.26 The amounts that may be spent from the 436.27 appropriation for each purpose are as 436.28 follows: 436.29 (a) Financial Operations 436.30 General .,...,... .,...,... 436.31 Health Care 436.32 Access ...,... ...,... 436.33 Federal TANF ...,... ...,... 436.34 (b) Legal and Regulation Operations 436.35 General .,...,... .,...,... 436.36 State Government 436.37 Special Revenue ...,... ...,... 436.38 Health Care 436.39 Access ...,... ...,... 436.40 (c) Management Operations 436.41 General ..,...,... ..,...,... 436.42 Health Care 436.43 Access .,...,... .,...,... 437.1 Subd. 3. Administrative Reimbursement/ 437.2 Pass Through 437.3 Federal TANF ..,... ..,... 437.4 Subd. 4. Children's Services Grants 437.5 General ..,...,... ..,...,... 437.6 Federal TANF .,...,... .,...,... 437.7 Subd. 5. Children's Services Management 437.8 General .,...,... .,...,... 437.9 Subd. 6. Basic Health Care Grants 437.10 Summary by Fund 437.11 General .,...,...,... .,...,...,... 437.12 Health Care 437.13 Access ...,...,... ...,...,... 437.14 The amounts that may be spent from this 437.15 appropriation for each purpose are as 437.16 follows: 437.17 (a) MinnesotaCare Grants 437.18 Health Care 437.19 Access ...,...,... ...,...,... 437.20 (b) MA Basic Health Care Grants - 437.21 Families and Children 437.22 General ...,...,... ...,...,... 437.23 (c) MA Basic Health Care Grants - 437.24 Elderly and Disabled 437.25 General ...,...,... ...,...,... 437.26 (d) General Assistance Medical Care 437.27 General ...,...,... ...,...,... 437.28 (e) Health Care Grants - Other Assistance 437.29 General ..,...,... ..,...,... 437.30 Health Care 437.31 Access ...,... ...,... 437.32 Subd. 7. Basic Health Care Management 437.33 General ..,...,... ..,...,... 437.34 Health Care 437.35 Access ..,...,... ..,...,... 437.36 The amounts that may be spent from this 437.37 appropriation for each purpose are as 437.38 follows: 437.39 (a) Health Care Policy Administration 437.40 General .,...,... .,...,... 437.41 Health Care 437.42 Access ...,... ...,... 438.1 (b) Health Care Operations 438.2 General ..,...,... ..,...,... 438.3 Health Care 438.4 Access ..,...,... ..,...,... 438.5 Subd. 8. State-Operated Services 438.6 General ...,...,... ...,...,... 438.7 Subd. 9. Continuing Care Grants 438.8 General .,...,...,... .,...,...,... 438.9 Lottery Cash Flow .,...,... .,...,... 438.10 The amounts that may be spent from this 438.11 appropriation for each purpose are as 438.12 follows: 438.13 (a) Community Social Services 438.14 Block Grants 438.15 ..,...,... ..,...,... 438.16 (b) Aging Adult Service Grants 438.17 ..,...,... ..,...,... 438.18 (c) Deaf and Hard-of-Hearing 438.19 Services Grants 438.20 .,...,... .,...,... 438.21 (d) Mental Health Grants 438.22 General ..,...,... ..,...,... 438.23 Lottery Cash Flow .,...,... .,...,... 438.24 (e) Community Support Grants 438.25 ..,...,... ..,...,... 438.26 (f) Medical Assistance Long-Term 438.27 Care Waivers and Home Care 438.28 ...,...,... ...,...,... 438.29 (g) Medical Assistance Long-Term 438.30 Care Facilities 438.31 ...,...,... ...,...,... 438.32 (h) Alternative Care Grants 438.33 General ..,...,... ..,...,... 438.34 (i) Group Residential Housing 438.35 General ..,...,... ..,...,... 438.36 (j) Chemical Dependency 438.37 Entitlement Grants 438.38 General ..,...,... ..,...,... 438.39 (k) Chemical Dependency 438.40 Nonentitlement Grants 439.1 General .,...,... .,...,... 439.2 Subd. 10. Continuing Care Management 439.3 General ..,...,... ..,...,... 439.4 State Government 439.5 Special Revenue ...,... ...,... 439.6 Lottery Cash Flow ...,... ...,... 439.7 Subd. 11. Economic Support Grants 439.8 General ..,...,... ..,...,... 439.9 Federal TANF ...,...,... ...,...,... 439.10 The amounts that may be spent from this 439.11 appropriation for each purpose are as 439.12 follows: 439.13 (a) Assistance to Families Grants 439.14 General ..,...,... ..,...,... 439.15 Federal TANF ...,...,... ...,...,... 439.16 (b) Work Grants 439.17 General .,...,... .,...,... 439.18 Federal TANF ..,...,... ..,...,... 439.19 (c) Economic Support Grants - 439.20 Other Assistance 439.21 General .,...,... .,...,... 439.22 Federal TANF .,...,... .,...,... 439.23 (d) Child Support Enforcement 439.24 General .,...,... .,...,... 439.25 Federal TANF ...,... ...,... 439.26 (e) General Assistance 439.27 General ..,...,... ..,...,... 439.28 (f) Minnesota Supplemental Aid 439.29 General ..,...,... ..,...,... 439.30 (g) Refugee Services 439.31 General ...,... ...,... 439.32 Subd. 12. Economic Support 439.33 Management 439.34 General ..,...,... ..,...,... 439.35 Health Care 439.36 Access .,...,... .,...,... 439.37 Federal TANF .,...,... ...,... 439.38 The amounts that may be spent from this 439.39 appropriation for each purpose are as 440.1 follows: 440.2 (a) Economic Support Policy 440.3 Administration 440.4 General .,...,... .,...,... 440.5 Federal TANF .,...,... ...,... 440.6 (b) Economic Support Operations 440.7 General ..,...,... ..,...,... 440.8 Health Care 440.9 Access .,...,... .,...,... 440.10 Federal TANF ...,...,... ...,...,... 440.11 Sec. 3. COMMISSIONER OF HEALTH 440.12 Subdivision 1. Total 440.13 Appropriation ...,...,... ...,...,... 440.14 Summary by Fund 440.15 General ..,...,... ..,...,... 440.16 State Government 440.17 Special Revenue ..,...,... ..,...,... 440.18 Health Care 440.19 Access .,...,... .,...,... 440.20 Federal TANF ..,...,... ..,...,... 440.21 Subd. 2. Family and 440.22 Community Health ..,...,... ..,...,... 440.23 Summary by Fund 440.24 General ..,...,... ..,...,... 440.25 State Government 440.26 Special Revenue ...,... .,...,... 440.27 Health Care 440.28 Access .,...,... .,...,... 440.29 Federal TANF ..,...,... ..,...,... 440.30 Subd. 3. Access and Quality 440.31 Improvement ..,...,... ..,...,... 440.32 Summary by Fund 440.33 General ..,...,... ..,...,... 440.34 State Government 440.35 Special Revenue .,...,... .,...,... 440.36 Health Care 440.37 Access .,...,... .,...,... 440.38 Subd. 4. Health Protection ..,...,... ..,...,... 440.39 Summary by Fund 440.40 General ..,...,... ..,...,... 440.41 State Government 440.42 Special Revenue ..,...,... ..,...,... 441.1 Subd. 5. Management and 441.2 Support Services .,...,... .,...,... 441.3 Summary by Fund 441.4 General .,...,... .,...,... 441.5 State Government 441.6 Special Revenue ...,... ...,... 441.7 Sec. 4. VETERANS NURSING 441.8 HOMES BOARD ..,...,... ..,...,... 441.9 Sec. 5. HEALTH-RELATED BOARDS 441.10 Subdivision 1. Total 441.11 Appropriation ..,...,... ..,...,... 441.12 Subd. 2. Board of Chiropractic 441.13 Examiners ...,... ...,... 441.14 Subd. 3. Board of Dentistry ...,... ...,... 441.15 Subd. 4. Board of Dietetic 441.16 and Nutrition Practice ..,... ..,... 441.17 Subd. 5. Board of Marriage and 441.18 Family Therapy ...,... ...,... 441.19 Subd. 6. Board of Medical 441.20 Practice .,...,... .,...,... 441.21 Subd. 7. Board of Nursing .,...,... .,...,... 441.22 Subd. 8. Board of Nursing 441.23 Home Administrators ...,... ...,... 441.24 Subd. 9. Board of Optometry ..,... ..,... 441.25 Subd. 10. Board of Pharmacy .,...,... .,...,... 441.26 Subd. 11. Board of Physical Therapy ...,... ...,... 441.27 Subd. 12. Board of Podiatry ..,... ..,... 441.28 Subd. 13. Board of Psychology ...,... ...,... 441.29 Subd. 14. Board of Social Work ...,... ...,... 441.30 Subd. 15. Board of Veterinary 441.31 Medicine ...,... ...,... 441.32 Sec. 6. EMERGENCY MEDICAL 441.33 SERVICES BOARD .,...,... .,...,... 441.34 Summary by Fund 441.35 General .,...,... .,...,... 441.36 Sec. 7. COUNCIL ON DISABILITY ...,... ...,... 441.37 Sec. 8. OMBUDSMAN FOR MENTAL 441.38 HEALTH AND MENTAL RETARDATION .,...,... .,...,... 441.39 Sec. 9. OMBUDSMAN 441.40 FOR FAMILIES ...,... ...,... 441.41 ARTICLE 17 441.42 APPROPRIATIONS 442.1 Section 1. [CRIMINAL JUSTICE APPROPRIATIONS.] 442.2 The sums shown in the columns marked "APPROPRIATIONS" are 442.3 appropriated from the general fund, or another named fund, to 442.4 the agencies and for the purposes specified in this act, to be 442.5 available for the fiscal years indicated for each purpose. The 442.6 figures "2001," "2002," and "2003" where used in this act, mean 442.7 that the appropriation or appropriations listed under them are 442.8 available for the year ending June 30, 2001, June 30, 2002, or 442.9 June 30, 2003, respectively. 442.10 APPROPRIATIONS 442.11 Available for the Year 442.12 Ending June 30 442.13 2002 2003 442.14 Sec. 2. BOARD OF PUBLIC DEFENSE 442.15 Subdivision 1. Total 442.16 Appropriation ..,...,... ..,...,... 442.17 Sec. 3. CORRECTIONS 442.18 Subdivision 1. Total 442.19 Appropriation ...,...,... ...,...,... 442.20 Summary by Fund 442.21 2002 2003 442.22 General ...,...,... ...,...,... 442.23 Special Revenue .,...,... .,...,... 442.24 Subd. 2. Correctional Institutions 442.25 Summary by Fund 442.26 2002 2003 442.27 General ...,...,... ...,...,... 442.28 Special Revenue ...,... ...,... 442.29 Subd. 3. Juvenile Services 442.30 ..,...,... ..,...,... 442.31 Subd. 4. Community Services 442.32 Summary by Fund 442.33 General ...,...,... ...,...,... 442.34 Special Revenue ...,... ...,... 442.35 Subd. 5. Management Services 442.36 Summary by Fund 442.37 General ..,...,... ..,...,... 442.38 Special Revenue ...,... ...,... 443.1 Sec. 4. SENTENCING 443.2 GUIDELINES COMMISSION ...,... ...,...