Minnesota Legislature
HF 904
1st Engrossment - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 03/13/2003 | |
| 1st Engrossment | Posted on 03/26/2003 |
Current Version - 1st Engrossment
1.1 A bill for an act 1.2 relating to state government; making changes to public 1.3 assistance programs, health care programs, continuing 1.4 care for persons with disabilities, and children's 1.5 services; establishing the Community Services Act; 1.6 changing estate recovery provisions for medical 1.7 assistance; modifying local public health grants; 1.8 appropriating money; amending Minnesota Statutes 2002, 1.9 sections 16A.724; 62J.692, subdivision 4, by adding a 1.10 subdivision; 62Q.19, subdivision 1; 69.021, 1.11 subdivision 11; 144.1222, by adding a subdivision; 1.12 144.125; 144.128; 144.1483; 144.1488, subdivision 4; 1.13 144.1491, subdivision 1; 144.1502, subdivision 4; 1.14 144.551, subdivision 1; 144A.4605, subdivision 4; 1.15 144E.11, subdivision 6; 145.88; 145.881, subdivision 1.16 2; 145.882, subdivisions 1, 2, 3, 7, by adding a 1.17 subdivision; 145.883, subdivisions 1, 9; 145A.02, 1.18 subdivisions 5, 6, 7; 145A.06, subdivision 1; 145A.09, 1.19 subdivisions 2, 4, 7; 145A.10, subdivisions 2, 10, by 1.20 adding a subdivision; 145A.11, subdivisions 2, 4; 1.21 145A.12, subdivisions 1, 2, by adding a subdivision; 1.22 145A.13, by adding a subdivision; 145A.14, subdivision 1.23 2; 147A.08; 148.5194, subdivisions 1, 2, 3, by adding 1.24 a subdivision; 148.6445, subdivision 7; 153A.17; 1.25 245.4874; 245A.10; 245B.06, subdivision 8; 246.54; 1.26 252.27, subdivision 2a; 252.46, subdivision 1; 256.01, 1.27 subdivision 2; 256.476, subdivisions 1, 3, 4, 5, 11; 1.28 256.482, subdivision 8; 256.935, subdivision 1; 1.29 256.955, subdivision 2a; 256.9657, subdivision 1; 1.30 256.969, subdivisions 2b, 3a; 256.9754, subdivisions 1.31 2, 3, 4, 5; 256.984, subdivision 1; 256B.055, by 1.32 adding a subdivision; 256B.056, subdivisions 1a, 1c; 1.33 256B.057, subdivisions 1, 2, 3b, 9; 256B.0595, 1.34 subdivisions 1, 2; 256B.06, subdivision 4; 256B.061; 1.35 256B.0625, subdivisions 13, 20, 23, by adding 1.36 subdivisions; 256B.0635, subdivisions 1, 2; 256B.0913, 1.37 subdivisions 2, 4, 5, 6, 7, 8, 10, 12; 256B.0915, 1.38 subdivision 3; 256B.0945, subdivisions 2, 4; 256B.15, 1.39 subdivisions 1, 1a, 2, 3, 4, by adding subdivisions; 1.40 256B.19, subdivisions 1, 1d; 256B.195, subdivision 4; 1.41 256B.32, subdivision 1; 256B.431, subdivisions 2r, 23, 1.42 32, 36, by adding subdivisions; 256B.434, subdivision 1.43 4; 256B.48, subdivision 1; 256B.501, subdivision 1, by 1.44 adding a subdivision; 256B.5012, by adding a 1.45 subdivision; 256B.5015; 256B.69, subdivisions 2, 4, 1.46 5c, by adding a subdivision; 256B.75; 256B.76; 2.1 256D.03, subdivisions 3, 4; 256D.06, subdivision 2; 2.2 256D.44, subdivision 5; 256D.46, subdivisions 1, 3; 2.3 256D.48, subdivision 1; 256E.081, subdivision 3; 2.4 256F.10, subdivision 6; 256G.05, subdivision 2; 2.5 256I.02; 256I.04, subdivision 3; 256I.05, subdivisions 2.6 1, 1a, 2, 7c; 256J.01, subdivision 5; 256J.02, 2.7 subdivision 2; 256J.021; 256J.08, subdivisions 35, 65, 2.8 82, 85, by adding subdivisions; 256J.09, subdivisions 2.9 2, 3, 3a, 3b, 8, 10; 256J.14; 256J.20, subdivision 3; 2.10 256J.21, subdivision 2; 256J.24, subdivisions 3, 5, 6, 2.11 7, 10; 256J.30, subdivision 9; 256J.32, subdivisions 2.12 2, 4, 5a, by adding a subdivision; 256J.37, 2.13 subdivision 9, by adding subdivisions; 256J.38, 2.14 subdivisions 3, 4; 256J.42, subdivisions 4, 5, 6; 2.15 256J.425, subdivisions 1, 1a, 2, 3, 4, 6, 7; 256J.45, 2.16 subdivision 2; 256J.46, subdivisions 1, 2, 2a; 2.17 256J.49, subdivisions 4, 5, 9, 13, by adding 2.18 subdivisions; 256J.50, subdivisions 1, 8, 9, 10; 2.19 256J.51, subdivisions 1, 2, 3, 4; 256J.53, 2.20 subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3, 2.21 5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57; 2.22 256J.62, subdivision 9; 256J.645, subdivision 3; 2.23 256J.66, subdivision 2; 256J.67, subdivisions 1, 3; 2.24 256J.69, subdivision 2; 256J.75, subdivision 3; 2.25 256J.751, subdivisions 1, 2, 5; 256L.02, by adding a 2.26 subdivision; 256L.03, subdivisions 3, 5; 256L.04, 2.27 subdivision 1; 256L.05, subdivisions 1, 3, 3a, 3c, 4; 2.28 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 2.29 256L.09, subdivision 4; 256L.12, subdivision 9, by 2.30 adding a subdivision; 256L.15, subdivisions 1, 2, 3; 2.31 259.67, subdivision 4; 260B.157, subdivision 1; 2.32 260B.176, subdivision 2; 260B.178, subdivision 1; 2.33 260B.193, subdivision 2; 260B.235, subdivision 6; 2.34 261.063; 295.55, subdivision 2; 295.58; 326.42; 2.35 393.07, subdivision 10; 514.981, subdivision 6; 2.36 518.551, subdivision 7; 518.6111, subdivisions 2, 3, 2.37 4, 16; 524.3-805; 626.559, subdivision 5; Laws 1997, 2.38 chapter 203, article 9, section 21, as amended; 2.39 proposing coding for new law in Minnesota Statutes, 2.40 chapters 144; 145; 145A; 148C; 256B; 256D; 256I; 256J; 2.41 514; proposing coding for new law as Minnesota 2.42 Statutes, chapter 256M; repealing Minnesota Statutes 2.43 2002, sections 62J.694, subdivisions 1, 2, 2a, 3; 2.44 144.126; 144.1484; 144.1494; 144.1495; 144.1496; 2.45 144.1497; 144.395, subdivisions 1, 2; 144.396; 2.46 144.401; 144.9507, subdivision 3; 144A.36; 144A.38; 2.47 145.56, subdivision 2; 145.882, subdivisions 4, 5, 6, 2.48 8; 145.883, subdivisions 4, 7; 145.884; 145.885; 2.49 145.886; 145.888; 145.889; 145.890; 145.9266, 2.50 subdivisions 2, 4, 5, 6, 7; 145.928, subdivision 9; 2.51 145A.02, subdivisions 9, 10, 11, 12, 13, 14; 145A.10, 2.52 subdivisions 5, 6, 8; 145A.11, subdivision 3; 145A.12, 2.53 subdivisions 3, 4, 5; 145A.14, subdivisions 3, 4; 2.54 145A.17, subdivision 2; 148.5194, subdivision 3a; 2.55 148.6445, subdivision 9; 245.4712, subdivision 2; 2.56 245.478; 245.4886; 245.4888; 245.496; 254A.17; 2.57 256.955, subdivision 8; 256.973; 256.9752; 256.9753; 2.58 256.976; 256.977; 256.9772; 256B.055, subdivision 10a; 2.59 256B.057, subdivision 1b; 256B.0625, subdivisions 5a, 2.60 35, 36; 256B.0917; 256B.0928; 256B.0945, subdivisions 2.61 6, 7, 8, 9, 10; 256B.095; 256B.0951; 256B.0952; 2.62 256B.0953; 256B.0954; 256B.0955; 256B.195, subdivision 2.63 5; 256B.437, subdivision 2; 256B.5013, subdivision 4; 2.64 256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 2.65 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 2.66 256E.11; 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 2.67 256F.02; 256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 2.68 256F.08; 256F.10, subdivision 7; 256F.11; 256F.12; 2.69 256F.14; 256J.02, subdivision 3; 256J.08, subdivisions 2.70 28, 70; 256J.24, subdivision 8; 256J.30, subdivision 2.71 10; 256J.462; 256J.47; 256J.48; 256J.49, subdivisions 3.1 1a, 2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 3.2 256J.52, subdivisions 1, 2, 3, 4, 5, 5a, 6, 7, 8, 9; 3.3 256J.55, subdivision 5; 256J.62, subdivisions 1, 2a, 3.4 3a, 4, 6, 7, 8; 256J.625; 256J.655; 256J.74, 3.5 subdivision 3; 256J.751, subdivisions 3, 4; 256J.76; 3.6 256K.30; 256L.02, subdivision 3; 256L.04, subdivision 3.7 9; 257.075; 257.81; 260.152; 626.562; Laws 1988, 3.8 chapter 689, article 2, section 251; Laws 2000, 3.9 chapter 488, article 10, section 29; Laws 2001, First 3.10 Special Session chapter 9, article 13, section 24; 3.11 Laws 2002, chapter 374, article 9, section 8; 3.12 Minnesota Rules, parts 4705.0100; 4705.0200; 3.13 4705.0300; 4705.0400; 4705.0500; 4705.0600; 4705.0700; 3.14 4705.0800; 4705.0900; 4705.1000; 4705.1100; 4705.1200; 3.15 4705.1300; 4705.1400; 4705.1500; 4705.1600; 4736.0010; 3.16 4736.0020; 4736.0030; 4736.0040; 4736.0050; 4736.0060; 3.17 4736.0070; 4736.0080; 4736.0090; 4736.0120; 4736.0130; 3.18 4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 3.19 4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 3.20 4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 3.21 4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295; 3.22 4763.0300; 9505.0324; 9505.0326; 9505.0327; 9545.2000; 3.23 9545.2010; 9545.2020; 9545.2030; 9545.2040; 9550.0010; 3.24 9550.0020; 9550.0030; 9550.0040; 9550.0050; 9550.0060; 3.25 9550.0070; 9550.0080; 9550.0090; 9550.0091; 9550.0092; 3.26 9550.0093. 3.27 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.28 ARTICLE 1 3.29 WELFARE REFORM; PUBLIC ASSISTANCE MODIFICATIONS 3.30 Section 1. Minnesota Statutes 2002, section 256.935, 3.31 subdivision 1, is amended to read: 3.32 Subdivision 1. [FUNERAL EXPENSES.] On the death of any 3.33 person receiving public assistance through MFIP, the county 3.34 agency shall pay an amount for funeral expenses not exceeding 3.35 the amount paid for comparable services under section 261.035 3.36 plus actual cemetery charges. No funeral expenses shall be paid 3.37 if the estate of the deceased is sufficient to pay such expenses 3.38 or if the spouse, who was legally responsible for the support of 3.39 the deceased while living, is able to pay such expenses; 3.40 provided, that the additional payment or donation of the cost of 3.41 cemetery lot, interment, religious service, or for the 3.42 transportation of the body into or out of the community in which 3.43 the deceased resided, shall not limit payment by the county 3.44 agency as herein authorized. Freedom of choice in the selection 3.45 of a funeral director shall be granted to persons lawfully 3.46 authorized to make arrangements for the burial of any such 3.47 deceased recipient. In determining the sufficiency of such 3.48 estate, due regard shall be had for the nature and marketability 4.1 of the assets of the estate. The county agency may grant 4.2 funeral expenses where the sale would cause undue loss to the 4.3 estate. Any amount paid for funeral expenses shall be a prior 4.4 claim against the estate, as provided in section 524.3-805, and 4.5 any amount recovered shall be reimbursed to the agency which 4.6 paid the expenses.The commissioner shall specify requirements4.7for reports, including fiscal reports, according to section4.8256.01, subdivision 2, paragraph (17). The state share shall4.9pay the entire amount of county agency expenditures.Benefits 4.10 shall be issued to recipients by thestate orcounty subject to 4.11 provisions of section 256.017. 4.12 Sec. 2. Minnesota Statutes 2002, section 256.984, 4.13 subdivision 1, is amended to read: 4.14 Subdivision 1. [DECLARATION.] Every application for public 4.15 assistance under this chapterand/oror chapters 256B, 256D, 4.16256K, MFIP program256J, and food stamps or food support under 4.17 chapter 393 shall be in writing or reduced to writing as 4.18 prescribed by the state agency and shall contain the following 4.19 declaration which shall be signed by the applicant: 4.20 "I declare under the penalties of perjury that this 4.21 application has been examined by me and to the best of my 4.22 knowledge is a true and correct statement of every material 4.23 point. I understand that a person convicted of perjury may 4.24 be sentenced to imprisonment of not more than five years or 4.25 to payment of a fine of not more than $10,000, or both." 4.26 Sec. 3. Minnesota Statutes 2002, section 256D.06, 4.27 subdivision 2, is amended to read: 4.28 Subd. 2. [EMERGENCY NEED.] Notwithstanding the provisions 4.29 of subdivision 1, a grant of emergency general assistance shall, 4.30 to the extent funds are available, be made to an eligible single 4.31 adult, married couple, or family for an emergency need, as 4.32 defined in rules promulgated by the commissioner, where the 4.33 recipient requests temporary assistance not exceeding 30 days if 4.34 an emergency situation appears to exist and(a) until March 31,4.351998, the individual is ineligible for the program of emergency4.36assistance under aid to families with dependent children and is5.1not a recipient of aid to families with dependent children at5.2the time of application; or (b)the individual or family is(i)5.3 ineligible for MFIP or is not a participant of MFIP; and (ii) is5.4ineligible for emergency assistance under section 256J.48. If 5.5 an applicant or recipient relates facts to the county agency 5.6 which may be sufficient to constitute an emergency situation, 5.7 the county agency shall, to the extent funds are available, 5.8 advise the person of the procedure for applying for assistance 5.9 according to this subdivision. An emergency general assistance 5.10 grant is available to a recipient not more than once in any 5.11 12-month period. Funding for an emergency general assistance 5.12 program is limited to an amount equal to the actual state 5.13 expenditure for emergency general assistance in fiscal year 5.14 2002. Each fiscal year, the commissioner shall allocate to 5.15 counties the money appropriated for emergency general assistance 5.16 grants based on each county agency's average share of state's 5.17 emergency general expenditures for the immediate past three 5.18 fiscal years, and may reallocate any unspent amounts to other 5.19 counties. Any emergency general assistance expenditures by a 5.20 county above the amount of the commissioner's allocation to the 5.21 county must be made from county funds. 5.22 Sec. 4. Minnesota Statutes 2002, section 256D.44, 5.23 subdivision 5, is amended to read: 5.24 Subd. 5. [SPECIAL NEEDS.] In addition to the state 5.25 standards of assistance established in subdivisions 1 to 4, 5.26 payments are allowed for the following special needs of 5.27 recipients of Minnesota supplemental aid who are not residents 5.28 of a nursing home, a regional treatment center, or a group 5.29 residential housing facility. 5.30 (a) The county agency shall pay a monthly allowance for 5.31 medically prescribed dietspayable under the Minnesota family5.32investment programif the cost of those additional dietary needs 5.33 cannot be met through some other maintenance benefit. The need 5.34 for special diets or dietary items must be prescribed by a 5.35 licensed physician. Costs for special diets shall be determined 5.36 as percentages of the allotment for a one-person household under 6.1 the thrifty food plan as defined by the United States Department 6.2 of Agriculture. The types of diets and the percentages of the 6.3 thrifty food plan that are covered are as follows: 6.4 (1) high protein diet, at least 80 grams daily, 25 percent 6.5 of thrifty food plan; 6.6 (2) controlled protein diet, 40 to 60 grams and requires 6.7 special products, 100 percent of thrifty food plan; 6.8 (3) controlled protein diet, less than 40 grams and 6.9 requires special products, 125 percent of thrifty food plan; 6.10 (4) low cholesterol diet, 25 percent of thrifty food plan; 6.11 (5) high residue diet, 20 percent of thrifty food plan; 6.12 (6) pregnancy and lactation diet, 35 percent of thrifty 6.13 food plan; 6.14 (7) gluten-free diet, 25 percent of thrifty food plan; 6.15 (8) lactose-free diet, 25 percent of thrifty food plan; 6.16 (9) antidumping diet, 15 percent of thrifty food plan; 6.17 (10) hypoglycemic diet, 15 percent of thrifty food plan; or 6.18 (11) ketogenic diet, 25 percent of thrifty food plan. 6.19 (b) Payment for nonrecurring special needs must be allowed 6.20 for necessary home repairs or necessary repairs or replacement 6.21 of household furniture and appliances using the payment standard 6.22 of the AFDC program in effect on July 16, 1996, for these 6.23 expenses, as long as other funding sources are not available. 6.24 (c) A fee for guardian or conservator service is allowed at 6.25 a reasonable rate negotiated by the county or approved by the 6.26 court. This rate shall not exceed five percent of the 6.27 assistance unit's gross monthly income up to a maximum of $100 6.28 per month. If the guardian or conservator is a member of the 6.29 county agency staff, no fee is allowed. 6.30 (d) The county agency shall continue to pay a monthly 6.31 allowance of $68 for restaurant meals for a person who was 6.32 receiving a restaurant meal allowance on June 1, 1990, and who 6.33 eats two or more meals in a restaurant daily. The allowance 6.34 must continue until the person has not received Minnesota 6.35 supplemental aid for one full calendar month or until the 6.36 person's living arrangement changes and the person no longer 7.1 meets the criteria for the restaurant meal allowance, whichever 7.2 occurs first. 7.3 (e) A fee of ten percent of the recipient's gross income or 7.4 $25, whichever is less, is allowed for representative payee 7.5 services provided by an agency that meets the requirements under 7.6 SSI regulations to charge a fee for representative payee 7.7 services. This special need is available to all recipients of 7.8 Minnesota supplemental aid regardless of their living 7.9 arrangement. 7.10 (f) Notwithstanding the language in this subdivision, an 7.11 amount equal to the maximum allotment authorized by the federal 7.12 Food Stamp Program for a single individual which is in effect on 7.13 the first day of January of the previous year will be added to 7.14 the standards of assistance established in subdivisions 1 to 4 7.15 for individuals under the age of 65 who are relocating from an 7.16 institution and who are shelter needy. An eligible individual 7.17 who receives this benefit prior to age 65 may continue to 7.18 receive the benefit after the age of 65. 7.19 "Shelter needy" means that the assistance unit incurs 7.20 monthly shelter costs that exceed 40 percent of the assistance 7.21 unit's gross income before the application of this special needs 7.22 standard. "Gross income" for the purposes of this section is 7.23 the applicant's or recipient's income as defined in section 7.24 256D.35, subdivision 10, or the standard specified in 7.25 subdivision 3, whichever is greater. A recipient of a federal 7.26 or state housing subsidy, that limits shelter costs to a 7.27 percentage of gross income, shall not be considered shelter 7.28 needy for purposes of this paragraph. 7.29 Sec. 5. Minnesota Statutes 2002, section 256D.46, 7.30 subdivision 1, is amended to read: 7.31 Subdivision 1. [ELIGIBILITY.] A county agency must grant 7.32 emergency Minnesota supplemental aidmust be granted, to the 7.33 extent funds are available, if the recipient is without adequate 7.34 resources to resolve an emergency that, if unresolved, will 7.35 threaten the health or safety of the recipient. For the 7.36 purposes of this section, the term "recipient" includes persons 8.1 for whom a group residential housing benefit is being paid under 8.2 sections 256I.01 to 256I.06. 8.3 Sec. 6. Minnesota Statutes 2002, section 256D.46, 8.4 subdivision 3, is amended to read: 8.5 Subd. 3. [PAYMENT AMOUNT.] The amount of assistance 8.6 granted under emergency Minnesota supplemental aid is limited to 8.7 the amount necessary to resolve the emergency. An emergency 8.8 Minnesota supplemental aid grant is available to a recipient no 8.9 more than once in any 12-month period. Funding for emergency 8.10 Minnesota supplemental aid is limited to an amount equal to the 8.11 actual state expenditure for emergency Minnesota supplemental 8.12 aid in state fiscal year 2002. Each fiscal year, the 8.13 commissioner shall allocate to counties the money appropriated 8.14 for emergency Minnesota supplemental aid grants based on each 8.15 county agency's average share of state's emergency Minnesota 8.16 supplemental aid expenditures for the immediate past three 8.17 fiscal years, and may reallocate any unspent amounts to other 8.18 counties. Any emergency Minnesota supplemental aid expenditures 8.19 by a county above the amount of the commissioner's allocation to 8.20 the county must be made from county funds. 8.21 Sec. 7. Minnesota Statutes 2002, section 256D.48, 8.22 subdivision 1, is amended to read: 8.23 Subdivision 1. [NEED FOR PROTECTIVE PAYEE.] The county 8.24 agency shall determine whether a recipient needs a protective 8.25 payee when a physical or mental condition renders the recipient 8.26 unable to manage funds and when payments to the recipient would 8.27 be contrary to the recipient's welfare. Protective payments 8.28 must be issued when there is evidence of: (1) repeated 8.29 inability to plan the use of income to meet necessary 8.30 expenditures; (2) repeated observation that the recipient is not 8.31 properly fed or clothed; (3) repeated failure to meet 8.32 obligations for rent, utilities, food, and other essentials; (4) 8.33 evictions or a repeated incurrence of debts; or (5) lost or 8.34 stolen checks; or (6) use of emergency Minnesota supplemental8.35aid more than twice in a calendar year. The determination of 8.36 representative payment by the Social Security Administration for 9.1 the recipient is sufficient reason for protective payment of 9.2 Minnesota supplemental aid payments. 9.3 Sec. 8. Minnesota Statutes 2002, section 256J.01, 9.4 subdivision 5, is amended to read: 9.5 Subd. 5. [COMPLIANCE SYSTEM.] The commissioner shall 9.6 administer a compliance system for the state's temporary 9.7 assistance for needy families (TANF) program, the food stamp 9.8 program,emergency assistance,general assistance, medical 9.9 assistance, general assistance medical care, emergency general 9.10 assistance, Minnesota supplemental aid, preadmission screening, 9.11 child support program, and alternative care grants under the 9.12 powers and authorities named in section 256.01, subdivision 2. 9.13 The purpose of the compliance system is to permit the 9.14 commissioner to supervise the administration of public 9.15 assistance programs and to enforce timely and accurate 9.16 distribution of benefits, completeness of service and efficient 9.17 and effective program management and operations, to increase 9.18 uniformity and consistency in the administration and delivery of 9.19 public assistance programs throughout the state, and to reduce 9.20 the possibility of sanction and fiscal disallowances for 9.21 noncompliance with federal regulations and state statutes. 9.22 Sec. 9. Minnesota Statutes 2002, section 256J.02, 9.23 subdivision 2, is amended to read: 9.24 Subd. 2. [USE OF MONEY.] State money appropriated for 9.25 purposes of this section and TANF block grant money must be used 9.26 for: 9.27 (1) financial assistance to or on behalf of any minor child 9.28 who is a resident of this state under section 256J.12; 9.29 (2)employment and training services under this chapter or9.30chapter 256K;9.31(3) emergency financial assistance and services under9.32section 256J.48;9.33(4) diversionary assistance under section 256J.47;9.34(5)the health care and human services training and 9.35 retention program under chapter 116L, for costs associated with 9.36 families with children with incomes below 200 percent of the 10.1 federal poverty guidelines; 10.2(6)(3) the pathways program under section 116L.04, 10.3 subdivision 1a; 10.4(7) welfare-to-work extended employment services for MFIP10.5participants with severe impairment to employment as defined in10.6section 268A.15, subdivision 1a;10.7(8) the family homeless prevention and assistance program10.8under section 462A.204;10.9(9) the rent assistance for family stabilization10.10demonstration project under section 462A.205;10.11(10)(4) welfare to work transportation authorized under 10.12 Public LawNumber105-178; 10.13(11)(5) reimbursements for the federal share of child 10.14 support collections passed through to the custodial parent; 10.15(12)(6) reimbursements for the working family credit under 10.16 section 290.0671; 10.17(13) intensive ESL grants under Laws 2000, chapter 489,10.18article 1;10.19(14) transitional housing programs under section 119A.43;10.20(15) programs and pilot projects under chapter 256K; and10.21(16)(7) program administration under this chapter; 10.22 (8) the diversionary work program under section 256J.95; 10.23 (9) the MFIP consolidated fund under section 256J.626; and 10.24 (10) the Minnesota department of health consolidated fund 10.25 under Laws 2001, First Special Session chapter 9, article 17, 10.26 section 3, subdivision 2. 10.27 Sec. 10. Minnesota Statutes 2002, section 256J.021, is 10.28 amended to read: 10.29 256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 10.30 Beginning October 1, 2001, and each year thereafter, the 10.31 commissioner of human services must treatfinancial assistance10.32 MFIP expenditures made to or on behalf of any minor child under 10.33 section 256J.02, subdivision 2, clause (1), who is a resident of 10.34 this state under section 256J.12, and who is part of a 10.35 two-parent eligible household as expenditures under a separately 10.36 funded state program and report those expenditures to the 11.1 federal Department of Health and Human Services as separate 11.2 state program expenditures under Code of Federal Regulations, 11.3 title 45, section 263.5. 11.4 Sec. 11. Minnesota Statutes 2002, section 256J.08, is 11.5 amended by adding a subdivision to read: 11.6 Subd. 11a. [CHILD ONLY CASE.] "Child only case" means a 11.7 case that would be part of the child only TANF program under 11.8 section 256J.88. 11.9 Sec. 12. Minnesota Statutes 2002, section 256J.08, is 11.10 amended by adding a subdivision to read: 11.11 Subd. 24b. [DIVERSIONARY WORK PROGRAM OR DWP.] 11.12 "Diversionary work program" or "DWP" has the meaning given in 11.13 section 256J.95. 11.14 Sec. 13. Minnesota Statutes 2002, section 256J.08, is 11.15 amended by adding a subdivision to read: 11.16 Subd. 28b. [EMPLOYABLE.] "Employable" means a person is 11.17 capable of performing existing positions in the local labor 11.18 market, regardless of the current availability of openings for 11.19 those positions. 11.20 Sec. 14. Minnesota Statutes 2002, section 256J.08, is 11.21 amended by adding a subdivision to read: 11.22 Subd. 34a. [FAMILY VIOLENCE.] (a) "Family violence" means 11.23 the following, if committed against a family or household member 11.24 by a family or household member: 11.25 (1) physical harm, bodily injury, or assault; 11.26 (2) the infliction of fear of imminent physical harm, 11.27 bodily injury, or assault; or 11.28 (3) terroristic threats, within the meaning of section 11.29 609.713, subdivision 1; criminal sexual conduct, within the 11.30 meaning of section 609.342, 609.343, 609.344, 609.345, or 11.31 609.3451; or interference with an emergency call within the 11.32 meaning of section 609.78, subdivision 2. 11.33 (b) For the purposes of family violence, "family or 11.34 household member" means: 11.35 (1) spouses and former spouses; 11.36 (2) parents and children; 12.1 (3) persons related by blood; 12.2 (4) persons who are residing together or who have resided 12.3 together in the past; 12.4 (5) persons who have a child in common regardless of 12.5 whether they have been married or have lived together at any 12.6 time; 12.7 (6) a man and woman if the woman is pregnant and the man is 12.8 alleged to be the father, regardless of whether they have been 12.9 married or have lived together at anytime; and 12.10 (7) persons involved in a current or past significant 12.11 romantic or sexual relationship. 12.12 Sec. 15. Minnesota Statutes, section 256J.08, is amended 12.13 by adding a subdivision to read: 12.14 Subd. 34b. [FAMILY VIOLENCE WAIVER.] "Family violence 12.15 waiver" means a waiver of the 60-month time limit for victims of 12.16 family violence who meet the criteria in section 256J.545 and 12.17 are complying with an employment plan in section 256J.521, 12.18 subdivision 3. 12.19 Sec. 16. Minnesota Statutes 2002, section 256J.08, 12.20 subdivision 35, is amended to read: 12.21 Subd. 35. [FAMILY WAGE LEVEL.] "Family wage level" means 12.22 110 percent of the transitional standard as specified in section 12.23 256J.24, subdivision 7. 12.24 Sec. 17. Minnesota Statutes 2002, section 256J.08, is 12.25 amended by adding a subdivision to read: 12.26 Subd. 51b. [LEARNING DISABLED.] "Learning disabled," for 12.27 purposes of an extension to the 60-month time limit under 12.28 section 256J.425, subdivision 3, clause (3), means the person 12.29 has a disorder in one or more of the psychological processes 12.30 involved in perceiving, understanding, or using concepts through 12.31 verbal language or nonverbal means. Learning disabled does not 12.32 include learning problems that are primarily the result of 12.33 visual, hearing, or motor handicaps, mental retardation, 12.34 emotional disturbance, or due to environmental, cultural, or 12.35 economic disadvantage. 12.36 Sec. 18. Minnesota Statutes 2002, section 256J.08, 13.1 subdivision 65, is amended to read: 13.2 Subd. 65. [PARTICIPANT.] "Participant" means a person who 13.3 is currently receiving cash assistance or the food portion 13.4 available through MFIPas funded by TANF and the food stamp13.5program. A person who fails to withdraw or access 13.6 electronically any portion of the person's cash and food 13.7 assistance payment by the end of the payment month, who makes a 13.8 written request for closure before the first of a payment month 13.9 and repays cash and food assistance electronically issued for 13.10 that payment month within that payment month, or who returns any 13.11 uncashed assistance check and food coupons and withdraws from 13.12 the program is not a participant. A person who withdraws a cash 13.13 or food assistance payment by electronic transfer or receives 13.14 and cashes an MFIP assistance check or food coupons and is 13.15 subsequently determined to be ineligible for assistance for that 13.16 period of time is a participant, regardless whether that 13.17 assistance is repaid. The term "participant" includes the 13.18 caregiver relative and the minor child whose needs are included 13.19 in the assistance payment. A person in an assistance unit who 13.20 does not receive a cash and food assistance payment because the 13.21personcase has been suspended from MFIP is a participant. A 13.22 person who receives cash payments under the diversionary work 13.23 program under section 256J.95 is a participant. 13.24 Sec. 19. Minnesota Statutes 2002, section 256J.08, is 13.25 amended by adding a subdivision to read: 13.26 Subd. 65a. [PARTICIPATION REQUIREMENTS OF 13.27 TANF.] "Participation requirements of TANF" means activities and 13.28 hourly requirements allowed under title IV-A of the federal 13.29 Social Security Act. 13.30 Sec. 20. Minnesota Statutes 2002, section 256J.08, is 13.31 amended by adding a subdivision to read: 13.32 Subd. 73a. [QUALIFIED PROFESSIONAL.] (a) For physical 13.33 illness, injury, or incapacity, a "qualified professional" means 13.34 a licensed physician, a physician's assistant, a nurse 13.35 practitioner, or in the case of spinal subluxation, a licensed 13.36 chiropractor. 14.1 (b) For mental retardation and intelligence testing, a 14.2 "qualified professional" means an individual qualified by 14.3 training and experience to administer the tests necessary to 14.4 make determinations, such as tests of intellectual functioning, 14.5 assessments of adaptive behavior, adaptive skills, and 14.6 developmental functioning. These professionals include licensed 14.7 psychologists, certified school psychologists, or certified 14.8 psychometrists working under the supervision of a licensed 14.9 psychologist. 14.10 (c) For learning disabilities, a "qualified professional" 14.11 means a licensed psychologist or school psychologist with 14.12 experience determining learning disabilities. 14.13 (d) For mental health, a "qualified professional" means a 14.14 licensed physician or a qualified mental health professional. A 14.15 "qualified mental health professional" means: 14.16 (1) for children, in psychiatric nursing, a registered 14.17 nurse who is licensed under sections 148.171 to 148.285, and who 14.18 is certified as a clinical specialist in child and adolescent 14.19 psychiatric or mental health nursing by a national nurse 14.20 certification organization or who has a master's degree in 14.21 nursing or one of the behavioral sciences or related fields from 14.22 an accredited college or university or its equivalent, with at 14.23 least 4,000 hours of post-master's supervised experience in the 14.24 delivery of clinical services in the treatment of mental 14.25 illness; 14.26 (2) for adults, in psychiatric nursing, a registered nurse 14.27 who is licensed under sections 148.171 to 148.285, and who is 14.28 certified as a clinical specialist in adult psychiatric and 14.29 mental health nursing by a national nurse certification 14.30 organization or who has a master's degree in nursing or one of 14.31 the behavioral sciences or related fields from an accredited 14.32 college or university or its equivalent, with at least 4,000 14.33 hours of post-master's supervised experience in the delivery of 14.34 clinical services in the treatment of mental illness; 14.35 (3) in clinical social work, a person licensed as an 14.36 independent clinical social worker under section 148B.21, 15.1 subdivision 6, or a person with a master's degree in social work 15.2 from an accredited college or university, with at least 4,000 15.3 hours of post-master's supervised experience in the delivery of 15.4 clinical services in the treatment of mental illness; 15.5 (4) in psychology, an individual licensed by the board of 15.6 psychology under sections 148.88 to 148.98, who has stated to 15.7 the board of psychology competencies in the diagnosis and 15.8 treatment of mental illness; 15.9 (5) in psychiatry, a physician licensed under chapter 147 15.10 and certified by the American Board of Psychiatry and Neurology 15.11 or eligible for board certification in psychiatry; and 15.12 (6) in marriage and family therapy, the mental health 15.13 professional must be a marriage and family therapist licensed 15.14 under sections 148B.29 to 148B.39, with at least two years of 15.15 post-master's supervised experience in the delivery of clinical 15.16 services in the treatment of mental illness. 15.17 Sec. 21. Minnesota Statutes 2002, section 256J.08, 15.18 subdivision 82, is amended to read: 15.19 Subd. 82. [SANCTION.] "Sanction" means the reduction of a 15.20 family's assistance payment by a specified percentage of the 15.21 MFIP standard of need because: a nonexempt participant fails to 15.22 comply with the requirements of sections256J.52256J.515 to 15.23256J.55256J.57; a parental caregiver fails without good cause 15.24 to cooperate with the child support enforcement requirements; or 15.25 a participant fails to comply withthe insurance, tort15.26liability, orother requirements of this chapter. 15.27 Sec. 22. Minnesota Statutes 2002, section 256J.08, is 15.28 amended by adding a subdivision to read: 15.29 Subd. 84a. [SSI RECIPIENT.] "SSI recipient" means a person 15.30 who receives at least $1 in SSI benefits, or who is not 15.31 receiving an SSI benefit due to recoupment or a one month 15.32 suspension by the Social Security Administration due to excess 15.33 income. 15.34 Sec. 23. Minnesota Statutes 2002, section 256J.08, 15.35 subdivision 85, is amended to read: 15.36 Subd. 85. [TRANSITIONAL STANDARD.] "Transitional standard" 16.1 means the basic standard for a familywith no other income or a16.2nonworking familywithout earned income and is a combination of 16.3 the cashassistance needsportion and foodassistance needs for16.4a family of that sizeportion as specified in section 256J.24, 16.5 subdivision 5. 16.6 Sec. 24. Minnesota Statutes 2002, section 256J.08, is 16.7 amended by adding a subdivision to read: 16.8 Subd. 90. [SEVERE FORMS OF TRAFFICKING IN 16.9 PERSONS.] "Severe forms of trafficking in persons" means: (1) 16.10 sex trafficking in which a commercial sex act is induced by 16.11 force, fraud, or coercion, or in which the person induced to 16.12 perform the act has not attained 18 years of age; or (2) the 16.13 recruitment, harboring, transportation, provision, or obtaining 16.14 of a person for labor or services through the use of force, 16.15 fraud, or coercion for the purposes of subjection to involuntary 16.16 servitude, peonage, debt bondage, or slavery. 16.17 Sec. 25. Minnesota Statutes 2002, section 256J.09, 16.18 subdivision 2, is amended to read: 16.19 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 16.20 INFORMATION.] When a person inquires about assistance, a county 16.21 agency must: 16.22 (1) explain the eligibility requirements of, and how to 16.23 apply for, diversionary assistance as provided in section16.24256J.47; emergency assistance as provided in section 256J.48;16.25MFIP as provided in section 256J.10; oranyotherassistance for 16.26 which the person may be eligible; and 16.27 (2) offer the person brochures developed or approved by the 16.28 commissioner that describe how to apply for assistance. 16.29 Sec. 26. Minnesota Statutes 2002, section 256J.09, 16.30 subdivision 3, is amended to read: 16.31 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 16.32 agency must offer, in person or by mail, the application forms 16.33 prescribed by the commissioner as soon as a person makes a 16.34 written or oral inquiry. At that time, the county agency must: 16.35 (1) inform the person that assistance begins with the date 16.36 the signed application is received by the county agency or the 17.1 date all eligibility criteria are met, whichever is later; 17.2 (2) inform the person that any delay in submitting the 17.3 application will reduce the amount of assistance paid for the 17.4 month of application; 17.5 (3) inform a person that the person may submit the 17.6 application before an interview; 17.7 (4) explain the information that will be verified during 17.8 the application process by the county agency as provided in 17.9 section 256J.32; 17.10 (5) inform a person about the county agency's average 17.11 application processing time and explain how the application will 17.12 be processed under subdivision 5; 17.13 (6) explain how to contact the county agency if a person's 17.14 application information changes and how to withdraw the 17.15 application; 17.16 (7) inform a person that the next step in the application 17.17 process is an interview and what a person must do if the 17.18 application is approved including, but not limited to, attending 17.19 orientation under section 256J.45 and complying with employment 17.20 and training services requirements in sections256J.52256J.515 17.21 to256J.55256J.57; 17.22 (8) explain the child care and transportation services that 17.23 are available under paragraph (c) to enable caregivers to attend 17.24 the interview, screening, and orientation; and 17.25 (9) identify any language barriers and arrange for 17.26 translation assistance during appointments, including, but not 17.27 limited to, screening under subdivision 3a, orientation under 17.28 section 256J.45, andthe initialassessment under section 17.29256J.52256J.521. 17.30 (b) Upon receipt of a signed application, the county agency 17.31 must stamp the date of receipt on the face of the application. 17.32 The county agency must process the application within the time 17.33 period required under subdivision 5. An applicant may withdraw 17.34 the application at any time by giving written or oral notice to 17.35 the county agency. The county agency must issue a written 17.36 notice confirming the withdrawal. The notice must inform the 18.1 applicant of the county agency's understanding that the 18.2 applicant has withdrawn the application and no longer wants to 18.3 pursue it. When, within ten days of the date of the agency's 18.4 notice, an applicant informs a county agency, in writing, that 18.5 the applicant does not wish to withdraw the application, the 18.6 county agency must reinstate the application and finish 18.7 processing the application. 18.8 (c) Upon a participant's request, the county agency must 18.9 arrange for transportation and child care or reimburse the 18.10 participant for transportation and child care expenses necessary 18.11 to enable participants to attend the screening under subdivision 18.12 3a and orientation under section 256J.45. 18.13 Sec. 27. Minnesota Statutes 2002, section 256J.09, 18.14 subdivision 3a, is amended to read: 18.15 Subd. 3a. [SCREENING.] The county agency, or at county 18.16 option, the county's employment and training service provider as 18.17 defined in section 256J.49, must screen each applicant to 18.18 determine immediate needs and to determine if the applicant may 18.19 be eligible for:18.20(1)another program that is not partially funded through 18.21 the federal temporary assistance to needy families block grant 18.22 under Title I of Public LawNumber104-193, including the 18.23 expedited issuance of food stamps under section 256J.28, 18.24 subdivision 1.If the applicant may be eligible for another18.25program, a county caseworker must provide the appropriate18.26referral to the program;18.27(2) the diversionary assistance program under section18.28256J.47; or18.29(3) the emergency assistance program under section18.30256J.48.If the applicant appears eligible for another program, 18.31 including any program funded by the MFIP consolidated fund, the 18.32 county must make a referral to the appropriate program. 18.33 Sec. 28. Minnesota Statutes 2002, section 256J.09, 18.34 subdivision 3b, is amended to read: 18.35 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 18.36 If the applicant is not diverted from applying for MFIP, and if 19.1 the applicant meets the MFIP eligibility requirements, then a 19.2 county agency must: 19.3 (1) identify an applicant who is under the age of 19.4 20 without a high school diploma or its equivalent and explain 19.5 to the applicant the assessment procedures and employment plan 19.6 requirementsfor minor parentsunder section 256J.54; 19.7 (2) explain to the applicant the eligibility criteria in 19.8 section 256J.545 foran exemption underthe family violence 19.9provisions in section 256J.52, subdivision 6waiver, andexplain19.10 what an applicant should do to develop analternativeemployment 19.11 plan; 19.12 (3) determine if an applicant qualifies for an exemption 19.13 under section 256J.56 from employment and training services 19.14 requirements, explain how a person should report to the county 19.15 agency any status changes, and explain that an applicant who is 19.16 exempt may volunteer to participate in employment and training 19.17 services; 19.18 (4) for applicants who are not exempt from the requirement 19.19 to attend orientation, arrange for an orientation under section 19.20 256J.45 and aninitialassessment under section256J.5219.21 256J.521; 19.22 (5) inform an applicant who is not exempt from the 19.23 requirement to attend orientation that failure to attend the 19.24 orientation is considered an occurrence of noncompliance with 19.25 program requirements and will result in an imposition of a 19.26 sanction under section 256J.46; and 19.27 (6) explain how to contact the county agency if an 19.28 applicant has questions about compliance with program 19.29 requirements. 19.30 Sec. 29. Minnesota Statutes 2002, section 256J.09, 19.31 subdivision 8, is amended to read: 19.32 Subd. 8. [ADDITIONAL APPLICATIONS.] Until a county agency 19.33 issues notice of approval or denial, additional applications 19.34 submitted by an applicant are void. However, an application for 19.35 monthly assistance or other benefits funded under section 19.36 256J.626 and an application foremergency assistance or20.1 emergency general assistance may exist concurrently. More than 20.2 one application for monthly assistance, emergency assistance,or 20.3 emergency general assistance may exist concurrently when the 20.4 county agency decisions on one or more earlier applications have 20.5 been appealed to the commissioner, and the applicant asserts 20.6 that a change in circumstances has occurred that would allow 20.7 eligibility. A county agency must require additional 20.8 application forms or supplemental forms as prescribed by the 20.9 commissioner when a payee's name changes, or when a caregiver 20.10 requests the addition of another person to the assistance unit. 20.11 Sec. 30. Minnesota Statutes 2002, section 256J.09, 20.12 subdivision 10, is amended to read: 20.13 Subd. 10. [APPLICANTS WHO DO NOT MEET ELIGIBILITY 20.14 REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 20.15 applicant is not eligible for MFIP or the diversionary work 20.16 program under section 256J.95 because the applicant does not 20.17 meet eligibility requirements, the county agency must determine 20.18 whether the applicant is eligible for food stamps, medical20.19assistance, diversionary assistance, or has a need for emergency20.20assistance when the applicant meets the eligibility requirements20.21for those programsor health care programs. The county must 20.22 also inform applicants about resources available through the 20.23 county or other agencies to meet short-term emergency needs. 20.24 Sec. 31. Minnesota Statutes 2002, section 256J.14, is 20.25 amended to read: 20.26 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 20.27 (a) The definitions in this paragraph only apply to this 20.28 subdivision. 20.29 (1) "Household of a parent, legal guardian, or other adult 20.30 relative" means the place of residence of: 20.31 (i) a natural or adoptive parent; 20.32 (ii) a legal guardian according to appointment or 20.33 acceptance under section 260C.325, 525.615, or 525.6165, and 20.34 related laws; 20.35 (iii) a caregiver as defined in section 256J.08, 20.36 subdivision 11; or 21.1 (iv) an appropriate adult relative designated by a county 21.2 agency. 21.3 (2) "Adult-supervised supportive living arrangement" means 21.4 a private family setting which assumes responsibility for the 21.5 care and control of the minor parent and minor child, or other 21.6 living arrangement, not including a public institution, licensed 21.7 by the commissioner of human services which ensures that the 21.8 minor parent receives adult supervision and supportive services, 21.9 such as counseling, guidance, independent living skills 21.10 training, or supervision. 21.11 (b) A minor parent and the minor child who is in the care 21.12 of the minor parent must reside in the household of a parent, 21.13 legal guardian, other adult relative, or in an adult-supervised 21.14 supportive living arrangement in order to receive MFIP unless: 21.15 (1) the minor parent has no living parent, other adult 21.16 relative, or legal guardian whose whereabouts is known; 21.17 (2) no living parent, other adult relative, or legal 21.18 guardian of the minor parent allows the minor parent to live in 21.19 the parent's, other adult relative's, or legal guardian's home; 21.20 (3) the minor parent lived apart from the minor parent's 21.21 own parent or legal guardian for a period of at least one year 21.22 before either the birth of the minor child or the minor parent's 21.23 application for MFIP; 21.24 (4) the physical or emotional health or safety of the minor 21.25 parent or minor child would be jeopardized if the minor parent 21.26 and the minor child resided in the same residence with the minor 21.27 parent's parent, other adult relative, or legal guardian; or 21.28 (5) an adult supervised supportive living arrangement is 21.29 not available for the minor parent and child in the county in 21.30 which the minor parent and child currently reside. If an adult 21.31 supervised supportive living arrangement becomes available 21.32 within the county, the minor parent and child must reside in 21.33 that arrangement. 21.34 (c) The county agency shall inform minor applicants both 21.35 orally and in writing about the eligibility requirements, their 21.36 rights and obligations under the MFIP program, and any other 22.1 applicable orientation information. The county must advise the 22.2 minor of the possible exemptions under section 256J.54, 22.3 subdivision 5, and specifically ask whether one or more of these 22.4 exemptions is applicable. If the minor alleges one or more of 22.5 these exemptions, then the county must assist the minor in 22.6 obtaining the necessary verifications to determine whether or 22.7 not these exemptions apply. 22.8 (d) If the county worker has reason to suspect that the 22.9 physical or emotional health or safety of the minor parent or 22.10 minor child would be jeopardized if they resided with the minor 22.11 parent's parent, other adult relative, or legal guardian, then 22.12 the county worker must make a referral to child protective 22.13 services to determine if paragraph (b), clause (4), applies. A 22.14 new determination by the county worker is not necessary if one 22.15 has been made within the last six months, unless there has been 22.16 a significant change in circumstances which justifies a new 22.17 referral and determination. 22.18 (e) If a minor parent is not living with a parent, legal 22.19 guardian, or other adult relative due to paragraph (b), clause 22.20 (1), (2), or (4), the minor parent must reside, when possible, 22.21 in a living arrangement that meets the standards of paragraph 22.22 (a), clause (2). 22.23 (f) Regardless of living arrangement, MFIP must be paid, 22.24 when possible, in the form of a protective payment on behalf of 22.25 the minor parent and minor child according to section 256J.39, 22.26 subdivisions 2 to 4. 22.27 Sec. 32. Minnesota Statutes 2002, section 256J.20, 22.28 subdivision 3, is amended to read: 22.29 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 22.30 MFIP, the equity value of all nonexcluded real and personal 22.31 property of the assistance unit must not exceed $2,000 for 22.32 applicants and $5,000 for ongoing participants. The value of 22.33 assets in clauses (1) to (19) must be excluded when determining 22.34 the equity value of real and personal property: 22.35 (1) a licensed vehicle up to a loan value of less than or 22.36 equal to $7,500. The county agency shall apply any excess loan 23.1 value as if it were equity value to the asset limit described in 23.2 this section. If the assistance unit owns more than one 23.3 licensed vehicle, the county agency shall determine the vehicle 23.4 with the highest loan value and count only the loan value over 23.5 $7,500, excluding: (i) the value of one vehicle per physically 23.6 disabled person when the vehicle is needed to transport the 23.7 disabled unit member; this exclusion does not apply to mentally 23.8 disabled people; (ii) the value of special equipment for a 23.9 handicapped member of the assistance unit; and (iii) any vehicle 23.10 used for long-distance travel, other than daily commuting, for 23.11 the employment of a unit member. 23.12 The county agency shall count the loan value of all other 23.13 vehicles and apply this amount as if it were equity value to the 23.14 asset limit described in this section. To establish the loan 23.15 value of vehicles, a county agency must use the N.A.D.A. 23.16 Official Used Car Guide, Midwest Edition, for newer model cars. 23.17 When a vehicle is not listed in the guidebook, or when the 23.18 applicant or participant disputes the loan value listed in the 23.19 guidebook as unreasonable given the condition of the particular 23.20 vehicle, the county agency may require the applicant or 23.21 participant document the loan value by securing a written 23.22 statement from a motor vehicle dealer licensed under section 23.23 168.27, stating the amount that the dealer would pay to purchase 23.24 the vehicle. The county agency shall reimburse the applicant or 23.25 participant for the cost of a written statement that documents a 23.26 lower loan value; 23.27 (2) the value of life insurance policies for members of the 23.28 assistance unit; 23.29 (3) one burial plot per member of an assistance unit; 23.30 (4) the value of personal property needed to produce earned 23.31 income, including tools, implements, farm animals, inventory, 23.32 business loans, business checking and savings accounts used at 23.33 least annually and used exclusively for the operation of a 23.34 self-employment business, and any motor vehicles if at least 50 23.35 percent of the vehicle's use is to produce income and if the 23.36 vehicles are essential for the self-employment business; 24.1 (5) the value of personal property not otherwise specified 24.2 which is commonly used by household members in day-to-day living 24.3 such as clothing, necessary household furniture, equipment, and 24.4 other basic maintenance items essential for daily living; 24.5 (6) the value of real and personal property owned by a 24.6 recipient of Supplemental Security Income or Minnesota 24.7 supplemental aid; 24.8 (7) the value of corrective payments, but only for the 24.9 month in which the payment is received and for the following 24.10 month; 24.11 (8) a mobile home or other vehicle used by an applicant or 24.12 participant as the applicant's or participant's home; 24.13 (9) money in a separate escrow account that is needed to 24.14 pay real estate taxes or insurance and that is used for this 24.15 purpose; 24.16 (10) money held in escrow to cover employee FICA, employee 24.17 tax withholding, sales tax withholding, employee worker 24.18 compensation, business insurance, property rental, property 24.19 taxes, and other costs that are paid at least annually, but less 24.20 often than monthly; 24.21 (11) monthly assistance, emergency assistance, and24.22diversionarypayments for the current month'sneedsor 24.23 short-term emergency needs under section 256J.626, subdivision 24.24 2; 24.25 (12) the value of school loans, grants, or scholarships for 24.26 the period they are intended to cover; 24.27 (13) payments listed in section 256J.21, subdivision 2, 24.28 clause (9), which are held in escrow for a period not to exceed 24.29 three months to replace or repair personal or real property; 24.30 (14) income received in a budget month through the end of 24.31 the payment month; 24.32 (15) savings from earned income of a minor child or a minor 24.33 parent that are set aside in a separate account designated 24.34 specifically for future education or employment costs; 24.35 (16) the federal earned income credit, Minnesota working 24.36 family credit, state and federal income tax refunds, state 25.1 homeowners and renters credits under chapter 290A, property tax 25.2 rebates and other federal or state tax rebates in the month 25.3 received and the following month; 25.4 (17) payments excluded under federal law as long as those 25.5 payments are held in a separate account from any nonexcluded 25.6 funds; 25.7 (18) the assets of children ineligible to receive MFIP 25.8 benefits because foster care or adoption assistance payments are 25.9 made on their behalf; and 25.10 (19) the assets of persons whose income is excluded under 25.11 section 256J.21, subdivision 2, clause (43). 25.12 Sec. 33. Minnesota Statutes 2002, section 256J.21, 25.13 subdivision 2, is amended to read: 25.14 Subd. 2. [INCOME EXCLUSIONS.] The following must be 25.15 excluded in determining a family's available income: 25.16 (1) payments for basic care, difficulty of care, and 25.17 clothing allowances received for providing family foster care to 25.18 children or adults under Minnesota Rules, parts 9545.0010 to 25.19 9545.0260 and 9555.5050 to 9555.6265, and payments received and 25.20 used for care and maintenance of a third-party beneficiary who 25.21 is not a household member; 25.22 (2) reimbursements for employment training received through 25.23 theJob Training PartnershipWorkforce Investment Act 1998, 25.24 United States Code, title2920, chapter1973,sections 150125.25to 1792bsection 9201; 25.26 (3) reimbursement for out-of-pocket expenses incurred while 25.27 performing volunteer services, jury duty, employment, or 25.28 informal carpooling arrangements directly related to employment; 25.29 (4) all educational assistance, except the county agency 25.30 must count graduate student teaching assistantships, 25.31 fellowships, and other similar paid work as earned income and, 25.32 after allowing deductions for any unmet and necessary 25.33 educational expenses, shall count scholarships or grants awarded 25.34 to graduate students that do not require teaching or research as 25.35 unearned income; 25.36 (5) loans, regardless of purpose, from public or private 26.1 lending institutions, governmental lending institutions, or 26.2 governmental agencies; 26.3 (6) loans from private individuals, regardless of purpose, 26.4 provided an applicant or participant documents that the lender 26.5 expects repayment; 26.6 (7)(i) state income tax refunds; and 26.7 (ii) federal income tax refunds; 26.8 (8)(i) federal earned income credits; 26.9 (ii) Minnesota working family credits; 26.10 (iii) state homeowners and renters credits under chapter 26.11 290A; and 26.12 (iv) federal or state tax rebates; 26.13 (9) funds received for reimbursement, replacement, or 26.14 rebate of personal or real property when these payments are made 26.15 by public agencies, awarded by a court, solicited through public 26.16 appeal, or made as a grant by a federal agency, state or local 26.17 government, or disaster assistance organizations, subsequent to 26.18 a presidential declaration of disaster; 26.19 (10) the portion of an insurance settlement that is used to 26.20 pay medical, funeral, and burial expenses, or to repair or 26.21 replace insured property; 26.22 (11) reimbursements for medical expenses that cannot be 26.23 paid by medical assistance; 26.24 (12) payments by a vocational rehabilitation program 26.25 administered by the state under chapter 268A, except those 26.26 payments that are for current living expenses; 26.27 (13) in-kind income, including any payments directly made 26.28 by a third party to a provider of goods and services; 26.29 (14) assistance payments to correct underpayments, but only 26.30 for the month in which the payment is received; 26.31 (15)emergency assistancepayments for short-term emergency 26.32 needs under section 256J.626, subdivision 2; 26.33 (16) funeral and cemetery payments as provided by section 26.34 256.935; 26.35 (17) nonrecurring cash gifts of $30 or less, not exceeding 26.36 $30 per participant in a calendar month; 27.1 (18) any form of energy assistance payment made through 27.2 Public LawNumber97-35, Low-Income Home Energy Assistance Act 27.3 of 1981, payments made directly to energy providers by other 27.4 public and private agencies, and any form of credit or rebate 27.5 payment issued by energy providers; 27.6 (19) Supplemental Security Income (SSI), including 27.7 retroactive SSI payments and other income of an SSI recipient, 27.8 except as described in section 256J.37, subdivision 3b; 27.9 (20) Minnesota supplemental aid, including retroactive 27.10 payments; 27.11 (21) proceeds from the sale of real or personal property; 27.12 (22) adoption assistance payments under section 259.67; 27.13 (23) state-funded family subsidy program payments made 27.14 under section 252.32 to help families care for children with 27.15 mental retardation or related conditions, consumer support grant 27.16 funds under section 256.476, and resources and services for a 27.17 disabled household member under one of the home and 27.18 community-based waiver services programs under chapter 256B; 27.19 (24) interest payments and dividends from property that is 27.20 not excluded from and that does not exceed the asset limit; 27.21 (25) rent rebates; 27.22 (26) income earned by a minor caregiver, minor child 27.23 through age 6, or a minor child who is at least a half-time 27.24 student in an approved elementary or secondary education 27.25 program; 27.26 (27) income earned by a caregiver under age 20 who is at 27.27 least a half-time student in an approved elementary or secondary 27.28 education program; 27.29 (28) MFIP child care payments under section 119B.05; 27.30 (29) all other payments made through MFIP to support a 27.31 caregiver's pursuit of greaterself-supporteconomic stability; 27.32 (30) income a participant receives related to shared living 27.33 expenses; 27.34 (31) reverse mortgages; 27.35 (32) benefits provided by the Child Nutrition Act of 1966, 27.36 United States Code, title 42, chapter 13A, sections 1771 to 28.1 1790; 28.2 (33) benefits provided by the women, infants, and children 28.3 (WIC) nutrition program, United States Code, title 42, chapter 28.4 13A, section 1786; 28.5 (34) benefits from the National School Lunch Act, United 28.6 States Code, title 42, chapter 13, sections 1751 to 1769e; 28.7 (35) relocation assistance for displaced persons under the 28.8 Uniform Relocation Assistance and Real Property Acquisition 28.9 Policies Act of 1970, United States Code, title 42, chapter 61, 28.10 subchapter II, section 4636, or the National Housing Act, United 28.11 States Code, title 12, chapter 13, sections 1701 to 1750jj; 28.12 (36) benefits from the Trade Act of 1974, United States 28.13 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 28.14 (37) war reparations payments to Japanese Americans and 28.15 Aleuts under United States Code, title 50, sections 1989 to 28.16 1989d; 28.17 (38) payments to veterans or their dependents as a result 28.18 of legal settlements regarding Agent Orange or other chemical 28.19 exposure under Public LawNumber101-239, section 10405, 28.20 paragraph (a)(2)(E); 28.21 (39) income that is otherwise specifically excluded from 28.22 MFIP consideration in federal law, state law, or federal 28.23 regulation; 28.24 (40) security and utility deposit refunds; 28.25 (41) American Indian tribal land settlements excluded under 28.26 PublicLaw NumbersLaws 98-123, 98-124, and 99-377 to the 28.27 Mississippi Band Chippewa Indians of White Earth, Leech Lake, 28.28 and Mille Lacs reservations and payments to members of the White 28.29 Earth Band, under United States Code, title 25, chapter 9, 28.30 section 331, and chapter 16, section 1407; 28.31 (42) all income of the minor parent's parents and 28.32 stepparents when determining the grant for the minor parent in 28.33 households that include a minor parent living with parents or 28.34 stepparents on MFIP with other children; 28.35 (43) income of the minor parent's parents and stepparents 28.36 equal to 200 percent of the federal poverty guideline for a 29.1 family size not including the minor parent and the minor 29.2 parent's child in households that include a minor parent living 29.3 with parents or stepparents not on MFIP when determining the 29.4 grant for the minor parent. The remainder of income is deemed 29.5 as specified in section 256J.37, subdivision 1b; 29.6 (44) payments made to children eligible for relative 29.7 custody assistance under section 257.85; 29.8 (45) vendor payments for goods and services made on behalf 29.9 of a client unless the client has the option of receiving the 29.10 payment in cash; and 29.11 (46) the principal portion of a contract for deed payment. 29.12 Sec. 34. Minnesota Statutes 2002, section 256J.24, 29.13 subdivision 3, is amended to read: 29.14 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 29.15 ASSISTANCE UNIT.] (a) The following individuals who are part of 29.16 the assistance unit determined under subdivision 2 are 29.17 ineligible to receive MFIP: 29.18 (1) individualsreceivingwho are recipients of 29.19 Supplemental Security Income or Minnesota supplemental aid; 29.20 (2) individuals disqualified from the food stamp program or 29.21 MFIP, until the disqualification ends; 29.22 (3) children on whose behalf federal, state or local foster 29.23 care payments are made, except as provided in sections 256J.13, 29.24 subdivision 2, and 256J.74, subdivision 2; and 29.25 (4) children receiving ongoing monthly adoption assistance 29.26 payments under section 259.67. 29.27 (b) The exclusion of a person under this subdivision does 29.28 not alter the mandatory assistance unit composition. 29.29 Sec. 35. Minnesota Statutes 2002, section 256J.24, 29.30 subdivision 5, is amended to read: 29.31 Subd. 5. [MFIP TRANSITIONAL STANDARD.] Thefollowing table29.32represents theMFIP transitional standardtable when all members29.33ofis based on the number of persons in the assistance unitare29.34 eligible for both food and cash assistance unless the 29.35 restrictions in subdivision 6 on the birth of a child apply. 29.36 The following table represents the transitional standards 30.1 effective October 1, 2002. 30.2 Number of Transitional Cash Food 30.3 Eligible People Standard Portion Portion 30.4 1$351$370: $250 $120 30.5 2$609$658: $437 $221 30.6 3$763$844: $532 $312 30.7 4$903$998: $621 $377 30.8 5$1,025$1,135: $697 $438 30.9 6$1,165$1,296: $773 $523 30.10 7$1,273$1,414: $850 $564 30.11 8$1,403$1,558: $916 $642 30.12 9$1,530$1,700: $980 $720 30.13 10$1,653$1,836: $1,035 $801 30.14 over 10 add$121$136: $53 $83 30.15 per additional member. 30.16 The commissioner shall annually publish in the State 30.17 Register the transitional standard for an assistance unit sizes 30.18 1 to 10 including a breakdown of the cash and food portions. 30.19 Sec. 36. Minnesota Statutes 2002, section 256J.24, 30.20 subdivision 6, is amended to read: 30.21 Subd. 6. [APPLICATION OF ASSISTANCE STANDARDSFAMILY CAP.] 30.22The standards apply to the number of eligible persons in the30.23assistance unit.(a) MFIP assistance units shall not receive an 30.24 increase in the cash portion of the transitional standard as a 30.25 result of the birth of a child, unless one of the conditions 30.26 under paragraph (b) is met. The child shall be considered a 30.27 member of the assistance unit according to subdivisions 1 to 3, 30.28 but shall be excluded in determining family size for purposes of 30.29 determining the amount of the cash portion of the transitional 30.30 standard under subdivision 5. The child shall be included in 30.31 determining family size for purposes of determining the food 30.32 portion of the transitional standard. The transitional standard 30.33 under this subdivision shall be the total of the cash and food 30.34 portions as specified in this paragraph. The family wage level 30.35 under this subdivision shall be based on the family size used to 30.36 determine the food portion of the transitional standard. 31.1 (b) A child shall be included in determining family size 31.2 for purposes of determining the amount of the cash portion of 31.3 the MFIP transitional standard when at least one of the 31.4 following conditions is met: 31.5 (1) for families receiving MFIP assistance on July 1, 2003, 31.6 the child is born to the adult parent before May 1, 2004; 31.7 (2) for families who apply for the diversionary work 31.8 program under section 256J.95 or MFIP assistance on or after 31.9 July 1, 2003, the child is born to the adult parent within ten 31.10 months of the date the family is eligible for assistance; 31.11 (3) the child was conceived as a result of a sexual assault 31.12 or incest, provided that: 31.13 (i) the incident has been reported to a law enforcement 31.14 agency which determines that there is probable cause to believe 31.15 the crime occurred; and 31.16 (ii) a physician verifies that there is reason to believe 31.17 the pregnancy or birth resulted from the reported incident; 31.18 (4) the child's mother is a minor caregiver as defined in 31.19 section 256J.08, subdivision 59, and the child, or multiple 31.20 children, are the mother's first birth; or 31.21 (5) any child previously excluded in determining family 31.22 size under paragraph (a) shall be included if the adult parent 31.23 or parents have not received benefits from the diversionary work 31.24 program under section 256J.95 or MFIP assistance in the previous 31.25 ten months. An adult parent or parents who reapply and have 31.26 received benefits from the diversionary work program or MFIP 31.27 assistance in the past ten months shall be under the ten-month 31.28 grace period of their previous application under clause (2). 31.29 (c) Income and resources of a child excluded under this 31.30 subdivision must be considered using the same policies as for 31.31 other children when determining the grant amount of the 31.32 assistance unit. 31.33 (d) The caregiver must assign support and cooperate with 31.34 the child support enforcement agency to establish paternity and 31.35 collect child support on behalf of the excluded child. Failure 31.36 to cooperate results in the sanction specified in section 32.1 256J.46, subdivisions 2 and 2a. Current support paid on behalf 32.2 of the excluded child shall be distributed according to section 32.3 256.741, subdivision 15, and counted to determine the grant 32.4 amount of the assistance unit. 32.5 (e) County agencies must inform applicants of the 32.6 provisions under this subdivision at the time of each 32.7 application and at recertification. 32.8 (f) Children excluded under this provision shall be deemed 32.9 MFIP recipients for purposes of child care under chapter 119B. 32.10 Sec. 37. Minnesota Statutes 2002, section 256J.24, 32.11 subdivision 7, is amended to read: 32.12 Subd. 7. [FAMILY WAGE LEVELSTANDARD.] The family wage 32.13 levelstandardis 110 percent of the transitional standard under 32.14 subdivision 5 or 6, when applicable, and is the standard used 32.15 when there is earned income in the assistance unit. As 32.16 specified in section 256J.21, earned income is subtracted from 32.17 the family wage level to determine the amount of the assistance 32.18 payment.Not includingThefamily wage level standard,32.19 assistancepaymentspayment may not exceed theMFIP standard of32.20needtransitional standard under subdivision 5 or 6, or the 32.21 shared household standard under subdivision 9, whichever is 32.22 applicable, for the assistance unit. 32.23 Sec. 38. Minnesota Statutes 2002, section 256J.24, 32.24 subdivision 10, is amended to read: 32.25 Subd. 10. [MFIP EXIT LEVEL.] The commissioner shall adjust 32.26 the MFIP earned income disregard to ensure that most 32.27 participants do not lose eligibility for MFIP until their income 32.28 reaches at least120115 percent of the federal poverty 32.29 guidelines in effect in October of each fiscal year. The 32.30 adjustment to the disregard shall be based on a household size 32.31 of three, and the resulting earned income disregard percentage 32.32 must be applied to all household sizes. The adjustment under 32.33 this subdivision must be implemented at the same time as the 32.34 October food stamp cost-of-living adjustment is reflected in the 32.35 food portion of MFIP transitional standard as required under 32.36 subdivision 5a. 33.1 Sec. 39. Minnesota Statutes 2002, section 256J.30, 33.2 subdivision 9, is amended to read: 33.3 Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must 33.4 report the changes or anticipated changes specified in clauses 33.5 (1) to(17)(16) within ten days of the date they occur, at the 33.6 time of the periodic recertification of eligibility under 33.7 section 256J.32, subdivision 6, or within eight calendar days of 33.8 a reporting period as in subdivision 5 or 6, whichever occurs 33.9 first. A caregiver must report other changes at the time of the 33.10 periodic recertification of eligibility under section 256J.32, 33.11 subdivision 6, or at the end of a reporting period under 33.12 subdivision 5 or 6, as applicable. A caregiver must make these 33.13 reports in writing to the county agency. When a county agency 33.14 could have reduced or terminated assistance for one or more 33.15 payment months if a delay in reporting a change specified under 33.16 clauses (1) to(16)(15) had not occurred, the county agency 33.17 must determine whether a timely notice under section 256J.31, 33.18 subdivision 4, could have been issued on the day that the change 33.19 occurred. When a timely notice could have been issued, each 33.20 month's overpayment subsequent to that notice must be considered 33.21 a client error overpayment under section 256J.38. Calculation 33.22 of overpayments for late reporting under clause(17)(16) is 33.23 specified in section 256J.09, subdivision 9. Changes in 33.24 circumstances which must be reported within ten days must also 33.25 be reported on the MFIP household report form for the reporting 33.26 period in which those changes occurred. Within ten days, a 33.27 caregiver must report: 33.28 (1) a change in initial employment; 33.29 (2) a change in initial receipt of unearned income; 33.30 (3) a recurring change in unearned income; 33.31 (4) a nonrecurring change of unearned income that exceeds 33.32 $30; 33.33 (5) the receipt of a lump sum; 33.34 (6) an increase in assets that may cause the assistance 33.35 unit to exceed asset limits; 33.36 (7) a change in the physical or mental status of an 34.1 incapacitated member of the assistance unit if the physical or 34.2 mental status is the basis of exemption from an MFIP employment 34.3 services program under section 256J.56 or for reducing the 34.4 hourly requirements under section 256J.55, subdivision 1, or the 34.5 type of activities included in an employment plan under section 34.6 256J.521, subdivision 2; 34.7 (8) a change in employment status; 34.8 (9) information affecting an exception under section 34.9 256J.24, subdivision 9; 34.10 (10)a change in health insurance coverage;34.11(11)the marriage or divorce of an assistance unit member; 34.12(12)(11) the death of a parent, minor child, or 34.13 financially responsible person; 34.14(13)(12) a change in address or living quarters of the 34.15 assistance unit; 34.16(14)(13) the sale, purchase, or other transfer of 34.17 property; 34.18(15)(14) a change in school attendance of acustodial34.19parentcaregiver under age 20 or an employed child; 34.20(16)(15) filing a lawsuit, a workers' compensation claim, 34.21 or a monetary claim against a third party; and 34.22(17)(16) a change in household composition, including 34.23 births, returns to and departures from the home of assistance 34.24 unit members and financially responsible persons, or a change in 34.25 the custody of a minor child. 34.26 Sec. 40. Minnesota Statutes 2002, section 256J.32, 34.27 subdivision 2, is amended to read: 34.28 Subd. 2. [DOCUMENTATION.] The applicant or participant 34.29 must document the information required under subdivisions 4 to 6 34.30 or authorize the county agency to verify the information. The 34.31 applicant or participant has the burden of providing documentary 34.32 evidence to verify eligibility. The county agency shall assist 34.33 the applicant or participant in obtaining required documents 34.34 when the applicant or participant is unable to do so.When an34.35applicant or participant and the county agency are unable to34.36obtain documents needed to verify information, the county agency35.1may accept an affidavit from an applicant or participant as35.2sufficient documentation.The county agency may accept an 35.3 affidavit only for factors specified under subdivision 8. 35.4 Sec. 41. Minnesota Statutes 2002, section 256J.32, 35.5 subdivision 4, is amended to read: 35.6 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 35.7 verify the following at application: 35.8 (1) identity of adults; 35.9 (2) presence of the minor child in the home, if 35.10 questionable; 35.11 (3) relationship of a minor child to caregivers in the 35.12 assistance unit; 35.13 (4) age, if necessary to determine MFIP eligibility; 35.14 (5) immigration status; 35.15 (6) social security number according to the requirements of 35.16 section 256J.30, subdivision 12; 35.17 (7) income; 35.18 (8) self-employment expenses used as a deduction; 35.19 (9) source and purpose of deposits and withdrawals from 35.20 business accounts; 35.21 (10) spousal support and child support payments made to 35.22 persons outside the household; 35.23 (11) real property; 35.24 (12) vehicles; 35.25 (13) checking and savings accounts; 35.26 (14) savings certificates, savings bonds, stocks, and 35.27 individual retirement accounts; 35.28 (15) pregnancy, if related to eligibility; 35.29 (16) inconsistent information, if related to eligibility; 35.30 (17)medical insurance;35.31(18)burial accounts; 35.32(19)(18) school attendance, if related to eligibility; 35.33(20)(19) residence; 35.34(21)(20) a claim of family violence if used as a basisfor35.35ato qualify for the family violence waiverfrom the 60-month35.36time limit in section 256J.42 and regular employment and36.1training services requirements in section 256J.56; 36.2(22)(21) disability if used as the basis for an exemption 36.3 from employment and training services requirements under section 36.4 256J.56 or as the basis for reducing the hourly participation 36.5 requirements under section 256J.55, subdivision 1, or the type 36.6 of activity included in an employment plan under section 36.7 256J.521, subdivision 2; and 36.8(23)(22) information needed to establish an exception 36.9 under section 256J.24, subdivision 9. 36.10 Sec. 42. Minnesota Statutes 2002, section 256J.32, 36.11 subdivision 5a, is amended to read: 36.12 Subd. 5a. [INCONSISTENT INFORMATION.] When the county 36.13 agency verifies inconsistent information under subdivision 4, 36.14 clause (16), or 6, clause(4)(5), the reason for verifying the 36.15 information must be documented in the financial case record. 36.16 Sec. 43. Minnesota Statutes 2002, section 256J.32, is 36.17 amended by adding a subdivision to read: 36.18 Subd. 8. [AFFIDAVIT.] The county agency may accept an 36.19 affidavit from the applicant or recipient as sufficient 36.20 documentation at the time of application or recertification only 36.21 for the following factors: 36.22 (1) a claim of family violence if used as a basis to 36.23 qualify for the family violence waiver; 36.24 (2) information needed to establish an exception under 36.25 section 256J.24, subdivision 9; 36.26 (3) relationship of a minor child to caregivers in the 36.27 assistance unit; and 36.28 (4) citizenship status from a noncitizen who reports to be, 36.29 or is identified as, a victim of severe forms of trafficking in 36.30 persons, if the noncitizen reports that the noncitizen's 36.31 immigration documents are being held by an individual or group 36.32 of individuals against the noncitizen's will. The noncitizen 36.33 must follow up with the Office of Refugee Resettlement (ORR) to 36.34 pursue certification. If verification that certification is 36.35 being pursued is not received within 30 days, the MFIP case must 36.36 be closed and the agency shall pursue overpayments. The ORR 37.1 documents certifying the noncitizen's status as a victim of 37.2 severe forms of trafficking in persons, or the reason for the 37.3 delay in processing, must be received within 90 days, or the 37.4 MFIP case must be closed and the agency shall pursue 37.5 overpayments. 37.6 Sec. 44. Minnesota Statutes 2002, section 256J.37, is 37.7 amended by adding a subdivision to read: 37.8 Subd. 3a. [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 37.9 Effective July 1, 2003, the county agency shall count $100 of 37.10 the value of public and assisted rental subsidies provided 37.11 through the Department of Housing and Urban Development (HUD) as 37.12 unearned income to the cash portion of the MFIP grant. The full 37.13 amount of the subsidy must be counted as unearned income when 37.14 the subsidy is less than $100. 37.15 (b) The provisions of this subdivision shall not apply to 37.16 an MFIP assistance unit which includes a participant who is: 37.17 (1) age 60 or older; 37.18 (2) a caregiver who is suffering from an illness, injury, 37.19 or incapacity that has been certified by a qualified 37.20 professional when the illness, injury, or incapacity is expected 37.21 to continue for more than 30 days and prevents the person from 37.22 obtaining or retaining employment; or 37.23 (3) a caregiver whose presence in the home is required due 37.24 to the illness or incapacity of another member in the assistance 37.25 unit, a relative in the household, or a foster child in the 37.26 household when the illness or incapacity and the need for the 37.27 participant's presence in the home has been certified by a 37.28 qualified professional and is expected to continue for more than 37.29 30 days. 37.30 (c) The provisions of this subdivision shall not apply to 37.31 an MFIP assistance unit where the parental caregiver is an SSI 37.32 recipient. 37.33 Sec. 45. Minnesota Statutes 2002, section 256J.37, is 37.34 amended by adding a subdivision to read: 37.35 Subd. 3b. [TREATMENT OF SUPPLEMENTAL SECURITY 37.36 INCOME.] Effective July 1, 2003, the county shall reduce the 38.1 cash portion of the MFIP grant by $175 per SSI recipient who 38.2 resides in the household, and who would otherwise be included in 38.3 the MFIP assistance unit under section 256J.24, subdivision 2, 38.4 but is excluded solely due to the supplemental security income 38.5 recipient status under section 256J.24, subdivision 3, paragraph 38.6 (a), clause (1). If the SSI recipient receives less than $175 38.7 of supplemental security income, only the amount received shall 38.8 be used in calculating the MFIP cash assistance payment. This 38.9 provision does not apply to relative caregivers who could elect 38.10 to be included in the MFIP assistance unit under section 38.11 256J.24, subdivision 4, unless the caregiver's children or 38.12 stepchildren are included in the MFIP assistance unit. 38.13 Sec. 46. Minnesota Statutes 2002, section 256J.37, 38.14 subdivision 9, is amended to read: 38.15 Subd. 9. [UNEARNED INCOME.](a)The county agency must 38.16 apply unearned income to the MFIP standard of need. When 38.17 determining the amount of unearned income, the county agency 38.18 must deduct the costs necessary to secure payments of unearned 38.19 income. These costs include legal fees, medical fees, and 38.20 mandatory deductions such as federal and state income taxes. 38.21(b) Effective July 1, 2003, the county agency shall count38.22$100 of the value of public and assisted rental subsidies38.23provided through the Department of Housing and Urban Development38.24(HUD) as unearned income. The full amount of the subsidy must38.25be counted as unearned income when the subsidy is less than $100.38.26(c) The provisions of paragraph (b) shall not apply to MFIP38.27participants who are exempt from the employment and training38.28services component because they are:38.29(i) individuals who are age 60 or older;38.30(ii) individuals who are suffering from a professionally38.31certified permanent or temporary illness, injury, or incapacity38.32which is expected to continue for more than 30 days and which38.33prevents the person from obtaining or retaining employment; or38.34(iii) caregivers whose presence in the home is required38.35because of the professionally certified illness or incapacity of38.36another member in the assistance unit, a relative in the39.1household, or a foster child in the household.39.2(d) The provisions of paragraph (b) shall not apply to an39.3MFIP assistance unit where the parental caregiver receives39.4supplemental security income.39.5 Sec. 47. Minnesota Statutes 2002, section 256J.38, 39.6 subdivision 3, is amended to read: 39.7 Subd. 3. [RECOVERING OVERPAYMENTSFROM FORMER39.8PARTICIPANTS.] A county agency must initiate efforts to recover 39.9 overpayments paid to a former participant or caregiver.Adults39.10 Caregivers, both parental and nonparental, and minor caregivers 39.11 of an assistance unit at the time an overpayment occurs, whether 39.12 receiving assistance or not, are jointly and individually liable 39.13 for repayment of the overpayment. The county agency must 39.14 request repayment from the former participants and caregivers. 39.15 When an agreement for repayment is not completed within six 39.16 months of the date of discovery or when there is a default on an 39.17 agreement for repayment after six months, the county agency must 39.18 initiate recovery consistent with chapter 270A, or section 39.19 541.05. When a person has been convicted of fraud under section 39.20 256.98, recovery must be sought regardless of the amount of 39.21 overpayment. When an overpayment is less than $35, and is not 39.22 the result of a fraud conviction under section 256.98, the 39.23 county agency must not seek recovery under this subdivision. 39.24 The county agency must retain information about all overpayments 39.25 regardless of the amount. When an adult, adult caregiver, or 39.26 minor caregiver reapplies for assistance, the overpayment must 39.27 be recouped under subdivision 4. 39.28 Sec. 48. Minnesota Statutes 2002, section 256J.38, 39.29 subdivision 4, is amended to read: 39.30 Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 39.31 participant may voluntarily repay, in part or in full, an 39.32 overpayment even if assistance is reduced under this 39.33 subdivision, until the total amount of the overpayment is 39.34 repaid. When an overpayment occurs due to fraud, the county 39.35 agency must recover from the overpaid assistance unit, including 39.36 child only cases, ten percent of the applicable standard or the 40.1 amount of the monthly assistance payment, whichever is less. 40.2 When a nonfraud overpayment occurs, the county agency must 40.3 recover from the overpaid assistance unit, including child only 40.4 cases, three percent of the MFIP standard of need or the amount 40.5 of the monthly assistance payment, whichever is less. 40.6 Sec. 49. Minnesota Statutes 2002, section 256J.42, 40.7 subdivision 4, is amended to read: 40.8 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 40.9 received by an assistance unit in a month when a caregiver 40.10 complied witha safetyan employment planor after October 1,40.112001, complied or is complying with an alternative employment40.12planunder section256J.49256J.521, subdivision1a3, does 40.13 not count toward the 60-month limitation on assistance. 40.14 Sec. 50. Minnesota Statutes 2002, section 256J.42, 40.15 subdivision 5, is amended to read: 40.16 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 40.17 assistance received by an assistance unit does not count toward 40.18 the 60-month limit on assistance during a month in which the 40.19 caregiver isin the category inage 60 or older, including 40.20 months during which the caregiver was exempt under section 40.21 256J.56, paragraph (a), clause (1). 40.22 (b) From July 1, 1997, until the date MFIP is operative in 40.23 the caregiver's county of financial responsibility, any cash 40.24 assistance received by a caregiver who is complying with 40.25 Minnesota Statutes 1996, section 256.73, subdivision 5a, and 40.26 Minnesota Statutes 1998, section 256.736, if applicable, does 40.27 not count toward the 60-month limit on assistance. Thereafter, 40.28 any cash assistance received by a minor caregiver who is 40.29 complying with the requirements of sections 256J.14 and 256J.54, 40.30 if applicable, does not count towards the 60-month limit on 40.31 assistance. 40.32 (c) Any diversionary assistance or emergency assistance 40.33 received prior to July 1, 2003, does not count toward the 40.34 60-month limit. 40.35 (d) Any cash assistance received by an 18- or 19-year-old 40.36 caregiver who is complying withthe requirements ofan 41.1 employment plan that includes an education option under section 41.2 256J.54 does not count toward the 60-month limit. 41.3 (e) Payments provided to meet short-term emergency needs 41.4 under section 256J.626 and diversionary work program benefits 41.5 provided under section 256J.95 do not count toward the 60-month 41.6 time limit. 41.7 Sec. 51. Minnesota Statutes 2002, section 256J.42, 41.8 subdivision 6, is amended to read: 41.9 Subd. 6. [CASE REVIEW.] (a) Within 180 days, but not less 41.10 than 60 days, before the end of the participant's 60th month on 41.11 assistance, the county agency or job counselor must review the 41.12 participant's case to determine if the employment plan is still 41.13 appropriate or if the participant is exempt under section 41.14 256J.56 from the employment and training services component, and 41.15 attempt to meet with the participant face-to-face. 41.16 (b) During the face-to-face meeting, a county agency or the 41.17 job counselor must: 41.18 (1) inform the participant how many months of counted 41.19 assistance the participant has accrued and when the participant 41.20 is expected to reach the 60th month; 41.21 (2) explain the hardship extension criteria under section 41.22 256J.425 and what the participant should do if the participant 41.23 thinks a hardship extension applies; 41.24 (3) identify other resources that may be available to the 41.25 participant to meet the needs of the family; and 41.26 (4) inform the participant of the right to appeal the case 41.27 closure under section 256J.40. 41.28 (c) If a face-to-face meeting is not possible, the county 41.29 agency must send the participant a notice of adverse action as 41.30 provided in section 256J.31, subdivisions 4 and 5. 41.31 (d) Before a participant's case is closed under this 41.32 section, the county must ensure that: 41.33 (1) the case has been reviewed by the job counselor's 41.34 supervisor or the review team designatedinby thecounty's41.35approved local service unit plancounty to determine if the 41.36 criteria for a hardship extension, if requested, were applied 42.1 appropriately; and 42.2 (2) the county agency or the job counselor attempted to 42.3 meet with the participant face-to-face. 42.4 Sec. 52. Minnesota Statutes 2002, section 256J.425, 42.5 subdivision 1, is amended to read: 42.6 Subdivision 1. [ELIGIBILITY.] (a) To be eligible for a 42.7 hardship extension, a participant in an assistance unit subject 42.8 to the time limit under section 256J.42, subdivision 1,in which42.9any participant has received 60 counted months of assistance,42.10 must be in compliance in the participant's 60th counted month 42.11the participant is applying for the extension. For purposes of 42.12 determining eligibility for a hardship extension, a participant 42.13 is in compliance in any month that the participant has not been 42.14 sanctioned. 42.15 (b) If one participant in a two-parent assistance unit is 42.16 determined to be ineligible for a hardship extension, the county 42.17 shall give the assistance unit the option of disqualifying the 42.18 ineligible participant from MFIP. In that case, the assistance 42.19 unit shall be treated as a one-parent assistance unit and the 42.20 assistance unit's MFIP grant shall be calculated using the 42.21 shared household standard under section 256J.08, subdivision 82a. 42.22 Sec. 53. Minnesota Statutes 2002, section 256J.425, 42.23 subdivision 1a, is amended to read: 42.24 Subd. 1a. [REVIEW.] If a county grants a hardship 42.25 extension under this section, a county agency shall review the 42.26 case every six or 12 months, whichever is appropriate based on 42.27 the participant's circumstances and the extension 42.28 category. More frequent reviews shall be required if 42.29 eligibility for an extension is based on a condition that is 42.30 subject to change in less than six months. 42.31 Sec. 54. Minnesota Statutes 2002, section 256J.425, 42.32 subdivision 2, is amended to read: 42.33 Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit 42.34 subject to the time limit in section 256J.42, subdivision 1,in42.35which any participant has received 60 counted months of42.36assistance,is eligible to receive months of assistance under a 43.1 hardship extension if the participant who reached the time limit 43.2 belongs to any of the following groups: 43.3 (1) participants who are suffering froma professionally43.4certifiedan illness, injury, or incapacity which has been 43.5 certified by a qualified professional when the illness, injury, 43.6 or incapacity is expected to continue for more than 30 days 43.7 andwhichprevents the person from obtaining or retaining 43.8 employmentand who are following. These participants must 43.9 follow the treatment recommendations of thehealth care provider43.10 qualified professional certifying the illness, injury, or 43.11 incapacity; 43.12 (2) participants whose presence in the home is required as 43.13 a caregiver because ofa professionally certifiedthe illness or 43.14 incapacity of another member in the assistance unit, a relative 43.15 in the household, or a foster child in the householdandwhen 43.16 the illness or incapacity and the need for the participant's 43.17 presence in the home has been certified by a qualified 43.18 professional and is expected to continue for more than 30 days; 43.19 or 43.20 (3) caregivers with a child or an adult in the household 43.21 who meets the disability or medical criteria for home care 43.22 services under section 256B.0627, subdivision 1, paragraph 43.23(c)(f), or a home and community-based waiver services program 43.24 under chapter 256B, or meets the criteria for severe emotional 43.25 disturbance under section 245.4871, subdivision 6, or for 43.26 serious and persistent mental illness under section 245.462, 43.27 subdivision 20, paragraph (c). Caregivers in this category are 43.28 presumed to be prevented from obtaining or retaining employment. 43.29 (b) An assistance unit receiving assistance under a 43.30 hardship extension under this subdivision may continue to 43.31 receive assistance as long as the participant meets the criteria 43.32 in paragraph (a), clause (1), (2), or (3). 43.33 Sec. 55. Minnesota Statutes 2002, section 256J.425, 43.34 subdivision 3, is amended to read: 43.35 Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 43.36 subject to the time limit in section 256J.42, subdivision 1,in44.1which any participant has received 60 counted months of44.2assistance,is eligible to receive months of assistance under a 44.3 hardship extension if the participant who reached the time limit 44.4 belongs to any of the following groups: 44.5 (1) a person who is diagnosed by a licensed physician, 44.6 psychological practitioner, or other qualified professional, as 44.7 mentally retarded or mentally ill, and that condition prevents 44.8 the person from obtaining or retaining unsubsidized employment; 44.9 (2) a person who: 44.10 (i) has been assessed by a vocational specialist or the 44.11 county agency to be unemployable for purposes of this 44.12 subdivision; or 44.13 (ii) has an IQ below 80 who has been assessed by a 44.14 vocational specialist or a county agency to be employable, but 44.15 not at a level that makes the participant eligible for an 44.16 extension under subdivision 4or,. The determination of IQ 44.17 level must be made by a qualified professional. In the case of 44.18 a non-English-speaking personfor whom it is not possible to44.19provide a determination due to language barriers or absence of44.20culturally appropriate assessment tools, is determined by a44.21qualified professional to have an IQ below 80. A person is44.22considered employable if positions of employment in the local44.23labor market exist, regardless of the current availability of44.24openings for those positions, that the person is capable of44.25performing: (A) the determination must be made by a qualified 44.26 professional with experience conducting culturally appropriate 44.27 assessments, whenever possible; (B) the county may accept 44.28 reports that identify an IQ range as opposed to a specific 44.29 score; (C) these reports must include a statement of confidence 44.30 in the results; 44.31 (3) a person who is determined bythe county agencya 44.32 qualified professional to be learning disabledor, and the 44.33 disability severely limits the person's ability to obtain, 44.34 perform, or maintain suitable employment. For purposes of the 44.35 initial approval of a learning disability extension, the 44.36 determination must have been made or confirmed within the 45.1 previous 12 months. In the case of a non-English-speaking 45.2 personfor whom it is not possible to provide a medical45.3diagnosis due to language barriers or absence of culturally45.4appropriate assessment tools, is determined by a qualified45.5professional to have a learning disability. If a rehabilitation45.6plan for the person is developed or approved by the county45.7agency, the plan must be incorporated into the employment plan.45.8However, a rehabilitation plan does not replace the requirement45.9to develop and comply with an employment plan under section45.10256J.52. For purposes of this section, "learning disabled"45.11means the applicant or recipient has a disorder in one or more45.12of the psychological processes involved in perceiving,45.13understanding, or using concepts through verbal language or45.14nonverbal means. The disability must severely limit the45.15applicant or recipient in obtaining, performing, or maintaining45.16suitable employment. Learning disabled does not include45.17learning problems that are primarily the result of visual,45.18hearing, or motor handicaps; mental retardation; emotional45.19disturbance; or due to environmental, cultural, or economic45.20disadvantage: (i) the determination must be made by a qualified 45.21 professional with experience conducting culturally appropriate 45.22 assessments, whenever possible; and (ii) these reports must 45.23 include a statement of confidence in the results. If a 45.24 rehabilitation plan for a participant extended as learning 45.25 disabled is developed or approved by the county agency, the plan 45.26 must be incorporated into the employment plan. However, a 45.27 rehabilitation plan does not replace the requirement to develop 45.28 and comply with an employment plan under section 256J.521; or 45.29 (4) a person whois a victim ofhas been granted a family 45.30 violenceas defined in section 256J.49, subdivision 2waiver, 45.31 and who isparticipating incomplying with analternative45.32 employment plan under section256J.49256J.521, subdivision1a45.33 3. 45.34 Sec. 56. Minnesota Statutes 2002, section 256J.425, 45.35 subdivision 4, is amended to read: 45.36 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 46.1 subject to the time limit under section 256J.42, subdivision 1, 46.2in which any participant has received 60 months of assistance,46.3 is eligible to receive assistance under a hardship extension if 46.4 the participant who reached the time limit belongs to: 46.5 (1) a one-parent assistance unit in which the participant 46.6 is participating in work activities for at least 30 hours per 46.7 week, of which an average of at least 25 hours per week every 46.8 month are spent participating in employment; 46.9 (2) a two-parent assistance unit in which the participants 46.10 are participating in work activities for at least 55 hours per 46.11 week, of which an average of at least 45 hours per week every 46.12 month are spent participating in employment; or 46.13 (3) an assistance unit in which a participant is 46.14 participating in employment for fewer hours than those specified 46.15 in clause (1), and the participant submits verification from a 46.16health care providerqualified professional, in a form 46.17 acceptable to the commissioner, stating that the number of hours 46.18 the participant may work is limited due to illness or 46.19 disability, as long as the participant is participating in 46.20 employment for at least the number of hours specified by 46.21 thehealth care providerqualified professional. The 46.22 participant must be following the treatment recommendations of 46.23 thehealth care providerqualified professional providing the 46.24 verification. The commissioner shall develop a form to be 46.25 completed and signed by thehealth care providerqualified 46.26 professional, documenting the diagnosis and any additional 46.27 information necessary to document the functional limitations of 46.28 the participant that limit work hours. If the participant is 46.29 part of a two-parent assistance unit, the other parent must be 46.30 treated as a one-parent assistance unit for purposes of meeting 46.31 the work requirements under this subdivision. 46.32 (b) For purposes of this section, employment means: 46.33 (1) unsubsidized employment under section 256J.49, 46.34 subdivision 13, clause (1); 46.35 (2) subsidized employment under section 256J.49, 46.36 subdivision 13, clause (2); 47.1 (3) on-the-job training under section 256J.49, subdivision 47.2 13, clause(4)(2); 47.3 (4) an apprenticeship under section 256J.49, subdivision 47.4 13, clause(19)(1); 47.5 (5) supported work. For purposes of this section,47.6"supported work" means services supporting a participant on the47.7job which include, but are not limited to, supervision, job47.8coaching, and subsidized wagesunder section 256J.49, 47.9 subdivision 13, clause (2); 47.10 (6) a combination of clauses (1) to (5); or 47.11 (7) child care under section 256J.49, subdivision 13, 47.12 clause(25)(7), if it is in combination with paid employment. 47.13 (c) If a participant is complying with a child protection 47.14 plan under chapter 260C, the number of hours required under the 47.15 child protection plan count toward the number of hours required 47.16 under this subdivision. 47.17 (d) The county shall provide the opportunity for subsidized 47.18 employment to participants needing that type of employment 47.19 within available appropriations. 47.20 (e) To be eligible for a hardship extension for employed 47.21 participants under this subdivision, a participantin a47.22one-parent assistance unit or both parents in a two-parent47.23assistance unitmust be in compliance for at least ten out of 47.24 the 12 months immediately preceding the participant's 61st month 47.25 on assistance.If only one parent in a two-parent assistance47.26unit fails to be in compliance ten out of the 12 months47.27immediately preceding the participant's 61st month, the county47.28shall give the assistance unit the option of disqualifying the47.29noncompliant parent. If the noncompliant participant is47.30disqualified, the assistance unit must be treated as a47.31one-parent assistance unit for the purposes of meeting the work47.32requirements under this subdivision and the assistance unit's47.33MFIP grant shall be calculated using the shared household47.34standard under section 256J.08, subdivision 82a.47.35 (f) The employment plan developed under section256J.5247.36 256J.521, subdivision52, for participants under this 48.1 subdivision must contain the number of hours specified in 48.2 paragraph (a) related to employment and work activities. The 48.3 job counselor and the participant must sign the employment plan 48.4 to indicate agreement between the job counselor and the 48.5 participant on the contents of the plan. 48.6 (g) Participants who fail to meet the requirements in 48.7 paragraph (a), without good cause under section 256J.57, shall 48.8 be sanctioned or permanently disqualified under subdivision 6. 48.9 Good cause may only be granted for that portion of the month for 48.10 which the good cause reason applies. Participants must meet all 48.11 remaining requirements in the approved employment plan or be 48.12 subject to sanction or permanent disqualification. 48.13 (h) If the noncompliance with an employment plan is due to 48.14 the involuntary loss of employment, the participant is exempt 48.15 from the hourly employment requirement under this subdivision 48.16 for one month. Participants must meet all remaining 48.17 requirements in the approved employment plan or be subject to 48.18 sanction or permanent disqualification. This exemption is 48.19 available toone-parent assistance unitsa participant two times 48.20 in a 12-month period, and two-parent assistance units, two times48.21per parent in a 12-month period. 48.22(i) This subdivision expires on June 30, 2004.48.23 Sec. 57. Minnesota Statutes 2002, section 256J.425, 48.24 subdivision 6, is amended to read: 48.25 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 48.26 both participants in an assistance unit receiving assistance 48.27 under subdivision 3 or 4 are not in compliance with the 48.28 employment and training service requirements in sections256J.5248.29 256J.521 to256J.55256J.57, the sanctions under this 48.30 subdivision apply. For a first occurrence of noncompliance, an 48.31 assistance unit must be sanctioned under section 256J.46, 48.32 subdivision 1, paragraph(d)(c), clause (1). For a second or 48.33 third occurrence of noncompliance, the assistance unit must be 48.34 sanctioned under section 256J.46, subdivision 1, 48.35 paragraph(d)(c), clause (2). For a fourth occurrence of 48.36 noncompliance, the assistance unit is disqualified from MFIP. 49.1 If a participant is determined to be out of compliance, the 49.2 participant may claim a good cause exception under section 49.3 256J.57, however, the participant may not claim an exemption 49.4 under section 256J.56. 49.5 (b) If both participants in a two-parent assistance unit 49.6 are out of compliance at the same time, it is considered one 49.7 occurrence of noncompliance. 49.8 Sec. 58. Minnesota Statutes 2002, section 256J.425, 49.9 subdivision 7, is amended to read: 49.10 Subd. 7. [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 49.11 assistance unit that is disqualified under subdivision 6, 49.12 paragraph (a), may be approved for MFIP if the participant 49.13 complies with MFIP program requirements and demonstrates 49.14 compliance for up to one month. No assistance shall be paid 49.15 during this period. 49.16 (b) An assistance unit that is disqualified under 49.17 subdivision 6, paragraph (a), and that reapplies under paragraph 49.18 (a) is subject to sanction under section 256J.46, subdivision 1, 49.19 paragraph(d)(c), clause (1), for a first occurrence of 49.20 noncompliance. A subsequent occurrence of noncompliance results 49.21 in a permanent disqualification. 49.22 (c) If one participant in a two-parent assistance unit 49.23 receiving assistance under a hardship extension under 49.24 subdivision 3 or 4 is determined to be out of compliance with 49.25 the employment and training services requirements under sections 49.26256J.52256J.521 to256J.55256J.57, the county shall give the 49.27 assistance unit the option of disqualifying the noncompliant 49.28 participant from MFIP. In that case, the assistance unit shall 49.29 be treated as a one-parent assistance unit for the purposes of 49.30 meeting the work requirements under subdivision 4 and the 49.31 assistance unit's MFIP grant shall be calculated using the 49.32 shared household standard under section 256J.08, subdivision 49.33 82a. An applicant who is disqualified from receiving assistance 49.34 under this paragraph may reapply under paragraph (a). If a 49.35 participant is disqualified from MFIP under this subdivision a 49.36 second time, the participant is permanently disqualified from 50.1 MFIP. 50.2 (d) Prior to a disqualification under this subdivision, a 50.3 county agency must review the participant's case to determine if 50.4 the employment plan is still appropriate and attempt to meet 50.5 with the participant face-to-face. If a face-to-face meeting is 50.6 not conducted, the county agency must send the participant a 50.7 notice of adverse action as provided in section 256J.31. During 50.8 the face-to-face meeting, the county agency must: 50.9 (1) determine whether the continued noncompliance can be 50.10 explained and mitigated by providing a needed preemployment 50.11 activity, as defined in section 256J.49, subdivision 13, clause 50.12(16), or services under a local intervention grant for50.13self-sufficiency under section 256J.625(9); 50.14 (2) determine whether the participant qualifies for a good 50.15 cause exception under section 256J.57; 50.16 (3) inform the participant of the family violence waiver 50.17 provisions and make appropriate referrals if the waiver is 50.18 requested; 50.19 (4) inform the participant of the participant's sanction 50.20 status and explain the consequences of continuing noncompliance; 50.21(4)(5) identify other resources that may be available to 50.22 the participant to meet the needs of the family; and 50.23(5)(6) inform the participant of the right to appeal under 50.24 section 256J.40. 50.25 Sec. 59. Minnesota Statutes 2002, section 256J.45, 50.26 subdivision 2, is amended to read: 50.27 Subd. 2. [GENERAL INFORMATION.] The MFIP orientation must 50.28 consist of a presentation that informs caregivers of: 50.29 (1) the necessity to obtain immediate employment; 50.30 (2) the work incentives under MFIP, including the 50.31 availability of the federal earned income tax credit and the 50.32 Minnesota working family tax credit; 50.33 (3) the requirement to comply with the employment plan and 50.34 other requirements of the employment and training services 50.35 component of MFIP, including a description of the range of work 50.36 and training activities that are allowable under MFIP to meet 51.1 the individual needs of participants; 51.2 (4) the consequences for failing to comply with the 51.3 employment plan and other program requirements, and that the 51.4 county agency may not impose a sanction when failure to comply 51.5 is due to the unavailability of child care or other 51.6 circumstances where the participant has good cause under 51.7 subdivision 3; 51.8 (5) the rights, responsibilities, and obligations of 51.9 participants; 51.10 (6) the types and locations of child care services 51.11 available through the county agency; 51.12 (7) the availability and the benefits of the early 51.13 childhood health and developmental screening under sections 51.14 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 51.15 (8) the caregiver's eligibility for transition year child 51.16 care assistance under section 119B.05; 51.17 (9)the caregiver's eligibility for extended medical51.18assistance when the caregiver loses eligibility for MFIP due to51.19increased earnings or increased child or spousal supportthe 51.20 availability of all health care programs, including transitional 51.21 medical assistance; 51.22 (10) the caregiver's option to choose an employment and 51.23 training provider and information about each provider, including 51.24 but not limited to, services offered, program components, job 51.25 placement rates, job placement wages, and job retention rates; 51.26 (11) the caregiver's option to request approval of an 51.27 education and training plan according to section256J.5251.28 256J.53; 51.29 (12) the work study programs available under the higher 51.30 education system; and 51.31 (13)effective October 1, 2001,information about the 51.32 60-month time limitexemption and waivers of regular employment51.33and training requirements for family violence victimsexemptions 51.34 under the family violence waiver and referral information about 51.35 shelters and programs for victims of family violence. 51.36 Sec. 60. Minnesota Statutes 2002, section 256J.46, 52.1 subdivision 1, is amended to read: 52.2 Subdivision 1. [PARTICIPANTS NOT COMPLYING WITH PROGRAM 52.3 REQUIREMENTS.] (a) A participant who fails without good 52.4 cause under section 256J.57 to comply with the requirements of 52.5 this chapter, and who is not subject to a sanction under 52.6 subdivision 2, shall be subject to a sanction as provided in 52.7 this subdivision. Prior to the imposition of a sanction, a 52.8 county agency shall provide a notice of intent to sanction under 52.9 section 256J.57, subdivision 2, and, when applicable, a notice 52.10 of adverse action as provided in section 256J.31. 52.11 (b)A participant who fails to comply with an alternative52.12employment plan must have the plan reviewed by a person trained52.13in domestic violence and a job counselor or the county agency to52.14determine if components of the alternative employment plan are52.15still appropriate. If the activities are no longer appropriate,52.16the plan must be revised with a person trained in domestic52.17violence and approved by a job counselor or the county agency.52.18A participant who fails to comply with a plan that is determined52.19not to need revision will lose their exemption and be required52.20to comply with regular employment services activities.52.21(c)A sanction under this subdivision becomes effective the 52.22 month following the month in which a required notice is given. 52.23 A sanction must not be imposed when a participant comes into 52.24 compliance with the requirements for orientation under section 52.25 256J.45or third-party liability for medical services under52.26section 256J.30, subdivision 10,prior to the effective date of 52.27 the sanction. A sanction must not be imposed when a participant 52.28 comes into compliance with the requirements for employment and 52.29 training services under sections256J.49256J.515 to 52.30256J.55256J.57 ten days prior to the effective date of the 52.31 sanction. For purposes of this subdivision, each month that a 52.32 participant fails to comply with a requirement of this chapter 52.33 shall be considered a separate occurrence of noncompliance.A52.34participant who has had one or more sanctions imposed must52.35remain in compliance with the provisions of this chapter for six52.36months in order for a subsequent occurrence of noncompliance to53.1be considered a first occurrence.If both participants in a 53.2 two-parent assistance unit are out of compliance at the same 53.3 time, it is considered one occurrence of noncompliance. 53.4(d)(c) Sanctions for noncompliance shall be imposed as 53.5 follows: 53.6 (1) For the first occurrence of noncompliance by a 53.7 participant in an assistance unit, the assistance unit's grant 53.8 shall be reduced by ten percent of the MFIP standard of need for 53.9 an assistance unit of the same size with the residual grant paid 53.10 to the participant. The reduction in the grant amount must be 53.11 in effect for a minimum of one month and shall be removed in the 53.12 month following the month that the participant returns to 53.13 compliance. 53.14 (2) For a secondor subsequent, third, fourth, fifth, or 53.15 sixth occurrence of noncompliance by a participant in an 53.16 assistance unit,or when each of the participants in a53.17two-parent assistance unit have a first occurrence of53.18noncompliance at the same time,the assistance unit's shelter 53.19 costs shall be vendor paid up to the amount of the cash portion 53.20 of the MFIP grant for which the assistance unit is eligible. At 53.21 county option, the assistance unit's utilities may also be 53.22 vendor paid up to the amount of the cash portion of the MFIP 53.23 grant remaining after vendor payment of the assistance unit's 53.24 shelter costs. The residual amount of the grant after vendor 53.25 payment, if any, must be reduced by an amount equal to 30 53.26 percent of the MFIP standard of need for an assistance unit of 53.27 the same size before the residual grant is paid to the 53.28 assistance unit. The reduction in the grant amount must be in 53.29 effect for a minimum of one month and shall be removed in the 53.30 month following the month that the participant in a one-parent 53.31 assistance unit returns to compliance. In a two-parent 53.32 assistance unit, the grant reduction must be in effect for a 53.33 minimum of one month and shall be removed in the month following 53.34 the month both participants return to compliance. The vendor 53.35 payment of shelter costs and, if applicable, utilities shall be 53.36 removed six months after the month in which the participant or 54.1 participants return to compliance. If an assistance unit is 54.2 sanctioned under this clause, the participant's case file must 54.3 be reviewedas required under paragraph (e)to determine if the 54.4 employment plan is still appropriate. 54.5(e) When a sanction under paragraph (d), clause (2), is in54.6effect(d) For a seventh occurrence of noncompliance by a 54.7 participant in an assistance unit, or when the participants in a 54.8 two-parent assistance unit have a total of seven occurrences of 54.9 noncompliance, the county agency shall close the MFIP assistance 54.10 unit's financial assistance case, both the cash and food 54.11 portions. The case must remain closed for a minimum of one full 54.12 month. Closure under this paragraph does not make a participant 54.13 automatically ineligible for food support, if otherwise eligible. 54.14 Before the case is closed, the county agency must review the 54.15 participant's case to determine if the employment plan is still 54.16 appropriate and attempt to meet with the participant 54.17 face-to-face. The participant may bring an advocate to the 54.18 face-to-face meeting. If a face-to-face meeting is not 54.19 conducted, the county agency must send the participant a written 54.20 notice that includes the information required under clause (1). 54.21 (1) During the face-to-face meeting, the county agency must: 54.22 (i) determine whether the continued noncompliance can be 54.23 explained and mitigated by providing a needed preemployment 54.24 activity, as defined in section 256J.49, subdivision 13, clause 54.25(16), or services under a local intervention grant for54.26self-sufficiency under section 256J.625(9); 54.27 (ii) determine whether the participant qualifies for a good 54.28 cause exception under section 256J.57, or if the sanction is for 54.29 noncooperation with child support requirements, determine if the 54.30 participant qualifies for a good cause exemption under section 54.31 256.741, subdivision 10; 54.32 (iii) determine whether the participant qualifies for an 54.33 exemption under section 256J.56 or the work activities in the 54.34 employment plan are appropriate based on the criteria in section 54.35 256J.521, subdivision 2 or 3; 54.36 (iv)determine whether the participant qualifies for an55.1exemption from regular employment services requirements for55.2victims of family violence under section 256J.52, subdivision55.36determine whether the participant qualifies for the family 55.4 violence waiver; 55.5 (v) inform the participant of the participant's sanction 55.6 status and explain the consequences of continuing noncompliance; 55.7 (vi) identify other resources that may be available to the 55.8 participant to meet the needs of the family; and 55.9 (vii) inform the participant of the right to appeal under 55.10 section 256J.40. 55.11 (2) If the lack of an identified activity or service can 55.12 explain the noncompliance, the county must work with the 55.13 participant to provide the identified activity, and the county55.14must restore the participant's grant amount to the full amount55.15for which the assistance unit is eligible. The grant must be55.16restored retroactively to the first day of the month in which55.17the participant was found to lack preemployment activities or to55.18qualify for an exemption under section 256J.56, a good cause55.19exception under section 256J.57, or an exemption for victims of55.20family violence under section 256J.52, subdivision 6. 55.21 (3)If the participant is found to qualify for a good cause55.22exception or an exemption, the county must restore the55.23participant's grant to the full amount for which the assistance55.24unit is eligible.The grant must be restored to the full amount 55.25 for which the assistance unit is eligible retroactively to the 55.26 first day of the month in which the participant was found to 55.27 lack preemployment activities or to qualify for an exemption 55.28 under section 256J.56, a family violence waiver, or for a good 55.29 cause exemption under section 256.741, subdivision 10, or 55.30 256J.57. 55.31 (e) For the purpose of applying sanctions under this 55.32 section, only occurrences of noncompliance that occur after the 55.33 effective date of this section shall be considered. If the 55.34 participant is in 30 percent sanction in the month this section 55.35 takes effect, that month counts as the first occurrence for 55.36 purposes of applying the sanctions under this section, but the 56.1 sanction shall remain at 30 percent for that month. 56.2 (f) An assistance unit whose case is closed under paragraph 56.3 (d) or (g), or under an approved county option sanction plan 56.4 under section 256J.462 in effect June 30, 2003, or a county 56.5 pilot project under Laws 2000, chapter 488, article 10, section 56.6 29, in effect June 30, 2003, may reapply for MFIP and shall be 56.7 eligible if the participant complies with MFIP program 56.8 requirements and demonstrates compliance for up to one month. 56.9 No assistance shall be paid during this period. 56.10 (g) An assistance unit whose case has been closed for 56.11 noncompliance, that reapplies under paragraph (f) is subject to 56.12 sanction under paragraph (c), clause (2), for a first occurrence 56.13 of noncompliance. Any subsequent occurrence of noncompliance 56.14 shall result in case closure under paragraph (d). 56.15 Sec. 61. Minnesota Statutes 2002, section 256J.46, 56.16 subdivision 2, is amended to read: 56.17 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 56.18 REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 56.19 cooperate, as determined by the child support enforcement 56.20 agency, with support requirements under section 256.741, shall 56.21 be subject to sanction as specified in this subdivision and 56.22 subdivision 1. For a first occurrence of noncooperation, the 56.23 assistance unit's grant must be reduced by2530 percent of the 56.24 applicable MFIP standard of need. Subsequent occurrences of 56.25 noncooperation shall be subject to sanction under subdivision 1, 56.26 paragraphs (c), clause (2), and (d). The residual amount of the 56.27 grant, if any, must be paid to the caregiver. A sanction under 56.28 this subdivision becomes effective the first month following the 56.29 month in which a required notice is given. A sanction must not 56.30 be imposed when a caregiver comes into compliance with the 56.31 requirements under section 256.741 prior to the effective date 56.32 of the sanction. The sanction shall be removed in the month 56.33 following the month that the caregiver cooperates with the 56.34 support requirements. Each month that an MFIP caregiver fails 56.35 to comply with the requirements of section 256.741 must be 56.36 considered a separate occurrence of noncompliance for the 57.1 purpose of applying sanctions under subdivision 1, paragraphs 57.2 (c), clause (2), and (d).An MFIP caregiver who has had one or57.3more sanctions imposed must remain in compliance with the57.4requirements of section 256.741 for six months in order for a57.5subsequent sanction to be considered a first occurrence.57.6 Sec. 62. Minnesota Statutes 2002, section 256J.46, 57.7 subdivision 2a, is amended to read: 57.8 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 57.9 provisions of subdivisions 1 and 2, for a participant subject to 57.10 a sanction for refusal to comply with child support requirements 57.11 under subdivision 2 and subject to a concurrent sanction for 57.12 refusal to cooperate with other program requirements under 57.13 subdivision 1, sanctions shall be imposed in the manner 57.14 prescribed in this subdivision. 57.15A participant who has had one or more sanctions imposed57.16under this subdivision must remain in compliance with the57.17provisions of this chapter for six months in order for a57.18subsequent occurrence of noncompliance to be considered a first57.19occurrence.Any vendor payment of shelter costs or utilities 57.20 under this subdivision must remain in effect for six months 57.21 after the month in which the participant is no longer subject to 57.22 sanction under subdivision 1. 57.23 (b) If the participant was subject to sanction for: 57.24 (i) noncompliance under subdivision 1 before being subject 57.25 to sanction for noncooperation under subdivision 2; or 57.26 (ii) noncooperation under subdivision 2 before being 57.27 subject to sanction for noncompliance under subdivision 1, the 57.28 participant is considered to have a second occurrence of 57.29 noncompliance and shall be sanctioned as provided in subdivision 57.30 1, paragraph(d)(c), clause (2). Each subsequent occurrence of 57.31 noncompliance shall be considered one additional occurrence and 57.32 shall be subject to the applicable level of sanction under 57.33 subdivision 1, paragraph (d), or section 256J.462. The 57.34 requirement that the county conduct a review as specified in 57.35 subdivision 1, paragraph(e)(d), remains in effect. 57.36 (c) A participant who first becomes subject to sanction 58.1 under both subdivisions 1 and 2 in the same month is subject to 58.2 sanction as follows: 58.3 (i) in the first month of noncompliance and noncooperation, 58.4 the participant's grant must be reduced by 25 percent of the 58.5 applicable MFIP standard of need, with any residual amount paid 58.6 to the participant; 58.7 (ii) in the second and subsequent months of noncompliance 58.8 and noncooperation, the participant shall be subject to the 58.9 applicable level of sanction under subdivision 1, paragraph (d),58.10or section 256J.462. 58.11 The requirement that the county conduct a review as 58.12 specified in subdivision 1, paragraph(e)(d), remains in effect. 58.13 (d) A participant remains subject to sanction under 58.14 subdivision 2 if the participant: 58.15 (i) returns to compliance and is no longer subject to 58.16 sanctionunder subdivision 1 or section 256J.462for 58.17 noncompliance with section 256J.45 or sections 256J.515 to 58.18 256J.57; or 58.19 (ii) has the sanctionunder subdivision 1, paragraph (d),58.20or section 256J.462for noncompliance with section 256J.45 or 58.21 sections 256J.515 to 256J.57 removed upon completion of the 58.22 review under subdivision 1, paragraph (e). 58.23 A participant remains subject to the applicable level of 58.24 sanction under subdivision 1, paragraph (d), or section 256J.46258.25 if the participant cooperates and is no longer subject to 58.26 sanction under subdivision 2. 58.27 Sec. 63. Minnesota Statutes 2002, section 256J.49, 58.28 subdivision 4, is amended to read: 58.29 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 58.30 "Employment and training service provider" means: 58.31 (1) a public, private, or nonprofit employment and training 58.32 agency certified by the commissioner of economic security under 58.33 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 58.34 is approved under section 256J.51 and is included in the county 58.35planservice agreement submitted under section256J.50256J.626, 58.36 subdivision74; 59.1 (2) a public, private, or nonprofit agency that is not 59.2 certified by the commissioner under clause (1), but with which a 59.3 county has contracted to provide employment and training 59.4 services and which is included in the county'splanservice 59.5 agreement submitted under section256J.50256J.626, 59.6 subdivision74; or 59.7 (3) a county agency, if the county has opted to provide 59.8 employment and training services and the county has indicated 59.9 that fact in theplanservice agreement submitted under section 59.10256J.50256J.626, subdivision74. 59.11 Notwithstanding section 268.871, an employment and training 59.12 services provider meeting this definition may deliver employment 59.13 and training services under this chapter. 59.14 Sec. 64. Minnesota Statutes 2002, section 256J.49, 59.15 subdivision 5, is amended to read: 59.16 Subd. 5. [EMPLOYMENT PLAN.] "Employment plan" means a plan 59.17 developed by the job counselor and the participant which 59.18 identifies the participant's most direct path to unsubsidized 59.19 employment, lists the specific steps that the caregiver will 59.20 take on that path, and includes a timetable for the completion 59.21 of each step. The plan should also identify any subsequent 59.22 steps that support long-term economic stability. For 59.23 participants who request and qualify for a family violence 59.24 waiver, an employment plan must be developed by the job 59.25 counselor, the participant, and a person trained in domestic 59.26 violence and follow the employment plan provisions in section 59.27 256J.521, subdivision 3. 59.28 Sec. 65. Minnesota Statutes 2002, section 256J.49, is 59.29 amended by adding a subdivision to read: 59.30 Subd. 6a. [FUNCTIONAL WORK LITERACY.] "Functional work 59.31 literacy" means an intensive English as a second language 59.32 program that is work focused and offers at least 20 hours of 59.33 class time per week. 59.34 Sec. 66. Minnesota Statutes 2002, section 256J.49, 59.35 subdivision 9, is amended to read: 59.36 Subd. 9. [PARTICIPANT.] "Participant" means a recipient of 60.1 MFIP assistance who participates or is required to participate 60.2 in employment and training services under sections 256J.515 to 60.3 256J.57 and 256J.95. 60.4 Sec. 67. Minnesota Statutes 2002, section 256J.49, 60.5 subdivision 13, is amended to read: 60.6 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 60.7 activity in a participant's approved employment plan thatis60.8tied to the participant'sleads to employmentgoal. For 60.9 purposes of the MFIP program,any activity that is included in a60.10participant's approved employment plan meetsthis includes 60.11 activities that meet the definition of work activityas counted60.12 under thefederalparticipationstandardsrequirements of TANF. 60.13 Work activity includes, but is not limited to: 60.14 (1) unsubsidized employment, including work study and paid 60.15 apprenticeships or internships; 60.16 (2) subsidized private sector or public sector employment, 60.17 including grant diversion as specified in section 256J.69, 60.18 on-the-job training as specified in section 256J.66, the 60.19 self-employment investment demonstration program (SEID) as 60.20 specified in section 256J.65, paid work experience, and 60.21 supported work when a wage subsidy is provided; 60.22 (3) unpaid work experience, includingCWEPcommunity 60.23 service, volunteer work, the community work experience program 60.24 as specified in section 256J.67, unpaid apprenticeships or 60.25 internships, andincluding work associated with the refurbishing60.26of publicly assisted housing if sufficient private sector60.27employment is not availablesupported work when a wage subsidy 60.28 is not provided; 60.29 (4)on-the-job training as specified in section 256J.66job 60.30 search including job readiness assistance, job clubs, job 60.31 placement, job-related counseling, and job retention services; 60.32(5) job search, either supervised or unsupervised;60.33(6) job readiness assistance;60.34(7) job clubs, including job search workshops;60.35(8) job placement;60.36(9) job development;61.1(10) job-related counseling;61.2(11) job coaching;61.3(12) job retention services;61.4(13) job-specific training or education;61.5(14) job skills training directly related to employment;61.6(15) the self-employment investment demonstration (SEID),61.7as specified in section 256J.65;61.8(16) preemployment activities, based on availability and61.9resources, such as volunteer work, literacy programs and related61.10activities, citizenship classes, English as a second language61.11(ESL) classes as limited by the provisions of section 256J.52,61.12subdivisions 3, paragraph (d), and 5, paragraph (c), or61.13participation in dislocated worker services, chemical dependency61.14treatment, mental health services, peer group networks,61.15displaced homemaker programs, strength-based resiliency61.16training, parenting education, or other programs designed to61.17help families reach their employment goals and enhance their61.18ability to care for their children;61.19(17) community service programs;61.20(18) vocational educational training or educational61.21programs that can reasonably be expected to lead to employment,61.22as limited by the provisions of section 256J.53;61.23(19) apprenticeships;61.24(20) satisfactory attendance in general educational61.25development diploma classes or an adult diploma program;61.26(21) satisfactory attendance at secondary school, if the61.27participant has not received a high school diploma;61.28(22) adult basic education classes;61.29(23) internships;61.30(24) bilingual employment and training services;61.31(25) providing child care services to a participant who is61.32working in a community service program; and61.33(26) activities included in an alternative employment plan61.34that is developed under section 256J.52, subdivision 6.61.35 (5) job readiness education, including English as a second 61.36 language (ESL) or functional work literacy classes as limited by 62.1 the provisions of section 256J.531, subdivision 2, general 62.2 educational development (GED) course work, high school 62.3 completion, and adult basic education as limited by the 62.4 provisions of section 256J.531, subdivision 1; 62.5 (6) job skills training directly related to employment, 62.6 including education and training that can reasonably be expected 62.7 to lead to employment, as limited by the provisions of section 62.8 256J.53; 62.9 (7) providing child care services to a participant who is 62.10 working in a community service program; 62.11 (8) activities included in the employment plan that is 62.12 developed under section 256J.521, subdivision 3; and 62.13 (9) preemployment activities including chemical and mental 62.14 health assessments, treatment, and services; learning 62.15 disabilities services; child protective services; family 62.16 stabilization services; or other programs designed to enhance 62.17 employability. 62.18 Sec. 68. Minnesota Statutes 2002, section 256J.49, is 62.19 amended by adding a subdivision to read: 62.20 Subd. 14. [SUPPORTED WORK.] "Supported work" means a 62.21 subsidized or unsubsidized work experience placement with a 62.22 public or private sector employer, which may include services 62.23 such as individual supervision and job coaching to support the 62.24 participant on the job. 62.25 Sec. 69. Minnesota Statutes 2002, section 256J.50, 62.26 subdivision 1, is amended to read: 62.27 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 62.28 OF MFIP.] (a)By January 1, 1998,Each county must develop and 62.29implementprovide an employment and training services component 62.30of MFIPwhich is designed to put participants on the most direct 62.31 path to unsubsidized employment. Participation in these 62.32 services is mandatory for all MFIP caregivers, unless the 62.33 caregiver is exempt under section 256J.56. 62.34 (b) A county must provide employment and training services 62.35 under sections 256J.515 to 256J.74 within 30 days after 62.36 thecaregiver's participation becomes mandatory under63.1subdivision 5 or within 30 days of receipt of a request for63.2services from a caregiver who under section 256J.42 is no longer63.3eligible to receive MFIP but whose income is below 120 percent63.4of the federal poverty guidelines for a family of the same63.5size. The request must be made within 12 months of the date the63.6caregivers' MFIP case was closedcaregiver is determined 63.7 eligible for MFIP, or within five days when the caregiver 63.8 participated in the diversionary work program under section 63.9 256J.95 within the past 12 months. 63.10 Sec. 70. Minnesota Statutes 2002, section 256J.50, 63.11 subdivision 8, is amended to read: 63.12 Subd. 8. [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 63.13 CHOICES FOR PARTICIPANTS.] Each county, or group of counties 63.14 working cooperatively, shall make available to participants the 63.15 choice of at least two employment and training service providers 63.16 as defined under section 256J.49, subdivision 4, except in 63.17 counties utilizing workforce centers that use multiple 63.18 employment and training services, offer multiple services 63.19 options under a collaborative effort and can document that 63.20 participants have choice among employment and training services 63.21 designed to meet specialized needs. The requirements of this 63.22 subdivision do not apply to the diversionary work program under 63.23 section 256J.95. 63.24 Sec. 71. Minnesota Statutes 2002, section 256J.50, 63.25 subdivision 9, is amended to read: 63.26 Subd. 9. [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 63.27 subdivision 8, a county that explains in theplanservice 63.28 agreement required under section 256J.626, subdivision74, that 63.29 the provision of alternative employment and training service 63.30 providers would result in financial hardship for the county is 63.31 not required to make available more than one employment and 63.32 training provider. 63.33 Sec. 72. Minnesota Statutes 2002, section 256J.50, 63.34 subdivision 10, is amended to read: 63.35 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 63.36 VIOLENCE.] (a) County agencies and their contractors must 64.1 provide universal notification to all applicants and recipients 64.2 of MFIP that: 64.3 (1) referrals to counseling and supportive services are 64.4 available for victims of family violence; 64.5 (2) nonpermanent resident battered individuals married to 64.6 United States citizens or permanent residents may be eligible to 64.7 petition for permanent residency under the federal Violence 64.8 Against Women Act, and that referrals to appropriate legal 64.9 services are available; 64.10 (3) victims of family violence are exempt from the 60-month 64.11 limit on assistancewhile the individual isif they are 64.12 complying with anapproved safety plan or, after October 1,64.132001, an alternativeemployment plan, as defined inunder 64.14 section256J.49256J.521, subdivision1a3; and 64.15 (4) victims of family violence may choose to have regular 64.16 work requirements waived while the individual is complying with 64.17 analternativeemployment planas defined inunder section 64.18256J.49256J.521, subdivision1a3. 64.19 (b) If analternativeemployment plan under section 64.20 256J.521, subdivision 3, is denied, the county or a job 64.21 counselor must provide reasons why the plan is not approved and 64.22 document how the denial of the plan does not interfere with the 64.23 safety of the participant or children. 64.24 Notification must be in writing and orally at the time of 64.25 application and recertification, when the individual is referred 64.26 to the title IV-D child support agency, and at the beginning of 64.27 any job training or work placement assistance program. 64.28 Sec. 73. Minnesota Statutes 2002, section 256J.51, 64.29 subdivision 1, is amended to read: 64.30 Subdivision 1. [PROVIDER APPLICATION.] An employment and 64.31 training service provider that is not included in a county's 64.32planservice agreement under section256J.50256J.626, 64.33 subdivision74, because the county has demonstrated financial 64.34 hardship under section 256J.50, subdivision9 of that section5, 64.35 may appeal its exclusion to the commissioner of economic 64.36 security under this section. 65.1 Sec. 74. Minnesota Statutes 2002, section 256J.51, 65.2 subdivision 2, is amended to read: 65.3 Subd. 2. [APPEAL; ALTERNATE APPROVAL.] (a) An employment 65.4 and training service provider that is not included by a county 65.5 agency in theplanservice agreement under section 65.6256J.50256J.626, subdivision74, and that meets the criteria 65.7 in paragraph (b), may appeal its exclusion to the commissioner 65.8 of economic security, and may request alternative approval by 65.9 the commissioner of economic security to provide services in the 65.10 county. 65.11 (b) An employment and training services provider that is 65.12 requesting alternative approval must demonstrate to the 65.13 commissioner that the provider meets the standards specified in 65.14 section 268.871, subdivision 1, paragraph (b), except that the 65.15 provider's past experience may be in services and programs 65.16 similar to those specified in section 268.871, subdivision 1, 65.17 paragraph (b). 65.18 Sec. 75. Minnesota Statutes 2002, section 256J.51, 65.19 subdivision 3, is amended to read: 65.20 Subd. 3. [COMMISSIONER'S REVIEW.] (a) The commissioner 65.21 must act on a request for alternative approval under this 65.22 section within 30 days of the receipt of the request. If after 65.23 reviewing the provider's request, and the county'splanservice 65.24 agreement submitted under section256J.50256J.626, 65.25 subdivision74, the commissioner determines that the provider 65.26 meets the criteria under subdivision 2, paragraph (b), and that 65.27 approval of the provider would not cause financial hardship to 65.28 the county, the county must submit a revisedplanservice 65.29 agreement under subdivision 4 that includes the approved 65.30 provider. 65.31 (b) If the commissioner determines that the approval of the 65.32 provider would cause financial hardship to the county, the 65.33 commissioner must notify the provider and the county of this 65.34 determination. The alternate approval process under this 65.35 section shall be closed to other requests for alternate approval 65.36 to provide employment and training services in the county for up 66.1 to 12 months from the date that the commissioner makes a 66.2 determination under this paragraph. 66.3 Sec. 76. Minnesota Statutes 2002, section 256J.51, 66.4 subdivision 4, is amended to read: 66.5 Subd. 4. [REVISEDPLANSERVICE AGREEMENT REQUIRED.] The 66.6 commissioner of economic security must notify the county agency 66.7 when the commissioner grants an alternative approval to an 66.8 employment and training service provider under subdivision 2. 66.9 Upon receipt of the notice, the county agency must submit a 66.10 revisedplanservice agreement under section256J.50256J.626, 66.11 subdivision74, that includes the approved provider. The 66.12 county has 90 days from the receipt of the commissioner's notice 66.13 to submit the revisedplanservice agreement. 66.14 Sec. 77. [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 66.15 Subdivision 1. [ASSESSMENTS.] (a) For purposes of MFIP 66.16 employment services, assessment is a continuing process of 66.17 gathering information related to employability for the purpose 66.18 of identifying both participant's strengths and strategies for 66.19 coping with issues that interfere with employment. The job 66.20 counselor must use information from the assessment process to 66.21 develop and update the employment plan under subdivision 2. 66.22 (b) The scope of assessment must cover at least the 66.23 following areas: 66.24 (1) basic information about the participant's ability to 66.25 obtain and retain employment, including: a review of the 66.26 participant's education level; interests, skills, and abilities; 66.27 prior employment or work experience; transferable work skills; 66.28 child care and transportation needs; 66.29 (2) identification of personal and family circumstances 66.30 that impact the participant's ability to obtain and retain 66.31 employment, including: any special needs of the children, the 66.32 level of English proficiency, and any involvement with social 66.33 services or the legal system; 66.34 (3) the results of a mental and chemical health screening 66.35 tool designed by the commissioner and results of the brief 66.36 screening tool for special learning needs. Screening for mental 67.1 and chemical health and special learning needs must be completed 67.2 by participants who are unable to find suitable employment after 67.3 six weeks of job search under subdivision 2, paragraph (b), and 67.4 participants who are determined to have barriers to employment 67.5 under subdivision 2, paragraph (d). Failure to complete the 67.6 screens will result in sanction under section 256J.46; and 67.7 (4) a comprehensive review of participation and progress 67.8 for participants who have received MFIP assistance and have not 67.9 worked in unsubsidized employment during the past 12 months. 67.10 The purpose of the review is to determine the need for 67.11 additional services and supports, including placement in 67.12 subsidized employment or unpaid work experience under section 67.13 256J.49, subdivision 13. 67.14 (c) Information gathered during a caregiver's participation 67.15 in the diversionary work program under section 256J.95 must be 67.16 incorporated into the assessment process. 67.17 (d) The job counselor may require the participant to 67.18 complete a professional chemical use assessment to be performed 67.19 according to the rules adopted under section 254A.03, 67.20 subdivision 3, including provisions in the administrative rules 67.21 which recognize the cultural background of the participant, or a 67.22 professional psychological assessment as a component of the 67.23 assessment process, when the job counselor has a reasonable 67.24 belief, based on objective evidence, that a participant's 67.25 ability to obtain and retain suitable employment is impaired by 67.26 a medical condition. The job counselor may assist the 67.27 participant with arranging services, including child care 67.28 assistance and transportation, necessary to meet needs 67.29 identified by the assessment. Data gathered as part of a 67.30 professional assessment must be classified and disclosed 67.31 according to the provisions in section 13.46. 67.32 Subd. 2. [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 67.33 assessment under subdivision 1, the job counselor and the 67.34 participant must develop an employment plan that includes 67.35 participation in activities and hours that meet the requirements 67.36 of section 256J.55, subdivision 1. The purpose of the 68.1 employment plan is to identify for each participant the most 68.2 direct path to unsubsidized employment and any subsequent steps 68.3 that support long-term economic stability. The employment plan 68.4 should be developed using the highest level of activity 68.5 appropriate for the participant. Activities must be chosen from 68.6 clauses (1) to (6), which are listed in order of preference. 68.7 The employment plan must also list the specific steps the 68.8 participant will take to obtain employment, including steps 68.9 necessary for the participant to progress from one level of 68.10 activity to another, and a timetable for completion of each 68.11 step. Levels of activity include: 68.12 (1) unsubsidized employment; 68.13 (2) job search; 68.14 (3) subsidized employment or unpaid work experience; 68.15 (4) unsubsidized employment and job readiness education or 68.16 job skills training; 68.17 (5) unsubsidized employment or unpaid work experience, and 68.18 activities related to a family violence waiver or preemployment 68.19 needs; and 68.20 (6) activities related to a family violence waiver or 68.21 preemployment needs. 68.22 (b) Participants who are determined able to work in 68.23 unsubsidized employment must job search at least 30 hours per 68.24 week for up to six weeks, and accept any offer of suitable 68.25 employment. The remaining hours necessary to meet the 68.26 requirements of section 256J.55, subdivision 1, may be met 68.27 through participation in other work activities under section 68.28 256J.49, subdivision 13. The participant's employment plan must 68.29 specify, at a minimum: (1) whether the job search is supervised 68.30 or unsupervised; (2) support services that will be provided; and 68.31 (3) how frequently the participant must report to the job 68.32 counselor. Participants who are unable to find suitable 68.33 employment after six weeks must meet with the job counselor to 68.34 determine whether other activities in paragraph (a) should be 68.35 incorporated into the employment plan. Job search activities 68.36 which are continued after six weeks must be structured and 69.1 supervised. 69.2 (c) Beginning July 1, 2004, activities and hourly 69.3 requirements in the employment plan may be adjusted as necessary 69.4 to accommodate the personal and family circumstances of 69.5 participants identified under section 256J.561, subdivision 1, 69.6 paragraph (d). Participants who no longer meet the provisions 69.7 of section 256J.561, subdivision 1, paragraph (d), must meet 69.8 with the job counselor within ten days of the determination to 69.9 revise the employment plan. 69.10 (d) Participants who are determined to have barriers that 69.11 will not be overcome during six weeks of job search under 69.12 paragraph (b) must work with the job counselor to develop an 69.13 employment plan that addresses those barriers by incorporating 69.14 appropriate activities from paragraph (a), clauses (1) to (6). 69.15 The employment plan must include enough hours to meet the 69.16 participation requirements in section 256J.55, subdivision 1, 69.17 unless a compelling reason to require fewer hours is noted in 69.18 the participant's file. 69.19 (e) The job counselor and the participant must sign the 69.20 employment plan to indicate agreement on the contents. Failure 69.21 to develop or comply with activities in the plan, or voluntarily 69.22 quitting suitable employment without good cause, will result in 69.23 the imposition of a sanction under section 256J.46. 69.24 (f) Employment plans must be reviewed at least every three 69.25 months to determine whether activities and hourly requirements 69.26 should be revised. 69.27 Subd. 3. [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 69.28 participant who requests and qualifies for a family violence 69.29 waiver shall develop or revise the employment plan as specified 69.30 in this subdivision with a job counselor or county, and a person 69.31 trained in domestic violence. The revised or new employment 69.32 plan must be approved by the county or the job counselor. The 69.33 plan may address safety, legal, or emotional issues, and other 69.34 demands on the family as a result of the family violence. 69.35 Information in section 256J.515, clauses (1) to (8), must be 69.36 included as part of the development of the plan. 70.1 (b) The primary goal of an employment plan developed under 70.2 this subdivision is to ensure the safety of the caregiver and 70.3 children. To the extent it is consistent with ensuring safety, 70.4 the plan shall also include activities that are designed to lead 70.5 to economic stability. An activity is inconsistent with 70.6 ensuring safety if, in the opinion of a person trained in 70.7 domestic violence, the activity would endanger the safety of the 70.8 participant or children. A plan under this subdivision may not 70.9 automatically include a provision that requires a participant to 70.10 obtain an order for protection or to attend counseling. 70.11 (c) If at any time there is a disagreement over whether the 70.12 activities in the plan are appropriate or the participant is not 70.13 complying with activities in the plan under this subdivision, 70.14 the participant must receive the assistance of a person trained 70.15 in domestic violence to help resolve the disagreement or 70.16 noncompliance with the county or job counselor. If the person 70.17 trained in domestic violence recommends that the activities are 70.18 still appropriate, the county or a job counselor must approve 70.19 the activities in the plan or provide written reasons why 70.20 activities in the plan are not approved and document how denial 70.21 of the activities do not endanger the safety of the participant 70.22 or children. 70.23 Subd. 4. [SELF-EMPLOYMENT.] (a) Self-employment activities 70.24 may be included in an employment plan contingent on the 70.25 development of a business plan which establishes a timetable and 70.26 earning goals that will result in the participant exiting MFIP 70.27 assistance. Business plans must be developed with assistance 70.28 from an individual or organization with expertise in small 70.29 business as approved by the job counselor. 70.30 (b) Participants with an approved plan that includes 70.31 self-employment must meet the participation requirements in 70.32 section 256J.55, subdivision 1. Only hours where the 70.33 participant earns at least minimum wage shall be counted toward 70.34 the requirement. Additional activities and hours necessary to 70.35 meet the participation requirements in section 256J.55, 70.36 subdivision 1, must be included in the employment plan. 71.1 (c) Employment plans which include self-employment 71.2 activities must be reviewed every three months. Participants 71.3 who fail, without good cause, to make satisfactory progress as 71.4 established in the business plan must revise the employment plan 71.5 to replace the self-employment with other approved work 71.6 activities. 71.7 (d) The requirements of this subdivision may be waived for 71.8 participants who are enrolled in the self-employment investment 71.9 demonstration program (SEID) under section 256J.65, and who make 71.10 satisfactory progress as determined by the job counselor and the 71.11 SEID provider. 71.12 Subd. 5. [TRANSITION FROM THE DIVERSIONARY WORK 71.13 PROGRAM.] Participants who become eligible for MFIP assistance 71.14 after completing the diversionary work program under section 71.15 256J.95 must comply with all requirements of subdivisions 1 and 71.16 2. Participants who become eligible for MFIP assistance after 71.17 being determined unable to benefit from the diversionary work 71.18 program must comply with the requirements of subdivisions 1 and 71.19 2, with the exception of subdivision 2, paragraph (b). 71.20 Subd. 6. [LOSS OF EMPLOYMENT.] Participants who are laid 71.21 off, quit with good cause, or are terminated from employment 71.22 through no fault of their own must meet with the job counselor 71.23 within ten working days to ascertain the reason for the job loss 71.24 and to revise the employment plan as necessary to address the 71.25 problem. 71.26 Sec. 78. Minnesota Statutes 2002, section 256J.53, 71.27 subdivision 1, is amended to read: 71.28 Subdivision 1. [LENGTH OF PROGRAM.] (a) In order for a 71.29 post-secondary education or training program to be an approved 71.30 work activity as defined in section 256J.49, subdivision 13, 71.31 clause(18)(6), it must be a program lasting2412 months or 71.32 less, and the participant must meet the requirements of 71.33 subdivisions 2and, 3, and 5. 71.34 (b) The 12 months of allowable postsecondary education or 71.35 training may be used to complete the final 12 months of a longer 71.36 program, provided the program does not exceed the undergraduate 72.1 level. 72.2 (c) All course work must be completed within 18 months of 72.3 enrollment in the program. 72.4 Sec. 79. Minnesota Statutes 2002, section 256J.53, 72.5 subdivision 2, is amended to read: 72.6 Subd. 2. [DOCUMENTATION SUPPORTING PROGRAMAPPROVAL OF 72.7 POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 72.8 post-secondary education or training program to be an approved 72.9 activity ina participant'san employment plan, the participant 72.10or the employment and training service providermustprovide72.11documentation that:be working in unsubsidized employment at 72.12 least 25 hours per week. 72.13 (b) Participants seeking approval of a postsecondary 72.14 education or training plan must provide documentation that: 72.15 (1) theparticipant'semploymentplan identifies specific72.16goals thatgoal can only be met with the additional education or 72.17 training; 72.18 (2) there are suitable employment opportunities that 72.19 require the specific education or training in the area in which 72.20 the participant resides or is willing to reside; 72.21 (3) the education or training will result in significantly 72.22 higher wages for the participant than the participant could earn 72.23 without the education or training; 72.24 (4) the participant can meet the requirements for admission 72.25 into the program; and 72.26 (5) there is a reasonable expectation that the participant 72.27 will complete the training program based on such factors as the 72.28 participant's MFIP assessment, previous education, training, and 72.29 work history; current motivation; and changes in previous 72.30 circumstances. 72.31 (c) The hourly unsubsidized employment requirement may be 72.32 reduced for intensive education or training programs lasting 12 72.33 weeks or less when full-time attendance is required. 72.34 (d) Participants with an approved employment plan in place 72.35 on July 1, 2003, which includes more than 12 months of 72.36 postsecondary education or training shall be allowed to complete 73.1 that plan provided that participation requirements in section 73.2 256J.55, subdivision 1, and conditions specified in paragraph 73.3 (b), and subdivisions 3 and 5 are met. 73.4 Sec. 80. Minnesota Statutes 2002, section 256J.53, 73.5 subdivision 5, is amended to read: 73.6 Subd. 5. [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY73.7 REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.]If a73.8participant's employment plan includes a post-secondary73.9educational or training program, the plan must include an73.10anticipated completion date for those activities. At the time73.11the education or training is completed, the participant must73.12participate in job search. If, after three months of job73.13search, the participant does not find a job that is consistent73.14with the participant's employment goal, the participant must73.15accept any offer of suitable employment.Upon completion of an 73.16 approved education or training program, a participant who does 73.17 not meet the participation requirements in section 256J.55, 73.18 subdivision 1, through unsubsidized employment must participate 73.19 in job search. If, after six weeks of job search, the 73.20 participant does not find a full-time job consistent with the 73.21 employment goal, the participant must accept any offer of 73.22 full-time suitable employment, or meet with the job counselor to 73.23 revise the employment plan to include additional work activities 73.24 necessary to meet hourly requirements. 73.25 Sec. 81. [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 73.26 LANGUAGE.] 73.27 Subdivision 1. [APPROVAL OF ADULT BASIC EDUCATION.] With 73.28 the exception of classes related to obtaining a general 73.29 equivalency development credential, a participant must have 73.30 reading or mathematics proficiency below a ninth grade level in 73.31 order for adult basic education classes to be an approved work 73.32 activity. The employment plan must also specify that the 73.33 participant fulfill no more than one-half of the participation 73.34 requirements in section 256J.55, subdivision 1, through 73.35 attending adult basic education or general education development 73.36 classes. 74.1 Subd. 2. [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 74.2 order for English as a second language (ESL) classes to be an 74.3 approved work activity in an employment plan, a participant must 74.4 be below a spoken language proficiency level of SPL6 or its 74.5 equivalent, as measured by a nationally recognized test. In 74.6 approving ESL as a work activity, the job counselor must give 74.7 preference to enrollment in a functional work literacy program, 74.8 if one is available, over a regular ESL program. A participant 74.9 may not be approved for more than a combined total of 24 months 74.10 of ESL classes while participating in the diversionary work 74.11 program and the employment and training services component of 74.12 MFIP. The employment plan must also specify that the 74.13 participant fulfill no more than one-half of the participation 74.14 requirements in section 256J.55, subdivision 1, through 74.15 attending ESL classes. 74.16 Sec. 82. Minnesota Statutes 2002, section 256J.54, 74.17 subdivision 1, is amended to read: 74.18 Subdivision 1. [ASSESSMENT OF EDUCATIONAL PROGRESS AND 74.19 NEEDS.] (a) The county agency must document the educational 74.20 level of each MFIP caregiver who is under the age of 20 and 74.21 determine if the caregiver has obtained a high school diploma or 74.22 its equivalent. If the caregiver has not obtained a high school 74.23 diploma or its equivalent,and is not exempt from the74.24requirement to attend school under subdivision 5,the county 74.25 agency must complete an individual assessment for the 74.26 caregiver unless the caregiver is exempt from the requirement to 74.27 attend school under subdivision 5 or has chosen to have an 74.28 employment plan under section 256J.521, subdivision 2, as 74.29 allowed in paragraph (b). The assessment must be performed as 74.30 soon as possible but within 30 days of determining MFIP 74.31 eligibility for the caregiver. The assessment must provide an 74.32 initial examination of the caregiver's educational progress and 74.33 needs, literacy level, child care and supportive service needs, 74.34 family circumstances, skills, and work experience. In the case 74.35 of a caregiver under the age of 18, the assessment must also 74.36 consider the results of either the caregiver's or the 75.1 caregiver's minor child's child and teen checkup under Minnesota 75.2 Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 75.3 and the effect of a child's development and educational needs on 75.4 the caregiver's ability to participate in the program. The 75.5 county agency must advise the caregiver that the caregiver's 75.6 first goal must be to complete an appropriateeducational75.7 education option if one is identified for the caregiver through 75.8 the assessment and, in consultation with educational agencies, 75.9 must review the various school completion options with the 75.10 caregiver and assist in selecting the most appropriate option. 75.11 (b) The county agency must give a caregiver, who is age 18 75.12 or 19 and has not obtained a high school diploma or its 75.13 equivalent, the option to choose an employment plan with an 75.14 education option under subdivision 3 or an employment plan under 75.15 section 256J.521, subdivision 2. 75.16 Sec. 83. Minnesota Statutes 2002, section 256J.54, 75.17 subdivision 2, is amended to read: 75.18 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 75.19 PLAN.] For caregivers who are under age 18 without a high school 75.20 diploma or its equivalent, the assessment under subdivision 1 75.21 and the employment plan under subdivision 3 must be completed by 75.22 the social services agency under section 257.33. For caregivers 75.23 who are age 18 or 19 without a high school diploma or its 75.24 equivalent who choose to have an employment plan with an 75.25 education option under subdivision 3, the assessment under 75.26 subdivision 1 and the employment plan under subdivision 3 must 75.27 be completed by the job counselor or, at county option, by the 75.28 social services agency under section 257.33. Upon reaching age 75.29 18 or 19 a caregiver who received social services under section 75.30 257.33 and is without a high school diploma or its equivalent 75.31 has the option to choose whether to continue receiving services 75.32 under the caregiver's plan from the social services agency or to 75.33 utilize an MFIP employment and training service provider. The 75.34 social services agency or the job counselor shall consult with 75.35 representatives of educational agencies that are required to 75.36 assist in developing educational plans under section 124D.331. 76.1 Sec. 84. Minnesota Statutes 2002, section 256J.54, 76.2 subdivision 3, is amended to read: 76.3 Subd. 3. [EDUCATIONALEDUCATION OPTION DEVELOPED.] If the 76.4 job counselor or county social services agency identifies an 76.5 appropriateeducationaleducation option for a minor caregiver 76.6under the age of 20without a high school diploma or its 76.7 equivalent, or a caregiver age 18 or 19 without a high school 76.8 diploma or its equivalent who chooses an employment plan with an 76.9 education option, the job counselor or agency must develop an 76.10 employment plan which reflects the identified option. The plan 76.11 must specify that participation in an educational activity is 76.12 required, what school or educational program is most 76.13 appropriate, the services that will be provided, the activities 76.14 the caregiver will take part in, including child care and 76.15 supportive services, the consequences to the caregiver for 76.16 failing to participate or comply with the specified 76.17 requirements, and the right to appeal any adverse action. The 76.18 employment plan must, to the extent possible, reflect the 76.19 preferences of the caregiver. 76.20 Sec. 85. Minnesota Statutes 2002, section 256J.54, 76.21 subdivision 5, is amended to read: 76.22 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 76.23 the provisions of section 256J.56, minor parents, or 18- or 76.24 19-year-old parents without a high school diploma or its 76.25 equivalent who chooses an employment plan with an education 76.26 option must attend school unless: 76.27 (1) transportation services needed to enable the caregiver 76.28 to attend school are not available; 76.29 (2) appropriate child care services needed to enable the 76.30 caregiver to attend school are not available; 76.31 (3) the caregiver is ill or incapacitated seriously enough 76.32 to prevent attendance at school; or 76.33 (4) the caregiver is needed in the home because of the 76.34 illness or incapacity of another member of the household. This 76.35 includes a caregiver of a child who is younger than six weeks of 76.36 age. 77.1 (b) The caregiver must be enrolled in a secondary school 77.2 and meeting the school's attendance requirements. The county, 77.3 social service agency, or job counselor must verify at least 77.4 once per quarter that the caregiver is meeting the school's 77.5 attendance requirements. An enrolled caregiver is considered to 77.6 be meeting the attendance requirements when the school is not in 77.7 regular session, including during holiday and summer breaks. 77.8 Sec. 86. [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 77.9 (a) In order to qualify for a family violence waiver, an 77.10 individual must provide documentation of past or current family 77.11 violence which may prevent the individual from participating in 77.12 certain employment activities. A claim of family violence must 77.13 be documented by the applicant or participant providing a sworn 77.14 statement which is supported by collateral documentation. 77.15 (b) Collateral documentation may consist of: 77.16 (1) police, government agency, or court records; 77.17 (2) a statement from a battered women's shelter staff with 77.18 knowledge of the circumstances or credible evidence that 77.19 supports the sworn statement; 77.20 (3) a statement from a sexual assault or domestic violence 77.21 advocate with knowledge of the circumstances or credible 77.22 evidence that supports the sworn statement; 77.23 (4) a statement from professionals from whom the applicant 77.24 or recipient has sought assistance for the abuse; or 77.25 (5) a sworn statement from any other individual with 77.26 knowledge of circumstances or credible evidence that supports 77.27 the sworn statement. 77.28 Sec. 87. Minnesota Statutes 2002, section 256J.55, 77.29 subdivision 1, is amended to read: 77.30 Subdivision 1. [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT77.31PLAN; SUITABLE EMPLOYMENTPARTICIPATION REQUIREMENTS.](a) Each77.32MFIP participant must comply with the terms of the participant's77.33job search support plan or employment plan. When the77.34participant has completed the steps listed in the employment77.35plan, the participant must comply with section 256J.53,77.36subdivision 5, if applicable, and then the participant must not78.1refuse any offer of suitable employment. The participant may78.2choose to accept an offer of suitable employment before the78.3participant has completed the steps of the employment plan.78.4(b) For a participant under the age of 20 who is without a78.5high school diploma or general educational development diploma,78.6the requirement to comply with the terms of the employment plan78.7means the participant must meet the requirements of section78.8256J.54.78.9(c) Failure to develop or comply with a job search support78.10plan or an employment plan, or quitting suitable employment78.11without good cause, shall result in the imposition of a sanction78.12as specified in sections 256J.46 and 256J.57.78.13 (a) All caregivers must participate in employment services 78.14 under sections 256J.515 to 256J.57 concurrent with receipt of 78.15 MFIP assistance. 78.16 (b) Until July 1, 2004, participants who meet the 78.17 requirements of section 256J.56 are exempt from participation 78.18 requirements. 78.19 (c) Participants under paragraph (a) must develop and 78.20 comply with an employment plan under section 256J.521, or 78.21 section 256J.54 in the case of a participant under the age of 20 78.22 who has not obtained a high school diploma or its equivalent. 78.23 (d) With the exception of participants under the age of 20 78.24 who must meet the education requirements of section 256J.54, all 78.25 participants must meet the hourly participation requirements of 78.26 TANF or the hourly requirements listed in clauses (1) to (3), 78.27 whichever is higher. 78.28 (1) In single-parent families with no children under six 78.29 years of age, the job counselor and the caregiver must develop 78.30 an employment plan that includes 30 to 35 hours per week of work 78.31 activities. 78.32 (2) In single-parent families with a child under six years 78.33 of age, the job counselor and the caregiver must develop an 78.34 employment plan that includes 20 to 35 hours per week of work 78.35 activities. 78.36 (3) In two-parent families, the job counselor and the 79.1 caregivers must develop employment plans which result in a 79.2 combined total of at least 55 hours per week of work activities. 79.3 (e) Failure to participate in employment services, 79.4 including the requirement to develop and comply with an 79.5 employment plan, including hourly requirements, without good 79.6 cause under section 256J.57, shall result in the imposition of a 79.7 sanction under section 256J.46. 79.8 Sec. 88. Minnesota Statutes 2002, section 256J.55, 79.9 subdivision 2, is amended to read: 79.10 Subd. 2. [DUTY TO REPORT.] The participant must inform the 79.11 job counselor withinthreeten working days regarding any 79.12 changes related to the participant's employment status. 79.13 Sec. 89. Minnesota Statutes 2002, section 256J.56, is 79.14 amended to read: 79.15 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 79.16 EXEMPTIONS.] 79.17 (a) An MFIP participant is exempt from the requirements of 79.18 sections256J.52256J.515 to256J.55256J.57 if the participant 79.19 belongs to any of the following groups: 79.20 (1) participants who are age 60 or older; 79.21 (2) participants who are suffering from aprofessionally79.22certifiedpermanent or temporary illness, injury, or incapacity 79.23 which has been certified by a qualified professional when the 79.24 illness, injury, or incapacity is expected to continue for more 79.25 than 30 days andwhichprevents the person from obtaining or 79.26 retaining employment. Persons in this category with a temporary 79.27 illness, injury, or incapacity must be reevaluated at least 79.28 quarterly; 79.29 (3) participants whose presence in the home is required as 79.30 a caregiver because ofa professionally certifiedthe illness or 79.31 incapacity of another member in the assistance unit, a relative 79.32 in the household, or a foster child in the householdandwhen 79.33 the illness or incapacity and the need for the participant's 79.34 presence in the home has been certified by a qualified 79.35 professional and is expected to continue for more than 30 days; 79.36 (4) women who are pregnant, if the pregnancy has resulted 80.1 ina professionally certifiedan incapacity that prevents the 80.2 woman from obtaining or retaining employment, and the incapacity 80.3 has been certified by a qualified professional; 80.4 (5) caregivers of a child under the age of one year who 80.5 personally provide full-time care for the child. This exemption 80.6 may be used for only 12 months in a lifetime. In two-parent 80.7 households, only one parent or other relative may qualify for 80.8 this exemption; 80.9 (6) participants experiencing a personal or family crisis 80.10 that makes them incapable of participating in the program, as 80.11 determined by the county agency. If the participant does not 80.12 agree with the county agency's determination, the participant 80.13 may seekprofessionalcertification from a qualified 80.14 professional, as defined in section 256J.08, that the 80.15 participant is incapable of participating in the program. 80.16 Persons in this exemption category must be reevaluated 80.17 every 60 days. A personal or family crisis related to family 80.18 violence, as determined by the county or a job counselor with 80.19 the assistance of a person trained in domestic violence, should 80.20 not result in an exemption, but should be addressed through the 80.21 development or revision of analternativeemployment plan under 80.22 section256J.52256J.521, subdivision63; or 80.23 (7) caregivers with a child or an adult in the household 80.24 who meets the disability or medical criteria for home care 80.25 services under section 256B.0627, subdivision 1, 80.26 paragraph(c)(f), or a home and community-based waiver services 80.27 program under chapter 256B, or meets the criteria for severe 80.28 emotional disturbance under section 245.4871, subdivision 6, or 80.29 for serious and persistent mental illness under section 245.462, 80.30 subdivision 20, paragraph (c). Caregivers in this exemption 80.31 category are presumed to be prevented from obtaining or 80.32 retaining employment. 80.33 A caregiver who is exempt under clause (5) must enroll in 80.34 and attend an early childhood and family education class, a 80.35 parenting class, or some similar activity, if available, during 80.36 the period of time the caregiver is exempt under this section. 81.1 Notwithstanding section 256J.46, failure to attend the required 81.2 activity shall not result in the imposition of a sanction. 81.3 (b) The county agency must provide employment and training 81.4 services to MFIP participants who are exempt under this section, 81.5 but who volunteer to participate. Exempt volunteers may request 81.6 approval for any work activity under section 256J.49, 81.7 subdivision 13. The hourly participation requirements for 81.8 nonexempt participants under section256J.50256J.55, 81.9 subdivision51, do not apply to exempt participants who 81.10 volunteer to participate. 81.11 (c) This section expires on June 30, 2004. 81.12 Sec. 90. [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 81.13 Subdivision 1. [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 81.14 REQUIREMENTS.] (a) All caregivers whose applications were 81.15 received July 1, 2004, or after, are immediately subject to the 81.16 requirements in subdivision 2. 81.17 (b) For all MFIP participants who were exempt from 81.18 participating in employment services under section 256J.56 as of 81.19 June 30, 2004, between July 1, 2004, and June 30, 2005, the 81.20 county, as part of the participant's recertification under 81.21 section 256J.32, subdivision 6, shall determine whether a new 81.22 employment plan is required to meet the requirements in 81.23 subdivision 2. Counties shall notify each participant who is in 81.24 need of an employment plan that the participant must meet with a 81.25 job counselor within ten days to develop an employment plan. 81.26 Until a participant's employment plan is developed, the 81.27 participant shall be considered in compliance with the 81.28 participation requirements in this section if the participant 81.29 continues to meet the criteria for an exemption under section 81.30 256J.56 as in effect on June 30, 2004, and is cooperating in the 81.31 development of the new plan. 81.32 Subd. 2. [PARTICIPATION REQUIREMENTS.] (a) All MFIP 81.33 caregivers, except caregivers who meet the criteria in 81.34 subdivision 3, must participate in employment services. Except 81.35 as specified in paragraphs (b) to (d), the employment plan must 81.36 meet the requirements of section 256J.521, subdivision 2, 82.1 contain allowable work activities, as defined in section 82.2 256J.49, subdivision 13, and, include at a minimum, the number 82.3 of participation hours required under section 256J.55, 82.4 subdivision 1. 82.5 (b) Minor caregivers and caregivers who are less than age 82.6 20 who have not completed high school or obtained a GED are 82.7 required to comply with section 256J.54. 82.8 (c) A participant who has a family violence waiver shall 82.9 develop and comply with an employment plan under section 82.10 256J.521, subdivision 3. 82.11 (d) As specified in section 256J.521, subdivision 2, 82.12 paragraph (c), a participant who meets any one of the following 82.13 criteria may work with the job counselor to develop an 82.14 employment plan that contains less than the number of 82.15 participation hours under section 256J.55, subdivision 1. 82.16 Employment plans for participants covered under this paragraph 82.17 must be tailored to recognize the special circumstances of 82.18 caregivers and families including limitations due to illness or 82.19 disability and caregiving needs: 82.20 (1) a participant who is age 60 or older; 82.21 (2) a participant who has been diagnosed by a qualified 82.22 professional as suffering from an illness or incapacity that is 82.23 expected to last for 30 days or more, including a pregnant 82.24 participant who is determined to be unable to obtain or retain 82.25 employment due to the pregnancy; or 82.26 (3) a participant who is determined by a qualified 82.27 professional as being needed in the home to care for an ill or 82.28 incapacitated family member, including caregivers with a child 82.29 or an adult in the household who meets the disability or medical 82.30 criteria for home care services under section 256B.0627, 82.31 subdivision 1, paragraph (f), or a home and community-based 82.32 waiver services program under chapter 256B, or meets the 82.33 criteria for severe emotional disturbance under section 82.34 245.4871, subdivision 6, or for serious and persistent mental 82.35 illness under section 245.462, subdivision 20, paragraph (c). 82.36 (e) For participants covered under paragraphs (c) and (d), 83.1 the county shall review the participant's employment services 83.2 status every three months to determine whether conditions have 83.3 changed. When it is determined that the participant's status is 83.4 no longer covered under paragraph (c) or (d), the county shall 83.5 notify the participant that a new or revised employment plan is 83.6 needed. The participant and job counselor shall meet within ten 83.7 days of the determination to revise the employment plan. 83.8 Subd. 3. [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 83.9 who has a natural born child who is less than 12 weeks of age 83.10 who meets the criteria in clauses (1) and (2) is not required to 83.11 participate in employment services until the child reaches 12 83.12 weeks of age. To be eligible for this provision, the following 83.13 conditions must be met: 83.14 (1) the child must have been born within ten months of the 83.15 caregiver's application for the diversionary work program or 83.16 MFIP; and 83.17 (2) the assistance unit must not have already used this 83.18 provision or the previously allowed child under age one 83.19 exemption. However, an assistance unit that has an approved 83.20 child under age one exemption at the time this provision becomes 83.21 effective may continue to use that exemption until the child 83.22 reaches one year of age. 83.23 (b) The provision in paragraph (a) ends the first full 83.24 month after the child reaches 12 weeks of age. This provision 83.25 is available only once in a caregiver's lifetime. In a 83.26 two-parent household, only one parent shall be allowed to use 83.27 this provision. The participant and job counselor must meet 83.28 within ten days after the child reaches 12 weeks of age to 83.29 revise the participant's employment plan. 83.30 [EFFECTIVE DATE.] This section is effective July 1, 2004. 83.31 Sec. 91. Minnesota Statutes 2002, section 256J.57, is 83.32 amended to read: 83.33 256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 83.34 CONCILIATION CONFERENCE.] 83.35 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 83.36 county agency shall not impose the sanction under section 84.1 256J.46 if it determines that the participant has good cause for 84.2 failing to comply with the requirements of sections256J.5284.3 256J.515 to256J.55256J.57. Good cause exists when: 84.4 (1) appropriate child care is not available; 84.5 (2) the job does not meet the definition of suitable 84.6 employment; 84.7 (3) the participant is ill or injured; 84.8 (4) a member of the assistance unit, a relative in the 84.9 household, or a foster child in the household is ill and needs 84.10 care by the participant that prevents the participant from 84.11 complying with thejob search support plan oremployment plan; 84.12 (5) the parental caregiver is unable to secure necessary 84.13 transportation; 84.14 (6) the parental caregiver is in an emergency situation 84.15 that prevents compliance with thejob search support plan or84.16 employment plan; 84.17 (7) the schedule of compliance with thejob search support84.18plan oremployment plan conflicts with judicial proceedings; 84.19 (8) a mandatory MFIP meeting is scheduled during a time 84.20 that conflicts with a judicial proceeding or a meeting related 84.21 to a juvenile court matter, or a participant's work schedule; 84.22 (9) the parental caregiver is already participating in 84.23 acceptable work activities; 84.24 (10) the employment plan requires an educational program 84.25 for a caregiver under age 20, but the educational program is not 84.26 available; 84.27 (11) activities identified in thejob search support plan84.28oremployment plan are not available; 84.29 (12) the parental caregiver is willing to accept suitable 84.30 employment, but suitable employment is not available; or 84.31 (13) the parental caregiver documents other verifiable 84.32 impediments to compliance with thejob search support plan or84.33 employment plan beyond the parental caregiver's control. 84.34 The job counselor shall work with the participant to 84.35 reschedule mandatory meetings for individuals who fall under 84.36 clauses (1), (3), (4), (5), (6), (7), and (8). 85.1 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 85.2 participant fails without good cause to comply with the 85.3 requirements of sections256J.52256J.515 to256J.55256J.57, 85.4 the job counselor or the county agency must provide a notice of 85.5 intent to sanction to the participant specifying the program 85.6 requirements that were not complied with, informing the 85.7 participant that the county agency will impose the sanctions 85.8 specified in section 256J.46, and informing the participant of 85.9 the opportunity to request a conciliation conference as 85.10 specified in paragraph (b). The notice must also state that the 85.11 participant's continuing noncompliance with the specified 85.12 requirements will result in additional sanctions under section 85.13 256J.46, without the need for additional notices or conciliation 85.14 conferences under this subdivision. The notice, written in 85.15 English, must include the department of human services language 85.16 block, and must be sent to every applicable participant. If the 85.17 participant does not request a conciliation conference within 85.18 ten calendar days of the mailing of the notice of intent to 85.19 sanction, the job counselor must notify the county agency that 85.20 the assistance payment should be reduced. The county must then 85.21 send a notice of adverse action to the participant informing the 85.22 participant of the sanction that will be imposed, the reasons 85.23 for the sanction, the effective date of the sanction, and the 85.24 participant's right to have a fair hearing under section 256J.40. 85.25 (b) The participant may request a conciliation conference 85.26 by sending a written request, by making a telephone request, or 85.27 by making an in-person request. The request must be received 85.28 within ten calendar days of the date the county agency mailed 85.29 the ten-day notice of intent to sanction. If a timely request 85.30 for a conciliation is received, the county agency's service 85.31 provider must conduct the conference within five days of the 85.32 request. The job counselor's supervisor, or a designee of the 85.33 supervisor, must review the outcome of the conciliation 85.34 conference. If the conciliation conference resolves the 85.35 noncompliance, the job counselor must promptly inform the county 85.36 agency and request withdrawal of the sanction notice. 86.1 (c) Upon receiving a sanction notice, the participant may 86.2 request a fair hearing under section 256J.40, without exercising 86.3 the option of a conciliation conference. In such cases, the 86.4 county agency shall not require the participant to engage in a 86.5 conciliation conference prior to the fair hearing. 86.6 (d) If the participant requests a fair hearing or a 86.7 conciliation conference, sanctions will not be imposed until 86.8 there is a determination of noncompliance. Sanctions must be 86.9 imposed as provided in section 256J.46. 86.10 Sec. 92. Minnesota Statutes 2002, section 256J.62, 86.11 subdivision 9, is amended to read: 86.12 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] Only if 86.13 services were approved as part of an employment plan prior to 86.14 June 30, 2003, at the request of the participant, the county may 86.15 continue to provide case management, counseling, or other 86.16 support services to a participant: 86.17(a)(1) who has achieved the employment goal; or 86.18(b)(2) who under section 256J.42 is no longer eligible to 86.19 receive MFIP but whose income is below 115 percent of the 86.20 federal poverty guidelines for a family of the same size. 86.21 These services may be provided for up to 12 months 86.22 following termination of the participant's eligibility for MFIP. 86.23 Sec. 93. [256J.626] [MFIP CONSOLIDATED FUND.] 86.24 Subdivision 1. [CONSOLIDATED FUND.] The consolidated fund 86.25 is established to support counties and tribes in meeting their 86.26 duties under this chapter. Counties and tribes must use funds 86.27 from the consolidated fund to develop programs and services that 86.28 are designed to improve participant outcomes as measured in 86.29 section 256J.751, subdivision 2. Counties may use the funds for 86.30 any allowable expenditures under subdivision 2. Tribes may use 86.31 the funds for any allowable expenditures under subdivision 2, 86.32 except those in clauses (1) and (6). 86.33 Subd. 2. [ALLOWABLE EXPENDITURES.] (a) The commissioner 86.34 must restrict expenditures under the consolidated fund to 86.35 benefits and services allowed under title IV-A of the federal 86.36 Social Security Act. Allowable expenditures under the 87.1 consolidated fund may include, but are not limited to: 87.2 (1) short-term, nonrecurring shelter and utility needs that 87.3 are excluded from the definition of assistance under Code of 87.4 Federal Regulations, title 45, section 260.31, for families who 87.5 meet the residency requirement in section 256J.12, subdivisions 87.6 1 and 1a. Payments under this subdivision are not considered 87.7 TANF cash assistance and are not counted towards the 60-month 87.8 time limit; 87.9 (2) transportation needed to obtain or retain employment or 87.10 to participate in other approved work activities; 87.11 (3) direct and administrative costs of staff to deliver 87.12 employment services for MFIP or the diversionary work program, 87.13 to administer financial assistance, and to provide specialized 87.14 services intended to assist hard-to-employ participants to 87.15 transition to work; 87.16 (4) costs of education and training including functional 87.17 work literacy and English as a second language; 87.18 (5) cost of work supports including tools, clothing, boots, 87.19 and other work-related expenses; 87.20 (6) county administrative expenses as defined in Code of 87.21 Federal Regulations, title 45, section 260(b); 87.22 (7) services to parenting and pregnant teens; 87.23 (8) supported work; 87.24 (9) wage subsidies; 87.25 (10) child care needed for MFIP or diversionary work 87.26 program participants to participate in social services; 87.27 (11) child care to ensure that families leaving MFIP or 87.28 diversionary work program will continue to receive child care 87.29 assistance from the time the family no longer qualifies for 87.30 transition year child care until an opening occurs under the 87.31 basic sliding fee child care program; and 87.32 (12) services to help noncustodial parents of minor 87.33 children receiving MFIP or DWP assistance who live in Minnesota, 87.34 but do not live in the same household as the child, obtain or 87.35 retain employment. 87.36 (b) Administrative costs that are not matched with county 88.1 funds as provided in subdivision 8 may not exceed 7.5 percent of 88.2 a county's or 15 percent of a tribe's reimbursement under this 88.3 section. The commissioner shall define administrative costs for 88.4 purposes of this subdivision. 88.5 Subd. 3. [ELIGIBILITY FOR SERVICES.] Families with a minor 88.6 child, as defined in section 256J.08, or a noncustodial parent 88.7 of a minor child receiving assistance, with incomes below 200 88.8 percent of the federal poverty guideline for a family of the 88.9 applicable size, are eligible for services funded under the 88.10 consolidated fund. Counties and tribes must give priority to 88.11 families currently receiving MFIP or diversionary work program, 88.12 and families at risk of receiving MFIP or diversionary work 88.13 program. 88.14 Subd. 4. [COUNTY AND TRIBAL BIENNIAL SERVICE 88.15 AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 88.16 period thereafter, each county and tribe must have in place an 88.17 approved biennial service agreement related to the services and 88.18 programs in this chapter. Counties may collaborate to develop 88.19 multicounty, multitribal, or regional service agreements. 88.20 (b) The service agreements will be completed in a form 88.21 prescribed by the commissioner. The agreement must include: 88.22 (1) a statement of the needs of the service population and 88.23 strengths and resources in the community; 88.24 (2) numerical goals for participant outcomes measures to be 88.25 accomplished during the biennial period. The commissioner may 88.26 identify outcomes from section 256J.751, subdivision 2, as core 88.27 outcomes for all counties and tribes; 88.28 (3) strategies the county or tribe will pursue to achieve 88.29 the outcome targets. Strategies must include specification of 88.30 how funds under this section will be used and may include 88.31 community partnerships that will be established or strengthened; 88.32 and 88.33 (4) other items prescribed by the commissioner in 88.34 consultation with counties and tribes. 88.35 (c) The commissioner shall provide each county and tribe 88.36 with information needed to complete an agreement, including: 89.1 (1) information on MFIP cases in the county or tribe; (2) 89.2 comparisons with the rest of the state; (3) baseline performance 89.3 on outcome measures; and (4) promising program practices. 89.4 (d) The service agreement must be submitted to the 89.5 commissioner by October 15, 2003, and October 15 of each second 89.6 year thereafter. The county or tribe must allow a period of not 89.7 less than 30 days prior to the submission of the agreement to 89.8 solicit comments from the public on the contents of the 89.9 agreement. 89.10 (e) The commissioner must, within 60 days of receiving each 89.11 county or tribal service agreement, inform the county or tribe 89.12 if the service agreement is approved. If the service agreement 89.13 is not approved, the commissioner must inform the county or 89.14 tribe of any revisions needed prior to approval. 89.15 (f) The service agreement in this subdivision supersedes 89.16 the plan requirements of section 268.88. 89.17 Subd. 5. [INNOVATION PROJECTS.] Beginning January 1, 2005, 89.18 no more than $3,000,000 of the funds annually appropriated to 89.19 the commissioner for use in the consolidated fund shall be 89.20 available to the commissioner for projects testing innovative 89.21 approaches to improving outcomes for MFIP participants, and 89.22 persons at risk of receiving MFIP as detailed in subdivision 3. 89.23 Projects shall be targeted to geographic areas with poor 89.24 outcomes as specified in section 256J.751, subdivision 5, or to 89.25 subgroups within the MFIP case load who are experiencing poor 89.26 outcomes. 89.27 Subd. 6. [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 89.28 purposes of this section, the following terms have the meanings 89.29 given them: 89.30 (1) "2002 historic spending base" means the commissioner's 89.31 determination of the sum of the reimbursement related to fiscal 89.32 year 2002 of county or tribal agency expenditures for the base 89.33 programs listed in clause (4), items (i) to (iv), and earnings 89.34 related to calendar year 2002 in the base program listed in 89.35 clause (4), item (v), and the amount of spending in fiscal year 89.36 2002 in the base program listed in clause (4), item (vi), issued 90.1 to or on behalf of persons residing in the county or tribal 90.2 service delivery area. 90.3 (2) "Initial allocation" means the amount potentially 90.4 available to each county or tribe based on the formula in 90.5 paragraphs (b) to (d). 90.6 (3) "Final allocation" means the amount available to each 90.7 county or tribe based on the formula in paragraphs (b) to (d), 90.8 after adjustment by subdivision 7. 90.9 (4) "Base programs" means the: 90.10 (i) MFIP employment and training services under section 90.11 256J.62, subdivision 1, in effect June 30, 2002; 90.12 (ii) bilingual employment and training services to refugees 90.13 under section 256J.62, subdivision 6, in effect June 30, 2002; 90.14 (iii) work literacy language programs under section 90.15 256J.62, subdivision 7, in effect June 30, 2002; 90.16 (iv) supported work program authorized in Laws 2001, First 90.17 Special Session chapter 9, article 17, section 2, in effect June 90.18 30, 2002; 90.19 (v) administrative aid program under section 256J.76 in 90.20 effect December 31, 2002; and 90.21 (vi) emergency assistance program under section 256J.48 in 90.22 effect June 30, 2002. 90.23 (b)(1) Beginning July 1, 2003, the commissioner shall 90.24 determine the initial allocation of funds available under this 90.25 section according to clause (2). 90.26 (2)(i) Ninety percent of the funds available for the period 90.27 beginning July 1, 2003, and ending December 31, 2004, shall be 90.28 allocated to each county or tribe in proportion to the county's 90.29 or tribe's share of the statewide 2002 historic spending base; 90.30 (ii) the remaining funds for the period beginning July 1, 90.31 2003, and ending December 31, 2004, shall be allocated to each 90.32 county or tribe in proportion to the average number of MFIP 90.33 cases: 90.34 (A) the average number of cases must be based upon counts 90.35 of MFIP or tribal TANF cases as of March 31, June 30, September 90.36 30, and December 31 using the most recent available data, less 91.1 the number of child only cases. Two-parent cases, with the 91.2 exception of those with a caregiver age 60 or over, will be 91.3 multiplied by a factor of two; 91.4 (B) the MFIP or tribal TANF case count for each eligible 91.5 tribal provider shall be based upon the number of MFIP or tribal 91.6 TANF cases with participating adults who are enrolled in, or are 91.7 eligible for enrollment in, the tribe; and to be counted, the 91.8 case must be an active MFIP case, and the case members must 91.9 reside within the tribal program's service delivery area; and 91.10 (C) to prevent duplicate counts, MFIP or tribal TANF cases 91.11 counted for determining allocations to tribal providers shall be 91.12 removed from the case counts of the respective counties where 91.13 they reside. 91.14 (c)(1) Beginning January 1, 2005, the commissioner shall 91.15 determine the initial allocation of funds to be made available 91.16 under this section according to clause (2). 91.17 (2)(i) Seventy percent of the funds available for the 91.18 calendar year shall be allocated to each county or tribe in 91.19 proportion to the county's or tribe's share of the statewide 91.20 2002 historic spending base; 91.21 (ii) the remaining funds shall be allocated to each county 91.22 or tribe in proportion to the sum of the average number of MFIP 91.23 cases and the average monthly count of diversionary work program 91.24 cases. The commissioner shall determine the count of MFIP and 91.25 diversionary work program cases according to subitems (A) to (C): 91.26 (A) the average number of cases must be based upon counts 91.27 of MFIP, tribal TANF, or diversionary work program cases as of 91.28 March 31, June 30, September 30, and December 31 using the most 91.29 recent available data, less the number of child only cases. 91.30 Two-parent cases, with the exception of those with a caregiver 91.31 age 60 or over, will be multiplied by a factor of two; 91.32 (B) the case count for each eligible tribal provider shall 91.33 be based upon the number of MFIP, tribal TANF, or diversionary 91.34 work program cases with participating adults who are enrolled 91.35 in, or are eligible for enrollment in, the tribe; and to be 91.36 counted, the case must be an active MFIP or diversionary work 92.1 program case, and the case members must reside within the tribal 92.2 program's service delivery area; and 92.3 (C) to prevent duplicate counts, MFIP, tribal TANF, or 92.4 diversionary work program cases counted for determining 92.5 allocations to tribal providers shall be removed from the case 92.6 counts of the respective counties where they reside. 92.7 (d)(1) Beginning January 1, 2006, and effective January 1 92.8 of each subsequent year, the commissioner shall determine the 92.9 initial allocation of funds available under this section 92.10 according to clause (2). 92.11 (2)(i) Fifty percent of the funds available for the 92.12 calendar year shall be allocated to each county or tribe in 92.13 proportion to the county's or tribe's share of the statewide 92.14 2002 historic spending base; 92.15 (ii) the remaining funds shall be allocated to each county 92.16 or tribe in proportion to the sum of the average number of MFIP 92.17 cases and the average monthly count of diversionary work program 92.18 cases. The commissioner shall determine the count of MFIP and 92.19 diversionary work program cases according to subitems (A) to (C): 92.20 (A) the average number of cases must be based upon counts 92.21 of MFIP, tribal TANF, or diversionary work program cases as of 92.22 March 31, June 30, September 30, and December 31 using the most 92.23 recent available data, less the number of child only cases. 92.24 Two-parent cases, with the exception of those with a caregiver 92.25 age 60 or over, will be multiplied by a factor of two; 92.26 (B) the case count for each eligible tribal provider shall 92.27 be based upon the number of MFIP, tribal TANF, or diversionary 92.28 work program cases with participating adults who are enrolled 92.29 in, or are eligible for, enrollment in the tribe; and to be 92.30 counted, the case must be an active MFIP or diversionary work 92.31 program case, and the case members must reside within the tribal 92.32 program's service delivery area; and 92.33 (C) to prevent duplicate counts, MFIP, tribal TANF, or 92.34 diversionary work program cases counted for determining 92.35 allocations to tribal providers shall be removed from the case 92.36 counts of the respective counties where they reside. 93.1 (e) Before November 30, 2003, a county or tribe may ask for 93.2 a review of the commissioner's determination of the historic 93.3 base spending when the county or tribe believes the 2002 93.4 information was inaccurate or incomplete. By January 1, 2004, 93.5 the commissioner must adjust that county's or tribe's base when 93.6 the commissioner has determined that inaccurate or incomplete 93.7 information was used to develop that base. The commissioner 93.8 shall adjust each county's or tribe's initial allocation under 93.9 paragraph (c) and final allocation under subdivision 7 to 93.10 reflect the base change. 93.11 (f) Effective January 1, 2005, and effective January 1 of 93.12 each succeeding year, counties and tribes will have their final 93.13 allocations adjusted based on the performance provisions of 93.14 subdivision 7. 93.15 Subd. 7. [PERFORMANCE BASE FUNDS.] (a) Beginning with 93.16 allocations for calendar year 2005, each county and tribe will 93.17 be allocated 95 percent of their initial allocation. Counties 93.18 and tribes will be allocated additional funds based on 93.19 performance as follows: 93.20 (1) a county or tribe that achieves a 50 percent rate or 93.21 higher on the MFIP participation rate under section 256J.751, 93.22 subdivision 2, clause (8), as averaged across the four quarterly 93.23 measurements in the preceding year, will receive an additional 93.24 allocation equal to 2.5 percent of its initial allocation; and 93.25 (2) a county or tribe that performs above the top of its 93.26 range of expected performance on the three-year self-support 93.27 index under section 256J.751, subdivision 2, clause (7), in both 93.28 measurements in the preceding year will receive an additional 93.29 allocation equal to five percent of its initial allocation; or 93.30 (3) a county or tribe that performs within its range of 93.31 expected performance on the three-year self-support index under 93.32 section 256J.751, subdivision 2, clause (7), in both 93.33 measurements in the preceding year, or above the top of its 93.34 range of expected performance in one measurement and within its 93.35 expected range of performance in the other measurement, will 93.36 receive an additional allocation equal to 2.5 percent of its 94.1 initial allocation. 94.2 (b) Funds remaining unallocated after the performance-based 94.3 allocations in paragraph (a) are available to the commissioner 94.4 for innovation projects under subdivision 5. 94.5 (c)(1) If available funds are insufficient to meet county 94.6 and tribal allocations under paragraph (a), the commissioner may 94.7 make available for allocation funds that are unobligated and 94.8 available from the innovation projects through the end of the 94.9 current biennium. 94.10 (2) If after the application of clause (1) funds remain 94.11 insufficient to meet county and tribal allocations under 94.12 paragraph (a), the commissioner must proportionally reduce the 94.13 allocation of each county and tribe with respect to their 94.14 maximum allocation available under paragraph (a). 94.15 Subd. 8. [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 94.16 The commissioner shall specify requirements for reporting 94.17 according to section 256.01, subdivision 2, clause (17). Each 94.18 county or tribe shall be reimbursed for eligible expenditures up 94.19 to the limit of its allocation and subject to availability of 94.20 funds. 94.21 (b) Reimbursements for county administrative-related 94.22 expenditures determined through the income maintenance random 94.23 moment time study shall be reimbursed at a rate of 50 percent of 94.24 eligible expenditures. 94.25 (c) The commissioner of human services shall review county 94.26 and tribal agency expenditures of the MFIP consolidated fund as 94.27 appropriate and may reallocate unencumbered or unexpended money 94.28 appropriated under this section to those county and tribal 94.29 agencies that can demonstrate a need for additional money. 94.30 Subd. 9. [REPORT.] By January 1, 2004, the commissioner 94.31 shall, in consultation with counties and tribes: 94.32 (1) determine how performance-based allocations under 94.33 subdivision 7, paragraph (a), clauses (2) and (3), will be 94.34 allocated to groupings of counties and tribes when groupings are 94.35 used to measure expected performance ranges for the self-support 94.36 index under section 256J.751, subdivision 2, clause (7); and 95.1 (2) determine how performance-based allocations under 95.2 subdivision 7, paragraph (a), clauses (2) and (3), will be 95.3 allocated to tribes. 95.4 Sec. 94. Minnesota Statutes 2002, section 256J.645, 95.5 subdivision 3, is amended to read: 95.6 Subd. 3. [FUNDING.] If the commissioner and an Indian 95.7 tribe are parties to an agreement under this subdivision, the 95.8 agreement shall annually provide to the Indian tribe the funding 95.9 allocated in section256J.62, subdivisions 1 and 2a256J.626. 95.10 Sec. 95. Minnesota Statutes 2002, section 256J.66, 95.11 subdivision 2, is amended to read: 95.12 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 95.13 shall limit the length of training based on the complexity of 95.14 the job and the caregiver's previous experience and training. 95.15 Placement in an on-the-job training position with an employer is 95.16 for the purpose of training and employment with the same 95.17 employer who has agreed to retain the person upon satisfactory 95.18 completion of training. 95.19 (b) Placement of any participant in an on-the-job training 95.20 position must be compatible with the participant's assessment 95.21 and employment plan under section256J.52256J.521. 95.22 Sec. 96. Minnesota Statutes 2002, section 256J.67, 95.23 subdivision 1, is amended to read: 95.24 Subdivision 1. [ESTABLISHING THE COMMUNITY WORK EXPERIENCE 95.25 PROGRAM.] To the extent of available resources, each county 95.26 agency may establish and operate a work experience component for 95.27 MFIP caregivers who are participating in employment and training 95.28 services. This option for county agencies supersedes the 95.29 requirement in section 402(a)(1)(B)(iv) of the Social Security 95.30 Act that caregivers who have received assistance for two months 95.31 and who are not exempt from work requirements must participate 95.32 in a work experience program. The purpose of the work 95.33 experience component is to enhance the caregiver's employability 95.34 and self-sufficiency and to provide meaningful, productive work 95.35 activities. The county shall use this program for an individual 95.36 after exhausting all other unsubsidized employment 96.1 opportunities.The county agency shall not require a caregiver96.2to participate in the community work experience program unless96.3the caregiver has been given an opportunity to participate in96.4other work activities.96.5 Sec. 97. Minnesota Statutes 2002, section 256J.67, 96.6 subdivision 3, is amended to read: 96.7 Subd. 3. [EMPLOYMENT OPTIONS.] (a) Work sites developed 96.8 under this section are limited to projects that serve a useful 96.9 public service such as: health, social service, environmental 96.10 protection, education, urban and rural development and 96.11 redevelopment, welfare, recreation, public facilities, public 96.12 safety, community service, services to aged or disabled 96.13 citizens, and child care. To the extent possible, the prior 96.14 training, skills, and experience of a caregiver must be 96.15 considered in making appropriate work experience assignments. 96.16 (b) Structured, supervised volunteer work with an agency or 96.17 organization, which is monitored by the county service provider, 96.18 may, with the approval of the county agency, be used as a work 96.19 experience placement. 96.20 (c) As a condition of placing a caregiver in a program 96.21 under this section, the county agency shall first provide the 96.22 caregiver the opportunity:96.23(1)for placement in suitablesubsidized orunsubsidized 96.24 employment through participation in a job search; or96.25(2) for placement in suitable employment through96.26participation in on-the-job training, if such employment is96.27available. 96.28 Sec. 98. Minnesota Statutes 2002, section 256J.69, 96.29 subdivision 2, is amended to read: 96.30 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 96.31 shall limit the length of training to nine months. Placement in 96.32 a grant diversion training position with an employer is for the 96.33 purpose of training and employment with the same employer who 96.34 has agreed to retain the person upon satisfactory completion of 96.35 training. 96.36 (b) Placement of any participant in a grant diversion 97.1 subsidized training position must be compatible with the 97.2 assessment and employment plan or employability development plan 97.3 established for the recipient under section256J.52 or 256K.03,97.4subdivision 8256J.521. 97.5 Sec. 99. Minnesota Statutes 2002, section 256J.75, 97.6 subdivision 3, is amended to read: 97.7 Subd. 3. [RESPONSIBILITY FOR INCORRECT ASSISTANCE 97.8 PAYMENTS.] A county of residence, when different from the county 97.9 of financial responsibility, will be charged by the commissioner 97.10 for the value of incorrect assistance paymentsand medical97.11assistancepaid to or on behalf of a person who was not eligible 97.12 to receive that amount. Incorrect payments include payments to 97.13 an ineligible person or family resulting from decisions, 97.14 failures to act, miscalculations, or overdue recertification. 97.15 However, financial responsibility does not accrue for a county 97.16 when the recertification is overdue at the time the referral is 97.17 received by the county of residence or when the county of 97.18 financial responsibility does not act on the recommendation of 97.19 the county of residence.When federal or state law requires97.20that medical assistance continue after assistance ends, this97.21subdivision also governs financial responsibility for the97.22extended medical assistance.97.23 Sec. 100. Minnesota Statutes 2002, section 256J.751, 97.24 subdivision 1, is amended to read: 97.25 Subdivision 1. [QUARTERLYMONTHLY COUNTY CASELOAD REPORT.] 97.26 The commissioner shall reportquarterlymonthly to each county 97.27onthecounty's performance on the following measuresfollowing 97.28 caseload information: 97.29(1) number of cases receiving only the food portion of97.30assistance;97.31(2) number of child-only cases;97.32(3) number of minor caregivers;97.33(4) number of cases that are exempt from the 60-month time97.34limit by the exemption category under section 256J.42;97.35(5) number of participants who are exempt from employment97.36and training services requirements by the exemption category98.1under section 256J.56;98.2(6) number of assistance units receiving assistance under a98.3hardship extension under section 256J.425;98.4(7) number of participants and number of months spent in98.5each level of sanction under section 256J.46, subdivision 1;98.6(8) number of MFIP cases that have left assistance;98.7(9) federal participation requirements as specified in98.8title 1 of Public Law Number 104-193;98.9(10) median placement wage rate; and98.10(11) of each county's total MFIP caseload less the number98.11of cases in clauses (1) to (6):98.12(i) number of one-parent cases;98.13(ii) number of two-parent cases;98.14(iii) percent of one-parent cases that are working more98.15than 20 hours per week;98.16(iv) percent of two-parent cases that are working more than98.1720 hours per week; and98.18(v) percent of cases that have received more than 36 months98.19of assistance.98.20 (1) total number of cases receiving MFIP, and subtotals of 98.21 cases with one eligible parent, two eligible parents, and an 98.22 eligible caregiver who is not a parent; 98.23 (2) total number of child only assistance cases; 98.24 (3) total number of eligible adults and children receiving 98.25 an MFIP grant, and subtotals for cases with one eligible parent, 98.26 two eligible parents, an eligible caregiver who is not a parent, 98.27 and child only cases; 98.28 (4) number of cases with an exemption from the 60-month 98.29 time limit based on a family violence waiver; 98.30 (5) number of MFIP cases with work hours, and subtotals for 98.31 cases with one eligible parent, two eligible parents, and an 98.32 eligible caregiver who is not a parent; 98.33 (6) number of employed MFIP cases, and subtotals for cases 98.34 with one eligible parent, two eligible parents, and an eligible 98.35 caregiver who is not a parent; 98.36 (7) average monthly gross earnings, and averages for 99.1 subgroups of cases with one eligible parent, two eligible 99.2 parents, and an eligible caregiver who is not a parent; 99.3 (8) number of employed cases receiving only the food 99.4 portion of assistance; 99.5 (9) number of parents or caregivers exempt from work 99.6 activity requirements, with subtotals for each exemption type; 99.7 and 99.8 (10) number of cases with a sanction, with subtotals by 99.9 level of sanction for cases with one eligible parent, two 99.10 eligible parents, and an eligible caregiver who is not a parent. 99.11 Sec. 101. Minnesota Statutes 2002, section 256J.751, 99.12 subdivision 2, is amended to read: 99.13 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 99.14 shall report quarterly to all counties on each county's 99.15 performance on the following measures: 99.16 (1) percent of MFIP caseload working in paid employment; 99.17 (2) percent of MFIP caseload receiving only the food 99.18 portion of assistance; 99.19 (3) number of MFIP cases that have left assistance; 99.20 (4) federal participation requirements as specified in 99.21 Title 1 of Public LawNumber104-193; 99.22 (5) median placement wage rate;and99.23 (6) caseload by months of TANF assistance; 99.24 (7) percent of MFIP cases off cash assistance or working 30 99.25 or more hours per week at one-year, two-year, and three-year 99.26 follow-up points from a base line quarter. This measure is 99.27 called the self-support index. Twice annually, the commissioner 99.28 shall report an expected range of performance for each county, 99.29 county grouping, and tribe on the self-support index. The 99.30 expected range shall be derived by a statistical methodology 99.31 developed by the commissioner in consultation with the counties 99.32 and tribes. The statistical methodology shall control 99.33 differences across counties in economic conditions and 99.34 demographics of the MFIP case load; and 99.35 (8) the MFIP work participation rate, defined as the 99.36 participation requirements specified in title 1 of Public Law 100.1 104-193 applied to all MFIP cases. 100.2 Sec. 102. Minnesota Statutes 2002, section 256J.751, 100.3 subdivision 5, is amended to read: 100.4 Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 100.5 (a) If sanctions occur for failure to meet the performance 100.6 standards specified in title 1 of Public LawNumber104-193 of 100.7 the Personal Responsibility and Work Opportunity Act of 1996, 100.8 the state shall pay 88 percent of the sanction. The remaining 100.9 12 percent of the sanction will be paid by the counties. The 100.10 county portion of the sanction will be distributed across all 100.11 counties in proportion to each county's percentage of the MFIP 100.12 average monthly caseload during the period for which the 100.13 sanction was applied. 100.14 (b) If a county fails to meet the performance standards 100.15 specified in title 1 of Public LawNumber104-193 of the 100.16 Personal Responsibility and Work Opportunity Act of 1996 for any 100.17 year, the commissioner shall work with counties to organize a 100.18 joint state-county technical assistance team to work with the 100.19 county. The commissioner shall coordinate any technical 100.20 assistance with other departments and agencies including the 100.21 departments of economic security and children, families, and 100.22 learning as necessary to achieve the purpose of this paragraph. 100.23 (c) For state performance measures, a low-performing county 100.24 is one that: 100.25 (1) performs below the bottom of their expected range for 100.26 the measure in subdivision 2, clause (7), in both measurements 100.27 during the year; or 100.28 (2) performs below 40 percent for the measure in 100.29 subdivision 2, clause (8), as averaged across the four quarterly 100.30 measurements for the year, or the ten counties with the lowest 100.31 rates if more than ten are below 40 percent. 100.32 (d) Low-performing counties under paragraph (c) must engage 100.33 in corrective action planning as defined by the commissioner. 100.34 The commissioner may coordinate technical assistance as 100.35 specified in paragraph (b) for low-performing counties under 100.36 paragraph (c). 101.1 Sec. 103. [256J.95] [DIVERSIONARY WORK PROGRAM.] 101.2 Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM 101.3 (DWP).] (a) The Personal Responsibility and Work Opportunity 101.4 Reconciliation Act of 1996, Public Law 104-193, establishes 101.5 block grants to states for temporary assistance for needy 101.6 families (TANF). TANF provisions allow states to use TANF 101.7 dollars for nonrecurrent, short-term diversionary benefits. The 101.8 diversionary work program established on July 1, 2003, is 101.9 Minnesota's TANF program to provide short-term diversionary 101.10 benefits to eligible recipients of the diversionary work program. 101.11 (b) The goal of the diversionary work program is to provide 101.12 short-term, necessary services and supports to families which 101.13 will lead to unsubsidized employment, increase economic 101.14 stability, and reduce the risk of those families needing longer 101.15 term assistance, under the Minnesota family investment program 101.16 (MFIP). 101.17 (c) When a family unit meets the eligibility criteria in 101.18 this section, the family must receive a diversionary work 101.19 program grant and is not eligible for MFIP. 101.20 (d) A family unit is eligible for the diversionary work 101.21 program for a maximum of four months only once in a 12-month 101.22 period. The 12-month period begins at the date of application 101.23 or the date eligibility is met, whichever is later. During the 101.24 four-month period, family maintenance needs as defined in 101.25 subdivision 2, shall be vendor paid, up to the cash portion of 101.26 the MFIP standard of need for the same size household. To the 101.27 extent there is a balance available between the amount paid for 101.28 family maintenance needs and the cash portion of the 101.29 transitional standard, a personal needs allowance of up to $70 101.30 per DWP recipient in the family unit shall be issued. The 101.31 personal needs allowance payment plus the family maintenance 101.32 needs shall not exceed the cash portion of the MFIP standard of 101.33 need. Counties may provide supportive and other allowable 101.34 services funded by the MFIP consolidated fund under section 101.35 256J.626 to eligible participants during the four-month 101.36 diversionary period. 102.1 Subd. 2. [DEFINITIONS.] The terms used in this section 102.2 have the following meanings. 102.3 (a) "Diversionary Work Program (DWP)" means the program 102.4 established under this section. 102.5 (b) "Employment plan" means a plan developed by the job 102.6 counselor and the participant which identifies the participant's 102.7 most direct path to unsubsidized employment, lists the specific 102.8 steps that the caregiver will take on that path, and includes a 102.9 timetable for the completion of each step. For participants who 102.10 request and qualify for a family violence waiver in section 102.11 256J.521, subdivision 3, an employment plan must be developed by 102.12 the job counselor, the participant and a person trained in 102.13 domestic violence and follow the employment plan provisions in 102.14 section 256J.521, subdivision 3. Employment plans under this 102.15 section shall be written for a period of time not to exceed four 102.16 months. 102.17 (c) "Employment services" means programs, activities, and 102.18 services in this section that are designed to assist 102.19 participants in obtaining and retaining employment. 102.20 (d) "Family maintenance needs" means current housing costs 102.21 including rent, manufactured home lot rental costs, or monthly 102.22 principal, interest, insurance premiums, and property taxes due 102.23 for mortgages or contracts for deed, association fees required 102.24 for homeownership, utility costs for current month expenses of 102.25 gas and electric, garbage, water and sewer, and a flat rate of 102.26 $35 for a telephone. 102.27 (e) "Family unit" means a group of people applying for or 102.28 receiving DWP benefits together. For the purposes of 102.29 determining eligibility for this program, the unit includes the 102.30 relationships in section 256J.08, subdivision 34. 102.31 (f) "Minnesota family investment program (MFIP)" means the 102.32 assistance program as defined in section 256J.08, subdivision 57. 102.33 (g) "Personal needs allowance" means an allowance of up to 102.34 $70 per month per DWP unit member to pay for expenses such as 102.35 household products and personal products. 102.36 (h) "Work activities" means allowable work activities as 103.1 defined in section 256J.49, subdivision 13. 103.2 Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 103.3 Except for the categories of family units listed below, all 103.4 family units who apply for cash benefits and who meet MFIP 103.5 eligibility as required in section 256J.10, are eligible and 103.6 must participate in the diversionary work program. Family units 103.7 that are not eligible for the diversionary work program include: 103.8 (1) child only cases; 103.9 (2) a single-parent family unit that includes a child under 103.10 12 weeks of age. A parent is eligible for this exception once 103.11 in a parent's lifetime and is not eligible if the parent has 103.12 already used the previously allowed child under age one 103.13 exemption from MFIP employment services; 103.14 (3) a minor parent without a high school diploma or its 103.15 equivalent; 103.16 (4) a caregiver 18 or 19 years of age without a high school 103.17 diploma or its equivalent who chooses to have an employment plan 103.18 with an education option; 103.19 (5) a caregiver age 60 or over; 103.20 (6) family units with a parent who received DWP benefits 103.21 within a 12-month period as defined in subdivision 1, paragraph 103.22 (d); and 103.23 (7) family units with a parent who received MFIP within the 103.24 past 12 months. 103.25 (b) A two-parent family must participate in DWP unless both 103.26 parents meet the criteria for an exception under paragraph (a), 103.27 clauses (1) through (5), or the family unit includes a parent 103.28 who meets the criteria in paragraph (a), clause (6) or (7). 103.29 Subd. 4. [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 103.30 be eligible for DWP, an applicant must comply with the 103.31 requirements of paragraphs (b) to (d). 103.32 (b) Applicants and participants must cooperate with the 103.33 requirements of the child support enforcement program, but will 103.34 not be charged a fee under section 518.551, subdivision 7. 103.35 (c) The applicant must provide each member of the family 103.36 unit's social security number to the county agency. This 104.1 requirement is satisfied when each member of the family unit 104.2 cooperates with the procedures for verification of numbers, 104.3 issuance of duplicate cards, and issuance of new numbers which 104.4 have been established jointly between the Social Security 104.5 Administration and the commissioner. 104.6 (d) Before DWP benefits can be issued to a family unit, the 104.7 caregiver must, in conjunction with a job counselor, develop and 104.8 sign an employment plan. In two-parent family units, both 104.9 parents must develop and sign employment plans before benefits 104.10 can be issued. Food support and health care benefits are not 104.11 contingent on the requirement for a signed employment plan. 104.12 Subd. 5. [SUBMITTING APPLICATION FORM.] The eligibility 104.13 date for the diversionary work program begins with the date the 104.14 signed combined application form (CAF) is received by the county 104.15 agency or the date diversionary work program eligibility 104.16 criteria are met, whichever is later. The county agency must 104.17 inform the applicant that any delay in submitting the 104.18 application will reduce the benefits paid for the month of 104.19 application. The county agency must inform a person that an 104.20 application may be submitted before the person has an interview 104.21 appointment. Upon receipt of a signed application, the county 104.22 agency must stamp the date of receipt on the face of the 104.23 application. The applicant may withdraw the application at any 104.24 time prior to approval by giving written or oral notice to the 104.25 county agency. The county agency must follow the notice 104.26 requirements in section 256J.09, subdivision 3, when issuing a 104.27 notice confirming the withdrawal. 104.28 Subd. 6. [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 104.29 of the application, the county agency must determine if the 104.30 applicant may be eligible for other benefits as required in 104.31 sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 104.32 and 5. The county must also follow the provisions in section 104.33 256J.09, subdivision 3b, clause (2). 104.34 Subd. 7. [PROGRAM AND PROCESSING STANDARDS.] (a) The 104.35 interview to determine financial eligibility for the 104.36 diversionary work program must be conducted within five working 105.1 days of the receipt of the cash application form. During the 105.2 intake interview the financial worker must discuss: 105.3 (1) the goals, requirements, and services of the 105.4 diversionary work program; 105.5 (2) the availability of child care assistance. If child 105.6 care is needed, the worker must obtain a completed application 105.7 for child care from the applicant before the interview is 105.8 terminated. The same day the application for child care is 105.9 received, the application must be forwarded to the appropriate 105.10 child care worker. For purposes of eligibility for child care 105.11 assistance under chapter 119B, DWP participants shall be 105.12 eligible for the same benefits as MFIP recipients; and 105.13 (3) if the applicant has not requested food support and 105.14 health care assistance on the application, the county agency 105.15 shall, during the interview process, talk with the applicant 105.16 about the availability of these benefits. 105.17 (b) The county shall follow section 256J.74, subdivision 2, 105.18 paragraph (b), clauses (1) and (2), when an applicant or a 105.19 recipient of DWP has a person who is a member of more than one 105.20 assistance unit in a given payment month. 105.21 (c) If within 30 days the county agency cannot determine 105.22 eligibility for the diversionary work program, the county must 105.23 deny the application and inform the applicant of the decision 105.24 according to the notice provisions in section 256J.31. A family 105.25 unit is eligible for a fair hearing under section 256J.40. 105.26 Subd. 8. [VERIFICATION REQUIREMENTS.] (a) A county agency 105.27 must only require verification of information necessary to 105.28 determine DWP eligibility and the amount of the payment. The 105.29 applicant or participant must document the information required 105.30 or authorize the county agency to verify the information. The 105.31 applicant or participant has the burden of providing documentary 105.32 evidence to verify eligibility. The county agency shall assist 105.33 the applicant or participant in obtaining required documents 105.34 when the applicant or participant is unable to do so. 105.35 (b) A county agency must not request information about an 105.36 applicant or participant that is not a matter of public record 106.1 from a source other than county agencies, the department of 106.2 human services, or the United States Department of Health and 106.3 Human Services without the person's prior written consent. An 106.4 applicant's signature on an application form constitutes consent 106.5 for contact with the sources specified on the application. A 106.6 county agency may use a single consent form to contact a group 106.7 of similar sources, but the sources to be contacted must be 106.8 identified by the county agency prior to requesting an 106.9 applicant's consent. 106.10 (c) Factors to be verified shall follow section 256J.32, 106.11 subdivision 4. Except for personal needs, family maintenance 106.12 needs must be verified before the expense can be allowed in the 106.13 calculation of the DWP grant. 106.14 Subd. 9. [PROPERTY AND INCOME LIMITATIONS.] The asset 106.15 limits and exclusions in section 256J.20, apply to applicants 106.16 and recipients of DWP. All payments, unless excluded in section 106.17 256J.21, must be counted as income to determine eligibility for 106.18 the diversionary work program. The county shall treat income as 106.19 outlined in section 256J.37, except for subdivision 3a. The 106.20 initial income test and the disregards in section 256J.21, 106.21 subdivision 3, shall be followed for determining eligibility for 106.22 the diversionary work program. 106.23 Subd. 10. [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 106.24 amount of cash benefits that a family unit is eligible for under 106.25 the diversionary work program is based on the number of persons 106.26 in the family unit, the family maintenance needs, personal needs 106.27 allowance, and countable income. The county agency shall 106.28 evaluate the income of the family unit that is requesting 106.29 payments under the diversionary work program. Countable income 106.30 means gross earned and unearned income not excluded or 106.31 disregarded under MFIP. The same disregards for earned income 106.32 that are allowed under MFIP are allowed for the diversionary 106.33 work program. 106.34 (b) The DWP grant is based on the family maintenance needs 106.35 for which the DWP family unit is responsible plus a personal 106.36 needs allowance. Housing and utilities shall be vendor paid. 107.1 Unless otherwise stated in this section, actual housing and 107.2 utility expenses shall be used when determining the amount of 107.3 the DWP grant. 107.4 (c) The maximum monthly benefit amount available under the 107.5 diversionary work program is the difference between the family 107.6 unit's family maintenance needs under paragraph (b) and the 107.7 family unit's countable income not to exceed the cash portion of 107.8 the MFIP standard of need as defined in section 256J.08, 107.9 subdivision 55a, for the family unit's size. The family wage 107.10 level as defined in section 256J.08, subdivision 35, shall be 107.11 used when determining the amount of countable income for working 107.12 members. 107.13 (d) Once the county has determined a grant amount, the DWP 107.14 grant amount will not be decreased if the determination is based 107.15 on the best information available at the time of approval and 107.16 shall not be decreased because of any additional income to the 107.17 family unit. The grant can be increased if a participant later 107.18 verifies an increase in family maintenance needs or family unit 107.19 size. The minimum cash benefit amount, if income and asset 107.20 tests are met, is $10. Benefits of $10 shall not be vendor paid. 107.21 (e) When all criteria are met, including the development of 107.22 an employment plan as described in subdivision 14 and 107.23 eligibility exists for the month of application, the amount of 107.24 benefits for the diversionary work program retroactive to the 107.25 date of application is as specified in section 256J.35, 107.26 paragraph (a). 107.27 (f) Any month during the four-month DWP period that a 107.28 person receives a DWP benefit directly or through a vendor 107.29 payment made on the person's behalf, that person is ineligible 107.30 for MFIP or any other TANF cash program except for benefits 107.31 defined in section 256J.626, subdivision 2, clause (1). 107.32 If during the four-month period a family unit that receives 107.33 DWP benefits moves to a county that has not established a 107.34 diversionary work program, the family unit may be eligible for 107.35 MFIP the month following the last month of the issuance of the 107.36 DWP benefit. 108.1 Subd. 11. [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 108.2 caregivers, except caregivers who meet the criteria in paragraph 108.3 (d), are required to participate in DWP employment services. 108.4 Except as specified in paragraphs (b) and (c), employment plans 108.5 under DWP must, at a minimum, meet the requirements in section 108.6 256J.55, subdivision 1. 108.7 (b) A caregiver who is a member of a two-parent family that 108.8 is required to participate in DWP who would otherwise be 108.9 ineligible for DWP under subdivision 3 may be allowed to develop 108.10 an employment plan under section 256J.521, subdivision 2, 108.11 paragraph (c), that may contain alternate activities and reduced 108.12 hours. 108.13 (c) A participant who has a family violence waiver shall be 108.14 allowed to develop an employment plan under section 256J.521, 108.15 subdivision 3. 108.16 (d) One parent in a two-parent family unit that has a 108.17 natural born child under 12 weeks of age is not required to have 108.18 an employment plan until the child reaches 12 weeks of age 108.19 unless the family unit has already used the exclusion under 108.20 section 256J.561, subdivision 2, or the previously allowed child 108.21 under age one exemption under section 256J.56, paragraph (a), 108.22 clause (5). 108.23 (e) The provision in paragraph (d) ends the first full 108.24 month after the child reaches 12 weeks of age. This provision 108.25 is allowable only once in a caregiver's lifetime. In a 108.26 two-parent household, only one parent shall be allowed to use 108.27 this category. 108.28 (f) The participant and job counselor must meet within ten 108.29 working days after the child reaches 12 weeks of age to revise 108.30 the participant's employment plan. The employment plan for a 108.31 family unit that has a child under 12 weeks of age that has 108.32 already used the exclusion in section 256J.561 or the previously 108.33 allowed child under age one exemption under section 256J.56, 108.34 paragraph (a), clause (5), must be tailored to recognize the 108.35 caregiving needs of the parent. 108.36 Subd. 12. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 109.1 time during the DWP application process or during the four-month 109.2 DWP eligibility period, it is determined that a participant is 109.3 unlikely to benefit from the diversionary work program, the 109.4 county shall convert or refer the participant to MFIP as 109.5 specified in paragraph (d). Participants who are determined to 109.6 be unlikely to benefit from the diversionary work program must 109.7 develop and sign an employment plan. Participants are 109.8 determined to be unlikely to benefit from the DWP program for 109.9 any one of the reasons listed in paragraph (b), provided the 109.10 necessary documentation is available to support the 109.11 determination. 109.12 (b)(1) a participant who has been determined by a qualified 109.13 professional as being unable to obtain or retain employment due 109.14 to an illness, injury, or incapacity that is expected to last at 109.15 least 60 days; 109.16 (2) a participant who is determined by a qualified 109.17 professional as being needed in the home to care for a family 109.18 member due to an illness, injury, or incapacity that is expected 109.19 to last at least 60 days; 109.20 (3) a participant who is determined by a qualified 109.21 professional as being needed in the home to care for a child 109.22 meeting the special medical criteria in section 256J.425, 109.23 subdivision 2, clause (3); 109.24 (4) a pregnant participant who is determined by a qualified 109.25 professional as being unable to obtain or retain employment due 109.26 to the pregnancy; and 109.27 (5) a participant who has applied for SSI or RSDI. 109.28 (c) In a two-parent family unit, both parents must be 109.29 determined to be unlikely to benefit from the diversionary work 109.30 program before the family unit can be converted or referred to 109.31 MFIP. 109.32 (d) A participant who is determined to be unlikely to 109.33 benefit from the diversionary work program shall be converted to 109.34 MFIP and, if the determination was made within 30 days of the 109.35 initial application for benefits, a new combined application 109.36 form will not be required. A participant who is determined to 110.1 be unlikely to benefit from the diversionary work program shall 110.2 be referred to MFIP and, if the determination is made more than 110.3 30 days after the initial application, the participant must 110.4 submit a new combined application form. The county agency shall 110.5 process the combined application form by the first of the 110.6 following month to ensure that no gap in benefits is due to 110.7 delayed action by the county agency. 110.8 Subd. 13. [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 110.9 Within one working day of determination that the applicant is 110.10 eligible for the diversionary work program, but before benefits 110.11 are issued to or on behalf of the family unit, the county shall 110.12 refer all caregivers to employment services. The referral to 110.13 the DWP employment services must be in writing and must contain 110.14 the following information: 110.15 (1) notification that, as part of the application process, 110.16 applicants are required to develop an employment plan or the DWP 110.17 application will be denied; 110.18 (2) the employment services provider name and phone number; 110.19 (3) the date, time, and location of the scheduled 110.20 employment services interview; 110.21 (4) the immediate availability of supportive services, 110.22 including, but not limited to, child care, transportation, and 110.23 other work-related aid; and 110.24 (5) the rights, responsibilities, and obligations of 110.25 participants in the program, including, but not limited to, the 110.26 grounds for good cause, the consequences of refusing or failing 110.27 to participate fully with program requirements, and the appeal 110.28 process. 110.29 Subd. 14. [EMPLOYMENT PLAN; DWP BENEFITS.] Within five 110.30 working days of being notified that a participant is financially 110.31 eligible for the diversionary work program, the employment 110.32 services provider and participant shall meet to develop an 110.33 employment plan. Once the employment plan has been developed 110.34 and signed by the participant and the job counselor, the 110.35 employment services provider shall notify the county within one 110.36 working day that the employment plan has been signed. The 111.1 county shall issue DWP benefits within one working day after 111.2 receiving notice that the employment plan has been signed. 111.3 Subd. 15. [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 111.4 Except as specified in paragraphs (b) to (d), employment 111.5 activities listed in section 256J.49, subdivision 13, are 111.6 allowable under the diversionary work program. 111.7 (b) Work activities under section 256J.49, subdivision 13, 111.8 clause (5), shall be allowable only when in combination with 111.9 approved work activities under section 256J.49, subdivision 13, 111.10 clauses (1) to (4), and shall be limited to no more than 111.11 one-half of the hours required in the employment plan. 111.12 (c) In order for an English as a second language (ESL) 111.13 class to be an approved work activity, a participant must: 111.14 (1) be below a spoken language proficiency level of SPL6 or 111.15 its equivalent, as measured by a nationally recognized test; and 111.16 (2) not have been enrolled in ESL for more than 24 months 111.17 while previously participating in MFIP or DWP. A participant 111.18 who has been enrolled in ESL for 20 or more months may be 111.19 approved for ESL until the participant has received 24 total 111.20 months. 111.21 (d) Work activities under section 256J.49, subdivision 13, 111.22 clause (6), shall be allowable only when the training or 111.23 education program will be completed within the four-month DWP 111.24 period. Training or education programs that will not be 111.25 completed within the four-month DWP period shall not be approved. 111.26 Subd. 16. [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 111.27 unit that includes a participant who fails to comply with DWP 111.28 employment service or child support enforcement requirements, 111.29 without good cause as defined in sections 256.741 and 256J.57, 111.30 shall be disqualified from the diversionary work program. The 111.31 county shall provide written notice as specified in section 111.32 256J.31 to the participant prior to disqualifying the family 111.33 unit due to noncompliance with employment service or child 111.34 support. The disqualification does not apply to food support or 111.35 health care benefits. 111.36 Subd. 17. [GOOD CAUSE FOR NOT COMPLYING WITH 112.1 REQUIREMENTS.] A participant who fails to comply with the 112.2 requirements of the diversionary work program may claim good 112.3 cause for reasons listed in sections 256.741 and 256J.57, 112.4 subdivision 1, clauses (1) to (13). The county shall not impose 112.5 a disqualification if good cause exists. 112.6 Subd. 18. [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 112.7 participant who has been disqualified from the diversionary work 112.8 program due to noncompliance with employment services may regain 112.9 eligibility for the diversionary work program by complying with 112.10 program requirements. A participant who has been disqualified 112.11 from the diversionary work program due to noncooperation with 112.12 child support enforcement requirements may regain eligibility by 112.13 complying with child support requirements under section 112.14 256J.741. Once a participant has been reinstated, the county 112.15 shall issue prorated benefits for the remaining portion of the 112.16 month. A family unit that has been disqualified from the 112.17 diversionary work program due to noncompliance shall not be 112.18 eligible for MFIP or any other TANF cash program during the 112.19 period of time the participant remains noncompliant. In a 112.20 two-parent family, both parents must be in compliance before the 112.21 family unit can regain eligibility for benefits. 112.22 Subd. 19. [RECOVERY OF OVERPAYMENTS.] When an overpayment 112.23 or an ATM error is determined, the overpayment shall be recouped 112.24 or recovered as specified in section 256J.38. 112.25 Subd. 20. [IMPLEMENTATION OF DWP.] Counties may establish 112.26 a diversionary work program according to this section any time 112.27 on or after July 1, 2003. Prior to establishing a diversionary 112.28 work program, the county must notify the commissioner. All 112.29 counties must implement the provisions of this section no later 112.30 than July 1, 2004. 112.31 Sec. 104. Minnesota Statutes 2002, section 261.063, is 112.32 amended to read: 112.33 261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 112.34 PENALTY.] 112.35 (a) The board of county commissioners of each county shall 112.36 annually levy taxes and fix a rate sufficient to produce the 113.1 full amount required for poor relief, general assistance, 113.2 Minnesota family investment program, diversionary work program, 113.3 county share of county and state supplemental aid to 113.4 supplemental security income applicants or recipients, and any 113.5 other social security measures wherein there is now or may 113.6 hereafter be county participation, sufficient to produce the 113.7 full amount necessary for each such item, including 113.8 administrative expenses, for the ensuing year, within the time 113.9 fixed by law in addition to all other tax levies and tax rates, 113.10 however fixed or determined, and any commissioner who shall fail 113.11 to comply herewith shall be guilty of a gross misdemeanor and 113.12 shall be immediately removed from office by the governor. For 113.13 the purposes of this paragraph, "poor relief" means county 113.14 services provided under sections 261.035, 261.04,and 261.21 to 113.15 261.231. 113.16 (b) Nothing within the provisions of this section shall be 113.17 construed as requiring a county agency to provide income support 113.18 or cash assistance to needy persons when they are no longer 113.19 eligible for assistance under general assistance,the Minnesota113.20family investment programchapter 256J, or Minnesota 113.21 supplemental aid. 113.22 Sec. 105. Minnesota Statutes 2002, section 393.07, 113.23 subdivision 10, is amended to read: 113.24 Subd. 10. [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 113.25 CHILD NUTRITION ACT.] (a) The local social services agency shall 113.26 establish and administer the food stamp or support program 113.27 according to rules of the commissioner of human services, the 113.28 supervision of the commissioner as specified in section 256.01, 113.29 and all federal laws and regulations. The commissioner of human 113.30 services shall monitor food stamp or support program delivery on 113.31 an ongoing basis to ensure that each county complies with 113.32 federal laws and regulations. Program requirements to be 113.33 monitored include, but are not limited to, number of 113.34 applications, number of approvals, number of cases pending, 113.35 length of time required to process each application and deliver 113.36 benefits, number of applicants eligible for expedited issuance, 114.1 length of time required to process and deliver expedited 114.2 issuance, number of terminations and reasons for terminations, 114.3 client profiles by age, household composition and income level 114.4 and sources, and the use of phone certification and home 114.5 visits. The commissioner shall determine the county-by-county 114.6 and statewide participation rate. 114.7 (b) On July 1 of each year, the commissioner of human 114.8 services shall determine a statewide and county-by-county food 114.9 stamp program participation rate. The commissioner may 114.10 designate a different agency to administer the food stamp 114.11 program in a county if the agency administering the program 114.12 fails to increase the food stamp program participation rate 114.13 among families or eligible individuals, or comply with all 114.14 federal laws and regulations governing the food stamp program. 114.15 The commissioner shall review agency performance annually to 114.16 determine compliance with this paragraph. 114.17 (c) A person who commits any of the following acts has 114.18 violated section 256.98 or 609.821, or both, and is subject to 114.19 both the criminal and civil penalties provided under those 114.20 sections: 114.21 (1) obtains or attempts to obtain, or aids or abets any 114.22 person to obtain by means of a willful statement or 114.23 misrepresentation, or intentional concealment of a material 114.24 fact, food stamps or vouchers issued according to sections 114.25 145.891 to 145.897 to which the person is not entitled or in an 114.26 amount greater than that to which that person is entitled or 114.27 which specify nutritional supplements to which that person is 114.28 not entitled; or 114.29 (2) presents or causes to be presented, coupons or vouchers 114.30 issued according to sections 145.891 to 145.897 for payment or 114.31 redemption knowing them to have been received, transferred or 114.32 used in a manner contrary to existing state or federal law; or 114.33 (3) willfully uses, possesses, or transfers food stamp 114.34 coupons, authorization to purchase cards or vouchers issued 114.35 according to sections 145.891 to 145.897 in any manner contrary 114.36 to existing state or federal law, rules, or regulations; or 115.1 (4) buys or sells food stamp coupons, authorization to 115.2 purchase cards, other assistance transaction devices, vouchers 115.3 issued according to sections 145.891 to 145.897, or any food 115.4 obtained through the redemption of vouchers issued according to 115.5 sections 145.891 to 145.897 for cash or consideration other than 115.6 eligible food. 115.7 (d) A peace officer or welfare fraud investigator may 115.8 confiscate food stamps, authorization to purchase cards, or 115.9 other assistance transaction devices found in the possession of 115.10 any person who is neither a recipient of the food stamp program 115.11 nor otherwise authorized to possess and use such materials. 115.12 Confiscated property shall be disposed of as the commissioner 115.13 may direct and consistent with state and federal food stamp 115.14 law. The confiscated property must be retained for a period of 115.15 not less than 30 days to allow any affected person to appeal the 115.16 confiscation under section 256.045. 115.17 (e) Food stamp overpayment claims which are due in whole or 115.18 in part to client error shall be established by the county 115.19 agency for a period of six years from the date of any resultant 115.20 overpayment. 115.21 (f) With regard to the federal tax revenue offset program 115.22 only, recovery incentives authorized by the federal food and 115.23 consumer service shall be retained at the rate of 50 percent by 115.24 the state agency and 50 percent by the certifying county agency. 115.25 (g) A peace officer, welfare fraud investigator, federal 115.26 law enforcement official, or the commissioner of health may 115.27 confiscate vouchers found in the possession of any person who is 115.28 neither issued vouchers under sections 145.891 to 145.897, nor 115.29 otherwise authorized to possess and use such vouchers. 115.30 Confiscated property shall be disposed of as the commissioner of 115.31 health may direct and consistent with state and federal law. 115.32 The confiscated property must be retained for a period of not 115.33 less than 30 days. 115.34 (h) The commissioner of human services shall seek a waiver 115.35 from the United States Department of Agriculture to allow the 115.36 state to specify foods that may and may not be purchased in 116.1 Minnesota with benefits funded by the federal Food Stamp Program. 116.2 Sec. 106. Laws 1997, chapter 203, article 9, section 21, 116.3 as amended by Laws 1998, chapter 407, article 6, section 111, 116.4 Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 116.5 First Special Session chapter 9, article 10, section 62, is 116.6 amended to read: 116.7 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 116.8 (a) Effective on the date specified, the following persons 116.9 will be ineligible for general assistance and general assistance 116.10 medical care under Minnesota Statutes, chapter 256D, group 116.11 residential housing under Minnesota Statutes, chapter 256I, and 116.12 MFIP assistance under Minnesota Statutes, chapter 256J, funded 116.13 with state money: 116.14 (1) Beginning July 1, 2002, persons who are terminated from 116.15 or denied Supplemental Security Income due to the 1996 changes 116.16 in the federal law making persons whose alcohol or drug 116.17 addiction is a material factor contributing to the person's 116.18 disability ineligible for Supplemental Security Income, and are 116.19 eligible for general assistance under Minnesota Statutes, 116.20 section 256D.05, subdivision 1, paragraph (a), clause (15), 116.21 general assistance medical care under Minnesota Statutes, 116.22 chapter 256D, or group residential housing under Minnesota 116.23 Statutes, chapter 256I; and 116.24 (2) Beginning July 1, 2002, legal noncitizens who are 116.25 ineligible for Supplemental Security Income due to the 1996 116.26 changes in federal law making certain noncitizens ineligible for 116.27 these programs due to their noncitizen status; and. 116.28(3) Beginning July 1, 2003, legal noncitizens who are116.29eligible for MFIP assistance, either the cash assistance portion116.30or the food assistance portion, funded entirely with state money.116.31 (b) State money that remains unspent due to changes in 116.32 federal law enacted after May 12, 1997, that reduce state 116.33 spending for legal noncitizens or for persons whose alcohol or 116.34 drug addiction is a material factor contributing to the person's 116.35 disability, or enacted after February 1, 1998, that reduce state 116.36 spending for food benefits for legal noncitizens shall not 117.1 cancel and shall be deposited in the TANF reserve account. 117.2 Sec. 107. [REVISOR'S INSTRUCTION.] 117.3 (a) In the next publication of Minnesota Statutes, the 117.4 revisor of statutes shall codify section 104 of this act. 117.5 (b) Wherever "food stamp" or "food stamps" appears in 117.6 Minnesota Statutes and Rules, the revisor of statutes shall 117.7 insert "food support" or "or food support" except for instances 117.8 where federal code or federal law is referenced. 117.9 (c) For sections in Minnesota Statutes and Minnesota Rules 117.10 affected by the repealed sections in this article, the revisor 117.11 shall delete internal cross-references where appropriate and 117.12 make changes necessary to correct the punctuation, grammar, or 117.13 structure of the remaining text and preserve its meaning. 117.14 Sec. 108. [REPEALER.] 117.15 (a) Minnesota Statutes 2002, sections 256J.02, subdivision 117.16 3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 117.17 256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 117.18 subdivisions 1a, 6, and 7; 256J.49, subdivision 2; 256J.50, 117.19 subdivisions 2, 3, 3a, 5, and 7; 256J.52, subdivisions 1, 2, 3, 117.20 4, 5, 5a, 6, 7, 8, and 9; 256J.55, subdivision 5; 256J.62, 117.21 subdivisions 1, 2a, 3a, 4, 6, 7, and 8; 256J.625; 256J.655; 117.22 256J.74, subdivision 3; 256J.751, subdivisions 3 and 4; 256J.76; 117.23 and 256K.30, are repealed. 117.24 (b) Laws 2000, chapter 488, article 10, section 29, is 117.25 repealed. 117.26 ARTICLE 2 117.27 HEALTH CARE 117.28 Section 1. Minnesota Statutes 2002, section 16A.724, is 117.29 amended to read: 117.30 16A.724 [HEALTH CARE ACCESS FUND.] 117.31 A health care access fund is created in the state 117.32 treasury. The fund is a direct appropriated special revenue 117.33 fund. The commissioner shall deposit to the credit of the fund 117.34 money made available to the fund. Notwithstanding section 117.35 11A.20, after June 30, 1997, all investment income and all 117.36 investment losses attributable to the investment of the health 118.1 care access fund not currently needed shall be credited to the 118.2 health care access fund. The health care access fund shall 118.3 sunset on June 30, 2005, and all remaining funds shall be 118.4 deposited in the general fund. Beginning July 1, 2005, all 118.5 activities which would otherwise receive funding from the health 118.6 care access fund shall be funded out of the general fund. 118.7 Sec. 2. Minnesota Statutes 2002, section 256.01, 118.8 subdivision 2, is amended to read: 118.9 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 118.10 section 241.021, subdivision 2, the commissioner of human 118.11 services shall: 118.12 (1) Administer and supervise all forms of public assistance 118.13 provided for by state law and other welfare activities or 118.14 services as are vested in the commissioner. Administration and 118.15 supervision of human services activities or services includes, 118.16 but is not limited to, assuring timely and accurate distribution 118.17 of benefits, completeness of service, and quality program 118.18 management. In addition to administering and supervising human 118.19 services activities vested by law in the department, the 118.20 commissioner shall have the authority to: 118.21 (a) require county agency participation in training and 118.22 technical assistance programs to promote compliance with 118.23 statutes, rules, federal laws, regulations, and policies 118.24 governing human services; 118.25 (b) monitor, on an ongoing basis, the performance of county 118.26 agencies in the operation and administration of human services, 118.27 enforce compliance with statutes, rules, federal laws, 118.28 regulations, and policies governing welfare services and promote 118.29 excellence of administration and program operation; 118.30 (c) develop a quality control program or other monitoring 118.31 program to review county performance and accuracy of benefit 118.32 determinations; 118.33 (d) require county agencies to make an adjustment to the 118.34 public assistance benefits issued to any individual consistent 118.35 with federal law and regulation and state law and rule and to 118.36 issue or recover benefits as appropriate; 119.1 (e) delay or deny payment of all or part of the state and 119.2 federal share of benefits and administrative reimbursement 119.3 according to the procedures set forth in section 256.017; 119.4 (f) make contracts with and grants to public and private 119.5 agencies and organizations, both profit and nonprofit, and 119.6 individuals, using appropriated funds; and 119.7 (g) enter into contractual agreements with federally 119.8 recognized Indian tribes with a reservation in Minnesota to the 119.9 extent necessary for the tribe to operate a federally approved 119.10 family assistance program or any other program under the 119.11 supervision of the commissioner. The commissioner shall consult 119.12 with the affected county or counties in the contractual 119.13 agreement negotiations, if the county or counties wish to be 119.14 included, in order to avoid the duplication of county and tribal 119.15 assistance program services. The commissioner may establish 119.16 necessary accounts for the purposes of receiving and disbursing 119.17 funds as necessary for the operation of the programs. 119.18 (2) Inform county agencies, on a timely basis, of changes 119.19 in statute, rule, federal law, regulation, and policy necessary 119.20 to county agency administration of the programs. 119.21 (3) Administer and supervise all child welfare activities; 119.22 promote the enforcement of laws protecting handicapped, 119.23 dependent, neglected and delinquent children, and children born 119.24 to mothers who were not married to the children's fathers at the 119.25 times of the conception nor at the births of the children; 119.26 license and supervise child-caring and child-placing agencies 119.27 and institutions; supervise the care of children in boarding and 119.28 foster homes or in private institutions; and generally perform 119.29 all functions relating to the field of child welfare now vested 119.30 in the state board of control. 119.31 (4) Administer and supervise all noninstitutional service 119.32 to handicapped persons, including those who are visually 119.33 impaired, hearing impaired, or physically impaired or otherwise 119.34 handicapped. The commissioner may provide and contract for the 119.35 care and treatment of qualified indigent children in facilities 119.36 other than those located and available at state hospitals when 120.1 it is not feasible to provide the service in state hospitals. 120.2 (5) Assist and actively cooperate with other departments, 120.3 agencies and institutions, local, state, and federal, by 120.4 performing services in conformity with the purposes of Laws 120.5 1939, chapter 431. 120.6 (6) Act as the agent of and cooperate with the federal 120.7 government in matters of mutual concern relative to and in 120.8 conformity with the provisions of Laws 1939, chapter 431, 120.9 including the administration of any federal funds granted to the 120.10 state to aid in the performance of any functions of the 120.11 commissioner as specified in Laws 1939, chapter 431, and 120.12 including the promulgation of rules making uniformly available 120.13 medical care benefits to all recipients of public assistance, at 120.14 such times as the federal government increases its participation 120.15 in assistance expenditures for medical care to recipients of 120.16 public assistance, the cost thereof to be borne in the same 120.17 proportion as are grants of aid to said recipients. 120.18 (7) Establish and maintain any administrative units 120.19 reasonably necessary for the performance of administrative 120.20 functions common to all divisions of the department. 120.21 (8) Act as designated guardian of both the estate and the 120.22 person of all the wards of the state of Minnesota, whether by 120.23 operation of law or by an order of court, without any further 120.24 act or proceeding whatever, except as to persons committed as 120.25 mentally retarded. For children under the guardianship of the 120.26 commissioner whose interests would be best served by adoptive 120.27 placement, the commissioner may contract with a licensed 120.28 child-placing agency or a Minnesota tribal social services 120.29 agency to provide adoption services. A contract with a licensed 120.30 child-placing agency must be designed to supplement existing 120.31 county efforts and may not replace existing county programs, 120.32 unless the replacement is agreed to by the county board and the 120.33 appropriate exclusive bargaining representative or the 120.34 commissioner has evidence that child placements of the county 120.35 continue to be substantially below that of other counties. 120.36 Funds encumbered and obligated under an agreement for a specific 121.1 child shall remain available until the terms of the agreement 121.2 are fulfilled or the agreement is terminated. 121.3 (9) Act as coordinating referral and informational center 121.4 on requests for service for newly arrived immigrants coming to 121.5 Minnesota. 121.6 (10) The specific enumeration of powers and duties as 121.7 hereinabove set forth shall in no way be construed to be a 121.8 limitation upon the general transfer of powers herein contained. 121.9 (11) Establish county, regional, or statewide schedules of 121.10 maximum fees and charges which may be paid by county agencies 121.11 for medical, dental, surgical, hospital, nursing and nursing 121.12 home care and medicine and medical supplies under all programs 121.13 of medical care provided by the state and for congregate living 121.14 care under the income maintenance programs. 121.15 (12) Have the authority to conduct and administer 121.16 experimental projects to test methods and procedures of 121.17 administering assistance and services to recipients or potential 121.18 recipients of public welfare. To carry out such experimental 121.19 projects, it is further provided that the commissioner of human 121.20 services is authorized to waive the enforcement of existing 121.21 specific statutory program requirements, rules, and standards in 121.22 one or more counties. The order establishing the waiver shall 121.23 provide alternative methods and procedures of administration, 121.24 shall not be in conflict with the basic purposes, coverage, or 121.25 benefits provided by law, and in no event shall the duration of 121.26 a project exceed four years. It is further provided that no 121.27 order establishing an experimental project as authorized by the 121.28 provisions of this section shall become effective until the 121.29 following conditions have been met: 121.30 (a) The secretary of health and human services of the 121.31 United States has agreed, for the same project, to waive state 121.32 plan requirements relative to statewide uniformity. 121.33 (b) A comprehensive plan, including estimated project 121.34 costs, shall be approved by the legislative advisory commission 121.35 and filed with the commissioner of administration. 121.36 (13) According to federal requirements, establish 122.1 procedures to be followed by local welfare boards in creating 122.2 citizen advisory committees, including procedures for selection 122.3 of committee members. 122.4 (14) Allocate federal fiscal disallowances or sanctions 122.5 which are based on quality control error rates for the aid to 122.6 families with dependent children program formerly codified in 122.7 sections 256.72 to 256.87, medical assistance, or food stamp 122.8 program in the following manner: 122.9 (a) One-half of the total amount of the disallowance shall 122.10 be borne by the county boards responsible for administering the 122.11 programs. For the medical assistance and the AFDC program 122.12 formerly codified in sections 256.72 to 256.87, disallowances 122.13 shall be shared by each county board in the same proportion as 122.14 that county's expenditures for the sanctioned program are to the 122.15 total of all counties' expenditures for the AFDC program 122.16 formerly codified in sections 256.72 to 256.87, and medical 122.17 assistance programs. For the food stamp program, sanctions 122.18 shall be shared by each county board, with 50 percent of the 122.19 sanction being distributed to each county in the same proportion 122.20 as that county's administrative costs for food stamps are to the 122.21 total of all food stamp administrative costs for all counties, 122.22 and 50 percent of the sanctions being distributed to each county 122.23 in the same proportion as that county's value of food stamp 122.24 benefits issued are to the total of all benefits issued for all 122.25 counties. Each county shall pay its share of the disallowance 122.26 to the state of Minnesota. When a county fails to pay the 122.27 amount due hereunder, the commissioner may deduct the amount 122.28 from reimbursement otherwise due the county, or the attorney 122.29 general, upon the request of the commissioner, may institute 122.30 civil action to recover the amount due. 122.31 (b) Notwithstanding the provisions of paragraph (a), if the 122.32 disallowance results from knowing noncompliance by one or more 122.33 counties with a specific program instruction, and that knowing 122.34 noncompliance is a matter of official county board record, the 122.35 commissioner may require payment or recover from the county or 122.36 counties, in the manner prescribed in paragraph (a), an amount 123.1 equal to the portion of the total disallowance which resulted 123.2 from the noncompliance, and may distribute the balance of the 123.3 disallowance according to paragraph (a). 123.4 (15) Develop and implement special projects that maximize 123.5 reimbursements and result in the recovery of money to the 123.6 state. For the purpose of recovering state money, the 123.7 commissioner may enter into contracts with third parties. Any 123.8 recoveries that result from projects or contracts entered into 123.9 under this paragraph shall be deposited in the state treasury 123.10 and credited to a special account until the balance in the 123.11 account reaches $1,000,000. When the balance in the account 123.12 exceeds $1,000,000, the excess shall be transferred and credited 123.13 to the general fund. All money in the account is appropriated 123.14 to the commissioner for the purposes of this paragraph. 123.15 (16) Have the authority to make direct payments to 123.16 facilities providing shelter to women and their children 123.17 according to section 256D.05, subdivision 3. Upon the written 123.18 request of a shelter facility that has been denied payments 123.19 under section 256D.05, subdivision 3, the commissioner shall 123.20 review all relevant evidence and make a determination within 30 123.21 days of the request for review regarding issuance of direct 123.22 payments to the shelter facility. Failure to act within 30 days 123.23 shall be considered a determination not to issue direct payments. 123.24 (17) Have the authority to establish and enforce the 123.25 following county reporting requirements: 123.26 (a) The commissioner shall establish fiscal and statistical 123.27 reporting requirements necessary to account for the expenditure 123.28 of funds allocated to counties for human services programs. 123.29 When establishing financial and statistical reporting 123.30 requirements, the commissioner shall evaluate all reports, in 123.31 consultation with the counties, to determine if the reports can 123.32 be simplified or the number of reports can be reduced. 123.33 (b) The county board shall submit monthly or quarterly 123.34 reports to the department as required by the commissioner. 123.35 Monthly reports are due no later than 15 working days after the 123.36 end of the month. Quarterly reports are due no later than 30 124.1 calendar days after the end of the quarter, unless the 124.2 commissioner determines that the deadline must be shortened to 124.3 20 calendar days to avoid jeopardizing compliance with federal 124.4 deadlines or risking a loss of federal funding. Only reports 124.5 that are complete, legible, and in the required format shall be 124.6 accepted by the commissioner. 124.7 (c) If the required reports are not received by the 124.8 deadlines established in clause (b), the commissioner may delay 124.9 payments and withhold funds from the county board until the next 124.10 reporting period. When the report is needed to account for the 124.11 use of federal funds and the late report results in a reduction 124.12 in federal funding, the commissioner shall withhold from the 124.13 county boards with late reports an amount equal to the reduction 124.14 in federal funding until full federal funding is received. 124.15 (d) A county board that submits reports that are late, 124.16 illegible, incomplete, or not in the required format for two out 124.17 of three consecutive reporting periods is considered 124.18 noncompliant. When a county board is found to be noncompliant, 124.19 the commissioner shall notify the county board of the reason the 124.20 county board is considered noncompliant and request that the 124.21 county board develop a corrective action plan stating how the 124.22 county board plans to correct the problem. The corrective 124.23 action plan must be submitted to the commissioner within 45 days 124.24 after the date the county board received notice of noncompliance. 124.25 (e) The final deadline for fiscal reports or amendments to 124.26 fiscal reports is one year after the date the report was 124.27 originally due. If the commissioner does not receive a report 124.28 by the final deadline, the county board forfeits the funding 124.29 associated with the report for that reporting period and the 124.30 county board must repay any funds associated with the report 124.31 received for that reporting period. 124.32 (f) The commissioner may not delay payments, withhold 124.33 funds, or require repayment under paragraph (c) or (e) if the 124.34 county demonstrates that the commissioner failed to provide 124.35 appropriate forms, guidelines, and technical assistance to 124.36 enable the county to comply with the requirements. If the 125.1 county board disagrees with an action taken by the commissioner 125.2 under paragraph (c) or (e), the county board may appeal the 125.3 action according to sections 14.57 to 14.69. 125.4 (g) Counties subject to withholding of funds under 125.5 paragraph (c) or forfeiture or repayment of funds under 125.6 paragraph (e) shall not reduce or withhold benefits or services 125.7 to clients to cover costs incurred due to actions taken by the 125.8 commissioner under paragraph (c) or (e). 125.9 (18) Allocate federal fiscal disallowances or sanctions for 125.10 audit exceptions when federal fiscal disallowances or sanctions 125.11 are based on a statewide random sample for the foster care 125.12 program under title IV-E of the Social Security Act, United 125.13 States Code, title 42, in direct proportion to each county's 125.14 title IV-E foster care maintenance claim for that period. 125.15 (19) Be responsible for ensuring the detection, prevention, 125.16 investigation, and resolution of fraudulent activities or 125.17 behavior by applicants, recipients, and other participants in 125.18 the human services programs administered by the department. 125.19 (20) Require county agencies to identify overpayments, 125.20 establish claims, and utilize all available and cost-beneficial 125.21 methodologies to collect and recover these overpayments in the 125.22 human services programs administered by the department. 125.23 (21) Have the authority to administer a drug rebate program 125.24 for drugs purchased pursuant to the prescription drug program 125.25 established under section 256.955 after the beneficiary's 125.26 satisfaction of any deductible established in the program. The 125.27 commissioner shall require a rebate agreement from all 125.28 manufacturers of covered drugs as defined in section 256B.0625, 125.29 subdivision 13. Rebate agreements for prescription drugs 125.30 delivered on or after July 1, 2002, must include rebates for 125.31 individuals covered under the prescription drug program who are 125.32 under 65 years of age. For each drug, the amount of the rebate 125.33 shall be equal to thebasicrebate as defined for purposes of 125.34 the federal rebate program in United States Code, title 42, 125.35 section 1396r-8(c)(1).This basic rebate shall be applied to125.36single-source and multiple-source drugs.The manufacturers must 126.1 provide full payment within 30 days of receipt of the state 126.2 invoice for the rebate within the terms and conditions used for 126.3 the federal rebate program established pursuant to section 1927 126.4 of title XIX of the Social Security Act. The manufacturers must 126.5 provide the commissioner with any information necessary to 126.6 verify the rebate determined per drug. The rebate program shall 126.7 utilize the terms and conditions used for the federal rebate 126.8 program established pursuant to section 1927 of title XIX of the 126.9 Social Security Act. 126.10 (22) Have the authority to administer the federal drug 126.11 rebate program for drugs purchased under the medical assistance 126.12 program as allowed by section 1927 of title XIX of the Social 126.13 Security Act and according to the terms and conditions of 126.14 section 1927. Rebates shall be collected for all drugs that 126.15 have been dispensed or administered in an outpatient setting and 126.16 that are from manufacturers who have signed a rebate agreement 126.17 with the United States Department of Health and Human Services. 126.18 (23) Have the authority to administer a supplemental drug 126.19 rebate program for drugs purchased under the medical assistance 126.20 program. The commissioner may enter into supplemental rebate 126.21 contracts with pharmaceutical manufacturers and may require 126.22 prior authorization for drugs that are from manufacturers that 126.23 have not signed a supplemental rebate contract. Prior 126.24 authorization of drugs shall be subject to the provisions of 126.25 section 256B.0625, subdivision 13. 126.26 (24) Operate the department's communication systems account 126.27 established in Laws 1993, First Special Session chapter 1, 126.28 article 1, section 2, subdivision 2, to manage shared 126.29 communication costs necessary for the operation of the programs 126.30 the commissioner supervises. A communications account may also 126.31 be established for each regional treatment center which operates 126.32 communications systems. Each account must be used to manage 126.33 shared communication costs necessary for the operations of the 126.34 programs the commissioner supervises. The commissioner may 126.35 distribute the costs of operating and maintaining communication 126.36 systems to participants in a manner that reflects actual usage. 127.1 Costs may include acquisition, licensing, insurance, 127.2 maintenance, repair, staff time and other costs as determined by 127.3 the commissioner. Nonprofit organizations and state, county, 127.4 and local government agencies involved in the operation of 127.5 programs the commissioner supervises may participate in the use 127.6 of the department's communications technology and share in the 127.7 cost of operation. The commissioner may accept on behalf of the 127.8 state any gift, bequest, devise or personal property of any 127.9 kind, or money tendered to the state for any lawful purpose 127.10 pertaining to the communication activities of the department. 127.11 Any money received for this purpose must be deposited in the 127.12 department's communication systems accounts. Money collected by 127.13 the commissioner for the use of communication systems must be 127.14 deposited in the state communication systems account and is 127.15 appropriated to the commissioner for purposes of this section. 127.16 (25) Receive any federal matching money that is made 127.17 available through the medical assistance program for the 127.18 consumer satisfaction survey. Any federal money received for 127.19 the survey is appropriated to the commissioner for this 127.20 purpose. The commissioner may expend the federal money received 127.21 for the consumer satisfaction survey in either year of the 127.22 biennium. 127.23 (26) Incorporate cost reimbursement claims from First Call 127.24 Minnesota and Greater Twin Cities United Way into the federal 127.25 cost reimbursement claiming processes of the department 127.26 according to federal law, rule, and regulations. Any 127.27 reimbursement received is appropriated to the commissioner and 127.28 shall be disbursed to First Call Minnesota and Greater Twin 127.29 Cities United Way according to normal department payment 127.30 schedules. 127.31 (27) Develop recommended standards for foster care homes 127.32 that address the components of specialized therapeutic services 127.33 to be provided by foster care homes with those services. 127.34 Sec. 3. Minnesota Statutes 2002, section 256.955, 127.35 subdivision 2a, is amended to read: 127.36 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 128.1 following requirements and the requirements described in 128.2 subdivision 2, paragraph (d), is eligible for the prescription 128.3 drug program: 128.4 (1) is at least 65 years of age or older; and 128.5 (2) is eligible as a qualified Medicare beneficiary 128.6 according to section 256B.057, subdivision 3,or 3a,or 3b,128.7clause (1),or is eligible under section 256B.057, subdivision 128.8 3,or 3a,or 3b, clause (1),and is also eligible for medical 128.9 assistance or general assistance medical care with a spenddown 128.10 as defined in section 256B.056, subdivision 5. 128.11 Sec. 4. Minnesota Statutes 2002, section 256.969, 128.12 subdivision 2b, is amended to read: 128.13 Subd. 2b. [OPERATING PAYMENT RATES.] In determining 128.14 operating payment rates for admissions occurring on or after the 128.15 rate year beginning January 1, 1991, and every two years after, 128.16 or more frequently as determined by the commissioner, the 128.17 commissioner shall obtain operating data from an updated base 128.18 year and establish operating payment rates per admission for 128.19 each hospital based on the cost-finding methods and allowable 128.20 costs of the Medicare program in effect during the base year. 128.21 Rates under the general assistance medical care, medical 128.22 assistance, and MinnesotaCare programs shall not be rebased to 128.23 more current data on January 1, 1997, and January 1, 2005. The 128.24 base year operating payment rate per admission is standardized 128.25 by the case mix index and adjusted by the hospital cost index, 128.26 relative values, and disproportionate population adjustment. 128.27 The cost and charge data used to establish operating rates shall 128.28 only reflect inpatient services covered by medical assistance 128.29 and shall not include property cost information and costs 128.30 recognized in outlier payments. 128.31 Sec. 5. Minnesota Statutes 2002, section 256.969, 128.32 subdivision 3a, is amended to read: 128.33 Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings 128.34 under the medical assistance program must not be submitted until 128.35 the recipient is discharged. However, the commissioner shall 128.36 establish monthly interim payments for inpatient hospitals that 129.1 have individual patient lengths of stay over 30 days regardless 129.2 of diagnostic category. Except as provided in section 256.9693, 129.3 medical assistance reimbursement for treatment of mental illness 129.4 shall be reimbursed based on diagnostic classifications. 129.5 Individual hospital payments established under this section and 129.6 sections 256.9685, 256.9686, and 256.9695, in addition to third 129.7 party and recipient liability, for discharges occurring during 129.8 the rate year shall not exceed, in aggregate, the charges for 129.9 the medical assistance covered inpatient services paid for the 129.10 same period of time to the hospital. This payment limitation 129.11 shall be calculated separately for medical assistance and 129.12 general assistance medical care services. The limitation on 129.13 general assistance medical care shall be effective for 129.14 admissions occurring on or after July 1, 1991. Services that 129.15 have rates established under subdivision 11 or 12, must be 129.16 limited separately from other services. After consulting with 129.17 the affected hospitals, the commissioner may consider related 129.18 hospitals one entity and may merge the payment rates while 129.19 maintaining separate provider numbers. The operating and 129.20 property base rates per admission or per day shall be derived 129.21 from the best Medicare and claims data available when rates are 129.22 established. The commissioner shall determine the best Medicare 129.23 and claims data, taking into consideration variables of recency 129.24 of the data, audit disposition, settlement status, and the 129.25 ability to set rates in a timely manner. The commissioner shall 129.26 notify hospitals of payment rates by December 1 of the year 129.27 preceding the rate year. The rate setting data must reflect the 129.28 admissions data used to establish relative values. Base year 129.29 changes from 1981 to the base year established for the rate year 129.30 beginning January 1, 1991, and for subsequent rate years, shall 129.31 not be limited to the limits ending June 30, 1987, on the 129.32 maximum rate of increase under subdivision 1. The commissioner 129.33 may adjust base year cost, relative value, and case mix index 129.34 data to exclude the costs of services that have been 129.35 discontinued by the October 1 of the year preceding the rate 129.36 year or that are paid separately from inpatient services. 130.1 Inpatient stays that encompass portions of two or more rate 130.2 years shall have payments established based on payment rates in 130.3 effect at the time of admission unless the date of admission 130.4 preceded the rate year in effect by six months or more. In this 130.5 case, operating payment rates for services rendered during the 130.6 rate year in effect and established based on the date of 130.7 admission shall be adjusted to the rate year in effect by the 130.8 hospital cost index. 130.9 (b) For fee-for-service admissions occurring on or after 130.10 July 1, 2002, the total payment, before third-party liability 130.11 and spenddown, made to hospitals for inpatient services is 130.12 reduced by .5 percent from the current statutory rates. 130.13 (c) In addition to the reduction in paragraph (b), the 130.14 total payment for fee-for-service admissions occurring on or 130.15 after July 1, 2003, made to hospitals for inpatient services 130.16 before third-party liability and spenddown, is reduced five 130.17 percent from the current statutory rates. Mental health 130.18 services within diagnosis related groups 424 to 432, and 130.19 facilities defined under subdivision 16 are excluded from this 130.20 paragraph. 130.21 Sec. 6. Minnesota Statutes 2002, section 256B.055, is 130.22 amended by adding a subdivision to read: 130.23 Subd. 13. [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 130.24 Beginning October 1, 2003, persons who would be eligible for 130.25 medical assistance under chapter 256B but for residing in a 130.26 facility that is determined by the commissioner or the federal 130.27 Centers for Medicare and Medicaid Services to be an institution 130.28 for mental diseases are eligible for medical assistance without 130.29 federal financial participation. 130.30 Sec. 7. Minnesota Statutes 2002, section 256B.056, 130.31 subdivision 1a, is amended to read: 130.32 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 130.33 specifically required by state law or rule or federal law or 130.34 regulation, the methodologies used in counting income and assets 130.35 to determine eligibility for medical assistance for persons 130.36 whose eligibility category is based on blindness, disability, or 131.1 age of 65 or more years, the methodologies for the supplemental 131.2 security income program shall be used. Increases in benefits 131.3 under title II of the Social Security Act shall not be counted 131.4 as income for purposes of this subdivision until July 1 of each 131.5 year. Effective upon federal approval, for children eligible 131.6 under section 256B.055, subdivision 12, or for home and 131.7 community-based waiver services whose eligibility for medical 131.8 assistance is determined without regard to parental income, 131.9 child support payments, including any payments made by an 131.10 obligor in satisfaction of or in addition to a temporary or 131.11 permanent order for child support, and social security payments 131.12 are not counted as income. For families and children, which 131.13 includes all other eligibility categories, the methodologies 131.14 under the state's AFDC plan in effect as of July 16, 1996, as 131.15 required by the Personal Responsibility and Work Opportunity 131.16 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 131.17 shall be used, except that effectiveJuly 1, 2002, the $90 and131.18$30 and one-third earned income disregards shall not apply and131.19the disregard specified in subdivision 1c shall applyOctober 1, 131.20 2003, the earned income disregards and deductions are limited to 131.21 those in subdivision 1c. For these purposes, a "methodology" 131.22 does not include an asset or income standard, or accounting 131.23 method, or method of determining effective dates. 131.24 Sec. 8. Minnesota Statutes 2002, section 256B.056, 131.25 subdivision 1c, is amended to read: 131.26 Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 131.27 (a)(1) For children ages one to five whose eligibility is 131.28 determined under section 256B.057, subdivision 2, 21 percent of 131.29 countable earned income shall be disregarded for up to four 131.30 months. This clause expires July 1, 2003. 131.31 (2) For children ages one through 18 whose eligibility is 131.32 determined under section 256B.057, subdivision 2, the following 131.33 deductions shall be applied to income counted toward the child's 131.34 eligibility as allowed under the state's AFDC plan in effect as 131.35 of July 16, 1996: $90 work expense, dependent care, and child 131.36 support paid under court order. This clause is effective 132.1 October 1, 2003. 132.2 (b) For families with children whose eligibility is 132.3 determined using the standard specified in section 256B.056, 132.4 subdivision 4, paragraph (c), 17 percent of countable earned 132.5 income shall be disregarded for up to four months and the 132.6 following deductions shall be applied to each individual's 132.7 income counted toward eligibility as allowed under the state's 132.8 AFDC plan in effect as of July 16, 1996: dependent care and 132.9 child support paid under court order. 132.10 (c) If the four month disregard in paragraph (b) has been 132.11 applied to the wage earner's income for four months, the 132.12 disregard shall not be applied again until the wage earner's 132.13 income has not been considered in determining medical assistance 132.14 eligibility for 12 consecutive months. 132.15 [EFFECTIVE DATE.] The amendments to paragraphs (b) and (c) 132.16 are effective July 1, 2003. 132.17 Sec. 9. Minnesota Statutes 2002, section 256B.057, 132.18 subdivision 1, is amended to read: 132.19 Subdivision 1. [PREGNANT WOMEN AND INFANTS.] (a) An infant 132.20 less than one year of ageor a pregnant woman who has written132.21verification of a positive pregnancy test from a physician or132.22licensed registered nurse,is eligible for medical assistance if 132.23 countable family income is equal to or less than 275 percent of 132.24 the federal poverty guideline for the same family size. A 132.25 pregnant woman who has written verification of a positive 132.26 pregnancy test from a physician or licensed registered nurse is 132.27 eligible for medical assistance if countable family income is 132.28 equal to or less than 200 percent of the federal poverty 132.29 guideline for the same family size. For purposes of this 132.30 subdivision, "countable family income" means the amount of 132.31 income considered available using the methodology of the AFDC 132.32 program under the state's AFDC plan as of July 16, 1996, as 132.33 required by the Personal Responsibility and Work Opportunity 132.34 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 132.35 except for the earned income disregard and employment deductions. 132.36 (b) An amount equal to the amount of earned income 133.1 exceeding 275 percent of the federal poverty guideline, up to a 133.2 maximum of the amount by which the combined total of 185 percent 133.3 of the federal poverty guideline plus the earned income 133.4 disregards and deductions of the AFDC program under the state's 133.5 AFDC plan as of July 16, 1996, as required by the Personal 133.6 Responsibility and Work Opportunity Reconciliation Act of 1996 133.7 (PRWORA), Public LawNumber104-193, exceeds 275 percent of the 133.8 federal poverty guideline will be deducted for pregnant women 133.9 and infants less than one year of age. This paragraph expires 133.10 July 1, 2003. 133.11 (c) Dependent care and child support paid under court order 133.12 shall be deducted from the countable income of pregnant women. 133.13(b)(d) An infant born on or after January 1, 1991, to a 133.14 woman who was eligible for and receiving medical assistance on 133.15 the date of the child's birth shall continue to be eligible for 133.16 medical assistance without redetermination until the child's 133.17 first birthday, as long as the child remains in the woman's 133.18 household. 133.19 [EFFECTIVE DATE.] This section is effective February 1, 133.20 2004, except where a different date is specified in the text. 133.21 Sec. 10. Minnesota Statutes 2002, section 256B.057, 133.22 subdivision 2, is amended to read: 133.23 Subd. 2. [CHILDREN.] Except as specified in subdivision 133.24 1b, effectiveJuly 1, 2002October 1, 2003, a child one through 133.25 18 years of age in a family whose countable income is no greater 133.26 than170150 percent of the federal poverty guidelines for the 133.27 same family size, is eligible for medical assistance. 133.28 Sec. 11. Minnesota Statutes 2002, section 256B.057, 133.29 subdivision 3b, is amended to read: 133.30 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 133.31 1998,to the extent of the federal allocation to Minnesota133.32 contingent upon federal funding, a person who would otherwise be 133.33 eligible as a qualified Medicare beneficiary under subdivision 133.34 3, except that the person's income is in excess of the limit, is 133.35 eligible as a qualifying individual according to the following 133.36 criteria: 134.1 (1) if the person's income is greater than 120 percent, but 134.2 less than 135 percent of the official federal poverty guidelines 134.3 for the applicable family size, the person is eligible for 134.4 medical assistance reimbursement of Medicare Part B premiums; or 134.5 (2) if the person's income is equal to or greater than 135 134.6 percent but less than 175 percent of the official federal 134.7 poverty guidelines for the applicable family size, the person is 134.8 eligible for medical assistance reimbursement of that portion of 134.9 the Medicare Part B premium attributable to an increase in Part 134.10 B expenditures which resulted from the shift of home care 134.11 services from Medicare Part A to Medicare Part B under Public 134.12 LawNumber105-33, section 4732, the Balanced Budget Act of 1997. 134.13 The commissioner shall limit enrollment of qualifying 134.14 individuals under this subdivision according to the requirements 134.15 of Public LawNumber105-33, section 4732. 134.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 134.17 Sec. 12. Minnesota Statutes 2002, section 256B.057, 134.18 subdivision 9, is amended to read: 134.19 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 134.20 assistance may be paid for a person who is employed and who: 134.21 (1) meets the definition of disabled under the supplemental 134.22 security income program; 134.23 (2) is at least 16 but less than 65 years of age; 134.24 (3) meets the asset limits in paragraph (b); and 134.25 (4) effective November 1, 2003, pays a premium, if134.26required,and other obligations under paragraph(c)(d). 134.27 Any spousal income or assets shall be disregarded for purposes 134.28 of eligibility and premium determinations. 134.29 After the month of enrollment, a person enrolled in medical 134.30 assistance under this subdivision who: 134.31 (1) is temporarily unable to work and without receipt of 134.32 earned income due to a medical condition, as verified by a 134.33 physician, may retain eligibility for up to four calendar 134.34 months; or 134.35 (2) effective January 1, 2004, loses employment for reasons 134.36 not attributable to the enrollee, may retain eligibility for up 135.1 to four consecutive months after the month of job loss. To 135.2 receive a four-month extension, enrollees must verify the 135.3 medical condition or provide notification of job loss. All 135.4 other eligibility requirements must be met and the enrollee must 135.5 pay all calculated premium costs for continued eligibility. 135.6 (b) For purposes of determining eligibility under this 135.7 subdivision, a person's assets must not exceed $20,000, 135.8 excluding: 135.9 (1) all assets excluded under section 256B.056; 135.10 (2) retirement accounts, including individual accounts, 135.11 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 135.12 (3) medical expense accounts set up through the person's 135.13 employer. 135.14 (c)(1) Effective January 1, 2004, for purposes of 135.15 eligibility, there will be a $65 earned income disregard. To be 135.16 eligible, a person applying for medical assistance under this 135.17 subdivision must have earned income above the disregard level. 135.18 (2) Effective January 1, 2004, to be considered earned 135.19 income, Medicare, social security, and applicable state and 135.20 federal income taxes must be withheld. To be eligible, a person 135.21 must document earned income tax withholding. 135.22 (d)(1) A person whose earned and unearned income is equal 135.23 to or greater than 100 percent of federal poverty guidelines for 135.24 the applicable family size must pay a premium to be eligible for 135.25 medical assistance under this subdivision. The premium shall be 135.26 based on the person's gross earned and unearned income and the 135.27 applicable family size using a sliding fee scale established by 135.28 the commissioner, which begins at one percent of income at 100 135.29 percent of the federal poverty guidelines and increases to 7.5 135.30 percent of income for those with incomes at or above 300 percent 135.31 of the federal poverty guidelines. Annual adjustments in the 135.32 premium schedule based upon changes in the federal poverty 135.33 guidelines shall be effective for premiums due in July of each 135.34 year. 135.35 (2) Effective January 1, 2004, all enrollees must pay a 135.36 premium to be eligible for medical assistance under this 136.1 subdivision. An enrollee shall pay the greater of a $35 premium 136.2 or the premium calculated in clause (1). 136.3 (3) Effective November 1, 2003, all enrollees who receive 136.4 unearned income must pay five percent of unearned income in 136.5 addition to the premium amount. 136.6 (4) Effective November 1, 2003, for enrollees with income 136.7 equal to or more than the limit under subdivision 3a who are 136.8 also enrolled in Medicare the commissioner must reduce 136.9 reimbursement to the enrollee for Medicare Part B premiums under 136.10 section 256B.0625, subdivision 15, paragraph (a), based on a 136.11 sliding fee scale established by the commissioner. The scale is 136.12 based on the person's gross earned and unearned income. The 136.13 obligation of the enrollee shall begin at a dollar amount 136.14 determined by the commissioner for incomes equal to the limit 136.15 under subdivision 3a and increase to the full amount of the 136.16 Medicare Part B premium cost for incomes equal to or greater 136.17 than 300 percent of the federal poverty guidelines. 136.18(d)(e) A person's eligibility and premium shall be 136.19 determined by the local county agency. Premiums must be paid to 136.20 the commissioner. All premiums are dedicated to the 136.21 commissioner. 136.22(e)(f) Any required premium shall be determined at 136.23 application and redeterminedannually at recertificationat the 136.24 enrollee's six-month income review or when a change in income or 136.25familyhousehold sizeoccursis reported. Enrollees must report 136.26 any change in income or household size within ten days of when 136.27 the change occurs. A decreased premium resulting from a 136.28 reported change in income or household size shall be effective 136.29 the first day of the next available billing month after the 136.30 change is reported. Except for changes occurring from annual 136.31 cost-of-living increases or verification of income under section 136.32 256B.061, paragraph (b), a change resulting in an increased 136.33 premium shall not affect the premium amount until the next 136.34 six-month review. 136.35(f)(g) Premium payment is due upon notification from the 136.36 commissioner of the premium amount required. Premiums may be 137.1 paid in installments at the discretion of the commissioner. 137.2(g)(h) Nonpayment of the premium shall result in denial or 137.3 termination of medical assistance unless the person demonstrates 137.4 good cause for nonpayment. Good cause exists if the 137.5 requirements specified in Minnesota Rules, part 9506.0040, 137.6 subpart 7, items B to D, are met. Except when an installment 137.7 agreement is accepted by the commissioner, all persons 137.8 disenrolled for nonpayment of a premium must pay any past due 137.9 premiums as well as current premiums due prior to being 137.10 reenrolled. Nonpayment shall include payment with a returned, 137.11 refused, or dishonored instrument. The commissioner may require 137.12 a guaranteed form of payment as the only means to replace a 137.13 returned, refused, or dishonored instrument. 137.14 [EFFECTIVE DATE.] This section is effective November 1, 137.15 2003, except the amendments to Minnesota Statutes 2002, section 137.16 256B.057, subdivision 9, paragraphs (e) and (g), are effective 137.17 July 1, 2003. 137.18 Sec. 13. Minnesota Statutes 2002, section 256B.0595, 137.19 subdivision 1, is amended to read: 137.20 Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers 137.21 of assets made on or before August 10, 1993, if a person or the 137.22 person's spouse has given away, sold, or disposed of, for less 137.23 than fair market value, any asset or interest therein, except 137.24 assets other than the homestead that are excluded under the 137.25 supplemental security program, within 30 months before or any 137.26 time after the date of institutionalization if the person has 137.27 been determined eligible for medical assistance, or within 30 137.28 months before or any time after the date of the first approved 137.29 application for medical assistance if the person has not yet 137.30 been determined eligible for medical assistance, the person is 137.31 ineligible for long-term care services for the period of time 137.32 determined under subdivision 2. 137.33 (b) Effective for transfers made after August 10, 1993, a 137.34 person, a person's spouse, or any person, court, or 137.35 administrative body with legal authority to act in place of, on 137.36 behalf of, at the direction of, or upon the request of the 138.1 person or person's spouse, may not give away, sell, or dispose 138.2 of, for less than fair market value, any asset or interest 138.3 therein, except assets other than the homestead that are 138.4 excluded under the supplemental security income program, for the 138.5 purpose of establishing or maintaining medical assistance 138.6 eligibility. This applies to all transfers, including those 138.7 made by a community spouse after the month in which the 138.8 institutionalized spouse is determined eligible for medical 138.9 assistance. For purposes of determining eligibility for 138.10 long-term care services, any transfer of such assets within 36 138.11 months before or any time after an institutionalized person 138.12 applies for medical assistance, or 36 months before or any time 138.13 after a medical assistance recipient becomes institutionalized, 138.14 for less than fair market value may be considered. Any such 138.15 transfer is presumed to have been made for the purpose of 138.16 establishing or maintaining medical assistance eligibility and 138.17 the person is ineligible for long-term care services for the 138.18 period of time determined under subdivision 2, unless the person 138.19 furnishes convincing evidence to establish that the transaction 138.20 was exclusively for another purpose, or unless the transfer is 138.21 permitted under subdivision 3 or 4. Notwithstanding the 138.22 provisions of this paragraph, in the case of payments from a 138.23 trust or portions of a trust that are considered transfers of 138.24 assets under federal law, any transfers made within 60 months 138.25 before or any time after an institutionalized person applies for 138.26 medical assistance and within 60 months before or any time after 138.27 a medical assistance recipient becomes institutionalized, may be 138.28 considered. 138.29 Effective July 1, 2003, or upon receipt of federal 138.30 approval, whichever is later, the 36-month period for transfers 138.31 of assets shall be extended by another 36 months, and the 138.32 60-month period for transfers to trusts shall be extended by 138.33 another 12 months for purposes of transfers under this paragraph 138.34 and paragraphs (c) through (f). 138.35 (c) This section applies to transfers, for less than fair 138.36 market value, of income or assets, including assets that are 139.1 considered income in the month received, such as inheritances, 139.2 court settlements, and retroactive benefit payments or income to 139.3 which the person or the person's spouse is entitled but does not 139.4 receive due to action by the person, the person's spouse, or any 139.5 person, court, or administrative body with legal authority to 139.6 act in place of, on behalf of, at the direction of, or upon the 139.7 request of the person or the person's spouse. 139.8 (d) This section applies to payments for care or personal 139.9 services provided by a relative, unless the compensation was 139.10 stipulated in a notarized, written agreement which was in 139.11 existence when the service was performed, the care or services 139.12 directly benefited the person, and the payments made represented 139.13 reasonable compensation for the care or services provided. A 139.14 notarized written agreement is not required if payment for the 139.15 services was made within 60 days after the service was provided. 139.16 (e) This section applies to the portion of any asset or 139.17 interest that a person, a person's spouse, or any person, court, 139.18 or administrative body with legal authority to act in place of, 139.19 on behalf of, at the direction of, or upon the request of the 139.20 person or the person's spouse, transfers to any annuity that 139.21 exceeds the value of the benefit likely to be returned to the 139.22 person or spouse while alive, based on estimated life expectancy 139.23 using the life expectancy tables employed by the supplemental 139.24 security income program to determine the value of an agreement 139.25 for services for life. The commissioner may adopt rules 139.26 reducing life expectancies based on the need for long-term 139.27 care. This section applies to an annuity described in this 139.28 paragraph purchased on or after March 1, 2002, that: 139.29 (1) is not purchased from an insurance company or financial 139.30 institution that is subject to licensing or regulation by the 139.31 Minnesota department of commerce or a similar regulatory agency 139.32 of another state; 139.33 (2) does not pay out principal and interest in equal 139.34 monthly installments; or 139.35 (3) does not begin payment at the earliest possible date 139.36 after annuitization. 140.1 (f) For purposes of this section, long-term care services 140.2 include services in a nursing facility, services that are 140.3 eligible for payment according to section 256B.0625, subdivision 140.4 2, because they are provided in a swing bed, intermediate care 140.5 facility for persons with mental retardation, and home and 140.6 community-based services provided pursuant to sections 140.7 256B.0915, 256B.092, and 256B.49. For purposes of this 140.8 subdivision and subdivisions 2, 3, and 4, "institutionalized 140.9 person" includes a person who is an inpatient in a nursing 140.10 facility or in a swing bed, or intermediate care facility for 140.11 persons with mental retardation or who is receiving home and 140.12 community-based services under sections 256B.0915, 256B.092, and 140.13 256B.49. 140.14 (g) The commissioner shall seek federal approval to extend 140.15 the period for evaluating transfers of assets or interests for 140.16 less than fair market value in subdivision 1, paragraphs (b) 140.17 through (f), to a total of 72 months. 140.18 [EFFECTIVE DATE.] This section is effective July 1, 2003. 140.19 If the amendments to this section are not effective because of 140.20 prohibitions in federal law, the commissioner shall seek a 140.21 waiver of those prohibitions or other federal authority, and 140.22 each provision shall become effective upon receipt of federal 140.23 approval, notification to the revisor of statutes, and 140.24 publication of a notice in the State Register. 140.25 Sec. 14. Minnesota Statutes 2002, section 256B.0595, 140.26 subdivision 2, is amended to read: 140.27 Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any 140.28 uncompensated transfer occurring on or before August 10, 1993, 140.29 the number of months of ineligibility for long-term care 140.30 services shall be the lesser of 30 months, or the uncompensated 140.31 transfer amount divided by the average medical assistance rate 140.32 for nursing facility services in the state in effect on the date 140.33 of application. The amount used to calculate the average 140.34 medical assistance payment rate shall be adjusted each July 1 to 140.35 reflect payment rates for the previous calendar year. The 140.36 period of ineligibility begins with the month in which the 141.1 assets were transferred. If the transfer was not reported to 141.2 the local agency at the time of application, and the applicant 141.3 received long-term care services during what would have been the 141.4 period of ineligibility if the transfer had been reported, a 141.5 cause of action exists against the transferee for the cost of 141.6 long-term care services provided during the period of 141.7 ineligibility, or for the uncompensated amount of the transfer, 141.8 whichever is less. The action may be brought by the state or 141.9 the local agency responsible for providing medical assistance 141.10 under chapter 256G. The uncompensated transfer amount is the 141.11 fair market value of the asset at the time it was given away, 141.12 sold, or disposed of, less the amount of compensation received. 141.13 (b) For uncompensated transfers made after August 10, 1993, 141.14 the number of months of ineligibility for long-term care 141.15 services shall be the total uncompensated value of the resources 141.16 transferred divided by the average medical assistance rate for 141.17 nursing facility services in the state in effect on the date of 141.18 application. The amount used to calculate the average medical 141.19 assistance payment rate shall be adjusted each July 1 to reflect 141.20 payment rates for the previous calendar year. The period of 141.21 ineligibility begins with the first day of the month after the 141.22 month in which the assets were transferred except that if one or 141.23 more uncompensated transfers are made during a period of 141.24 ineligibility, the total assets transferred during the 141.25 ineligibility period shall be combined and a penalty period 141.26 calculated to begininon the first day of the month after the 141.27 month in which the first uncompensated transfer was 141.28 made. Effective upon federal approval, the period of 141.29 ineligibility for uncompensated transfers begins on the first 141.30 day of the month in which an applicant would otherwise be 141.31 eligible for long-term care services, or in the case of a 141.32 transfer affecting a person receiving long-term care services, 141.33 on the first day of the month after the month the local agency 141.34 learns of the uncompensated transfer. If the transfer was not 141.35 reported to the local agencyat the time of application, and the 141.36 applicant received medical assistance services during what would 142.1 have been the period of ineligibility if the transfer had been 142.2 reported, a cause of action exists against the transferee for 142.3 the cost of medical assistance services provided during the 142.4 period of ineligibility, or for the uncompensated amount of the 142.5 transfer, whichever is less. The action may be brought by the 142.6 state or the local agency responsible for providing medical 142.7 assistance under chapter 256G. The uncompensated transfer 142.8 amount is the fair market value of the asset at the time it was 142.9 given away, sold, or disposed of, less the amount of 142.10 compensation received. Effective for transfers made on or after 142.11 March 1, 1996, involving persons who apply for medical 142.12 assistance on or after April 13, 1996, no cause of action exists 142.13 for a transfer unless: 142.14 (1) the transferee knew or should have known that the 142.15 transfer was being made by a person who was a resident of a 142.16 long-term care facility or was receiving that level of care in 142.17 the community at the time of the transfer; 142.18 (2) the transferee knew or should have known that the 142.19 transfer was being made to assist the person to qualify for or 142.20 retain medical assistance eligibility; or 142.21 (3) the transferee actively solicited the transfer with 142.22 intent to assist the person to qualify for or retain eligibility 142.23 for medical assistance. 142.24 (c) If a calculation of a penalty period results in a 142.25 partial month, payments for long-term care services shall be 142.26 reduced in an amount equal to the fraction, except that in 142.27 calculating the value of uncompensated transfers, if the total 142.28 value of all uncompensated transfers made in a month not 142.29 included in an existing penalty period does not exceed $200, 142.30 then such transfers shall be disregarded for each month prior to 142.31 the month of application for or during receipt of medical 142.32 assistance. 142.33 (d) The commissioner shall seek federal approval for 142.34 purposes of establishing that the period of ineligibility 142.35 determined under paragraphs (b) and (c) shall begin on the first 142.36 day of the month in which the applicant would otherwise be 143.1 eligible for long-term care services, or in the case of a 143.2 transfer affecting a recipient of long-term care services, the 143.3 first day of the month after the month in which the local agency 143.4 learns of the uncompensated transfer. 143.5 [EFFECTIVE DATE.] Paragraph (b) of this section is 143.6 effective July 1, 2003. If the amendments to this section are 143.7 not effective because of prohibitions in federal law, the 143.8 commissioner shall seek a waiver of those prohibitions or other 143.9 federal authority, and each provision shall become effective 143.10 upon receipt of federal approval, notification to the revisor of 143.11 statutes, and publication of a notice in the State Register to 143.12 that effect. 143.13 Sec. 15. Minnesota Statutes 2002, section 256B.06, 143.14 subdivision 4, is amended to read: 143.15 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 143.16 medical assistance is limited to citizens of the United States, 143.17 qualified noncitizens as defined in this subdivision, and other 143.18 persons residing lawfully in the United States. 143.19 (b) "Qualified noncitizen" means a person who meets one of 143.20 the following immigration criteria: 143.21 (1) admitted for lawful permanent residence according to 143.22 United States Code, title 8; 143.23 (2) admitted to the United States as a refugee according to 143.24 United States Code, title 8, section 1157; 143.25 (3) granted asylum according to United States Code, title 143.26 8, section 1158; 143.27 (4) granted withholding of deportation according to United 143.28 States Code, title 8, section 1253(h); 143.29 (5) paroled for a period of at least one year according to 143.30 United States Code, title 8, section 1182(d)(5); 143.31 (6) granted conditional entrant status according to United 143.32 States Code, title 8, section 1153(a)(7); 143.33 (7) determined to be a battered noncitizen by the United 143.34 States Attorney General according to the Illegal Immigration 143.35 Reform and Immigrant Responsibility Act of 1996, title V of the 143.36 Omnibus Consolidated Appropriations Bill, Public Law Number 144.1 104-200; 144.2 (8) is a child of a noncitizen determined to be a battered 144.3 noncitizen by the United States Attorney General according to 144.4 the Illegal Immigration Reform and Immigrant Responsibility Act 144.5 of 1996, title V, of the Omnibus Consolidated Appropriations 144.6 Bill, Public Law Number 104-200; or 144.7 (9) determined to be a Cuban or Haitian entrant as defined 144.8 in section 501(e) of Public Law Number 96-422, the Refugee 144.9 Education Assistance Act of 1980. 144.10 (c) All qualified noncitizens who were residing in the 144.11 United States before August 22, 1996, who otherwise meet the 144.12 eligibility requirements of chapter 256B, are eligible for 144.13 medical assistance with federal financial participation. 144.14 (d) All qualified noncitizens who entered the United States 144.15 on or after August 22, 1996, and who otherwise meet the 144.16 eligibility requirements of chapter 256B, are eligible for 144.17 medical assistance with federal financial participation through 144.18 November 30, 1996. 144.19 Beginning December 1, 1996, qualified noncitizens who 144.20 entered the United States on or after August 22, 1996, and who 144.21 otherwise meet the eligibility requirements of chapter 256B are 144.22 eligible for medical assistance with federal participation for 144.23 five years if they meet one of the following criteria: 144.24 (i) refugees admitted to the United States according to 144.25 United States Code, title 8, section 1157; 144.26 (ii) persons granted asylum according to United States 144.27 Code, title 8, section 1158; 144.28 (iii) persons granted withholding of deportation according 144.29 to United States Code, title 8, section 1253(h); 144.30 (iv) veterans of the United States Armed Forces with an 144.31 honorable discharge for a reason other than noncitizen status, 144.32 their spouses and unmarried minor dependent children; or 144.33 (v) persons on active duty in the United States Armed 144.34 Forces, other than for training, their spouses and unmarried 144.35 minor dependent children. 144.36 Beginning December 1, 1996, qualified noncitizens who do 145.1 not meet one of the criteria in items (i) to (v) are eligible 145.2 for medical assistance without federal financial participation 145.3 as described in paragraph(j)(i). 145.4 (e) Noncitizens who are not qualified noncitizens as 145.5 defined in paragraph (b), who are lawfully residing in the 145.6 United States and who otherwise meet the eligibility 145.7 requirements of chapter 256B, are eligible for medical 145.8 assistance under clauses (1) to (3). These individuals must 145.9 cooperate with the Immigration and Naturalization Service to 145.10 pursue any applicable immigration status, including citizenship, 145.11 that would qualify them for medical assistance with federal 145.12 financial participation. 145.13 (1) Persons who were medical assistance recipients on 145.14 August 22, 1996, are eligible for medical assistance with 145.15 federal financial participation through December 31, 1996. 145.16 (2) Beginning January 1, 1997, persons described in clause 145.17 (1) are eligible for medical assistance without federal 145.18 financial participation as described in paragraph(j)(i). 145.19 (3) Beginning December 1, 1996, persons residing in the 145.20 United States prior to August 22, 1996, who were not receiving 145.21 medical assistance and persons who arrived on or after August 145.22 22, 1996, are eligible for medical assistance without federal 145.23 financial participation as described in paragraph(j)(i). 145.24 (f) Nonimmigrants who otherwise meet the eligibility 145.25 requirements of chapter 256B are eligible for the benefits as 145.26 provided in paragraphs (g)to (i)and (h). For purposes of this 145.27 subdivision, a "nonimmigrant" is a person in one of the classes 145.28 listed in United States Code, title 8, section 1101(a)(15). 145.29 (g) Payment shall also be made for care and services that 145.30 are furnished to noncitizens, regardless of immigration status, 145.31 who otherwise meet the eligibility requirements of chapter 256B, 145.32 if such care and services are necessary for the treatment of an 145.33 emergency medical condition, except for organ transplants and 145.34 related care and services and routine prenatal care. 145.35 (h) For purposes of this subdivision, the term "emergency 145.36 medical condition" means a medical condition that meets the 146.1 requirements of United States Code, title 42, section 1396b(v). 146.2 (i)Pregnant noncitizens who are undocumented or146.3nonimmigrants, who otherwise meet the eligibility requirements146.4of chapter 256B, are eligible for medical assistance payment146.5without federal financial participation for care and services146.6through the period of pregnancy, and 60 days postpartum, except146.7for labor and delivery.146.8(j)Qualified noncitizens as described in paragraph (d), 146.9 and all other noncitizens lawfully residing in the United States 146.10 as described in paragraph (e), who are ineligible for medical 146.11 assistance with federal financial participation and who 146.12 otherwise meet the eligibility requirements of chapter 256B and 146.13 of this paragraph, are eligible for medical assistance without 146.14 federal financial participation. Qualified noncitizens as 146.15 described in paragraph (d) are only eligible for medical 146.16 assistance without federal financial participation for five 146.17 years from their date of entry into the United States. 146.18(k) The commissioner shall submit to the legislature by146.19December 31, 1998, a report on the number of recipients and cost146.20of coverage of care and services made according to paragraphs146.21(i) and (j).146.22 (j) Beginning October 1, 2003, persons who are receiving 146.23 care and rehabilitation services from a nonprofit center 146.24 established to serve victims of torture and are otherwise 146.25 ineligible for medical assistance under chapter 256B or general 146.26 assistance medical care under section 256D.03 are eligible for 146.27 medical assistance without federal financial participation. 146.28 These individuals are eligible only for the period during which 146.29 they are receiving services from the center. Individuals 146.30 eligible under this clause shall not be required to participate 146.31 in prepaid medical assistance. 146.32 [EFFECTIVE DATE.] This section is effective July 1, 2003, 146.33 except where a different date is specified in the text. 146.34 Sec. 16. Minnesota Statutes 2002, section 256B.061, is 146.35 amended to read: 146.36 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 147.1(a)If any individual has been determined to be eligible 147.2 for medical assistance, it will be made available for care and 147.3 services included under the plan and furnished in or after the 147.4 third month before the month in which the individual made 147.5 application for such assistance, if such individual was, or upon 147.6 application would have been, eligible for medical assistance at 147.7 the time the care and services were furnished. The commissioner 147.8 may limit, restrict, or suspend the eligibility of an individual 147.9 for up to one year upon that individual's conviction of a 147.10 criminal offense related to application for or receipt of 147.11 medical assistance benefits. 147.12(b) On the basis of information provided on the completed147.13application, an applicant who meets the following criteria shall147.14be determined eligible beginning in the month of application:147.15(1) whose gross income is less than 90 percent of the147.16applicable income standard;147.17(2) whose total liquid assets are less than 90 percent of147.18the asset limit;147.19(3) does not reside in a long-term care facility; and147.20(4) meets all other eligibility requirements.147.21The applicant must provide all required verifications within 30147.22days' notice of the eligibility determination or eligibility147.23shall be terminated.147.24 [EFFECTIVE DATE.] This section is repealed April 1, 2005, 147.25 if the HealthMatch system is operational. If the HealthMatch 147.26 system is not operational, this section is effective July 1, 147.27 2005. 147.28 Sec. 17. Minnesota Statutes 2002, section 256B.0625, 147.29 subdivision 13, is amended to read: 147.30 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 147.31 except for fertility drugs when specifically used to enhance 147.32 fertility, if prescribed by a licensed practitioner and 147.33 dispensed by a licensed pharmacist, by a physician enrolled in 147.34 the medical assistance program as a dispensing physician, or by 147.35 a physician or a nurse practitioner employed by or under 147.36 contract with a community health board as defined in section 148.1 145A.02, subdivision 5, for the purposes of communicable disease 148.2 control. The commissioner, after receiving recommendations from 148.3 professional medical associations and professional pharmacist 148.4 associations, shall designate a formulary committee to advise 148.5 the commissioner on the names of drugs for which payment is 148.6 made, recommend a system for reimbursing providers on a set fee 148.7 or charge basis rather than the present system, and develop 148.8 methods encouraging use of generic drugs when they are less 148.9 expensive and equally effective as trademark drugs. The 148.10 formulary committee shall consist of nine members, four of whom 148.11 shall be physicians who are not employed by the department of 148.12 human services, and a majority of whose practice is for persons 148.13 paying privately or through health insurance, three of whom 148.14 shall be pharmacists who are not employed by the department of 148.15 human services, and a majority of whose practice is for persons 148.16 paying privately or through health insurance, a consumer 148.17 representative, and a nursing home representative. Committee 148.18 members shall serve three-year terms and shall serve without 148.19 compensation. Members may be reappointed once. 148.20 (b) The commissioner shall establish a drug formulary. Its 148.21 establishment and publication shall not be subject to the 148.22 requirements of the Administrative Procedure Act, but the 148.23 formulary committee shall review and comment on the formulary 148.24 contents. 148.25 The formulary shall not include: 148.26 (i) drugs or products for which there is no federal 148.27 funding; 148.28 (ii) over-the-counter drugs, except for antacids, 148.29 acetaminophen, family planning products, aspirin, insulin, 148.30 products for the treatment of lice, vitamins for adults with 148.31 documented vitamin deficiencies, vitamins for children under the 148.32 age of seven and pregnant or nursing women, and any other 148.33 over-the-counter drug identified by the commissioner, in 148.34 consultation with the drug formulary committee, as necessary, 148.35 appropriate, and cost-effective for the treatment of certain 148.36 specified chronic diseases, conditions or disorders, and this 149.1 determination shall not be subject to the requirements of 149.2 chapter 14; 149.3 (iii)anorectics, except that medically necessary149.4anorectics shall be covered for a recipient previously diagnosed149.5as having pickwickian syndrome and currently diagnosed as having149.6diabetes and being morbidly obesedrugs used for weight loss; 149.7 (iv) drugs for which medical value has not been 149.8 established; and 149.9 (v) drugs from manufacturers who have not signed a rebate 149.10 agreement with the Department of Health and Human Services 149.11 pursuant to section 1927 of title XIX of the Social Security Act. 149.12 The commissioner shall publish conditions for prohibiting 149.13 payment for specific drugs after considering the formulary 149.14 committee's recommendations. An honorarium of $100 per meeting 149.15 and reimbursement for mileage shall be paid to each committee 149.16 member in attendance. 149.17 (c) The dispensed quantity of a prescribed drug must not 149.18 exceed a 30-day supply. The basis for determining the amount of 149.19 payment shall be the lower of the actual acquisition costs of 149.20 the drugs plus a fixed dispensing fee; the maximum allowable 149.21 cost set by the federal government or by the commissioner plus 149.22 the fixed dispensing fee; or the usual and customary price 149.23 charged to the public. The amount of payment basis must be 149.24 reduced to reflect all discount amounts applied to the charge by 149.25 any provider/insurer agreement or contract for submitted charges 149.26 to medical assistance programs. The net submitted charge may 149.27 not be greater than the patient liability for the service. The 149.28 pharmacy dispensing fee shall be $3.65, except that the 149.29 dispensing fee for intravenous solutions which must be 149.30 compounded by the pharmacist shall be $8 per bag, $14 per bag 149.31 for cancer chemotherapy products, and $30 per bag for total 149.32 parenteral nutritional products dispensed in one liter 149.33 quantities, or $44 per bag for total parenteral nutritional 149.34 products dispensed in quantities greater than one liter. Actual 149.35 acquisition cost includes quantity and other special discounts 149.36 except time and cash discounts. The actual acquisition cost of 150.1 a drug shall be estimated by the commissioner, at average 150.2 wholesale price minusnine14 percent, except that where a drug 150.3 has had its wholesale price reduced as a result of the actions 150.4 of the National Association of Medicaid Fraud Control Units, the 150.5 estimated actual acquisition cost shall be the reduced average 150.6 wholesale price, without thenine14 percent deduction. The 150.7 maximum allowable cost of a multisource drug may be set by the 150.8 commissioner and it shall be comparable to, but no higher than, 150.9 the maximum amount paid by other third-party payors in this 150.10 state who have maximum allowable cost programs.The150.11commissioner shall set maximum allowable costs for multisource150.12drugs that are not on the federal upper limit list as described150.13in United States Code, title 42, chapter 7, section 1396r-8(e),150.14the Social Security Act, and Code of Federal Regulations, title150.1542, part 447, section 447.332.Establishment of the amount of 150.16 payment for drugs shall not be subject to the requirements of 150.17 the Administrative Procedure Act. An additional dispensing fee 150.18 of $.30 may be added to the dispensing fee paid to pharmacists 150.19 for legend drug prescriptions dispensed to residents of 150.20 long-term care facilities when a unit dose blister card system, 150.21 approved by the department, is used. Under this type of 150.22 dispensing system, the pharmacist must dispense a 30-day supply 150.23 of drug. The National Drug Code (NDC) from the drug container 150.24 used to fill the blister card must be identified on the claim to 150.25 the department. The unit dose blister card containing the drug 150.26 must meet the packaging standards set forth in Minnesota Rules, 150.27 part 6800.2700, that govern the return of unused drugs to the 150.28 pharmacy for reuse. The pharmacy provider will be required to 150.29 credit the department for the actual acquisition cost of all 150.30 unused drugs that are eligible for reuse. Over-the-counter 150.31 medications must be dispensed in the manufacturer's unopened 150.32 package. The commissioner may permit the drug clozapine to be 150.33 dispensed in a quantity that is less than a 30-day supply. 150.34 Whenever a generically equivalent product is available, payment 150.35 shall be on the basis of the actual acquisition cost of the 150.36 generic drug,unless the prescriber specifically indicates151.1"dispense as written - brand necessary" on the prescription as151.2required by section 151.21, subdivision 2.or on the maximum 151.3 allowable cost established by the commissioner. The 151.4 commissioner may require prior authorization for brand-name 151.5 drugs whenever a generically equivalent product is available 151.6 even if the prescriber specifically indicates "dispense as 151.7 written - brand necessary" on the prescription as required by 151.8 section 151.21, subdivision 2. The formulary committee shall 151.9 establish general criteria to be used for the prior 151.10 authorization of brand-name drugs for which generically 151.11 equivalent drugs are available, but formulary committee review 151.12 of each brand-name drug for which a generically equivalent drug 151.13 is available shall not be required. 151.14 (d)For purposes of this subdivision, "multisource drugs"151.15means covered outpatient drugs, excluding innovator multisource151.16drugs for which there are two or more drug products, which:151.17(1) are related as therapeutically equivalent under the151.18Food and Drug Administration's most recent publication of151.19"Approved Drug Products with Therapeutic Equivalence151.20Evaluations";151.21(2) are pharmaceutically equivalent and bioequivalent as151.22determined by the Food and Drug Administration; and151.23(3) are sold or marketed in Minnesota.151.24"Innovator multisource drug" means a multisource drug that was151.25originally marketed under an original new drug application151.26approved by the Food and Drug Administration.151.27(e)The formulary committee shall review and recommend 151.28 drugs which require prior authorization. The formulary 151.29 committee may recommend drugs for prior authorization directly 151.30 to the commissioner, as long as opportunity for public input is 151.31 provided. Prior authorization may be requested by the 151.32 commissioner based on medical and clinical criteria and on cost 151.33 before certain drugs are eligible for payment. Before a drug 151.34 may be considered for prior authorization at the request of the 151.35 commissioner: 151.36 (1) the drug formulary committee must develop criteria to 152.1 be used for identifying drugs; the development of these criteria 152.2 is not subject to the requirements of chapter 14, but the 152.3 formulary committee shall provide opportunity for public input 152.4 in developing criteria; 152.5 (2) the drug formulary committee must hold a public forum 152.6 and receive public comment for an additional 15 days; 152.7 (3) the drug formulary committee must consider data from 152.8 the state Medicaid program if such data is available; and 152.9 (4) the commissioner must provide information to the 152.10 formulary committee on the impact that placing the drug on prior 152.11 authorization will have on the quality of patient care and on 152.12 program costs, and information regarding whether the drug is 152.13 subject to clinical abuse or misuse. 152.14 Prior authorization may be required by the commissioner 152.15 before certain formulary drugs are eligible for payment. If 152.16 prior authorization of a drug is required by the commissioner, 152.17 the commissioner must provide a 30-day notice period before 152.18 implementing the prior authorization. If a prior authorization 152.19 request is denied by the department, the recipient may appeal 152.20 the denial in accordance with section 256.045. If an appeal is 152.21 filed, the drug must be provided without prior authorization 152.22 until a decision is made on the appeal. 152.23(f)(e) The basis for determining the amount of payment for 152.24 drugs administered in an outpatient setting shall be the lower 152.25 of the usual and customary cost submitted by the provider; the 152.26 average wholesale price minus five percent; or the maximum 152.27 allowable cost set by the federal government under United States 152.28 Code, title 42, chapter 7, section 1396r-8(e), and Code of 152.29 Federal Regulations, title 42, section 447.332, or by the 152.30 commissioner under paragraph (c). 152.31(g)(f) Prior authorization shall not be required or 152.32 utilized for any antipsychotic drug prescribed for the treatment 152.33 of mental illness where there is no generically equivalent drug 152.34 available unless the commissioner determines that prior 152.35 authorization is necessary for patient safety. This paragraph 152.36 applies to any supplemental drug rebate program established or 153.1 administered by the commissioner. 153.2(h)(g) Prior authorization shall not be required or 153.3 utilized for any antihemophilic factor drug prescribed for the 153.4 treatment of hemophilia and blood disorders where there is no 153.5 generically equivalent drug available unless the commissioner 153.6 determines that prior authorization is necessary for patient 153.7 safety. This paragraph applies to any supplemental drug rebate 153.8 program established or administered by the commissioner. This 153.9 paragraph expires July 1, 2003. 153.10 Sec. 18. [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 153.11 Subdivision 1. [CO-PAYMENTS.] (a) Except as provided in 153.12 subdivision 2, the medical assistance benefit plan shall include 153.13 the following co-payments for all recipients, effective for 153.14 services provided on or after October 1, 2003: 153.15 (1) $3 per nonpreventive visit. For purposes of this 153.16 subdivision, a visit means an episode of service which is 153.17 required because of a recipient's symptoms, diagnosis, or 153.18 established illness, and which is delivered in an ambulatory 153.19 setting by a physician or physician ancillary, dentist, 153.20 chiropractor, podiatrist, nurse midwife, mental health 153.21 professional, advanced practice nurse, physical therapist, 153.22 occupational therapist, speech therapist, audiologist, optician, 153.23 or optometrist; 153.24 (2) $3 for eyeglasses; 153.25 (3) $6 for nonemergency visits to a hospital-based 153.26 emergency room; and 153.27 (4) $3 per brand-name drug prescription and $1 per generic 153.28 drug prescription. 153.29 (b) Recipients of medical assistance are responsible for 153.30 all co-payments in this subdivision. 153.31 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 153.32 following exceptions: 153.33 (1) children under the age of 21; 153.34 (2) pregnant women for services that relate to the 153.35 pregnancy or any other medical condition that may complicate the 153.36 pregnancy; 154.1 (3) recipients expected to reside for at least 30 days in a 154.2 hospital, nursing home, or intermediate care facility for the 154.3 mentally retarded; 154.4 (4) recipients receiving hospice care; 154.5 (5) 100 percent federally funded services provided by an 154.6 Indian health service; 154.7 (6) emergency services; 154.8 (7) family planning services; 154.9 (8) services that are paid by Medicare, resulting in the 154.10 medical assistance program paying for the coinsurance and 154.11 deductible; and 154.12 (9) co-payments that exceed one per day per provider for 154.13 nonpreventive visits, eyeglasses, and nonemergency visits to a 154.14 hospital-based emergency room. 154.15 Subd. 3. [COLLECTION.] The medical assistance 154.16 reimbursement to the provider shall be reduced by the amount of 154.17 the co-payment. The provider collects the co-payment from the 154.18 recipient. Providers may not deny services to individuals who 154.19 are unable to pay the co-payment. Providers must accept an 154.20 assertion from the recipient that they are unable to pay. 154.21 Sec. 19. Minnesota Statutes 2002, section 256B.0635, 154.22 subdivision 1, is amended to read: 154.23 Subdivision 1. [INCREASED EMPLOYMENT.] (a) Until June 30, 154.24 2002, medical assistance may be paid for persons who received 154.25 MFIP or medical assistance for families and children in at least 154.26 three of six months preceding the month in which the person 154.27 became ineligible for MFIP or medical assistance, if the 154.28 ineligibility was due to an increase in hours of employment or 154.29 employment income or due to the loss of an earned income 154.30 disregard. In addition, to receive continued assistance under 154.31 this section, persons who received medical assistance for 154.32 families and children but did not receive MFIP must have had 154.33 income less than or equal to the assistance standard for their 154.34 family size under the state's AFDC plan in effect as of July 16, 154.35 1996, increased by three percent effective July 1, 2000, at the 154.36 time medical assistance eligibility began. A person who is 155.1 eligible for extended medical assistance is entitled to six 155.2 months of assistance without reapplication, unless the 155.3 assistance unit ceases to include a dependent child. For a 155.4 person under 21 years of age, medical assistance may not be 155.5 discontinued within the six-month period of extended eligibility 155.6 until it has been determined that the person is not otherwise 155.7 eligible for medical assistance. Medical assistance may be 155.8 continued for an additional six months if the person meets all 155.9 requirements for the additional six months, according to title 155.10 XIX of the Social Security Act, as amended by section 303 of the 155.11 Family Support Act of 1988, Public LawNumber100-485. 155.12 (b) Beginning July 1, 2002, contingent upon federal 155.13 funding, medical assistance for families and children may be 155.14 paid for persons who were eligible under section 256B.055, 155.15 subdivision 3a, in at least three of six months preceding the 155.16 month in which the person became ineligible under that section 155.17 if the ineligibility was due to an increase in hours of 155.18 employment or employment income or due to the loss of an earned 155.19 income disregard. A person who is eligible for extended medical 155.20 assistance is entitled to six months of assistance without 155.21 reapplication, unless the assistance unit ceases to include a 155.22 dependent child, except medical assistance may not be 155.23 discontinued for that dependent child under 21 years of age 155.24 within the six-month period of extended eligibility until it has 155.25 been determined that the person is not otherwise eligible for 155.26 medical assistance. Medical assistance may be continued for an 155.27 additional six months if the person meets all requirements for 155.28 the additional six months, according to title XIX of the Social 155.29 Security Act, as amended by section 303 of the Family Support 155.30 Act of 1988, Public LawNumber100-485. 155.31 [EFFECTIVE DATE.] This section is effective July 1, 2003. 155.32 Sec. 20. Minnesota Statutes 2002, section 256B.0635, 155.33 subdivision 2, is amended to read: 155.34 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 155.35 June 30, 2002, medical assistance may be paid for persons who 155.36 received MFIP or medical assistance for families and children in 156.1 at least three of the six months preceding the month in which 156.2 the person became ineligible for MFIP or medical assistance, if 156.3 the ineligibility was the result of the collection of child or 156.4 spousal support under part D of title IV of the Social Security 156.5 Act. In addition, to receive continued assistance under this 156.6 section, persons who received medical assistance for families 156.7 and children but did not receive MFIP must have had income less 156.8 than or equal to the assistance standard for their family size 156.9 under the state's AFDC plan in effect as of July 16, 1996, 156.10 increased by three percent effective July 1, 2000, at the time 156.11 medical assistance eligibility began. A person who is eligible 156.12 for extended medical assistance under this subdivision is 156.13 entitled to four months of assistance without reapplication, 156.14 unless the assistance unit ceases to include a dependent child, 156.15 except medical assistance may not be discontinued for that 156.16 dependent child under 21 years of age within the four-month 156.17 period of extended eligibility until it has been determined that 156.18 the person is not otherwise eligible for medical assistance. 156.19 (b) Beginning July 1, 2002, contingent upon federal 156.20 funding, medical assistance for families and children may be 156.21 paid for persons who were eligible under section 256B.055, 156.22 subdivision 3a, in at least three of the six months preceding 156.23 the month in which the person became ineligible under that 156.24 section if the ineligibility was the result of the collection of 156.25 child or spousal support under part D of title IV of the Social 156.26 Security Act. A person who is eligible for extended medical 156.27 assistance under this subdivision is entitled to four months of 156.28 assistance without reapplication, unless the assistance unit 156.29 ceases to include a dependent child, except medical assistance 156.30 may not be discontinued for that dependent child under 21 years 156.31 of age within the four-month period of extended eligibility 156.32 until it has been determined that the person is not otherwise 156.33 eligible for medical assistance. 156.34 [EFFECTIVE DATE.] This section is effective July 1, 2003. 156.35 Sec. 21. Minnesota Statutes 2002, section 256B.15, 156.36 subdivision 1, is amended to read: 157.1 Subdivision 1. [POLICY, APPLICABILITY, PURPOSE, AND 157.2 CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 157.3 that individuals or couples, either or both of whom participate 157.4 in the medical assistance program, use their own assets to pay 157.5 their share of the total cost of their care during or after 157.6 their enrollment in the program according to applicable federal 157.7 law and the laws of this state. The following provisions apply: 157.8 (1) subdivisions 1c to 1k shall not apply to claims arising 157.9 under this section which are presented under section 525.313; 157.10 (2) the provisions of subdivisions 1c to 1k expanding the 157.11 interests included in an estate for purposes of recovery under 157.12 this section give effect to the provisions of United States 157.13 Code, title 42, section 1396p, governing recoveries, but do not 157.14 give rise to any express or implied liens in favor of any other 157.15 parties not named in these provisions; 157.16 (3) the continuation of a recipient's life estate or joint 157.17 tenancy interest in real property after the recipient's death 157.18 for the purpose of recovering medical assistance under this 157.19 section modifies common law principles holding that these 157.20 interests terminate on the death of the holder; 157.21 (4) all laws, rules, and regulations governing or involved 157.22 with a recovery of medical assistance shall be liberally 157.23 construed to accomplish their intended purposes; and 157.24 (5) a deceased recipient's life estate and joint tenancy 157.25 interests continued under this section shall be owned by the 157.26 remaindermen or surviving joint tenants as their interests may 157.27 appear on the date of the recipient's death. They shall not be 157.28 merged into the remainder interest or the interests of the 157.29 surviving joint tenants by reason of ownership. They shall be 157.30 subject to the provisions of this section. Any conveyance, 157.31 transfer, sale, assignment, or encumbrance by a remainderman, a 157.32 surviving joint tenant, or their heirs, successors, and assigns 157.33 shall be deemed to include all of their interest in the deceased 157.34 recipient's life estate or joint tenancy interest continued 157.35 under this section. 157.36 (b) For purposes of this section, "medical assistance" 158.1 includes the medical assistance program under this chapter and 158.2 the general assistance medical care program under chapter 256D, 158.3 but does not include the alternative care program for nonmedical 158.4 assistance recipients under section 256B.0913, subdivision 4. 158.5 [EFFECTIVE DATE.] This section is effective August 1, 2003, 158.6 and applies to estates of decedents who die on or after that 158.7 date. 158.8 Sec. 22. Minnesota Statutes 2002, section 256B.15, 158.9 subdivision 1a, is amended to read: 158.10 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 158.11 receives any medical assistance hereunder, on the person's 158.12 death, if single, or on the death of the survivor of a married 158.13 couple, either or both of whom received medical assistance, or 158.14 as otherwise provided for in this section, the total amount paid 158.15 for medical assistance rendered for the person and spouse shall 158.16 be filed as a claim against the estate of the person or the 158.17 estate of the surviving spouse in the court having jurisdiction 158.18 to probate the estate or to issue a decree of descent according 158.19 to sections 525.31 to 525.313. 158.20 A claim shall be filed if medical assistance was rendered 158.21 for either or both persons under one of the following 158.22 circumstances: 158.23 (a) the person was over 55 years of age, and received 158.24 services under this chapter, excluding alternative care; 158.25 (b) the person resided in a medical institution for six 158.26 months or longer, received services under this chapter excluding 158.27 alternative care, and, at the time of institutionalization or 158.28 application for medical assistance, whichever is later, the 158.29 person could not have reasonably been expected to be discharged 158.30 and returned home, as certified in writing by the person's 158.31 treating physician. For purposes of this section only, a 158.32 "medical institution" means a skilled nursing facility, 158.33 intermediate care facility, intermediate care facility for 158.34 persons with mental retardation, nursing facility, or inpatient 158.35 hospital; or 158.36 (c) the person received general assistance medical care 159.1 services under chapter 256D. 159.2 The claim shall be considered an expense of the last 159.3 illness of the decedent for the purpose of section 524.3-805. 159.4 Any statute of limitations that purports to limit any county 159.5 agency or the state agency, or both, to recover for medical 159.6 assistance granted hereunder shall not apply to any claim made 159.7 hereunder for reimbursement for any medical assistance granted 159.8 hereunder. Notice of the claim shall be given to all heirs and 159.9 devisees of the decedent whose identity can be ascertained with 159.10 reasonable diligence. The notice must include procedures and 159.11 instructions for making an application for a hardship waiver 159.12 under subdivision 5; time frames for submitting an application 159.13 and determination; and information regarding appeal rights and 159.14 procedures. Counties are entitled to one-half of the nonfederal 159.15 share of medical assistance collections from estates that are 159.16 directly attributable to county effort. 159.17 [EFFECTIVE DATE.] This section is effective August 1, 2003, 159.18 and applies to the estates of decedents who die on and after 159.19 that date. 159.20 Sec. 23. Minnesota Statutes 2002, section 256B.15, is 159.21 amended by adding a subdivision to read: 159.22 Subd. 1c. [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 159.23 with a claim or potential claim under this section may file a 159.24 notice of potential claim under this subdivision anytime before 159.25 or after a medical assistance recipient dies. The claimant 159.26 shall be the state agency. A notice filed prior to the 159.27 recipient's death shall not take effect and shall not be 159.28 effective as notice until the recipient dies. A notice filed 159.29 after a recipient dies shall be effective from the time of 159.30 filing. 159.31 (b) The notice of claim shall be filed or recorded in the 159.32 real estate records in the office of the county recorder or 159.33 registrar of titles for each county in which any part of the 159.34 property is located. The recorder shall accept the notice for 159.35 recording or filing. The registrar of titles shall accept the 159.36 notice for filing if the recipient has a recorded interest in 160.1 the property. The notice must be filed within one year after 160.2 the date of the recipient's death. The registrar of titles 160.3 shall not carry forward to a new certificate of title any notice 160.4 filed more than one year from the date of the recipient's death. 160.5 (c) The notice must be dated, state the name of the 160.6 claimant, the medical assistance recipient's name and social 160.7 security number if filed before their death and their date of 160.8 death if filed after they die, the name and date of death of any 160.9 predeceased spouse of the medical assistance recipient for whom 160.10 a claim may exist, a statement that the claimant may have a 160.11 claim arising under this section, generally identify the 160.12 recipient's interest in the property, contain a legal 160.13 description for the property and whether it is abstract or 160.14 registered property, a statement of when the notice becomes 160.15 effective and the effect of the notice, be signed by an 160.16 authorized representative of the state agency, and may include 160.17 such other contents as the state or county agency may deem 160.18 appropriate. 160.19 Sec. 24. Minnesota Statutes 2002, section 256B.15, is 160.20 amended by adding a subdivision to read: 160.21 Subd. 1d. [EFFECT OF NOTICE.] From the time it takes 160.22 effect, the notice shall be notice to remaindermen, joint 160.23 tenants, or to anyone else owning or acquiring an interest in or 160.24 encumbrance against the property described in the notice that 160.25 the medical assistance recipient's life estate, joint tenancy, 160.26 or other interests in the real estate described in the notice: 160.27 (1) shall, in the case of life estate and joint tenancy 160.28 interests, continue to exist for purposes of this section, and 160.29 be subject to liens and claims as provided in this section; 160.30 (2) shall be subject to a lien in favor of the claimant 160.31 effective upon the death of the recipient and dealt with as 160.32 provided in this section; 160.33 (3) may be included in the recipient's estate, as defined 160.34 in this section; and 160.35 (4) may be subject to administration and all other 160.36 provisions of chapter 524 and may be sold, assigned, 161.1 transferred, or encumbered free and clear of their interest or 161.2 encumbrance to satisfy claims under this section. 161.3 Sec. 25. Minnesota Statutes 2002, section 256B.15, is 161.4 amended by adding a subdivision to read: 161.5 Subd. 1e. [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 161.6 claimant may fully or partially release the notice and the lien 161.7 arising out of the notice of record in the real estate records 161.8 where the notice is filed or recorded at any time. The claimant 161.9 may give a full or partial release to extinguish any life 161.10 estates or joint tenancy interests which are or may be continued 161.11 under this section or whose existence or nonexistence may create 161.12 a cloud on the title to real property at any time whether or not 161.13 a notice has been filed. The recorder or registrar of titles 161.14 shall accept the release for recording or filing. If the 161.15 release is a partial release, it must include a legal 161.16 description of the property being released. 161.17 (b) At any time, the claimant may, at the claimant's 161.18 discretion, wholly or partially release, subordinate, modify, or 161.19 amend the recorded notice and the lien arising out of the notice. 161.20 Sec. 26. Minnesota Statutes 2002, section 256B.15, is 161.21 amended by adding a subdivision to read: 161.22 Subd. 1f. [AGENCY LIEN.] (a) The notice shall constitute a 161.23 lien in favor of the department of human services against the 161.24 recipient's interests in the real estate it describes for a 161.25 period of 20 years from the date of filing or the date of the 161.26 recipient's death, whichever is later. Notwithstanding any law 161.27 or rule to the contrary, a recipient's life estate and joint 161.28 tenancy interests shall not end upon the recipient's death but 161.29 shall continue according to subdivisions 1h, 1i, and 1j. The 161.30 amount of the lien shall be equal to the total amount of the 161.31 claims that could be presented in the recipient's estate under 161.32 this section. 161.33 (b) If no estate has been opened for the deceased 161.34 recipient, any holder of an interest in the property may apply 161.35 to the lien holder for a statement of the amount of the lien or 161.36 for a full or partial release of the lien. The application 162.1 shall include the applicant's name, current mailing address, 162.2 current home and work telephone numbers, and a description of 162.3 their interest in the property, a legal description of the 162.4 recipient's interest in the property, and the deceased 162.5 recipient's name, date of birth, and social security number. 162.6 The lien holder shall send the applicant by certified mail, 162.7 return receipt requested, a written statement showing the amount 162.8 of the lien, whether the lien holder is willing to release the 162.9 lien and under what conditions, and inform them of the right to 162.10 a hearing under section 256.045. The lien holder shall have the 162.11 discretion to compromise and settle the lien upon any terms and 162.12 conditions the lien holder deems appropriate. 162.13 (c) Any holder of an interest in property subject to the 162.14 lien has a right to request a hearing under section 256.045 to 162.15 determine the validity, extent, or amount of the lien. The 162.16 request must be in writing, and must include the names, current 162.17 addresses, and home and business telephone numbers for all other 162.18 parties holding an interest in the property. A request for a 162.19 hearing by any holder of an interest in the property shall be 162.20 deemed to be a request for a hearing by all parties owning 162.21 interests in the property. Notice of the hearing shall be given 162.22 to the lien holder, the party filing the appeal, and all of the 162.23 other holders of interests in the property at the addresses 162.24 listed in the appeal by certified mail, return receipt 162.25 requested, or by ordinary mail. Any owner of an interest in the 162.26 property to whom notice of the hearing is mailed shall be deemed 162.27 to have waived any and all claims or defenses in respect to the 162.28 lien unless they appear and assert any claims or defenses at the 162.29 hearing. 162.30 (d) If the claim the lien secures could be filed under 162.31 subdivision 1h, the lien holder may collect, compromise, settle, 162.32 or release the lien upon any terms and conditions it deems 162.33 appropriate. If the claim the lien secures could be filed under 162.34 subdivision 1i or 1j, the lien may be adjusted or enforced to 162.35 the same extent had it been filed under subdivisions 1i and 1j, 162.36 and the provisions of subdivisions 1i, clause (f), and lj, 163.1 clause (d), shall apply to voluntary payment, settlement, or 163.2 satisfaction of the lien. 163.3 (e) If no probate proceedings have been commenced for the 163.4 recipient as of the date the lien holder executes a release of 163.5 the lien on a recipient's life estate or joint tenancy interest, 163.6 created for purposes of this section, the release shall 163.7 terminate the life estate or joint tenancy interest created 163.8 under this section as of the date it is recorded or filed to the 163.9 extent of the release. If the claimant executes a release for 163.10 purposes of extinguishing a life estate or a joint tenancy 163.11 interest created under this section to remove a cloud on title 163.12 to real property, the release shall have the effect of 163.13 extinguishing any life estate or joint tenancy interests in the 163.14 property it describes which may have been continued by reason of 163.15 this section retroactive to the date of death of the deceased 163.16 life tenant or joint tenant except as provided for in section 163.17 514.981, subdivision 6. 163.18 (f) If the deceased recipient's estate is probated, a claim 163.19 shall be filed under this section. The amount of the lien shall 163.20 be limited to the amount of the claim as finally allowed. If 163.21 the claim the lien secures is filed under subdivision 1h, the 163.22 lien may be released in full after any allowance of the claim 163.23 becomes final or according to any agreement to settle and 163.24 satisfy the claim. The release shall release the lien but shall 163.25 not extinguish or terminate the interest being released. If the 163.26 claim the lien secures is filed under subdivision 1i or 1j, the 163.27 lien shall be released after the lien under subdivision 1i or 1j 163.28 is filed or recorded, or settled according to any agreement to 163.29 settle and satisfy the claim. The release shall not extinguish 163.30 or terminate the interest being released. If the claim is 163.31 finally disallowed in full, the claimant shall release the 163.32 claimant's lien at the claimant's expense. 163.33 [EFFECTIVE DATE.] This section takes effect on August 1, 163.34 2003, and applies to the estates of decedents who die on or 163.35 after that date. 163.36 Sec. 27. Minnesota Statutes 2002, section 256B.15, is 164.1 amended by adding a subdivision to read: 164.2 Subd. 1g. [ESTATE PROPERTY.] Notwithstanding any law or 164.3 rule to the contrary, if a claim is presented under this 164.4 section, interests or the proceeds of interests in real property 164.5 a decedent owned as a life tenant or a joint tenant with a right 164.6 of survivorship shall be part of the decedent's estate, subject 164.7 to administration, and shall be dealt with as provided in this 164.8 section. 164.9 [EFFECTIVE DATE.] This section takes effect on August 1, 164.10 2003, and applies to the estates of decedents who die on or 164.11 after that date. 164.12 Sec. 28. Minnesota Statutes 2002, section 256B.15, is 164.13 amended by adding a subdivision to read: 164.14 Subd. 1h. [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 164.15 ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 164.16 (k) apply if a person received medical assistance for which a 164.17 claim may be filed under this section and died single, or the 164.18 surviving spouse of the couple and was not survived by any of 164.19 the persons described in subdivisions 3 and 4. 164.20 (b) For purposes of this section, the person's estate 164.21 consists of: (1) their probate estate; (2) all of the person's 164.22 interests or proceeds of those interests in real property the 164.23 person owned as a life tenant or as a joint tenant with a right 164.24 of survivorship at the time of the person's death; (3) all of 164.25 the person's interests or proceeds of those interests in 164.26 securities the person owned in beneficiary form as provided 164.27 under sections 524.6-301 to 524.6-311 at the time of the 164.28 person's death, to the extent they become part of the probate 164.29 estate under section 524.6-307; and (4) all of the person's 164.30 interests in joint accounts, multiple party accounts, and pay on 164.31 death accounts, or the proceeds of those accounts, as provided 164.32 under sections 524.6-201 to 524.6-214 at the time of the 164.33 person's death to the extent they become part of the probate 164.34 estate under section 524.6-207. Notwithstanding any law or rule 164.35 to the contrary, a state or county agency with a claim under 164.36 this section shall be a creditor under section 524.6-307. 165.1 (c) Notwithstanding any law or rule to the contrary, the 165.2 person's life estate or joint tenancy interest in real property 165.3 not subject to a medical assistance lien under sections 514.980 165.4 to 514.985 on the date of the person's death shall not end upon 165.5 the person's death and shall continue as provided in this 165.6 subdivision. The life estate in the person's estate shall be 165.7 that portion of the interest in the real property subject to the 165.8 life estate which is equal to the percentage factor for the life 165.9 estate of the person and the medical assistance recipient's age 165.10 on the date of the person's death as listed in the Life Estate 165.11 Mortality Table of the health care program's manual. The joint 165.12 tenancy interest in real property in the estate shall be equal 165.13 to the fractional interest the person would have owned in the 165.14 jointly held interest in the property had they and the other 165.15 owners held title to the property as tenants in common on the 165.16 date the person died. 165.17 (d) The court upon its own motion, or upon motion by the 165.18 personal representative or any interested party, may enter an 165.19 order directing the remaindermen or surviving joint tenants and 165.20 their spouses, if any, to sign all documents, take all actions, 165.21 and otherwise fully cooperate with the personal representative 165.22 and the court to liquidate the decedent's life estate or joint 165.23 tenancy interests in the estate and deliver the cash or the 165.24 proceeds of those interests to the personal representative and 165.25 provide for any legal and equitable sanctions as the court deems 165.26 appropriate to enforce and carry out the order, including an 165.27 award of reasonable attorney fees. 165.28 (e) The personal representative may make, execute, and 165.29 deliver any conveyances or other documents necessary to convey 165.30 the decedent's life estate or joint tenancy interest in the 165.31 estate that are necessary to liquidate and reduce to cash the 165.32 decedent's interest or for any other purposes. 165.33 (f) Subject to administration, all costs, including 165.34 reasonable attorney fees, directly and immediately related to 165.35 liquidating the decedent's life estate or joint tenancy interest 165.36 in the decedent's estate, shall be paid from the gross proceeds 166.1 of the liquidation allocable to the decedent's interest and the 166.2 net proceeds shall be turned over to the personal representative 166.3 and applied to payment of the claim presented under this section. 166.4 (g) The personal representative shall bring a motion in the 166.5 district court in which the estate is being probated to compel 166.6 the remaindermen or surviving joint tenants to account for and 166.7 deliver to the personal representative all or any part of the 166.8 proceeds of any sale, mortgage, transfer, conveyance, or any 166.9 disposition of real property allocable to the decedent's life 166.10 estate or joint tenancy interest in the decedent's estate, and 166.11 do everything necessary to liquidate and reduce to cash the 166.12 decedent's interest and turn the proceeds of the sale or other 166.13 disposition over to the personal representative. The court may 166.14 grant any legal or equitable relief including, but not limited 166.15 to, ordering a partition of real estate under chapter 558 166.16 necessary to make the value of the decedent's life estate or 166.17 joint tenancy interest available to the estate for payment of a 166.18 claim under this section. 166.19 (h) Subject to administration, the personal representative 166.20 shall use all of the cash or proceeds of interests to pay an 166.21 allowable claim under this section. The remaindermen or 166.22 surviving joint tenants and their spouses, if any, may enter 166.23 into a written agreement with the personal representative or the 166.24 claimant to settle and satisfy obligations imposed at any time 166.25 before or after a claim is filed. 166.26 (i) The personal representative may provide any or all of 166.27 the other owners, remaindermen, or surviving joint tenants with 166.28 an affidavit terminating the decedent's estate's interest in 166.29 real property the decedent owned as a life tenant or as a joint 166.30 tenant with others, if the personal representative determines 166.31 that neither the decedent nor any of the decedent's predeceased 166.32 spouses received any medical assistance for which a claim could 166.33 be filed under this section, or if the personal representative 166.34 has filed an affidavit with the court that the estate has other 166.35 assets sufficient to pay a claim, as presented, or if there is a 166.36 written agreement under paragraph (h), or if the claim, as 167.1 allowed, has been paid in full or to the full extent of the 167.2 assets the estate has available to pay it. The affidavit may be 167.3 recorded in the office of the county recorder or filed in the 167.4 office of the registrar of titles for the county in which the 167.5 real property is located. Except as provided in section 167.6 514.981, subdivision 6, when recorded or filed, the affidavit 167.7 shall terminate the decedent's interest in real estate the 167.8 decedent owned as a life tenant or a joint tenant with others. 167.9 The affidavit shall: (1) be signed by the personal 167.10 representative; (2) identify the decedent and the interest being 167.11 terminated; (3) give recording information sufficient to 167.12 identify the instrument that created the interest in real 167.13 property being terminated; (4) legally describe the affected 167.14 real property; (5) state that the personal representative has 167.15 determined that neither the decedent nor any of the decedent's 167.16 predeceased spouses received any medical assistance for which a 167.17 claim could be filed under this section; (6) state that the 167.18 decedent's estate has other assets sufficient to pay the claim, 167.19 as presented, or that there is a written agreement between the 167.20 personal representative and the claimant and the other owners or 167.21 remaindermen or other joint tenants to satisfy the obligations 167.22 imposed under this subdivision; and (7) state that the affidavit 167.23 is being given to terminate the estate's interest under this 167.24 subdivision, and any other contents as may be appropriate. 167.25 The recorder or registrar of titles shall accept the affidavit 167.26 for recording or filing. The affidavit shall be effective as 167.27 provided in this section and shall constitute notice even if it 167.28 does not include recording information sufficient to identify 167.29 the instrument creating the interest it terminates. The 167.30 affidavit shall be conclusive evidence of the stated facts. 167.31 (j) The holder of a lien arising under subdivision 1c shall 167.32 release the lien at the holder's expense against an interest 167.33 terminated under paragraph (h) to the extent of the termination. 167.34 (k) If a lien arising under subdivision 1c is not released 167.35 under paragraph (j), prior to closing the estate, the personal 167.36 representative shall deed the interest subject to the lien to 168.1 the remaindermen or surviving joint tenants as their interests 168.2 may appear. Upon recording or filing, the deed shall work a 168.3 merger of the recipient's life estate or joint tenancy interest, 168.4 subject to the lien, into the remainder interest or interest the 168.5 decedent and others owned jointly. The lien shall attach to and 168.6 run with the property to the extent of the decedent's interest 168.7 at the time of the decedent's death. 168.8 [EFFECTIVE DATE.] This section takes effect on August 1, 168.9 2003, and applies to the estates of decedents who die on or 168.10 after that date. 168.11 Sec. 29. Minnesota Statutes 2002, section 256B.15, is 168.12 amended by adding a subdivision to read: 168.13 Subd. 1i. [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 168.14 AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 168.15 the person's estate consists of the person's probate estate and 168.16 all of the person's interests in real property the person owned 168.17 as a life tenant or a joint tenant at the time of the person's 168.18 death. 168.19 (b) Notwithstanding any law or rule to the contrary, this 168.20 subdivision applies if a person received medical assistance for 168.21 which a claim could be filed under this section but for the fact 168.22 the person was survived by a spouse or by a person listed in 168.23 subdivision 3, or if subdivision 4 applies to a claim arising 168.24 under this section. 168.25 (c) The person's life estate or joint tenancy interests in 168.26 real property not subject to a medical assistance lien under 168.27 sections 514.980 to 514.985 on the date of the person's death 168.28 shall not end upon death and shall continue as provided in this 168.29 subdivision. The life estate in the estate shall be the portion 168.30 of the interest in the property subject to the life estate that 168.31 is equal to the percentage factor for the life estate of the 168.32 medical assistance recipient's age on the date of the person's 168.33 death as listed in the Life Estate Mortality Table in the health 168.34 care program's manual. The joint tenancy interest in the estate 168.35 shall be equal to the fractional interest the medical assistance 168.36 recipient would have owned in the jointly held interest in the 169.1 property had they and the other owners held title to the 169.2 property as tenants in common on the date the medical assistance 169.3 recipient died. 169.4 (d) The county agency shall file a claim in the estate 169.5 under this section on behalf of the claimant who shall be the 169.6 commissioner of human services, notwithstanding that the 169.7 decedent is survived by a spouse or a person listed in 169.8 subdivision 3. The claim, as allowed, shall not be paid by the 169.9 estate and shall be disposed of as provided in this paragraph. 169.10 The personal representative or the court shall make, execute, 169.11 and deliver a lien in favor of the claimant on the decedent's 169.12 interest in real property in the estate in the amount of the 169.13 allowed claim on forms provided by the commissioner to the 169.14 county agency filing the lien. The lien shall bear interest as 169.15 provided under section 524.3-806, shall attach to the property 169.16 it describes upon filing or recording, and shall remain a lien 169.17 on the real property it describes for a period of 20 years from 169.18 the date it is filed or recorded. The lien shall be a 169.19 disposition of the claim sufficient to permit the estate to 169.20 close. 169.21 (e) The state or county agency shall file or record the 169.22 lien in the office of the county recorder or registrar of titles 169.23 for each county in which any of the real property is located. 169.24 The recorder or registrar of titles shall accept the lien for 169.25 filing or recording. All recording or filing fees shall be paid 169.26 by the department of human services. The recorder or registrar 169.27 of titles shall mail the recorded lien to the department of 169.28 human services. The lien need not be attested, certified, or 169.29 acknowledged as a condition of recording or filing. Upon 169.30 recording or filing of a lien against a life estate or a joint 169.31 tenancy interest, the interest subject to the lien shall merge 169.32 into the remainder interest or the interest the recipient and 169.33 others owned jointly. The lien shall attach to and run with the 169.34 property to the extent of the decedent's interest in the 169.35 property at the time of the decedent's death as determined under 169.36 this section. 170.1 (f) The department shall make no adjustment or recovery 170.2 under the lien until after the decedent's spouse, if any, has 170.3 died, and only at a time when the decedent has no surviving 170.4 child described in subdivision 3. The estate, any owner of an 170.5 interest in the property which is or may be subject to the lien, 170.6 or any other interested party, may voluntarily pay off, settle, 170.7 or otherwise satisfy the claim secured or to be secured by the 170.8 lien at any time before or after the lien is filed or recorded. 170.9 Such payoffs, settlements, and satisfactions shall be deemed to 170.10 be voluntary repayments of past medical assistance payments for 170.11 the benefit of the deceased recipient, and neither the process 170.12 of settling the claim, the payment of the claim, or the 170.13 acceptance of a payment shall constitute an adjustment or 170.14 recovery that is prohibited under this subdivision. 170.15 (g) The lien under this subdivision may be enforced or 170.16 foreclosed in the manner provided by law for the enforcement of 170.17 judgment liens against real estate or by a foreclosure by action 170.18 under chapter 581. When the lien is paid, satisfied, or 170.19 otherwise discharged, the state or county agency shall prepare 170.20 and file a release of lien at its own expense. No action to 170.21 foreclose the lien shall be commenced unless the lien holder has 170.22 first given 30 days' prior written notice to pay the lien to the 170.23 owners and parties in possession of the property subject to the 170.24 lien. The notice shall: (1) include the name, address, and 170.25 telephone number of the lien holder; (2) describe the lien; (3) 170.26 give the amount of the lien; (4) inform the owner or party in 170.27 possession that payment of the lien in full must be made to the 170.28 lien holder within 30 days after service of the notice or the 170.29 lien holder may begin proceedings to foreclose the lien; and (5) 170.30 be served by personal service, certified mail, return receipt 170.31 requested, ordinary first class mail, or by publishing it once 170.32 in a newspaper of general circulation in the county in which any 170.33 part of the property is located. Service of the notice shall be 170.34 complete upon mailing or publication. 170.35 [EFFECTIVE DATE.] This section takes effect August 1, 2003, 170.36 and applies to estates of decedents who die on and after that 171.1 date. 171.2 Sec. 30. Minnesota Statutes 2002, section 256B.15, is 171.3 amended by adding a subdivision to read: 171.4 Subd. 1j. [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 171.5 OTHER SURVIVORS.] For purposes of this subdivision, the 171.6 provisions in subdivision 1i, paragraphs (a) to (c) apply. 171.7 (a) If payment of a claim filed under this section is 171.8 limited as provided in subdivision 4, and if the estate does not 171.9 have other assets sufficient to pay the claim in full, as 171.10 allowed, the personal representative or the court shall make, 171.11 execute, and deliver a lien on the property in the estate that 171.12 is exempt from the claim under subdivision 4 in favor of the 171.13 commissioner of human services on forms provided by the 171.14 commissioner to the county agency filing the claim. If the 171.15 estate pays a claim filed under this section in full from other 171.16 assets of the estate, no lien shall be filed against the 171.17 property described in subdivision 4. 171.18 (b) The lien shall be in an amount equal to the unpaid 171.19 balance of the allowed claim under this section remaining after 171.20 the estate has applied all other available assets of the estate 171.21 to pay the claim. The property exempt under subdivision 4 shall 171.22 not be sold, assigned, transferred, conveyed, encumbered, or 171.23 distributed until after the personal representative has 171.24 determined the estate has other assets sufficient to pay the 171.25 allowed claim in full, or until after the lien has been filed or 171.26 recorded. The lien shall bear interest as provided under 171.27 section 524.3-806, shall attach to the property it describes 171.28 upon filing or recording, and shall remain a lien on the real 171.29 property it describes for a period of 20 years from the date it 171.30 is filed or recorded. The lien shall be a disposition of the 171.31 claim sufficient to permit the estate to close. 171.32 (c) The state or county agency shall file or record the 171.33 lien in the office of the county recorder or registrar of titles 171.34 in each county in which any of the real property is located. 171.35 The department shall pay the filing fees. The lien need not be 171.36 attested, certified, or acknowledged as a condition of recording 172.1 or filing. The recorder or registrar of titles shall accept the 172.2 lien for filing or recording. 172.3 (d) The commissioner shall make no adjustment or recovery 172.4 under the lien until none of the persons listed in subdivision 4 172.5 are residing on the property or until the property is sold or 172.6 transferred. The estate or any owner of an interest in the 172.7 property that is or may be subject to the lien, or any other 172.8 interested party, may voluntarily pay off, settle, or otherwise 172.9 satisfy the claim secured or to be secured by the lien at any 172.10 time before or after the lien is filed or recorded. The 172.11 payoffs, settlements, and satisfactions shall be deemed to be 172.12 voluntary repayments of past medical assistance payments for the 172.13 benefit of the deceased recipient and neither the process of 172.14 settling the claim, the payment of the claim, or acceptance of a 172.15 payment shall constitute an adjustment or recovery that is 172.16 prohibited under this subdivision. 172.17 (e) A lien under this subdivision may be enforced or 172.18 foreclosed in the manner provided for by law for the enforcement 172.19 of judgment liens against real estate or by a foreclosure by 172.20 action under chapter 581. When the lien has been paid, 172.21 satisfied, or otherwise discharged, the claimant shall prepare 172.22 and file a release of lien at the claimant's expense. No action 172.23 to foreclose the lien shall be commenced unless the lien holder 172.24 has first given 30 days prior written notice to pay the lien to 172.25 the record owners of the property and the parties in possession 172.26 of the property subject to the lien. The notice shall: (1) 172.27 include the name, address, and telephone number of the lien 172.28 holder; (2) describe the lien; (3) give the amount of the lien; 172.29 (4) inform the owner or party in possession that payment of the 172.30 lien in full must be made to the lien holder within 30 days 172.31 after service of the notice or the lien holder may begin 172.32 proceedings to foreclose the lien; and (5) be served by personal 172.33 service, certified mail, return receipt requested, ordinary 172.34 first class mail, or by publishing it once in a newspaper of 172.35 general circulation in the county in which any part of the 172.36 property is located. Service shall be complete upon mailing or 173.1 publication. 173.2 (f) Upon filing or recording of a lien against a life 173.3 estate or joint tenancy interest under this subdivision, the 173.4 interest subject to the lien shall merge into the remainder 173.5 interest or the interest the decedent and others owned jointly, 173.6 effective on the date of recording and filing. The lien shall 173.7 attach to and run with the property to the extent of the 173.8 decedent's interest in the property at the time of the 173.9 decedent's death as determined under this section. 173.10 (g)(1) An affidavit may be provided by a personal 173.11 representative stating the personal representative has 173.12 determined in good faith that a decedent survived by a spouse or 173.13 a person listed in subdivision 3, or by a person listed in 173.14 subdivision 4, or the decedent's predeceased spouse did not 173.15 receive any medical assistance giving rise to a claim under this 173.16 section, or that the real property described in subdivision 4 is 173.17 not needed to pay in full a claim arising under this section. 173.18 (2) The affidavit shall: (i) describe the property and the 173.19 interest being extinguished; (ii) name the decedent and give the 173.20 date of death; (iii) state the facts listed in clause (1); (iv) 173.21 state that the affidavit is being filed to terminate the life 173.22 estate or joint tenancy interest created under this subdivision; 173.23 (v) be signed by the personal representative; and (vi) contain 173.24 any other information that the affiant deems appropriate. 173.25 (3) Except as provided in section 514.981, subdivision 6, 173.26 when the affidavit is filed or recorded, the life estate or 173.27 joint tenancy interest in real property that the affidavit 173.28 describes shall be terminated effective as of the date of filing 173.29 or recording. The termination shall be final and may not be set 173.30 aside for any reason. 173.31 [EFFECTIVE DATE.] This section takes effect on August 1, 173.32 2003, and applies to the estates of decedents who die on or 173.33 after that date. 173.34 Sec. 31. Minnesota Statutes 2002, section 256B.15, is 173.35 amended by adding a subdivision to read: 173.36 Subd. 1k. [FILING.] Any notice, lien, release, or other 174.1 document filed under subdivisions 1c to 1l, and any lien, 174.2 release of lien, or other documents relating to a lien filed 174.3 under subdivisions 1h and 1i must be filed or recorded in the 174.4 office of the county recorder or registrar of titles, as 174.5 appropriate, in the county where the affected real property is 174.6 located. Notwithstanding section 386.77, the state or county 174.7 agency shall pay any applicable filing fee. An attestation, 174.8 certification, or acknowledgment is not required as a condition 174.9 of filing. If the property described in the filing is 174.10 registered property, the registrar of titles shall record the 174.11 filing on the certificate of title for each parcel of property 174.12 described in the filing. If the property described in the 174.13 filing is abstract property, the recorder shall file and index 174.14 the property in the county's grantor-grantee indexes and any 174.15 tract indexes the county maintains for each parcel of property 174.16 described in the filing. The recorder or registrar of titles 174.17 shall return the filed document to the party filing it at no 174.18 cost. If the party making the filing provides a duplicate copy 174.19 of the filing, the recorder or registrar of titles shall show 174.20 the recording or filing data on the copy and return it to the 174.21 party at no extra cost. 174.22 [EFFECTIVE DATE.] This section takes effect on August 1, 174.23 2003, and applies to the estates of decedents who die on or 174.24 after that date. 174.25 Sec. 32. Minnesota Statutes 2002, section 256B.15, 174.26 subdivision 3, is amended to read: 174.27 Subd. 3. [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 174.28 CHILDREN.] If a decedentwhois survived by a spouse, or was 174.29 single,orwho wasthe surviving spouse of a married couple,and 174.30 is survived by a child who is under age 21 or blind or 174.31 permanently and totally disabled according to the supplemental 174.32 security income program criteria,noa claim shall be filed 174.33 against the estate according to this section. 174.34 [EFFECTIVE DATE.] This section is effective August 1, 2003, 174.35 and applies to decedents who die on or after that date. 174.36 Sec. 33. Minnesota Statutes 2002, section 256B.15, 175.1 subdivision 4, is amended to read: 175.2 Subd. 4. [OTHER SURVIVORS.] If the decedent who was single 175.3 or the surviving spouse of a married couple is survived by one 175.4 of the following persons, a claim exists against the estate in 175.5 an amount not to exceed the value of the nonhomestead property 175.6 included in the estate and the personal representative shall 175.7 make, execute, and deliver to the county agency a lien against 175.8 the homestead property in the estate for any unpaid balance of 175.9 the claim to the claimant as provided under this section: 175.10 (a) a sibling who resided in the decedent medical 175.11 assistance recipient's home at least one year before the 175.12 decedent's institutionalization and continuously since the date 175.13 of institutionalization; or 175.14 (b) a son or daughter or a grandchild who resided in the 175.15 decedent medical assistance recipient's home for at least two 175.16 years immediately before the parent's or grandparent's 175.17 institutionalization and continuously since the date of 175.18 institutionalization, and who establishes by a preponderance of 175.19 the evidence having provided care to the parent or grandparent 175.20 who received medical assistance, that the care was provided 175.21 before institutionalization, and that the care permitted the 175.22 parent or grandparent to reside at home rather than in an 175.23 institution. 175.24 [EFFECTIVE DATE.] This section is effective August 1, 2003, 175.25 and applies to decedents who die on or after that date. 175.26 Sec. 34. Minnesota Statutes 2002, section 256B.195, 175.27 subdivision 4, is amended to read: 175.28 Subd. 4. [ADJUSTMENTS PERMITTED.] (a) The commissioner may 175.29 adjust the intergovernmental transfers under subdivision 2 and 175.30 the payments under subdivision 3,and payments and transfers175.31under subdivision 5,based on the commissioner's determination 175.32 of Medicare upper payment limits, hospital-specific charge 175.33 limits, and hospital-specific limitations on disproportionate 175.34 share payments. Any adjustments must be made on a proportional 175.35 basis. If participation by a particular hospital under this 175.36 section is limited, the commissioner shall adjust the payments 176.1 that relate to that hospital under subdivisions 2,and 3, and 5176.2 on a proportional basis in order to allow the hospital to 176.3 participate under this section to the fullest extent possible 176.4 and shall increase other payments under subdivisions 2,and 3,176.5and 5to the extent allowable to maintain the overall level of 176.6 payments under this section. The commissioner may make 176.7 adjustments under this subdivision only after consultation with 176.8 the counties and hospitals identified in subdivisions 2 and 3,176.9and, if subdivision 5 receives federal approval, with the176.10hospital and educational institution identified in subdivision 5. 176.11 (b) The ratio of medical assistance payments specified in 176.12 subdivision 3 to the intergovernmental transfers specified in 176.13 subdivision 2 shall not be reduced except as provided under 176.14 paragraph (a). 176.15 (c) The increase in intergovernmental transfers and 176.16 payments that result from section 256.969, subdivision 3a, 176.17 paragraph (c), shall be paid to the general fund. 176.18 Sec. 35. Minnesota Statutes 2002, section 256B.32, 176.19 subdivision 1, is amended to read: 176.20 Subdivision 1. [FACILITY FEE PAYMENT.] (a) The 176.21 commissioner shall establish a facility fee payment mechanism 176.22 that will pay a facility fee to all enrolled outpatient 176.23 hospitals for each emergency room or outpatient clinic visit 176.24 provided on or after July 1, 1989. This payment mechanism may 176.25 not result in an overall increase in outpatient payment rates. 176.26 This section does not apply to federally mandated maximum 176.27 payment limits, department approved program packages, or 176.28 services billed using a nonoutpatient hospital provider number. 176.29 (b) For fee-for-service services provided on or after July 176.30 1, 2002, the total payment, before third-party liability and 176.31 spenddown, made to hospitals for outpatient hospital facility 176.32 services is reduced by .5 percent from the current statutory 176.33 rates. 176.34 (c) In addition to the reduction in paragraph (b), the 176.35 total payment for fee-for-service services provided on or after 176.36 July 1, 2003, made to hospitals for outpatient hospital facility 177.1 services before third-party liability and spenddown, is reduced 177.2 five percent from the current statutory rates. Facilities 177.3 defined under section 256.969, subdivision 16, are excluded from 177.4 this paragraph. 177.5 Sec. 36. Minnesota Statutes 2002, section 256B.69, 177.6 subdivision 2, is amended to read: 177.7 Subd. 2. [DEFINITIONS.] For the purposes of this section, 177.8 the following terms have the meanings given. 177.9 (a) "Commissioner" means the commissioner of human services. 177.10 For the remainder of this section, the commissioner's 177.11 responsibilities for methods and policies for implementing the 177.12 project will be proposed by the project advisory committees and 177.13 approved by the commissioner. 177.14 (b) "Demonstration provider" means a health maintenance 177.15 organization, community integrated service network, or 177.16 accountable provider network authorized and operating under 177.17 chapter 62D, 62N, or 62T that participates in the demonstration 177.18 project according to criteria, standards, methods, and other 177.19 requirements established for the project and approved by the 177.20 commissioner. For purposes of this section, a county board, or 177.21 group of county boards operating under a joint powers agreement, 177.22 is considered a demonstration provider if the county or group of 177.23 county boards meets the requirements of section 256B.692. 177.24 Notwithstanding the above, Itasca county may continue to 177.25 participate as a demonstration provider until July 1, 2004. 177.26 (c) "Eligible individuals" means those persons eligible for 177.27 medical assistance benefits as defined in sections 256B.055, 177.28 256B.056, and 256B.06. 177.29 (d) "Limitation of choice" means suspending freedom of 177.30 choice while allowing eligible individuals to choose among the 177.31 demonstration providers. 177.32(e) This paragraph supersedes paragraph (c) as long as the177.33Minnesota health care reform waiver remains in effect. When the177.34waiver expires, this paragraph expires and the commissioner of177.35human services shall publish a notice in the State Register and177.36notify the revisor of statutes. "Eligible individuals" means178.1those persons eligible for medical assistance benefits as178.2defined in sections 256B.055, 256B.056, and 256B.06.178.3Notwithstanding sections 256B.055, 256B.056, and 256B.06, an178.4individual who becomes ineligible for the program because of178.5failure to submit income reports or recertification forms in a178.6timely manner, shall remain enrolled in the prepaid health plan178.7and shall remain eligible to receive medical assistance coverage178.8through the last day of the month following the month in which178.9the enrollee became ineligible for the medical assistance178.10program.178.11 [EFFECTIVE DATE.] This section is effective July 1, 2003. 178.12 Sec. 37. Minnesota Statutes 2002, section 256B.69, 178.13 subdivision 4, is amended to read: 178.14 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 178.15 shall develop criteria to determine when limitation of choice 178.16 may be implemented in the experimental counties. The criteria 178.17 shall ensure that all eligible individuals in the county have 178.18 continuing access to the full range of medical assistance 178.19 services as specified in subdivision 6. 178.20 (b) The commissioner shall exempt the following persons 178.21 from participation in the project, in addition to those who do 178.22 not meet the criteria for limitation of choice: 178.23 (1) persons eligible for medical assistance according to 178.24 section 256B.055, subdivision 1; 178.25 (2) persons eligible for medical assistance due to 178.26 blindness or disability as determined by the social security 178.27 administration or the state medical review team, unless: 178.28 (i) they are 65 years of age or older; or 178.29 (ii) they reside in Itasca county or they reside in a 178.30 county in which the commissioner conducts a pilot project under 178.31 a waiver granted pursuant to section 1115 of the Social Security 178.32 Act; 178.33 (3) recipients who currently have private coverage through 178.34 a health maintenance organization; 178.35 (4) recipients who are eligible for medical assistance by 178.36 spending down excess income for medical expenses other than the 179.1 nursing facility per diem expense; 179.2 (5) recipients who receive benefits under the Refugee 179.3 Assistance Program, established under United States Code, title 179.4 8, section 1522(e); 179.5 (6) children who are both determined to be severely 179.6 emotionally disturbed and receiving case management services 179.7 according to section 256B.0625, subdivision 20; 179.8 (7) adults who are both determined to be seriously and 179.9 persistently mentally ill and received case management services 179.10 according to section 256B.0625, subdivision 20;and179.11 (8) persons eligible for medical assistance according to 179.12 section 256B.057, subdivision 10; and 179.13 (9) persons with access to cost-effective 179.14 employer-sponsored private health insurance or persons enrolled 179.15 in an individual health plan determined to be cost-effective 179.16 according to section 256B.0625, subdivision 15. 179.17 Children under age 21 who are in foster placement may enroll in 179.18 the project on an elective basis. Individuals excluded under 179.19 clauses (6) and (7) may choose to enroll on an elective basis. 179.20 (c) The commissioner may allow persons with a one-month 179.21 spenddown who are otherwise eligible to enroll to voluntarily 179.22 enroll or remain enrolled, if they elect to prepay their monthly 179.23 spenddown to the state. 179.24 (d) The commissioner may require those individuals to 179.25 enroll in the prepaid medical assistance program who otherwise 179.26 would have been excluded under paragraph (b), clauses (1), (3), 179.27 and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 179.28 items H, K, and L. 179.29 (e) Before limitation of choice is implemented, eligible 179.30 individuals shall be notified and after notification, shall be 179.31 allowed to choose only among demonstration providers. The 179.32 commissioner may assign an individual with private coverage 179.33 through a health maintenance organization, to the same health 179.34 maintenance organization for medical assistance coverage, if the 179.35 health maintenance organization is under contract for medical 179.36 assistance in the individual's county of residence. After 180.1 initially choosing a provider, the recipient is allowed to 180.2 change that choice only at specified times as allowed by the 180.3 commissioner. If a demonstration provider ends participation in 180.4 the project for any reason, a recipient enrolled with that 180.5 provider must select a new provider but may change providers 180.6 without cause once more within the first 60 days after 180.7 enrollment with the second provider. 180.8 Sec. 38. Minnesota Statutes 2002, section 256B.69, 180.9 subdivision 5c, is amended to read: 180.10 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 180.11 commissioner of human services shall transfer each year to the 180.12 medical education and research fund established under section 180.13 62J.692, the following: 180.14 (1) an amount equal to the reduction in the prepaid medical 180.15 assistance and prepaid general assistance medical care payments 180.16 as specified in this clause. Until January 1, 2002, the county 180.17 medical assistance and general assistance medical care 180.18 capitation base rate prior to plan specific adjustments and 180.19 after the regional rate adjustments under section 256B.69, 180.20 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 180.21 percent for the remaining metropolitan counties, and no 180.22 reduction for nonmetropolitan Minnesota counties; and after 180.23 January 1, 2002, the county medical assistance and general 180.24 assistance medical care capitation base rate prior to plan 180.25 specific adjustments is reduced 6.3 percent for Hennepin county, 180.26 two percent for the remaining metropolitan counties, and 1.6 180.27 percent for nonmetropolitan Minnesota counties. Nursing 180.28 facility and elderly waiver payments and demonstration project 180.29 payments operating under subdivision 23 are excluded from this 180.30 reduction. The amount calculated under this clause shall not be 180.31 adjusted for periods already paid due to subsequent changes to 180.32 the capitation payments; 180.33 (2) beginning July 1,2001, $2,537,0002003, $2,157,000 180.34 from the capitation rates paid under this section plus any 180.35 federal matching funds on this amount; 180.36 (3) beginning July 1, 2002, an additional $12,700,000 from 181.1 the capitation rates paid under this section; and 181.2 (4) beginning July 1, 2003, an additional $4,700,000 from 181.3 the capitation rates paid under this section. 181.4 (b) This subdivision shall be effective upon approval of a 181.5 federal waiver which allows federal financial participation in 181.6 the medical education and research fund. 181.7 (c) Effective July 1, 2003, the amount from general 181.8 assistance medical care under paragraph (a), clause (1), shall 181.9 be transferred to the general fund. 181.10 Sec. 39. Minnesota Statutes 2002, section 256B.69, is 181.11 amended by adding a subdivision to read: 181.12 Subd. 5h. [PAYMENT REDUCTION.] In addition to the 181.13 reduction in subdivision 5g, the total payment made to managed 181.14 care plans under the medical assistance program is reduced one 181.15 percent for services provided on or after October 1, 2003, and 181.16 an additional one percent for services provided on or after 181.17 January 1, 2004. This provision excludes payments for nursing 181.18 home services, home and community-based waivers, and payments to 181.19 demonstration projects for persons with disabilities. 181.20 Sec. 40. Minnesota Statutes 2002, section 256B.75, is 181.21 amended to read: 181.22 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 181.23 (a) For outpatient hospital facility fee payments for 181.24 services rendered on or after October 1, 1992, the commissioner 181.25 of human services shall pay the lower of (1) submitted charge, 181.26 or (2) 32 percent above the rate in effect on June 30, 1992, 181.27 except for those services for which there is a federal maximum 181.28 allowable payment. Effective for services rendered on or after 181.29 January 1, 2000, payment rates for nonsurgical outpatient 181.30 hospital facility fees and emergency room facility fees shall be 181.31 increased by eight percent over the rates in effect on December 181.32 31, 1999, except for those services for which there is a federal 181.33 maximum allowable payment. Services for which there is a 181.34 federal maximum allowable payment shall be paid at the lower of 181.35 (1) submitted charge, or (2) the federal maximum allowable 181.36 payment. Total aggregate payment for outpatient hospital 182.1 facility fee services shall not exceed the Medicare upper 182.2 limit. If it is determined that a provision of this section 182.3 conflicts with existing or future requirements of the United 182.4 States government with respect to federal financial 182.5 participation in medical assistance, the federal requirements 182.6 prevail. The commissioner may, in the aggregate, prospectively 182.7 reduce payment rates to avoid reduced federal financial 182.8 participation resulting from rates that are in excess of the 182.9 Medicare upper limitations. 182.10 (b) Notwithstanding paragraph (a), payment for outpatient, 182.11 emergency, and ambulatory surgery hospital facility fee services 182.12 for critical access hospitals designated under section 144.1483, 182.13 clause (11), shall be paid on a cost-based payment system that 182.14 is based on the cost-finding methods and allowable costs of the 182.15 Medicare program. 182.16 (c) Effective for services provided on or after July 1, 182.17 2003, rates that are based on the Medicare outpatient 182.18 prospective payment system shall be replaced by a budget neutral 182.19 prospective payment system that is derived using medical 182.20 assistance data. The commissioner shall provide a proposal to 182.21 the 2003 legislature to define and implement this provision. 182.22 (d) For fee-for-service services provided on or after July 182.23 1, 2002, the total payment, before third-party liability and 182.24 spenddown, made to hospitals for outpatient hospital facility 182.25 services is reduced by .5 percent from the current statutory 182.26 rate. 182.27 (e) In addition to the reduction in paragraph (d), the 182.28 total payment for fee-for-service services provided on or after 182.29 July 1, 2003, made to hospitals for outpatient hospital facility 182.30 services before third-party liability and spenddown, is reduced 182.31 five percent from the current statutory rates. Facilities 182.32 defined under section 256.969, subdivision 16, are excluded from 182.33 this paragraph. 182.34 Sec. 41. Minnesota Statutes 2002, section 256B.76, is 182.35 amended to read: 182.36 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 183.1 (a) Effective for services rendered on or after October 1, 183.2 1992, the commissioner shall make payments for physician 183.3 services as follows: 183.4 (1) payment for level one Centers for Medicare and Medicaid 183.5 Services' common procedural coding system codes titled "office 183.6 and other outpatient services," "preventive medicine new and 183.7 established patient," "delivery, antepartum, and postpartum 183.8 care," "critical care," cesarean delivery and pharmacologic 183.9 management provided to psychiatric patients, and level three 183.10 codes for enhanced services for prenatal high risk, shall be 183.11 paid at the lower of (i) submitted charges, or (ii) 25 percent 183.12 above the rate in effect on June 30, 1992. If the rate on any 183.13 procedure code within these categories is different than the 183.14 rate that would have been paid under the methodology in section 183.15 256B.74, subdivision 2, then the larger rate shall be paid; 183.16 (2) payments for all other services shall be paid at the 183.17 lower of (i) submitted charges, or (ii) 15.4 percent above the 183.18 rate in effect on June 30, 1992; 183.19 (3) all physician rates shall be converted from the 50th 183.20 percentile of 1982 to the 50th percentile of 1989, less the 183.21 percent in aggregate necessary to equal the above increases 183.22 except that payment rates for home health agency services shall 183.23 be the rates in effect on September 30, 1992; 183.24 (4) effective for services rendered on or after January 1, 183.25 2000, payment rates for physician and professional services 183.26 shall be increased by three percent over the rates in effect on 183.27 December 31, 1999, except for home health agency and family 183.28 planning agency services; and 183.29 (5) the increases in clause (4) shall be implemented 183.30 January 1, 2000, for managed care. 183.31 (b) Effective for services rendered on or after October 1, 183.32 1992, the commissioner shall make payments for dental services 183.33 as follows: 183.34 (1) dental services shall be paid at the lower of (i) 183.35 submitted charges, or (ii) 25 percent above the rate in effect 183.36 on June 30, 1992; 184.1 (2) dental rates shall be converted from the 50th 184.2 percentile of 1982 to the 50th percentile of 1989, less the 184.3 percent in aggregate necessary to equal the above increases; 184.4 (3) effective for services rendered on or after January 1, 184.5 2000, payment rates for dental services shall be increased by 184.6 three percent over the rates in effect on December 31, 1999; 184.7 (4) the commissioner shall award grants to community 184.8 clinics or other nonprofit community organizations, political 184.9 subdivisions, professional associations, or other organizations 184.10 that demonstrate the ability to provide dental services 184.11 effectively to public program recipients. Grants may be used to 184.12 fund the costs related to coordinating access for recipients, 184.13 developing and implementing patient care criteria, upgrading or 184.14 establishing new facilities, acquiring furnishings or equipment, 184.15 recruiting new providers, or other development costs that will 184.16 improve access to dental care in a region. In awarding grants, 184.17 the commissioner shall give priority to applicants that plan to 184.18 serve areas of the state in which the number of dental providers 184.19 is not currently sufficient to meet the needs of recipients of 184.20 public programs or uninsured individuals. The commissioner 184.21 shall consider the following in awarding the grants: 184.22 (i) potential to successfully increase access to an 184.23 underserved population; 184.24 (ii) the ability to raise matching funds; 184.25 (iii) the long-term viability of the project to improve 184.26 access beyond the period of initial funding; 184.27 (iv) the efficiency in the use of the funding; and 184.28 (v) the experience of the proposers in providing services 184.29 to the target population. 184.30 The commissioner shall monitor the grants and may terminate 184.31 a grant if the grantee does not increase dental access for 184.32 public program recipients. The commissioner shall consider 184.33 grants for the following: 184.34 (i) implementation of new programs or continued expansion 184.35 of current access programs that have demonstrated success in 184.36 providing dental services in underserved areas; 185.1 (ii) a pilot program for utilizing hygienists outside of a 185.2 traditional dental office to provide dental hygiene services; 185.3 and 185.4 (iii) a program that organizes a network of volunteer 185.5 dentists, establishes a system to refer eligible individuals to 185.6 volunteer dentists, and through that network provides donated 185.7 dental care services to public program recipients or uninsured 185.8 individuals; 185.9 (5) beginning October 1, 1999, the payment for tooth 185.10 sealants and fluoride treatments shall be the lower of (i) 185.11 submitted charge, or (ii) 80 percent of median 1997 charges; 185.12 (6) the increases listed in clauses (3) and (5) shall be 185.13 implemented January 1, 2000, for managed care; and 185.14 (7) effective for services provided on or after January 1, 185.15 2002, payment for diagnostic examinations and dental x-rays 185.16 provided to children under age 21 shall be the lower of (i) the 185.17 submitted charge, or (ii) 85 percent of median 1999 charges. 185.18 (c) Effective for dental services rendered on or after 185.19 January 1, 2002, the commissioner may, within the limits of 185.20 available appropriation, increase reimbursements to dentists and 185.21 dental clinics deemed by the commissioner to be critical access 185.22 dental providers. Reimbursement to a critical access dental 185.23 provider may be increased by not more than 50 percent above the 185.24 reimbursement rate that would otherwise be paid to the 185.25 provider. Payments to health plan companies shall be adjusted 185.26 to reflect increased reimbursements to critical access dental 185.27 providers as approved by the commissioner. In determining which 185.28 dentists and dental clinics shall be deemed critical access 185.29 dental providers, the commissioner shall review: 185.30 (1) the utilization rate in the service area in which the 185.31 dentist or dental clinic operates for dental services to 185.32 patients covered by medical assistance, general assistance 185.33 medical care, or MinnesotaCare as their primary source of 185.34 coverage; 185.35 (2) the level of services provided by the dentist or dental 185.36 clinic to patients covered by medical assistance, general 186.1 assistance medical care, or MinnesotaCare as their primary 186.2 source of coverage; and 186.3 (3) whether the level of services provided by the dentist 186.4 or dental clinic is critical to maintaining adequate levels of 186.5 patient access within the service area. 186.6 In the absence of a critical access dental provider in a service 186.7 area, the commissioner may designate a dentist or dental clinic 186.8 as a critical access dental provider if the dentist or dental 186.9 clinic is willing to provide care to patients covered by medical 186.10 assistance, general assistance medical care, or MinnesotaCare at 186.11 a level which significantly increases access to dental care in 186.12 the service area. 186.13 (d) Effective July 1, 2001, the medical assistance rates 186.14 for outpatient mental health services provided by an entity that 186.15 operates: 186.16 (1) a Medicare-certified comprehensive outpatient 186.17 rehabilitation facility; and 186.18 (2) a facility that was certified prior to January 1, 1993, 186.19 with at least 33 percent of the clients receiving rehabilitation 186.20 services in the most recent calendar year who are medical 186.21 assistance recipients, will be increased by 38 percent, when 186.22 those services are provided within the comprehensive outpatient 186.23 rehabilitation facility and provided to residents of nursing 186.24 facilities owned by the entity. 186.25 (e) An entity that operates both a Medicare certified 186.26 comprehensive outpatient rehabilitation facility and a facility 186.27 which was certified prior to January 1, 1993, that is licensed 186.28 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 186.29 whom at least 33 percent of the clients receiving rehabilitation 186.30 services in the most recent calendar year are medical assistance 186.31 recipients, shall be reimbursed by the commissioner for 186.32 rehabilitation services at rates that are 38 percent greater 186.33 than the maximum reimbursement rate allowed under paragraph (a), 186.34 clause (2), when those services are (1) provided within the 186.35 comprehensive outpatient rehabilitation facility and (2) 186.36 provided to residents of nursing facilities owned by the entity. 187.1 (f) Effective for services rendered on or after January 1, 187.2 2007, the commissioner shall make payments for physician and 187.3 professional services based on the Medicare relative value units 187.4 (RVUs). This change shall be budget neutral and the cost of 187.5 implementing RVUs will be incorporated in the established 187.6 conversion factor. 187.7 Sec. 42. Minnesota Statutes 2002, section 256D.03, 187.8 subdivision 3, is amended to read: 187.9 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 187.10 (a) General assistance medical care may be paid for any person 187.11 who is not eligible for medical assistance under chapter 256B, 187.12 including eligibility for medical assistance based on a 187.13 spenddown of excess income according to section 256B.056, 187.14 subdivision 5, or MinnesotaCare as defined in paragraph (b), 187.15 except as provided in paragraph (c);, and: 187.16 (1)who is receiving assistance under section 256D.05,187.17except for families with children who are eligible under187.18Minnesota family investment program (MFIP), who is having a187.19payment made on the person's behalf under sections 256I.01 to187.20256I.06, or who resides in group residential housing as defined187.21in chapter 256I and can meet a spenddown using the cost of187.22remedial services received through group residential housing; or187.23(2)(i)who is a resident of Minnesota; and whose equity in 187.24 assets is not in excess of$1,000 per assistance unitthe limits 187.25 in section 256B.056, subdivision 3c. Exempt assets, the187.26reduction of excess assets, and the waiver of excess assets must187.27conform to the medical assistance program in chapter 256B, with187.28the following exception: the maximum amount of undistributed187.29funds in a trust that could be distributed to or on behalf of187.30the beneficiary by the trustee, assuming the full exercise of187.31the trustee's discretion under the terms of the trust, must be187.32applied toward the asset maximum; and 187.33(ii)(2) who has gross countable income not in excess of 187.34the assistance standards established in section 256B.056,187.35subdivision 5c, paragraph (b), or whose excess income is spent187.36down to that standard using a six-month budget period. The188.1method for calculating earned income disregards and deductions188.2for a person who resides with a dependent child under age 21188.3shall follow the AFDC income disregard and deductions in effect188.4under the July 16, 1996, AFDC state plan. The earned income and188.5work expense deductions for a person who does not reside with a188.6dependent child under age 21 shall be the same as the method188.7used to determine eligibility for a person under section188.8256D.06, subdivision 1, except the disregard of the first $50 of188.9earned income is not allowed;188.10(3) who would be eligible for medical assistance except188.11that the person resides in a facility that is determined by the188.12commissioner or the federal Centers for Medicare and Medicaid188.13Services to be an institution for mental diseases; or188.14(4) who is ineligible for medical assistance under chapter188.15256B or general assistance medical care under any other188.16provision of this section, and is receiving care and188.17rehabilitation services from a nonprofit center established to188.18serve victims of torture. These individuals are eligible for188.19general assistance medical care only for the period during which188.20they are receiving services from the center. During this period188.21of eligibility, individuals eligible under this clause shall not188.22be required to participate in prepaid general assistance medical188.23care75 percent of the federal poverty guidelines for the family 188.24 size in effect on October 1, 2003. 188.25 (b) Beginning January 1, 2000, applicants or recipients who 188.26 meet all eligibility requirements of MinnesotaCare as defined in 188.27 sections 256L.01 to 256L.16, and are: 188.28 (i) adults with dependent children under 21 whose gross 188.29 family income is equal to or less than 275 percent of the 188.30 federal poverty guidelines; or 188.31 (ii) adults without children with earned income and whose 188.32 family gross income isbetweenequal to or less than 75 percent 188.33 of the federal poverty guidelinesand the amount set by section188.34256L.04, subdivision 7in effect on October 1, 2003, shall be 188.35 terminated from general assistance medical care upon enrollment 188.36 in MinnesotaCare. Earned income is deemed available to family 189.1 members as defined in section 256D.02, subdivision 8. 189.2 (c) Forservices rendered on or after July 1, 1997,189.3eligibility is limited to one month prior to application if the189.4person is determined eligible in the prior monthapplications 189.5 received on or after October 1, 2003, eligibility may begin no 189.6 earlier than the date of application. A redetermination of 189.7 eligibility must occur every 12 months. Beginning January 1, 189.8 2000, Minnesota health care program applications completed by 189.9 recipients and applicants who are persons described in paragraph 189.10 (b), may be returned to the county agency to be forwarded to the 189.11 department of human services or sent directly to the department 189.12 of human services for enrollment in MinnesotaCare. If all other 189.13 eligibility requirements of this subdivision are met, 189.14 eligibility for general assistance medical care shall be 189.15 available in any month during which a MinnesotaCare eligibility 189.16 determination and enrollment are pending. Upon notification of 189.17 eligibility for MinnesotaCare, notice of termination for 189.18 eligibility for general assistance medical care shall be sent to 189.19 an applicant or recipient. If all other eligibility 189.20 requirements of this subdivision are met, eligibility for 189.21 general assistance medical care shall be available until 189.22 enrollment in MinnesotaCare subject to the provisions of 189.23 paragraph (e). 189.24 (d) The date of an initial Minnesota health care program 189.25 application necessary to begin a determination of eligibility 189.26 shall be the date the applicant has provided a name, address, 189.27 and social security number, signed and dated, to the county 189.28 agency or the department of human services. If the applicant is 189.29 unable to provide an initial application when health care is 189.30 delivered due to a medical condition or disability, a health 189.31 care provider may act on the person's behalf to complete the 189.32 initial application. The applicant must complete the remainder 189.33 of the application and provide necessary verification before 189.34 eligibility can be determined. The county agency must assist 189.35 the applicant in obtaining verification if necessary.On the189.36basis of information provided on the completed application, an190.1applicant who meets the following criteria shall be determined190.2eligible beginning in the month of application:190.3(1) has gross income less than 90 percent of the applicable190.4income standard;190.5(2) has liquid assets that total within $300 of the asset190.6standard;190.7(3) does not reside in a long-term care facility; and190.8(4) meets all other eligibility requirements.190.9The applicant must provide all required verifications within 30190.10days' notice of the eligibility determination or eligibility190.11shall be terminated.190.12 (e) County agencies are authorized to use all automated 190.13 databases containing information regarding recipients' or 190.14 applicants' income in order to determine eligibility for general 190.15 assistance medical care or MinnesotaCare. Such use shall be 190.16 considered sufficient in order to determine eligibility and 190.17 premium payments by the county agency. 190.18 (f) General assistance medical care is not available for a 190.19 person in a correctional facility unless the person is detained 190.20 by law for less than one year in a county correctional or 190.21 detention facility as a person accused or convicted of a crime, 190.22 or admitted as an inpatient to a hospital on a criminal hold 190.23 order, and the person is a recipient of general assistance 190.24 medical care at the time the person is detained by law or 190.25 admitted on a criminal hold order and as long as the person 190.26 continues to meet other eligibility requirements of this 190.27 subdivision. 190.28 (g) General assistance medical care is not available for 190.29 applicants or recipients who do not cooperate with the county 190.30 agency to meet the requirements of medical assistance.General190.31assistance medical care is limited to payment of emergency190.32services only for applicants or recipients as described in190.33paragraph (b), whose MinnesotaCare coverage is denied or190.34terminated for nonpayment of premiums as required by sections190.35256L.06 and 256L.07.190.36 (h) In determining the amount of assets of an individual, 191.1 there shall be included any asset or interest in an asset, 191.2 including an asset excluded under paragraph (a), that was given 191.3 away, sold, or disposed of for less than fair market value 191.4 within the 60 months preceding application for general 191.5 assistance medical care or during the period of eligibility. 191.6 Any transfer described in this paragraph shall be presumed to 191.7 have been for the purpose of establishing eligibility for 191.8 general assistance medical care, unless the individual furnishes 191.9 convincing evidence to establish that the transaction was 191.10 exclusively for another purpose. For purposes of this 191.11 paragraph, the value of the asset or interest shall be the fair 191.12 market value at the time it was given away, sold, or disposed 191.13 of, less the amount of compensation received. For any 191.14 uncompensated transfer, the number of months of ineligibility, 191.15 including partial months, shall be calculated by dividing the 191.16 uncompensated transfer amount by the average monthly per person 191.17 payment made by the medical assistance program to skilled 191.18 nursing facilities for the previous calendar year. The 191.19 individual shall remain ineligible until this fixed period has 191.20 expired. The period of ineligibility may exceed 30 months, and 191.21 a reapplication for benefits after 30 months from the date of 191.22 the transfer shall not result in eligibility unless and until 191.23 the period of ineligibility has expired. The period of 191.24 ineligibility begins in the month the transfer was reported to 191.25 the county agency, or if the transfer was not reported, the 191.26 month in which the county agency discovered the transfer, 191.27 whichever comes first. For applicants, the period of 191.28 ineligibility begins on the date of the first approved 191.29 application. 191.30 (i) When determining eligibility for any state benefits 191.31 under this subdivision, the income and resources of all 191.32 noncitizens shall be deemed to include their sponsor's income 191.33 and resources as defined in the Personal Responsibility and Work 191.34 Opportunity Reconciliation Act of 1996, title IV, Public Law 191.35 Number 104-193, sections 421 and 422, and subsequently set out 191.36 in federal rules. 192.1 (j)(1) AnUndocumentednoncitizen or a nonimmigrant192.2isnoncitizens and nonimmigrants are ineligible for general 192.3 assistance medical careother than emergency services, except 192.4 for an individual eligible under paragraph (a), clause (4). For 192.5 purposes of this subdivision, a nonimmigrant is an individual in 192.6 one or more of the classes listed in United States Code, title 192.7 8, section 1101(a)(15), and an undocumented noncitizen is an 192.8 individual who resides in the United States without the approval 192.9 or acquiescence of the Immigration and Naturalization Service. 192.10(2) This paragraph does not apply to a child under age 18,192.11to a Cuban or Haitian entrant as defined in Public Law Number192.1296-422, section 501(e)(1) or (2)(a), or to a noncitizen who is192.13aged, blind, or disabled as defined in Code of Federal192.14Regulations, title 42, sections 435.520, 435.530, 435.531,192.15435.540, and 435.541, or effective October 1, 1998, to an192.16individual eligible for general assistance medical care under192.17paragraph (a), clause (4), who cooperates with the Immigration192.18and Naturalization Service to pursue any applicable immigration192.19status, including citizenship, that would qualify the individual192.20for medical assistance with federal financial participation.192.21 (k)For purposes of paragraphs (g) and (j), "emergency192.22services" has the meaning given in Code of Federal Regulations,192.23title 42, section 440.255(b)(1), except that it also means192.24services rendered because of suspected or actual pesticide192.25poisoning.192.26 (l) Notwithstanding any other provision of law, a 192.27 noncitizen who is ineligible for medical assistance due to the 192.28 deeming of a sponsor's income and resources, is ineligible for 192.29 general assistance medical care. 192.30 (m) Effective July 1, 2003, general assistance medical care 192.31 emergency services end. Effective October 1, 2004, the general 192.32 assistance medical care program ends. Persons enrolled in 192.33 general assistance medical care as of September 30, 2004, will 192.34 be converted to MinnesotaCare if they meet all the requirements 192.35 of chapter 256L. 192.36 [EFFECTIVE DATE.] (a) The amendments to paragraphs (a), 193.1 clauses (1) to (4), and (b) and (c), are effective October 1, 193.2 2003. 193.3 (b) The amendment to paragraph (d) is effective April 1, 193.4 2005, if the HealthMatch system is operational. If the 193.5 HealthMatch system is not operational on April 1, 2005, then the 193.6 amendment to paragraph (d) is effective July 1, 2005. 193.7 (c) The amendments to paragraphs (j), (g), and (k), are 193.8 effective July 1, 2003. 193.9 Sec. 43. Minnesota Statutes 2002, section 256D.03, 193.10 subdivision 4, is amended to read: 193.11 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 193.12 For a person who is eligible under subdivision 3, paragraph (a), 193.13 clause (3), general assistance medical care covers, except as 193.14 provided in paragraph (c): 193.15 (1) inpatient hospital services; 193.16 (2) outpatient hospital services; 193.17 (3) services provided by Medicare certified rehabilitation 193.18 agencies; 193.19 (4) prescription drugs and other products recommended 193.20 through the process established in section 256B.0625, 193.21 subdivision 13; 193.22 (5) equipment necessary to administer insulin and 193.23 diagnostic supplies and equipment for diabetics to monitor blood 193.24 sugar level; 193.25 (6) eyeglasses and eye examinations provided by a physician 193.26 or optometrist; 193.27 (7) hearing aids; 193.28 (8) prosthetic devices; 193.29 (9) laboratory and X-ray services; 193.30 (10) physician's services; 193.31 (11) medical transportation; 193.32 (12) chiropractic services as covered under the medical 193.33 assistance program; 193.34 (13) podiatric services; 193.35 (14) dental services; 193.36 (15) outpatient services provided by a mental health center 194.1 or clinic that is under contract with the county board and is 194.2 established under section 245.62; 194.3 (16) day treatment services for mental illness provided 194.4 under contract with the county board; 194.5 (17) prescribed medications for persons who have been 194.6 diagnosed as mentally ill as necessary to prevent more 194.7 restrictive institutionalization; 194.8 (18) psychological services, medical supplies and 194.9 equipment, and Medicare premiums, coinsurance and deductible 194.10 payments; 194.11 (19) medical equipment not specifically listed in this 194.12 paragraph when the use of the equipment will prevent the need 194.13 for costlier services that are reimbursable under this 194.14 subdivision; 194.15 (20) services performed by a certified pediatric nurse 194.16 practitioner, a certified family nurse practitioner, a certified 194.17 adult nurse practitioner, a certified obstetric/gynecological 194.18 nurse practitioner, a certified neonatal nurse practitioner, or 194.19 a certified geriatric nurse practitioner in independent 194.20 practice, if (1) the service is otherwise covered under this 194.21 chapter as a physician service, (2) the service provided on an 194.22 inpatient basis is not included as part of the cost for 194.23 inpatient services included in the operating payment rate, and 194.24 (3) the service is within the scope of practice of the nurse 194.25 practitioner's license as a registered nurse, as defined in 194.26 section 148.171; 194.27 (21) services of a certified public health nurse or a 194.28 registered nurse practicing in a public health nursing clinic 194.29 that is a department of, or that operates under the direct 194.30 authority of, a unit of government, if the service is within the 194.31 scope of practice of the public health nurse's license as a 194.32 registered nurse, as defined in section 148.171; and 194.33 (22) telemedicine consultations, to the extent they are 194.34 covered under section 256B.0625, subdivision 3b. 194.35 (b) Except as provided in paragraph (c), for a recipient 194.36 who is eligible under subdivision 3, paragraph (a), clause (1) 195.1 or (2), general assistance medical care covers the services 195.2 listed in paragraph (a) with the exception of special 195.3 transportation services. 195.4 (c) Gender reassignment surgery and related services are 195.5 not covered services under this subdivision unless the 195.6 individual began receiving gender reassignment services prior to 195.7 July 1, 1995. 195.8 (d) In order to contain costs, the commissioner of human 195.9 services shall select vendors of medical care who can provide 195.10 the most economical care consistent with high medical standards 195.11 and shall where possible contract with organizations on a 195.12 prepaid capitation basis to provide these services. The 195.13 commissioner shall consider proposals by counties and vendors 195.14 for prepaid health plans, competitive bidding programs, block 195.15 grants, or other vendor payment mechanisms designed to provide 195.16 services in an economical manner or to control utilization, with 195.17 safeguards to ensure that necessary services are provided. 195.18 Before implementing prepaid programs in counties with a county 195.19 operated or affiliated public teaching hospital or a hospital or 195.20 clinic operated by the University of Minnesota, the commissioner 195.21 shall consider the risks the prepaid program creates for the 195.22 hospital and allow the county or hospital the opportunity to 195.23 participate in the program in a manner that reflects the risk of 195.24 adverse selection and the nature of the patients served by the 195.25 hospital, provided the terms of participation in the program are 195.26 competitive with the terms of other participants considering the 195.27 nature of the population served. Payment for services provided 195.28 pursuant to this subdivision shall be as provided to medical 195.29 assistance vendors of these services under sections 256B.02, 195.30 subdivision 8, and 256B.0625. For payments made during fiscal 195.31 year 1990 and later years, the commissioner shall consult with 195.32 an independent actuary in establishing prepayment rates, but 195.33 shall retain final control over the rate methodology. 195.34Notwithstanding the provisions of subdivision 3, an individual195.35who becomes ineligible for general assistance medical care195.36because of failure to submit income reports or recertification196.1forms in a timely manner, shall remain enrolled in the prepaid196.2health plan and shall remain eligible for general assistance196.3medical care coverage through the last day of the month in which196.4the enrollee became ineligible for general assistance medical196.5care.196.6 (e)There shall be no copayment required of any recipient196.7of benefits for any services provided under this subdivision.A 196.8 hospital receiving a reduced payment as a result of this section 196.9 may apply the unpaid balance toward satisfaction of the 196.10 hospital's bad debts. 196.11 (f) Any county may, from its own resources, provide medical 196.12 payments for which state payments are not made. 196.13 (g) Chemical dependency services that are reimbursed under 196.14 chapter 254B must not be reimbursed under general assistance 196.15 medical care. 196.16 (h) The maximum payment for new vendors enrolled in the 196.17 general assistance medical care program after the base year 196.18 shall be determined from the average usual and customary charge 196.19 of the same vendor type enrolled in the base year. 196.20 (i) The conditions of payment for services under this 196.21 subdivision are the same as the conditions specified in rules 196.22 adopted under chapter 256B governing the medical assistance 196.23 program, unless otherwise provided by statute or rule. 196.24 Sec. 44. [256D.031] [GAMC CO-PAYMENTS AND COINSURANCE.] 196.25 Subdivision 1. [CO-PAYMENTS AND COINSURANCE.] (a) Except 196.26 as provided in subdivision 2, the general assistance medical 196.27 care benefit plan under section 256D.03, subdivision 3, shall 196.28 include the following co-payments for all recipients effective 196.29 for services provided on or after October 1, 2003: 196.30 (1) $3 per nonpreventive visit. For purposes of this 196.31 subdivision, a visit means an episode of service which is 196.32 required because of a recipient's symptoms, diagnosis, or 196.33 established illness, and which is delivered in an ambulatory 196.34 setting by a physician or physician ancillary, dentist, 196.35 chiropractor, podiatrist, nurse midwife, mental health 196.36 professional, advanced practice nurse, physical therapist, 197.1 occupational therapist, speech therapist, audiologist, optician, 197.2 or optometrist; 197.3 (2) $3 for eyeglasses; 197.4 (3) $6 for nonemergency visits to a hospital-based 197.5 emergency room; and 197.6 (4) $3 per brand-name drug prescription and $1 per generic 197.7 drug prescription. 197.8 (b) Recipients of general assistance medical care are 197.9 responsible for all co-payments in this subdivision. 197.10 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 197.11 following exceptions: 197.12 (1) children under the age of 21; 197.13 (2) pregnant women for services that relate to the 197.14 pregnancy or any other medical condition that may complicate the 197.15 pregnancy; 197.16 (3) recipients expected to reside for at least 30 days in a 197.17 hospital, nursing home, or intermediate care facility for the 197.18 mentally retarded; 197.19 (4) recipients receiving hospice care; 197.20 (5) 100 percent federally funded services provided by an 197.21 Indian health service; 197.22 (6) emergency services; 197.23 (7) family planning services; 197.24 (8) services that are paid by Medicare, resulting in the 197.25 medical assistance program paying for the coinsurance and 197.26 deductible; and 197.27 (9) co-payments that exceed one per day per provider for 197.28 nonpreventive office visits, eyeglasses, and nonemergency visits 197.29 to a hospital-based emergency room. 197.30 Subd. 3. [COLLECTION.] The general assistance medical care 197.31 reimbursement to the provider shall be reduced by the amount of 197.32 the co-payment. The provider collects the co-payment from the 197.33 recipient. Providers may not deny services to individuals who 197.34 are unable to pay the co-payment. Providers must accept an 197.35 assertion from the recipient that they are unable to pay. 197.36 Sec. 45. Minnesota Statutes 2002, section 256G.05, 198.1 subdivision 2, is amended to read: 198.2 Subd. 2. [NON-MINNESOTA RESIDENTS.] State residence is not 198.3 required for receiving emergency assistance in the Minnesota 198.4 supplemental aid program. The receipt of emergency assistance 198.5 must not be used as a factor in determining county or state 198.6 residence.Non-Minnesota residents are not eligible for198.7emergency general assistance medical care, except emergency198.8hospital services, and professional services incident to the198.9hospital services, for the treatment of acute trauma resulting198.10from an accident occurring in Minnesota. To be eligible under198.11this subdivision a non-Minnesota resident must verify that they198.12are not eligible for coverage under any other health care198.13program, including coverage from a program in their state of198.14residence.198.15 [EFFECTIVE DATE.] This section is effective July 1, 2003. 198.16 Sec. 46. Minnesota Statutes 2002, section 256L.02, is 198.17 amended by adding a subdivision to read: 198.18 Subd. 3a. [FUNDING SOURCE.] Beginning July 1, 2005, all 198.19 MinnesotaCare obligations shall be funded out of the general 198.20 fund. 198.21 Sec. 47. Minnesota Statutes 2002, section 256L.03, 198.22 subdivision 3, is amended to read: 198.23 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a) Covered health 198.24 services shall include inpatient hospital services, including 198.25 inpatient hospital mental health services and inpatient hospital 198.26 and residential chemical dependency treatment, subject to those 198.27 limitations necessary to coordinate the provision of these 198.28 services with eligibility under the medical assistance 198.29 spenddown. Prior to July 1, 1997, the inpatient hospital 198.30 benefit for adult enrollees is subject to an annual benefit 198.31 limit of $10,000. The inpatient hospital benefit for adult 198.32 enrollees who qualify under section 256L.04, subdivision 7, or 198.33 who qualify under section 256L.04, subdivisions 1 and 2, with 198.34 family gross income that exceeds 175 percent of the federal 198.35 poverty guidelines and who are not pregnant, is subject to an 198.36 annual limit of $10,000. For services provided on or after 199.1 October 1, 2004, the annual limit of $10,000 does not apply to 199.2 adults who qualify under section 256L.04, subdivision 7, whose 199.3 gross income is at or below 75 percent of the federal poverty 199.4 guidelines. 199.5 (b) Admissions for inpatient hospital services paid for 199.6 under section 256L.11, subdivision 3, must be certified as 199.7 medically necessary in accordance with Minnesota Rules, parts 199.8 9505.0500 to 9505.0540, except as provided in clauses (1) and 199.9 (2): 199.10 (1) all admissions must be certified, except those 199.11 authorized under rules established under section 254A.03, 199.12 subdivision 3, or approved under Medicare; and 199.13 (2) payment under section 256L.11, subdivision 3, shall be 199.14 reduced by five percent for admissions for which certification 199.15 is requested more than 30 days after the day of admission. The 199.16 hospital may not seek payment from the enrollee for the amount 199.17 of the payment reduction under this clause. 199.18 Sec. 48. Minnesota Statutes 2002, section 256L.03, 199.19 subdivision 5, is amended to read: 199.20 Subd. 5. [COPAYMENTS AND COINSURANCE.] (a) Except as 199.21 provided in paragraphs (b) and (c), the MinnesotaCare benefit 199.22 plan shall include the following copayments and coinsurance 199.23 requirements for all enrollees effective for services provided 199.24 on or after October 1, 2003: 199.25 (1) ten percent of the paid charges for inpatient hospital 199.26 services for adult enrollees, subject to an annual inpatient 199.27 out-of-pocket maximum of $1,000 per individual and $3,000 per 199.28 family; 199.29 (2) $3 perprescription for adult enrolleesnonpreventive 199.30 visit. For purposes of this subdivision, a visit means an 199.31 episode of service which is required because of a recipient's 199.32 symptoms, diagnosis, or established illness, and which is 199.33 delivered in an ambulatory setting by a physician or physician 199.34 ancillary, dentist, chiropractor, podiatrist, nurse, midwife, 199.35 mental health professional, advanced practice nurse, physical 199.36 therapist, occupational therapist, speech therapist, 200.1 audiologist, optician, or optometrist; 200.2 (3) $25 for eyeglassesfor adult enrollees;and200.3 (4) $6 for nonemergency visits to a hospital-based 200.4 emergency room; 200.5 (5) $3 per prescription; and 200.6 (6) 50 percent of the fee-for-service rate for adult dental 200.7 care services other than preventive care services for persons 200.8 eligible under section256L.04256L.05, subdivisions 1 to 7, 200.9 with income equal to or less than 175 percent of the federal 200.10 poverty guidelines. 200.11 (b) Paragraph (a), clause (1), does not apply to parents 200.12 and relative caretakers of children under the age of 21 in 200.13 households with family income equal to or less than 175 percent 200.14 of the federal poverty guidelines. Paragraph (a), clause (1), 200.15 does not apply to parents and relative caretakers of children 200.16 under the age of 21 in households with family income greater 200.17 than 175 percent of the federal poverty guidelines for inpatient 200.18 hospital admissions occurring on or after January 1, 200.19 2001. Effective for services provided on or after October 1, 200.20 2004, paragraph (a), clause (1), does not apply to single adults 200.21 and households without children whose gross income is at or 200.22 below 75 percent of the federal poverty guidelines. 200.23 (c) Paragraph (a), clauses (1) to(4)(6), do not apply to 200.24pregnant women and children under the age of 21.: 200.25 (1) children under the age of 21; 200.26 (2) pregnant women for services that relate to the 200.27 pregnancy or any other medical condition that may complicate the 200.28 pregnancy; 200.29 (3) enrollees expected to reside for at least 30 days in a 200.30 hospital, nursing home, or intermediate care facility for the 200.31 mentally retarded; 200.32 (4) enrollees receiving hospice care; 200.33 (5) 100 percent federally funded services provided by an 200.34 Indian Health Service; 200.35 (6) emergency services; 200.36 (7) family planning services; 201.1 (8) services that are paid by Medicare, resulting in the 201.2 medical assistance program paying for the coinsurance and 201.3 deductible; and 201.4 (9) co-payments that exceed one per day per provider for 201.5 nonpreventive office visits, eyeglasses, and nonemergency visits 201.6 to a hospital emergency room. 201.7 (d) Adult enrollees with family gross income that exceeds 201.8 175 percent of the federal poverty guidelines and who are not 201.9 pregnant shall be financially responsible for the coinsurance 201.10 amount, if applicable, and amounts which exceed the $10,000 201.11 inpatient hospital benefit limit. 201.12 (e) When a MinnesotaCare enrollee becomes a member of a 201.13 prepaid health plan, or changes from one prepaid health plan to 201.14 another during a calendar year, any charges submitted towards 201.15 the $10,000 annual inpatient benefit limit, and any 201.16 out-of-pocket expenses incurred by the enrollee for inpatient 201.17 services, that were submitted or incurred prior to enrollment, 201.18 or prior to the change in health plans, shall be disregarded. 201.19 (f) Enrollees are responsible for all co-payments and 201.20 coinsurance in this subdivision. 201.21 (g) The MinnesotaCare reimbursement to the provider shall 201.22 be reduced by the amount of the co-payment. The provider 201.23 collects the co-payment from the recipient. Providers may not 201.24 deny services to individuals who are unable to pay the 201.25 co-payment. Providers must accept an assertion from the 201.26 recipient that they are unable to pay. 201.27 Sec. 49. Minnesota Statutes 2002, section 256L.04, 201.28 subdivision 1, is amended to read: 201.29 Subdivision 1. [FAMILIES WITH CHILDREN.] (a) Families with 201.30 children with family income equal to or less than 275 percent of 201.31 the federal poverty guidelines for the applicable family size 201.32 shall be eligible for MinnesotaCare according to this section. 201.33 All other provisions of sections 256L.01 to 256L.18, including 201.34 the insurance-related barriers to enrollment under section 201.35 256L.07, shall apply unless otherwise specified. 201.36 (b) Parents who enroll in the MinnesotaCare program must 202.1 also enroll their childrenand dependent siblings, if the 202.2 childrenand their dependent siblingsare eligible. Children 202.3and dependent siblingsmay be enrolled separately without 202.4 enrollment by parents. However, if one parent in the household 202.5 enrolls, both parents must enroll, unless other insurance is 202.6 available. If one child from a family is enrolled, all children 202.7 must be enrolled, unless other insurance is available. If one 202.8 spouse in a household enrolls, the other spouse in the household 202.9 must also enroll, unless other insurance is available. Families 202.10 cannot choose to enroll only certain uninsured members. 202.11 (c) Beginning February 1, 2004, the dependent sibling 202.12 definition no longer applies to the MinnesotaCare program. 202.13 These persons are no longer counted in the parental household 202.14 and may apply as a separate household. 202.15 [EFFECTIVE DATE.] This section is effective February 1, 202.16 2004. 202.17 Sec. 50. Minnesota Statutes 2002, section 256L.05, 202.18 subdivision 1, is amended to read: 202.19 Subdivision 1. [APPLICATION AND INFORMATION AVAILABILITY.] 202.20 Applications and other information must be made available to 202.21 provider offices, local human services agencies, school 202.22 districts, public and private elementary schools in which 25 202.23 percent or more of the students receive free or reduced price 202.24 lunches, community health offices, and Women, Infants and 202.25 Children (WIC) program sites. These sites may accept 202.26 applications and forward the forms to the commissioner. 202.27 Otherwise, applicants may apply directly to the commissioner. 202.28 Beginning January 1, 2000, MinnesotaCare enrollment sites will 202.29 be expanded to include local county human services agencies 202.30 which choose to participate. Beginning October 1, 2004, all 202.31 local county human service agencies must accept and process 202.32 applications and renewals for single adults and households 202.33 without children with income at or below 75 percent of the 202.34 federal poverty guidelines who choose to have the county 202.35 administer their case. 202.36 Sec. 51. Minnesota Statutes 2002, section 256L.05, 203.1 subdivision 3, is amended to read: 203.2 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] (a) The effective 203.3 date of coverage is the first day of the month following the 203.4 month in which eligibility is approved and the first premium 203.5 payment has been received. As provided in section 256B.057, 203.6 coverage for newborns is automatic from the date of birth and 203.7 must be coordinated with other health coverage. The effective 203.8 date of coverage for eligible newly adoptive children added to a 203.9 family receiving covered health services is the date of entry 203.10 into the family. The effective date of coverage for other new 203.11 recipients added to the family receiving covered health services 203.12 is the first day of the month following the month in which 203.13 eligibility is approved or at renewal, whichever the family 203.14 receiving covered health services prefers. All eligibility 203.15 criteria must be met by the family at the time the new family 203.16 member is added. The income of the new family member is 203.17 included with the family's gross income and the adjusted premium 203.18 begins in the month the new family member is added. 203.19 (b) The initial premium must be received by the last 203.20 working day of the month for coverage to begin the first day of 203.21 the following month. 203.22 (c) Benefits are not available until the day following 203.23 discharge if an enrollee is hospitalized on the first day of 203.24 coverage. 203.25 (d) Notwithstanding any other law to the contrary, benefits 203.26 under sections 256L.01 to 256L.18 are secondary to a plan of 203.27 insurance or benefit program under which an eligible person may 203.28 have coverage and the commissioner shall use cost avoidance 203.29 techniques to ensure coordination of any other health coverage 203.30 for eligible persons. The commissioner shall identify eligible 203.31 persons who may have coverage or benefits under other plans of 203.32 insurance or who become eligible for medical assistance. 203.33 (e) Notwithstanding paragraphs (a) and (b), effective 203.34 October 1, 2004, coverage begins for single adults and 203.35 households without children with gross family income at or below 203.36 75 percent of the federal poverty guidelines the first day of 204.1 the month following approval. 204.2 (f) Effective October 1, 2004, the date of an initial 204.3 application necessary to begin a determination of eligibility 204.4 for single adults and households without children with gross 204.5 family income at or below 75 percent of the federal poverty 204.6 guidelines shall be the date the applicant has provided a name, 204.7 address, and social security number, signed and dated, to the 204.8 county agency or the department of human services. If the 204.9 applicant is unable to provide an initial application when 204.10 health care is delivered due to a medical condition or 204.11 disability, a health care provider may act on the person's 204.12 behalf to complete the initial application. The applicant must 204.13 complete the remainder of the application and provide necessary 204.14 verification before eligibility can be determined. The county 204.15 agency must assist the applicant in obtaining verification if 204.16 necessary. 204.17 Sec. 52. Minnesota Statutes 2002, section 256L.05, 204.18 subdivision 3a, is amended to read: 204.19 Subd. 3a. [RENEWAL OF ELIGIBILITY.] (a) Beginning January 204.20 1, 1999, an enrollee's eligibility must be renewed every 12 204.21 months. The 12-month period begins in the month after the month 204.22 the application is approved. 204.23 (b) Beginning October 1, 2004, an enrollee's eligibility 204.24 must be renewed every six months. The first six-month period of 204.25 eligibility begins in the month after the month the application 204.26 is approved. Each new period of eligibility must take into 204.27 account any changes in circumstances that impact eligibility and 204.28 premium amount. An enrollee must provide all the information 204.29 needed to redetermine eligibility by the first day of the month 204.30 that ends the eligibility period. The premium for the new 204.31 period of eligibility must be received as provided in section 204.32 256L.06 in order for eligibility to continue. 204.33 Sec. 53. Minnesota Statutes 2002, section 256L.05, 204.34 subdivision 3c, is amended to read: 204.35 Subd. 3c. [RETROACTIVE COVERAGE.] Notwithstanding 204.36 subdivision 3, the effective date of coverage shall be the first 205.1 day of the month following termination from medical assistance 205.2or general assistance medical carefor families and individuals 205.3 who are eligible for MinnesotaCare and who submitted a written 205.4 request for retroactive MinnesotaCare coverage with a completed 205.5 application within 30 days of the mailing of notification of 205.6 termination from medical assistanceor general assistance205.7medical care. The applicant must provide all required 205.8 verifications within 30 days of the written request for 205.9 verification. For retroactive coverage, premiums must be paid 205.10 in full for any retroactive month, current month, and next month 205.11 within 30 days of the premium billing. 205.12 [EFFECTIVE DATE.] This section is effective November 1, 205.13 2004. 205.14 Sec. 54. Minnesota Statutes 2002, section 256L.05, 205.15 subdivision 4, is amended to read: 205.16 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 205.17 human services shall determine an applicant's eligibility for 205.18 MinnesotaCare no more than 30 days from the date that the 205.19 application is received by the department of human services. 205.20 Beginning January 1, 2000, this requirement also applies to 205.21 local county human services agencies that determine eligibility 205.22 for MinnesotaCare.Once annually at application or205.23reenrollment, to prevent processing delays, applicants or205.24enrollees who, from the information provided on the application,205.25appear to meet eligibility requirements shall be enrolled upon205.26timely payment of premiums. The enrollee must provide all205.27required verifications within 30 days of notification of the205.28eligibility determination or coverage from the program shall be205.29terminated. Enrollees who are determined to be ineligible when205.30verifications are provided shall be disenrolled from the program.205.31 [EFFECTIVE DATE.] This section is effective April 1, 2005, 205.32 if the HealthMatch system is operational. If the HealthMatch 205.33 system is not operational on April 1, 2005, then this section is 205.34 effective July 1, 2005. 205.35 Sec. 55. Minnesota Statutes 2002, section 256L.06, 205.36 subdivision 3, is amended to read: 206.1 Subd. 3. [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 206.2 are dedicated to the commissioner for MinnesotaCare. 206.3 (b) The commissioner shall develop and implement procedures 206.4 to: (1) require enrollees to report changes in income; (2) 206.5 adjust sliding scale premium payments, based upon changes in 206.6 enrollee income; and (3) disenroll enrollees from MinnesotaCare 206.7 for failure to pay required premiums. Failure to pay includes 206.8 payment with a dishonored check, a returned automatic bank 206.9 withdrawal, or a refused credit card or debit card payment. The 206.10 commissioner may demand a guaranteed form of payment, including 206.11 a cashier's check or a money order, as the only means to replace 206.12 a dishonored, returned, or refused payment. 206.13 (c) Premiums are calculated on a calendar month basis and 206.14 may be paid on a monthly, quarterly, orannualsemiannual basis, 206.15 with the first payment due upon notice from the commissioner of 206.16 the premium amount required. The commissioner shall inform 206.17 applicants and enrollees of these premium payment options. 206.18 Premium payment is required before enrollment is complete and to 206.19 maintain eligibility in MinnesotaCare. Premium payments 206.20 received before noon are credited the same day. Premium 206.21 payments received after noon are credited on the next working 206.22 day. 206.23 (d) Nonpayment of the premium will result in disenrollment 206.24 from the plan effective for the calendar month for which the 206.25 premium was due. Persons disenrolled for nonpayment or who 206.26 voluntarily terminate coverage from the program may not reenroll 206.27 until four calendar months have elapsed. Persons disenrolled 206.28 for nonpayment who pay all past due premiums as well as current 206.29 premiums due, including premiums due for the period of 206.30 disenrollment, within 20 days of disenrollment, shall be 206.31 reenrolled retroactively to the first day of disenrollment. 206.32 Persons disenrolled for nonpayment or who voluntarily terminate 206.33 coverage from the program may not reenroll for four calendar 206.34 months unless the person demonstrates good cause for 206.35 nonpayment. Good cause does not exist if a person chooses to 206.36 pay other family expenses instead of the premium. The 207.1 commissioner shall define good cause in rule. 207.2 [EFFECTIVE DATE.] This section is effective October 1, 2004. 207.3 Sec. 56. Minnesota Statutes 2002, section 256L.07, 207.4 subdivision 1, is amended to read: 207.5 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 207.6 enrolled in the original children's health plan as of September 207.7 30, 1992, children who enrolled in the MinnesotaCare program 207.8 after September 30, 1992, pursuant to Laws 1992, chapter 549, 207.9 article 4, section 17, and children who have family gross 207.10 incomes that are equal to or less than175150 percent of the 207.11 federal poverty guidelines are eligible without meeting the 207.12 requirements of subdivision 2 and the four-month requirement in 207.13 subdivision 3, as long as they maintain continuous coverage in 207.14 the MinnesotaCare program or medical assistance. Children who 207.15 apply for MinnesotaCare on or after the implementation date of 207.16 the employer-subsidized health coverage program as described in 207.17 Laws 1998, chapter 407, article 5, section 45, who have family 207.18 gross incomes that are equal to or less than175150 percent of 207.19 the federal poverty guidelines, must meet the requirements of 207.20 subdivision 2 to be eligible for MinnesotaCare. 207.21 (b) Families enrolled in MinnesotaCare under section 207.22 256L.04, subdivision 1, whose income increases above 275 percent 207.23 of the federal poverty guidelines, are no longer eligible for 207.24 the program and shall be disenrolled by the commissioner. 207.25 Individuals enrolled in MinnesotaCare under section 256L.04, 207.26 subdivision 7, whose income increases above 175 percent of the 207.27 federal poverty guidelines are no longer eligible for the 207.28 program and shall be disenrolled by the commissioner. For 207.29 persons disenrolled under this subdivision, MinnesotaCare 207.30 coverage terminates the last day of the calendar month following 207.31 the month in which the commissioner determines that the income 207.32 of a family or individual exceeds program income limits. 207.33 (c)(1) Notwithstanding paragraph (b),individuals and207.34 families enrolled in MinnesotaCare under section 256L.04, 207.35 subdivision 1, may remain enrolled in MinnesotaCare if ten 207.36 percent of their annual income is less than the annual premium 208.1 for a policy with a $500 deductible available through the 208.2 Minnesota comprehensive health association.Individuals and208.3 Families who are no longer eligible for MinnesotaCare under this 208.4 subdivision shall be given an 18-month notice period from the 208.5 date that ineligibility is determined before 208.6 disenrollment. This clause expires February 1, 2004. 208.7 (2) Effective February 1, 2004, notwithstanding paragraph 208.8 (b), children may remain enrolled in MinnesotaCare if ten 208.9 percent of their annual family income is less than the annual 208.10 premium for a policy with a $500 deductible available through 208.11 the Minnesota comprehensive health association. Children who 208.12 are no longer eligible for MinnesotaCare under this clause shall 208.13 be given a 12-month notice period from the date that 208.14 ineligibility is determined before disenrollment. The premium 208.15 for children remaining eligible under this clause shall be the 208.16 maximum premium determined under section 256L.15, subdivision 2, 208.17 paragraph (b), until July 1, 2005, when the premium shall be 208.18 determined by section 256L.15, subdivision 2, paragraph (c). 208.19 [EFFECTIVE DATE.] The amendments to paragraph (a) are 208.20 effective July 1, 2003. The amendments to paragraph (c), clause 208.21 (1), are effective October 1, 2003. 208.22 Sec. 57. Minnesota Statutes 2002, section 256L.07, 208.23 subdivision 2, is amended to read: 208.24 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 208.25 COVERAGE.] (a) To be eligible, a family or individual must not 208.26 have access to subsidized health coverage through an employer 208.27 and must not have had access to employer-subsidized coverage 208.28 through a current employer for 18 months prior to application or 208.29 reapplication. A family or individual whose employer-subsidized 208.30 coverage is lost due to an employer terminating health care 208.31 coverage as an employee benefit during the previous 18 months is 208.32 not eligible. 208.33 (b) This subdivision does not apply to a family or 208.34 individual who was enrolled in MinnesotaCare within six months 208.35 or less of reapplication and who no longer has 208.36 employer-subsidized coverage due to the employer terminating 209.1 health care coverage as an employee benefit. 209.2 (c) For purposes of this requirement, subsidized health 209.3 coverage means health coverage for which the employer pays at 209.4 least 50 percent of the cost of coverage for the employee or 209.5 dependent, or a higher percentage as specified by the 209.6 commissioner. Children are eligible for employer-subsidized 209.7 coverage through either parent, including the noncustodial 209.8 parent. The commissioner must treat employer contributions to 209.9 Internal Revenue Code Section 125 plans and any other employer 209.10 benefits intended to pay health care costs as qualified employer 209.11 subsidies toward the cost of health coverage for employees for 209.12 purposes of this subdivision. 209.13 (d) Notwithstanding paragraph (c), beginning February 1, 209.14 2004, health coverage for single adults and households without 209.15 children and adults in families with children shall be 209.16 considered to be subsidized health coverage if the employer 209.17 contributes any amount towards the cost of coverage. 209.18 Sec. 58. Minnesota Statutes 2002, section 256L.07, 209.19 subdivision 3, is amended to read: 209.20 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 209.21 individuals enrolled in the MinnesotaCare program must have no 209.22 health coverage while enrolled or for at least four months prior 209.23 to application and renewal. Children enrolled in the original 209.24 children's health plan and children in families with income 209.25 equal to or less than175150 percent of the federal poverty 209.26 guidelines, who have other health insurance, are eligible if the 209.27 coverage: 209.28 (1) lacks two or more of the following: 209.29 (i) basic hospital insurance; 209.30 (ii) medical-surgical insurance; 209.31 (iii) prescription drug coverage; 209.32 (iv) dental coverage; or 209.33 (v) vision coverage; 209.34 (2) requires a deductible of $100 or more per person per 209.35 year; or 209.36 (3) lacks coverage because the child has exceeded the 210.1 maximum coverage for a particular diagnosis or the policy 210.2 excludes a particular diagnosis. 210.3 The commissioner may change this eligibility criterion for 210.4 sliding scale premiums in order to remain within the limits of 210.5 available appropriations. The requirement of no health coverage 210.6 does not apply to newborns. 210.7 (b) Medical assistance, general assistance medical care, 210.8 and the Civilian Health and Medical Program of the Uniformed 210.9 Service, CHAMPUS, or other coverage provided under United States 210.10 Code, title 10, subtitle A, part II, chapter 55, are not 210.11 considered insurance or health coverage for purposes of the 210.12 four-month requirement described in this subdivision. 210.13 (c) For purposes of this subdivision, Medicare Part A or B 210.14 coverage under title XVIII of the Social Security Act, United 210.15 States Code, title 42, sections 1395c to 1395w-4, is considered 210.16 health coverage. An applicant or enrollee may not refuse 210.17 Medicare coverage to establish eligibility for MinnesotaCare. 210.18 (d) Applicants who were recipients of medical assistance or 210.19 general assistance medical care within one month of application 210.20 must meet the provisions of this subdivision and subdivision 2. 210.21 (e) Effective October 1, 2003, applicants who were 210.22 recipients of medical assistance and had cost-effective health 210.23 insurance which was paid for by medical assistance are exempt 210.24 from the four-month requirement under this section. 210.25 (f) Notwithstanding paragraph (a), effective October 1, 210.26 2004, individuals enrolled in the MinnesotaCare program under 210.27 section 256L.04, subdivision 7, who have gross family income at 210.28 or below 75 percent are not subject to the requirement of having 210.29 no other health coverage for four months prior to application 210.30 and renewal. 210.31 [EFFECTIVE DATE.] This section is effective July 1, 2003, 210.32 except where a different effective date is specified in the text. 210.33 Sec. 59. Minnesota Statutes 2002, section 256L.09, 210.34 subdivision 4, is amended to read: 210.35 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 210.36 purposes of this section, a permanent Minnesota resident is a 211.1 person who has demonstrated, through persuasive and objective 211.2 evidence, that the person is domiciled in the state and intends 211.3 to live in the state permanently. 211.4 (b) To be eligible as a permanent resident, an applicant 211.5 must demonstrate the requisite intent to live in the state 211.6 permanently by: 211.7 (1) showing that the applicant maintains a residence at a 211.8 verified address other than a place of public accommodation, 211.9 through the use of evidence of residence described in section 211.10 256D.02, subdivision 12a, clause (1); 211.11 (2) demonstrating that the applicant has been continuously 211.12 domiciled in the state for no less than 180 days immediately 211.13 before the application;and211.14 (3) signing an affidavit declaring that (A) the applicant 211.15 currently resides in the state and intends to reside in the 211.16 state permanently; and (B) the applicant did not come to the 211.17 state for the primary purpose of obtaining medical coverage or 211.18 treatment; 211.19 (4) effective October 1, 2004, single adults and adults in 211.20 households without children who have gross family income at or 211.21 below 75 percent of the federal poverty guidelines are exempt 211.22 from the requirements of clause (1); 211.23 (5) effective October 1, 2004, single adults and adults in 211.24 households without children who have gross family income at or 211.25 below 75 percent of the federal poverty guidelines are exempt 211.26 from clause (2), but shall demonstrate that they have been 211.27 continuously domiciled in the state for no less than 30 days 211.28 before the date of application. In cases of medical 211.29 emergencies, the 30-day residency requirement is waived; and 211.30 (6) effective October 1, 2004, migrant workers as defined 211.31 in section 256J.08 who are single adults and adults in 211.32 households without children who have gross family income at or 211.33 below 75 percent of the federal poverty guidelines are exempt 211.34 from the residency requirements of this section, provided the 211.35 migrant worker provides verification that the migrant family 211.36 worked in this state within the last 12 months and earned at 212.1 least $1,000 in gross wages during the time the migrant worker 212.2 worked in this state. 212.3 (c) A person who is temporarily absent from the state does 212.4 not lose eligibility for MinnesotaCare. "Temporarily absent 212.5 from the state" means the person is out of the state for a 212.6 temporary purpose and intends to return when the purpose of the 212.7 absence has been accomplished. A person is not temporarily 212.8 absent from the state if another state has determined that the 212.9 person is a resident for any purpose. If temporarily absent 212.10 from the state, the person must follow the requirements of the 212.11 health plan in which the person is enrolled to receive services. 212.12 Sec. 60. Minnesota Statutes 2002, section 256L.12, 212.13 subdivision 9, is amended to read: 212.14 Subd. 9. [RATE SETTING; PERFORMANCE WITHHOLDS.] (a) Rates 212.15 will be prospective, per capita, where possible. The 212.16 commissioner may allow health plans to arrange for inpatient 212.17 hospital services on a risk or nonrisk basis. The commissioner 212.18 shall consult with an independent actuary to determine 212.19 appropriate rates. 212.20 (b) For services rendered on or after January 1, 2003, to 212.21 December 31, 2003, the commissioner shall withhold .5 percent of 212.22 managed care plan payments under this section pending completion 212.23 of performance targets. The withheld funds must be returned no 212.24 sooner than July 1 and no later than July 31 of the following 212.25 year if performance targets in the contract are achieved. A 212.26 managed care plan may include as admitted assets under section 212.27 62D.044 any amount withheld under this paragraph that is 212.28 reasonably expected to be returned. 212.29 (c) For services rendered on or after January 1, 2004, the 212.30 commissioner shall withhold five percent of managed care plan 212.31 payments under this section pending completion of performance 212.32 targets. The withheld funds must be returned no sooner than 212.33 July 1 and no later than July 31 of the following calendar year 212.34 if performance targets in the contract are achieved. A managed 212.35 care plan may include as admitted assets under section 62D.044 212.36 any amount withheld under this paragraph that is reasonably 213.1 expected to be returned. 213.2 Sec. 61. Minnesota Statutes 2002, section 256L.12, is 213.3 amending by adding a subdivision to read: 213.4 Subd. 9a. [RATE SETTING; RATABLE REDUCTION.] For services 213.5 rendered on or after October 1, 2003, the total payment made to 213.6 managed care plans under the MinnesotaCare program is reduced 213.7 one percent. 213.8 Sec. 62. Minnesota Statutes 2002, section 256L.15, 213.9 subdivision 1, is amended to read: 213.10 Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with 213.11 children and individuals shall pay a premium determined 213.12 according toa sliding fee based on a percentage of the family's213.13gross family incomesubdivision 2. 213.14 (b) Pregnant women and children under age two are exempt 213.15 from the provisions of section 256L.06, subdivision 3, paragraph 213.16 (b), clause (3), requiring disenrollment for failure to pay 213.17 premiums. For pregnant women, this exemption continues until 213.18 the first day of the month following the 60th day postpartum. 213.19 Women who remain enrolled during pregnancy or the postpartum 213.20 period, despite nonpayment of premiums, shall be disenrolled on 213.21 the first of the month following the 60th day postpartum for the 213.22 penalty period that otherwise applies under section 256L.06, 213.23 unless they begin paying premiums. 213.24 (c) Effective October 1, 2004, single adults and households 213.25 without children with gross family income at or below 75 percent 213.26 of the federal poverty guidelines who are eligible under section 213.27 256L.04, subdivision 7, do not have a premium obligation. 213.28 Sec. 63. Minnesota Statutes 2002, section 256L.15, 213.29 subdivision 2, is amended to read: 213.30 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 213.31 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 213.32 establish a sliding fee scale to determine the percentage of 213.33 grossindividual orfamily income that households at different 213.34 income levels must pay to obtain coverage through the 213.35 MinnesotaCare program. The sliding fee scale must be based on 213.36 the enrollee's grossindividual orfamily income. The sliding 214.1 fee scale must contain separate tables based on enrollment of 214.2 one, two, or three or more persons. The sliding fee scale 214.3 begins with a premium of 1.5 percent of grossindividual or214.4 family income forindividuals orfamilies with incomes below the 214.5 limits for the medical assistance program for families and 214.6 children in effect on January 1, 1999, and proceeds through the 214.7 following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 214.8 7.4, and 8.8 percent. These percentages are matched to evenly 214.9 spaced income steps ranging from the medical assistance income 214.10 limit for families and children in effect on January 1, 1999, to 214.11 275 percent of the federal poverty guidelines for the applicable 214.12 family size, up to a family size of five. The sliding fee scale 214.13 for a family of five must be used for families of more than 214.14 five. The sliding fee scale and percentages are not subject to 214.15 the provisions of chapter 14. If a familyor individualreports 214.16 increased income after enrollment, premiums shall not be 214.17 adjusted until eligibility renewal. 214.18 (b)(1) Enrolledindividuals andfamilies whose gross annual 214.19 income increases above 275 percent of the federal poverty 214.20 guideline shall pay the maximum premium. This clause expires 214.21 effective February 1, 2004. 214.22 (2) Effective October 1, 2003, enrolled single adults and 214.23 households without children who have gross family income above 214.24 75 percent of the federal poverty guidelines shall pay the 214.25 maximum premium. 214.26 (3) Effective February 1, 2004, adults in families with 214.27 children whose gross income is above 200 percent of the federal 214.28 poverty guidelines shall pay the maximum premium. 214.29 (4) The maximum premium is defined as a base charge for 214.30 one, two, or three or more enrollees so that if all 214.31 MinnesotaCare cases paid the maximum premium, the total revenue 214.32 would equal the total cost of MinnesotaCare medical coverage and 214.33 administration. In this calculation, administrative costs shall 214.34 be assumed to equal ten percent of the total. The costs of 214.35 medical coverage for pregnant women and children under age two 214.36 and the enrollees in these groups shall be excluded from the 215.1 total. The maximum premium for two enrollees shall be twice the 215.2 maximum premium for one, and the maximum premium for three or 215.3 more enrollees shall be three times the maximum premium for one. 215.4 (c) Effective July 1, 2005, single adults and households 215.5 without children who have gross family income above 75 percent 215.6 of the federal poverty guidelines and adults in families with 215.7 children whose gross income is above 200 percent of the federal 215.8 poverty guidelines shall pay the full cost premium. The full 215.9 cost premium is defined as a base charge for one, two, or three 215.10 or more enrollees so that if the base charge were paid by all 215.11 MinnesotaCare cases subject to the full cost premium, the total 215.12 revenue would approximately equal the total cost of 215.13 MinnesotaCare medical coverage and administration for cases 215.14 subject to the full cost premium. In this calculation, 215.15 administrative costs shall be assumed to equal ten percent of 215.16 the total. The full cost premium for two enrollees shall be 215.17 twice the full cost premium for one, and the full cost premium 215.18 for three or more enrollees shall be three times the full cost 215.19 premium for one. 215.20 [EFFECTIVE DATE.] The amendments to paragraph (a) are 215.21 effective October 1, 2004. The amendment to paragraph (b) is 215.22 effective October 1, 2003. 215.23 Sec. 64. Minnesota Statutes 2002, section 256L.15, 215.24 subdivision 3, is amended to read: 215.25 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 215.26 of $48 is required for all children in families with income at 215.27 or less than175150 percent of federal poverty guidelines. 215.28 [EFFECTIVE DATE.] This section is effective July 1, 2003. 215.29 Sec. 65. Minnesota Statutes 2002, section 295.58, is 215.30 amended to read: 215.31 295.58 [DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.] 215.32 The commissioner shall deposit all revenues, including 215.33 penalties and interest, derived from the taxes imposed by 215.34 sections 295.50 to 295.57 and from the insurance premiums tax 215.35 imposed by section 297I.05, subdivision 5, on health maintenance 215.36 organizations, community integrated service networks, and 216.1 nonprofit health service plan corporations in the health care 216.2 access fund. There is annually appropriated from the health 216.3 care access fund to the commissioner of revenue the amount 216.4 necessary to make refunds under this chapter. Beginning July 1, 216.5 2005, the commissioner shall deposit all revenues, including 216.6 penalties and interest, derived from the taxes imposed by 216.7 sections 295.50 to 295.57 and from the insurance premiums tax 216.8 imposed by section 297I.05, subdivision 5, on health maintenance 216.9 organizations, community integrated service networks, and 216.10 nonprofit health service plan corporations in the general fund. 216.11 There is annually appropriated from the general fund to the 216.12 commissioner of revenue the amount necessary to make refunds 216.13 under this chapter. 216.14 Sec. 66. Minnesota Statutes 2002, section 514.981, 216.15 subdivision 6, is amended to read: 216.16 Subd. 6. [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 216.17 AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 216.18 the real property it describes for a period of ten years from 216.19 the date it attaches according to section 514.981, subdivision 216.20 2, paragraph (a), except as otherwise provided for in sections 216.21 514.980 to 514.985. The agency may renew a medical assistance 216.22 lien for an additional ten years from the date it would 216.23 otherwise expire by recording or filing a certificate of renewal 216.24 before the lien expires. The certificate shall be recorded or 216.25 filed in the office of the county recorder or registrar of 216.26 titles for the county in which the lien is recorded or filed. 216.27 The certificate must refer to the recording or filing data for 216.28 the medical assistance lien it renews. The certificate need not 216.29 be attested, certified, or acknowledged as a condition for 216.30 recording or filing. The registrar of titles or the recorder 216.31 shall file, record, index, and return the certificate of renewal 216.32 in the same manner as provided for medical assistance liens in 216.33 section 514.982, subdivision 2. 216.34 (b) A medical assistance lien is not enforceable against 216.35 the real property of an estate to the extent there is a 216.36 determination by a court of competent jurisdiction, or by an 217.1 officer of the court designated for that purpose, that there are 217.2 insufficient assets in the estate to satisfy the agency's 217.3 medical assistance lien in whole or in part because of the 217.4 homestead exemption under section 256B.15, subdivision 4, the 217.5 rights of the surviving spouse or minor children under section 217.6 524.2-403, paragraphs (a) and (b), or claims with a priority 217.7 under section 524.3-805, paragraph (a), clauses (1) to (4). For 217.8 purposes of this section, the rights of the decedent's adult 217.9 children to exempt property under section 524.2-403, paragraph 217.10 (b), shall not be considered costs of administration under 217.11 section 524.3-805, paragraph (a), clause (1). 217.12 (c) Notwithstanding any law or rule to the contrary, the 217.13 provisions in clauses (1) to (7) apply if a life estate subject 217.14 to a medical assistance lien ends according to its terms, or if 217.15 a medical assistance recipient who owns a life estate or any 217.16 interest in real property as a joint tenant that is subject to a 217.17 medical assistance lien dies. 217.18 (1) The medical assistance recipient's life estate or joint 217.19 tenancy interest in the real property shall not end upon the 217.20 recipient's death but shall merge into the remainder interest or 217.21 other interest in real property the medical assistance recipient 217.22 owned in joint tenancy with others. The medical assistance lien 217.23 shall attach to and run with the remainder or other interest in 217.24 the real property to the extent of the medical assistance 217.25 recipient's interest in the property at the time of the 217.26 recipient's death as determined under this section. 217.27 (2) If the medical assistance recipient's interest was a 217.28 life estate in real property, the lien shall be a lien against 217.29 the portion of the remainder equal to the percentage factor for 217.30 the life estate of a person the medical assistance recipient's 217.31 age on the date the life estate ended according to its terms or 217.32 the date of the medical assistance recipient's death as listed 217.33 in the Life Estate Mortality Table in the health care program's 217.34 manual. 217.35 (3) If the medical assistance recipient owned the interest 217.36 in real property in joint tenancy with others, the lien shall be 218.1 a lien against the portion of that interest equal to the 218.2 fractional interest the medical assistance recipient would have 218.3 owned in the jointly owned interest had the medical assistance 218.4 recipient and the other owners held title to that interest as 218.5 tenants in common on the date the medical assistance recipient 218.6 died. 218.7 (4) The medical assistance lien shall remain a lien against 218.8 the remainder or other jointly owned interest for the length of 218.9 time and be renewable as provided in paragraph (a). 218.10 (5) Section 514.981, subdivision 5, paragraphs (a), clause 218.11 (4), (b), clauses (1) and (2); and subdivision 6, paragraph (b), 218.12 do not apply to medical assistance liens which attach to 218.13 interests in real property as provided under this subdivision. 218.14 (6) The continuation of a medical assistance recipient's 218.15 life estate or joint tenancy interest in real property after the 218.16 medical assistance recipient's death for the purpose of 218.17 recovering medical assistance provided for in sections 514.980 218.18 to 514.985 modifies common law principles holding that these 218.19 interests terminate on the death of the holder. 218.20 (7) Notwithstanding any law or rule to the contrary, no 218.21 release, satisfaction, discharge, or affidavit under section 218.22 256B.15 shall extinguish or terminate the life estate or joint 218.23 tenancy interest of a medical assistance recipient subject to a 218.24 lien under sections 514.980 to 514.985 on the date the recipient 218.25 dies. 218.26 [EFFECTIVE DATE.] This section is effective August 1, 2003, 218.27 and applies to all medical assistance liens recorded or filed on 218.28 or after that date. 218.29 Sec. 67. [REVISOR'S INSTRUCTION.] 218.30 For sections in Minnesota Statutes and Minnesota Rules 218.31 affected by the repealed sections in this article, the revisor 218.32 shall delete internal cross-references where appropriate and 218.33 make changes necessary to correct the punctuation, grammar, or 218.34 structure of the remaining text and preserve its meaning. 218.35 Sec. 68. [REPEALER.] 218.36 (a) Minnesota Statutes 2002, sections 256.955, subdivision 219.1 8; 256B.0625, subdivision 5a; 256B.057, subdivision 1b; and 219.2 256B.195, subdivision 5, are repealed July 1, 2003. 219.3 (b) Minnesota Statutes 2002, section 256L.04, subdivision 219.4 9, is repealed October 1, 2004. 219.5 (c) Minnesota Statutes 2002, section 256B.055, subdivision 219.6 10a, is repealed July 1, 2003, or upon federal approval, 219.7 whichever is later. 219.8 (d) Minnesota Statutes 2002, section 256L.02, subdivision 219.9 3, is repealed June 30, 2005. 219.10 ARTICLE 3 219.11 LONG-TERM CARE 219.12 Section 1. Minnesota Statutes 2002, section 144A.4605, 219.13 subdivision 4, is amended to read: 219.14 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 219.15 establishment registered under chapter 144D that is required to 219.16 obtain a home care license must obtain an assisted living home 219.17 care license according to this section or a class A or class E 219.18 license according to rule. A housing with services 219.19 establishment that obtains a class E license under this 219.20 subdivision remains subject to the payment limitations in 219.21 sections 256B.0913, subdivision55f, paragraph(h)(b), and 219.22 256B.0915, subdivision3, paragraph (g)3d. 219.23 (b) A board and lodging establishment registered for 219.24 special services as of December 31, 1996, and also registered as 219.25 a housing with services establishment under chapter 144D, must 219.26 deliver home care services according to sections 144A.43 to 219.27 144A.47, and may apply for a waiver from requirements under 219.28 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 219.29 licensed agency under the standards of section 157.17. Such 219.30 waivers as may be granted by the department will expire upon 219.31 promulgation of home care rules implementing section 144A.4605. 219.32 (c) An adult foster care provider licensed by the 219.33 department of human services and registered under chapter 144D 219.34 may continue to provide health-related services under its foster 219.35 care license until the promulgation of home care rules 219.36 implementing this section. 220.1 (d) An assisted living home care provider licensed under 220.2 this section must comply with the disclosure provisions of 220.3 section 325F.72 to the extent they are applicable. 220.4 Sec. 2. Minnesota Statutes 2002, section 256.9657, 220.5 subdivision 1, is amended to read: 220.6 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 220.7 Effective July 1, 1993, each non-state-operated nursing home 220.8 licensed under chapter 144A shall pay to the commissioner an 220.9 annual surcharge according to the schedule in subdivision 4. 220.10 The surcharge shall be calculated as $620 per licensed bed. If 220.11 the number of licensed beds is reduced, the surcharge shall be 220.12 based on the number of remaining licensed beds the second month 220.13 following the receipt of timely notice by the commissioner of 220.14 human services that beds have been delicensed. The nursing home 220.15 must notify the commissioner of health in writing when beds are 220.16 delicensed. The commissioner of health must notify the 220.17 commissioner of human services within ten working days after 220.18 receiving written notification. If the notification is received 220.19 by the commissioner of human services by the 15th of the month, 220.20 the invoice for the second following month must be reduced to 220.21 recognize the delicensing of beds. Beds on layaway status 220.22 continue to be subject to the surcharge. The commissioner of 220.23 human services must acknowledge a medical care surcharge appeal 220.24 within 30 days of receipt of the written appeal from the 220.25 provider. 220.26 (b) Effective July 1, 1994, the surcharge in paragraph (a) 220.27 shall be increased to $625. 220.28 (c) Effective August 15, 2002, the surcharge under 220.29 paragraph (b) shall be increased to $990. 220.30 (d) Effective July 15, 2003, the surcharge under paragraph 220.31 (c) shall be increased to $2,700. 220.32 (e) The commissioner may reduce, and may subsequently 220.33 restore, the surcharge under paragraph (d) based on the 220.34 commissioner's determination of a permissible surcharge. 220.35 (f) Between April 1, 2002, and August 15,20032004, a 220.36 facility governed by this subdivision may elect to assume full 221.1 participation in the medical assistance program by agreeing to 221.2 comply with all of the requirements of the medical assistance 221.3 program, including the rate equalization law in section 256B.48, 221.4 subdivision 1, paragraph (a), and all other requirements 221.5 established in law or rule, and to begin intake of new medical 221.6 assistance recipients. Rates will be determined under Minnesota 221.7 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 221.8 256B.431, subdivision 27, paragraph (i), rate calculations will 221.9 be subject to limits as prescribed in rule and law. Other than 221.10 the adjustments in sections 256B.431, subdivisions 30 and 32; 221.11 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 221.12 9549.0057, and any other applicable legislation enacted prior to 221.13 the finalization of rates, facilities assuming full 221.14 participation in medical assistance under this paragraph are not 221.15 eligible for any rate adjustments until the July 1 following 221.16 their settle-up period. 221.17 [EFFECTIVE DATE.] This section is effective June 30, 2003. 221.18 Sec. 3. Minnesota Statutes 2002, section 256.9754, 221.19 subdivision 2, is amended to read: 221.20 Subd. 2. [CREATION.]The community services development221.21grants programThere is createdunder the administration of the221.22commissioner of human servicesthe consolidated ElderCare 221.23 development grant fund for the purpose of rebalancing the 221.24 long-term care system and increasing home and community-based 221.25 care alternatives that sustain independent living. 221.26 Sec. 4. Minnesota Statutes 2002, section 256.9754, 221.27 subdivision 3, is amended to read: 221.28 Subd. 3. [PROVISION OF GRANTS.]The commissioner shall221.29make grants available to communities, providers of older adult221.30services identified in subdivision 1, or to a consortium of221.31providers of older adult services, to establish older adult221.32services.Grants may be provided for capital and other costs 221.33 including, but not limited to, start-up and training costs, 221.34 equipment, and supplies related to older adult services or other 221.35 residential or service alternatives to nursing facility care. 221.36 Grants may also be made to renovate current buildings, provide 222.1 transportation services, fund programs that would allow older 222.2 adults or disabled individuals to stay in their own homes by 222.3 sharing a home, fund programs that coordinate and manage formal 222.4 and informal services to older adults in their homes to enable 222.5 them to live as independently as possible in their own homes as 222.6 an alternative to nursing home care, or expand state-funded 222.7 programs in the area. Other services eligible for funding 222.8 include: transportation; chore services and homemaking; home 222.9 health care and personal care assistance; care coordination; 222.10 housing with services, such as assisted living and foster care; 222.11 home modification; adult day services; caregiver support and 222.12 respite; living-at-home block nurse; service integration and 222.13 development; telemedicine, telehomecare, or other 222.14 technology-based solutions; grocery shopping; and services 222.15 identified as needed for community transition. 222.16 Sec. 5. Minnesota Statutes 2002, section 256.9754, 222.17 subdivision 4, is amended to read: 222.18 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 222.19 communities and providers, including for-profits, nonprofits, 222.20 and governmental units, or to a consortium of providers that 222.21 have a local match of 25 percent in the form of cash or in-kind 222.22 services, except that for capital costs the match is 50 percent 222.23of the costs for the project in the form of donations, local tax222.24dollars, in-kind donations, fund-raising, or other local matches. 222.25 Sec. 6. Minnesota Statutes 2002, section 256.9754, 222.26 subdivision 5, is amended to read: 222.27 Subd. 5. [GRANT PREFERENCE.] The commissionerof human222.28servicesshall give preference when awarding grants under this 222.29 section to areas where nursing facility closures have occurred 222.30 or are occurring. The commissioner may award grants to the 222.31 extent grant funds are available and to the extent applications 222.32 are approved by the commissioner. Denial of approval of an 222.33 application in one year does not preclude submission of an 222.34 application in a subsequent year.The maximum grant amount is222.35limited to $750,000.222.36 Sec. 7. Minnesota Statutes 2002, section 256B.0913, 223.1 subdivision 2, is amended to read: 223.2 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 223.3 services are available to Minnesotans age 65 or olderwho are223.4not eligible for medical assistance without a spenddown or223.5waiver obligation butwho would be eligible for medical 223.6 assistance within 180 days of admission to a nursing facility 223.7 and subject to subdivisions 4 to 13. 223.8 Sec. 8. Minnesota Statutes 2002, section 256B.0913, 223.9 subdivision 4, is amended to read: 223.10 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 223.11 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 223.12 under the alternative care program is available to persons who 223.13 meet the following criteria: 223.14 (1) the person has been determined by a community 223.15 assessment under section 256B.0911 to be a person who would 223.16 require the level of care provided in a nursing facility, but 223.17 for the provision of services under the alternative care 223.18 program; 223.19 (2) the person is age 65 or older; 223.20 (3) the person would be eligible for medical assistance 223.21 within 180 days of admission to a nursing facility; 223.22 (4) the person is not ineligible for the medical assistance 223.23 program due to an asset transfer penalty; 223.24 (5) the person needs services that are not funded through 223.25 other state or federal funding;and223.26 (6) the monthly cost of the alternative care services 223.27 funded by the program for this person does not exceed 75 percent 223.28 of thestatewide weighted average monthly nursing facility rate223.29of the case mix resident class to which the individual223.30alternative care client would be assigned under Minnesota Rules,223.31parts 9549.0050 to 9549.0059, less the recipient's maintenance223.32needs allowance as described in section 256B.0915, subdivision223.331d, paragraph (a), until the first day of the state fiscal year223.34in which the resident assessment system, under section 256B.437,223.35for nursing home rate determination is implemented. Effective223.36on the first day of the state fiscal year in which a resident224.1assessment system, under section 256B.437, for nursing home rate224.2determination is implemented and the first day of each224.3subsequent state fiscal year, the monthly cost of alternative224.4care services for this person shall not exceed the alternative224.5care monthly cap for the case mix resident class to which the224.6alternative care client would be assigned under Minnesota Rules,224.7parts 9549.0050 to 9549.0059, which was in effect on the last224.8day of the previous state fiscal year, and adjusted by the224.9greater of any legislatively adopted home and community-based224.10services cost-of-living percentage increase or any legislatively224.11adopted statewide percent rate increase for nursing224.12facilitiesmonthly limit described under section 256B.0915, 224.13 subdivision 3a. This monthly limit does not prohibit the 224.14 alternative care client from payment for additional services, 224.15 but in no case may the cost of additional services purchased 224.16 under this section exceed the difference between the client's 224.17 monthly service limit defined under section 256B.0915, 224.18 subdivision 3, and the alternative care program monthly service 224.19 limit defined in this paragraph. If medical supplies and 224.20 equipment or environmental modifications are or will be 224.21 purchased for an alternative care services recipient, the costs 224.22 may be prorated on a monthly basis for up to 12 consecutive 224.23 months beginning with the month of purchase. If the monthly 224.24 cost of a recipient's other alternative care services exceeds 224.25 the monthly limit established in this paragraph, the annual cost 224.26 of the alternative care services shall be determined. In this 224.27 event, the annual cost of alternative care services shall not 224.28 exceed 12 times the monthly limit described in this paragraph.; 224.29 and 224.30 (7) the person is not ineligible due to nonpayment of the 224.31 assessed monthly premium charge over 60 days past due. 224.32 Following disenrollment due to nonpayment of a monthly premium, 224.33 eligibility shall not be reinstated for a period of 90 days 224.34 pending eligibility redetermination. 224.35 (b) Alternative care funding under this subdivision is not 224.36 available for a person who is a medical assistance recipient or 225.1 who would be eligible for medical assistance without a spenddown 225.2 or waiver obligation. A person whose initial application for 225.3 medical assistance and the elderly waiver program is being 225.4 processed may be served under the alternative care program for a 225.5 period up to 60 days. If the individual is found to be eligible 225.6 for medical assistance, medical assistance must be billed for 225.7 services payable under the federally approved elderly waiver 225.8 plan and delivered from the date the individual was found 225.9 eligible for the federally approved elderly waiver plan. 225.10 Notwithstanding this provision,upon federal approval,225.11 alternative care funds may not be used to pay for any service 225.12 the cost of which is payable by medical assistance or which is 225.13 used by a recipient to meet amedical assistance income225.14spenddown orwaiver obligation; or a medical assistance income 225.15 spenddown for a person who is eligible to participate under the 225.16 special income standard provisions through the federally 225.17 approved elderly waiver program. 225.18 (c) Alternative care funding is not available for a person 225.19 who resides in a licensed nursing home, certified boarding care 225.20 home, hospital, or intermediate care facility, except for case 225.21 management services which are provided in support of the 225.22 discharge planning processtofor a nursing home resident or 225.23 certified boarding care home resident to assist with a 225.24 relocation process to a community-based setting. 225.25 (d) Alternative care funding is not available for a person 225.26 whose income is greater than the maintenance needs allowance 225.27 under section 256B.0915, subdivision 1, paragraph (d), but equal 225.28 to or less than 120 percent of the federal poverty guideline 225.29 effective July 1, in the year for which alternative care 225.30 eligibility is determined, who would be eligible for the elderly 225.31 waiver with a waiver obligation. 225.32 Sec. 9. Minnesota Statutes 2002, section 256B.0913, 225.33 subdivision 5, is amended to read: 225.34 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.](a)225.35 Alternative care funding may be used for payment of costs of: 225.36 (1) adult foster care; 226.1 (2) adult day care; 226.2 (3) home health aide; 226.3 (4) homemaker services; 226.4 (5) personal care; 226.5 (6) case management; 226.6 (7) respite care; 226.7 (8) assisted living; 226.8 (9) residential care services; 226.9 (10) care-related supplies and equipment; 226.10 (11) meals delivered to the home; 226.11 (12) transportation; 226.12 (13) nursing services; 226.13 (14) chore services; 226.14 (15) companion services; 226.15 (16) nutrition services; 226.16 (17) training for direct informal caregivers; 226.17 (18) telehome caredevicestomonitor recipientsprovide 226.18 services in their own homesas an alternative to hospital care,226.19nursing home care, or homein conjunction with in-home visits; 226.20 (19)other services which includesdiscretionaryfunds and226.21direct cash payments to clients,services, for which counties 226.22 may make payment from their alternative care program allocation 226.23 or services not otherwise defined in this section or section 226.24 256B.0625, following approval by the commissioner, subject to226.25the provisions of paragraph (j). Total annual payments for226.26"other services" for all clients within a county may not exceed226.2725 percent of that county's annual alternative care program base226.28allocation;and226.29 (20) environmental modifications.; and 226.30 (21) direct cash payments for which counties may make 226.31 payment from their alternative care program allocation to 226.32 clients for the purpose of purchasing services, following 226.33 approval by the commissioner, and subject to the provisions of 226.34 subdivision 5h, until approval and implementation of 226.35 consumer-directed services through the federally approved 226.36 elderly waiver plan. Upon implementation, consumer-directed 227.1 services under the alternative care program are available 227.2 statewide and limited to the average monthly expenditures 227.3 representative of all alternative care program participants for 227.4 the same case mix resident class assigned in the most recent 227.5 fiscal year for which complete expenditure data is available. 227.6 Total annual payments for discretionary services and direct 227.7 cash payments, until the federally approved consumer-directed 227.8 service option is implemented statewide, for all clients within 227.9 a county may not exceed 25 percent of that county's annual 227.10 alternative care program base allocation. Thereafter, 227.11 discretionary services are limited to 25 percent of the county's 227.12 annual alternative care program base allocation. 227.13 Subd. 5a. [SERVICES; SERVICE DEFINITIONS; SERVICE 227.14 STANDARDS.] (a) Unless specified in statute, the services, 227.15 service definitions, and standards for alternative care services 227.16 shall be the same as the services, service definitions, and 227.17 standards specified in the federally approved elderly waiver 227.18 plan, except for transitional support services. 227.19 (b) The county agency must ensure that the funds are not 227.20 used to supplant services available through other public 227.21 assistance or services programs. 227.22(c) Unless specified in statute, the services, service227.23definitions, and standards for alternative care services shall227.24be the same as the services, service definitions, and standards227.25specified in the federally approved elderly waiver plan. Except227.26for the county agencies' approval of direct cash payments to227.27clients as described in paragraph (j) orFor a provider of 227.28 supplies and equipment when the monthly cost of the supplies and 227.29 equipment is less than $250, persons or agencies must be 227.30 employed by or under a contract with the county agency or the 227.31 public health nursing agency of the local board of health in 227.32 order to receive funding under the alternative care program. 227.33 Supplies and equipment may be purchased from a vendor not 227.34 certified to participate in the Medicaid program if the cost for 227.35 the item is less than that of a Medicaid vendor. 227.36 (c) Personal care services must meet the service standards 228.1 defined in the federally approved elderly waiver plan, except 228.2 that a county agency may contract with a client's relative who 228.3 meets the relative hardship waiver requirements or a relative 228.4 who meets the criteria and is also the responsible party under 228.5 an individual service plan that ensures the client's health and 228.6 safety and supervision of the personal care services by a 228.7 qualified professional as defined in section 256B.0625, 228.8 subdivision 19c. Relative hardship is established by the county 228.9 when the client's care causes a relative caregiver to do any of 228.10 the following: resign from a paying job, reduce work hours 228.11 resulting in lost wages, obtain a leave of absence resulting in 228.12 lost wages, incur substantial client-related expenses, provide 228.13 services to address authorized, unstaffed direct care time, or 228.14 meet special needs of the client unmet in the formal service 228.15 plan. 228.16(d)Subd. 5b. [ADULT FOSTER CARE RATE.] The adult foster 228.17 care rate shall be considered a difficulty of care payment and 228.18 shall not include room and board. The adult foster care rate 228.19 shall be negotiated between the county agency and the foster 228.20 care provider. The alternative care payment for the foster care 228.21 service in combination with the payment for other alternative 228.22 care services, including case management, must not exceed the 228.23 limit specified in subdivision 4, paragraph (a), clause (6). 228.24(e) Personal care services must meet the service standards228.25defined in the federally approved elderly waiver plan, except228.26that a county agency may contract with a client's relative who228.27meets the relative hardship waiver requirement as defined in228.28section 256B.0627, subdivision 4, paragraph (b), clause (10), to228.29provide personal care services if the county agency ensures228.30supervision of this service by a qualified professional as228.31defined in section 256B.0625, subdivision 19c.228.32(f)Subd. 5c. [RESIDENTIAL CARE SERVICES; SUPPORTIVE 228.33 SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 228.34 section, residential care services are services which are 228.35 provided to individuals living in residential care homes. 228.36 Residential care homes are currently licensed as board and 229.1 lodging establishments under section 157.16, and are registered 229.2 with the department of health as providing special services 229.3 under section 157.17and are not subject to registrationexcept 229.4 settings that are currently registered under chapter 144D. 229.5 Residential care services are defined as "supportive services" 229.6 and "health-related services." "Supportive services" meansthe229.7provision of up to 24-hour supervision and oversight.229.8Supportive services includes: (1) transportation, when provided229.9by the residential care home only; (2) socialization, when229.10socialization is part of the plan of care, has specific goals229.11and outcomes established, and is not diversional or recreational229.12in nature; (3) assisting clients in setting up meetings and229.13appointments; (4) assisting clients in setting up medical and229.14social services; (5) providing assistance with personal laundry,229.15such as carrying the client's laundry to the laundry room.229.16Assistance with personal laundry does not include any laundry,229.17such as bed linen, that is included in the room and board rate229.18 services as defined in section 157.17, subdivision 1, paragraph 229.19 (a). "Health-related services"are limited to minimal229.20assistance with dressing, grooming, and bathing and providing229.21reminders to residents to take medications that are229.22self-administered or providing storage for medications, if229.23requestedmeans services covered in section 157.17, subdivision 229.24 1, paragraph (b). Individuals receiving residential care 229.25 services cannot receive homemaking services funded under this 229.26 section. 229.27(g)Subd. 5d. [ASSISTED LIVING SERVICES.] For the purposes 229.28 of this section, "assisted living" refers to supportive services 229.29 provided by a single vendor to clients who reside in the same 229.30 apartment building of three or more units which are not subject 229.31 to registration under chapter 144D and are licensed by the 229.32 department of health as a class A home care provider or a class 229.33 E home care provider. Assisted living services are defined as 229.34 up to 24-hour supervision,andoversight, and supportive 229.35 services as defined inclause (1)section 157.17, subdivision 1, 229.36 paragraph (a), individualized home care aide tasks as defined in 230.1clause (2)Minnesota Rules, part 4668.0110, and individualized 230.2 home management tasks as defined inclause (3)Minnesota Rules, 230.3 part 4668.0120 provided to residents of a residential center 230.4 living in their units or apartments with a full kitchen and 230.5 bathroom. A full kitchen includes a stove, oven, refrigerator, 230.6 food preparation counter space, and a kitchen utensil storage 230.7 compartment. Assisted living services must be provided by the 230.8 management of the residential center or by providers under 230.9 contract with the management or with the county. 230.10(1) Supportive services include:230.11(i) socialization, when socialization is part of the plan230.12of care, has specific goals and outcomes established, and is not230.13diversional or recreational in nature;230.14(ii) assisting clients in setting up meetings and230.15appointments; and230.16(iii) providing transportation, when provided by the230.17residential center only.230.18(2) Home care aide tasks means:230.19(i) preparing modified diets, such as diabetic or low230.20sodium diets;230.21(ii) reminding residents to take regularly scheduled230.22medications or to perform exercises;230.23(iii) household chores in the presence of technically230.24sophisticated medical equipment or episodes of acute illness or230.25infectious disease;230.26(iv) household chores when the resident's care requires the230.27prevention of exposure to infectious disease or containment of230.28infectious disease; and230.29(v) assisting with dressing, oral hygiene, hair care,230.30grooming, and bathing, if the resident is ambulatory, and if the230.31resident has no serious acute illness or infectious disease.230.32Oral hygiene means care of teeth, gums, and oral prosthetic230.33devices.230.34(3) Home management tasks means:230.35(i) housekeeping;230.36(ii) laundry;231.1(iii) preparation of regular snacks and meals; and231.2(iv) shopping.231.3 Subd. 5e. [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 231.4 Individuals receiving assisted living services shall not receive 231.5 both assisted living services and homemaking services. 231.6 Individualized means services are chosen and designed 231.7 specifically for each resident's needs, rather than provided or 231.8 offered to all residents regardless of their illnesses, 231.9 disabilities, or physical conditions. Assisted living services 231.10 as defined in this section shall not be authorized in boarding 231.11 and lodging establishments licensed according to sections 231.12 157.011 and 157.15 to 157.22. 231.13(h)(b) For establishments registered under chapter 144D, 231.14 assisted living services under this section means either the 231.15 services described inparagraph (g)subdivision 5d and delivered 231.16 by a class E home care provider licensed by the department of 231.17 health or the services described under section 144A.4605 and 231.18 delivered by an assisted living home care provider or a class A 231.19 home care provider licensed by the commissioner of health. 231.20(i)Subd. 5f. [PAYMENT RATES FOR ASSISTED LIVING SERVICES 231.21 AND RESIDENTIAL CARE.] (a) Payment for assisted living services 231.22 and residential care services shall be a monthly rate negotiated 231.23 and authorized by the county agency based on an individualized 231.24 service plan for each resident and may not cover direct rent or 231.25 food costs. 231.26(1)(b) The individualized monthly negotiated payment for 231.27 assisted living services as described inparagraph231.28(g)subdivision 5d or(h)5e, paragraph (b), and residential 231.29 care services as described inparagraph (f)subdivision 5c, 231.30 shall not exceed the nonfederal share in effect on July 1 of the 231.31 state fiscal year for which the rate limit is being calculated 231.32 of the greater of either the statewide or any of the geographic 231.33groups' weighted average monthly nursing facility payment rate231.34of the case mix resident class to which the alternative care231.35eligible client would be assigned under Minnesota Rules, parts231.369549.0050 to 9549.0059, less the maintenance needs allowance as232.1described in section 256B.0915, subdivision 1d, paragraph (a),232.2until the first day of the state fiscal year in which a resident232.3assessment system, under section 256B.437, of nursing home rate232.4determination is implemented. Effective on the first day of the232.5state fiscal year in which a resident assessment system, under232.6section 256B.437, of nursing home rate determination is232.7implemented and the first day of each subsequent state fiscal232.8year, the individualized monthly negotiated payment for the232.9services described in this clause shall not exceed the limit232.10described in this clause which was in effect on the last day of232.11the previous state fiscal year and which has been adjusted by232.12the greater of any legislatively adopted home and232.13community-based services cost-of-living percentage increase or232.14any legislatively adopted statewide percent rate increase for232.15nursing facilitiesgroups according to subdivision 4, paragraph 232.16 (a), clause (6). 232.17(2)(c) The individualized monthly negotiated payment for 232.18 assisted living services described under section 144A.4605 and 232.19 delivered by a provider licensed by the department of health as 232.20 a class A home care provider or an assisted living home care 232.21 provider and provided in a building that is registered as a 232.22 housing with services establishment under chapter 144D and that 232.23 provides 24-hour supervision in combination with the payment for 232.24 other alternative care services, including case management, must 232.25 not exceed the limit specified in subdivision 4, paragraph (a), 232.26 clause (6). 232.27(j)Subd. 5g. [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 232.28 A county agency may make payment from their alternative care 232.29 program allocation for"other services" which include use of232.30"discretionary funds" for services that are not otherwise232.31defined in this section anddirect cash payments to the client 232.32 for the purpose of purchasing the services. The following 232.33 provisions apply to payments under thisparagraphsubdivision: 232.34 (1) a cash payment to a client under this provision cannot 232.35 exceed the monthly payment limit for that client as specified in 232.36 subdivision 4, paragraph (a), clause (6); and 233.1 (2) a county may not approve any cash payment for a client 233.2 who meets either of the following: 233.3 (i) has been assessed as having a dependency in 233.4 orientation, unless the client has an authorized 233.5 representative. An "authorized representative" means an 233.6 individual who is at least 18 years of age and is designated by 233.7 the person or the person's legal representative to act on the 233.8 person's behalf. This individual may be a family member, 233.9 guardian, representative payee, or other individual designated 233.10 by the person or the person's legal representative, if any, to 233.11 assist in purchasing and arranging for supports; or 233.12 (ii) is concurrently receiving adult foster care, 233.13 residential care, or assisted living services;. 233.14(3)Subd. 5h. [CASH PAYMENTS TO PERSONS.] (a) Cash 233.15 payments to a person or a person's family will be provided 233.16 through a monthly payment and be in the form of cash, voucher, 233.17 or direct county payment to a vendor. Fees or premiums assessed 233.18 to the person for eligibility for health and human services are 233.19 not reimbursable through this service option. Services and 233.20 goods purchased through cash payments must be identified in the 233.21 person's individualized care plan and must meet all of the 233.22 following criteria: 233.23(i)(1) they must be over and above the normal cost of 233.24 caring for the person if the person did not have functional 233.25 limitations; 233.26(ii)(2) they must be directly attributable to the person's 233.27 functional limitations; 233.28(iii)(3) they must have the potential to be effective at 233.29 meeting the goals of the program; and 233.30(iv)(4) they must be consistent with the needs identified 233.31 in the individualized service plan. The service plan shall 233.32 specify the needs of the person and family, the form and amount 233.33 of payment, the items and services to be reimbursed, and the 233.34 arrangements for management of the individual grant; and. 233.35(v)(b) The person, the person's family, or the legal 233.36 representative shall be provided sufficient information to 234.1 ensure an informed choice of alternatives. The local agency 234.2 shall document this information in the person's care plan, 234.3 including the type and level of expenditures to be reimbursed;. 234.4 (c) Persons receiving grants under this section shall have 234.5 the following responsibilities: 234.6 (1) spend the grant money in a manner consistent with their 234.7 individualized service plan with the local agency; 234.8 (2) notify the local agency of any necessary changes in the 234.9 grant expenditures; 234.10 (3) arrange and pay for supports; and 234.11 (4) inform the local agency of areas where they have 234.12 experienced difficulty securing or maintaining supports. 234.13 (d) The county shall report client outcomes, services, and 234.14 costs under this paragraph in a manner prescribed by the 234.15 commissioner. 234.16(4)Subd. 5i. [IMMUNITY.] The state of Minnesota, county, 234.17 lead agency under contract, or tribal government under contract 234.18 to administer the alternative care program shall not be liable 234.19 for damages, injuries, or liabilities sustained through the 234.20 purchase of direct supports or goods by the person, the person's 234.21 family, or the authorized representative with funds received 234.22 through the cash payments under this section. Liabilities 234.23 include, but are not limited to, workers' compensation, the 234.24 Federal Insurance Contributions Act (FICA), or the Federal 234.25 Unemployment Tax Act (FUTA);. 234.26(5) persons receiving grants under this section shall have234.27the following responsibilities:234.28(i) spend the grant money in a manner consistent with their234.29individualized service plan with the local agency;234.30(ii) notify the local agency of any necessary changes in234.31the grant expenditures;234.32(iii) arrange and pay for supports; and234.33(iv) inform the local agency of areas where they have234.34experienced difficulty securing or maintaining supports; and234.35(6) the county shall report client outcomes, services, and234.36costs under this paragraph in a manner prescribed by the235.1commissioner.235.2 Sec. 10. Minnesota Statutes 2002, section 256B.0913, 235.3 subdivision 6, is amended to read: 235.4 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 235.5 The alternative care program is administered by the county 235.6 agency. This agency is the lead agency responsible for the 235.7 local administration of the alternative care program as 235.8 described in this section. However, it may contract with the 235.9 public health nursing service to be the lead agency. The 235.10 commissioner may contract with federally recognized Indian 235.11 tribes with a reservation in Minnesota to serve as the lead 235.12 agency responsible for the local administration of the 235.13 alternative care program as described in the contract. 235.14 (b) Alternative care pilot projects operate according to 235.15 this section and the provisions of Laws 1993, First Special 235.16 Session chapter 1, article 5, section 133, under agreement with 235.17 the commissioner. Each pilot project contract period shall 235.18 begin no later than the first payment cycle of the state fiscal 235.19 year and continue through the last payment cycle of the state 235.20 fiscal year. 235.21 Sec. 11. Minnesota Statutes 2002, section 256B.0913, 235.22 subdivision 7, is amended to read: 235.23 Subd. 7. [CASE MANAGEMENT.]Providers of case management235.24services for persons receiving services funded by the235.25alternative care program must meet the qualification235.26requirements and standards specified in section 256B.0915,235.27subdivision 1b.The case manager must not approve alternative 235.28 care funding for a client in any setting in which the case 235.29 manager cannot reasonably ensure the client's health and 235.30 safety. The case manager is responsible for the 235.31 cost-effectiveness of the alternative care individual care plan 235.32 and must not approve any care plan in which the cost of services 235.33 funded by alternative care and client contributions exceeds the 235.34 limit specified in section 256B.0915, subdivision 3, paragraph 235.35 (b).The county may allow a case manager employed by the county235.36to delegate certain aspects of the case management activity to236.1another individual employed by the county provided there is236.2oversight of the individual by the case manager. The case236.3manager may not delegate those aspects which require236.4professional judgment including assessments, reassessments, and236.5care plan development.236.6 Sec. 12. Minnesota Statutes 2002, section 256B.0913, 236.7 subdivision 8, is amended to read: 236.8 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 236.9 case manager shall implement the plan of care for each 236.10 alternative care client and ensure that a client's service needs 236.11 and eligibility are reassessed at least every 12 months. The 236.12 plan shall include any services prescribed by the individual's 236.13 attending physician as necessary to allow the individual to 236.14 remain in a community setting. In developing the individual's 236.15 care plan, the case manager should include the use of volunteers 236.16 from families and neighbors, religious organizations, social 236.17 clubs, and civic and service organizations to support the formal 236.18 home care services. The county shall be held harmless for 236.19 damages or injuries sustained through the use of volunteers 236.20 under this subdivision including workers' compensation 236.21 liability. The lead agency shall provide documentation in each 236.22 individual's plan of care and, if requested, to the commissioner 236.23 that the most cost-effective alternatives available have been 236.24 offered to the individual and that the individual was free to 236.25 choose among available qualified providers, both public and 236.26 private, including qualified case management or service 236.27 coordination providers other than those employed by the lead 236.28 agency when the lead agency maintains responsibility for prior 236.29 authorizing services in accordance with statutory and 236.30 administrative requirements. The case manager must give the 236.31 individual a ten-day written notice of any denial, termination, 236.32 or reduction of alternative care services. 236.33 (b) If the county administering alternative care services 236.34 is different than the county of financial responsibility, the 236.35 care plan may be implemented without the approval of the county 236.36 of financial responsibility. 237.1 Sec. 13. Minnesota Statutes 2002, section 256B.0913, 237.2 subdivision 10, is amended to read: 237.3 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 237.4 appropriation for fiscal years 1992 and beyond shall cover only 237.5 alternative care eligible clients. By July 1 of each year, the 237.6 commissioner shall allocate to county agencies the state funds 237.7 available for alternative care for persons eligible under 237.8 subdivision 2. 237.9 (b) The adjusted base for each county is the county's 237.10 current fiscal year base allocation plus any targeted funds 237.11 approved during the current fiscal year. Calculations for 237.12 paragraphs (c) and (d) are to be made as follows: for each 237.13 county, the determination of alternative care program 237.14 expenditures shall be based on payments for services rendered 237.15 from April 1 through March 31 in the base year, to the extent 237.16 that claims have been submitted and paid by June 1 of that year. 237.17 (c) If the alternative care program expenditures as defined 237.18 in paragraph (b) are 95 percent or more of the county's adjusted 237.19 base allocation, the allocation for the next fiscal year is 100 237.20 percent of the adjusted base, plus inflation to the extent that 237.21 inflation is included in the state budget. 237.22 (d) If the alternative care program expenditures as defined 237.23 in paragraph (b) are less than 95 percent of the county's 237.24 adjusted base allocation, the allocation for the next fiscal 237.25 year is the adjusted base allocation less the amount of unspent 237.26 funds below the 95 percent level. 237.27 (e) If the annual legislative appropriation for the 237.28 alternative care program is inadequate to fund the combined 237.29 county allocations for a biennium, the commissioner shall 237.30 distribute to each county the entire annual appropriation as 237.31 that county's percentage of the computed base as calculated in 237.32 paragraphs (c) and (d). 237.33 (f) On agreement between the commissioner and the lead 237.34 agency, the commissioner may have discretion to reallocate 237.35 alternative care base allocations distributed to lead agencies 237.36 in which the base amount exceeds program expenditures. 238.1 Sec. 14. Minnesota Statutes 2002, section 256B.0913, 238.2 subdivision 12, is amended to read: 238.3 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 238.4 all alternative care eligible clients to help pay for the cost 238.5 of participating in the program. The amount of the premium for 238.6 the alternative care client shall be determined as follows: 238.7 (1) when the alternative care client's income less 238.8 recurring and predictable medical expenses isgreater than the238.9recipient's maintenance needs allowance as defined in section238.10256B.0915, subdivision 1d, paragraph (a), butless than 150 238.11 percent of the federal poverty guideline effective on July 1 of 238.12 the state fiscal year in which the premium is being computed, 238.13 and total assets are less than $10,000, the fee iszeroten 238.14 percent of the cost of alternative care services; or 238.15 (2) when the alternative care client's income less 238.16 recurring and predictable medical expenses isgreater than150 238.17 percent or greater of the federal poverty guideline effective on 238.18 July 1 of the state fiscal year in which the premium is being 238.19 computed, and total assets are less than $10,000, the fee is 25238.20percent of the cost of alternative care services or the238.21difference between 150 percent of the federal poverty guideline238.22effective on July 1 of the state fiscal year in which the238.23premium is being computed and the client's income less recurring238.24and predictable medical expenses, whichever is less; and238.25(3) when the alternative care client'sor total assets are 238.26 greater than or equal to $10,000, the fee is 25 percent of the 238.27 cost of alternative care services. 238.28 For married persons, total assets are defined as the total 238.29 marital assets less the estimated community spouse asset 238.30 allowance, under section 256B.059, if applicable. For married 238.31 persons, total income is defined as the client's income less the 238.32 monthly spousal allotment, under section 256B.058. 238.33 All alternative care servicesexcept case managementshall 238.34 be included in the estimated costs for the purpose of 238.35 determining25 percent ofthecostspremium amount. 238.36 Premiums are due and payable each month alternative care 239.1 services are received unless the actual cost of the services is 239.2 less than the premium, in which case the fee is the lesser 239.3 amount. 239.4 (b) The fee shall be waived by the commissioner when: 239.5 (1) a person who is residing in a nursing facility is 239.6 receiving case management only; 239.7 (2)a person is applying for medical assistance;239.8(3)a married couple is requesting an asset assessment 239.9 under the spousal impoverishment provisions; 239.10(4)(3) a person is found eligible for alternative care, 239.11 but is not yet receiving alternative care services;or239.12(5)(4) a person's fee under paragraph (a) is less than 239.13 $25; or 239.14 (5) a person has chosen to participate in a 239.15 consumer-directed service plan for which the cost is no greater 239.16 than the total cost of the person's alternative care service 239.17 plan less the monthly premium amount that would otherwise be 239.18 assessed. 239.19 (c) The county agency must record in the state's receivable 239.20 system the client's assessed premium amount or the reason the 239.21 premium has been waived. The commissioner will bill and collect 239.22 the premium from the client. Money collected must be deposited 239.23 in the general fund and is appropriated to the commissioner for 239.24 the alternative care program. The client must supply the county 239.25 with the client's social security number at the time of 239.26 application. The county shall supply the commissioner with the 239.27 client's social security number and other information the 239.28 commissioner requires to collect the premium from the client. 239.29 The commissioner shall collect unpaid premiums using the Revenue 239.30 Recapture Act in chapter 270A and other methods available to the 239.31 commissioner. The commissioner may require counties to inform 239.32 clients of the collection procedures that may be used by the 239.33 state if a premium is not paid. This paragraph does not apply 239.34 to alternative care pilot projects authorized in Laws 1993, 239.35 First Special Session chapter 1, article 5, section 133, if a 239.36 county operating under the pilot project reports the following 240.1 dollar amounts to the commissioner quarterly: 240.2 (1) total premiums billed to clients; 240.3 (2) total collections of premiums billed; and 240.4 (3) balance of premiums owed by clients. 240.5 If a county does not adhere to these reporting requirements, the 240.6 commissioner may terminate the billing, collecting, and 240.7 remitting portions of the pilot project and require the county 240.8 involved to operate under the procedures set forth in this 240.9 paragraph. 240.10 Sec. 15. Minnesota Statutes 2002, section 256B.0915, 240.11 subdivision 3, is amended to read: 240.12 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND240.13FORECASTING.](a)The number of medical assistance waiver 240.14 recipients that a county may serve must be allocated according 240.15 to the number of medical assistance waiver cases open on July 1 240.16 of each fiscal year. Additional recipients may be served with 240.17 the approval of the commissioner. 240.18(b)Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) The 240.19 monthly limit for the cost of waivered services to an individual 240.20 elderly waiver client shall be the weighted average monthly 240.21 nursing facility rate of the case mix resident class to which 240.22 the elderly waiver client would be assigned under Minnesota 240.23 Rules, parts 9549.0050 to 9549.0059, less the recipient's 240.24 maintenance needs allowance as described in subdivision 1d, 240.25 paragraph (a), until the first day of the state fiscal year in 240.26 which the resident assessment system as described in section 240.27 256B.437 for nursing home rate determination is implemented. 240.28 Effective on the first day of the state fiscal year in which the 240.29 resident assessment system as described in section 256B.437 for 240.30 nursing home rate determination is implemented and the first day 240.31 of each subsequent state fiscal year, the monthly limit for the 240.32 cost of waivered services to an individual elderly waiver client 240.33 shall be the rate of the case mix resident class to which the 240.34 waiver client would be assigned under Minnesota Rules, parts 240.35 9549.0050 to 9549.0059, in effect on the last day of the 240.36 previous state fiscal year, adjusted by the greater of any 241.1 legislatively adopted home and community-based services 241.2 cost-of-living percentage increase or any legislatively adopted 241.3 statewide percent rate increase for nursing facilities. 241.4(c)(b) If extended medical supplies and equipment or 241.5 environmental modifications are or will be purchased for an 241.6 elderly waiver client, the costs may be prorated for up to 12 241.7 consecutive months beginning with the month of purchase. If the 241.8 monthly cost of a recipient's waivered services exceeds the 241.9 monthly limit established in paragraph(b)(a), the annual cost 241.10 of all waivered services shall be determined. In this event, 241.11 the annual cost of all waivered services shall not exceed 12 241.12 times the monthly limit of waivered services as described in 241.13 paragraph(b)(a). 241.14(d)Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 241.15 WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 241.16 nursing facility resident at the time of requesting a 241.17 determination of eligibility for elderly waivered services, a 241.18 monthly conversion limit for the cost of elderly waivered 241.19 services may be requested. The monthly conversion limit for the 241.20 cost of elderly waiver services shall be the resident class 241.21 assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 241.22 for that resident in the nursing facility where the resident 241.23 currently resides until July 1 of the state fiscal year in which 241.24 the resident assessment system as described in section 256B.437 241.25 for nursing home rate determination is implemented. Effective 241.26 on July 1 of the state fiscal year in which the resident 241.27 assessment system as described in section 256B.437 for nursing 241.28 home rate determination is implemented, the monthly conversion 241.29 limit for the cost of elderly waiver services shall be the per 241.30 diem nursing facility rate as determined by the resident 241.31 assessment system as described in section 256B.437 for that 241.32 resident in the nursing facility where the resident currently 241.33 resides multiplied by 365 and divided by 12, less the 241.34 recipient's maintenance needs allowance as described in 241.35 subdivision 1d. The initially approved conversion rate may be 241.36 adjusted by the greater of any subsequent legislatively adopted 242.1 home and community-based services cost-of-living percentage 242.2 increase or any subsequent legislatively adopted statewide 242.3 percentage rate increase for nursing facilities. The limit 242.4 under thisclausesubdivision only applies to persons discharged 242.5 from a nursing facility after a minimum 30-day stay and found 242.6 eligible for waivered services on or after July 1, 1997. 242.7 (b) The following costs must be included in determining the 242.8 total monthly costs for the waiver client: 242.9 (1) cost of all waivered services, including extended 242.10 medical supplies and equipment and environmental modifications; 242.11 and 242.12 (2) cost of skilled nursing, home health aide, and personal 242.13 care services reimbursable by medical assistance. 242.14(e)Subd. 3c. [SERVICE APPROVAL AND CONTRACTING 242.15 PROVISIONS.] (a) Medical assistance funding for skilled nursing 242.16 services, private duty nursing, home health aide, and personal 242.17 care services for waiver recipients must be approved by the case 242.18 manager and included in the individual care plan. 242.19(f)(b) A county is not required to contract with a 242.20 provider of supplies and equipment if the monthly cost of the 242.21 supplies and equipment is less than $250. 242.22(g)Subd. 3d. [ADULT FOSTER CARE RATE.] The adult foster 242.23 care rate shall be considered a difficulty of care payment and 242.24 shall not include room and board. The adult foster care service 242.25 rate shall be negotiated between the county agency and the 242.26 foster care provider. The elderly waiver payment for the foster 242.27 care service in combination with the payment for all other 242.28 elderly waiver services, including case management, must not 242.29 exceed the limit specified in subdivision 3a, paragraph(b)(a). 242.30(h)Subd. 3e. [ASSISTED LIVING SERVICE RATE.] (a) Payment 242.31 for assisted living service shall be a monthly rate negotiated 242.32 and authorized by the county agency based on an individualized 242.33 service plan for each resident and may not cover direct rent or 242.34 food costs. 242.35(1)(b) The individualized monthly negotiated payment for 242.36 assisted living services as described in section 256B.0913, 243.1subdivision 5, paragraph (g) or (h)subdivisions 5d to 5f, and 243.2 residential care services as described in section 256B.0913, 243.3 subdivision5, paragraph (f)5c, shall not exceed the nonfederal 243.4 share, in effect on July 1 of the state fiscal year for which 243.5 the rate limit is being calculated, of the greater of either the 243.6 statewide or any of the geographic groups' weighted average 243.7 monthly nursing facility rate of the case mix resident class to 243.8 which the elderly waiver eligible client would be assigned under 243.9 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 243.10 maintenance needs allowance as described in subdivision 1d, 243.11 paragraph (a), until the July 1 of the state fiscal year in 243.12 which the resident assessment system as described in section 243.13 256B.437 for nursing home rate determination is implemented. 243.14 Effective on July 1 of the state fiscal year in which the 243.15 resident assessment system as described in section 256B.437 for 243.16 nursing home rate determination is implemented and July 1 of 243.17 each subsequent state fiscal year, the individualized monthly 243.18 negotiated payment for the services described in this clause 243.19 shall not exceed the limit described in this clause which was in 243.20 effect on June 30 of the previous state fiscal year and which 243.21 has been adjusted by the greater of any legislatively adopted 243.22 home and community-based services cost-of-living percentage 243.23 increase or any legislatively adopted statewide percent rate 243.24 increase for nursing facilities. 243.25(2)(c) The individualized monthly negotiated payment for 243.26 assisted living services described in section 144A.4605 and 243.27 delivered by a provider licensed by the department of health as 243.28 a class A home care provider or an assisted living home care 243.29 provider and provided in a building that is registered as a 243.30 housing with services establishment under chapter 144D and that 243.31 provides 24-hour supervision in combination with the payment for 243.32 other elderly waiver services, including case management, must 243.33 not exceed the limit specified inparagraph (b)subdivision 3a. 243.34(i)Subd. 3f. [INDIVIDUAL SERVICE RATES; EXPENDITURE 243.35 FORECASTS.] (a) The county shall negotiate individual service 243.36 rates with vendors and may authorize payment for actual costs up 244.1 to the county's current approved rate. Persons or agencies must 244.2 be employed by or under a contract with the county agency or the 244.3 public health nursing agency of the local board of health in 244.4 order to receive funding under the elderly waiver program, 244.5 except as a provider of supplies and equipment when the monthly 244.6 cost of the supplies and equipment is less than $250. 244.7(j)(b) Reimbursement for the medical assistance recipients 244.8 under the approved waiver shall be made from the medical 244.9 assistance account through the invoice processing procedures of 244.10 the department's Medicaid Management Information System (MMIS), 244.11 only with the approval of the client's case manager. The budget 244.12 for the state share of the Medicaid expenditures shall be 244.13 forecasted with the medical assistance budget, and shall be 244.14 consistent with the approved waiver. 244.15(k)Subd. 3g. [SERVICE RATE LIMITS; STATE ASSUMPTION OF 244.16 COSTS.] (a) To improve access to community services and 244.17 eliminate payment disparities between the alternative care 244.18 program and the elderly waiver, the commissioner shall establish 244.19 statewide maximum service rate limits and eliminate 244.20 county-specific service rate limits. 244.21(1)(b) Effective July 1, 2001, for service rate limits, 244.22 except those described or defined inparagraphs (g) and244.23(h)subdivisions 3d and 3e, the rate limit for each service 244.24 shall be the greater of the alternative care statewide maximum 244.25 rate or the elderly waiver statewide maximum rate. 244.26(2)(c) Counties may negotiate individual service rates 244.27 with vendors for actual costs up to the statewide maximum 244.28 service rate limit. 244.29 Sec. 16. Minnesota Statutes 2002, section 256B.15, 244.30 subdivision 1, is amended to read: 244.31 Subdivision 1. [DEFINITION.] For purposes of this section, 244.32 "medical assistance" includes the medical assistance program 244.33 under this chapter and the general assistance medical care 244.34 program under chapter 256D, but does not include the alternative244.35care program for nonmedical assistance recipients under section244.36256B.0913, subdivision 4and alternative care for nonmedical 245.1 assistance recipients under section 256B.0913. 245.2 [EFFECTIVE DATE.] This section is effective July 1, 2003, 245.3 for decedents dying on or after that date. 245.4 Sec. 17. Minnesota Statutes 2002, section 256B.15, 245.5 subdivision 1a, is amended to read: 245.6 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 245.7 receives any medical assistance hereunder, on the person's 245.8 death, if single, or on the death of the survivor of a married 245.9 couple, either or both of whom received medical assistance, the 245.10 total amount paid for medical assistance rendered for the person 245.11 and spouse shall be filed as a claim against the estate of the 245.12 person or the estate of the surviving spouse in the court having 245.13 jurisdiction to probate the estate or to issue a decree of 245.14 descent according to sections 525.31 to 525.313. 245.15 A claim shall be filed if medical assistance was rendered 245.16 for either or both persons under one of the following 245.17 circumstances: 245.18 (a) the person was over 55 years of age, and received 245.19 services under this chapter, excluding alternative care; 245.20 (b) the person resided in a medical institution for six 245.21 months or longer, received services under this chapterexcluding245.22alternative care,and, at the time of institutionalization or 245.23 application for medical assistance, whichever is later, the 245.24 person could not have reasonably been expected to be discharged 245.25 and returned home, as certified in writing by the person's 245.26 treating physician. For purposes of this section only, a 245.27 "medical institution" means a skilled nursing facility, 245.28 intermediate care facility, intermediate care facility for 245.29 persons with mental retardation, nursing facility, or inpatient 245.30 hospital; or 245.31 (c) the person received general assistance medical care 245.32 services under chapter 256D. 245.33 The claim shall be considered an expense of the last 245.34 illness of the decedent for the purpose of section 524.3-805. 245.35 Any statute of limitations that purports to limit any county 245.36 agency or the state agency, or both, to recover for medical 246.1 assistance granted hereunder shall not apply to any claim made 246.2 hereunder for reimbursement for any medical assistance granted 246.3 hereunder. Notice of the claim shall be given to all heirs and 246.4 devisees of the decedent whose identity can be ascertained with 246.5 reasonable diligence. The notice must include procedures and 246.6 instructions for making an application for a hardship waiver 246.7 under subdivision 5; time frames for submitting an application 246.8 and determination; and information regarding appeal rights and 246.9 procedures. Counties are entitled to one-half of the nonfederal 246.10 share of medical assistance collections from estates that are 246.11 directly attributable to county effort. Counties are entitled 246.12 to ten percent of the collections for alternative care directly 246.13 attributable to county effort. 246.14 [EFFECTIVE DATE.] This section is effective July 1, 2003, 246.15 for decedents dying on or after that date. 246.16 Sec. 18. Minnesota Statutes 2002, section 256B.15, 246.17 subdivision 2, is amended to read: 246.18 Subd. 2. [LIMITATIONS ON CLAIMS.] The claim shall include 246.19 only the total amount of medical assistance rendered after age 246.20 55 or during a period of institutionalization described in 246.21 subdivision 1a, clause (b), and the total amount of general 246.22 assistance medical care rendered, and shall not include 246.23 interest. Claims that have been allowed but not paid shall bear 246.24 interest according to section 524.3-806, paragraph (d). A claim 246.25 against the estate of a surviving spouse who did not receive 246.26 medical assistance, for medical assistance rendered for the 246.27 predeceased spouse, is limited to the value of the assets of the 246.28 estate that were marital property or jointly owned property at 246.29 any time during the marriage. Claims for alternative care shall 246.30 be net of all premiums paid under section 256B.0913, subdivision 246.31 12, on or after July 1, 2003, and shall be limited to services 246.32 provided on or after July 1, 2003. 246.33 [EFFECTIVE DATE.] This section is effective July 1, 2003, 246.34 for decedents dying on or after that date. 246.35 Sec. 19. Minnesota Statutes 2002, section 256B.19, 246.36 subdivision 1d, is amended to read: 247.1 Subd. 1d. [PORTION OF NONFEDERAL SHARE TO BE PAID BY 247.2 CERTAIN COUNTIES.] (a) In addition to the percentage 247.3 contribution paid by a county under subdivision 1, the 247.4 governmental units designated in this subdivision shall be 247.5 responsible for an additional portion of the nonfederal share of 247.6 medical assistance cost. For purposes of this subdivision, 247.7 "designated governmental unit" means the counties of Becker, 247.8 Beltrami, Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, 247.9 Pennington, Pipestone, Ramsey, St. Louis, Steele, Todd, 247.10 Traverse, and Wadena. 247.11 (b) Beginning in 1994, each of the governmental units 247.12 designated in this subdivision shall transfer before noon on May 247.13 31 to the state Medicaid agency an amount equal to the number of 247.14 licensed beds in any nursing home owned and operated by the 247.15 county on that date, with the county named as licensee, 247.16 multiplied by $5,723. If two or more counties own and operate a 247.17 nursing home, the payment shall be prorated. These sums shall 247.18 be part of the designated governmental unit's portion of the 247.19 nonfederal share of medical assistance costs. 247.20 (c) Beginning in 2002, in addition to any transfer under 247.21 paragraph (b), each of the governmental units designated in this 247.22 subdivision shall transfer before noon on May 31 to the state 247.23 Medicaid agency an amount equal to the number of licensed beds 247.24 in any nursing home owned and operated by the county on that 247.25 date, with the county named as licensee, multiplied by $10,784. 247.26 The provisions of paragraph (b) apply to transfers under this 247.27 paragraph. 247.28 (d) Beginning in 2004, in addition to any transfer under 247.29 paragraphs (b) and (c), each of the governmental units 247.30 designated in this subdivision shall transfer before noon on May 247.31 31 to the state Medicaid agency an amount equal to the number of 247.32 licensed beds in any nursing home owned and operated by the 247.33 county on that date, with the county named as licensee, 247.34 multiplied by $2,230. The provisions of paragraph (b) apply to 247.35 transfers under this paragraph. 247.36 (e) The commissioner may reduce the intergovernmental 248.1 transfers underparagraphparagraphs (c) and (d) based on the 248.2 commissioner's determination of the payment rate in section 248.3 256B.431, subdivision 23, paragraphs (c)and, (d), and (e). Any 248.4 adjustments must be made on a per-bed basis and must result in 248.5 an amount equivalent to the total amount resulting from the rate 248.6 adjustment in section 256B.431, subdivision 23, paragraphs (c) 248.7and, (d), and (e). 248.8 [EFFECTIVE DATE.] This section is effective June 30, 2003. 248.9 Sec. 20. Minnesota Statutes 2002, section 256B.431, 248.10 subdivision 2r, is amended to read: 248.11 Subd. 2r. [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 248.12 July 1, 1993, the commissioner shall limit payment for leave 248.13 days in a nursing facility to 79 percent of that nursing 248.14 facility's total payment rate for the involved 248.15 resident. Effective July 1, 2003, for facilities reimbursed 248.16 under this section or section 256B.434, the commissioner shall 248.17 limit payment for leave days in a nursing facility to 60 percent 248.18 of that nursing facility's total payment rate for the involved 248.19 resident. 248.20 Sec. 21. Minnesota Statutes 2002, section 256B.431, is 248.21 amended by adding a subdivision to read: 248.22 Subd. 2t. [PAYMENT LIMITATION.] Beginning July 1, 2003, 248.23 for facilities reimbursed under this section or section 248.24 256B.434, the amount that shall be paid by or on behalf of the 248.25 Medicaid program for days with co-payments during a 248.26 Medicare-covered skilled nursing facility stay shall not result 248.27 in total payment to the facility by the Medicare program and the 248.28 Medicaid program being greater than the Medicaid RUG-III 248.29 case-mix payment rate. 248.30 Sec. 22. Minnesota Statutes 2002, section 256B.431, 248.31 subdivision 23, is amended to read: 248.32 Subd. 23. [COUNTY NURSING HOME PAYMENT ADJUSTMENTS.] (a) 248.33 Beginning in 1994, the commissioner shall pay a nursing home 248.34 payment adjustment on May 31 after noon to a county in which is 248.35 located a nursing home that, on that date, was county-owned and 248.36 operated, with the county named as licensee by the commissioner 249.1 of health, and had over 40 beds and medical assistance occupancy 249.2 in excess of 50 percent during the reporting year ending 249.3 September 30, 1991. The adjustment shall be an amount equal to 249.4 $16 per calendar day multiplied by the number of beds licensed 249.5 in the facilityas of September 30, 1991on that date. 249.6 (b) Payments under paragraph (a) are excluded from medical 249.7 assistance per diem rate calculations. These payments are 249.8 required notwithstanding any rule prohibiting medical assistance 249.9 payments from exceeding payments from private pay residents. A 249.10 facility receiving a payment under paragraph (a) may not 249.11 increase charges to private pay residents by an amount 249.12 equivalent to the per diem amount payments under paragraph (a) 249.13 would equal if converted to a per diem. 249.14 (c) Beginning in 2002, in addition to any payment under 249.15 paragraph (a), the commissioner shall pay to a nursing facility 249.16 described in paragraph (a) an adjustment in an amount equal to 249.17 $29.55 per calendar day multiplied by the number of beds 249.18 licensed in the facility on that date. The provisions of 249.19 paragraphs (a) and (b) apply to payments under this paragraph. 249.20 (d) Beginning in 2004, in addition to any payment under 249.21 paragraphs (a) and (c), the commissioner shall pay to a nursing 249.22 facility described in paragraph (a) an adjustment in an amount 249.23 equal to $6.11 per calendar day multiplied by the number of beds 249.24 licensed in the facility on that date. The provisions of 249.25 paragraphs (a) and (b) apply to payments under this paragraph. 249.26 (e) The commissioner may reduce payments under 249.27paragraphparagraphs (c) and (d) based on the commissioner's 249.28 determination of Medicare upper payment limits. Any adjustments 249.29 must be proportional to adjustments made under section 256B.19, 249.30 subdivision 1d, paragraph(d)(e). 249.31 [EFFECTIVE DATE.] This section is effective June 30, 2003. 249.32 Sec. 23. Minnesota Statutes 2002, section 256B.431, 249.33 subdivision 32, is amended to read: 249.34 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 249.35 years beginning on or after July 1, 2001, the total payment rate 249.36 for a facility reimbursed under this section, section 256B.434, 250.1 or any other section for the first 90 paid days after admission 250.2 shall be: 250.3 (1) for the first 30 paid days, the rate shall be 120 250.4 percent of the facility's medical assistance rate for each case 250.5 mix class;and250.6 (2) for the next 60 paid days after the first 30 paid days, 250.7 the rate shall be 110 percent of the facility's medical 250.8 assistance rate for each case mix class.; 250.9(b)(3) beginning with the 91st paid day after admission, 250.10 the payment rate shall be the rate otherwise determined under 250.11 this section, section 256B.434, or any other section.; and 250.12(c)(4) payments under thissubdivision appliesparagraph 250.13 apply to admissions occurring on or after July 1, 2001, and 250.14 resident days from that date through June 30, 2003. 250.15 (b) For rate years beginning on or after July 1, 2003, the 250.16 total payment rate for a facility reimbursed under this section, 250.17 section 256B.434, or any other section shall be: 250.18 (1) for the first 30 calendar days after admission, the 250.19 rate shall be 120 percent of the facility's medical assistance 250.20 rate for each RUG class; 250.21 (2) beginning with the 31st calendar day after admission, 250.22 the payment rate shall be the rate otherwise determined under 250.23 this section, section 256B.434, or any other section; and 250.24 (3) payments under this paragraph apply to admissions 250.25 occurring on or after July 1, 2003. 250.26 (c) Effective January 1, 2004, the enhanced rates under 250.27 this subdivision shall not be allowed if a resident has resided 250.28 in any nursing facility during the previous 30 calendar days. 250.29 Sec. 24. Minnesota Statutes 2002, section 256B.431, 250.30 subdivision 36, is amended to read: 250.31 Subd. 36. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 250.32 ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 250.33 1, 2001, and June 30, 2003, the commissioner shall provide to 250.34 each nursing facility reimbursed under this section, section 250.35 256B.434, or any other section, a scholarship per diem of 25 250.36 cents to the total operating payment rate to be used: 251.1 (1) for employee scholarships that satisfy the following 251.2 requirements: 251.3 (i) scholarships are available to all employees who work an 251.4 average of at least 20 hours per week at the facility except the 251.5 administrator, department supervisors, and registered nurses; 251.6 and 251.7 (ii) the course of study is expected to lead to career 251.8 advancement with the facility or in long-term care, including 251.9 medical care interpreter services and social work; and 251.10 (2) to provide job-related training in English as a second 251.11 language. 251.12 (b) A facility receiving a rate adjustment under this 251.13 subdivision may submit to the commissioner on a schedule 251.14 determined by the commissioner and on a form supplied by the 251.15 commissioner a calculation of the scholarship per diem, 251.16 including: the amount received from this rate adjustment; the 251.17 amount used for training in English as a second language; the 251.18 number of persons receiving the training; the name of the person 251.19 or entity providing the training; and for each scholarship 251.20 recipient, the name of the recipient, the amount awarded, the 251.21 educational institution attended, the nature of the educational 251.22 program, the program completion date, and a determination of the 251.23 per diem amount of these costs based on actual resident days. 251.24 (c) On July 1, 2003, the commissioner shall remove the 25 251.25 cent scholarship per diem from the total operating payment rate 251.26 of each facility. 251.27(d) For rate years beginning after June 30, 2003, the251.28commissioner shall provide to each facility the scholarship per251.29diem determined in paragraph (b).251.30 Sec. 25. Minnesota Statutes 2002, section 256B.431, is 251.31 amended by adding a subdivision to read: 251.32 Subd. 38. [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 251.33 YEAR 2004.] Effective June 1, 2003, the commissioner shall 251.34 provide to each nursing home reimbursed under this section or 251.35 section 256B.434, an increase in each case mix payment rate 251.36 equal to the increase in the per-bed surcharge paid under 252.1 section 256.9657, subdivision 1, paragraph (d), divided by 365 252.2 and further divided by .90. The increase shall not be subject 252.3 to any annual percentage increase. The 30-day advance notice 252.4 requirement in section 256B.47, subdivision 2, shall not apply 252.5 to rate increases resulting from this section. The commissioner 252.6 shall not adjust the rate increase under this subdivision unless 252.7 an adjustment under section 256.9657, subdivision 1, paragraph 252.8 (e), is greater than 1.5 percent of the surcharge amount. 252.9 [EFFECTIVE DATE.] This section is effective May 31, 2003. 252.10 Sec. 26. Minnesota Statutes 2002, section 256B.431, is 252.11 amended by adding a subdivision to read: 252.12 Subd. 39. [NURSING FACILITY RATE ADJUSTMENT.] (a) For the 252.13 rate year beginning July 1, 2003, the commissioner shall 252.14 implement a reduction to the rates provided to each nursing 252.15 facility reimbursed under this section or section 256B.434, 252.16 equal to four percent of the operating and property components 252.17 of the total payment rates in effect on June 30, 2003. 252.18 (b) Nursing facilities, individually or as groups, may 252.19 elect to reduce their licensed capacity as an alternative to the 252.20 rate adjustment in paragraph (a). This election must be 252.21 requested within 60 days of the effective date of this section 252.22 and agreed to on a form to be provided by the commissioner. The 252.23 facility or group of facilities electing to reduce licensed 252.24 capacity must agree to: (i) reduce their licensed number of 252.25 beds by October 1, 2003, to 95 percent of the number of beds 252.26 actually occupied on January 1, 2003; (ii) reduce their licensed 252.27 number of beds by January 1, 2004, to 90 percent of the number 252.28 of beds actually occupied on January 1, 2003; (iii) reduce their 252.29 licensed number of beds by April 1, 2004, to 85 percent of the 252.30 number of beds actually occupied on January 1, 2003; and (iv) 252.31 not remove any beds from layaway until after June 30, 2007. For 252.32 beds placed in layaway prior to January 1, 2003, in determining 252.33 the five-year limit that a bed may remain in layaway under 252.34 section 144A.071, subdivision 4b, the commissioner shall allow 252.35 beds to be removed from layaway until January 1, 2008. For 252.36 purposes of this section, a vacant bed shall be considered 253.1 occupied on January 1, 2003, if the facility was holding the bed 253.2 for a resident on hospital leave or therapeutic leave. For 253.3 purposes of this section, a bed shall be considered removed from 253.4 service on the date the commissioner receives notification from 253.5 a nursing facility that a bed is to be delicensed within 60 253.6 days. Any bed delicensed on or after January 1, 2003, may be 253.7 counted by the facility toward the capacity reduction elected 253.8 under this paragraph. 253.9 (c) If a nursing facility that elects to reduce its 253.10 capacity according to paragraph (b) fails to do so, the 253.11 commissioner shall reduce the payment rate of that nursing 253.12 facility according to paragraph (a), retroactively from July 1, 253.13 2003. The commissioner may grant extensions of up to 90 days to 253.14 the requirements in paragraph (b) to facilities electing to 253.15 reduce capacity. In granting an extension, the commissioner 253.16 shall consider the number of admissions to and discharges from 253.17 the facility, progress in reducing occupancy, and the 253.18 availability of beds in the county in which the facility is 253.19 located, measured by the number of beds per 1,000 individuals 253.20 age 65 and older. 253.21 [EFFECTIVE DATE.] This section is effective the day 253.22 following final enactment. 253.23 Sec. 27. Minnesota Statutes 2002, section 256B.434, 253.24 subdivision 4, is amended to read: 253.25 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 253.26 nursing facilities which have their payment rates determined 253.27 under this section rather than section 256B.431, the 253.28 commissioner shall establish a rate under this subdivision. The 253.29 nursing facility must enter into a written contract with the 253.30 commissioner. 253.31 (b) A nursing facility's case mix payment rate for the 253.32 first rate year of a facility's contract under this section is 253.33 the payment rate the facility would have received under section 253.34 256B.431. 253.35 (c) A nursing facility's case mix payment rates for the 253.36 second and subsequent years of a facility's contract under this 254.1 section are the previous rate year's contract payment rates plus 254.2 an inflation adjustment and, for facilities reimbursed under 254.3 this section or section 256B.431, an adjustment to include the 254.4 cost of any increase in health department licensing fees for the 254.5 facility taking effect on or after July 1, 2001. The index for 254.6 the inflation adjustment must be based on the change in the 254.7 Consumer Price Index-All Items (United States City average) 254.8 (CPI-U) forecasted byData Resources, Inc.the commissioner of 254.9 finance's national economic consultant, as forecasted in the 254.10 fourth quarter of the calendar year preceding the rate year. 254.11 The inflation adjustment must be based on the 12-month period 254.12 from the midpoint of the previous rate year to the midpoint of 254.13 the rate year for which the rate is being determined. For the 254.14 rate years beginning on July 1, 1999, July 1, 2000, July 1, 254.15 2001,andJuly 1, 2002, July 1, 2003, and July 1, 2004, this 254.16 paragraph shall apply only to the property-related payment rate, 254.17 except that adjustments to include the cost of any increase in 254.18 health department licensing fees taking effect on or after July 254.19 1, 2001, shall be provided. In determining the amount of the 254.20 property-related payment rate adjustment under this paragraph, 254.21 the commissioner shall determine the proportion of the 254.22 facility's rates that are property-related based on the 254.23 facility's most recent cost report. 254.24 (d) The commissioner shall develop additional 254.25 incentive-based payments of up to five percent above the 254.26 standard contract rate for achieving outcomes specified in each 254.27 contract. The specified facility-specific outcomes must be 254.28 measurable and approved by the commissioner. The commissioner 254.29 may establish, for each contract, various levels of achievement 254.30 within an outcome. After the outcomes have been specified the 254.31 commissioner shall assign various levels of payment associated 254.32 with achieving the outcome. Any incentive-based payment cancels 254.33 if there is a termination of the contract. In establishing the 254.34 specified outcomes and related criteria the commissioner shall 254.35 consider the following state policy objectives: 254.36 (1) improved cost effectiveness and quality of life as 255.1 measured by improved clinical outcomes; 255.2 (2) successful diversion or discharge to community 255.3 alternatives; 255.4 (3) decreased acute care costs; 255.5 (4) improved consumer satisfaction; 255.6 (5) the achievement of quality; or 255.7 (6) any additional outcomes proposed by a nursing facility 255.8 that the commissioner finds desirable. 255.9 Sec. 28. Minnesota Statutes 2002, section 256B.48, 255.10 subdivision 1, is amended to read: 255.11 Subdivision 1. [PROHIBITED PRACTICES.] A nursing facility 255.12 is not eligible to receive medical assistance payments unless it 255.13 refrains from all of the following: 255.14 (a) Charging private paying residents rates for similar 255.15 services which exceed those which are approved by the state 255.16 agency for medical assistance recipients as determined by the 255.17 prospective desk audit rate, except under the following 255.18 circumstances: (1) the nursing facility may(1)(i) charge 255.19 private paying residents a higher rate for a private room,and 255.20(2)(ii) charge for special services which are not included in 255.21 the daily rate if medical assistance residents are charged 255.22 separately at the same rate for the same services in addition to 255.23 the daily rate paid by the commissioner.; (2) effective July 1, 255.24 2003, nursing facilities may charge private paying residents 255.25 rates up to two percent higher than the allowable payment rate 255.26 in effect on June 30, 2003, plus an adjustment equal to any 255.27 other rate increase provided in law, for the RUGs group 255.28 currently assigned to the resident; (3) effective July 1, 2004, 255.29 nursing facilities may charge private paying residents rates up 255.30 to four percent higher than the allowable payment rate in effect 255.31 on June 30, 2003, plus an adjustment equal to any other rate 255.32 increase provided in law, for the RUGs group currently assigned 255.33 to the resident; (4) effective July 1, 2005, nursing facilities 255.34 may charge private paying residents rates up to six percent 255.35 higher than the allowable payment rate in effect on June 30, 255.36 2003, plus an adjustment equal to any other rate increase 256.1 provided in law, for the RUGs group currently assigned to the 256.2 resident; and (5) effective July 1, 2006, nursing facilities may 256.3 charge private paying residents rates up to eight percent higher 256.4 than the allowable payment rate in effect on June 30, 2003, plus 256.5 an adjustment equal to any other rate increase provided in law, 256.6 for the RUGs group currently assigned to the resident. For 256.7 purposes of this subdivision, the allowable payment rate is the 256.8 total payment rate under section 256B.431 or 256B.434 including 256.9 adjustments for enhanced rates during the first 30 days under 256.10 section 256B.431, subdivision 32, and private room differentials 256.11 under clause (1), item (i), and Minnesota Rules, part 9549.0060, 256.12 subpart 11, item C. Services covered by the payment rate must 256.13 be the same regardless of payment source. Special services, if 256.14 offered, must be available to all residents in all areas of the 256.15 nursing facility and charged separately at the same rate. 256.16 Residents are free to select or decline special services. 256.17 Special services must not include services which must be 256.18 provided by the nursing facility in order to comply with 256.19 licensure or certification standards and that if not provided 256.20 would result in a deficiency or violation by the nursing 256.21 facility. Services beyond those required to comply with 256.22 licensure or certification standards must not be charged 256.23 separately as a special service if they were included in the 256.24 payment rate for the previous reporting year. A nursing 256.25 facility that charges a private paying resident a rate in 256.26 violation of this clause is subject to an action by the state of 256.27 Minnesota or any of its subdivisions or agencies for civil 256.28 damages. A private paying resident or the resident's legal 256.29 representative has a cause of action for civil damages against a 256.30 nursing facility that charges the resident rates in violation of 256.31 this clause. The damages awarded shall include three times the 256.32 payments that result from the violation, together with costs and 256.33 disbursements, including reasonable attorneys' fees or their 256.34 equivalent. A private paying resident or the resident's legal 256.35 representative, the state, subdivision or agency, or a nursing 256.36 facility may request a hearing to determine the allowed rate or 257.1 rates at issue in the cause of action. Within 15 calendar days 257.2 after receiving a request for such a hearing, the commissioner 257.3 shall request assignment of an administrative law judge under 257.4 sections 14.48 to 14.56 to conduct the hearing as soon as 257.5 possible or according to agreement by the parties. The 257.6 administrative law judge shall issue a report within 15 calendar 257.7 days following the close of the hearing. The prohibition set 257.8 forth in this clause shall not apply to facilities licensed as 257.9 boarding care facilities which are not certified as skilled or 257.10 intermediate care facilities level I or II for reimbursement 257.11 through medical assistance. 257.12 (b) Effective July 1, 2007, paragraph (a) no longer 257.13 applies, except that special services, if offered, must be 257.14 available to all residents in all areas of the nursing facility 257.15 and charged separately at the same rate. Residents are free to 257.16 select or decline special services. Special services must not 257.17 include services which must be provided by the nursing facility 257.18 in order to comply with licensure or certification standards and 257.19 that if not provided would result in a deficiency or violation 257.20 by the nursing facility. 257.21(b)(c)(1) Charging, soliciting, accepting, or receiving 257.22 from an applicant for admission to the facility, or from anyone 257.23 acting in behalf of the applicant, as a condition of admission, 257.24 expediting the admission, or as a requirement for the 257.25 individual's continued stay, any fee, deposit, gift, money, 257.26 donation, or other consideration not otherwise required as 257.27 payment under the state plan for residents on medical 257.28 assistance, medical assistance payment according to the state 257.29 plan must be accepted as payment in full for continued stay, 257.30 except where otherwise provided for under statute; 257.31 (2) requiring an individual, or anyone acting in behalf of 257.32 the individual, to loan any money to the nursing facility; 257.33 (3) requiring an individual, or anyone acting in behalf of 257.34 the individual, to promise to leave all or part of the 257.35 individual's estate to the facility; or 257.36 (4) requiring a third-party guarantee of payment to the 258.1 facility as a condition of admission, expedited admission, or 258.2 continued stay in the facility. 258.3 Nothing in this paragraph would prohibit discharge for 258.4 nonpayment of services in accordance with state and federal 258.5 regulations. 258.6(c)(d) Requiring any resident of the nursing facility to 258.7 utilize a vendor of health care services chosen by the nursing 258.8 facility. A nursing facility may require a resident to use 258.9 pharmacies that utilize unit dose packing systems approved by 258.10 the Minnesota board of pharmacy, and may require a resident to 258.11 use pharmacies that are able to meet the federal regulations for 258.12 safe and timely administration of medications such as systems 258.13 with specific number of doses, prompt delivery of medications, 258.14 or access to medications on a 24-hour basis. Notwithstanding 258.15 the provisions of this paragraph, nursing facilities shall not 258.16 restrict a resident's choice of pharmacy because the pharmacy 258.17 utilizes a specific system of unit dose drug packing. 258.18(d)(e) Providing differential treatment on the basis of 258.19 status with regard to public assistance. 258.20(e)(f) Discriminating in admissions, services offered, or 258.21 room assignment on the basis of status with regard to public 258.22 assistanceor refusal to purchase special258.23services. Discrimination in admissionsdiscrimination, services 258.24 offered, or room assignment shall include, but is not limited to: 258.25 (1) basing admissions decisions uponassurance by the258.26applicant to the nursing facility, or the applicant's guardian258.27or conservator, that the applicant is neither eligible for nor258.28will seekinformation or assurances regarding current or future 258.29 eligibility for public assistance for payment of nursing 258.30 facility carecosts; and 258.31 (2)engaging in preferential selection from waiting lists258.32based on an applicant's ability to pay privately or an258.33applicant's refusal to pay for a special servicerequiring a 258.34 person who is eligible for public assistance to accept a room 258.35 transfer from a single bed room to a multiple bed room. 258.36 The collection and use by a nursing facility of financial 259.1 information of any applicant pursuant to a preadmission 259.2 screening program established by law shall not raise an 259.3 inference that the nursing facility is utilizing that 259.4 information for any purpose prohibited by this paragraph. 259.5 (g) In a case where the commissioner determines that a 259.6 nursing facility is not in compliance with the requirements in 259.7 paragraphs (a) to (f), the commissioner shall provide to the 259.8 facility notice of a finding of noncompliance. If after 30 days 259.9 the commissioner finds the facility is still not in compliance, 259.10 the commissioner shall initiate withholding of ten percent of 259.11 medical assistance payments due to the facility. If, after 90 259.12 days after the original notification, the nursing facility is 259.13 still not in compliance, the commissioner shall not assume 259.14 payments for any resident admitted after that date. Upon 259.15 determination by the commissioner that the facility is in 259.16 compliance, these penalties shall be removed and payments of 259.17 withheld amounts and for newly admitted residents shall be made 259.18 retroactive for no more than 90 days. 259.19(f)(h) Requiring any vendor of medical care as defined by 259.20 section 256B.02, subdivision 7, who is reimbursed by medical 259.21 assistance under a separate fee schedule, to pay any amount 259.22 based on utilization or service levels or any portion of the 259.23 vendor's fee to the nursing facility except as payment for 259.24 renting or leasing space or equipment or purchasing support 259.25 services from the nursing facility as limited by section 259.26 256B.433. All agreements must be disclosed to the commissioner 259.27 upon request of the commissioner. Nursing facilities and 259.28 vendors of ancillary services that are found to be in violation 259.29 of this provision shall each be subject to an action by the 259.30 state of Minnesota or any of its subdivisions or agencies for 259.31 treble civil damages on the portion of the fee in excess of that 259.32 allowed by this provision and section 256B.433. Damages awarded 259.33 must include three times the excess payments together with costs 259.34 and disbursements including reasonable attorney's fees or their 259.35 equivalent. 259.36(g)(i) Refusing, for more than 24 hours, to accept a 260.1 resident returning to the same bed or a bed certified for the 260.2 same level of care, in accordance with a physician's order 260.3 authorizing transfer, after receiving inpatient hospital 260.4 services. 260.5 For a period not to exceed 180 days, the commissioner may 260.6 continue to make medical assistance payments to a nursing 260.7 facility or boarding care home which is in violation of this 260.8 section if extreme hardship to the residents would result. In 260.9 these cases the commissioner shall issue an order requiring the 260.10 nursing facility to correct the violation. The nursing facility 260.11 shall have 20 days from its receipt of the order to correct the 260.12 violation. If the violation is not corrected within the 20-day 260.13 period the commissioner may reduce the payment rate to the 260.14 nursing facility by up to 20 percent. The amount of the payment 260.15 rate reduction shall be related to the severity of the violation 260.16 and shall remain in effect until the violation is corrected. 260.17 The nursing facility or boarding care home may appeal the 260.18 commissioner's action pursuant to the provisions of chapter 14 260.19 pertaining to contested cases. An appeal shall be considered 260.20 timely if written notice of appeal is received by the 260.21 commissioner within 20 days of notice of the commissioner's 260.22 proposed action. 260.23 In the event that the commissioner determines that a 260.24 nursing facility is not eligible for reimbursement for a 260.25 resident who is eligible for medical assistance, the 260.26 commissioner may authorize the nursing facility to receive 260.27 reimbursement on a temporary basis until the resident can be 260.28 relocated to a participating nursing facility. 260.29 Certified beds in facilities which do not allow medical 260.30 assistance intake on July 1, 1984, or after shall be deemed to 260.31 be decertified for purposes of section 144A.071 only. 260.32 Sec. 29. Minnesota Statutes 2002, section 256I.02, is 260.33 amended to read: 260.34 256I.02 [PURPOSE.] 260.35 The Group Residential Housing Act establishes a 260.36 comprehensive system of rates and payments for persons who 261.1 reside ina group residencethe community and who meet the 261.2 eligibility criteria under section 256I.04, subdivision 1. 261.3 Sec. 30. Minnesota Statutes 2002, section 256I.04, 261.4 subdivision 3, is amended to read: 261.5 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 261.6 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 261.7 into agreements for new group residential housing beds with 261.8 total rates in excess of the MSA equivalent rate except: (1) 261.9for group residential housing establishments meeting the261.10requirements of subdivision 2a, clause (2) with department261.11approval; (2)for group residential housing establishments 261.12 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 261.13 provided the facility is needed to meet the census reduction 261.14 targets for persons with mental retardation or related 261.15 conditions at regional treatment centers;(3)(2) to ensure 261.16 compliance with the federal Omnibus Budget Reconciliation Act 261.17 alternative disposition plan requirements for inappropriately 261.18 placed persons with mental retardation or related conditions or 261.19 mental illness;(4)(3) up to 80 beds in a single, specialized 261.20 facility located in Hennepin county that will provide housing 261.21 for chronic inebriates who are repetitive users of 261.22 detoxification centers and are refused placement in emergency 261.23 shelters because of their state of intoxication, and planning 261.24 for the specialized facility must have been initiated before 261.25 July 1, 1991, in anticipation of receiving a grant from the 261.26 housing finance agency under section 462A.05, subdivision 20a, 261.27 paragraph (b);(5)(4) notwithstanding the provisions of 261.28 subdivision 2a, for up to 190 supportive housing units in Anoka, 261.29 Dakota, Hennepin, or Ramsey county for homeless adults with a 261.30 mental illness, a history of substance abuse, or human 261.31 immunodeficiency virus or acquired immunodeficiency syndrome. 261.32 For purposes of this section, "homeless adult" means a person 261.33 who is living on the street or in a shelter or discharged from a 261.34 regional treatment center, community hospital, or residential 261.35 treatment program and has no appropriate housing available and 261.36 lacks the resources and support necessary to access appropriate 262.1 housing. At least 70 percent of the supportive housing units 262.2 must serve homeless adults with mental illness, substance abuse 262.3 problems, or human immunodeficiency virus or acquired 262.4 immunodeficiency syndrome who are about to be or, within the 262.5 previous six months, has been discharged from a regional 262.6 treatment center, or a state-contracted psychiatric bed in a 262.7 community hospital, or a residential mental health or chemical 262.8 dependency treatment program. If a person meets the 262.9 requirements of subdivision 1, paragraph (a), and receives a 262.10 federal or state housing subsidy, the group residential housing 262.11 rate for that person is limited to the supplementary rate under 262.12 section 256I.05, subdivision 1a, and is determined by 262.13 subtracting the amount of the person's countable income that 262.14 exceeds the MSA equivalent rate from the group residential 262.15 housing supplementary rate. A resident in a demonstration 262.16 project site who no longer participates in the demonstration 262.17 program shall retain eligibility for a group residential housing 262.18 payment in an amount determined under section 256I.06, 262.19 subdivision 8, using the MSA equivalent rate. Service funding 262.20 under section 256I.05, subdivision 1a, will end June 30, 1997, 262.21 if federal matching funds are available and the services can be 262.22 provided through a managed care entity. If federal matching 262.23 funds are not available, then service funding will continue 262.24 under section 256I.05, subdivision 1a; or (6) for group 262.25 residential housing beds in settings meeting the requirements of 262.26 subdivision 2a, clauses (1) and (3), which are used exclusively 262.27 for recipients receiving home and community-based waiver 262.28 services under sections 256B.0915, 256B.092, subdivision 5, 262.29 256B.093, and 256B.49, and who resided in a nursing facility for 262.30 the six months immediately prior to the month of entry into the 262.31 group residential housing setting. The group residential 262.32 housing rate for these beds must be set so that the monthly 262.33 group residential housing payment for an individual occupying 262.34 the bed when combined with the nonfederal share of services 262.35 delivered under the waiver for that person does not exceed the 262.36 nonfederal share of the monthly medical assistance payment made 263.1 for the person to the nursing facility in which the person 263.2 resided prior to entry into the group residential housing 263.3 establishment. The rate may not exceed the MSA equivalent rate 263.4 plus $426.37 for any case. 263.5 (b) A county agency may enter into a group residential 263.6 housing agreement for beds with rates in excess of the MSA 263.7 equivalent rate in addition to those currently covered under a 263.8 group residential housing agreement if the additional beds are 263.9 only a replacement of beds with rates in excess of the MSA 263.10 equivalent rate which have been made available due to closure of 263.11 a setting, a change of licensure or certification which removes 263.12 the beds from group residential housing payment, or as a result 263.13 of the downsizing of a group residential housing setting. The 263.14 transfer of available beds from one county to another can only 263.15 occur by the agreement of both counties. 263.16 Sec. 31. Minnesota Statutes 2002, section 256I.05, 263.17 subdivision 1, is amended to read: 263.18 Subdivision 1. [MAXIMUM RATES.](a)Monthly room and board 263.19 rates negotiated by a county agency for a recipient living in 263.20 group residential housing must not exceed the MSA equivalent 263.21 rate specified under section 256I.03, subdivision 5,.with the263.22exception that a county agency may negotiate a supplementary263.23room and board rate that exceeds the MSA equivalent rate for263.24recipients of waiver services under title XIX of the Social263.25Security Act. This exception is subject to the following263.26conditions:263.27(1) the setting is licensed by the commissioner of human263.28services under Minnesota Rules, parts 9555.5050 to 9555.6265;263.29(2) the setting is not the primary residence of the license263.30holder and in which the license holder is not the primary263.31caregiver; and263.32(3) the average supplementary room and board rate in a263.33county for a calendar year may not exceed the average263.34supplementary room and board rate for that county in effect on263.35January 1, 2000. For calendar years beginning on or after263.36January 1, 2002, within the limits of appropriations264.1specifically for this purpose, the commissioner shall increase264.2each county's supplemental room and board rate average on an264.3annual basis by a factor consisting of the percentage change in264.4the Consumer Price Index-All items, United States city average264.5(CPI-U) for that calendar year compared to the preceding264.6calendar year as forecasted by Data Resources, Inc., in the264.7third quarter of the preceding calendar year. If a county has264.8not negotiated supplementary room and board rates for any264.9facilities located in the county as of January 1, 2000, or has264.10an average supplemental room and board rate under $100 per264.11person as of January 1, 2000, it may submit a supplementary room264.12and board rate request with budget information for a facility to264.13the commissioner for approval.264.14The county agency may at any time negotiate a higher or lower264.15room and board rate than the average supplementary room and264.16board rate.264.17(b) Notwithstanding paragraph (a), clause (3), county264.18agencies may negotiate a supplementary room and board rate that264.19exceeds the MSA equivalent rate by up to $426.37 for up to five264.20facilities, serving not more than 20 individuals in total, that264.21were established to replace an intermediate care facility for264.22persons with mental retardation and related conditions located264.23in the city of Roseau that became uninhabitable due to flood264.24damage in June 2002.264.25 [EFFECTIVE DATE.] This section is effective July 1, 2004, 264.26 or upon receipt of federal approval of waiver amendment, 264.27 whichever is later. 264.28 Sec. 32. Minnesota Statutes 2002, section 256I.05, 264.29 subdivision 1a, is amended to read: 264.30 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 264.31 the provisions of section 256I.04, subdivision 3,in addition to264.32the room and board rate specified in subdivision 1,the county 264.33 agency may negotiate a payment not to exceed $426.37 for other 264.34 services necessary to provide room and board provided by the 264.35 group residence if the residence is licensed by or registered by 264.36 the department of health, or licensed by the department of human 265.1 services to provide services in addition to room and board, and 265.2 if the provider of services is not also concurrently receiving 265.3 funding for services for a recipient under a home and 265.4 community-based waiver under title XIX of the Social Security 265.5 Act; or funding from the medical assistance program under 265.6 section 256B.0627, subdivision 4, for personal care services for 265.7 residents in the setting; or residing in a setting which 265.8 receives funding under Minnesota Rules, parts 9535.2000 to 265.9 9535.3000. If funding is available for other necessary services 265.10 through a home and community-based waiver, or personal care 265.11 services under section 256B.0627, subdivision 4, then the GRH 265.12 rate is limited to the rate set in subdivision 1. Unless 265.13 otherwise provided in law, in no case may the supplementary 265.14 service rateplus the supplementary room and board rateexceed 265.15 $426.37. The registration and licensure requirement does not 265.16 apply to establishments which are exempt from state licensure 265.17 because they are located on Indian reservations and for which 265.18 the tribe has prescribed health and safety requirements. 265.19 Service payments under this section may be prohibited under 265.20 rules to prevent the supplanting of federal funds with state 265.21 funds. The commissioner shall pursue the feasibility of 265.22 obtaining the approval of the Secretary of Health and Human 265.23 Services to provide home and community-based waiver services 265.24 under title XIX of the Social Security Act for residents who are 265.25 not eligible for an existing home and community-based waiver due 265.26 to a primary diagnosis of mental illness or chemical dependency 265.27 and shall apply for a waiver if it is determined to be 265.28 cost-effective. 265.29 (b) The commissioner is authorized to make cost-neutral 265.30 transfers from the GRH fund for beds under this section to other 265.31 funding programs administered by the department after 265.32 consultation with the county or counties in which the affected 265.33 beds are located. The commissioner may also make cost-neutral 265.34 transfers from the GRH fund to county human service agencies for 265.35 beds permanently removed from the GRH census under a plan 265.36 submitted by the county agency and approved by the 266.1 commissioner. The commissioner shall report the amount of any 266.2 transfers under this provision annually to the legislature. 266.3 (c) The provisions of paragraph (b) do not apply to a 266.4 facility that has its reimbursement rate established under 266.5 section 256B.431, subdivision 4, paragraph (c). 266.6 Sec. 33. Minnesota Statutes 2002, section 256I.05, 266.7 subdivision 2, is amended to read: 266.8 Subd. 2. [MONTHLY RATES; EXEMPTIONS.] The maximum group 266.9 residential housing rate does not apply to a residence that on 266.10 August 1, 1984, was licensed by the commissioner of health only 266.11 as a boarding care home, certified by the commissioner of health 266.12 as an intermediate care facility, and licensed by the 266.13 commissioner of human services under Minnesota Rules, parts 266.14 9520.0500 to 9520.0690. Notwithstanding the provisions of 266.15 subdivision 1c, the rate paid to a facility reimbursed under 266.16 this subdivision shall be determined under section 256B.431, or 266.17 under section 256B.434 if the facility is accepted by the 266.18 commissioner for participation in the alternative payment 266.19 demonstration project. Section 256B.431, subdivision 39, 266.20 paragraph (a), shall not apply to the monthly rates determined 266.21 according to the provisions of this subdivision. 266.22 Sec. 34. Minnesota Statutes 2002, section 256I.05, 266.23 subdivision 7c, is amended to read: 266.24 Subd. 7c. [DEMONSTRATION PROJECT.] The commissioner is 266.25 authorized to pursue a demonstration project under federal food 266.26 stamp regulation for the purpose of gaining federal 266.27 reimbursement of food and nutritional costs currently paid by 266.28 the state group residential housing program. The commissioner 266.29 shall seek approval no later than January 1, 2004. Any 266.30 reimbursement received is nondedicated revenue to the general 266.31 fund. 266.32 Sec. 35. [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 266.33 Subdivision 1. [APPLICABILITY.] The definitions in this 266.34 section apply to sections 514.991 to 514.995. 266.35 Subd. 2. [ALTERNATIVE CARE AGENCY, AGENCY, OR 266.36 DEPARTMENT.] "Alternative care agency," "agency," or "department" 267.1 means the department of human services when it pays for or 267.2 provides alternative care benefits for a nonmedical assistance 267.3 recipient directly or through a county social services agency 267.4 under chapter 256B according to section 256B.0913. 267.5 Subd. 3. [ALTERNATIVE CARE BENEFIT OR 267.6 BENEFITS.] "Alternative care benefit" or "benefits" means a 267.7 benefit provided to a nonmedical assistance recipient under 267.8 chapter 256B according to section 256B.0913. 267.9 Subd. 4. [ALTERNATIVE CARE RECIPIENT OR 267.10 RECIPIENT.] "Alternative care recipient" or "recipient" means a 267.11 person who receives alternative care grant benefits. 267.12 Subd. 5. [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 267.13 care lien" or "lien" means a lien filed under sections 514.992 267.14 to 514.995. 267.15 [EFFECTIVE DATE.] This section is effective July 1, 2003, 267.16 for services for persons first enrolling in the alternative care 267.17 program on or after that date and on the first day of the first 267.18 eligibility renewal period for persons enrolled in the 267.19 alternative care program prior to July 1, 2003. 267.20 Sec. 36. [514.992] [ALTERNATIVE CARE LIEN.] 267.21 Subdivision 1. [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a) 267.22 Subject to sections 514.991 to 514.995, payments made by an 267.23 alternative care agency to provide benefits to a recipient or to 267.24 the recipient's spouse who owns property in this state 267.25 constitute a lien in favor of the agency on all real property 267.26 the recipient owns at and after the time the benefits are first 267.27 paid. 267.28 (b) The amount of the lien is limited to benefits paid for 267.29 services provided to recipients over 55 years of age and 267.30 provided on and after July 1, 2003. 267.31 Subd. 2. [ATTACHMENT.] (a) A lien attaches to and becomes 267.32 enforceable against specific real property as of the date when 267.33 all of the following conditions are met: 267.34 (1) the agency has paid benefits for a recipient; 267.35 (2) the recipient has been given notice and an opportunity 267.36 for a hearing under paragraph (b); 268.1 (3) the lien has been filed as provided for in section 268.2 514.993 or memorialized on the certificate of title for the 268.3 property it describes; and 268.4 (4) all restrictions against enforcement have ceased to 268.5 apply. 268.6 (b) An agency may not file a lien until it has sent the 268.7 recipient, their authorized representative, or their legal 268.8 representative written notice of its lien rights by certified 268.9 mail, return receipt requested, or registered mail and there has 268.10 been an opportunity for a hearing under section 256.045. No 268.11 person other than the recipient shall have a right to a hearing 268.12 under section 256.045 prior to the time the lien is filed. The 268.13 hearing shall be limited to whether the agency has met all of 268.14 the prerequisites for filing the lien and whether any of the 268.15 exceptions in this section apply. 268.16 (c) An agency may not file a lien against the recipient's 268.17 homestead when any of the following exceptions apply: 268.18 (1) while the recipient's spouse is also physically present 268.19 and lawfully and continuously residing in the homestead; 268.20 (2) a child of the recipient who is under age 21 or who is 268.21 blind or totally and permanently disabled according to 268.22 supplemental security income criteria is also physically present 268.23 on the property and lawfully and continuously residing on the 268.24 property from and after the date the recipient first receives 268.25 benefits; 268.26 (3) a child of the recipient who has also lawfully and 268.27 continuously resided on the property for a period beginning at 268.28 least two years before the first day of the month in which the 268.29 recipient began receiving alternative care, and who provided 268.30 uncompensated care to the recipient which enabled the recipient 268.31 to live without alternative care services for the two-year 268.32 period; 268.33 (4) a sibling of the recipient who has an ownership 268.34 interest in the property of record in the office of the county 268.35 recorder or registrar of titles for the county in which the real 268.36 property is located and who has also continuously occupied the 269.1 homestead for a period of at least one year immediately prior to 269.2 the first day of the first month in which the recipient received 269.3 benefits and continuously since that date. 269.4 (d) A lien only applies to the real property it describes. 269.5 Subd. 3. [CONTINUATION OF LIEN.] A lien remains effective 269.6 from the time it is filed until it is paid, satisfied, 269.7 discharged, or becomes unenforceable under sections 514.991 to 269.8 514.995. 269.9 Subd. 4. [PRIORITY OF LIEN.] (a) A lien which attaches to 269.10 the real property it describes is subject to the rights of 269.11 anyone else whose interest in the real property is perfected of 269.12 record before the lien has been recorded or filed under section 269.13 514.993, including: 269.14 (1) an owner, other than the recipient or the recipient's 269.15 spouse; 269.16 (2) a good faith purchaser for value without notice of the 269.17 lien; 269.18 (3) a holder of a mortgage or security interest; or 269.19 (4) a judgment lien creditor whose judgment lien has 269.20 attached to the recipient's interest in the real property. 269.21 (b) The rights of the other person have the same 269.22 protections against an alternative care lien as are afforded 269.23 against a judgment lien that arises out of an unsecured 269.24 obligation and arises as of the time of the filing of an 269.25 alternative care grant lien under section 514.993. The lien 269.26 shall be inferior to a lien for property taxes and special 269.27 assessments and shall be superior to all other matters first 269.28 appearing of record after the time and date the lien is filed or 269.29 recorded. 269.30 Subd. 5. [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 269.31 agency may, with absolute discretion, settle or subordinate the 269.32 lien to any other lien or encumbrance of record upon the terms 269.33 and conditions it deems appropriate. 269.34 (b) The agency filing the lien shall release and discharge 269.35 the lien: 269.36 (1) if it has been paid, discharged, or satisfied; 270.1 (2) if it has received reimbursement for the amounts 270.2 secured by the lien, has entered into a binding and legally 270.3 enforceable agreement under which it is reimbursed for the 270.4 amount of the lien, or receives other collateral sufficient to 270.5 secure payment of the lien; 270.6 (3) against some, but not all, of the property it describes 270.7 upon the terms, conditions, and circumstances the agency deems 270.8 appropriate; 270.9 (4) to the extent it cannot be lawfully enforced against 270.10 the property it describes because of an error, omission, or 270.11 other material defect in the legal description contained in the 270.12 lien or a necessary prerequisite to enforcement of the lien; and 270.13 (5) if, in its discretion, it determines the filing or 270.14 enforcement of the lien is contrary to the public interest. 270.15 (c) The agency executing the lien shall execute and file 270.16 the release as provided for in section 514.993, subdivision 2. 270.17 Subd. 6. [LENGTH OF LIEN.] (a) A lien shall be a lien on 270.18 the real property it describes for a period of ten years from 270.19 the date it attaches according to subdivision 2, paragraph (a), 270.20 except as otherwise provided for in sections 514.992 to 270.21 514.995. The agency filing the lien may renew the lien for one 270.22 additional ten-year period from the date it would otherwise 270.23 expire by recording or filing a certificate of renewal before 270.24 the lien expires. The certificate of renewal shall be recorded 270.25 or filed in the office of the county recorder or registrar of 270.26 titles for the county in which the lien is recorded or filed. 270.27 The certificate must refer to the recording or filing data for 270.28 the lien it renews. The certificate need not be attested, 270.29 certified, or acknowledged as a condition for recording or 270.30 filing. The recorder or registrar of titles shall record, file, 270.31 index, and return the certificate of renewal in the same manner 270.32 provided for liens in section 514.993, subdivision 2. 270.33 (b) An alternative care lien is not enforceable against the 270.34 real property of an estate to the extent there is a 270.35 determination by a court of competent jurisdiction, or by an 270.36 officer of the court designated for that purpose, that there are 271.1 insufficient assets in the estate to satisfy the lien in whole 271.2 or in part because of the homestead exemption under section 271.3 256B.15, subdivision 4, the rights of a surviving spouse or a 271.4 minor child under section 524.2-403, paragraphs (a) and (b), or 271.5 claims with a priority under section 524.3-805, paragraph (a), 271.6 clauses (1) to (4). For purposes of this section, the rights of 271.7 the decedent's adult children to exempt property under section 271.8 524.2-403, paragraph (b), shall not be considered costs of 271.9 administration under section 524.3-805, paragraph (a), clause 271.10 (1). 271.11 [EFFECTIVE DATE.] This section is effective July 1, 2003, 271.12 for services for persons first enrolling in the alternative care 271.13 program on or after that date and on the first day of the first 271.14 eligibility renewal period for persons enrolled in the 271.15 alternative care program prior to July 1, 2003. 271.16 Sec. 37. [514.993] [LIEN; CONTENTS AND FILING.] 271.17 Subdivision 1. [CONTENTS.] A lien shall be dated and must 271.18 contain: 271.19 (1) the recipient's full name, last known address, and 271.20 social security number; 271.21 (2) a statement that benefits have been paid to or for the 271.22 recipient's benefit; 271.23 (3) a statement that all of the recipient's interests in 271.24 the in the real property described in the lien may be subject to 271.25 or affected by the agency's right to reimbursement for benefits; 271.26 (4) a legal description of the real property subject to the 271.27 lien and whether it is registered or abstract property; 271.28 (5) such other contents, if any, as the agency deems 271.29 appropriate. 271.30 Subd. 2. [FILING.] Any lien, release, or other document 271.31 required or permitted to be filed under sections 514.991 to 271.32 514.995 must be recorded or filed in the office of the county 271.33 recorder or registrar of titles, as appropriate, in the county 271.34 where the real property is located. Notwithstanding section 271.35 386.77, the agency shall pay the applicable filing fee for any 271.36 documents filed under sections 514.991 to 514.995. An 272.1 attestation, certification, or acknowledgment is not required as 272.2 a condition of filing. If the property described in the lien is 272.3 registered property, the registrar of titles shall record it on 272.4 the certificate of title for each parcel of property described 272.5 in the lien. If the property described in the lien is abstract 272.6 property, the recorder shall file the lien in the county's 272.7 grantor-grantee indexes and any tract indexes the county 272.8 maintains for each parcel of property described in the lien. 272.9 The recorder or registrar shall return the recorded or filed 272.10 lien to the agency at no cost. If the agency provides a 272.11 duplicate copy of the lien, the recorder or registrar of titles 272.12 shall show the recording or filing data on the copy and return 272.13 it to the agency at no cost. The agency is responsible for 272.14 filing any lien, release, or other documents under sections 272.15 514.991 to 514.995. 272.16 [EFFECTIVE DATE.] This section is effective July 1, 2003, 272.17 for services for persons first enrolling in the alternative care 272.18 program on or after that date and on the first day of the first 272.19 eligibility renewal period for persons enrolled in the 272.20 alternative care program prior to July 1, 2003. 272.21 Sec. 38. [514.994] [ENFORCEMENT; OTHER REMEDIES.] 272.22 Subdivision 1. [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 272.23 agency may enforce or foreclose a lien filed under sections 272.24 514.991 to 514.995 in the manner provided for by law for 272.25 enforcement of judgment liens against real estate or by a 272.26 foreclosure by action under chapter 581. The lien shall remain 272.27 enforceable as provided for in sections 514.991 to 514.995 272.28 notwithstanding any laws limiting the enforceability of 272.29 judgments. 272.30 Subd. 2. [HOMESTEAD EXEMPTION.] The lien may not be 272.31 enforced against the homestead property of the recipient or the 272.32 spouse while they physically occupy it as their lawful residence. 272.33 Subd. 3. [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 272.34 514.995 do not limit the agency's right to file a claim against 272.35 the recipient's estate or the estate of the recipient's spouse, 272.36 do not limit any other claims for reimbursement the agency may 273.1 have, and do not limit the availability of any other remedy to 273.2 the agency. 273.3 [EFFECTIVE DATE.] This section is effective July 1, 2003, 273.4 for services for persons first enrolling in the alternative care 273.5 program on or after that date and on the first day of the first 273.6 eligibility renewal period for persons enrolled in the 273.7 alternative care program prior to July 1, 2003. 273.8 Sec. 39. [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 273.9 Amounts the agency receives to satisfy the lien must be 273.10 deposited in the state treasury and credited to the fund from 273.11 which the benefits were paid. 273.12 [EFFECTIVE DATE.] This section is effective July 1, 2003, 273.13 for services for persons first enrolling in the alternative care 273.14 program on or after that date and on the first day of the first 273.15 eligibility renewal period for persons enrolled in the 273.16 alternative care program prior to July 1, 2003. 273.17 Sec. 40. Minnesota Statutes 2002, section 524.3-805, is 273.18 amended to read: 273.19 524.3-805 [CLASSIFICATION OF CLAIMS.] 273.20 (a) If the applicable assets of the estate are insufficient 273.21 to pay all claims in full, the personal representative shall 273.22 make payment in the following order: 273.23 (1) costs and expenses of administration; 273.24 (2) reasonable funeral expenses; 273.25 (3) debts and taxes with preference under federal law; 273.26 (4) reasonable and necessary medical, hospital, or nursing 273.27 home expenses of the last illness of the decedent, including 273.28 compensation of persons attending the decedent, a claim filed 273.29 under section 256B.15 for recovery of expenditures for 273.30 alternative care for nonmedical assistance recipients under 273.31 section 256B.0913, and including a claim filed pursuant to 273.32 section 256B.15; 273.33 (5) reasonable and necessary medical, hospital, and nursing 273.34 home expenses for the care of the decedent during the year 273.35 immediately preceding death; 273.36 (6) debts with preference under other laws of this state, 274.1 and state taxes; 274.2 (7) all other claims. 274.3 (b) No preference shall be given in the payment of any 274.4 claim over any other claim of the same class, and a claim due 274.5 and payable shall not be entitled to a preference over claims 274.6 not due, except that if claims for expenses of the last illness 274.7 involve only claims filed under section 256B.15 for recovery of 274.8 expenditures for alternative care for nonmedical assistance 274.9 recipients under section 256B.0913, section 246.53 for costs of 274.10 state hospital care and claims filed under section 256B.15, 274.11 claims filed to recover expenditures for alternative care for 274.12 nonmedical assistance recipients under section 256B.0913 shall 274.13 have preference over claims filed under both sections 246.53 and 274.14 other claims filed under section 256B.15, and claims filed under 274.15 section 246.53 have preference over claims filed under section 274.16 256B.15 for recovery of amounts other than those for 274.17 expenditures for alternative care for nonmedical assistance 274.18 recipients under section 256B.0913. 274.19 [EFFECTIVE DATE.] This section is effective July 1, 2003, 274.20 for decedents dying on or after that date. 274.21 Sec. 41. [REVISOR'S INSTRUCTION.] 274.22 For sections in Minnesota Statutes and Minnesota Rules 274.23 affected by the repealed sections in this article, the revisor 274.24 shall delete internal cross-references where appropriate and 274.25 make changes necessary to correct the punctuation, grammar, or 274.26 structure of the remaining text and preserve its meaning. 274.27 Sec. 42. [REPEALER.] 274.28 (a) Minnesota Statutes 2002, sections 256.973; 256.9752; 274.29 256.9753; 256.976; 256.977; 256.9772; 256B.0917; 256B.0928; and 274.30 256B.437, subdivision 2, are repealed effective July 1, 2003. 274.31 (b) Laws 1988, chapter 689, article 2, section 251, is 274.32 repealed effective July 1, 2003. 274.33 ARTICLE 4 274.34 CONTINUING CARE FOR PERSONS WITH DISABILITIES 274.35 Section 1. Minnesota Statutes 2002, section 245B.06, 274.36 subdivision 8, is amended to read: 275.1 Subd. 8. [LEAVING THE RESIDENCE.] As specified in each 275.2 consumer's individual service plan, each consumer requiring a 275.3 24-hour plan of caremustmay leave the residence to participate 275.4 in regular education, employment, or community activities. 275.5 License holders, providing services to consumers living in a 275.6 licensed site, shall ensure that they are prepared to care for 275.7 consumers whenever they are at the residence during the day 275.8 because of illness, work schedules, or other reasons. 275.9 Sec. 2. Minnesota Statutes 2002, section 246.54, is 275.10 amended to read: 275.11 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 275.12 Subdivision 1. [COUNTY PORTION FOR COST OF CARE.] Except 275.13 for chemical dependency services provided under sections 254B.01 275.14 to 254B.09, the client's county shall pay to the state of 275.15 Minnesota a portion of the cost of care provided in a regional 275.16 treatment center or a state nursing facility to a client legally 275.17 settled in that county. A county's payment shall be made from 275.18 the county's own sources of revenue and payments shall be paid 275.19 as follows: payments to the state from the county shall 275.20 equalten20 percent of the cost of care, as determined by the 275.21 commissioner, for each day, or the portion thereof, that the 275.22 client spends at a regional treatment center or a state nursing 275.23 facility. If payments received by the state under sections 275.24 246.50 to 246.53 exceed9080 percent of the cost of care, the 275.25 county shall be responsible for paying the state only the 275.26 remaining amount. The county shall not be entitled to 275.27 reimbursement from the client, the client's estate, or from the 275.28 client's relatives, except as provided in section 246.53. No 275.29 such payments shall be made for any client who was last 275.30 committed prior to July 1, 1947. 275.31 Subd. 2. [EXCEPTIONS.] Subdivision 1 does not apply to 275.32 services provided at the Minnesota security hospital, the 275.33 Minnesota sex offender program, or the Minnesota extended 275.34 treatment options program. For services at these facilities, a 275.35 county's payment shall be made from the county's own sources of 275.36 revenue and payments shall be paid as follows: payments to the 276.1 state from the county shall equal ten percent of the cost of 276.2 care, as determined by the commissioner, for each day, or the 276.3 portion thereof, that the client spends at the facility. If 276.4 payments received by the state under sections 246.50 to 246.53 276.5 exceed 90 percent of the cost of care, the county shall be 276.6 responsible for paying the state only the remaining amount. The 276.7 county shall not be entitled to reimbursement from the client, 276.8 the client's estate, or from the client's relatives, except as 276.9 provided in section 246.53. 276.10 [EFFECTIVE DATE.] This section is effective January 1, 2004. 276.11 Sec. 3. Minnesota Statutes 2002, section 252.46, 276.12 subdivision 1, is amended to read: 276.13 Subdivision 1. [RATES.] (a) Payment rates to vendors, 276.14 except regional centers, for county-funded day training and 276.15 habilitation services and transportation provided to persons 276.16 receiving day training and habilitation services established by 276.17 a county board are governed by subdivisions 2 to 19. The 276.18 commissioner shall approve the following three payment rates for 276.19 services provided by a vendor: 276.20 (1) a full-day service rate for persons who receive at 276.21 least six service hours a day, including the time it takes to 276.22 transport the person to and from the service site; 276.23 (2) a partial-day service rate that must not exceed 75 276.24 percent of the full-day service rate for persons who receive 276.25 less than a full day of service; and 276.26 (3) a transportation rate for providing, or arranging and 276.27 paying for, transportation of a person to and from the person's 276.28 residence to the service site. 276.29(b) The commissioner may also approve an hourly job-coach,276.30follow-along rate for services provided by one employee at or en276.31route to or from community locations to supervise, support, and276.32assist one person receiving the vendor's services to learn276.33job-related skills necessary to obtain or retain employment when276.34and where no other persons receiving services are present and276.35when all the following criteria are met:276.36(1) the vendor requests and the county recommends the277.1optional rate;277.2(2) the service is prior authorized by the county on the277.3Medicaid Management Information System for no more than 414277.4hours in a 12-month period and the daily per person charge to277.5medical assistance does not exceed the vendor's approved full277.6day plus transportation rates;277.7(3) separate full day, partial day, and transportation277.8rates are not billed for the same person on the same day;277.9(4) the approved hourly rate does not exceed the sum of the277.10vendor's current average hourly direct service wage, including277.11fringe benefits and taxes, plus a component equal to the277.12vendor's average hourly nondirect service wage expenses; and277.13(5) the actual revenue received for provision of hourly277.14job-coach, follow-along services is subtracted from the vendor's277.15total expenses for the same time period and those adjusted277.16expenses are used for determining recommended full day and277.17transportation payment rates under subdivision 5 in accordance277.18with the limitations in subdivision 3.277.19 (b) Notwithstanding any law or rule to the contrary, the 277.20 commissioner may authorize county participation in a voluntary 277.21 individualized payment rate structure for day training and 277.22 habilitation services to allow a county the flexibility to 277.23 change from a site-based payment rate structure to an individual 277.24 payment rate structure for the providers of day training and 277.25 habilitation services in the county. The commissioner shall 277.26 establish procedures for determining the structure of voluntary 277.27 individualized payment rates to ensure that there is no 277.28 additional cost to the state. 277.29 (c) Medical assistance rates for home and community-based 277.30 service provided under section 256B.501, subdivision 4, by 277.31 licensed vendors of day training and habilitation services must 277.32 not be greater than the rates for the same services established 277.33 by counties under sections 252.40 to 252.46. For very dependent 277.34 persons with special needs the commissioner may approve an 277.35 exception to the approved payment rate under section 256B.501, 277.36 subdivision 4 or 8. 278.1 Sec. 4. Minnesota Statutes 2002, section 256.476, 278.2 subdivision 1, is amended to read: 278.3 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 278.4 human services shall establish a consumer support grant program 278.5 for individuals with functional limitations and their families 278.6 who wish to purchase and secure their own supports. The 278.7 commissioner and local agencies shall jointly develop an 278.8 implementation plan which must include a way to resolve the 278.9 issues related to county liability. The program shall: 278.10 (1) make support grantsor exception grants described in278.11subdivision 11available to individuals or families as an 278.12 effective alternative toexisting programs and services, such as278.13 the developmental disability family support program, personal 278.14 care attendant services, home health aide services, and private 278.15 duty nursing services; 278.16 (2) provide consumers more control, flexibility, and 278.17 responsibility over their services and supports; 278.18 (3) promote local program management and decision making; 278.19 and 278.20 (4) encourage the use of informal and typical community 278.21 supports. 278.22 Sec. 5. Minnesota Statutes 2002, section 256.476, 278.23 subdivision 3, is amended to read: 278.24 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 278.25 is eligible to apply for a consumer support grant if the person 278.26 meets all of the following criteria: 278.27 (1) the person is eligible for and has been approved to 278.28 receive services under medical assistance as determined under 278.29 sections 256B.055 and 256B.056 or the person has been approved 278.30 to receive a grant under the developmental disability family 278.31 support program under section 252.32; 278.32 (2) the person is able to direct and purchase the person's 278.33 own care and supports, or the person has a family member, legal 278.34 representative, or other authorized representative who can 278.35 purchase and arrange supports on the person's behalf; 278.36 (3) the person has functional limitations, requires ongoing 279.1 supports to live in the community, and is at risk of or would 279.2 continue institutionalization without such supports; and 279.3 (4) the person will live in a home. For the purpose of 279.4 this section, "home" means the person's own home or home of a 279.5 person's family member. These homes are natural home settings 279.6 and are not licensed by the department of health or human 279.7 services. 279.8 (b) Persons may not concurrently receive a consumer support 279.9 grant if they are: 279.10 (1) receivinghome and community-based services under279.11United States Code, title 42, section 1396h(c);personal care 279.12 attendant and home health aide services, or private duty nursing 279.13 under section 256B.0625; a developmental disability family 279.14 support grant; or alternative care services under section 279.15 256B.0913; or 279.16 (2) residing in an institutional or congregate care setting. 279.17 (c) A person or person's family receiving a consumer 279.18 support grant shall not be charged a fee or premium by a local 279.19 agency for participating in the program. 279.20 (d)The commissioner may limit the participation of279.21recipients of services from federal waiver programs in the279.22consumer support grant program if the participation of these279.23individuals will result in an increase in the cost to the279.24state.Individuals receiving home and community-based waivers 279.25 under United States Code, title 42, section 1396h(c), are not 279.26 eligible for the consumer support grant. 279.27 (e) The commissioner shall establish a budgeted 279.28 appropriation each fiscal year for the consumer support grant 279.29 program. The number of individuals participating in the program 279.30 will be adjusted so the total amount allocated to counties does 279.31 not exceed the amount of the budgeted appropriation. The 279.32 budgeted appropriation will be adjusted annually to accommodate 279.33 changes in demand for the consumer support grants. 279.34 Sec. 6. Minnesota Statutes 2002, section 256.476, 279.35 subdivision 4, is amended to read: 279.36 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 280.1 county board may choose to participate in the consumer support 280.2 grant program. If a county has not chosen to participate by 280.3 July 1, 2002, the commissioner shall contract with another 280.4 county or other entity to provide access to residents of the 280.5 nonparticipating county who choose the consumer support grant 280.6 option. The commissioner shall notify the county board in a 280.7 county that has declined to participate of the commissioner's 280.8 intent to enter into a contract with another county or other 280.9 entity at least 30 days in advance of entering into the 280.10 contract. The local agency shall establish written procedures 280.11 and criteria to determine the amount and use of support grants. 280.12 These procedures must include, at least, the availability of 280.13 respite care, assistance with daily living, and adaptive aids. 280.14 The local agency may establish monthly or annual maximum amounts 280.15 for grants and procedures where exceptional resources may be 280.16 required to meet the health and safety needs of the person on a 280.17 time-limited basis, however, the total amount awarded to each 280.18 individual may not exceed the limits established in subdivision 280.19 11. 280.20 (b) Support grants to a person or a person's family will be 280.21 provided through a monthly subsidy payment and be in the form of 280.22 cash, voucher, or direct county payment to vendor. Support 280.23 grant amounts must be determined by the local agency. Each 280.24 service and item purchased with a support grant must meet all of 280.25 the following criteria: 280.26 (1) it must be over and above the normal cost of caring for 280.27 the person if the person did not have functional limitations; 280.28 (2) it must be directly attributable to the person's 280.29 functional limitations; 280.30 (3) it must enable the person or the person's family to 280.31 delay or prevent out-of-home placement of the person; and 280.32 (4) it must be consistent with the needs identified in the 280.33 serviceplanagreement, when applicable. 280.34 (c) Items and services purchased with support grants must 280.35 be those for which there are no other public or private funds 280.36 available to the person or the person's family. Fees assessed 281.1 to the person or the person's family for health and human 281.2 services are not reimbursable through the grant. 281.3 (d) In approving or denying applications, the local agency 281.4 shall consider the following factors: 281.5 (1) the extent and areas of the person's functional 281.6 limitations; 281.7 (2) the degree of need in the home environment for 281.8 additional support; and 281.9 (3) the potential effectiveness of the grant to maintain 281.10 and support the person in the family environment or the person's 281.11 own home. 281.12 (e) At the time of application to the program or screening 281.13 for other services, the person or the person's family shall be 281.14 provided sufficient information to ensure an informed choice of 281.15 alternatives by the person, the person's legal representative, 281.16 if any, or the person's family. The application shall be made 281.17 to the local agency and shall specify the needs of the person 281.18 and family, the form and amount of grant requested, the items 281.19 and services to be reimbursed, and evidence of eligibility for 281.20 medical assistance. 281.21 (f) Upon approval of an application by the local agency and 281.22 agreement on a support plan for the person or person's family, 281.23 the local agency shall make grants to the person or the person's 281.24 family. The grant shall be in an amount for the direct costs of 281.25 the services or supports outlined in the service agreement. 281.26 (g) Reimbursable costs shall not include costs for 281.27 resources already available, such as special education classes, 281.28 day training and habilitation, case management, other services 281.29 to which the person is entitled, medical costs covered by 281.30 insurance or other health programs, or other resources usually 281.31 available at no cost to the person or the person's family. 281.32 (h) The state of Minnesota, the county boards participating 281.33 in the consumer support grant program, or the agencies acting on 281.34 behalf of the county boards in the implementation and 281.35 administration of the consumer support grant program shall not 281.36 be liable for damages, injuries, or liabilities sustained 282.1 through the purchase of support by the individual, the 282.2 individual's family, or the authorized representative under this 282.3 section with funds received through the consumer support grant 282.4 program. Liabilities include but are not limited to: workers' 282.5 compensation liability, the Federal Insurance Contributions Act 282.6 (FICA), or the Federal Unemployment Tax Act (FUTA). For 282.7 purposes of this section, participating county boards and 282.8 agencies acting on behalf of county boards are exempt from the 282.9 provisions of section 268.04. 282.10 Sec. 7. Minnesota Statutes 2002, section 256.476, 282.11 subdivision 5, is amended to read: 282.12 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 282.13 For the purpose of transferring persons to the consumer support 282.14 grant program fromspecific programs or services, such asthe 282.15 developmental disability family support program and personal 282.16 care assistant services, home health aide services, or private 282.17 duty nursing services, the amount of funds transferred by the 282.18 commissioner between the developmental disability family support 282.19 program account, the medical assistance account, or the consumer 282.20 support grant account shall be based on each county's 282.21 participation in transferring persons to the consumer support 282.22 grant program from those programs and services. 282.23 (b) At the beginning of each fiscal year, county 282.24 allocations for consumer support grants shall be based on: 282.25 (1) the number of persons to whom the county board expects 282.26 to provide consumer supports grants; 282.27 (2) their eligibility for current program and services; 282.28 (3) the amount of nonfederal dollars allowed under 282.29 subdivision 11; and 282.30 (4) projected dates when persons will start receiving 282.31 grants. County allocations shall be adjusted periodically by 282.32 the commissioner based on the actual transfer of persons or 282.33 service openings, and the nonfederal dollars associated with 282.34 those persons or service openings, to the consumer support grant 282.35 program. 282.36 (c) The amount of funds transferred by the commissioner 283.1 from the medical assistance account for an individual may be 283.2 changed if it is determined by the county or its agent that the 283.3 individual's need for support has changed. 283.4 (d) The authority to utilize funds transferred to the 283.5 consumer support grant account for the purposes of implementing 283.6 and administering the consumer support grant program will not be 283.7 limited or constrained by the spending authority provided to the 283.8 program of origination. 283.9 (e) The commissioner may use up to five percent of each 283.10 county's allocation, as adjusted, for payments for 283.11 administrative expenses, to be paid as a proportionate addition 283.12 to reported direct service expenditures. 283.13 (f) The county allocation for each individual or 283.14 individual's family cannot exceed the amount allowed under 283.15 subdivision 11. 283.16 (g) The commissioner may recover, suspend, or withhold 283.17 payments if the county board, local agency, or grantee does not 283.18 comply with the requirements of this section. 283.19 (h) Grant funds unexpended by consumers shall return to the 283.20 state once a year. The annual return of unexpended grant funds 283.21 shall occur in the quarter following the end of the state fiscal 283.22 year. 283.23 Sec. 8. Minnesota Statutes 2002, section 256.476, 283.24 subdivision 11, is amended to read: 283.25 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 283.26 2001.] (a) Effective July 1, 2001, the commissioner shall 283.27 allocate consumer support grant resources to serve additional 283.28 individuals based on a review of Medicaid authorization and 283.29 payment information of persons eligible for a consumer support 283.30 grant from the most recent fiscal year. The commissioner shall 283.31 use the following methodology to calculate maximum allowable 283.32 monthly consumer support grant levels: 283.33 (1) For individuals whose program of origination is medical 283.34 assistance home care under section 256B.0627, the maximum 283.35 allowable monthly grant levels are calculated by: 283.36 (i) determining the nonfederal share of the average service 284.1 authorization for each home care rating; 284.2 (ii) calculating the overall ratio of actual payments to 284.3 service authorizations by program; 284.4 (iii) applying the overall ratio to the average service 284.5 authorization level of each home care rating; 284.6 (iv) adjusting the result for any authorized rate increases 284.7 provided by the legislature; and 284.8 (v) adjusting the result for the average monthly 284.9 utilization per recipient; and. 284.10 (2)for persons with programs of origination other than the284.11program described in clause (1), the maximum grant level for an284.12individual shall not exceed the total of the nonfederal dollars284.13expended on the individual by the program of originationThe 284.14 commissioner may review and evaluate the methodology to reflect 284.15 changes in the home care programs overall ratio of actual 284.16 payments to service authorizations. 284.17 (b) Effective July 1, 2003, persons previously receiving 284.18consumer supportexception grantsprior to July 1, 2001, may284.19continue to receive the grant amount established prior to July284.201, 2001will have their grants calculated using the methodology 284.21 in paragraph (a), clause (1). If a person currently receiving 284.22 an exception grant wishes to have their home care rating 284.23 reevaluated, they may request an assessment as defined in 284.24 section 256B.0627, subdivision 1, paragraph (b). 284.25(c) The commissioner may provide up to 200 exception284.26grants, including grants in use under paragraph (b). Eligible284.27persons shall be provided an exception grant in priority order284.28based upon the date of the commissioner's receipt of the county284.29request. The maximum allowable grant level for an exception284.30grant shall be based upon the nonfederal share of the average284.31service authorization from the most recent fiscal year for each284.32home care rating category. The amount of each exception grant284.33shall be based upon the commissioner's determination of the284.34nonfederal dollars that would have been expended if services had284.35been available for an individual who is unable to obtain the284.36support needed from the program of origination due to the285.1unavailability of qualified service providers at the time or the285.2location where the supports are needed.285.3 Sec. 9. [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 285.4 HEALTH SERVICES.] 285.5 Subdivision 1. [SCOPE.] Subject to federal approval, 285.6 medical assistance covers medically necessary, intensive 285.7 nonresidential and residential rehabilitative mental health 285.8 services as defined in subdivision 2, for recipients as defined 285.9 in subdivision 3, when the services are provided by an entity 285.10 meeting the standards in this section. 285.11 Subd. 2. [DEFINITIONS.] For purposes of this section, the 285.12 following terms have the meanings given them. 285.13 (a) "Intensive nonresidential rehabilitative mental health 285.14 services" means adult rehabilitative mental health services as 285.15 defined in section 256B.0623, subdivision 2, paragraph (a), 285.16 except that these services are provided by a multidisciplinary 285.17 staff using a total team approach consistent with assertive 285.18 community treatment and other evidence-based practices, and 285.19 directed to recipients with a serious mental illness who require 285.20 intensive services. 285.21 (b) "Intensive residential rehabilitative mental health 285.22 services" means short-term, time-limited services provided in a 285.23 residential setting to recipients who are in need of more 285.24 restrictive settings and are at risk of significant functional 285.25 deterioration if they do not receive these services. Services 285.26 are designed to develop and enhance psychiatric stability, 285.27 personal and emotional adjustment, self-sufficiency, and skills 285.28 to live in a more independent setting. Services must be 285.29 directed toward a targeted discharge date with specified client 285.30 outcomes and must be consistent with evidence-based practices. 285.31 (c) "Evidence-based practices" are nationally recognized 285.32 mental health services that are proven by substantial research 285.33 to be effective in helping individuals with serious mental 285.34 illness obtain specific treatment goals. 285.35 (d) "Overnight staff" means a member of the intensive 285.36 residential rehabilitative mental health treatment team who is 286.1 responsible during hours when recipients are typically asleep. 286.2 (e) "Treatment team" means all staff who provide services 286.3 under this section to recipients. At a minimum, this includes 286.4 the clinical supervisor, mental health professionals, mental 286.5 health practitioners, and mental health rehabilitation workers. 286.6 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 286.7 individual who: 286.8 (1) is age 18 or older; 286.9 (2) is eligible for medical assistance; 286.10 (3) is diagnosed with a mental illness; 286.11 (4) because of a mental illness, has substantial disability 286.12 and functional impairment in three or more of the areas listed 286.13 in section 245.462, subdivision 11a, so that self-sufficiency is 286.14 markedly reduced; 286.15 (5) has one or more of the following: a history of two or 286.16 more inpatient hospitalizations in the past year, significant 286.17 independent living instability, homelessness, or very frequent 286.18 use of mental health and related services yielding poor 286.19 outcomes; and 286.20 (6) in the written opinion of a licensed mental health 286.21 professional, has the need for mental health services that 286.22 cannot be met with other available community-based services, or 286.23 is likely to experience a mental health crisis or require a more 286.24 restrictive setting if intensive rehabilitative mental health 286.25 services are not provided. 286.26 Subd. 4. [PROVIDER CERTIFICATION AND CONTRACT 286.27 REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 286.28 mental health services provider must: 286.29 (1) have a contract with the host county to provide 286.30 intensive adult rehabilitative mental health services; and 286.31 (2) be certified by the commissioner as being in compliance 286.32 with this section and section 256B.0623. 286.33 (b) The intensive residential rehabilitative mental health 286.34 services provider must: 286.35 (1) be licensed under Minnesota Rules, parts 9520.0500 to 286.36 9520.0670; 287.1 (2) not exceed 16 beds per site; 287.2 (3) comply with the additional standards in this section; 287.3 and 287.4 (4) have a contract with the host county to provide these 287.5 services. 287.6 (c) The commissioner shall develop procedures for counties 287.7 and providers to submit contracts and other documentation as 287.8 needed to allow the commissioner to determine whether the 287.9 standards in this section are met. 287.10 Subd. 5. [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 287.11 RESIDENTIAL PROVIDERS.] (a) Services must be provided by 287.12 qualified staff as defined in section 256B.0623, subdivision 5, 287.13 who are trained and supervised according to section 256B.0623, 287.14 subdivision 6, except that mental health rehabilitation workers 287.15 acting as overnight staff are not required to comply with 287.16 section 256B.0623, subdivision 5, clause (3)(iv). 287.17 (b) The clinical supervisor must be an active member of the 287.18 treatment team. The treatment team must meet with the clinical 287.19 supervisor at least weekly to discuss recipients' progress and 287.20 make rapid adjustments to meet recipients' needs. The team 287.21 meeting shall include recipient-specific case reviews and 287.22 general treatment discussions among team members. 287.23 Recipient-specific case reviews and planning must be documented 287.24 in the individual recipient's treatment record. 287.25 (c) Treatment staff must have prompt access in person or by 287.26 telephone to a mental health practitioner or mental health 287.27 professional. The provider must have the capacity to promptly 287.28 and appropriately respond to emergent needs and make any 287.29 necessary staffing adjustments to assure the health and safety 287.30 of recipients. 287.31 (d) The initial functional assessment must be completed 287.32 within ten days of intake and updated at least every three 287.33 months or prior to discharge from the service, whichever comes 287.34 first. 287.35 (e) The initial individual treatment plan must be completed 287.36 within ten days of intake and reviewed and updated at least 288.1 monthly with the recipient. 288.2 Subd. 6. [ADDITIONAL STANDARDS APPLICABLE ONLY TO 288.3 INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 288.4 SERVICES.] (a) The provider of intensive residential services 288.5 must have sufficient staff to provide 24 hour per day coverage 288.6 to deliver the rehabilitative services described in the 288.7 treatment plan and to safely supervise and direct the activities 288.8 of recipients given the recipient's level of behavioral and 288.9 psychiatric stability, cultural needs, and vulnerability. The 288.10 provider must have the capacity within the facility to provide 288.11 integrated services for chemical dependency, illness management 288.12 services, and family education when appropriate. 288.13 (b) At a minimum: 288.14 (1) staff must be available and provide direction and 288.15 supervision whenever recipients are present in the facility; 288.16 (2) staff must remain awake during all work hours; 288.17 (3) there must be a staffing ratio of at least one to eight 288.18 recipients for each day and evening shift. If more than eight 288.19 recipients are present at the residential site, there must be a 288.20 minimum of two staff during day and evening shifts, one of whom 288.21 must be a mental health practitioner or mental health 288.22 professional; 288.23 (4) if services are provided to recipients who need the 288.24 services of a medical professional, the provider shall assure 288.25 that these services are provided either by the provider's own 288.26 medical staff or through referral to a medical professional; and 288.27 (5) the provider must employ or contract with a licensed 288.28 registered nurse to ensure the effectiveness and safety of 288.29 medication administration in the facility. 288.30 Subd. 7. [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 288.31 SERVICES.] The standards in this subdivision apply to intensive 288.32 nonresidential rehabilitative mental health services. 288.33 (1) The treatment team must use team treatment, not an 288.34 individual treatment model. 288.35 (2) The clinical supervisor must function as a practicing 288.36 clinician at least on a part-time basis. 289.1 (3) The staffing ratio must not exceed ten recipients to 289.2 one full-time equivalent treatment team position. 289.3 (4) At a minimum, the team must operate Monday through 289.4 Friday, eight hours per day, and be on call all other hours. 289.5 (5) The treatment team must actively and assertively engage 289.6 and reach out to the recipient's family members and significant 289.7 others, after obtaining the recipient's permission. 289.8 (6) The treatment team must establish ongoing communication 289.9 and collaboration between the team, family, and significant 289.10 others and educate the family and significant others about 289.11 mental illness, symptom management, and the family's role in 289.12 treatment. 289.13 (7) The treatment team must provide interventions to 289.14 promote positive interpersonal relationships. 289.15 Subd. 8. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 289.16 REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 289.17 residential and nonresidential services in this section shall be 289.18 based on one daily rate per provider inclusive of the following 289.19 services received by an eligible recipient in a given calendar 289.20 day: all rehabilitative services under section 256B.0623 and 289.21 crisis stabilization services under section 256B.0624. 289.22 (b) Payment will not be made to more than one entity for 289.23 each recipient for services provided under this section on a 289.24 given day. If services under this section are provided by a 289.25 team that includes staff from more than one entity, the team 289.26 must determine how to distribute the payment among the members. 289.27 (c) The host county shall recommend to the commissioner one 289.28 rate for each entity that will bill medical assistance for 289.29 services under this section. In developing this rate, the host 289.30 county shall consider and document: 289.31 (1) the cost for similar services in the local trade area; 289.32 (2) actual costs incurred by entities providing the 289.33 services; 289.34 (3) the intensity and frequency of services to be provided 289.35 to each recipient; 289.36 (4) the degree to which recipients will receive services 290.1 other than services under this section; 290.2 (5) the costs of other services, such as case management, 290.3 that will be separately reimbursed; and 290.4 (6) input from the local planning process authorized by the 290.5 adult mental health initiative under section 245.4661, regarding 290.6 recipients' service needs. 290.7 (d) The rate for intensive rehabilitative mental health 290.8 services must exclude room and board, as defined in section 290.9 256I.03, subdivision 6, and services not covered under this 290.10 section, such as case management, physician services, partial 290.11 hospitalization, home care, and inpatient services. The 290.12 county's recommendation shall specify the period for which the 290.13 rate will be applicable, not to exceed two years. 290.14 (e) When services under this section are provided by an 290.15 assertive community team, case management functions must be an 290.16 integral part of the team. The county must allocate costs which 290.17 are reimbursable under this section versus costs which are 290.18 reimbursable through case management or other reimbursement, so 290.19 that payment is not duplicated. 290.20 (f) The rate for a provider must not exceed the rate 290.21 charged by that provider for the same service to other payors. 290.22 (g) The commissioner shall approve or reject the county's 290.23 rate recommendation, based on the commissioner's own analysis of 290.24 the criteria in paragraph (c). 290.25 Subd. 9. [PROVIDER ENROLLMENT; RATE SETTING FOR 290.26 COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 290.27 to provide services under this section shall apply directly to 290.28 the commissioner for enrollment and rate setting. In this case, 290.29 a county contract is not required and the commissioner shall 290.30 perform the program review and rate setting duties which would 290.31 otherwise be required of counties under this section. 290.32 Subd. 10. [PROVIDER ENROLLMENT; RATE SETTING FOR 290.33 SPECIALIZED PROGRAM.] A provider proposing to serve a 290.34 subpopulation of eligible recipients may bypass the county 290.35 approval procedures in this section and receive approval for 290.36 provider enrollment and rate setting directly from the 291.1 commissioner under the following circumstances: 291.2 (1) the provider demonstrates that the subpopulation to be 291.3 served requires a specialized program which is not available 291.4 from county-approved entities; and 291.5 (2) the subpopulation to be served is of such a low 291.6 incidence that it is not feasible to develop a program serving a 291.7 single county or regional group of counties. 291.8 For providers meeting the criteria in clauses (1) and (2), 291.9 the commissioner shall perform the program review and rate 291.10 setting duties which would otherwise be required of counties 291.11 under this section. 291.12 Sec. 10. Minnesota Statutes 2002, section 256B.0625, 291.13 subdivision 23, is amended to read: 291.14 Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance 291.15 covers day treatment services as specified in sections 245.462, 291.16 subdivision 8, and 245.4871, subdivision 10, that are provided 291.17 under contract with the county board. Medical assistance 291.18 coverage for day treatment for adults ends on June 30, 2005. 291.19 Sec. 11. Minnesota Statutes 2002, section 256B.19, 291.20 subdivision 1, is amended to read: 291.21 Subdivision 1. [DIVISION OF COST.] The state and county 291.22 share of medical assistance costs not paid by federal funds 291.23 shall be as follows: 291.24 (1) beginning January 1, 1992, 50 percent state funds and 291.25 50 percent county funds for the cost of placement of severely 291.26 emotionally disturbed children in regional treatment centers; 291.27and291.28 (2) beginning January 1, 2003, 80 percent state funds and 291.29 20 percent county funds for the costs of nursing facility 291.30 placements of persons with disabilities under the age of 65 that 291.31 have exceeded 90 days. This clause shall be subject to chapter 291.32 256G and shall not apply to placements in facilities not 291.33 certified to participate in medical assistance.; 291.34 (3) beginning January 1, 2004, 80 percent state funds and 291.35 20 percent county funds for the costs of placements that have 291.36 exceeded 90 days in intermediate care facilities for persons 292.1 with mental retardation or a related condition that have seven 292.2 or more beds. This provision includes pass-through payments 292.3 made under section 256B.5015; and 292.4 (4) beginning January 1, 2004, when state funds are used to 292.5 pay for a nursing facility placement due to the facility's 292.6 status as an institution for mental diseases (IMD), the county 292.7 shall pay 20 percent of the nonfederal share of costs that have 292.8 exceeded 90 days. This clause is subject to chapter 256G. 292.9 For counties that participate in a Medicaid demonstration 292.10 project under sections 256B.69 and 256B.71, the division of the 292.11 nonfederal share of medical assistance expenses for payments 292.12 made to prepaid health plans or for payments made to health 292.13 maintenance organizations in the form of prepaid capitation 292.14 payments, this division of medical assistance expenses shall be 292.15 95 percent by the state and five percent by the county of 292.16 financial responsibility. 292.17 In counties where prepaid health plans are under contract 292.18 to the commissioner to provide services to medical assistance 292.19 recipients, the cost of court ordered treatment ordered without 292.20 consulting the prepaid health plan that does not include 292.21 diagnostic evaluation, recommendation, and referral for 292.22 treatment by the prepaid health plan is the responsibility of 292.23 the county of financial responsibility. 292.24 Sec. 12. Minnesota Statutes 2002, section 256B.501, 292.25 subdivision 1, is amended to read: 292.26 Subdivision 1. [DEFINITIONS.] For the purposes of this 292.27 section, the following terms have the meaning given them. 292.28 (a) "Commissioner" means the commissioner of human services. 292.29 (b) "Facility" means a facility licensed as a mental 292.30 retardation residential facility under section 252.28, licensed 292.31 as a supervised living facility under chapter 144, and certified 292.32 as an intermediate care facility for persons with mental 292.33 retardation or related conditions. The term does not include a 292.34 state regional treatment center. 292.35 (c) "Services during the day" means services or supports 292.36 provided to a person that enables the person to be fully 293.1 integrated into the community. Services during the day may 293.2 include a variety of supports to enable the person to exercise 293.3 choices for community integration and inclusion activities. 293.4 Services during the day may include, but are not limited to: 293.5 supported work, support during community adult education, 293.6 community volunteer opportunities, adult day care, recreational 293.7 activities, and other individualized integrated supports. 293.8 (d) "Waivered service" means home or community-based 293.9 service authorized under United States Code, title 42, section 293.10 1396n(c), as amended through December 31, 1987, and defined in 293.11 the Minnesota state plan for the provision of medical assistance 293.12 services. Waivered services include, at a minimum, case 293.13 management, family training and support, developmental training 293.14 homes, supervised living arrangements, semi-independent living 293.15 services, respite care, and training and habilitation services. 293.16 Sec. 13. Minnesota Statutes 2002, section 256B.501, is 293.17 amended by adding a subdivision to read: 293.18 Subd. 3m. [SERVICES DURING THE DAY.] When establishing a 293.19 rate for services during the day, the commissioner shall ensure 293.20 that these services comply with active treatment requirements 293.21 for persons residing in an ICF/MR as defined under federal 293.22 regulations. 293.23 Sec. 14. Minnesota Statutes 2002, section 256B.5012, is 293.24 amended by adding a subdivision to read: 293.25 Subd. 5. [PAYMENT RATE REDUCTION.] (a) Effective July 1, 293.26 2003, the commissioner shall reduce payment rates for each 293.27 facility reimbursed under this section by decreasing the total 293.28 operating payment rate for intermediate care facilities for the 293.29 mentally retarded by four percent. 293.30 (b) For each facility, the commissioner shall apply the 293.31 adjustment using the percentage specified in paragraph (a) 293.32 multiplied by the total payment rate, excluding the 293.33 property-related payment rate, in effect on June 30. 293.34 (c) A facility whose payment rates are governed by closure 293.35 agreements, receivership agreements, or Minnesota Rules, part 293.36 9553.0075, is not eligible for an adjustment otherwise granted 294.1 under this subdivision. 294.2 Sec. 15. Minnesota Statutes 2002, section 256B.5015, is 294.3 amended to read: 294.4 256B.5015 [PASS-THROUGH OFTRAINING AND HABILITATIONOTHER 294.5 SERVICES COSTS.] 294.6 Subdivision 1. [DAY TRAINING AND HABILITATION SERVICES.] 294.7 Day training and habilitation services costs shall be paid as a 294.8 pass-through payment at the lowest rate paid for the comparable 294.9 services at that site under sections 252.40 to 252.46. The 294.10 pass-through payments for training and habilitation services 294.11 shall be paid separately by the commissioner and shall not be 294.12 included in the computation of the ICF/MR facility total payment 294.13 rate. 294.14 Subd. 2. [SERVICES DURING THE DAY.] Services during the 294.15 day, as defined in section 256B.501, shall be paid as a 294.16 pass-through payment no later than January 1, 2004. The 294.17 commissioner shall establish rates for these services at levels 294.18 that do not exceed 75 percent of a recipient's day training and 294.19 habilitation costs prior to the service change. 294.20 When establishing a rate for these services, the 294.21 commissioner shall also consider: an individual recipient's 294.22 needs as identified in the individualized service plan and the 294.23 person's need for active treatment as defined under federal 294.24 regulations. The pass-through payments for services during the 294.25 day may be paid separately by the commissioner and may be 294.26 included in the computation of the ICF/MR facility total payment 294.27 rate. 294.28 Sec. 16. Minnesota Statutes 2002, section 256E.081, 294.29 subdivision 3, is amended to read: 294.30 Subd. 3. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 294.31 county has made reasonable efforts, as defined in subdivision 2, 294.32 to comply with all social services administrative rule 294.33 requirements and is unable to meet all requirements, the county 294.34 must provide services according to an amended community social 294.35 services plan developed by the county and approved by the 294.36 commissioner under section 256E.09, subdivision 6. The plan 295.1 must identify for the remainder of the calendar year the social 295.2 services administrative rule requirements the county shall 295.3 comply with within its fiscal limitations and identify the 295.4 social services administrative rule requirements the county will 295.5 not comply with due to fiscal limitations. The plan must 295.6 specify how the county intends to provide services required by 295.7 federal law or state statute, including but not limited to: 295.8 (1) providing services needed to protect children and 295.9 vulnerable adults from maltreatment, abuse, and neglect; 295.10 (2) providing emergency and crisis services needed to 295.11 protect clients from physical, emotional, or psychological harm; 295.12 (3) assessing and documenting the needs of persons applying 295.13 for services; 295.14 (4) providing case management services to developmentally 295.15 disabled clients, adults with serious and persistent mental 295.16 illness, and children with severe emotional disturbances; 295.17 (5) providingday training and habilitation services for295.18persons with developmental disabilities andfamily community 295.19 support services for children with severe emotional 295.20 disturbances; 295.21 (6) providing subacute detoxification services; 295.22 (7) providing public guardianship services; and 295.23 (8) fulfilling licensing responsibilities delegated to the 295.24 county by the commissioner under section 245A.16. 295.25 Sec. 17. [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 295.26 FACILITY STAYS.] 295.27 Beginning January 1, 2004, if group residential housing is 295.28 used to pay for a nursing facility placement due to the 295.29 facility's status as an Institution for Mental Diseases, the 295.30 county is liable for 20 percent of the nonfederal share of costs 295.31 for persons under the age of 65 that have exceeded 90 days. 295.32 Sec. 18. [REVISOR'S INSTRUCTION.] 295.33 For sections in Minnesota Statutes and Minnesota Rules 295.34 affected by the repealed sections in this article, the revisor 295.35 shall delete internal cross-references where appropriate and 295.36 make changes necessary to correct the punctuation, grammar, or 296.1 structure of the remaining text and preserve its meaning. 296.2 Sec. 19. [REPEALER.] 296.3 (a) Minnesota Statutes 2002, sections 254A.17, subdivision 296.4 3; 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; 296.5 256B.0955; and 256B.5013, subdivision 4, are repealed July 1, 296.6 2003. 296.7 (b) Minnesota Statutes 2002, section 245.4712, subdivision 296.8 2, is repealed July 1, 2005. 296.9 (c) Laws 2001, First Special Session chapter 9, article 13, 296.10 section 24, is repealed July 1, 2003. 296.11 ARTICLE 5 296.12 CHILDREN'S SERVICES 296.13 Section 1. Minnesota Statutes 2002, section 144.551, 296.14 subdivision 1, is amended to read: 296.15 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 296.16 (a) The following construction or modification may not be 296.17 commenced: 296.18 (1) any erection, building, alteration, reconstruction, 296.19 modernization, improvement, extension, lease, or other 296.20 acquisition by or on behalf of a hospital that increases the bed 296.21 capacity of a hospital, relocates hospital beds from one 296.22 physical facility, complex, or site to another, or otherwise 296.23 results in an increase or redistribution of hospital beds within 296.24 the state; and 296.25 (2) the establishment of a new hospital. 296.26 (b) This section does not apply to: 296.27 (1) construction or relocation within a county by a 296.28 hospital, clinic, or other health care facility that is a 296.29 national referral center engaged in substantial programs of 296.30 patient care, medical research, and medical education meeting 296.31 state and national needs that receives more than 40 percent of 296.32 its patients from outside the state of Minnesota; 296.33 (2) a project for construction or modification for which a 296.34 health care facility held an approved certificate of need on May 296.35 1, 1984, regardless of the date of expiration of the 296.36 certificate; 297.1 (3) a project for which a certificate of need was denied 297.2 before July 1, 1990, if a timely appeal results in an order 297.3 reversing the denial; 297.4 (4) a project exempted from certificate of need 297.5 requirements by Laws 1981, chapter 200, section 2; 297.6 (5) a project involving consolidation of pediatric 297.7 specialty hospital services within the Minneapolis-St. Paul 297.8 metropolitan area that would not result in a net increase in the 297.9 number of pediatric specialty hospital beds among the hospitals 297.10 being consolidated; 297.11 (6) a project involving the temporary relocation of 297.12 pediatric-orthopedic hospital beds to an existing licensed 297.13 hospital that will allow for the reconstruction of a new 297.14 philanthropic, pediatric-orthopedic hospital on an existing site 297.15 and that will not result in a net increase in the number of 297.16 hospital beds. Upon completion of the reconstruction, the 297.17 licenses of both hospitals must be reinstated at the capacity 297.18 that existed on each site before the relocation; 297.19 (7) the relocation or redistribution of hospital beds 297.20 within a hospital building or identifiable complex of buildings 297.21 provided the relocation or redistribution does not result in: 297.22 (i) an increase in the overall bed capacity at that site; (ii) 297.23 relocation of hospital beds from one physical site or complex to 297.24 another; or (iii) redistribution of hospital beds within the 297.25 state or a region of the state; 297.26 (8) relocation or redistribution of hospital beds within a 297.27 hospital corporate system that involves the transfer of beds 297.28 from a closed facility site or complex to an existing site or 297.29 complex provided that: (i) no more than 50 percent of the 297.30 capacity of the closed facility is transferred; (ii) the 297.31 capacity of the site or complex to which the beds are 297.32 transferred does not increase by more than 50 percent; (iii) the 297.33 beds are not transferred outside of a federal health systems 297.34 agency boundary in place on July 1, 1983; and (iv) the 297.35 relocation or redistribution does not involve the construction 297.36 of a new hospital building; 298.1 (9) a construction project involving up to 35 new beds in a 298.2 psychiatric hospital in Rice county that primarily serves 298.3 adolescents and that receives more than 70 percent of its 298.4 patients from outside the state of Minnesota; 298.5 (10) a project to replace a hospital or hospitals with a 298.6 combined licensed capacity of 130 beds or less if: (i) the new 298.7 hospital site is located within five miles of the current site; 298.8 and (ii) the total licensed capacity of the replacement 298.9 hospital, either at the time of construction of the initial 298.10 building or as the result of future expansion, will not exceed 298.11 70 licensed hospital beds, or the combined licensed capacity of 298.12 the hospitals, whichever is less; 298.13 (11) the relocation of licensed hospital beds from an 298.14 existing state facility operated by the commissioner of human 298.15 services to a new or existing facility, building, or complex 298.16 operated by the commissioner of human services; from one 298.17 regional treatment center site to another; or from one building 298.18 or site to a new or existing building or site on the same 298.19 campus; 298.20 (12) the construction or relocation of hospital beds 298.21 operated by a hospital having a statutory obligation to provide 298.22 hospital and medical services for the indigent that does not 298.23 result in a net increase in the number of hospital beds; 298.24 (13) a construction project involving the addition of up to 298.25 31 new beds in an existing nonfederal hospital in Beltrami 298.26 county;or298.27 (14) a construction project involving the addition of up to 298.28 eight new beds in an existing nonfederal hospital in Otter Tail 298.29 county with 100 licensed acute care beds; or 298.30 (15) a project for the construction or relocation of up to 298.31 20 hospital beds for the operation of up to two psychiatric 298.32 facilities or units for children provided that the operation of 298.33 the facilities or units have received the approval of the 298.34 commissioner of human services. 298.35 Sec. 2. Minnesota Statutes 2002, section 245.4874, is 298.36 amended to read: 299.1 245.4874 [DUTIES OF COUNTY BOARD.] 299.2 The county board in each county shall use its share of 299.3 mental health and Community Social Services Act funds allocated 299.4 by the commissioner according to a biennial children's mental 299.5 health component of the community social services plan required 299.6 under section 245.4888, and approved by the commissioner. The 299.7 county board must: 299.8 (1) develop a system of affordable and locally available 299.9 children's mental health services according to sections 245.487 299.10 to 245.4888; 299.11 (2) establish a mechanism providing for interagency 299.12 coordination as specified in section 245.4875, subdivision 6; 299.13 (3) develop a biennial children's mental health component 299.14 of the community social services plan required under section 299.15 256E.09 which considers the assessment of unmet needs in the 299.16 county as reported by the local children's mental health 299.17 advisory council under section 245.4875, subdivision 5, 299.18 paragraph (b), clause (3). The county shall provide, upon 299.19 request of the local children's mental health advisory council, 299.20 readily available data to assist in the determination of unmet 299.21 needs; 299.22 (4) assure that parents and providers in the county receive 299.23 information about how to gain access to services provided 299.24 according to sections 245.487 to 245.4888; 299.25 (5) coordinate the delivery of children's mental health 299.26 services with services provided by social services, education, 299.27 corrections, health, and vocational agencies to improve the 299.28 availability of mental health services to children and the 299.29 cost-effectiveness of their delivery; 299.30 (6) assure that mental health services delivered according 299.31 to sections 245.487 to 245.4888 are delivered expeditiously and 299.32 are appropriate to the child's diagnostic assessment and 299.33 individual treatment plan; 299.34 (7) provide the community with information about predictors 299.35 and symptoms of emotional disturbances and how to access 299.36 children's mental health services according to sections 245.4877 300.1 and 245.4878; 300.2 (8) provide for case management services to each child with 300.3 severe emotional disturbance according to sections 245.486; 300.4 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, 300.5 and 5; 300.6 (9) provide for screening of each child under section 300.7 245.4885 upon admission to a residential treatment facility, 300.8 acute care hospital inpatient treatment, or informal admission 300.9 to a regional treatment center; 300.10 (10) prudently administer grants and purchase-of-service 300.11 contracts that the county board determines are necessary to 300.12 fulfill its responsibilities under sections 245.487 to 245.4888; 300.13 (11) assure that mental health professionals, mental health 300.14 practitioners, and case managers employed by or under contract 300.15 to the county to provide mental health services are qualified 300.16 under section 245.4871; 300.17 (12) assure that children's mental health services are 300.18 coordinated with adult mental health services specified in 300.19 sections 245.461 to 245.486 so that a continuum of mental health 300.20 services is available to serve persons with mental illness, 300.21 regardless of the person's age;and300.22 (13) assure that culturally informed mental health 300.23 consultants are used as necessary to assist the county board in 300.24 assessing and providing appropriate treatment for children of 300.25 cultural or racial minority heritage; and 300.26 (14) arrange for or provide a children's mental health 300.27 screening to a child receiving child protective services or a 300.28 child in out-of-home placement, a child for whom parental rights 300.29 have been terminated, a child alleged or found to be delinquent, 300.30 and a child found to have committed a juvenile petty offense for 300.31 the third or subsequent time, unless a screening has been 300.32 performed within the previous 180 days, or the child is 300.33 currently under the care of a mental health professional. The 300.34 screening shall be conducted with a screening instrument 300.35 approved by the commissioner of human services and shall be 300.36 conducted by a mental health practitioner as defined in section 301.1 245.4871, subdivision 26, or a probation officer or local social 301.2 services agency staff person who is trained in the use of the 301.3 screening instrument. If the screen indicates a need for 301.4 assessment, the child's family, or if the family lacks mental 301.5 health insurance, the local social services agency, in 301.6 consultation with the child's family, shall have conducted a 301.7 diagnostic assessment, including a functional assessment, as 301.8 defined in section 245.4871. 301.9 Sec. 3. Minnesota Statutes 2002, section 256B.0625, 301.10 subdivision 20, is amended to read: 301.11 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 301.12 extent authorized by rule of the state agency, medical 301.13 assistance covers case management services to persons with 301.14 serious and persistent mental illness and children with severe 301.15 emotional disturbance. Services provided under this section 301.16 must meet the relevant standards in sections 245.461 to 301.17 245.4888, the Comprehensive Adult and Children's Mental Health 301.18 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 301.19 9505.0322, excluding subpart 10. 301.20 (b) Entities meeting program standards set out in rules 301.21 governing family community support services as defined in 301.22 section 245.4871, subdivision 17, are eligible for medical 301.23 assistance reimbursement for case management services for 301.24 children with severe emotional disturbance when these services 301.25 meet the program standards in Minnesota Rules, parts 9520.0900 301.26 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 301.27 (c) Medical assistance and MinnesotaCare payment for mental 301.28 health case management shall be made on a monthly basis. In 301.29 order to receive payment for an eligible child, the provider 301.30 must document at least a face-to-face contact with the child, 301.31 the child's parents, or the child's legal representative. To 301.32 receive payment for an eligible adult, the provider must 301.33 document: 301.34 (1) at least a face-to-face contact with the adult or the 301.35 adult's legal representative; or 301.36 (2) at least a telephone contact with the adult or the 302.1 adult's legal representative and document a face-to-face contact 302.2 with the adult or the adult's legal representative within the 302.3 preceding two months. 302.4 (d) Payment for mental health case management provided by 302.5 county or state staff shall be based on the monthly rate 302.6 methodology under section 256B.094, subdivision 6, paragraph 302.7 (b), with separate rates calculated for child welfare and mental 302.8 health, and within mental health, separate rates for children 302.9 and adults. 302.10 (e) Payment for mental health case management provided by 302.11 Indian health services or by agencies operated by Indian tribes 302.12 may be made according to this section or other relevant 302.13 federally approved rate setting methodology. 302.14 (f) Payment for mental health case management provided by 302.15 vendors who contract with a county or Indian tribe shall be 302.16 based on a monthly rate negotiated by the host county or tribe. 302.17 The negotiated rate must not exceed the rate charged by the 302.18 vendor for the same service to other payers. If the service is 302.19 provided by a team of contracted vendors, the county or tribe 302.20 may negotiate a team rate with a vendor who is a member of the 302.21 team. The team shall determine how to distribute the rate among 302.22 its members. No reimbursement received by contracted vendors 302.23 shall be returned to the county or tribe, except to reimburse 302.24 the county or tribe for advance funding provided by the county 302.25 or tribe to the vendor. 302.26 (g) If the service is provided by a team which includes 302.27 contracted vendors, tribal staff, and county or state staff, the 302.28 costs for county or state staff participation in the team shall 302.29 be included in the rate for county-provided services. In this 302.30 case, the contracted vendor, the tribal agency, and the county 302.31 may each receive separate payment for services provided by each 302.32 entity in the same month. In order to prevent duplication of 302.33 services, each entity must document, in the recipient's file, 302.34 the need for team case management and a description of the roles 302.35 of the team members. 302.36 (h) The commissioner shall calculate the nonfederal share 303.1 of actual medical assistance and general assistance medical care 303.2 payments for each county, based on the higher of calendar year 303.3 1995 or 1996, by service date, project that amount forward to 303.4 1999, and transfer one-half of the result from medical 303.5 assistance and general assistance medical care to each county's 303.6 mental health grants under sections 245.4886 and 256E.12 for 303.7 calendar year 1999. The annualized minimum amount added to each 303.8 county's mental health grant shall be $3,000 per year for 303.9 children and $5,000 per year for adults. The commissioner may 303.10 reduce the statewide growth factor in order to fund these 303.11 minimums. The annualized total amount transferred shall become 303.12 part of the base for future mental health grants for each county. 303.13 (i)Any net increase in revenue to the county or tribe as a303.14result of the change in this section must be used to provide303.15expanded mental health services as defined in sections 245.461303.16to 245.4888, the Comprehensive Adult and Children's Mental303.17Health Acts, excluding inpatient and residential treatment. For303.18adults, increased revenue may also be used for services and303.19consumer supports which are part of adult mental health projects303.20approved under Laws 1997, chapter 203, article 7, section 25.303.21For children, increased revenue may also be used for respite303.22care and nonresidential individualized rehabilitation services303.23as defined in section 245.492, subdivisions 17 and 23.303.24"Increased revenue" has the meaning given in Minnesota Rules,303.25part 9520.0903, subpart 3.303.26(j)Notwithstanding section 256B.19, subdivision 1, the 303.27 nonfederal share of costs for mental health case management 303.28 shall be provided by the recipient's county of responsibility, 303.29 as defined in sections 256G.01 to 256G.12, from sources other 303.30 than federal funds or funds used to match other federal funds. 303.31 If the service is provided by a tribal agency, the nonfederal 303.32 share, if any, shall be provided by the recipient's tribe. 303.33(k)(j) The commissioner may suspend, reduce, or terminate 303.34 the reimbursement to a provider that does not meet the reporting 303.35 or other requirements of this section. The county of 303.36 responsibility, as defined in sections 256G.01 to 256G.12, or, 304.1 if applicable, the tribal agency, is responsible for any federal 304.2 disallowances. The county or tribe may share this 304.3 responsibility with its contracted vendors. 304.4(l)(k) The commissioner shall set aside a portion of the 304.5 federal funds earned under this section to repay the special 304.6 revenue maximization account under section 256.01, subdivision 304.7 2, clause (15). The repayment is limited to: 304.8 (1) the costs of developing and implementing this section; 304.9 and 304.10 (2) programming the information systems. 304.11(m)(l) Payments to counties and tribal agencies for case 304.12 management expenditures under this section shall only be made 304.13 from federal earnings from services provided under this 304.14 section. Payments to county-contracted vendors shall include 304.15 both the federal earnings and the county share. 304.16(n)(m) Notwithstanding section 256B.041, county payments 304.17 for the cost of mental health case management services provided 304.18 by county or state staff shall not be made to the state 304.19 treasurer. For the purposes of mental health case management 304.20 services provided by county or state staff under this section, 304.21 the centralized disbursement of payments to counties under 304.22 section 256B.041 consists only of federal earnings from services 304.23 provided under this section. 304.24(o)(n) Case management services under this subdivision do 304.25 not include therapy, treatment, legal, or outreach services. 304.26(p)(o) If the recipient is a resident of a nursing 304.27 facility, intermediate care facility, or hospital, and the 304.28 recipient's institutional care is paid by medical assistance, 304.29 payment for case management services under this subdivision is 304.30 limited to the last 180 days of the recipient's residency in 304.31 that facility and may not exceed more than six months in a 304.32 calendar year. 304.33(q)(p) Payment for case management services under this 304.34 subdivision shall not duplicate payments made under other 304.35 program authorities for the same purpose. 304.36(r)(q) By July 1, 2000, the commissioner shall evaluate 305.1 the effectiveness of the changes required by this section, 305.2 including changes in number of persons receiving mental health 305.3 case management, changes in hours of service per person, and 305.4 changes in caseload size. 305.5(s)(r) For each calendar year beginning with the calendar 305.6 year 2001, the annualized amount of state funds for each county 305.7 determined under paragraph (h) shall be adjusted by the county's 305.8 percentage change in the average number of clients per month who 305.9 received case management under this section during the fiscal 305.10 year that ended six months prior to the calendar year in 305.11 question, in comparison to the prior fiscal year. 305.12(t)(s) For counties receiving the minimum allocation of 305.13 $3,000 or $5,000 described in paragraph (h), the adjustment in 305.14 paragraph(s)(r) shall be determined so that the county 305.15 receives the higher of the following amounts: 305.16 (1) a continuation of the minimum allocation in paragraph 305.17 (h); or 305.18 (2) an amount based on that county's average number of 305.19 clients per month who received case management under this 305.20 section during the fiscal year that ended six months prior to 305.21 the calendar year in question, times the average statewide grant 305.22 per person per month for counties not receiving the minimum 305.23 allocation. 305.24(u)(t) The adjustments in paragraphs(s)(r) and 305.25(t)(s) shall be calculated separately for children and adults. 305.26 Sec. 4. Minnesota Statutes 2002, section 256B.0625, 305.27 subdivision 23, is amended to read: 305.28 Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance 305.29 covers day treatment services for adults as specified in 305.30sectionssection 245.462, subdivision 8,and 245.4871,305.31subdivision 10,that are provided under contract with the county 305.32 board. Medical assistance covers day treatment services for 305.33 children as specified under section 256B.0943. 305.34 [EFFECTIVE DATE.] This section is effective July 1, 2004. 305.35 Sec. 5. Minnesota Statutes 2002, section 256B.0625, is 305.36 amended by adding a subdivision to read: 306.1 Subd. 35a. [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 306.2 SERVICES.] Medical assistance covers children's mental health 306.3 crisis response services according to section 256B.0944. 306.4 [EFFECTIVE DATE.] This section is effective July 1, 2004. 306.5 Sec. 6. Minnesota Statutes 2002, section 256B.0625, is 306.6 amended by adding a subdivision to read: 306.7 Subd. 35b. [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 306.8 Medical assistance covers children's therapeutic services and 306.9 supports according to section 256B.0943. 306.10 Sec. 7. Minnesota Statutes 2002, section 256B.0625, is 306.11 amended by adding a subdivision to read: 306.12 Subd. 45. [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 306.13 YEARS OF AGE.] Medical assistance covers subacute psychiatric 306.14 care for person under 21 years of age when: 306.15 (1) the services meet the requirements of Code of Federal 306.16 Regulations, title 42, section 440.160; 306.17 (2) the facility is accredited as a psychiatric treatment 306.18 facility by the joint commission on accreditation of healthcare 306.19 organizations, the commission on accreditation of rehabilitation 306.20 facilities, or the council on accreditation; and 306.21 (3) the facility is licensed by the commissioner of health 306.22 under section 144.50. 306.23 Sec. 8. [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 306.24 SUPPORTS.] 306.25 Subdivision 1. [SCOPE.] Children's therapeutic services 306.26 and supports are an array of mental health services for children 306.27 who require different therapeutic and rehabilitative levels of 306.28 intervention. 306.29 Subd. 2. [DEFINITIONS.] For the purposes of this section, 306.30 the following terms have the meanings given them. 306.31 (a) [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 306.32 "Children's therapeutic services and supports" means the array 306.33 of mental health services for children who require different 306.34 therapeutic and rehabilitative levels of intervention as 306.35 identified in the client's individual treatment plan through a 306.36 child-centered, family-driven planning process that identifies 307.1 individualized, planned, and culturally appropriate 307.2 interventions. Children's therapeutic services and supports are 307.3 time-limited interventions that are delivered using various 307.4 treatment modalities and combinations of service to reach 307.5 treatment outcomes identified in the individual treatment plan. 307.6 Services such as psychotherapy, skills training, crisis 307.7 assistance, and mental health behavioral aide services may be 307.8 provided to a child in the child's home or a community setting. 307.9 Community settings may include the child's preschool or school, 307.10 the home of a relative of the child, a recreational or leisure 307.11 setting, or a site where the child receives day care. 307.12 (b) [CLINICAL SUPERVISION.] "Clinical supervision" means 307.13 the overall responsibility of the mental health professional as 307.14 defined in section 245.4871, subdivision 27, clauses (1) to (5), 307.15 for the control and direction of individualized treatment 307.16 planning, service delivery, and treatment review for each 307.17 client. The mental health professional who is an enrolled 307.18 Minnesota health care program provider accepts full professional 307.19 responsibility for the actions and decisions of the persons 307.20 supervised, instructs the person in the person's work, and 307.21 oversees or directs the work of the person supervised. 307.22 (c) [COUNTY BOARD.] "County board" means the county board 307.23 of commissioners or board established under sections 402.01 to 307.24 402.10 or 471.59. 307.25 (d) [CRISIS ASSISTANCE.] "Crisis assistance" has the 307.26 meaning given in section 245.4871, subdivision 9a. 307.27 (e) [CULTURAL COMPETENCE OR CULTURALLY COMPETENT.] 307.28 "Cultural competence or culturally competent" means the ability 307.29 and the capacity to respond to the unique needs of an individual 307.30 client that arise from the client's culture and the ability to 307.31 use the person's culture as a resource or tool to assist with 307.32 the intervention and help meet the person's needs. 307.33 (f) [CULTURALLY COMPETENT PROVIDER.] "Culturally competent 307.34 provider" means a service professional who understands, and can 307.35 utilize to the client's benefit, the client's culture either 307.36 because the service professional is of the same cultural or 308.1 ethnic group or because the provider has developed the knowledge 308.2 and skills through training and personal growth to provide 308.3 high-quality service to diverse clients. 308.4 (g) [CULTURALLY SPECIFIC PROVIDER.] "Culturally specific 308.5 provider" means one that is characteristically found or proven 308.6 especially effective within a particular cultural or linguistic 308.7 population. 308.8 (h) [DAY TREATMENT PROGRAM FOR CHILDREN.] "Day treatment 308.9 program for children" means a site-based structured program 308.10 consisting of group psychotherapy for more than three 308.11 individuals and other intensive therapeutic services provided by 308.12 a multidisciplinary team, under the clinical supervision of a 308.13 mental health professional. Day treatment services stabilize 308.14 the client's mental health status while developing and improving 308.15 the client's independent living and socialization skills. The 308.16 goal is to reduce or relieve the effects of mental illness and 308.17 provide training to enable the client to live in the community. 308.18 Day treatment services are not part of inpatient or residential 308.19 treatment services. Day treatment services are provided to a 308.20 client in and by: an outpatient hospital accredited by the 308.21 joint commission on accreditation of health organizations and 308.22 licensed under sections 144.50 to 144.55; a community mental 308.23 health center under section 245.62; or an entity that is under 308.24 contract with the county board to operate a program that meets 308.25 the requirements of sections 245.4712, subdivision 2, 245.4884, 308.26 subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. 308.27 (i) [DIAGNOSTIC ASSESSMENT.] "Diagnostic assessment" has 308.28 the meaning given in section 245.4871, subdivision 11. A 308.29 written evaluation by a mental health professional of a person's 308.30 current life situation and sources of stress, including the 308.31 reasons for referral; history of the person's current mental 308.32 health problem, including important developmental incidents, 308.33 strengths, and vulnerabilities; current functioning and 308.34 symptoms; diagnosis, including whether or not a person has an 308.35 emotional disturbance or serious emotional disturbance; and 308.36 mental health services needed by the client. 309.1 (j) [DIRECTION OF MENTAL HEALTH BEHAVIORAL AIDE.] 309.2 "Direction of mental health behavioral aide" means the 309.3 activities of the mental health professional, or mental health 309.4 practitioner under the clinical supervision of a mental health 309.5 professional, to guide the work of the mental health behavioral 309.6 aide. Direction is based on the individualized treatment plan. 309.7 The person giving direction begins with the goals on the 309.8 individualized treatment plan, and instructs the mental health 309.9 behavioral aide in how to construct therapeutic activities and 309.10 interventions that will lead to goal attainment. The person 309.11 giving direction also instructs the mental health behavioral 309.12 aide about the diagnosis, functional status, and other 309.13 characteristics of the client that are likely to affect service 309.14 delivery. Direction must also include determining whether the 309.15 mental health behavioral aide has the skills to interact with 309.16 the client and the client's family in ways which convey personal 309.17 and cultural respect and that the aide actively solicits 309.18 information relevant to treatment from the family while being 309.19 able to clearly explain the activities the aide is doing with 309.20 the client and their relationship to treatment goals. Direction 309.21 is more didactic than is supervision, and requires the 309.22 professional and practitioner providing direction to 309.23 continuously evaluate the mental health behavioral aide's 309.24 ability to carry out the activities of the individualized 309.25 treatment plan and the individualized behavior plan. 309.26 (k) [EMOTIONAL DISTURBANCE.] "Emotional disturbance" is 309.27 defined in section 245.4871, subdivision 15, and, for persons 309.28 age 18 to 20, a mental illness as defined in section 245.462, 309.29 subdivision 20, paragraph (a). 309.30 (l) [FACE-TO-FACE TIME.] "Face-to-face time" means time 309.31 that a mental health professional, mental health practitioner, 309.32 or mental health behavioral aide spends face-to-face with the 309.33 client and the client's family. This includes time in which the 309.34 provider performs tasks such as obtaining a history, or 309.35 providing service components of children's therapeutic services 309.36 and supports. Activities such as scheduling, maintaining 310.1 clinical records, consulting with others about the client's 310.2 mental health status, preparing reports, receiving clinical 310.3 supervision directly related to the client's psychotherapy 310.4 session, and revising the client's individual treatment plan are 310.5 not included in the time component of services in this section. 310.6 (m) [INDIVIDUAL BEHAVIORAL PLAN.] "Individual behavioral 310.7 plan" means a plan of intervention, treatment, and services 310.8 written by a mental health professional or mental health 310.9 practitioner under the clinical supervision of a mental health 310.10 professional, for a mental health behavioral aide to provide. 310.11 The plan documents instruction for services to be provided by 310.12 the mental health behavioral aide. The individual behavior plan 310.13 must include: 310.14 (1) detailed instructions on the service to be provided; 310.15 (2) time allocated to each service; 310.16 (3) methods of documenting the child's behavior; 310.17 (4) methods of monitoring the progress of the child in 310.18 reaching objectives; and 310.19 (5) goals to increase or decrease targeted behavior as 310.20 identified in the individual treatment plan. 310.21 (n) [INDIVIDUAL TREATMENT PLAN.] "Individual treatment plan" 310.22 has the meaning given in section 245.4871, subdivision 21. 310.23 (o) [MENTAL HEALTH PROFESSIONAL.] "Mental health 310.24 professional" means an individual as defined in section 310.25 245.4871, subdivision 27, clauses (1) to (5), or tribal vendor 310.26 as defined in section 256B.02, subdivision 7, paragraph (b). 310.27 (p) [PRESCHOOL PROGRAM.] "Preschool program" means a day 310.28 program licensed under Minnesota Rules, parts 9503.0005 to 310.29 9503.0175, and enrolled as a children's therapeutic services and 310.30 supports provider to provide a structured program of treatment 310.31 that includes therapeutic and rehabilitative components of 310.32 mental health services provided by a team of multidisciplinary 310.33 staff under the clinical supervision of a mental health 310.34 professional to a child who is at least 33 months old but who 310.35 has not yet reached the first day of kindergarten. The 310.36 structured program of treatment must be available at least one 311.1 day a week for a minimum two-hour time block. The two-hour time 311.2 block may include individual and group psychotherapy and any of 311.3 the following developmentally and therapeutically appropriate 311.4 activities: recreation therapy, socialization therapy, and 311.5 independent living skills therapy to the extent the activities 311.6 are included in the child's individual treatment plan. 311.7 (q) [RESIDENCE.] "Residence" means a person's own home, 311.8 foster home, shelter, or a setting where a child resides that 311.9 does not provide active mental health treatment services as part 311.10 of the per diem charged by a residential program. Residence 311.11 does not include an acute care hospital licensed under chapter 311.12 144, a regional treatment center, nursing home, ICF/MR facility, 311.13 or facilities that provide active treatment services. 311.14 (r) [SKILLS TRAINING.] "Skills training" means individual, 311.15 family, or group skills training designed to improve the basic 311.16 functioning of the child with severe emotional disturbance and 311.17 the child's family in the activities of daily living and 311.18 community living, and to improve the social functioning of the 311.19 child and the child's family in areas important to the child's 311.20 maintaining or reestablishing residency in the community. The 311.21 individual, family, and group skills training must: 311.22 (1) consist of activities designed to promote skill 311.23 development of the child and the child's family in the use of 311.24 age-appropriate daily living skills, interpersonal and family 311.25 relationships, and leisure and recreational services; 311.26 (2) consist of activities which will assist the family in 311.27 improving the family's understanding of normal child development 311.28 and to use parenting skills that will help the child with 311.29 emotional disturbance or severe emotional disturbance achieve 311.30 the goals outlined in the child's individual treatment plan; and 311.31 (3) promote family preservation and unification, promote 311.32 the family's integration with the community, and reduce the use 311.33 of unnecessary out-of-home placement or institutionalization of 311.34 children with emotional disturbance or severe emotional 311.35 disturbance. 311.36 Subd. 3. [COVERED SERVICE COMPONENTS OF CHILDREN'S 312.1 THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 312.2 approval, medical assistance covers medically necessary 312.3 children's therapeutic services and supports as defined in this 312.4 section for clients defined under subdivision 5, by providers 312.5 under subdivisions 7 and 8. The service components of 312.6 children's therapeutic services and supports are: 312.7 (1) individual, family, and group psychotherapy provided by 312.8 a mental health professional; 312.9 (2) individual, family, or group skills training provided 312.10 by a mental health professional or mental health practitioner 312.11 under the clinical supervision of a mental health professional; 312.12 (3) crisis assistance as defined in this section; 312.13 (4) mental health behavioral aide services as defined in 312.14 this section; and 312.15 (5) direction of a mental health behavioral aide or a 312.16 program staff as defined in subdivision 2, paragraph (j). 312.17 (b) Service components may be combined to constitute 312.18 therapeutic programs, including day treatment programs, 312.19 preschool programs, home-based mental health treatment, and 312.20 therapeutic support of foster care. While these programs have 312.21 specific client and provider eligibility requirements and 312.22 service standards, medical assistance only pays for the service 312.23 components listed in paragraph (a). 312.24 Subd. 4. [DIAGNOSIS OF EMOTIONAL DISTURBANCE OR MENTAL 312.25 ILLNESS.] A client's eligibility for mental health services 312.26 under this section shall be based on a diagnostic assessment 312.27 performed within 180 days that documents a diagnosis of 312.28 emotional disturbance or mental illness. A diagnostic 312.29 assessment that includes current diagnoses on all five axes of 312.30 the client's current mental health status and service needs, and 312.31 determines whether the client has a diagnosis of emotional 312.32 disturbance or mental illness, shall be used in the development 312.33 of the individualized treatment plan. A new diagnostic 312.34 assessment must be completed yearly until the client reaches the 312.35 age of 18. The diagnostic assessment is necessary to verify 312.36 diagnosis of emotional disturbance or mental illness, verify the 313.1 need for mental health services, and to structure the individual 313.2 treatment plan. For individuals between the ages of 18 and 21, 313.3 a diagnostic assessment which documents a diagnosis of emotional 313.4 disturbance or mental illness must be performed within 180 313.5 days. For continuing services, an updated assessment must be 313.6 done yearly. Updating means a written summary by a mental 313.7 health professional of the client's current mental health status 313.8 and service needs including current diagnoses on all five axes. 313.9 The client record must include the initial diagnostic assessment 313.10 and all subsequent written updates or diagnostic assessments. 313.11 Subd. 5. [DETERMINATION OF CLIENT ELIGIBILITY.] The 313.12 determination of a client's eligibility to receive children's 313.13 therapeutic services and supports under this section shall be 313.14 based on a diagnostic assessment by a mental health professional 313.15 that documents mental health services are medically necessary to 313.16 address identified disability, functional impairments, and 313.17 individual client needs and goals. An eligible client is a 313.18 child under the age of 18 who has been diagnosed with emotional 313.19 disturbance, or if the individual is between the ages of 18 and 313.20 21, a person who has been diagnosed with mental illness. 313.21 Subd. 6. [DETERMINATION OF PROVIDER ENTITY ELIGIBILITY.] 313.22 (a) The provider entity must complete the provider application 313.23 and certification process as established by the commissioner to 313.24 become a children's therapeutic services and supports provider. 313.25 The process shall determine whether the entity meets the 313.26 applicable requirements in subdivisions 7 to 10. 313.27 Recertification must occur at least every two years. The 313.28 county, tribe, and the commissioner shall be equally responsible 313.29 and accountable for certification. A provider entity must be: 313.30 (1) an Indian health services facility or a facility owned 313.31 and operated by a tribe or tribal organization operating as a 313.32 638 facility under Public Law 93-638 certified by the state; 313.33 (2) a county-operated entity certified by the state; or 313.34 (3) a noncounty entity certified by the provider's host 313.35 county. 313.36 (b) If a noncounty entity seeks to provide services outside 314.1 the host county, it must obtain additional recommendations for 314.2 certification from each county in which it will provide 314.3 services. The additional recommendations must be based on the 314.4 adequacy of the entity's knowledge of that county's local health 314.5 and human service system, and the ability of the entity to 314.6 coordinate its services with the other services available in 314.7 that county. 314.8 (c) The commissioner may intervene at any time and 314.9 decertify providers with cause. The decertification is subject 314.10 to appeal to the state. A county board or tribal government may 314.11 recommend that the state decertify a provider for cause, based 314.12 on the decertification process as established by the 314.13 commissioner. The commissioner shall develop statewide 314.14 procedures for provider certification, including timelines for 314.15 counties to certify qualified providers. 314.16 Subd. 7. [PROVIDER ENTITY ADMINISTRATIVE STANDARDS.] (a) 314.17 An entity shall have written policies and procedures regarding 314.18 organizational operation and service provision. These policies 314.19 and procedures will be reviewed and updated every two years and 314.20 distributed to staff initially and upon each subsequent update. 314.21 (b) An entity's written policies and procedures must 314.22 include: 314.23 (1) organizational policies for clinical, ethical, 314.24 administrative, fiscal, and quality assurance responsibilities 314.25 that include: 314.26 (i) clear lines of accountability, authority, and 314.27 supervision of all clinical personnel and documentation of such 314.28 supervision; 314.29 (ii) a clinical and organizational code of ethics and 314.30 procedures for investigating, reporting, and acting on 314.31 violations of codes, policies, and procedures; 314.32 (iii) data privacy policies regarding record keeping, 314.33 communication, treatment, reporting, and reimbursement that are 314.34 compliant with federal and state laws; 314.35 (iv) fiscal policies and internal control practices; 314.36 (v) a performance measurement system that includes 315.1 monitoring to determine cultural appropriateness as determined 315.2 by the client's culture, beliefs, values, and language as 315.3 identified in the individual treatment plan and family-driven 315.4 services; 315.5 (vi) criteria for preservice and in-service training for 315.6 all staff; 315.7 (vii) criteria to ensure a flexible response to the 315.8 changing and intermittent care needs of a client as identified 315.9 by the client and in the individual treatment plan; 315.10 (viii) service coordination policies and procedures that 315.11 ensure services are coordinated with other service entities or 315.12 providers and others after obtaining the consent of the client. 315.13 If the client is receiving case management or care coordination 315.14 services, services must also be coordinated with the client's 315.15 case manager or care coordinator; 315.16 (ix) criteria for health and safety of clients, employees, 315.17 subcontractors, and volunteers; 315.18 (x) documentation policies regarding client records, 315.19 personnel records, and clinical supervision that are consistent 315.20 with federal and state laws; and 315.21 (xi) provider entities that offer site-based programs such 315.22 as day treatment or therapeutic preschool programs must provide 315.23 staffing and facilities to ensure the health, safety, and 315.24 protection of rights of each client; 315.25 (2) personnel policies for recruiting, hiring, training, 315.26 and retention of individuals providing administrative and 315.27 clinical services that include: 315.28 (i) recruiting procedures that define a process to recruit, 315.29 train, and retain culturally and linguistically competent 315.30 providers; 315.31 (ii) screening criteria for employees, subcontractors, and 315.32 volunteers to determine whether the knowledge, skills, ability, 315.33 and behaviors possessed by the individual are sufficient to 315.34 allow the individual to perform the job correctly and skillfully 315.35 and a process for criminal background checks for all direct 315.36 service providers; 316.1 (iii) the duties, responsibilities, and required minimum 316.2 qualifications of personnel for various positions; 316.3 (iv) standards governing the ethical conduct of staff and 316.4 volunteers; 316.5 (v) standards governing confidentiality of information 316.6 regarding clients and client records; 316.7 (vi) written policies and procedures governing volunteer 316.8 services for entities that utilize volunteers that include 316.9 screening of applicants, training, supervision, and 316.10 documentation of the supervision and liability coverage for 316.11 volunteers; and 316.12 (vii) staff development and evaluation; and 316.13 (3) documentation policies for client records, personnel 316.14 files, and records of fiscal activities where individual 316.15 providers are responsible to document service provisions that 316.16 include: 316.17 (i) for the individual personnel file of each employee or 316.18 subcontractor: the individual's name, birth date, address, and 316.19 telephone number; documentation that the staff member or 316.20 volunteer meets the qualifications required in this section and 316.21 are included in the job description to provide children's 316.22 therapeutic services and supports; evidence of academic degree 316.23 and qualifications; a copy of any required professional license; 316.24 documentation that includes a record of the dates and locations 316.25 of work experience, education, and training; dates of employment 316.26 or volunteer assignments; a copy of required licenses or 316.27 certification; documentation of all clinical supervision or 316.28 direction provided; an annual performance review; a summary of 316.29 on-site service observations and charting review; a criminal 316.30 background check of all direct service staff; any job 316.31 performance recognition and disciplinary actions; any written 316.32 input from individual staff; and documentation of compliance 316.33 with continuing education requirements; and 316.34 (ii) for the individual client file: the client's name, 316.35 address, telephone number, date of birth, primary language, and 316.36 culture or ethnicity; diagnostic assessment and updates; 317.1 individual treatment plan and individual behavior plan, if 317.2 necessary; progress notes documenting delivery of services; 317.3 telephone contacts; and discharge plan. 317.4 Subd. 8. [PROVIDER ENTITY CLINICAL STANDARDS.] An 317.5 effective mental health system of care utilizes diagnostic 317.6 assessment, individualized treatment plan, service delivery, and 317.7 individual treatment plan review that is culturally competent, 317.8 child-centered, and family-driven to achieve maximum benefit for 317.9 the client. The diagnostic assessment must identify acute and 317.10 chronic clinical disorders, co-occurring medical conditions, 317.11 sources of psychological and environmental problems, and 317.12 functional assessment. The functional assessment should clearly 317.13 summarize the individual strengths and needs of the client. The 317.14 individual treatment plan is a written plan of intervention, 317.15 treatment, and services developed on the basis of the diagnostic 317.16 assessment. Service delivery is the process of implementing the 317.17 individual treatment plan in order to achieve the goals and 317.18 objectives identified in it. Individual treatment plan review 317.19 determines the extent to which the services have met the goals 317.20 and objectives and may lead to an updating of the individual 317.21 treatment plan. Clinical policies and procedures will be 317.22 reviewed and updated every two years and distributed to staff 317.23 initially and upon each subsequent update. Services billed 317.24 under children's therapeutic services and supports that are not 317.25 documented according to this subdivision shall be subject to 317.26 monetary recovery by the commissioner. Clinical policies must: 317.27 (1) define policies and procedures for providing or 317.28 obtaining a diagnostic assessment for each client as required in 317.29 this section; 317.30 (2) define policies and procedures for development of an 317.31 individual treatment plan to ensure that individual treatment 317.32 plan standards are met. The individualized treatment plan must: 317.33 (i) be based on the information and outcome of the client's 317.34 diagnostic assessment; 317.35 (ii) be developed no later than the end of the first 317.36 psychotherapy session or skills training after the completion of 318.1 the client's diagnostic assessment by the mental health 318.2 professional who provides the client's psychotherapy, or the 318.3 mental health practitioner under the clinical supervision of a 318.4 mental health professional who is a provider; 318.5 (iii) be developed through a child-centered, family-driven 318.6 planning process that identifies individualized, planned, and 318.7 culturally appropriate interventions that contain specific 318.8 treatment goals and objectives for the client and the client's 318.9 family or foster family and identify service needs; 318.10 (iv) be reviewed at least once every 90 days and revised, 318.11 if necessary. The treatment plan review assesses the client's 318.12 progress and ensures that services and treatment goals continue 318.13 to be necessary and appropriate to the client and the client's 318.14 family or foster family. Revision of the individual treatment 318.15 plan does not require a new diagnostic assessment unless the 318.16 client's mental health status has changed markedly; and 318.17 (v) be signed by the client, as appropriate, the client's 318.18 parent, primary caregiver, or other person authorized by statute 318.19 to consent to mental health services for the child; 318.20 (3) define a service coordination process to ensure 318.21 services are provided in the most appropriate manner to achieve 318.22 maximum benefit to the client if the client is receiving 318.23 services from other providers or provider entities. If it is 318.24 determined that the client has a relationship with other 318.25 providers, the children's therapeutic services and support 318.26 provider shall ensure coordination and nonduplication of 318.27 services consistent with the county board coordination 318.28 procedures under section 245.4881, subdivision 5; 318.29 (4) define caseload size for each direct service provider. 318.30 The caseload of each provider must be of a size that recognizes 318.31 both clients with severe, complex needs and clients with less 318.32 intensive needs. The size of each caseload should reasonably be 318.33 expected to enable the provider to play a very active role in 318.34 service planning, monitoring, and service delivery to meet the 318.35 needs of the client and the client's family as specified in each 318.36 client's individual treatment plan; 319.1 (5) define clinical supervision policies and procedures 319.2 that identify who will provide clinical supervision, who must 319.3 have supervision, how supervision will be implemented, and how 319.4 clinical supervision standards, as developed by the 319.5 commissioner, will be met. The mental health professional must 319.6 document the clinical supervision by cosigning individual 319.7 treatment plans and by making entries in the client's record on 319.8 supervisory activities. Clinical supervision does not include 319.9 authority to make or terminate court-ordered placements of the 319.10 child. A clinical supervisor must be available for urgent 319.11 consultation as needed by the individual client or the clinical 319.12 situation necessitates. Clinical supervision may occur 319.13 individually or in a small group to discuss treatment and review 319.14 of the client's progress toward goals. The focus of supervision 319.15 should be the client's treatment needs and progress and the 319.16 supervised person's ability to effect the change; 319.17 (6) define policies and procedures for providing direction 319.18 to a mental health behavior aide. For provider entities that 319.19 employ mental health behavioral aides, the clinical supervisor 319.20 must be employed by the provider entity to ensure necessary and 319.21 appropriate oversight for the treatment and continuity of care 319.22 for the client. When providing direction, the mental health 319.23 professional or the mental health practitioner under a mental 319.24 health professional supervision must: 319.25 (i) review progress notes prepared by the mental health 319.26 behavioral aide for accuracy and consistency with diagnostic 319.27 assessment, treatment plan, and behavior goals. Progress notes 319.28 must be approved and signed by the mental health professional or 319.29 mental health practitioner; 319.30 (ii) identify changes in treatment strategies, revise the 319.31 individual behavior plan, and communicate treatment instructions 319.32 and methodologies appropriate to ensure that treatment is 319.33 implemented correctly; 319.34 (iii) demonstrate family-friendly behaviors that support 319.35 healthy collaboration among the child, the child's family, and 319.36 providers as treatment is planned and implemented; 320.1 (iv) ensure that the mental health behavioral aide is able 320.2 to effectively communicate with the child, the child's family, 320.3 and the provider; and 320.4 (v) record the results of any evaluation and corrective 320.5 actions taken to modify the work of the mental health behavioral 320.6 aide; 320.7 (7) ensure that documentation standards meet requirements 320.8 of federal and state laws. The individual mental health 320.9 provider must maintain sufficient documentation to support each 320.10 service for which billing is made. Documentation in the 320.11 client's record must include: 320.12 (i) the specific service rendered, including the date, 320.13 time, length, setting, and scope of the mental health service; 320.14 (ii) the name of the person who gave the service; 320.15 (iii) contact, including the name and date of the contact, 320.16 made with other persons interested in the client such as 320.17 representatives of the courts, corrections systems, or schools; 320.18 (iv) any contact made with the client's other mental health 320.19 providers, case manager, family members, primary caregiver, 320.20 legal representative, or, if applicable, the reason the client's 320.21 family members, primary caregiver, or legal representative was 320.22 not contacted; and 320.23 (v) as appropriate, required clinical supervision. 320.24 Documentation must be completed promptly after the provision of 320.25 service. 320.26 Subd. 9. [QUALIFICATIONS OF INDIVIDUAL AND TEAM 320.27 PROVIDERS.] Children's therapeutic services and supports are 320.28 provided by individual or team providers working within the 320.29 scope of the provider's practice or qualifications to provide 320.30 services identified as medically necessary by the individual 320.31 treatment plan. Providers and multidisciplinary teams include: 320.32 (1) a mental health professional as defined in subdivision 320.33 2; 320.34 (2) a mental health practitioner as defined in section 320.35 245.4871, subdivision 26. The mental health practitioner must 320.36 work under the clinical supervision of a mental health 321.1 professional; 321.2 (3) a mental health behavioral aide who is a 321.3 paraprofessional working under the direction of a mental health 321.4 professional or mental health practitioner who is under the 321.5 clinical supervision of a mental health professional in the 321.6 implementation of rehabilitative mental health services as 321.7 identified in the client's individual treatment plan. 321.8 (i) A level I mental health behavioral aide must: 321.9 (A) be at least 18 years of age; 321.10 (B) have a high school diploma or general equivalency 321.11 diploma (GED) or two years of experience as a primary caregiver 321.12 to a child with severe emotional disturbance within the previous 321.13 ten years; and 321.14 (C) meet preservices and continuing education requirements 321.15 in subdivision 10. 321.16 (ii) A level II mental health behavioral aide must: 321.17 (A) be at least 18 years of age; 321.18 (B) have an associate or bachelor's degree or 4,000 hours 321.19 of experience in delivering clinical services in the treatment 321.20 of mental illness concerning children or adolescents; and 321.21 (C) meet the orientation and training requirements in 321.22 subdivision 10; 321.23 (4) a preschool program multidisciplinary team that 321.24 includes at least one mental health professional and one or more 321.25 of the following under the clinical supervision of a mental 321.26 health professional: a mental health practitioner or a program 321.27 person such as a teacher, assistant teacher, or aide, who meets 321.28 the qualifications and training standards of a level I mental 321.29 health behavioral aid; and 321.30 (5) a day treatment multidisciplinary team that includes 321.31 mental health professionals and mental health practitioners as 321.32 defined in this section. 321.33 Subd. 10. [REQUIRED PRESERVICE AND ONGOING TRAINING.] (a) 321.34 A provider entity shall establish a plan to provide preservices 321.35 and continuing education for staff that clearly describes the 321.36 type of training necessary to maintain current skills, obtain 322.1 new skills, and that relates to the goals and objectives of the 322.2 provider entity program plan for services offered. A provider 322.3 that employs a mental health behavioral aide under this section 322.4 shall require the aide to complete 30 hours of preservice 322.5 training. Topics covered during preservice training include 322.6 those specified in Minnesota Rules, part 9535.4068, subparts 1 322.7 and 2, and parent team training. The preservice training must 322.8 include 15 hours of face-to-face training in mental health 322.9 services delivery and eight hours of parent team training. 322.10 Components of parent team training include: (1) partnering with 322.11 parents; (2) fundamentals of family support; (3) fundamentals of 322.12 policy and decision-making; (4) defining equal partnership; (5) 322.13 complexities of parent and service provider partnership in 322.14 multiple service delivery systems due to system strengths and 322.15 weaknesses; (6) sibling impacts; (7) support networks; and (8) 322.16 community resources. 322.17 (b) A provider entity that employs a mental health 322.18 practitioner and mental health behavioral aide to provide 322.19 children's therapeutic services and supports under this section 322.20 shall require the mental health practitioner and mental health 322.21 behavioral aide to complete 20 hours of continuing education 322.22 every two calendar years. The continuing education must be 322.23 related to serving the needs of a child with emotional 322.24 disturbance or severe emotional disturbance in the child's home 322.25 environment and the child's family. The topics covered in 322.26 orientation and training must conform to Minnesota Rules, part 322.27 9535.4068. The provider, as specified in subdivisions 6 and 7, 322.28 shall document completion of the required continuing education 322.29 on an annual basis. The documentation must include: 322.30 (1) documentation of staff development and training 322.31 sessions, which shall be kept for each employee at a central 322.32 location and in the employee's personnel file. Documentation 322.33 must include the: date, number of hours, training subject, 322.34 attendance as verified by the signature of a staff member with 322.35 job title, and the instructor's name; and 322.36 (2) records of attendance at professional workshops and 323.1 conferences which shall be kept for each employee at a central 323.2 location and in the employee's personnel file. 323.3 Subd. 11. [SERVICE DELIVERY REQUIREMENTS.] (a) Service 323.4 delivery is the process of implementing the individual treatment 323.5 plan to achieve the goals and objectives identified in it. The 323.6 commissioner shall develop procedures for disseminating 323.7 information on evidence-based practices and for providing 323.8 ongoing technical assistance and consultation to county, tribes, 323.9 and certified provider entities in order to promote statewide 323.10 development of appropriate, accessible, and cost-effective 323.11 medical assistance services and related policy. A provider 323.12 entity must comply with the following service delivery 323.13 requirements: 323.14 (1) individual, family, and group psychotherapy must be 323.15 delivered as specified in Minnesota Rules, part 9505.0323; and 323.16 (2) individual, family, or group skills training must be 323.17 designed as specified in subdivision 2 and delivered according 323.18 to the goals and objectives of the individual treatment plan. 323.19 (b) Up to 35 hours of children's therapeutic services and 323.20 supports are eligible for medical assistance payment if the 323.21 services and supports are part of the discharge plan and are 323.22 provided within a six-month period to a child with severe 323.23 emotional disturbance who is residing in a hospital, a group 323.24 home, a licensed residential treatment facility, a regional 323.25 treatment center, or other institutional group setting or is 323.26 participating in a program of partial hospitalization. 323.27 (c) Provider entities that offer site-based programs such 323.28 as day treatment and therapeutic preschool programs must provide 323.29 staffing and facilities to ensure the health, safety, and 323.30 protection of rights of each client and be able to implement 323.31 each client's individual treatment plan. 323.32 (d) The structured treatment program offered by a licensed 323.33 preschool program must be available at least one day per week 323.34 for a minimum two-hour time block. The structured treatment 323.35 program may include individual or group psychotherapy and any of 323.36 the following: recreational therapy, socialization therapy, and 324.1 independent living skills therapy that is necessary, 324.2 appropriate, and included in the client's individual treatment 324.3 plan. Notwithstanding other requirements in this section, 324.4 documentation of day treatment may be provided on a daily basis 324.5 by use of a checklist of available therapies in which the client 324.6 participated and on a weekly basis by a summary of the 324.7 information required under this subdivision. 324.8 (e) Crisis assistance for a child is an intense component 324.9 of children's therapeutic services and supports designed to 324.10 address abrupt or substantial changes in the functioning of the 324.11 child or the child's family evidenced by a sudden change in 324.12 behavior with negative consequences for well being, a loss of 324.13 usual coping mechanisms, or the presentation of danger to self 324.14 or others. The services must focus on crisis prevention, 324.15 identification, and management. Crisis assistance may be used 324.16 to reduce immediate personal distress and to assess factors that 324.17 precipitated the crisis in order to reduce the chance of future 324.18 crisis situations by implementing preventive strategies and 324.19 plans. These are time-limited services designed to resolve or 324.20 stabilize crisis through the arrangement of direct intervention, 324.21 support services to the child and family, and the utilization of 324.22 more appropriate resources. Crisis assistance service 324.23 components are: crisis risk assessment, screening for 324.24 hospitalization, referral and follow up to suitable community 324.25 resources, and planning for crisis intervention and counseling 324.26 services with other service providers, the child, and the 324.27 child's family. Crisis assistance does not mean necessary 324.28 emergency services or services designed to secure the safety of 324.29 a child who is at risk of abuse or neglect. 324.30 (f) Medically necessary services provided by a mental 324.31 health behavioral aide are designed to improve the functioning 324.32 of the child and support the family in activities of daily and 324.33 community living. Delivery of these services must be documented 324.34 by the mental health behavioral aide by written progress notes. 324.35 The mental health behavioral aide must implement goals in the 324.36 treatment plan that allows the child to acquire developmentally 325.1 and therapeutically appropriate daily living skills, social 325.2 skills, and leisure and recreational skills through targeted 325.3 activities. These activities may include: 325.4 (1) assisting the child with skill development in dressing, 325.5 eating, and toileting; 325.6 (2) assisting, monitoring, and guiding the child to 325.7 complete tasks, including facilitating the child's participation 325.8 in medical appointments; 325.9 (3) observing and intervening to redirect inappropriate 325.10 behavior; 325.11 (4) assisting the child in using age-appropriate 325.12 self-management skills as related to the child's emotional 325.13 disorder or mental illness, including problem solving, decision 325.14 making, communication, conflict resolution, anger management, 325.15 social skills, and recreational skills; 325.16 (5) implementing deescalation techniques as recommended by 325.17 the mental health professional; 325.18 (6) implementing any other mental health service that the 325.19 mental health professional has approved as being within the 325.20 scope of the behavioral aide's duties; or 325.21 (7) assisting the parents to develop and use parenting 325.22 skills that help the child achieve the goals outlined in the 325.23 child's individual treatment plan or individual behavioral 325.24 plan. Parenting skills must be directed exclusively to the 325.25 treatment of the child. 325.26 (g) Direction for a mental health behavioral aide must be 325.27 delivered as specified in subdivision 8, clause (6). 325.28 (h) A day treatment program must be provided to a group of 325.29 clients by a multidisciplinary staff under the clinical 325.30 supervision of a mental health professional. The program must 325.31 be available at least one day per week for a minimum three-hour 325.32 time block. The three-hour time block must include at least one 325.33 hour, but no more than two hours, of individual or group 325.34 psychotherapy. The remainder of the three-hour time block must 325.35 consist of any of the following: recreational therapy, 325.36 socialization therapy, and independent living skills therapy. 326.1 The remainder of the three-hour time block may include 326.2 recreational therapy, socialization therapy, and independent 326.3 living skills therapy only if they are included in the client's 326.4 individual treatment plan as necessary and appropriate. 326.5 Subd. 12. [SERVICE AUTHORIZATION.] The commissioner shall 326.6 publish in the State Register a list of health services that 326.7 require prior authorization as well as the criteria and 326.8 standards used to select health services on the list. The list 326.9 and the criteria and standards used to formulate the list are 326.10 not subject to the requirements of sections 14.001 to 14.69. 326.11 The commissioner's decision on whether prior authorization is 326.12 required for a health service is not subject to administrative 326.13 appeal. 326.14 Subd. 13. [EXCLUDED SERVICES.] The services specified in 326.15 clauses (1) to (6) are not eligible for medical assistance 326.16 payment as children's therapeutic services and supports: 326.17 (1) children's therapeutic services and supports 326.18 simultaneously provided by more than one provider entity unless 326.19 prior authorization is obtained; 326.20 (2) children's therapeutic services and supports provided 326.21 to a child who, at the time of service provision, has not had a 326.22 diagnostic assessment to determine if the child has an emotional 326.23 disturbance, except that the first ten hours of children's 326.24 therapeutic services and supports provided to a child who is 326.25 later assessed and determined to have an emotional disturbance 326.26 at the time services were initiated shall be eligible for 326.27 medical assistance payments; 326.28 (3) children's therapeutic services and supports provided 326.29 in violation of medical assistance policy in Minnesota Rules, 326.30 part 9505.0220; 326.31 (4) mental health behavioral aide services provided by a 326.32 personal care assistant who is not qualified as a mental health 326.33 behavioral aide despite being employed by a certified children's 326.34 therapeutic services and supports provider entity; 326.35 (5) services that are the responsibility of a residential 326.36 or program license holder, including foster care providers under 327.1 the terms of a service agreement or administrative rules 327.2 governing licensure; 327.3 (6) adjunctive activities which otherwise may be offered by 327.4 a provider entity but are not covered by medical assistance, 327.5 including: 327.6 (i) a service that is primarily recreation-oriented or that 327.7 is provided in a setting that is not medically supervised. This 327.8 includes sports activities, exercise groups, activities such as 327.9 craft hours, leisure time, social hours, meal or snack time, 327.10 trips to community activities, and tours; 327.11 (ii) a social or educational service that does not have or 327.12 cannot reasonably be expected to have a therapeutic outcome 327.13 related to the client's emotional disturbance; 327.14 (iii) consultation with other providers or service agency 327.15 staff about the care or progress of a client; 327.16 (iv) prevention or education programs provided to the 327.17 community; 327.18 (v) treatment for clients with primary diagnoses of alcohol 327.19 or other drug abuse; and 327.20 (vi) psychotherapy in a day treatment program for more than 327.21 two hours daily; and 327.22 (7) activities such as recreational therapy, socialization 327.23 therapy, and independent living skills therapy. These 327.24 activities may be authorized as components of skills training on 327.25 an individual basis. 327.26 [EFFECTIVE DATE.] This section is effective July 1, 2004. 327.27 Sec. 9. [256B.0944] [COVERED SERVICE; CHILDREN'S MENTAL 327.28 HEALTH CRISIS RESPONSE SERVICES.] 327.29 Subdivision 1. [SCOPE.] Medical assistance covers 327.30 medically necessary children's mental health crisis response 327.31 services as defined in subdivision 2, paragraphs (c) to (e), 327.32 subject to federal approval, if provided to an eligible 327.33 recipient and provided by a qualified provider entity and by a 327.34 qualified individual provider working within the provider's 327.35 scope of practice and identified in the recipient's individual 327.36 crisis treatment plan as defined in subdivision 11. 328.1 Subd. 2. [DEFINITIONS.] For purposes of this section, the 328.2 following terms have the meanings given them. 328.3 (a) "Mental health crisis" is a children's behavioral, 328.4 emotional, or psychiatric situation which, but for the provision 328.5 of crisis response services, would likely result in 328.6 significantly reduced levels of functioning in primary 328.7 activities of daily living, or in an emergency situation, or in 328.8 the placement of the recipient in a more restrictive setting, 328.9 including, but not limited to, inpatient hospitalization. 328.10 (b) "Mental health emergency" is a children's behavioral, 328.11 emotional, or psychiatric situation which causes an immediate 328.12 need for mental health services and is consistent with section 328.13 62Q.55. A mental health crisis or emergency is determined for 328.14 medical assistance service reimbursement by a physician, a 328.15 mental health professional, or crisis mental health practitioner 328.16 with input from the recipient whenever possible. 328.17 (c) "Mental health crisis assessment" means an immediate 328.18 face-to-face assessment by a physician, a mental health 328.19 professional, or a mental health practitioner under the clinical 328.20 supervision of a mental health professional, following a 328.21 screening that suggests the child may be experiencing a mental 328.22 health crisis or mental health emergency situation. 328.23 (d) "Mental health mobile crisis intervention services" 328.24 means face-to-face, short-term, intensive mental health services 328.25 initiated during a mental health crisis or mental health 328.26 emergency to help the recipient cope with immediate stressors, 328.27 identify and utilize available resources and strengths, and 328.28 begin to return to the recipient's baseline level of functioning. 328.29 (1) This service is provided on site by a mobile crisis 328.30 intervention team outside of an inpatient hospital setting. 328.31 (2) The initial screening must consider other available 328.32 services to determine which service intervention would best 328.33 address the recipient's needs and circumstances. 328.34 (3) The mobile crisis intervention team must be available 328.35 to meet promptly face-to-face with a person in a mental health 328.36 crisis or mental health emergency in a community setting. 329.1 (4) The intervention must be based on a mental health 329.2 crisis assessment and a crisis treatment plan. 329.3 (5) The treatment plan must include recommendations for any 329.4 needed crisis stabilization services for the recipient. 329.5 (e) "Mental health crisis stabilization services" means 329.6 individualized mental health services provided to a recipient 329.7 following crisis intervention services which are designed to 329.8 restore the recipient to the recipient's prior functional 329.9 level. The individual treatment plan recommending mental health 329.10 crisis stabilization must be completed by the intervention team 329.11 or by staff after an inpatient or urgent care visit. Mental 329.12 health crisis stabilization services may be provided in the 329.13 recipient's home, the home of a family member or friend of the 329.14 recipient, another community setting, or a short-term 329.15 supervised, licensed residential program (if the service is not 329.16 included in the facilities cost pool or per diem). Mental 329.17 health crisis stabilization does not include partial 329.18 hospitalization or day treatment. 329.19 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 329.20 individual who: 329.21 (a) is under age 21; 329.22 (b) is screened as possibly experiencing a mental health 329.23 crisis or mental health emergency where a mental health crisis 329.24 assessment is needed; and 329.25 (c) is assessed as experiencing a mental health crisis or 329.26 mental health emergency, and mental health crisis intervention 329.27 or crisis intervention and stabilization services are determined 329.28 to be medically necessary. 329.29 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider 329.30 entity is an entity that meets the standards listed in paragraph 329.31 (b) and: 329.32 (1) is an Indian health service facility or a facility 329.33 owned and operated by a tribe or a tribal organization operating 329.34 as a 638 facility under Public Law 93-638 certified by the 329.35 state; 329.36 (2) is a county board operated facility; or 330.1 (3) is a provider entity that is under contract with the 330.2 county board in the county where the potential crisis or 330.3 emergency is occurring. To provide services under this section, 330.4 the provider entity must directly provide the services; or if 330.5 services are subcontracted, the provider entity must maintain 330.6 clinical responsibility for services and billing. 330.7 (b) The children's mental health crisis response services 330.8 provider entity must meet the following standards: 330.9 (1) has the capacity to recruit, hire, train, and retain 330.10 culturally and linguistically competent mental health 330.11 professionals and practitioners; 330.12 (2) has adequate administrative ability to ensure 330.13 availability of services; 330.14 (3) is able to ensure adequate preservice and in-service 330.15 training; 330.16 (4) is able to ensure that staff providing these services 330.17 are skilled in the delivery of mental health crisis response 330.18 services to recipients; 330.19 (5) is able to ensure that staff are capable of 330.20 implementing culturally specific treatment identified in the 330.21 individual treatment plan that is meaningful and appropriate as 330.22 determined by the recipient's culture, beliefs, values, and 330.23 language; 330.24 (6) is able to ensure enough flexibility to respond to the 330.25 changing intervention and care needs of a recipient as 330.26 identified by the recipient during the service partnership 330.27 between the recipient and providers; 330.28 (7) is able to ensure that mental health professionals and 330.29 mental health practitioners have the communication tools and 330.30 procedures to communicate and consult promptly about crisis 330.31 assessment and interventions as services occur; 330.32 (8) is able to coordinate these services with county 330.33 emergency services and mental health crisis services; 330.34 (9) is able to ensure that mental health crisis assessment 330.35 and mobile crisis intervention services are available 24 hours a 330.36 day, seven days a week; 331.1 (10) is able to ensure that services are coordinated with 331.2 other mental health service providers, county mental health 331.3 authorities, or federally recognized American Indian authorities 331.4 and others as necessary, with the consent of the recipient or 331.5 legal guardian. Services must also be coordinated with the 331.6 recipient's case manager if the child is receiving case 331.7 management services; 331.8 (11) is able to ensure that crisis intervention services 331.9 are provided in a manner consistent with sections 245.487 to 331.10 245.4888; 331.11 (12) is able to submit information as required by the 331.12 state; 331.13 (13) maintains staff training and personnel files; 331.14 (14) is able to establish and maintain a quality assurance 331.15 and evaluation plan to evaluate the outcomes of services and 331.16 recipient satisfaction; 331.17 (15) is able to keep records as required by applicable 331.18 laws; 331.19 (16) is able to comply with all applicable laws and 331.20 statutes; and 331.21 (17) develops and maintains written policies and procedures 331.22 regarding service provision and administration of the provider 331.23 entity, including safety of staff and recipients in high-risk 331.24 situations. 331.25 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 331.26 QUALIFICATIONS.] For provision of children's mental health 331.27 mobile crisis intervention services, a mobile crisis 331.28 intervention team is comprised of at least two mental health 331.29 professionals as defined in section 245.4871, subdivision 27, 331.30 clauses (1) to (5), or a combination of at least one mental 331.31 health professional and one mental health practitioner as 331.32 defined in section 245.4871, subdivision 26, with the required 331.33 mental health crisis training under the clinical supervision of 331.34 a mental health professional on the team. The team must have at 331.35 least two people with at least one member providing on-site 331.36 crisis intervention services when needed. Team members must be 332.1 experienced in mental health assessment, crisis intervention 332.2 techniques, and clinical decision-making under emergency 332.3 conditions and have knowledge of local services and resources. 332.4 The team must recommend and coordinate the team's services with 332.5 appropriate local resources such as the county social services 332.6 agency, mental health services, and local law enforcement when 332.7 necessary. 332.8 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 332.9 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 332.10 crisis intervention services, a screening of the potential 332.11 crisis situation must be conducted. The screening may use the 332.12 resources of crisis assistance and emergency services as defined 332.13 in sections 245.4871, subdivision 14, and 245.4879, subdivisions 332.14 1 and 2. The screening must gather information, determine 332.15 whether a crisis situation exists, identify parties involved, 332.16 and determine an appropriate response. 332.17 (b) If a crisis exists, a crisis assessment must be 332.18 completed. A crisis assessment evaluates any immediate needs 332.19 for which emergency services are needed and, as time permits, 332.20 the recipient's current life situation, sources of stress, 332.21 mental health problems and symptoms, strengths, cultural 332.22 considerations, support network, vulnerabilities, and current 332.23 functioning. 332.24 (c) If the crisis assessment determines mobile crisis 332.25 intervention services are needed, the intervention services must 332.26 be provided promptly. As opportunity presents during the 332.27 intervention, at least two members of the mobile crisis 332.28 intervention team must confer directly or by telephone about the 332.29 assessment, treatment plan, and actions taken and needed. At 332.30 least one of the team members must be on site providing crisis 332.31 intervention services. If providing on-site crisis intervention 332.32 services, a mental health practitioner must seek clinical 332.33 supervision as required in subdivision 9. 332.34 (d) The mobile crisis intervention team must develop an 332.35 initial, brief crisis treatment plan as soon as appropriate, but 332.36 no later than 24 hours after the initial face-to-face 333.1 intervention. The plan must address the needs and problems 333.2 noted in the crisis assessment and include measurable short-term 333.3 goals, cultural considerations, and frequency and type of 333.4 services to be provided to achieve the goals and reduce or 333.5 eliminate the crisis. The treatment plan must be updated as 333.6 needed to reflect current goals and services. The team must 333.7 involve the child and the child's family in developing and 333.8 implementing the plan. 333.9 (e) The team must document which short-term goals have been 333.10 met and when no further crisis intervention services are 333.11 required. 333.12 (f) If the recipient's crisis is stabilized, but the 333.13 recipient needs a referral to other services, the team must 333.14 provide referrals to these services. If the recipient has a 333.15 case manager, planning for other services must be coordinated 333.16 with the case manager. 333.17 Subd. 7. [CRISIS STABILIZATION SERVICES.] Crisis 333.18 stabilization services must be provided by qualified staff of a 333.19 crisis stabilization services provider entity and must meet the 333.20 following standards: 333.21 (1) a crisis stabilization treatment plan must be developed 333.22 which meets the criteria in subdivision 11; 333.23 (2) staff must be qualified as defined in subdivision 8; 333.24 and 333.25 (3) services must be delivered according to the treatment 333.26 plan and include face-to-face contact with the recipient by 333.27 qualified staff for further assessment, help with referrals, 333.28 updating of the crisis stabilization treatment plan, supportive 333.29 counseling, skills training, and collaboration with other 333.30 service providers in the community. 333.31 Subd. 8. [CHILDREN'S CRISIS STABILIZATION STAFF 333.32 QUALIFICATIONS.] Children's mental health crisis stabilization 333.33 services must be provided by qualified individual staff of a 333.34 qualified provider entity. Individual provider staff must have 333.35 the following qualifications: 333.36 (1) be a mental health professional as defined in section 334.1 245.4871, subdivision 27, clauses (1) to (5); or 334.2 (2) be a mental health practitioner as defined in section 334.3 245.4871, subdivision 26. The mental health practitioner must 334.4 work under the clinical supervision of a mental health 334.5 professional and have completed at least 30 hours of training in 334.6 crisis intervention and stabilization during the past two years. 334.7 Subd. 9. [SUPERVISION.] (a) Mental health practitioners 334.8 may provide crisis assessment and mobile crisis intervention 334.9 services if the following clinical supervision requirements are 334.10 met: 334.11 (1) the mental health provider entity must accept full 334.12 responsibility for the services provided; 334.13 (2) the mental health professional who is supervising the 334.14 mental health practitioner and is an employee or under contract 334.15 with the provider entity, must be immediately available by 334.16 telephone or in person for clinical supervision; and 334.17 (3) the mental health professional is consulted, in person 334.18 or by telephone, during the first three hours when a mental 334.19 health practitioner provides on-site service. 334.20 (b) The mental health professional must: 334.21 (1) review and approve of the tentative crisis assessment 334.22 and crisis treatment plan; 334.23 (2) document the consultation; and 334.24 (3) sign the crisis assessment and treatment plan within 334.25 the next business day. 334.26 (c) If the mobile crisis intervention services continue 334.27 into a second calendar day, a mental health professional must 334.28 contact the recipient face-to-face on the second day to provide 334.29 services and update the crisis treatment plan. The on-site 334.30 observation must be documented in the recipient's record and 334.31 signed by the mental health professional. 334.32 Subd. 10. [RECIPIENT FILE.] (a) Providers of mobile crisis 334.33 intervention or crisis stabilization services must maintain a 334.34 file for each recipient containing the following information: 334.35 (1) individual crisis treatment plans signed by the 334.36 recipient, mental health professional, and mental health 335.1 practitioner who developed the crisis treatment plan, or if the 335.2 recipient refused to sign the plan, the date and reason stated 335.3 by the recipient as to why the recipient would not sign the 335.4 plan; 335.5 (2) signed release of information forms; 335.6 (3) recipient health information and current medications; 335.7 (4) emergency contacts for the recipient; 335.8 (5) case records which document the date of service, place 335.9 of service delivery, direct or telephone contact with the 335.10 recipient's family or others, signature of the person providing 335.11 the service, and the nature, extent, and units of service; 335.12 (6) required clinical supervision by mental health 335.13 professionals; 335.14 (7) summary of the recipient's case reviews by staff; and 335.15 (8) any written information by the recipient that the 335.16 recipient wants in the file. 335.17 (b) Documentation in the file must comply with all 335.18 requirements of the commissioner. 335.19 Subd. 11. [TREATMENT PLAN.] (a) The individual crisis 335.20 stabilization treatment plan must include, at a minimum: 335.21 (1) a list of problems identified in the assessment; 335.22 (2) a list of the recipient's strengths and resources; 335.23 (3) concrete, measurable, short-term goals and tasks to be 335.24 achieved, including time frames for achievement; 335.25 (4) specific objectives directed toward the achievement of 335.26 each of the goals; 335.27 (5) documentation of the participants involved in the 335.28 service planning; 335.29 (6) planned frequency and type of services initiated; 335.30 (7) a crisis response action plan if a crisis should occur; 335.31 and 335.32 (8) clear progress notes on outcome of goals. 335.33 (b) The recipient, if possible, must be a participant. The 335.34 recipient or the recipient's legal guardian must sign the 335.35 service plan or document why this was not possible. A copy of 335.36 the plan must be given to the recipient and the recipient's 336.1 legal guardian. The plan should include the services arranged, 336.2 including specific providers where applicable. 336.3 (c) A treatment plan must be developed by a mental health 336.4 professional or mental health practitioner under the clinical 336.5 supervision of a mental health professional. A written plan 336.6 must be completed within 24 hours of beginning services with the 336.7 recipient. The mental health professional must approve and sign 336.8 all treatment plans. 336.9 Subd. 12. [EXCLUDED SERVICES.] (a) The following services 336.10 are excluded from reimbursement under this section: 336.11 (1) room and board services; 336.12 (2) services delivered to a recipient while admitted to an 336.13 inpatient hospital; 336.14 (3) transportation services under children's mental health 336.15 crisis response service; 336.16 (4) services provided and billed by a provider who is not 336.17 enrolled under medical assistance to provide children's mental 336.18 health crisis response services; 336.19 (5) crisis response services provided by a residential 336.20 treatment center to recipients in their facility; 336.21 (6) services performed by volunteers; 336.22 (7) direct billing of time spent "on call" when not 336.23 delivering services to a recipient; 336.24 (8) provider service time included in case management 336.25 reimbursement; 336.26 (9) outreach services to potential recipients; and 336.27 (10) a mental health service that is not medically 336.28 necessary. 336.29 (b) When a provider is eligible to provide more than one 336.30 type of medical assistance service, the recipient must have a 336.31 choice of provider for each service, unless otherwise provided 336.32 by law. 336.33 [EFFECTIVE DATE.] This section is effective July 1, 2004. 336.34 Sec. 10. Minnesota Statutes 2002, section 256B.0945, 336.35 subdivision 2, is amended to read: 336.36 Subd. 2. [COVERED SERVICES.] All services must be included 337.1 in a child's individualized treatment or multiagency plan of 337.2 care as defined in chapter 245. 337.3(a) For facilities that are institutions for mental337.4diseases according to statute and regulation or are not337.5institutions for mental diseases but are approved by the337.6commissioner to provide services under this paragraph, medical337.7assistance covers the full contract rate, including room and337.8board if the services meet the requirements of Code of Federal337.9Regulations, title 42, section 440.160.337.10(b)For facilities that are not institutions for mental 337.11 diseases according to federal statute and regulationand are not337.12providing services under paragraph (a), medical assistance 337.13 covers mental health related services that are required to be 337.14 provided by a residential facility under section 245.4882 and 337.15 administrative rules promulgated thereunder, except for room and 337.16 board. 337.17 Sec. 11. Minnesota Statutes 2002, section 256B.0945, 337.18 subdivision 4, is amended to read: 337.19 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 337.20 256B.19 and 256B.041, payments to counties for residential 337.21 services provided by a residential facility shall only be made 337.22 of federal earnings for services provided under this section, 337.23 and the nonfederal share of costs for services provided under 337.24 this section shall be paid by the county from sources other than 337.25 federal funds or funds used to match other federal funds. 337.26Payment to counties for services provided according to337.27subdivision 2, paragraph (a), shall be the federal share of the337.28contract rate.Payment to counties for services provided 337.29 according tosubdivision 2, paragraph (b),this section shall be 337.30 a proportion of the per day contract rate that relates to 337.31 rehabilitative mental health services and shall not include 337.32 payment for costs or services that are billed to the IV-E 337.33 program as room and board. 337.34 (b) The commissioner shall set aside a portion not to 337.35 exceed five percent of the federal funds earned under this 337.36 section to cover the state costs of administering this section. 338.1 Any unexpended funds from the set-aside shall be distributed to 338.2 the counties in proportion to their earnings under this section. 338.3 Sec. 12. Minnesota Statutes 2002, section 256F.10, 338.4 subdivision 6, is amended to read: 338.5 Subd. 6. [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 338.6 for portion set aside in paragraph (b), the federal funds earned 338.7 under this section and section 256B.094 by providers shall be 338.8 paid to each provider based on its earnings, and must be used by338.9each provider to expand preventive child welfare services. 338.10 If a county or tribal social services agency chooses to be a 338.11 provider of child welfare targeted case management and if that 338.12 county or tribal social services agency also joins a local 338.13 children's mental health collaborative as authorized by the 1993 338.14 legislature, then the federal reimbursement received by the 338.15 county or tribal social services agency for providing child 338.16 welfare targeted case management services to children served by 338.17 the local collaborative shall be transferred by the county or 338.18 tribal social services agency to the integrated fund. The 338.19 federal reimbursement transferred to the integrated fund by the 338.20 county or tribal social services agency must not be used for 338.21 residential care other than respite care described under 338.22 subdivision 7, paragraph (d). 338.23 (b) The commissioner shall set aside a portion of the 338.24 federal funds earned under this section to repay the special 338.25 revenue maximization account under section 256.01, subdivision 338.26 2, clause (15). The repayment is limited to: 338.27 (1) the costs of developing and implementing this section 338.28 and sections 256B.094 and 256J.48; 338.29 (2) programming the information systems; and 338.30 (3) the lost federal revenue for the central office claim 338.31 directly caused by the implementation of these sections. 338.32 Any unexpended funds from the set aside under this 338.33 paragraph shall be distributed to providers according to 338.34 paragraph (a). 338.35 Sec. 13. Minnesota Statutes 2002, section 259.67, 338.36 subdivision 4, is amended to read: 339.1 Subd. 4. [ELIGIBILITY CONDITIONS.] (a) The placing agency 339.2 shall use the AFDC requirements as specified in federal law as 339.3 of July 16, 1996, when determining the child's eligibility for 339.4 adoption assistance under title IV-E of the Social Security 339.5 Act. If the child does not qualify, the placing agency shall 339.6 certify a child as eligible for state funded adoption assistance 339.7 only if the following criteria are met: 339.8 (1) Due to the child's characteristics or circumstances it 339.9 would be difficult to provide the child an adoptive home without 339.10 adoption assistance. 339.11 (2)(i) A placement agency has made reasonable efforts to 339.12 place the child for adoption without adoption assistance, but 339.13 has been unsuccessful; or 339.14 (ii) the child's licensed foster parents desire to adopt 339.15 the child and it is determined by the placing agency that the 339.16 adoption is in the best interest of the child. 339.17 (3) The child has been a ward of the commissioneror, a 339.18 Minnesota-licensed child-placing agency, or a tribal social 339.19 service agency of Minnesota recognized by the Secretary of the 339.20 Interior. 339.21 (b) For purposes of this subdivision, the characteristics 339.22 or circumstances that may be considered in determining whether a 339.23 child is a child with special needs under United States Code, 339.24 title 42, chapter 7, subchapter IV, part E, or meets the 339.25 requirements of paragraph (a), clause (1), are the following: 339.26 (1) The child is a member of a sibling group to be placed 339.27 as one unit in which at least one sibling is older than 15 339.28 months of age or is described in clause (2) or (3). 339.29 (2) The child has documented physical, mental, emotional, 339.30 or behavioral disabilities. 339.31 (3) The child has a high risk of developing physical, 339.32 mental, emotional, or behavioral disabilities. 339.33 (4) The child is adopted according to tribal law without a 339.34 termination of parental rights or relinquishment, provided that 339.35 the tribe has documented the valid reason why the child cannot 339.36 or should not be returned to the home of the child's parent. 340.1 (c) When a child's eligibility for adoption assistance is 340.2 based upon the high risk of developing physical, mental, 340.3 emotional, or behavioral disabilities, payments shall not be 340.4 made under the adoption assistance agreement unless and until 340.5 the potential disability manifests itself as documented by an 340.6 appropriate health care professional. 340.7 Sec. 14. Minnesota Statutes 2002, section 260B.157, 340.8 subdivision 1, is amended to read: 340.9 Subdivision 1. [INVESTIGATION.] Upon request of the court 340.10 the local social services agency or probation officer shall 340.11 investigate the personal and family history and environment of 340.12 any minor coming within the jurisdiction of the court under 340.13 section 260B.101 and shall report its findings to the court. 340.14 The court may order any minor coming within its jurisdiction to 340.15 be examined by a duly qualified physician, psychiatrist, or 340.16 psychologist appointed by the court. 340.17 The court shall have a chemical use assessment conducted 340.18 when a child is (1) found to be delinquent for violating a 340.19 provision of chapter 152, or for committing a felony-level 340.20 violation of a provision of chapter 609 if the probation officer 340.21 determines that alcohol or drug use was a contributing factor in 340.22 the commission of the offense, or (2) alleged to be delinquent 340.23 for violating a provision of chapter 152, if the child is being 340.24 held in custody under a detention order. The assessor's 340.25 qualifications and the assessment criteria shall comply with 340.26 Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under 340.27 chapter 254B are to be used to pay for the recommended 340.28 treatment, the assessment and placement must comply with all 340.29 provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 340.30 9530.7000 to 9530.7030. The commissioner of human services 340.31 shall reimburse the court for the cost of the chemical use 340.32 assessment, up to a maximum of $100. 340.33 The court shall have a children's mental health screening 340.34 conducted when a child is alleged to be delinquent or is found 340.35 to be delinquent. The screening shall be conducted with a 340.36 screening instrument approved by the commissioner of human 341.1 services and shall be conducted by a mental health practitioner 341.2 as defined in section 245.4871, subdivision 26, or a probation 341.3 officer who is trained in the use of the screening instrument. 341.4 If the screening indicates a need for assessment, the local 341.5 social services agency, in consultation with the child's family, 341.6 shall have a diagnostic assessment conducted, including a 341.7 functional assessment, as defined in section 245.4871. 341.8 With the consent of the commissioner of corrections and 341.9 agreement of the county to pay the costs thereof, the court may, 341.10 by order, place a minor coming within its jurisdiction in an 341.11 institution maintained by the commissioner for the detention, 341.12 diagnosis, custody and treatment of persons adjudicated to be 341.13 delinquent, in order that the condition of the minor be given 341.14 due consideration in the disposition of the case. Any funds 341.15 received under the provisions of this subdivision shall not 341.16 cancel until the end of the fiscal year immediately following 341.17 the fiscal year in which the funds were received. The funds are 341.18 available for use by the commissioner of corrections during that 341.19 period and are hereby appropriated annually to the commissioner 341.20 of corrections as reimbursement of the costs of providing these 341.21 services to the juvenile courts. 341.22 Sec. 15. Minnesota Statutes 2002, section 260B.176, 341.23 subdivision 2, is amended to read: 341.24 Subd. 2. [REASONS FOR DETENTION.] (a) If the child is not 341.25 released as provided in subdivision 1, the person taking the 341.26 child into custody shall notify the court as soon as possible of 341.27 the detention of the child and the reasons for detention. 341.28 (b) No child may be detained in a juvenile secure detention 341.29 facility or shelter care facility longer than 36 hours, 341.30 excluding Saturdays, Sundays, and holidays, after being taken 341.31 into custody for a delinquent act as defined in section 341.32 260B.007, subdivision 6, unless a petition has been filed and 341.33 the judge or referee determines pursuant to section 260B.178 341.34 that the child shall remain in detention. 341.35 (c) No child may be detained in an adult jail or municipal 341.36 lockup longer than 24 hours, excluding Saturdays, Sundays, and 342.1 holidays, or longer than six hours in an adult jail or municipal 342.2 lockup in a standard metropolitan statistical area, after being 342.3 taken into custody for a delinquent act as defined in section 342.4 260B.007, subdivision 6, unless: 342.5 (1) a petition has been filed under section 260B.141; and 342.6 (2) a judge or referee has determined under section 342.7 260B.178 that the child shall remain in detention. 342.8 After August 1, 1991, no child described in this paragraph 342.9 may be detained in an adult jail or municipal lockup longer than 342.10 24 hours, excluding Saturdays, Sundays, and holidays, or longer 342.11 than six hours in an adult jail or municipal lockup in a 342.12 standard metropolitan statistical area, unless the requirements 342.13 of this paragraph have been met and, in addition, a motion to 342.14 refer the child for adult prosecution has been made under 342.15 section 260B.125. Notwithstanding this paragraph, continued 342.16 detention of a child in an adult detention facility outside of a 342.17 standard metropolitan statistical area county is permissible if: 342.18 (i) the facility in which the child is detained is located 342.19 where conditions of distance to be traveled or other ground 342.20 transportation do not allow for court appearances within 24 342.21 hours. A delay not to exceed 48 hours may be made under this 342.22 clause; or 342.23 (ii) the facility is located where conditions of safety 342.24 exist. Time for an appearance may be delayed until 24 hours 342.25 after the time that conditions allow for reasonably safe 342.26 travel. "Conditions of safety" include adverse life-threatening 342.27 weather conditions that do not allow for reasonably safe travel. 342.28 The continued detention of a child under clause (i) or (ii) 342.29 must be reported to the commissioner of corrections. 342.30 (d) If a child described in paragraph (c) is to be detained 342.31 in a jail beyond 24 hours, excluding Saturdays, Sundays, and 342.32 holidays, the judge or referee, in accordance with rules and 342.33 procedures established by the commissioner of corrections, shall 342.34 notify the commissioner of the place of the detention and the 342.35 reasons therefor. The commissioner shall thereupon assist the 342.36 court in the relocation of the child in an appropriate juvenile 343.1 secure detention facility or approved jail within the county or 343.2 elsewhere in the state, or in determining suitable 343.3 alternatives. The commissioner shall direct that a child 343.4 detained in a jail be detained after eight days from and 343.5 including the date of the original detention order in an 343.6 approved juvenile secure detention facility with the approval of 343.7 the administrative authority of the facility. If the court 343.8 refers the matter to the prosecuting authority pursuant to 343.9 section 260B.125, notice to the commissioner shall not be 343.10 required. 343.11 (e) When a child is detained for an alleged delinquent act 343.12 in a state licensed juvenile facility or program, or when a 343.13 child is detained in an adult jail or municipal lockup as 343.14 provided in paragraph (c), the supervisor of the facility shall 343.15 have a children's mental health screening conducted with a 343.16 screening instrument approved by the commissioner of human 343.17 services, unless a screening has been performed within the 343.18 previous 180 days or the child is currently under the care of a 343.19 mental health professional. The screening shall be conducted by 343.20 a mental health practitioner as defined in section 245.4871, 343.21 subdivision 26, or a probation officer who is trained in the use 343.22 of the screening instrument. The screening shall be conducted 343.23 after the child is taken into custody for a delinquent act but 343.24 before any subsequent detention hearing, as defined in section 343.25 260B.178, and the results of the screening shall be presented to 343.26 the court at the detention hearing. If the screening indicates 343.27 a need for assessment, the local social services agency or 343.28 probation officer, in consultation with the child's family, 343.29 shall have a diagnostic assessment conducted, including a 343.30 functional assessment, as defined in section 245.4871. 343.31 Sec. 16. Minnesota Statutes 2002, section 260B.178, 343.32 subdivision 1, is amended to read: 343.33 Subdivision 1. [HEARING AND RELEASE REQUIREMENTS.] (a) The 343.34 court shall hold a detention hearing: 343.35 (1) within 36 hours of the time the child was taken into 343.36 custody, excluding Saturdays, Sundays, and holidays, if the 344.1 child is being held at a juvenile secure detention facility or 344.2 shelter care facility; or 344.3 (2) within 24 hours of the time the child was taken into 344.4 custody, excluding Saturdays, Sundays, and holidays, if the 344.5 child is being held at an adult jail or municipal lockup. 344.6 (b) Unless there is reason to believe that the child would 344.7 endanger self or others, not return for a court hearing, run 344.8 away from the child's parent, guardian, or custodian or 344.9 otherwise not remain in the care or control of the person to 344.10 whose lawful custody the child is released, or that the child's 344.11 health or welfare would be immediately endangered, the child 344.12 shall be released to the custody of a parent, guardian, 344.13 custodian, or other suitable person, subject to reasonable 344.14 conditions of release including, but not limited to, a 344.15 requirement that the child undergo a chemical use assessment as 344.16 provided in section 260B.157, subdivision 1, and a children's 344.17 mental health screening as provided in section 260B.176, 344.18 subdivision 2, paragraph (e). In determining whether the 344.19 child's health or welfare would be immediately endangered, the 344.20 court shall consider whether the child would reside with a 344.21 perpetrator of domestic child abuse. 344.22 Sec. 17. Minnesota Statutes 2002, section 260B.193, 344.23 subdivision 2, is amended to read: 344.24 Subd. 2. [CONSIDERATION OF REPORTS.] Before making a 344.25 disposition in a case, or appointing a guardian for a child, the 344.26 court may consider any report or recommendation made by the 344.27 local social services agency, probation officer, licensed 344.28 child-placing agency, foster parent, guardian ad litem, tribal 344.29 representative, or other authorized advocate for the child or 344.30 child's family, a school district concerning the effect on 344.31 student transportation of placing a child in a school district 344.32 in which the child is not a resident, or any other information 344.33 deemed material by the court. In addition, the court may 344.34 consider the results of the children's mental health screening 344.35 provided in section 260B.157, subdivision 1. 344.36 Sec. 18. Minnesota Statutes 2002, section 260B.235, 345.1 subdivision 6, is amended to read: 345.2 Subd. 6. [ALTERNATIVE DISPOSITION.] In addition to 345.3 dispositional alternatives authorized by subdivision34, in the 345.4 case of a third or subsequent finding by the court pursuant to 345.5 an admission in court or after trial that a child has committed 345.6 a juvenile alcohol or controlled substance offense, the juvenile 345.7 court shall order a chemical dependency evaluation of the child 345.8 and if warranted by the evaluation, the court may order 345.9 participation by the child in an inpatient or outpatient 345.10 chemical dependency treatment program, or any other treatment 345.11 deemed appropriate by the court. In the case of a third or 345.12 subsequent finding that a child has committed any juvenile petty 345.13 offense, the court shall order a children's mental health 345.14 screening be conducted as provided in section 260B.157, 345.15 subdivision 1, and if indicated by the screening, to undergo a 345.16 diagnostic assessment, including a functional assessment, as 345.17 defined in section 245.4871. 345.18 Sec. 19. Minnesota Statutes 2002, section 626.559, 345.19 subdivision 5, is amended to read: 345.20 Subd. 5. [REVENUE.] The commissioner of human services 345.21 shall add the following funds to the funds appropriated under 345.22 section 626.5591, subdivision 2, to develop and support training: 345.23 (a) The commissioner of human services shall submit claims 345.24 for federal reimbursement earned through the activities and 345.25 services supported through department of human services child 345.26 protection or child welfare training funds. Federal revenue 345.27 earned must be used to improve and expand training services by 345.28 the department. The department expenditures eligible for 345.29 federal reimbursement under this section must not be made from 345.30 federal funds or funds used to match other federal funds. 345.31 (b) Each year, the commissioner of human services shall 345.32 withhold from funds distributed to each county under Minnesota 345.33 Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5 345.34 percent of each county's annual title XX allocation under 345.35 section256E.07256M.50. The commissioner must use these funds 345.36 to ensure decentralization of training. 346.1 (c) The federal revenue under this subdivision is available 346.2 for these purposes until the funds are expended. 346.3 Sec. 20. [CONFLICTS.] 346.4 The amendments to Minnesota Statutes 2002, section 256F.10, 346.5 subdivision 6, in this article prevail over any conflicting law 346.6 that amends or repeals it regardless of the order or date of 346.7 enactment. 346.8 Sec. 21. [REVISOR'S INSTRUCTION.] 346.9 For sections in Minnesota Statutes and Minnesota Rules 346.10 affected by the repealed sections in this article, the revisor 346.11 shall delete internal cross-references where appropriate and 346.12 make changes necessary to correct the punctuation, grammar, or 346.13 structure of the remaining text and preserve its meaning. 346.14 Sec. 22. [REPEALER.] 346.15 (a) Minnesota Statutes 2002, sections 256B.0945, 346.16 subdivision 10; and 256F.10, subdivision 7, are repealed. 346.17 (b) Minnesota Statutes 2002, section 256B.0625, 346.18 subdivisions 35 and 36, are repealed effective July 1, 2004. 346.19 (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 346.20 9505.0327, are repealed effective July 1, 2004. 346.21 ARTICLE 6 346.22 COMMUNITY SERVICES ACT 346.23 Section 1. [256M.01] [CITATION.] 346.24 Sections 256M.01 to 256M.80 may be cited as the "Children 346.25 and Community Services Act." This act establishes a fund to 346.26 address the needs of children, adolescents, and young adults 346.27 within each county in accordance with a service agreement 346.28 entered into by the board of county commissioners of each county 346.29 and the commissioner of human services. The service agreement 346.30 shall specify the outcomes to be achieved, the general 346.31 strategies to be employed, and the respective state and county 346.32 roles. The service agreement shall be reviewed and updated 346.33 every two years, or sooner if both the state and the county deem 346.34 it necessary. 346.35 Sec. 2. [256M.10] [DEFINITIONS.] 346.36 Subdivision 1. [SCOPE.] For the purposes of sections 347.1 256M.01 to 256M.80, the terms defined in this section have the 347.2 meanings given them. 347.3 Subd. 2. [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 347.4 and community services" means services provided or arranged for 347.5 by county boards for children, adolescents, and young adults who 347.6 experience dependency, abuse, neglect, poverty, disability, 347.7 chronic health conditions, or other factors, including ethnicity 347.8 and race, that may result in poor outcomes or disparities, as 347.9 well as services for family members to support those individuals. 347.10 (b) Services eligible as allowable expenditures under 347.11 sections 256M.01 to 256M.80 include, but are not limited to, 347.12 services that: (1) protect a person from harm; (2) support 347.13 permanent living arrangements; (3) provide treatment; (4) 347.14 maintain family relationships; (5) increase parenting skills; 347.15 (6) reduce substance abuse; and (7) reduce domestic violence. 347.16 These services may be provided by professionals or 347.17 nonprofessionals, including the person's natural supports in the 347.18 community. 347.19 (c) Services shall, to the extent possible: (1) build on 347.20 family and community strengths; (2) help prevent crisis by 347.21 meeting needs early; (3) provide transitional supports to 347.22 adolescents and young adults making the transition to adulthood; 347.23 (4) offer help in basic needs, special needs, and referrals; (5) 347.24 respond flexibly to the needs of the person and the family; (6) 347.25 be culturally sensitive and responsive to the needs of the 347.26 person; and (7) be offered in the family home as well as in 347.27 other settings. 347.28 (d) Children and community services do not include services 347.29 under the public assistance programs known as the Minnesota 347.30 family investment program, Minnesota supplemental aid, medical 347.31 assistance, general assistance, general assistance medical care, 347.32 MinnesotaCare, or community health services. 347.33 Subd. 3. [COMMISSIONER.] "Commissioner" means the 347.34 commissioner of human services. 347.35 Subd. 4. [COUNTY BOARD.] "County board" means the board of 347.36 county commissioners in each county. 348.1 Subd. 5. [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 348.2 GRANTS.] "Former children's services and community service 348.3 grants" means allocations for the following grants: 348.4 (1) community social service grants under sections 252.24, 348.5 256E.06, and 256E.14; 348.6 (2) family preservation grants under section 256F.05, 348.7 subdivision 3; 348.8 (3) concurrent permanency planning grants under section 348.9 260C.213, subdivision 5; 348.10 (4) social service block grants (Title XX) under section 348.11 256E.07; 348.12 (5) children's mental health grants under sections 245.4886 348.13 and 260.152. 348.14 Subd. 6. [HUMAN SERVICES BOARD.] "Human services board" 348.15 means a board established under section 402.02; Laws 1974, 348.16 chapter 293; or Laws 1976, chapter 340. 348.17 Subd. 7. [YOUNG ADULT.] "Young adult" means a person 348.18 between the ages of 18 and 25. 348.19 Sec. 3. [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 348.20 SERVICES.] 348.21 Subdivision 1. [GENERAL SUPERVISION.] Each year the 348.22 commissioner shall allocate funds to each county according to 348.23 section 256M.40 and service agreements under section 256M.30. 348.24 The funds shall be used to address the needs of children, 348.25 adolescents, and young adults. The commissioner, in 348.26 consultation with counties, shall establish performance 348.27 standards, provide technical assistance, and evaluate county 348.28 performance in achieving outcomes. 348.29 Subd. 2. [ADDITIONAL DUTIES.] The commissioner shall: 348.30 (1) provide necessary information and instructions to each 348.31 county for establishing baselines and desired improvements on 348.32 safety, permanency, and well-being for children, adolescents, 348.33 and young adults; 348.34 (2) provide training, technical assistance, and other 348.35 supports to each county board to assist in needs assessment, 348.36 planning, implementation, and monitoring of outcomes and service 349.1 quality; 349.2 (3) design and implement a continuous quality improvement 349.3 method, including site visits that utilize quality reviews and 349.4 timely feedback to each county regarding the county's 349.5 performance in the context of the service agreement under 349.6 section 256M.30; 349.7 (4) specify requirements for reports, including fiscal 349.8 reports to account for funds distributed; 349.9 (5) request waivers from federal programs as necessary to 349.10 implement this act; and 349.11 (6) have authority under sections 14.055 and 14.056 to 349.12 grant a variance to existing state rules as needed to eliminate 349.13 barriers to achieving desired outcomes. 349.14 Subd. 3. [SANCTIONS.] (a) The commissioner shall establish 349.15 and maintain a monitoring program designed to reduce the 349.16 possibility of noncompliance with federal laws and federal 349.17 regulations that may result in federal fiscal sanctions. If a 349.18 county is not complying with federal law or federal regulation 349.19 and the noncompliance may result in federal fiscal sanctions, 349.20 the commissioner may withhold a portion of the county's share of 349.21 state and federal funds for that program. The amount withheld 349.22 must be equal to the percentage difference between the level of 349.23 compliance maintained by the county and the level of compliance 349.24 required by the federal regulations, multiplied by the county's 349.25 share of state and federal funds for the program. The state and 349.26 federal funds may be withheld until the county is found to be in 349.27 compliance with all federal laws or federal regulations 349.28 applicable to the program. If a county remains out of 349.29 compliance for more than six consecutive months, the 349.30 commissioner may reallocate the withheld funds to counties that 349.31 are in compliance with the federal regulations. 349.32 (b) The commissioner may require a county to enter into a 349.33 joint powers agreement with one or more counties in good 349.34 standing if the commissioner determines that a county has failed 349.35 to reach the targets identified in its approved service 349.36 agreements over a four-year period for the core outcomes 350.1 established for all counties. 350.2 Subd. 4. [CORRECTIVE ACTION PROCEDURE.] The commissioner 350.3 must comply with the following procedures when reducing county 350.4 funds under subdivision 3, paragraph (a), or requiring a joint 350.5 powers agreement under subdivision 3, paragraph (b). 350.6 (a) The commissioner shall notify the county, by certified 350.7 mail, of the statute, rule, federal law, or federal regulation 350.8 with which the county has not complied. 350.9 (b) The commissioner shall give the county 30 days to 350.10 demonstrate to the commissioner that the county is in compliance 350.11 with the statute, rule, federal law, or federal regulation cited 350.12 in the notice or to develop a corrective action plan to address 350.13 the problem. Upon request from the county, the commissioner 350.14 shall provide technical assistance to the county in developing a 350.15 corrective action plan. The county shall have 30 days from the 350.16 date the technical assistance is provided to develop the 350.17 corrective action plan. 350.18 (c) The commissioner shall take no further action if the 350.19 county demonstrates compliance with the statute, rule, federal 350.20 law, or federal regulation cited in the notice. 350.21 (d) The commissioner shall review and approve or disapprove 350.22 the corrective action plan within 30 days after the commissioner 350.23 receives the corrective action plan. 350.24 (e) If the commissioner approves the corrective action plan 350.25 submitted by the county, the county has 90 days after the date 350.26 of approval to implement the corrective action plan. 350.27 (f) If the county fails to demonstrate compliance or fails 350.28 to implement the corrective action plan approved by the 350.29 commissioner, the commissioner may reduce the county's share of 350.30 state or federal funds according to subdivision 3. 350.31 Sec. 4. [256M.30] [SERVICE AGREEMENT.] 350.32 Subdivision 1. [APPROVAL REQUIRED BY COMMISSIONER.] 350.33 Effective January 1, 2004, and each two-year period thereafter, 350.34 each county must have a biennial service agreement approved by 350.35 the commissioner in order to receive funds. Counties may submit 350.36 multicounty or regional service agreements. 351.1 Subd. 2. [CONTENTS.] The service agreement shall be 351.2 completed in a form prescribed by the commissioner. The 351.3 agreement must include: 351.4 (1) a statement of the needs of the children, adolescents, 351.5 and young adults who experience the conditions defined in 351.6 section 256M.10, subdivision 2, paragraph (a), and strengths and 351.7 resources available in the community to address those needs; 351.8 (2) outcomes prescribed by the commissioner that set 351.9 minimum performance standards for all counties, and additional 351.10 outcomes, identified by the county, to improve the safety, 351.11 permanency, and well-being of these individuals to be 351.12 accomplished annually. This information shall include current 351.13 baseline information for each outcome and annual performance 351.14 target to be reached; 351.15 (3) strategies the county will pursue to achieve the 351.16 performance targets. Strategies must include specification of 351.17 how funds under this section and other community resources will 351.18 be used to achieve desired performance targets; and 351.19 (4) description of the county's process to solicit public 351.20 input and a summary of that input. 351.21 Subd. 3. [INFORMATION.] The commissioner shall provide 351.22 each county with information and technical assistance needed to 351.23 complete the service agreement, including: information on child 351.24 safety, permanency, and well-being in the county; comparisons 351.25 with other counties; baseline performance on outcome measures; 351.26 and promising program practices. 351.27 Subd. 4. [TIMELINES.] The preliminary service agreement 351.28 must be submitted to the commissioner by October 15, 2003, and 351.29 October 15 of every two years thereafter. 351.30 Subd. 5. [PUBLIC COMMENT.] The county board must determine 351.31 how citizens in the county will participate in the development 351.32 of the service agreement and provide opportunities for such 351.33 participation. The county must allow a period of no less than 351.34 30 days prior to the submission of the agreement to the 351.35 commissioner to solicit comments from the public on the contents 351.36 of the agreement. 352.1 Subd. 6. [COMMISSIONER RESPONSIBILITIES.] The commissioner 352.2 must, within 60 days of receiving each county service agreement, 352.3 inform the county if the service agreement has been approved. 352.4 If the service agreement is not approved, the commissioner must 352.5 inform the county of any revisions needed prior to approval. 352.6 Sec. 5. [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 352.7 GRANT ALLOCATION.] 352.8 Subdivision 1. [FORMULA.] Exclusive of subdivision 3, the 352.9 commissioner shall allocate state funds appropriated for 352.10 children and community services grants to each county board on a 352.11 calendar year basis in an amount determined according to the 352.12 formula in paragraphs (a) to (c). 352.13 (a) For July 1, 2003, through December 31, 2003, the 352.14 commissioner shall allocate funds to each county equal to that 352.15 county's allocation for the grants under section 256M.10, 352.16 subdivision 5, for calendar year 2003 less payments made on or 352.17 before June 30, 2003. 352.18 (b) For calendar year 2004 and 2005, the commissioner shall 352.19 allocate available funds to each county in proportion to that 352.20 county's share of the calendar year 2003 allocations for the 352.21 grants under section 256M.10, subdivision 5. 352.22 (c) For calendar year 2006 and each calendar year 352.23 thereafter, the commissioner shall allocate available funds to 352.24 each county in proportion to that county's share in the 352.25 preceding calendar year. 352.26 Subd. 2. [PERFORMANCE INCENTIVE.] Beginning with the 352.27 calendar year 2006 allocation, the commissioner shall withhold 352.28 five percent of the annual allocation for each county. This 352.29 portion shall be released to the county based on the 352.30 commissioner's determination of the county's achievement of 352.31 positive outcomes as agreed to in the service agreement. Any 352.32 funds not disbursed under this subdivision to a county shall be 352.33 reallocated by the commissioner to other counties who, based on 352.34 the commissioner's determination, have achieved positive 352.35 outcomes as agreed to in the service agreements. 352.36 Subd. 3. [PROJECT OF REGIONAL SIGNIFICANCE.] Beginning 353.1 with the calendar year 2006 allocation, $25,000,000 of the 353.2 available annual funds are dedicated for projects of regional 353.3 significance. The commissioner shall publish a request to 353.4 solicit proposals from groups of counties by region. The 353.5 regional groupings shall be designated by the commissioner, in 353.6 consultation with counties. These projects shall support the 353.7 efforts in paragraphs (a) to (c). 353.8 (a) Funds are available to regional consortia of counties 353.9 to support cooperative regional projects between governments, 353.10 schools, and nonprofit providers designed to put in place 353.11 comprehensive health and developmental screening for all 353.12 children below six years, and to support projects that address 353.13 early identification of physical and mental health needs in 353.14 children. Project partners applying under this provision must 353.15 show how local resources will also be aligned to meet project 353.16 goals. 353.17 (b) Funds are available to the different geographic regions 353.18 to support efforts that lead to simplification and improve 353.19 outcomes through regional administration of human services. 353.20 (c) Funds are available to counties for innovative regional 353.21 projects designed to improve outcomes for children, adolescents, 353.22 young adults, and their families to reduce the cost of providing 353.23 services through innovative delivery or service design 353.24 strategies, to test alternative incentives within a support 353.25 strategy, or to develop new strategies to engage communities in 353.26 caring for risk populations especially populations with 353.27 disparities in outcome indicators. Up to five percent of funds 353.28 for innovation may be made to organizations other than counties. 353.29 Subd. 4. [PAYMENTS.] Calendar year allocations under 353.30 subdivisions 1 and 2 shall be paid to counties on or before July 353.31 10 of each year. Funds awarded under subdivision 3 shall be 353.32 paid according to requirements in the contract between the 353.33 commissioner and the contracting entities. 353.34 Sec. 6. [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 353.35 GRANT ALLOCATION.] 353.36 In federal fiscal year 2004 and subsequent years, money for 354.1 social services received from the federal government to 354.2 reimburse counties for social service expenditures according to 354.3 Title XX of the Social Security Act shall be allocated to each 354.4 county according to section 256M.40, except for funds allocated 354.5 for migrant day care. 354.6 Sec. 7. [256M.60] [DUTIES OF COUNTY BOARDS.] 354.7 Subdivision 1. [RESPONSIBILITIES.] The county board of 354.8 each county shall be responsible for administration and funding 354.9 of children and community services as defined in section 354.10 256M.10, subdivisions 1 and 2. Each county board shall singly 354.11 or in combination with other county boards use funds available 354.12 to the county under this act to carry out these responsibilities. 354.13 The county board shall coordinate and facilitate the effective 354.14 use of formal and informal helping systems to best support and 354.15 nurture children, adolescents, and young adults within the 354.16 county who experience dependency, abuse, neglect, poverty, 354.17 disability, chronic health conditions, or other factors, 354.18 including ethnicity and race, that may result in poor outcomes 354.19 or disparities, as well as services for family members to 354.20 support such individuals. This includes assisting individuals 354.21 to function at the highest level of ability while maintaining 354.22 family and community relationships to the greatest extent 354.23 possible. 354.24 Subd. 2. [REPORTS.] The county board shall provide 354.25 necessary reports and data as required by the commissioner. 354.26 Subd. 3. [CONTRACTS FOR SERVICES.] The county board may 354.27 contract with a human services board, a multicounty board 354.28 established by a joint powers agreement, other political 354.29 subdivisions, a children's mental health collaborative, a family 354.30 services collaborative, or private organizations in discharging 354.31 its duties. 354.32 Subd. 4. [EXEMPTION FROM LIABILITY.] The state of 354.33 Minnesota, the county boards, or the agencies acting on behalf 354.34 of the county boards in the implementation and administration of 354.35 children and community services shall not be liable for damages, 354.36 injuries, or liabilities sustained through the purchase of 355.1 services by the individual, the individual's family, or the 355.2 authorized representative under this section. 355.3 Sec. 8. [256M.70] [FISCAL LIMITATIONS.] 355.4 Subdivision 1. [SERVICE LIMITATION.] If the county has met 355.5 the requirements in subdivisions 2 to 4, the county shall not be 355.6 required to provide children and community services beyond 355.7 requirements in federal or state law. 355.8 Subd. 2. [DEMONSTRATION OF REASONABLE EFFORT.] The county 355.9 shall make reasonable efforts to comply with all children and 355.10 community services requirements. For the purposes of this 355.11 section, a county is making reasonable efforts if the county has 355.12 made efforts to comply with requirements within the limits of 355.13 available funding, including efforts to identify and apply for 355.14 commonly available state and federal funding for services. 355.15 Subd. 3. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 355.16 county has made reasonable efforts to comply with all applicable 355.17 administrative rule requirements and is unable to meet all 355.18 requirements, the county must provide services using the 355.19 following considerations: 355.20 (1) providing services needed to protect children, 355.21 adolescents, and young adults from maltreatment, abuse, and 355.22 neglect; 355.23 (2) providing emergency and crisis services needed to 355.24 protect clients from physical, emotional, or psychological harm; 355.25 (3) assessing and documenting the needs of persons applying 355.26 for services and referring to appropriate services when 355.27 necessary; 355.28 (4) providing public guardianship services for children; 355.29 and 355.30 (5) fulfilling licensing responsibilities delegated to the 355.31 county by the commissioner under section 245A.16. 355.32 Subd. 4. [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 355.33 DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 355.34 terminates services to an individual due to fiscal limitations, 355.35 the county must meet the requirements in subdivisions 2 and 3. 355.36 The county must notify the individual and the individual's 356.1 guardian in writing of the reason for the denial, reduction, or 356.2 termination of services and must inform the individual and the 356.3 individual's guardian in writing that the county will, upon 356.4 request, meet to discuss alternatives before services are 356.5 terminated or reduced. 356.6 Subd. 5. [APPEAL RIGHTS.] An individual who applies for or 356.7 receives children and community services under this chapter, 356.8 whose application is denied, or whose services are reduced or 356.9 terminated does not have the right to a fair hearing under 356.10 section 256.045. 356.11 Subd. 6. [RIGHT TO PETITION FOR REVIEW.] Any individual 356.12 who applies for or receives children and community services 356.13 under this chapter, whose application is denied, or whose 356.14 services are reduced or terminated may petition the commissioner 356.15 to review the county's performance under the county service 356.16 agreement. The petition must be in writing and must be specific 356.17 as to what action the individual believes is inconsistent with 356.18 the county service agreement, and what action the individual 356.19 believes should be required. Upon receiving a petition, the 356.20 commissioner shall have 60 days in which to make a reply in 356.21 writing as to its determination and any corrective action 356.22 required. 356.23 Sec. 9. [256M.80] [PROGRAM EVALUATION.] 356.24 Subdivision 1. [COUNTY EVALUATION.] Each county shall 356.25 submit to the commissioner data from the past calendar year on 356.26 the outcomes in the approved service agreement. The 356.27 commissioner shall prescribe standard methods to be used by the 356.28 counties in providing the data. The data shall be submitted no 356.29 later than March 1 of each year, beginning with March 1, 2005. 356.30 Subd. 2. [STATEWIDE EVALUATION.] Six months after the end 356.31 of the first full calendar year and annually thereafter, the 356.32 commissioner shall prepare a report on the counties' progress in 356.33 improving the outcomes of children, adolescents, and young 356.34 adults related to safety, permanency, and well-being. This 356.35 report shall be disseminated throughout the state. 356.36 Sec. 10. [REVISOR'S INSTRUCTION.] 357.1 For sections in Minnesota Statutes and Minnesota Rules 357.2 affected by the repealed sections in this article, the revisor 357.3 shall delete internal cross-references where appropriate and 357.4 make changes necessary to correct the punctuation, grammar, or 357.5 structure of the remaining text and preserve its meaning. 357.6 Sec. 11. [REPEALER.] 357.7 (a) Minnesota Statutes 2002, sections 245.478; 245.4886; 357.8 245.4888; 245.496; 254A.17; 256B.0945, subdivisions 6, 7, 8, 9, 357.9 and 10; 256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 357.10 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 256E.11; 357.11 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 256F.03; 357.12 256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 357.13 256F.14; 257.075; 257.81; 260.152; and 626.562, are repealed. 357.14 (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 357.15 9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 357.16 9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 357.17 ARTICLE 7 357.18 HUMAN SERVICES MISCELLANEOUS 357.19 Section 1. Minnesota Statutes 2002, section 69.021, 357.20 subdivision 11, is amended to read: 357.21 Subd. 11. [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 357.22 The excess police state-aid holding account is established in 357.23 the general fund. The excess police state-aid holding account 357.24 must be administered by the commissioner. 357.25 (b) Excess police state aid determined according to 357.26 subdivision 10, must be deposited in the excess police state-aid 357.27 holding account. 357.28 (c) From the balance in the excess police state-aid holding 357.29 account,$1,000,000$900,000 is appropriated to and must be 357.30 transferred annually to the ambulance service personnel 357.31 longevity award and incentive suspense account established by 357.32 section 144E.42, subdivision 2. 357.33 (d) If a police officer stress reduction program is created 357.34 by law and money is appropriated for that program, an amount 357.35 equal to that appropriation must be transferred from the balance 357.36 in the excess police state-aid holding account. 358.1 (e) On October 1, 1997, and annually on each subsequent 358.2 October 1, one-half of the balance of the excess police 358.3 state-aid holding account remaining after the deductions under 358.4 paragraphs (c) and (d) is appropriated for additional 358.5 amortization aid under section 423A.02, subdivision 1b. 358.6 (f) Annually, the remaining balance in the excess police 358.7 state-aid holding account, after the deductions under paragraphs 358.8 (c), (d), and (e), cancels to the general fund. 358.9 Sec. 2. Minnesota Statutes 2002, section 245A.10, is 358.10 amended to read: 358.11 245A.10 [FEES.] 358.12 Subdivision 1. [APPLICATION OR LICENSE FEE REQUIRED, 358.13 PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 358.14 (b), the commissioner shall charge a fee for evaluation of 358.15 applications and inspection of programs, other than family day358.16care and foster care,which are licensed under this chapter. 358.17The commissioner may charge a fee for the licensing of school358.18age child care programs, in an amount sufficient to cover the358.19cost to the state agency of processing the license.358.20 (b) Notwithstanding paragraph (a), no application or 358.21 license fee shall be charged for family child care, child foster 358.22 care, adult foster care, or state-operated programs, unless the 358.23 state-operated program is an intermediate care facility for 358.24 persons with mental retardation or related conditions (ICF/MR). 358.25 Subd. 2. [APPLICATION FEE FOR INITIAL LICENSE OR 358.26 CERTIFICATION.] (a) Unless exempt from paying a license fee 358.27 under subdivision 1, an applicant for an initial license or 358.28 certification issued by the commissioner shall submit a $500 358.29 application fee with each new application required under this 358.30 subdivision. The application fee shall not be prorated, is 358.31 nonrefundable, and is in lieu of the annual license or 358.32 certification fee that expires on December 31. The commissioner 358.33 shall not process an application until the application fee is 358.34 paid. 358.35 (b) Except as provided in clauses (1) to (3), an applicant 358.36 shall apply for a license to provide services at a specific 359.1 location. 359.2 (1) For a license to provide waivered services to persons 359.3 with developmental disabilities or related conditions, an 359.4 applicant shall submit an application for each county in which 359.5 the waivered services will be provided. 359.6 (2) For a license to provide semi-independent living 359.7 services to persons with developmental disabilities or related 359.8 conditions, an applicant shall submit a single application to 359.9 provide services statewide. 359.10 (3) For a license to provide independent living assistance 359.11 for youth under section 245A.22, an applicant shall submit a 359.12 single application to provide services statewide. 359.13 Subd. 3. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 359.14 WITH LICENSED CAPACITY.] (a) Child care centers and programs 359.15 with a licensed capacity shall pay an annual nonrefundable 359.16 license or certification fee based on the following schedule: 359.17 Licensed Capacity Child Care Residential 359.18 Center Program 359.19 License Fee License Fee 359.20 1 to 24 persons $300 $400 359.21 25 to 49 persons $450 $600 359.22 50 to 74 persons $600 $800 359.23 75 to 99 persons $750 $1,000 359.24 100 to 124 persons $900 $1,200 359.25 125 to 149 persons $1,200 $1,400 359.26 150 to 174 persons $1,400 $1,600 359.27 175 to 199 persons $1,600 $1,800 359.28 200 to 224 persons $1,800 $2,000 359.29 225 or more persons $2,000 $2,500 359.30 (b) A day training and habilitation program serving persons 359.31 with developmental disabilities or related conditions shall be 359.32 assessed a license fee based on the schedule in paragraph (a) 359.33 unless the license holder serves more than 50 percent of the 359.34 same persons at two or more locations in the community. When a 359.35 day training and habilitation program serves more than 50 359.36 percent of the same persons in two or more locations in a 360.1 community, the day training and habilitation program shall pay a 360.2 license fee based on the licensed capacity of the largest 360.3 facility and the other facility or facilities shall be charged a 360.4 license fee based on a licensed capacity of a residential 360.5 program serving one to 24 persons. 360.6 Subd. 4. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 360.7 WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 360.8 paragraph (b), a program without a stated licensed capacity 360.9 shall pay a license or certification fee of $400. 360.10 (b) A mental health center or mental health clinic 360.11 requesting certification for purposes of insurance and 360.12 subscriber contract reimbursement under Minnesota Rules, parts 360.13 9520.0750 to 9520.0870 shall pay a certification fee of $1,000 360.14 per year. If the mental health center or mental health clinic 360.15 provides services at a primary location with satellite 360.16 facilities, the satellite facilities shall be certified with the 360.17 primary location without an additional charge. 360.18 Subd. 5. [LICENSE NOT ISSUED UNTIL LICENSE OR 360.19 CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 360.20 license or certification until the license or certification fee 360.21 is paid. The commissioner shall send a bill for the license or 360.22 certification fee to the billing address identified by the 360.23 license holder. If the license holder does not submit the 360.24 license or certification fee payment by the due date, the 360.25 commissioner shall send the license holder a past due notice. 360.26 If the license holder fails to pay the license or certification 360.27 fee by the due date on the past due notice, the commissioner 360.28 shall send a final notice to the license holder informing the 360.29 license holder that the program license will expire on December 360.30 31 unless the license fee is paid before December 31. If a 360.31 license expires, the program is no longer licensed and, unless 360.32 exempt from licensure under section 245A.03, subdivision 2, must 360.33 not operate after the expiration date. After a license expires, 360.34 if the former license holder wishes to provide licensed 360.35 services, the former license holder must submit a new license 360.36 application and application fee under subdivision 2. 361.1 Sec. 3. Minnesota Statutes 2002, section 252.27, 361.2 subdivision 2a, is amended to read: 361.3 Subd. 2a. [CONTRIBUTION AMOUNT.] (a) The natural or 361.4 adoptive parents of a minor child, including a child determined 361.5 eligible for medical assistance without consideration of 361.6 parental income, must contribute monthly to the cost of 361.7 services, unless the child is married or has been married, 361.8 parental rights have been terminated, or the child's adoption is 361.9 subsidized according to section 259.67 or through title IV-E of 361.10 the Social Security Act. 361.11 (b) For households with adjusted gross income equal to or 361.12 greater than 100 percent of federal poverty guidelines, the 361.13 parental contribution shall bethe greater of a minimum monthly361.14fee of $25 for households with adjusted gross income of $30,000361.15and over, or an amount to becomputed by applying the following 361.16 schedule of rates to the adjusted gross income of the natural or 361.17 adoptive parentsthat exceeds 150 percent of the federal poverty361.18guidelines for the applicable household size, the following361.19schedule of rates: 361.20 (1)on the amount of adjusted gross income over 150 percent361.21of poverty, but not over $50,000, ten percentif the adjusted 361.22 gross income is equal to or greater than 100 percent of federal 361.23 poverty guidelines and less than 175 percent of federal poverty 361.24 guidelines, the parental contribution is $4 per month; 361.25 (2)onif theamount ofadjusted gross incomeover 150361.26percent of poverty and over $50,000 but not over $60,000, 12361.27percentis equal to or greater than 175 percent of federal 361.28 poverty guidelines and less than or equal to 375 percent of 361.29 federal poverty guidelines, the parental contribution shall be 361.30 determined using a sliding fee scale established by the 361.31 commissioner of human services which begins at one percent of 361.32 adjusted gross income at 175 percent of federal poverty 361.33 guidelines and increases to 7.5 percent of adjusted gross income 361.34 for those with adjusted gross income up to 375 percent of 361.35 federal poverty guidelines; 361.36 (3)onif theamount ofadjusted gross incomeover 150is 362.1 greater than 375 percent of federal poverty, and over $60,000362.2but not over $75,000, 14 percentguidelines and less than 675 362.3 percent of federal poverty guidelines, the parental contribution 362.4 shall be 7.5 percent of adjusted gross income;and362.5 (4)on allif the adjusted gross incomeamounts over 150is 362.6 equal to or greater than 675 percent of federal poverty, and362.7over $75,000, 15 percentguidelines and less than 975 percent of 362.8 federal poverty guidelines, the parental contribution shall be 362.9 ten percent of adjusted gross income; and 362.10 (5) if the adjusted gross income is equal to or greater 362.11 than 975 percent of federal poverty guidelines, the parental 362.12 contribution shall be 12.5 percent of adjusted gross income. 362.13 If the child lives with the parent, theparental362.14contributionannual adjusted gross income is reduced by$200,362.15except that the parent must pay the minimum monthly $25 fee362.16under this paragraph$2,400 prior to calculating the parental 362.17 contribution. If the child resides in an institution specified 362.18 in section 256B.35, the parent is responsible for the personal 362.19 needs allowance specified under that section in addition to the 362.20 parental contribution determined under this section. The 362.21 parental contribution is reduced by any amount required to be 362.22 paid directly to the child pursuant to a court order, but only 362.23 if actually paid. 362.24 (c) The household size to be used in determining the amount 362.25 of contribution under paragraph (b) includes natural and 362.26 adoptive parents and their dependents under age 21, including 362.27 the child receiving services. Adjustments in the contribution 362.28 amount due to annual changes in the federal poverty guidelines 362.29 shall be implemented on the first day of July following 362.30 publication of the changes. 362.31 (d) For purposes of paragraph (b), "income" means the 362.32 adjusted gross income of the natural or adoptive parents 362.33 determined according to the previous year's federal tax form. 362.34 (e) The contribution shall be explained in writing to the 362.35 parents at the time eligibility for services is being 362.36 determined. The contribution shall be made on a monthly basis 363.1 effective with the first month in which the child receives 363.2 services. Annually upon redetermination or at termination of 363.3 eligibility, if the contribution exceeded the cost of services 363.4 provided, the local agency or the state shall reimburse that 363.5 excess amount to the parents, either by direct reimbursement if 363.6 the parent is no longer required to pay a contribution, or by a 363.7 reduction in or waiver of parental fees until the excess amount 363.8 is exhausted. 363.9 (f) The monthly contribution amount must be reviewed at 363.10 least every 12 months; when there is a change in household size; 363.11 and when there is a loss of or gain in income from one month to 363.12 another in excess of ten percent. The local agency shall mail a 363.13 written notice 30 days in advance of the effective date of a 363.14 change in the contribution amount. A decrease in the 363.15 contribution amount is effective in the month that the parent 363.16 verifies a reduction in income or change in household size. 363.17 (g) Parents of a minor child who do not live with each 363.18 other shall each pay the contribution required under paragraph 363.19 (a), except that a. An amount equal to the annual court-ordered 363.20 child support payment actually paid on behalf of the child 363.21 receiving services shall be deducted from thecontribution363.22 adjusted gross income of the parent making the payment prior to 363.23 calculating the parental contribution under paragraph (b). 363.24 (h) The contribution under paragraph (b) shall be increased 363.25 by an additional five percent if the local agency determines 363.26 that insurance coverage is available but not obtained for the 363.27 child. For purposes of this section, "available" means the 363.28 insurance is a benefit of employment for a family member at an 363.29 annual cost of no more than five percent of the family's annual 363.30 income. For purposes of this section, "insurance" means health 363.31 and accident insurance coverage, enrollment in a nonprofit 363.32 health service plan, health maintenance organization, 363.33 self-insured plan, or preferred provider organization. 363.34 Parents who have more than one child receiving services 363.35 shall not be required to pay more than the amount for the child 363.36 with the highest expenditures. There shall be no resource 364.1 contribution from the parents. The parent shall not be required 364.2 to pay a contribution in excess of the cost of the services 364.3 provided to the child, not counting payments made to school 364.4 districts for education-related services. Notice of an increase 364.5 in fee payment must be given at least 30 days before the 364.6 increased fee is due. 364.7 (i) The contribution under paragraph (b) shall be reduced 364.8 by $300 per fiscal year if, in the 12 months prior to July 1: 364.9 (1) the parent applied for insurance for the child; 364.10 (2) the insurer denied insurance; 364.11 (3) the parents submitted a complaint or appeal, in writing 364.12 to the insurer, submitted a complaint or appeal, in writing, to 364.13 the commissioner of health or the commissioner of commerce, or 364.14 litigated the complaint or appeal; and 364.15 (4) as a result of the dispute, the insurer reversed its 364.16 decision and granted insurance. 364.17 For purposes of this section, "insurance" has the meaning 364.18 given in paragraph (h). 364.19 A parent who has requested a reduction in the contribution 364.20 amount under this paragraph shall submit proof in the form and 364.21 manner prescribed by the commissioner or county agency, 364.22 including, but not limited to, the insurer's denial of 364.23 insurance, the written letter or complaint of the parents, court 364.24 documents, and the written response of the insurer approving 364.25 insurance. The determinations of the commissioner or county 364.26 agency under this paragraph are not rules subject to chapter 14. 364.27 [EFFECTIVE DATE.] This section is effective July 1, 2003. 364.28 Sec. 4. Minnesota Statutes 2002, section 256.482, 364.29 subdivision 8, is amended to read: 364.30 Subd. 8. [SUNSET.] Notwithstanding section 15.059, 364.31 subdivision 5, the council on disability shall not sunset until 364.32 June 30,20032005. 364.33 Sec. 5. Minnesota Statutes 2002, section 518.551, 364.34 subdivision 7, is amended to read: 364.35 Subd. 7. [SERVICE FEEFEES AND COST RECOVERY FEES FOR IV-D 364.36 SERVICES.]When the public agency responsible for child support365.1enforcement provides child support collection services either to365.2a public assistance recipient or to a party who does not receive365.3public assistance, the public agency may upon written notice to365.4the obligor charge a monthly collection fee equivalent to the365.5full monthly cost to the county of providing collection365.6services, in addition to the amount of the child support which365.7was ordered by the court. The fee shall be deposited in the365.8county general fund. The service fee assessed is limited to ten365.9percent of the monthly court ordered child support and shall not365.10be assessed to obligors who are current in payment of the365.11monthly court ordered child support.(a) When a recipient of 365.12 IV-D services is no longer receiving assistance under the 365.13 state's plan for foster care, medical assistance, or 365.14 MinnesotaCare programs, the public authority responsible for 365.15 child support enforcement must notify the recipient, within five 365.16 working days of the notification of ineligibility, that IV-D 365.17 services will be continued unless the public authority is 365.18 notified to the contrary by the recipient. The notice must 365.19 include the implications of continuing to receive IV-D services, 365.20 including the available services and fees, cost recovery fees, 365.21 and distribution policies relating to fees. 365.22 (b) An application fee of $25 shall be paid by the person 365.23 who applies for child support and maintenance collection 365.24 services, except persons who are receiving public assistance as 365.25 defined in section 256.741 and, if enacted, the diversionary 365.26 work program under section 256J.95, persons who transfer from 365.27 public assistance to nonpublic assistance status, and minor 365.28 parents and parents enrolled in a public secondary school, area 365.29 learning center, or alternative learning program approved by the 365.30 commissioner of children, families, and learning. 365.31 (c) When the public authority provides full IV-D services 365.32 to an obligee who has applied for those services, upon written 365.33 notice to the obligee, the public authority must charge a cost 365.34 recovery fee of one percent of the amount collected. This fee 365.35 must be deducted from the amount of the child support and 365.36 maintenance collected and not assigned under section 256.741, 366.1 before disbursement to the obligee. This fee applies to an 366.2 obligee who: 366.3 (1) has never received assistance under the state's title 366.4 IV-A, IV-E foster care, medical assistance, or MinnesotaCare 366.5 programs; 366.6 (2) has received assistance under the state's medical 366.7 assistance or MinnesotaCare programs. The fee must be charged 366.8 immediately upon becoming ineligible; or 366.9 (3) has received assistance under the state's title IV-A or 366.10 IV-E foster care programs. The fee must not be charged until 366.11 the person has not received these services for 24 consecutive 366.12 months. 366.13 (d) When the public authority provides full IV-D services 366.14 to an obligor who has applied for such services, upon written 366.15 notice to the obligor, the public authority must charge a cost 366.16 recovery fee of one percent of the monthly court ordered child 366.17 support and maintenance obligation and may be collected through 366.18 income withholding, as well as by any other enforcement remedy 366.19 available to the public authority responsible for child support 366.20 enforcement. 366.21 (e) Fees assessed by state and federal tax agencies for 366.22 collection of overdue support owed to or on behalf of a person 366.23 not receiving public assistance must be imposed on the person 366.24 for whom these services are provided. The public authority upon 366.25 written notice to the obligee shall assess a fee of $25 to the 366.26 person not receiving public assistance for each successful 366.27 federal tax interception. The fee must be withheld prior to the 366.28 release of the funds received from each interception and 366.29 deposited in the general fund. 366.30 (f) Cost recovery fees collected under paragraphs (c) and 366.31 (d) shall be considered child support program income according 366.32 to Code of Federal Regulations, title 45, section 304.50, and 366.33 shall be deposited in the cost recovery fee account established 366.34 under paragraph (h). The commissioner of human services must 366.35 elect to recover costs based on either actual or standardized 366.36 costs. 367.1However,(g) The limitations of this subdivision on the 367.2 assessment of fees shall not apply to the extent inconsistent 367.3 with the requirements of federal law for receiving funds for the 367.4 programs under Title IV-A and Title IV-D of the Social Security 367.5 Act, United States Code, title 42, sections 601 to 613 and 367.6 United States Code, title 42, sections 651 to 662. 367.7 (h) The commissioner of human services is authorized to 367.8 establish a special revenue fund account to receive child 367.9 support cost recovery fees. A portion of the nonfederal share 367.10 of these fees may be retained for expenditures necessary to 367.11 administer the fee, and must be transferred to the child support 367.12 system special revenue account. The remaining nonfederal share 367.13 of the cost recovery fee must be retained by the commissioner 367.14 and dedicated to the child support general fund county 367.15 performance based grant account authorized under sections 367.16 256.979 and 256.9791. 367.17 [EFFECTIVE DATE.] This section is effective July 1, 2004, 367.18 except paragraph (d) is effective July 1, 2005. 367.19 Sec. 6. Minnesota Statutes 2002, section 518.6111, 367.20 subdivision 2, is amended to read: 367.21 Subd. 2. [APPLICATION.] This section applies to all 367.22 support orders issued by a court or an administrative tribunal 367.23 and orders for or notices of withholding issued by the public 367.24 authorityaccording to section 518.5513, subdivision 5,367.25paragraph (a), clause (5). 367.26 [EFFECTIVE DATE.] This section is effective July 1, 2004. 367.27 Sec. 7. Minnesota Statutes 2002, section 518.6111, 367.28 subdivision 3, is amended to read: 367.29 Subd. 3. [ORDER.] Every support order must address income 367.30 withholding. Whenever a support order is initially entered or 367.31 modified, the full amount of the support order must be 367.32withheldsubject to income withholding from the income of the 367.33 obligor. If the obligee or obligor applies for either full IV-D 367.34 services or for income withholding only services from the public 367.35 authority responsible for child support enforcement, the full 367.36 amount of the support order must be withheld from the income of 368.1 the obligor and forwarded to the public authority. Every order 368.2 for support or maintenance shall provide for a conspicuous 368.3 notice of the provisions of this section that complies with 368.4 section 518.68, subdivision 2. An order without this notice 368.5 remains subject to this section. This section applies 368.6 regardless of the source of income of the person obligated to 368.7 pay the support or maintenance. 368.8 A payor of funds shall implement income withholding 368.9 according to this section upon receipt of an order for or notice 368.10 of withholding. The notice of withholding shall be on a form 368.11 provided by the commissioner of human services. 368.12 [EFFECTIVE DATE.] This section is effective July 1, 2004. 368.13 Sec. 8. Minnesota Statutes 2002, section 518.6111, 368.14 subdivision 4, is amended to read: 368.15 Subd. 4. [COLLECTION SERVICES.] (a) The commissioner of 368.16 human services shall prepare and make available to the courts a 368.17 notice of services that explains child support and maintenance 368.18 collection services available through the public authority, 368.19 including income withholding, and the fees for such services. 368.20 Upon receiving a petition for dissolution of marriage or legal 368.21 separation, the court administrator shall promptly send the 368.22 notice of services to the petitioner and respondent at the 368.23 addresses stated in the petition. 368.24 (b) Either the obligee or obligor may at any time apply to 368.25 the public authority for either full IV-D services or for income 368.26 withholding only services. 368.27Upon receipt of a support order requiring income368.28withholding, a petitioner or respondent, who is not a recipient368.29of public assistance and does not receive child support services368.30from the public authority, shall apply to the public authority368.31for either full child support collection services or for income368.32withholding only services.368.33 (c) For those persons applying for income withholding only 368.34 services, a monthly service fee of $15 must be charged to the 368.35 obligor. This fee is in addition to the amount of the support 368.36 order and shall be withheld through income withholding. The 369.1 public authority shall explain the service options in this 369.2 section to the affected parties and encourage the application 369.3 for full child support collection services. 369.4 (d) If the obligee is not a current recipient of public 369.5 assistance as defined in section 256.741, the person who applied 369.6 for services may at any time choose to terminate either full 369.7 IV-D services or income withholding only services regardless of 369.8 whether income withholding is currently in place. The obligee 369.9 or obligor may reapply for either full IV-D services or income 369.10 withholding only services at any time. Unless the applicant is 369.11 a recipient of public assistance as defined in section 256.741, 369.12 a $25 application fee shall be charged at the time of each 369.13 application. 369.14 (e) When a person terminates IV-D services, if an arrearage 369.15 for public assistance as defined in section 256.741 exists, the 369.16 public authority may continue income withholding, as well as use 369.17 any other enforcement remedy for the collection of child 369.18 support, until all public assistance arrears are paid in full. 369.19 Income withholding shall be in an amount equal to 20 percent of 369.20 the support order in effect at the time the services terminated. 369.21 [EFFECTIVE DATE.] This section is effective July 1, 2004. 369.22 Sec. 9. Minnesota Statutes 2002, section 518.6111, 369.23 subdivision 16, is amended to read: 369.24 Subd. 16. [WAIVER.] (a) If the public authority is 369.25 providing child support and maintenance enforcement services and 369.26 child support or maintenance is not assigned under section 369.27 256.741, the court may waive the requirements of this section if 369.28the court finds there is no arrearage in child support and369.29maintenance as of the date of the hearing and: 369.30 (1) one party demonstrates and the courtfindsdetermines 369.31 there is good cause to waive the requirements of this section or 369.32 to terminate an order for or notice of income withholding 369.33 previously entered under this section. The court must make 369.34 written findings to include the reasons income withholding would 369.35 not be in the best interests of the child. In cases involving a 369.36 modification of support, the court must also make a finding that 370.1 support payments have been timely made; or 370.2 (2)all parties reach anthe obligee and obligor sign a 370.3 written agreementand the agreementproviding for an alternative 370.4 payment arrangement which isapprovedreviewed and entered in 370.5 the record by the courtafter a finding that the agreement is370.6likely to result in regular and timely payments. The court's370.7findings waiving the requirements of this paragraph shall370.8include a written explanation of the reasons why income370.9withholding would not be in the best interests of the child. 370.10In addition to the other requirements in this subdivision,370.11if the case involves a modification of support, the court shall370.12make a finding that support has been timely made.370.13 (b) If the public authority is not providing child support 370.14 and maintenance enforcement services and child support or 370.15 maintenance is not assigned under section 256.741, the court may 370.16 waive the requirements of this section if the parties sign a 370.17 written agreement. 370.18 (c) If the court waives income withholding, the obligee or 370.19 obligor may at any time request income withholding under 370.20 subdivision 7. 370.21 [EFFECTIVE DATE.] This section is effective July 1, 2004. 370.22 Sec. 10. [REVISOR'S INSTRUCTION.] 370.23 For sections in Minnesota Statutes and Minnesota Rules 370.24 affected by the repealed sections in this article, the revisor 370.25 shall delete internal cross-references where appropriate and 370.26 make changes necessary to correct the punctuation, grammar, or 370.27 structure of the remaining text and preserve its meaning. 370.28 Sec. 11. [REPEALER.] 370.29 Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 370.30 9545.2030; and 9545.2040, are repealed. 370.31 ARTICLE 8 370.32 HEALTH DEPARTMENT MISCELLANEOUS 370.33 Section 1. Minnesota Statutes 2002, section 62J.692, 370.34 subdivision 4, is amended to read: 370.35 Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner 370.36 shall annually distribute medical education funds to all 371.1 qualifying applicants based on the following criteria: 371.2 (1) total medical education funds available for 371.3 distribution; 371.4 (2) total number of eligible trainee FTEs in each clinical 371.5 medical education program; and 371.6 (3) the statewide average cost per trainee as determined by 371.7 the application information provided in the first year of the 371.8 biennium, by type of trainee, in each clinical medical education 371.9 program. 371.10 (b) Funds distributed shall not be used to displace current 371.11 funding appropriations from federal or state sources. 371.12 (c) Funds shall be distributed to the sponsoring 371.13 institutions indicating the amount to be distributed to each of 371.14 the sponsor's clinical medical education programs based on the 371.15 criteria in this subdivision and in accordance with the 371.16 commissioner's approval letter. Each clinical medical education 371.17 program must distribute funds to the training sites as specified 371.18 in the commissioner's approval letter. Sponsoring institutions, 371.19 which are accredited through an organization recognized by the 371.20 department of education or the Centers for Medicare and Medicaid 371.21 Services, may contract directly with training sites to provide 371.22 clinical training. To ensure the quality of clinical training, 371.23 those accredited sponsoring institutions must: 371.24 (1) develop contracts specifying the terms, expectations, 371.25 and outcomes of the clinical training conducted at sites; and 371.26 (2) take necessary action if the contract requirements are 371.27 not met. Action may include the withholding of payments under 371.28 this section or the removal of students from the site. 371.29 (d) Any funds not distributed in accordance with the 371.30 commissioner's approval letter must be returned to the medical 371.31 education and research fund within 30 days of receiving notice 371.32 from the commissioner. The commissioner shall distribute 371.33 returned funds to the appropriate training sites in accordance 371.34 with the commissioner's approval letter. 371.35 (e) The commissioner shall distribute by June 30 of each 371.36 year an amount equal to the funds transferred undersection372.162J.694, subdivision 2a, paragraph (b)subdivision 10, plus five 372.2 percent interest to the University of Minnesota board of regents 372.3 for thecosts of the academic health center as specified under372.4section 62J.694, subdivision 2a, paragraph (a).instructional 372.5 costs of health professional programs at the academic health 372.6 center and for interdisciplinary academic initiatives within the 372.7 academic health center. 372.8 (f) A maximum of $150,000 of the funds dedicated to the 372.9 commissioner under section 297F.10, subdivision 1, paragraph 372.10 (b), clause (2), may be used by the commissioner for 372.11 administrative expenses associated with implementing this 372.12 section. 372.13 Sec. 2. Minnesota Statutes 2002, section 62J.692, is 372.14 amended by adding a subdivision to read: 372.15 Subd. 10. [TRANSFERS FROM UNIVERSITY OF MINNESOTA.] Of the 372.16 funds dedicated to the academic health center under section 372.17 297F.10, subdivision 1, paragraph (b), clause (1), $4,850,000 372.18 shall be transferred annually to the commissioner of health no 372.19 later than April 15 of each year for distribution under 372.20 subdivision 4, paragraph (e). 372.21 Sec. 3. Minnesota Statutes 2002, section 62Q.19, 372.22 subdivision 1, is amended to read: 372.23 Subdivision 1. [DESIGNATION.] (a) The commissioner shall 372.24 designate essential community providers. The criteria for 372.25 essential community provider designation shall be the following: 372.26 (1) a demonstrated ability to integrate applicable 372.27 supportive and stabilizing services with medical care for 372.28 uninsured persons and high-risk and special needs populations, 372.29 underserved, and other special needs populations; and 372.30 (2) a commitment to serve low-income and underserved 372.31 populations by meeting the following requirements: 372.32 (i) has nonprofit status in accordance with chapter 317A; 372.33 (ii) has tax exempt status in accordance with the Internal 372.34 Revenue Service Code, section 501(c)(3); 372.35 (iii) charges for services on a sliding fee schedule based 372.36 on current poverty income guidelines; and 373.1 (iv) does not restrict access or services because of a 373.2 client's financial limitation; 373.3 (3) status as a local government unit as defined in section 373.4 62D.02, subdivision 11, a hospital district created or 373.5 reorganized under sections 447.31 to 447.37, an Indian tribal 373.6 government, an Indian health service unit, or a community health 373.7 board as defined in chapter 145A; 373.8 (4) a former state hospital that specializes in the 373.9 treatment of cerebral palsy, spina bifida, epilepsy, closed head 373.10 injuries, specialized orthopedic problems, and other disabling 373.11 conditions; or 373.12 (5)a rural hospital that has qualified fora sole 373.13 community hospitalfinancial assistance grant in the past three373.14years under section 144.1484, subdivision 1. For these rural 373.15 hospitals, the essential community provider designation applies 373.16 to all health services provided, including both inpatient and 373.17 outpatient services. For purposes of this section, "sole 373.18 community hospital" means a rural hospital that: 373.19 (i) is eligible to be classified as a sole community 373.20 hospital according to Code of Federal Regulations, title 42, 373.21 section 412.92, or is located in a community with a population 373.22 of less than 5,000 and located more than 25 miles from a like 373.23 hospital currently providing acute short-term services; 373.24 (ii) has experienced net operating income losses in two of 373.25 the previous three most recent consecutive hospital fiscal years 373.26 for which audited financial information is available; and 373.27 (iii) consists of 40 or fewer licensed beds. 373.28 (b) Prior to designation, the commissioner shall publish 373.29 the names of all applicants in the State Register. The public 373.30 shall have 30 days from the date of publication to submit 373.31 written comments to the commissioner on the application. No 373.32 designation shall be made by the commissioner until the 30-day 373.33 period has expired. 373.34 (c) The commissioner may designate an eligible provider as 373.35 an essential community provider for all the services offered by 373.36 that provider or for specific services designated by the 374.1 commissioner. 374.2 (d) For the purpose of this subdivision, supportive and 374.3 stabilizing services include at a minimum, transportation, child 374.4 care, cultural, and linguistic services where appropriate. 374.5 Sec. 4. Minnesota Statutes 2002, section 144.1222, is 374.6 amended by adding a subdivision to read: 374.7 Subd. 1a. [FEES.] All plans and specifications for public 374.8 swimming pool and spa construction, installation, or alteration 374.9 or requests for a variance that are submitted to the 374.10 commissioner according to Minnesota Rules, part 4717.3975, shall 374.11 be accompanied by the appropriate fees. If the commissioner 374.12 determines, upon review of the plans, that inadequate fees were 374.13 paid, the necessary additional fees shall be paid before plan 374.14 approval. For purposes of determining fees, a project is 374.15 defined as a proposal to construct or install a public pool, 374.16 spa, special purpose pool, or wading pool and all associated 374.17 water treatment equipment and drains, gutters, decks, water 374.18 recreation features, spray pads, and those design and safety 374.19 features that are within five feet of any pool or spa. The 374.20 commissioner shall charge the following fees for plan review and 374.21 inspection of public pools and spas and for requests for 374.22 variance from the public pool and spa rules: 374.23 (1) each spa pool, $500; 374.24 (2) projects valued at $250,000 or less, a minimum of $800 374.25 plus: 374.26 (i) for each slide, an additional $400; and 374.27 (ii) for each spa pool, an additional $500; 374.28 (3) projects valued at $250,000 or more, 0.5 percent of 374.29 documented estimated project cost to a maximum fee of $10,000; 374.30 (4) alterations to an existing pool without changing the 374.31 size or configuration of the pool, $400; 374.32 (5) removal or replacement of pool disinfection equipment 374.33 only, $75; and 374.34 (6) request for variance from the public pool and spa 374.35 rules, $500. 374.36 Sec. 5. Minnesota Statutes 2002, section 144.125, is 375.1 amended to read: 375.2 144.125 [TESTS OF INFANTS FORINBORN METABOLIC ERRORS375.3 HERITABLE AND CONGENITAL DISORDERS.] 375.4 Subdivision 1. [DUTY TO PERFORM TESTING.] It is the duty 375.5 of (1) the administrative officer or other person in charge of 375.6 each institution caring for infants 28 days or less of age, (2) 375.7 the person required in pursuance of the provisions of section 375.8 144.215, to register the birth of a child, or (3) the nurse 375.9 midwife or midwife in attendance at the birth, to arrange to 375.10 have administered to every infant or child in its care tests for 375.11inborn errors of metabolism in accordance withheritable and 375.12 congenital disorders according to subdivision 2 and rules 375.13 prescribed by the state commissioner of health.In determining375.14which tests must be administered, the commissioner shall take375.15into consideration the adequacy of laboratory methods to detect375.16the inborn metabolic error, the ability to treat or prevent375.17medical conditions caused by the inborn metabolic error, and the375.18severity of the medical conditions caused by the inborn375.19metabolic error.Testing and the recording and reporting of 375.20 test results shall be performed at the times and in the manner 375.21 prescribed by the commissioner of health. The commissioner 375.22 shall charge laboratory service fees so that the total of fees 375.23 collected will approximate the costs of conducting the tests and 375.24 implementing and maintaining a system to follow-up infants with 375.25inborn metabolic errorsheritable or congenital disorders. The 375.26 laboratory service fee is $61 per specimen. Costs associated 375.27 with capital expenditures and the development of new procedures 375.28 may be prorated over a three-year period when calculating the 375.29 amount of the fees. 375.30 Subd. 2. [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 375.31 commissioner shall periodically revise the list of tests to be 375.32 administered for determining the presence of a heritable or 375.33 congenital disorder. Revisions to the list shall reflect 375.34 advances in medical science, new and improved testing methods, 375.35 or other factors that will improve the public health. In 375.36 determining whether a test must be administered, the 376.1 commissioner shall take into consideration the adequacy of 376.2 laboratory methods to detect the heritable or congenital 376.3 disorder, the ability to treat or prevent medical conditions 376.4 caused by the heritable or congenital disorder, and the severity 376.5 of the medical conditions caused by the heritable or congenital 376.6 disorder. The list of tests to be performed may be revised if 376.7 the changes are recommended by the advisory committee 376.8 established under section 144.1255, approved by the 376.9 commissioner, and published in the State Register. The revision 376.10 is exempt from the rulemaking requirements in chapter 14 and 376.11 sections 14.385 and 14.386 do not apply. 376.12 Subd. 3. [OBJECTION OF PARENTS TO TEST.] If the parents of 376.13 an infant object in writing to testing for heritable and 376.14 congenital disorders as being in conflict with their religious 376.15 tenets and practice, the objection shall be recorded on a form 376.16 that is signed by a parent or legal guardian and made part of 376.17 the infant's medical record. A written objection exempts an 376.18 infant from the requirements of this section and section 144.128. 376.19 Sec. 6. [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 376.20 CONGENITAL DISORDERS.] 376.21 Subdivision 1. [CREATION AND MEMBERSHIP.] (a) By July 1, 376.22 2003, the commissioner of health shall appoint an advisory 376.23 committee to provide advice and recommendations to the 376.24 commissioner concerning tests and treatments for heritable and 376.25 congenital disorders found in newborn children. Membership of 376.26 the committee shall include, but not be limited to, at least one 376.27 member from each of the following representative groups: 376.28 (1) parents and other consumers; 376.29 (2) primary care providers; 376.30 (3) clinicians and researchers specializing in newborn 376.31 diseases and disorders; 376.32 (4) genetic counselors; 376.33 (5) birth hospital representatives; 376.34 (6) newborn screening laboratory professionals; 376.35 (7) nutritionists; and 376.36 (8) other experts as needed representing related fields 377.1 such as emerging technologies and health insurance. 377.2 (b) The terms and removal of members are governed by 377.3 section 15.059. Members shall not receive per diems but shall 377.4 be compensated for expenses. Notwithstanding section 15.059, 377.5 subdivision 5, the advisory committee does not expire. 377.6 Subd. 2. [FUNCTION AND OBJECTIVES.] The committee's 377.7 activities include, but are not limited to: 377.8 (1) collection of information on the efficacy and 377.9 reliability of various tests for heritable and congenital 377.10 disorders; 377.11 (2) collection of information on the availability and 377.12 efficacy of treatments for heritable and congenital disorders; 377.13 (3) collection of information on the severity of medical 377.14 conditions caused by heritable and congenital disorders; 377.15 (4) discussion and assessment of the benefits of performing 377.16 tests for heritable or congenital disorders as compared to the 377.17 costs, treatment limitations, or other potential disadvantages 377.18 of requiring the tests; 377.19 (5) discussion and assessment of ethical considerations 377.20 surrounding the testing, treatment, and handling of data and 377.21 specimens generated by the testing requirements of sections 377.22 144.125 to 144.128; and 377.23 (6) providing advice and recommendations to the 377.24 commissioner concerning tests and treatments for heritable and 377.25 congenital disorders found in newborn children. 377.26 [EFFECTIVE DATE.] This section is effective the day 377.27 following final enactment. 377.28 Sec. 7. Minnesota Statutes 2002, section 144.128, is 377.29 amended to read: 377.30 144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF377.31CASESCOMMISSIONER'S DUTIES.] 377.32 The commissioner shall: 377.33 (1) makearrangementsreferrals for the necessary treatment 377.34 of diagnosed cases ofhemoglobinopathy, phenylketonuria, and377.35other inborn errors of metabolismheritable or congenital 377.36 disorders when treatment is indicatedand the family is378.1uninsured and, because of a lack of available income, is unable378.2to pay the cost of the treatment; 378.3 (2) maintain a registry of the cases ofhemoglobinopathy,378.4phenylketonuria, and other inborn errors of metabolismheritable 378.5 and congenital disorders detected by the screening program for 378.6 the purpose of follow-up services; and 378.7 (3) adopt rules to carry outsection 144.126 and this378.8sectionsections 144.125 to 144.128. 378.9 Sec. 8. Minnesota Statutes 2002, section 144.1483, is 378.10 amended to read: 378.11 144.1483 [RURAL HEALTH INITIATIVES.] 378.12 The commissioner of health, through the office of rural 378.13 health, and consulting as necessary with the commissioner of 378.14 human services, the commissioner of commerce, the higher 378.15 education services office, and other state agencies, shall: 378.16 (1) develop a detailed plan regarding the feasibility of 378.17 coordinating rural health care services by organizing individual 378.18 medical providers and smaller hospitals and clinics into 378.19 referral networks with larger rural hospitals and clinics that 378.20 provide a broader array of services; 378.21 (2) develop and implement a program to assist rural 378.22 communities in establishing community health centers, as 378.23 required by section 144.1486; 378.24 (3)administer the program of financial assistance378.25established under section 144.1484 for rural hospitals in378.26isolated areas of the state that are in danger of closing378.27without financial assistance, and that have exhausted local378.28sources of support;378.29(4)develop recommendations regarding health education and 378.30 training programs in rural areas, including but not limited to a 378.31 physician assistants' training program, continuing education 378.32 programs for rural health care providers, and rural outreach 378.33 programs for nurse practitioners within existing training 378.34 programs; 378.35(5)(4) develop a statewide, coordinated recruitment 378.36 strategy for health care personnel and maintain a database on 379.1 health care personnel as required under section 144.1485; 379.2(6)(5) develop and administer technical assistance 379.3 programs to assist rural communities in: (i) planning and 379.4 coordinating the delivery of local health care services; and 379.5 (ii) hiring physicians, nurse practitioners, public health 379.6 nurses, physician assistants, and other health personnel; 379.7(7)(6) study and recommend changes in the regulation of 379.8 health care personnel, such as nurse practitioners and physician 379.9 assistants, related to scope of practice, the amount of on-site 379.10 physician supervision, and dispensing of medication, to address 379.11 rural health personnel shortages; 379.12(8)(7) support efforts to ensure continued funding for 379.13 medical and nursing education programs that will increase the 379.14 number of health professionals serving in rural areas; 379.15(9)(8) support efforts to secure higher reimbursement for 379.16 rural health care providers from the Medicare and medical 379.17 assistance programs; 379.18(10)(9) coordinate the development of a statewide plan for 379.19 emergency medical services, in cooperation with the emergency 379.20 medical services advisory council; 379.21(11)(10) establish a Medicare rural hospital flexibility 379.22 program pursuant to section 1820 of the federal Social Security 379.23 Act, United States Code, title 42, section 1395i-4, by 379.24 developing a state rural health plan and designating, consistent 379.25 with the rural health plan, rural nonprofit or public hospitals 379.26 in the state as critical access hospitals. Critical access 379.27 hospitals shall include facilities that are certified by the 379.28 state as necessary providers of health care services to 379.29 residents in the area. Necessary providers of health care 379.30 services are designated as critical access hospitals on the 379.31 basis of being more than 20 miles, defined as official mileage 379.32 as reported by the Minnesota department of transportation, from 379.33 the next nearest hospital, being the sole hospital in the 379.34 county, being a hospital located in a county with a designated 379.35 medically underserved area or health professional shortage area, 379.36 or being a hospital located in a county contiguous to a county 380.1 with a medically underserved area or health professional 380.2 shortage area. A critical access hospital located in a county 380.3 with a designated medically underserved area or a health 380.4 professional shortage area or in a county contiguous to a county 380.5 with a medically underserved area or health professional 380.6 shortage area shall continue to be recognized as a critical 380.7 access hospital in the event the medically underserved area or 380.8 health professional shortage area designation is subsequently 380.9 withdrawn; and 380.10(12)(11) carry out other activities necessary to address 380.11 rural health problems. 380.12 Sec. 9. Minnesota Statutes 2002, section 144.1488, 380.13 subdivision 4, is amended to read: 380.14 Subd. 4. [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 380.15 eligible to apply to the commissioner for the loan repayment 380.16 program, health professionals must be citizens or nationals of 380.17 the United States, must not have any unserved obligations for 380.18 service to a federal, state, or local government, or other 380.19 entity, must have a current and unrestricted Minnesota license 380.20 to practice, and must be ready to begin full-time clinical 380.21 practice upon signing a contract for obligated service. 380.22 (b) Eligible providers are those specified by the federal 380.23 Bureau ofPrimary Health CareHealth Professions in the policy 380.24 information notice for the state's current federal grant 380.25 application. A health professional selected for participation 380.26 is not eligible for loan repayment until the health professional 380.27 has an employment agreement or contract with an eligible loan 380.28 repayment site and has signed a contract for obligated service 380.29 with the commissioner. 380.30 Sec. 10. Minnesota Statutes 2002, section 144.1491, 380.31 subdivision 1, is amended to read: 380.32 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 380.33 program participant who fails to completetwothe required years 380.34 of obligated service shall repay the amount paid, as well as a 380.35 financial penaltybased upon the length of the service380.36obligation not fulfilled. If the participant has served at381.1least one year, the financial penalty is the number of unserved381.2months multiplied by $1,000. If the participant has served less381.3than one year, the financial penalty is the total number of381.4obligated months multiplied by $1,000specified by the federal 381.5 Bureau of Health Professions in the policy information notice 381.6 for the state's current federal grant application. The 381.7 commissioner shall report to the appropriate health-related 381.8 licensing board a participant who fails to complete the service 381.9 obligation and fails to repay the amount paid or fails to pay 381.10 any financial penalty owed under this subdivision. 381.11 Sec. 11. [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 381.12 FORGIVENESS PROGRAM.] 381.13 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 381.14 section, the following definitions apply. 381.15 (b) "Designated rural area" means: 381.16 (1) an area in Minnesota outside the counties of Anoka, 381.17 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 381.18 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 381.19 and St. Cloud; or 381.20 (2) a municipal corporation, as defined under section 381.21 471.634, that is physically located, in whole or in part, in an 381.22 area defined as a designated rural area under clause (1). 381.23 (c) "Emergency circumstances" means those conditions that 381.24 make it impossible for the participant to fulfill the service 381.25 commitment, including death, total and permanent disability, or 381.26 temporary disability lasting more than two years. 381.27 (d) "Medical resident" means an individual participating in 381.28 a medical residency in family practice, internal medicine, 381.29 obstetrics and gynecology, pediatrics, or psychiatry. 381.30 (e) "Midlevel practitioner" means a nurse practitioner, 381.31 nurse-midwife, nurse anesthetist, advanced clinical nurse 381.32 specialist, or physician assistant. 381.33 (f) "Nurse" means an individual who has completed training 381.34 and received all licensing or certification necessary to perform 381.35 duties as a licensed practical nurse or registered nurse. 381.36 (g) "Nurse-midwife" means a registered nurse who has 382.1 graduated from a program of study designed to prepare registered 382.2 nurses for advanced practice as nurse-midwives. 382.3 (h) "Nurse practitioner" means a registered nurse who has 382.4 graduated from a program of study designed to prepare registered 382.5 nurses for advanced practice as nurse practitioners. 382.6 (i) "Physician" means an individual who is licensed to 382.7 practice medicine in the areas of family practice, internal 382.8 medicine, obstetrics and gynecology, pediatrics, or psychiatry. 382.9 (j) "Physician assistant" means a person registered under 382.10 chapter 147A. 382.11 (k) "Qualified educational loan" means a government, 382.12 commercial, or foundation loan for actual costs paid for 382.13 tuition, reasonable education expenses, and reasonable living 382.14 expenses related to the graduate or undergraduate education of a 382.15 health care professional. 382.16 (l) "Underserved urban community" means a Minnesota urban 382.17 area or population included in the list of designated primary 382.18 medical care health professional shortage areas (HPSAs), 382.19 medically underserved areas (MUAs), or medically underserved 382.20 populations (MUPs) maintained and updated by the United States 382.21 Department of Health and Human Services. 382.22 Subd. 2. [CREATION OF ACCOUNT.] A health professional 382.23 education loan forgiveness program account is established. The 382.24 commissioner of health shall use money from the account to 382.25 establish a loan forgiveness program for medical residents 382.26 agreeing to practice in designated rural areas or underserved 382.27 urban communities, for midlevel practitioners agreeing to 382.28 practice in designated rural areas, and for nurses who agree to 382.29 practice in a Minnesota nursing home or intermediate care 382.30 facility for persons with mental retardation or related 382.31 conditions. Appropriations made to the account do not cancel 382.32 and are available until expended, except that at the end of each 382.33 biennium, any remaining balance in the account that is not 382.34 committed by contract and not needed to fulfill existing 382.35 commitments shall cancel to the fund. 382.36 Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate 383.1 in the loan forgiveness program, an individual must: 383.2 (1) be a medical resident or be enrolled in a midlevel 383.3 practitioner, registered nurse, or a licensed practical nurse 383.4 training program; and 383.5 (2) submit an application to the commissioner of health. 383.6 (b) An applicant selected to participate must sign a 383.7 contract to agree to serve a minimum three-year full-time 383.8 service obligation according to subdivision 2, which shall begin 383.9 no later than March 31 following completion of required training. 383.10 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 383.11 may select applicants each year for participation in the loan 383.12 forgiveness program, within the limits of available funding. 383.13 The commissioner shall distribute available funds for loan 383.14 forgiveness proportionally among the eligible professions 383.15 according to the vacancy rate for each profession in the 383.16 required geographic area or facility type specified in 383.17 subdivision 2. The commissioner shall allocate funds for 383.18 physician loan forgiveness so that 75 percent of the funds 383.19 available are used for rural physician loan forgiveness and 25 383.20 percent of the funds available are used for underserved urban 383.21 communities loan forgiveness. If the commissioner does not 383.22 receive enough qualified applicants each year to use the entire 383.23 allocation of funds for urban underserved communities, the 383.24 remaining funds may be allocated for rural physician loan 383.25 forgiveness. Applicants are responsible for securing their own 383.26 qualified educational loans. The commissioner shall select 383.27 participants based on their suitability for practice serving the 383.28 required geographic area or facility type specified in 383.29 subdivision 2, as indicated by experience or training. The 383.30 commissioner shall give preference to applicants closest to 383.31 completing their training. For each year that a participant 383.32 meets the service obligation required under subdivision 3, up to 383.33 a maximum of four years, the commissioner shall make annual 383.34 disbursements directly to the participant equivalent to 15 383.35 percent of the average educational debt for indebted graduates 383.36 in their profession in the year closest to the applicant's 384.1 selection for which information is available, not to exceed the 384.2 balance of the participant's qualifying educational loans. 384.3 Before receiving loan repayment disbursements and as requested, 384.4 the participant must complete and return to the commissioner an 384.5 affidavit of practice form provided by the commissioner 384.6 verifying that the participant is practicing as required under 384.7 subdivisions 2 and 3. The participant must provide the 384.8 commissioner with verification that the full amount of loan 384.9 repayment disbursement received by the participant has been 384.10 applied toward the designated loans. After each disbursement, 384.11 verification must be received by the commissioner and approved 384.12 before the next loan repayment disbursement is made. 384.13 Participants who move their practice remain eligible for loan 384.14 repayment as long as they practice as required under subdivision 384.15 2. 384.16 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 384.17 does not fulfill the required minimum commitment of service 384.18 according to subdivision 3, the commissioner of health shall 384.19 collect from the participant the total amount paid to the 384.20 participant under the loan forgiveness program plus interest at 384.21 a rate established according to section 270.75. The 384.22 commissioner shall deposit the money collected in the health 384.23 care access fund to be credited to the health professional 384.24 education loan forgiveness program account established in 384.25 subdivision 2. The commissioner shall allow waivers of all or 384.26 part of the money owed the commissioner as a result of a 384.27 nonfulfillment penalty if emergency circumstances prevented 384.28 fulfillment of the minimum service commitment. 384.29 Subd. 6. [RULES.] The commissioner may adopt rules to 384.30 implement this section. 384.31 Sec. 12. Minnesota Statutes 2002, section 144.1502, 384.32 subdivision 4, is amended to read: 384.33 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 384.34 may acceptup to 14applicantspereach year for participation 384.35 in the loan forgiveness program, within the limits of available 384.36 funding. Applicants are responsible for securing their own 385.1 loans. The commissioner shall select participants based on 385.2 their suitability for practice serving public program patients, 385.3 as indicated by experience or training. The commissioner shall 385.4 give preference to applicants who have attended a Minnesota 385.5 dentistry educational institution and to applicants closest to 385.6 completing their training. For each year that a participant 385.7 meets the service obligation required under subdivision 3, up to 385.8 a maximum of four years, the commissioner shall make annual 385.9 disbursements directly to the participant equivalent to$10,000385.10per year of service, not to exceed $40,00015 percent of the 385.11 average educational debt for indebted dental school graduates in 385.12 the year closest to the applicant's selection for which 385.13 information is available or the balance of the qualifying 385.14 educational loans, whichever is less. Before receiving loan 385.15 repayment disbursements and as requested, the participant must 385.16 complete and return to the commissioner an affidavit of practice 385.17 form provided by the commissioner verifying that the participant 385.18 is practicing as required under subdivision 3. The participant 385.19 must provide the commissioner with verification that the full 385.20 amount of loan repayment disbursement received by the 385.21 participant has been applied toward the designated loans. After 385.22 each disbursement, verification must be received by the 385.23 commissioner and approved before the next loan repayment 385.24 disbursement is made. Participants who move their practice 385.25 remain eligible for loan repayment as long as they practice as 385.26 required under subdivision 3. 385.27 Sec. 13. Minnesota Statutes 2002, section 147A.08, is 385.28 amended to read: 385.29 147A.08 [EXEMPTIONS.] 385.30 (a) This chapter does not apply to, control, prevent, or 385.31 restrict the practice, service, or activities of persons listed 385.32 in section 147.09, clauses (1) to (6) and (8) to (13), persons 385.33 regulated under section 214.01, subdivision 2, or persons 385.34 defined in section144.1495144.1501, subdivision 1, 385.35 paragraphs(a) to (d)(e), (g), and (h). 385.36 (b) Nothing in this chapter shall be construed to require 386.1 registration of: 386.2 (1) a physician assistant student enrolled in a physician 386.3 assistant or surgeon assistant educational program accredited by 386.4 the Committee on Allied Health Education and Accreditation or by 386.5 its successor agency approved by the board; 386.6 (2) a physician assistant employed in the service of the 386.7 federal government while performing duties incident to that 386.8 employment; or 386.9 (3) technicians, other assistants, or employees of 386.10 physicians who perform delegated tasks in the office of a 386.11 physician but who do not identify themselves as a physician 386.12 assistant. 386.13 Sec. 14. Minnesota Statutes 2002, section 148.5194, 386.14 subdivision 1, is amended to read: 386.15 Subdivision 1. [FEE PRORATION.] The commissioner shall 386.16 prorate the registration fee for clinical fellowship, temporary, 386.17 and first time registrants according to the number of months 386.18 that have elapsed between the date registration is issued and 386.19 the date registration expires or must be renewed under section 386.20 148.5191, subdivision 4. 386.21 Sec. 15. Minnesota Statutes 2002, section 148.5194, 386.22 subdivision 2, is amended to read: 386.23 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 386.24 registration and biennial registration, clinical fellowship 386.25 registration, temporary registration, or renewal is $200. 386.26 Sec. 16. Minnesota Statutes 2002, section 148.5194, 386.27 subdivision 3, is amended to read: 386.28 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL 386.29 REGISTRATION.] The fee for initial registration and biennial 386.30 registration, clinical fellowship registration, temporary 386.31 registration, or renewal is $200. 386.32 Sec. 17. Minnesota Statutes 2002, section 148.5194, is 386.33 amended by adding a subdivision to read: 386.34 Subd. 6. [VERIFICATION OF CREDENTIAL.] The fee for written 386.35 verification of credentialed status is $25. 386.36 Sec. 18. Minnesota Statutes 2002, section 148.6445, 387.1 subdivision 7, is amended to read: 387.2 Subd. 7. [CERTIFICATIONVERIFICATION TO OTHER STATES.] The 387.3 fee forcertificationverification of licensure to other states 387.4 is $25. 387.5 Sec. 19. [148C.12] [FEES.] 387.6 Subdivision 1. [APPLICATION.] The application fee for a 387.7 license to practice alcohol and drug counseling is $295. 387.8 Subd. 2. [BIENNIAL RENEWAL.] The license renewal fee is 387.9 $295. If the commissioner changes the renewal schedule and the 387.10 expiration date is less than two years, the fee must be prorated. 387.11 Subd. 3. [TEMPORARY PRACTICE STATUS.] The initial fee for 387.12 applicants under section 148C.04, subdivision 6, paragraph (a), 387.13 clause (1), item (i), is $100. The initial fee for applicants 387.14 under section 148C.04, subdivision 6, paragraph (a), clause (1), 387.15 item (ii) or (iii), is the license application fee under 387.16 subdivision 1. The fee for annual renewal of temporary practice 387.17 status is $100. 387.18 Subd. 4. [EXAMINATION.] The examination fee is $95 for the 387.19 written examination and $200 for the oral examination. 387.20 Subd. 5. [INACTIVE RENEWAL.] The inactive renewal fee is 387.21 $150. 387.22 Subd. 6. [LATE FEE.] The late fee is 25 percent of the 387.23 biennial renewal fee, the inactive renewal fee, or the annual 387.24 fee for renewal of temporary practice status. 387.25 Subd. 7. [RENEWAL AFTER EXPIRATION.] The fee for renewal 387.26 of a license that has expired is the total of the biennial 387.27 renewal fee, the late fee, and a fee of $100 for review and 387.28 approval of the continuing education report. 387.29 Subd. 8. [LICENSE VERIFICATION.] The fee for license 387.30 verification to institutions and other jurisdictions is $25. 387.31 Subd. 9. [SURCHARGE.] Notwithstanding section 16A.1285, 387.32 subdivision 2, a surcharge of $172 shall be paid at the time of 387.33 application for or renewal of an alcohol and drug counseling 387.34 license until June 30, 2009. 387.35 Subd. 10. [RENEWAL FOLLOWING LAPSE IN LICENSING 387.36 STATUS.] Renewal applications received after the expiration date 388.1 of the license shall include an amount equal to 50 percent of 388.2 the renewal fee in addition to the late fee. 388.3 Subd. 11. [NONREFUNDABLE FEES.] All fees are nonrefundable. 388.4 Sec. 20. Minnesota Statutes 2002, section 153A.17, is 388.5 amended to read: 388.6 153A.17 [EXPENSES; FEES.] 388.7 The expenses for administering the certification 388.8 requirements including the complaint handling system for hearing 388.9 aid dispensers in sections 153A.14 and 153A.15 and the consumer 388.10 information center under section 153A.18 must be paid from 388.11 initial application and examination fees, renewal fees, 388.12 penalties, and fines. All fees are nonrefundable. The 388.13 certificate application fee is$165 for audiologists registered388.14under section 148.511 and $490 for all others$350, the 388.15 examination fee is$200$250 for the written portion and 388.16$200$250 for the practical portion each time one or the other 388.17 is taken, and the trainee application fee 388.18 is$100$200.Notwithstanding the policy set forth in section388.1916A.1285, subdivision 2, a surcharge of $165 for audiologists388.20registered under section 148.511 and $330 for all others shall388.21be paid at the time of application or renewal until June 30,388.222003, to recover the commissioner's accumulated direct388.23expenditures for administering the requirements of this388.24chapter.The penalty fee for late submission of a renewal 388.25 application is $200. The fee for verification of certification 388.26 to other jurisdictions or entities is $25. All fees, penalties, 388.27 and fines received must be deposited in the state government 388.28 special revenue fund. The commissioner may prorate the 388.29 certification fee for new applicants based on the number of 388.30 quarters remaining in the annual certification period. 388.31 Sec. 21. Minnesota Statutes 2002, section 256B.69, 388.32 subdivision 5c, is amended to read: 388.33 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 388.34 commissioner of human services shall transfer each year to the 388.35 medical education and research fund established under section 388.36 62J.692, the following: 389.1 (1) an amount equal to the reduction in the prepaid medical 389.2 assistance and prepaid general assistance medical care payments 389.3 as specified in this clause. Until January 1, 2002, the county 389.4 medical assistance and general assistance medical care 389.5 capitation base rate prior to plan specific adjustments and 389.6 after the regional rate adjustments under section 256B.69, 389.7 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 389.8 percent for the remaining metropolitan counties, and no 389.9 reduction for nonmetropolitan Minnesota counties; and after 389.10 January 1, 2002, the county medical assistance and general 389.11 assistance medical care capitation base rate prior to plan 389.12 specific adjustments is reduced 6.3 percent for Hennepin county, 389.13 two percent for the remaining metropolitan counties, and 1.6 389.14 percent for nonmetropolitan Minnesota counties. Nursing 389.15 facility and elderly waiver payments and demonstration project 389.16 payments operating under subdivision 23 are excluded from this 389.17 reduction. The amount calculated under this clause shall not be 389.18 adjusted for periods already paid due to subsequent changes to 389.19 the capitation payments; 389.20 (2) beginning July 1, 2001,$2,537,000$2,157,000 from the 389.21 capitation rates paid under this section plus any federal 389.22 matching funds on this amount; 389.23 (3) beginning July 1, 2002, an additional $12,700,000 from 389.24 the capitation rates paid under this section; and 389.25 (4) beginning July 1, 2003, an additional $4,700,000 from 389.26 the capitation rates paid under this section. 389.27 (b) This subdivision shall be effective upon approval of a 389.28 federal waiver which allows federal financial participation in 389.29 the medical education and research fund. 389.30 Sec. 22. Minnesota Statutes 2002, section 295.55, 389.31 subdivision 2, is amended to read: 389.32 Subd. 2. [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 389.33 Each hospital or surgical center must make estimated payments of 389.34 the taxes for the calendar year in monthly installments to the 389.35 commissioner within 15 days after the end of the month. 389.36 (b) Estimated tax payments are not required of hospitals or 390.1 surgical centers if: (1) the tax for the current calendar year 390.2 is less than $500; or (2) the tax for the previous calendar year 390.3 is less than $500, if the taxpayer had a tax liability and was 390.4 doing business the entire year; or (3) if a hospital has been390.5allowed a grant under section 144.1484, subdivision 2, for the390.6year. 390.7 (c) Underpayment of estimated installments bear interest at 390.8 the rate specified in section 270.75, from the due date of the 390.9 payment until paid or until the due date of the annual return 390.10 whichever comes first. An underpayment of an estimated 390.11 installment is the difference between the amount paid and the 390.12 lesser of (1) 90 percent of one-twelfth of the tax for the 390.13 calendar year or (2) one-twelfth of the total tax for the 390.14 previous calendar year if the taxpayer had a tax liability and 390.15 was doing business the entire year. 390.16 Sec. 23. Minnesota Statutes 2002, section 326.42, is 390.17 amended to read: 390.18 326.42 [APPLICATIONS, FEES.] 390.19 Subdivision 1. [APPLICATION.] Applications for plumber's 390.20 license shall be made to the state commissioner of health, with 390.21 fee. Unless the applicant is entitled to a renewal, the 390.22 applicant shall be licensed by the state commissioner of health 390.23 only after passing a satisfactory examination by the examiners 390.24 showing fitness. Examination fees for both journeyman and 390.25 master plumbers shall be in an amount prescribed by the state 390.26 commissioner of health pursuant to section 144.122. Upon being 390.27 notified that of having successfully passed the examination for 390.28 original license the applicant shall submit an application, with 390.29 the license fee herein provided. License fees shall be in an 390.30 amount prescribed by the state commissioner of health pursuant 390.31 to section 144.122. Licenses shall expire and be renewed as 390.32 prescribed by the commissioner pursuant to section 144.122. 390.33 Subd. 2. [FEES.] Plumbing system plans and specifications 390.34 that are submitted to the commissioner for review shall be 390.35 accompanied by the appropriate plan examination fees. If the 390.36 commissioner determines, upon review of the plans, that 391.1 inadequate fees were paid, the necessary additional fees shall 391.2 be paid prior to plan approval. The commissioner shall charge 391.3 the following fees for plan reviews and audits of plumbing 391.4 installations for public, commercial, and industrial buildings: 391.5 (1) systems with both water distribution and drain, waste, 391.6 and vent systems and having: 391.7 (i) 25 or fewer drainage fixture units, $150; 391.8 (ii) 26 to 50 drainage fixture units, $250; 391.9 (iii) 51 to 150 drainage fixture units, $350; 391.10 (iv) 151 to 249 drainage fixture units, $500; 391.11 (v) 250 or more drainage fixture units, $3 per drainage 391.12 fixture unit to a maximum of $4,000; and 391.13 (vi) interceptors, separators, or catch basins, $70 per 391.14 interceptor, separator, or catch basin; 391.15 (2) building sewer service only, $150; 391.16 (3) building water service only, $150; 391.17 (4) building water distribution system only, no drainage 391.18 system, $5 per supply fixture unit or $150, whichever is 391.19 greater; 391.20 (5) storm drainage system, a minimum fee of $150 or: 391.21 (i) $50 per drain opening, up to a maximum of $500; and 391.22 (ii) $70 per interceptor, separator, or catch basin; 391.23 (6) manufactured home park or campground, 1 to 25 sites, 391.24 $300; 391.25 (7) manufactured home park or campground, 26 to 50 sites, 391.26 $350; 391.27 (8) manufactured home park or campground, 51 to 125 sites, 391.28 $400; 391.29 (9) manufactured home park or campground, more than 125 391.30 sites, $500; 391.31 (10) accelerated review, double the regular fee, one-half 391.32 to be refunded if no response from the commissioner within 15 391.33 business days; and 391.34 (11) revision to previously reviewed or incomplete plans: 391.35 (i) review of plans for which commissioner has issued two 391.36 or more requests for additional information, per review, $100 or 392.1 ten percent of the original fee, whichever is greater; 392.2 (ii) proposer-requested revision with no increase in 392.3 project scope, $50 or ten percent of original fee, whichever is 392.4 greater; and 392.5 (iii) proposer-requested revision with an increase in 392.6 project scope, $50 plus the difference between the original 392.7 project fee and the revised project fee. 392.8 Sec. 24. [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 392.9 (a) The commissioner's authority to collect the certificate 392.10 application fee from hearing instrument dispensers under 392.11 Minnesota Statutes, section 153A.17, is suspended for certified 392.12 hearing instrument dispensers renewing certification in fiscal 392.13 year 2004. 392.14 (b) The commissioner's authority to collect the license 392.15 renewal fee from occupational therapy practitioners under 392.16 Minnesota Statutes, section 148.6445, subdivision 2, is 392.17 suspended for fiscal years 2004 and 2005. 392.18 Sec. 25. [REVISOR'S INSTRUCTION.] 392.19 (a) The revisor of statutes shall delete the reference to 392.20 "144.1495" in Minnesota Statutes, section 62Q.145, and insert 392.21 "144.1501." 392.22 (b) For sections in Minnesota Statutes and Minnesota Rules 392.23 affected by the repealed sections in this article, the revisor 392.24 shall delete internal cross-references where appropriate and 392.25 make changes necessary to correct the punctuation, grammar, or 392.26 structure of the remaining text and preserve its meaning. 392.27 Sec. 26. [REPEALER.] 392.28 (a) Minnesota Statutes 2002, sections 62J.694, subdivisions 392.29 1, 2, 2a, and 3; 144.126; 144.1484; 144.1494; 144.1495; 392.30 144.1496; 144.1497; 144.395, subdivisions 1 and 2; 144.396; 392.31 144A.36; 144A.38; 148.5194, subdivision 3a; and 148.6445, 392.32 subdivision 9, are repealed. 392.33 (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 392.34 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 392.35 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 392.36 4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 393.1 4763.0285; 4763.0295; and 4763.0300, are repealed. 393.2 ARTICLE 9 393.3 LOCAL PUBLIC HEALTH GRANTS 393.4 Section 1. Minnesota Statutes 2002, section 144E.11, 393.5 subdivision 6, is amended to read: 393.6 Subd. 6. [REVIEW CRITERIA.] When reviewing an application 393.7 for licensure, the board and administrative law judge shall 393.8 consider the following factors: 393.9 (1)the relationship of the proposed service or expansion393.10in primary service area to the current community health plan as393.11approved by the commissioner of health under section 145A.12,393.12subdivision 4;393.13(2)the recommendations or comments of the governing bodies 393.14 of the counties, municipalities, community health boards as 393.15 defined under section 145A.09, subdivision 2, and regional 393.16 emergency medical services system designated under section 393.17 144E.50 in which the service would be provided; 393.18(3)(2) the deleterious effects on the public health from 393.19 duplication, if any, of ambulance services that would result 393.20 from granting the license; 393.21(4)(3) the estimated effect of the proposed service or 393.22 expansion in primary service area on the public health; and 393.23(5)(4) whether any benefit accruing to the public health 393.24 would outweigh the costs associated with the proposed service or 393.25 expansion in primary service area. The administrative law judge 393.26 shall recommend that the board either grant or deny a license or 393.27 recommend that a modified license be granted. The reasons for 393.28 the recommendation shall be set forth in detail. The 393.29 administrative law judge shall make the recommendations and 393.30 reasons available to any individual requesting them. 393.31 Sec. 2. Minnesota Statutes 2002, section 145.88, is 393.32 amended to read: 393.33 145.88 [PURPOSE.] 393.34The legislature finds that it is in the public interest to393.35assure:393.36(a) statewide planning and coordination of maternal and394.1child health services through the acquisition and analysis of394.2population-based health data, provision of technical support and394.3training, and coordination of the various public and private394.4maternal and child health efforts; and394.5(b) support for targeted maternal and child health services394.6in communities with significant populations of high risk, low394.7income families through a grants process.394.8 Federal money received by the Minnesota department of 394.9 health, pursuant to United States Code, title 42, sections 701 394.10 to 709, shall be expended to: 394.11 (1) assure access to quality maternal and child health 394.12 services for mothers and children, especially those of low 394.13 income and with limited availability to health services and 394.14 those children at risk of physical, neurological, emotional, and 394.15 developmental problems arising from chemical abuse by a mother 394.16 during pregnancy; 394.17 (2) reduce infant mortality and the incidence of 394.18 preventable diseases and handicapping conditions among children; 394.19 (3) reduce the need for inpatient and long-term care 394.20 services and to otherwise promote the health of mothers and 394.21 children, especially by providing preventive and primary care 394.22 services for low-income mothers and children and prenatal, 394.23 delivery and postpartum care for low-income mothers; 394.24 (4) provide rehabilitative services for blind and disabled 394.25 children under age 16 receiving benefits under title XVI of the 394.26 Social Security Act; and 394.27 (5) provide and locate medical, surgical, corrective and 394.28 other service for children who are crippled or who are suffering 394.29 from conditions that lead to crippling. 394.30 Sec. 3. Minnesota Statutes 2002, section 145.881, 394.31 subdivision 2, is amended to read: 394.32 Subd. 2. [DUTIES.] The advisory task force shall meet on a 394.33 regular basis to perform the following duties: 394.34 (a) review and report on the health care needs of mothers 394.35 and children throughout the state of Minnesota; 394.36 (b) review and report on the type, frequency and impact of 395.1 maternal and child health care services provided to mothers and 395.2 children under existing maternal and child health care programs, 395.3 including programs administered by the commissioner of health; 395.4 (c) establish, review, and report to the commissioner a 395.5 list of program guidelines and criteria which the advisory task 395.6 force considers essential to providing an effective maternal and 395.7 child health care program to low income populations and high 395.8 risk persons and fulfilling the purposes defined in section 395.9 145.88; 395.10 (d)review staff recommendations of the department of395.11health regarding maternal and child health grant awards before395.12the awards are made;395.13(e)make recommendations to the commissioner for the use of 395.14 other federal and state funds available to meet maternal and 395.15 child health needs; 395.16(f)(e) make recommendations to the commissioner of health 395.17 on priorities for funding the following maternal and child 395.18 health services: (1) prenatal, delivery and postpartum care, (2) 395.19 comprehensive health care for children, especially from birth 395.20 through five years of age, (3) adolescent health services, (4) 395.21 family planning services, (5) preventive dental care, (6) 395.22 special services for chronically ill and handicapped children 395.23 and (7) any other services which promote the health of mothers 395.24 and children; and 395.25(g) make recommendations to the commissioner of health on395.26the process to distribute, award and administer the maternal and395.27child health block grant funds; and395.28(h) review the measures that are used to define the395.29variables of the funding distribution formula in section395.30145.882, subdivision 4, every two years and make recommendations395.31to the commissioner of health for changes based upon principles395.32established by the advisory task force for this purpose.395.33 (f) establish, in consultation with the commissioner and 395.34 the state community health advisory committee established under 395.35 section 145A.10, subdivision 10, paragraph (a), statewide 395.36 outcomes that will improve the health status of mothers and 396.1 children as required in section 145A.12, subdivision 7. 396.2 Sec. 4. Minnesota Statutes 2002, section 145.882, 396.3 subdivision 1, is amended to read: 396.4 Subdivision 1. [FUNDINGLEVELS AND ADVISORY TASK FORCE396.5REVIEW.] Any decrease in the amount of federal funding to the 396.6 state for the maternal and child health block grant must be 396.7 apportioned to reflect a proportional decrease for each 396.8 recipient. Any increase in the amount of federal funding to the 396.9 state must be distributed under subdivisions 2,and 3, and 4. 396.10The advisory task force shall review and recommend the396.11proportion of maternal and child health block grant funds to be396.12expended for indirect costs, direct services and special396.13projects.396.14 Sec. 5. Minnesota Statutes 2002, section 145.882, 396.15 subdivision 2, is amended to read: 396.16 Subd. 2. [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 396.17 Beginning January 1, 1986, up to one-third of the total maternal 396.18 and child health block grant money may be retained by the 396.19 commissioner of healthfor administrative and technical396.20assistance services, projects of regional or statewide396.21significance, direct services to children with handicaps, and396.22other activities of the commissioner.to: 396.23 (1) meet federal maternal and child block grant 396.24 requirements of a statewide needs assessment every five years 396.25 and prepare the annual federal block grant application and 396.26 report; 396.27 (2) collect and disseminate statewide data on the health 396.28 status of mothers and children; 396.29 (3) provide technical assistance to community health boards 396.30 in meeting statewide outcomes under section 145A.12, subdivision 396.31 7; 396.32 (4) evaluate the impact of maternal and child health 396.33 activities on the health status of mothers and children; 396.34 (5) provide services to children under age 16 receiving 396.35 benefits under title XVI of the Social Security Act; and 396.36 (6) perform other maternal and child health activities 397.1 listed in section 145.88 and as deemed necessary by the 397.2 commissioner. 397.3 Sec. 6. Minnesota Statutes 2002, section 145.882, 397.4 subdivision 3, is amended to read: 397.5 Subd. 3. [ALLOCATION TO COMMUNITY HEALTHSERVICES397.6AREASBOARDS.](a)The maternal and child health block grant 397.7 money remaining after distributions made under subdivision 2 397.8 must be allocated according to the formula insubdivision 4 to397.9community health services areassection 145A.131, subdivision 2, 397.10 for distributionbyto community health boards.as defined in397.11section 145A.02, subdivision 5, to qualified programs that397.12provide essential services within the community health services397.13area as long as:397.14(1) the Minneapolis community health service area is397.15allocated at least $1,626,215 per year;397.16(2) the St. Paul community health service area is allocated397.17at least $822,931 per year; and397.18(3) all other community health service areas are allocated397.19at least $30,000 per county per year or their 1988-1989 funding397.20cycle award, whichever is less.397.21(b) Notwithstanding paragraph (a), if the total amount of397.22maternal and child health block grant funding decreases, the397.23decrease must be apportioned to reflect a proportional decrease397.24for each recipient, including recipients who would otherwise397.25receive a guaranteed minimum allocation under paragraph (a).397.26 Sec. 7. Minnesota Statutes 2002, section 145.882, is 397.27 amended by adding a subdivision to read: 397.28 Subd. 5a. [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 397.29 community health board decides not to participate in maternal 397.30 and child health block grant activities under subdivision 3 or 397.31 the commissioner determines under section 145A.131, subdivision 397.32 7, not to fund the community health board, the commissioner is 397.33 responsible for directing maternal and child health block grant 397.34 activities in that community health board's geographic area. 397.35 The commissioner may elect to directly provide public health 397.36 activities to meet the statewide outcomes or to contract with 398.1 other governmental units or nonprofit organizations. 398.2 Sec. 8. Minnesota Statutes 2002, section 145.882, 398.3 subdivision 7, is amended to read: 398.4 Subd. 7. [USE OF BLOCK GRANT MONEY.](a)Maternal and 398.5 child health block grant money allocated to a community health 398.6 boardor community health services areaunder this section must 398.7 be used for qualified programs for high risk and low-income 398.8 individuals. Block grant money must be used for programs that: 398.9 (1) specifically address the highest risk populations, 398.10 particularly low-income and minority groups with a high rate of 398.11 infant mortality and children with low birth weight, by 398.12 providing services, including prepregnancy family planning 398.13 services, calculated to produce measurable decreases in infant 398.14 mortality rates, instances of children with low birth weight, 398.15 and medical complications associated with pregnancy and 398.16 childbirth, including infant mortality, low birth rates, and 398.17 medical complications arising from chemical abuse by a mother 398.18 during pregnancy; 398.19 (2) specifically target pregnant women whose age, medical 398.20 condition, maternal history, or chemical abuse substantially 398.21 increases the likelihood of complications associated with 398.22 pregnancy and childbirth or the birth of a child with an 398.23 illness, disability, or special medical needs; 398.24 (3) specifically address the health needs of young children 398.25 who have or are likely to have a chronic disease or disability 398.26 or special medical needs, including physical, neurological, 398.27 emotional, and developmental problems that arise from chemical 398.28 abuse by a mother during pregnancy; 398.29 (4) provide family planning and preventive medical care for 398.30 specifically identified target populations, such as minority and 398.31 low-income teenagers, in a manner calculated to decrease the 398.32 occurrence of inappropriate pregnancy and minimize the risk of 398.33 complications associated with pregnancy and childbirth;or398.34 (5) specifically address the frequency and severity of 398.35 childhood and adolescent health issues, including injuries in 398.36 high risk target populations by providing services calculated to 399.1 produce measurable decreases in mortality and morbidity.; 399.2However, money may be used for this purpose only if the399.3community health board's application includes program components399.4for the purposes in clauses (1) to (4) in the proposed399.5geographic service area and the total expenditure for399.6injury-related programs under this clause does not exceed ten399.7percent of the total allocation under subdivision 3.399.8(b) Maternal and child health block grant money may be used399.9for purposes other than the purposes listed in this subdivision399.10only under the following conditions:399.11(1) the community health board or community health services399.12area can demonstrate that existing programs fully address the399.13needs of the highest risk target populations described in this399.14subdivision; or399.15(2) the money is used to continue projects that received399.16funding before creation of the maternal and child health block399.17grant in 1981.399.18(c) Projects that received funding before creation of the399.19maternal and child health block grant in 1981, must be allocated399.20at least the amount of maternal and child health special project399.21grant funds received in 1989, unless (1) the local board of399.22health provides equivalent alternative funding for the project399.23from another source; or (2) the local board of health399.24demonstrates that the need for the specific services provided by399.25the project has significantly decreased as a result of changes399.26in the demographic characteristics of the population, or other399.27factors that have a major impact on the demand for services. If399.28the amount of federal funding to the state for the maternal and399.29child health block grant is decreased, these projects must399.30receive a proportional decrease as required in subdivision 1.399.31Increases in allocation amounts to local boards of health under399.32subdivision 4 may be used to increase funding levels for these399.33projects.399.34 (6) specifically address preventing child abuse and 399.35 neglect, reducing juvenile delinquency, promoting positive 399.36 parenting and resiliency in children, and promoting family 400.1 health and economic sufficiency through public health nurse home 400.2 visits under section 145A.17; or 400.3 (7) specifically address nutritional issues of women, 400.4 infants, and young children through WIC clinic services. 400.5 Sec. 9. [145.8821] [ACCOUNTABILITY.] 400.6 (a) Coordinating with the statewide outcomes established 400.7 under section 145A.12, subdivision 7, and with accountability 400.8 measures outlined in section 145A.131, subdivision 7, each 400.9 community health board that receives money under section 400.10 145.882, subdivision 3, shall select by February 1, 2005, and 400.11 every five years thereafter, up to two statewide maternal and 400.12 child health outcomes. 400.13 (b) For the period January 1, 2004, to December 31, 2005, 400.14 each community health board must work to achieve the Healthy 400.15 People 2010 goal to reduce the state's percentage of low birth 400.16 weight infants to no more than five percent of all births. 400.17 (c) The commissioner shall monitor and evaluate whether 400.18 each community health board has made sufficient progress toward 400.19 the statewide outcomes established in paragraph (b) and under 400.20 section 145A.12, subdivision 7. 400.21 (d) Community health boards shall provide the commissioner 400.22 with annual information necessary to evaluate progress toward 400.23 statewide outcomes and to meet federal reporting requirements. 400.24 Sec. 10. Minnesota Statutes 2002, section 145.883, 400.25 subdivision 1, is amended to read: 400.26 Subdivision 1. [SCOPE.] For purposes of sections 145.881 400.27 to145.888145.883, the terms defined in this section shall have 400.28 the meanings given them. 400.29 Sec. 11. Minnesota Statutes 2002, section 145.883, 400.30 subdivision 9, is amended to read: 400.31 Subd. 9. [COMMUNITY HEALTHSERVICES AREABOARD.] 400.32 "Community healthservices areaboard" meansa city, county, or400.33multicounty area that is organized as a community health board400.34under section 145A.09 and for which a state subsidy is received400.35under sections 145A.09 to 145A.13a board of health established, 400.36 operating, and eligible for a local public health grant under 401.1 sections 145A.09 to 145A.131. 401.2 Sec. 12. Minnesota Statutes 2002, section 145A.02, 401.3 subdivision 5, is amended to read: 401.4 Subd. 5. [COMMUNITY HEALTH BOARD.] "Community health 401.5 board" means a board of health established, operating, and 401.6 eligible for asubsidylocal public health grant under sections 401.7 145A.09 to145A.13145A.131. 401.8 Sec. 13. Minnesota Statutes 2002, section 145A.02, 401.9 subdivision 6, is amended to read: 401.10 Subd. 6. [COMMUNITY HEALTH SERVICES.] "Community health 401.11 services" means activities designed to protect and promote the 401.12 health of the general population within a community health 401.13 service area by emphasizing the prevention of disease, injury, 401.14 disability, and preventable death through the promotion of 401.15 effective coordination and use of community resources, and by 401.16 extending health services into the community.Program401.17categories of community health services include disease401.18prevention and control, emergency medical care, environmental401.19health, family health, health promotion, and home health care.401.20 Sec. 14. Minnesota Statutes 2002, section 145A.02, 401.21 subdivision 7, is amended to read: 401.22 Subd. 7. [COMMUNITY HEALTH SERVICE AREA.] "Community 401.23 health service area" means a city, county, or multicounty area 401.24 that is organized as a community health board under section 401.25 145A.09 and for which asubsidylocal public health grant is 401.26 received under sections 145A.09 to145A.13145A.131. 401.27 Sec. 15. Minnesota Statutes 2002, section 145A.06, 401.28 subdivision 1, is amended to read: 401.29 Subdivision 1. [GENERALLY.] In addition to other powers 401.30 and duties provided by law, the commissioner has the powers 401.31 listed in subdivisions 2 to45. 401.32 Sec. 16. Minnesota Statutes 2002, section 145A.09, 401.33 subdivision 2, is amended to read: 401.34 Subd. 2. [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 401.35 health that meets the requirements of sections 145A.09 401.36 to145A.13145A.131 is a community health board and is eligible 402.1 for acommunity health subsidylocal public health grant under 402.2 section145A.13145A.131. 402.3 Sec. 17. Minnesota Statutes 2002, section 145A.09, 402.4 subdivision 4, is amended to read: 402.5 Subd. 4. [CITIES.] A city that received a subsidy under 402.6 section 145A.13 and that meets the requirements of sections 402.7 145A.09 to145A.13145A.131 is eligible for acommunity health402.8subsidylocal public health grant under section 402.9145A.13145A.131. 402.10 Sec. 18. Minnesota Statutes 2002, section 145A.09, 402.11 subdivision 7, is amended to read: 402.12 Subd. 7. [WITHDRAWAL.] (a) A county or city that has 402.13 established or joined a community health board may withdraw from 402.14 thesubsidylocal public health grant program authorized by 402.15 sections 145A.09 to145A.13145A.131 by resolution of its 402.16 governing body in accordance with section 145A.03, subdivision 402.17 3, and this subdivision. 402.18 (b) A county or city may not withdraw from a joint powers 402.19 community health board during the first two calendar years 402.20 following that county's or city's initial adoption of the joint 402.21 powers agreement. 402.22 (c) The withdrawal of a county or city from a community 402.23 health board does not affect the eligibility for thecommunity402.24health subsidylocal public health grant of any remaining county 402.25 or city for one calendar year following the effective date of 402.26 withdrawal. 402.27 (d)The amount of additional annual payment for calendar402.28year 1985 made pursuant to Minnesota Statutes 1984, section402.29145.921, subdivision 4, must be subtracted from the subsidy for402.30a county that, due to withdrawal from a community health board,402.31ceases to meet the terms and conditions under which that402.32additional annual payment was madeThe local public health grant 402.33 for a county that chooses to withdraw from a multicounty 402.34 community health board shall be reduced by the amount of the 402.35 local partnership incentive under section 145A.131, subdivision 402.36 2, paragraph (c). 403.1 Sec. 19. Minnesota Statutes 2002, section 145A.10, 403.2 subdivision 2, is amended to read: 403.3 Subd. 2. [PREEMPTION.] (a) Not later than 365 days after 403.4 theapproval of a community health plan by the403.5commissionerformation of a community health board, any other 403.6 board of health within the community health service area for 403.7 which the plan has been prepared must cease operation, except as 403.8 authorized in a joint powers agreement under section 145A.03, 403.9 subdivision 2, or delegation agreement under section 145A.07, 403.10 subdivision 2, or as otherwise allowed by this subdivision. 403.11 (b) This subdivision does not preempt or otherwise change 403.12 the powers and duties of any city or county eligible forsubsidy403.13 a local public health grant under section 145A.09. 403.14 (c) This subdivision does not preempt the authority to 403.15 operate a community health services program of any city of the 403.16 first or second class operating an existing program of community 403.17 health services located within a county with a population of 403.18 300,000 or more persons until the city council takes action to 403.19 allow the county to preempt the city's powers and duties. 403.20 Sec. 20. Minnesota Statutes 2002, section 145A.10, is 403.21 amended by adding a subdivision to read: 403.22 Subd. 5a. [DUTIES.] (a) Consistent with the guidelines and 403.23 standards established under section 145A.12, and in consultation 403.24 with the community health advisory committee established under 403.25 subdivision 10, paragraph (b), the community health board shall: 403.26 (1) establish local public health priorities based on an 403.27 assessment of community health needs and assets; and 403.28 (2) determine the mechanisms by which the community health 403.29 board will address the local public health priorities 403.30 established under clause (1) and achieve the statewide outcomes 403.31 established under sections 145.8821 and 145A.12, subdivision 7, 403.32 including leveraging local and regional partnerships and 403.33 contracting with community-based organizations, private sector 403.34 organizations, or other units of government, including tribal 403.35 governments. In determining the mechanisms to address local 403.36 public health priorities and achieve statewide outcomes, the 404.1 community health board shall consider the recommendations of the 404.2 community health advisory committee and the following essential 404.3 public health services: 404.4 (i) monitor health status to identify community health 404.5 problems; 404.6 (ii) diagnose and investigate problems and health hazards 404.7 in the community; 404.8 (iii) inform, educate, and empower people about health 404.9 issues; 404.10 (iv) mobilize community partnerships to identify and solve 404.11 health problems; 404.12 (v) develop policies and plans that support individual and 404.13 community health efforts; 404.14 (vi) enforce laws and regulations that protect health and 404.15 ensure safety; 404.16 (vii) link people to needed personal health care services; 404.17 (viii) ensure a competent public health and personal health 404.18 care workforce; 404.19 (ix) evaluate effectiveness, accessibility, and quality of 404.20 personal and population-based health services; and 404.21 (x) research for new insights and innovative solutions to 404.22 health problems. 404.23 (b) By February 1, 2005, and every five years thereafter, 404.24 each community health board that receives a local public health 404.25 grant under section 145A.131 shall notify the commissioner in 404.26 writing of the statewide outcomes established under sections 404.27 145.8821 and 145A.12, subdivision 7, that the board will address 404.28 and the local priorities established under paragraph (a) that 404.29 the board will address. 404.30 (c) Each community health board receiving a local public 404.31 health grant under section 145A.131 must submit an annual report 404.32 to the commissioner documenting progress towards the achievement 404.33 of statewide outcomes established under sections 145.8821 and 404.34 145A.12, subdivision 7, and the local public health priorities 404.35 established under paragraph (a), using reporting standards and 404.36 procedures established by the commissioner and in compliance 405.1 with all applicable federal requirements. If a community health 405.2 board has identified additional local priorities for use of the 405.3 local public health grant since the last notification of 405.4 outcomes and priorities under paragraph (b), the community 405.5 health board shall notify the commissioner of the additional 405.6 local public health priorities in the annual report. 405.7 Sec. 21. Minnesota Statutes 2002, section 145A.10, 405.8 subdivision 10, is amended to read: 405.9 Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 405.10 state community health advisory committee is established to 405.11 advise, consult with, and make recommendations to the 405.12 commissioner on the development, maintenance, funding, and 405.13 evaluation of community health services. Each community health 405.14 board may appoint a member to serve on the committee. The 405.15 committee must meet at least quarterly, and special meetings may 405.16 be called by the committee chair or a majority of the members. 405.17 Members or their alternates mayreceive a per diem and mustbe 405.18 reimbursed for travel and other necessary expenses while engaged 405.19 in their official duties. 405.20 (b) The city councils or county boards that have 405.21 established or are members of a community health board must 405.22 appoint a community health advisory committee to advise, consult 405.23 with, and make recommendations to the community health board on 405.24matters relating to the development, maintenance, funding, and405.25evaluation of community health services. The committee must405.26consist of at least five members and must be generally405.27representative of the population and health care providers of405.28the community health service area. The committee must meet at405.29least three times a year and at the call of the chair or a405.30majority of the members. Members may receive a per diem and405.31reimbursement for travel and other necessary expenses while405.32engaged in their official duties.405.33(c) State and local advisory committees must adopt bylaws405.34or operating procedures that specify the length of terms of405.35membership, procedures for assuring that no more than half of405.36these terms expire during the same year, and other matters406.1relating to the conduct of committee business. Bylaws or406.2operating procedures may allow one alternate to be appointed for406.3each member of a state or local advisory committee. Alternates406.4may be given full or partial powers and duties of membersthe 406.5 duties under subdivision 5a. The committee must be broadly 406.6 representative, including health care, nonprofit, private 406.7 sector, and consumer members, and must reflect the racial and 406.8 ethnic populations within the geographic area served by the 406.9 community health board. The community health advisory committee 406.10 shall recommend to the community health board mechanisms by 406.11 which community resources can most effectively be used to 406.12 achieve local public health priorities and statewide outcomes 406.13 with local public health grant funds, including leveraging local 406.14 and regional partnerships and contracting with community-based 406.15 organizations, private sector organizations, or other units of 406.16 government, including tribal governments. 406.17 Sec. 22. Minnesota Statutes 2002, section 145A.11, 406.18 subdivision 2, is amended to read: 406.19 Subd. 2. [CONSIDERATION OFCOMMUNITY HEALTH PLANLOCAL 406.20 PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 406.21 levying taxes authorized under section 145A.08, subdivision 3, a 406.22 city council or county board that has formed or is a member of a 406.23 community health board must consider the income and expenditures 406.24 required to meetthe objectives of the community health plan for406.25its arealocal public health priorities established under 406.26 section 145A.10, subdivision 5a, and statewide outcomes 406.27 established under section 145A.12, subdivision 7. 406.28 Sec. 23. Minnesota Statutes 2002, section 145A.11, 406.29 subdivision 4, is amended to read: 406.30 Subd. 4. [ORDINANCES RELATING TO COMMUNITY HEALTH 406.31 SERVICES.] A city council or county board that has established 406.32 or is a member of a community health board may by ordinance 406.33 adopt and enforce minimum standards for services provided 406.34 according to sections 145A.02 and 145A.10, subdivision 5. An 406.35 ordinance must not conflict with state law or with more 406.36 stringent standards established either by rule of an agency of 407.1 state government or by the provisions of the charter or 407.2 ordinances of any city organized under section 145A.09, 407.3 subdivision 4. 407.4 Sec. 24. Minnesota Statutes 2002, section 145A.12, 407.5 subdivision 1, is amended to read: 407.6 Subdivision 1. [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 407.7 commissioner must assist community health boards in the 407.8 development, administration, and implementation of community 407.9 health services. This assistance may consist of but is not 407.10 limited to: 407.11 (1) informational resources, consultation, and training to 407.12 help community health boards plan, develop, integrate, provide 407.13 and evaluate community health services; and 407.14 (2) administrative and program guidelines and standards, 407.15 developed with the advice of the state community health advisory 407.16 committee.Adoption of these guidelines by a community health407.17board is not a prerequisite for plan approval as prescribed in407.18subdivision 4.407.19 Sec. 25. Minnesota Statutes 2002, section 145A.12, 407.20 subdivision 2, is amended to read: 407.21 Subd. 2. [PERSONNEL STANDARDS.] In accordance with chapter 407.22 14, and in consultation with the state community health advisory 407.23 committee, the commissioner may adopt rules to set standards for 407.24 administrative and program personnel to ensure competence in 407.25 administration and planningand in each program area defined in407.26section 145A.02. 407.27 Sec. 26. Minnesota Statutes 2002, section 145A.12, is 407.28 amended by adding a subdivision to read: 407.29 Subd. 7. [STATEWIDE OUTCOMES.] (a) The commissioner, in 407.30 consultation with the state community health advisory committee 407.31 established under section 145A.10, subdivision 10, paragraph 407.32 (a), shall establish statewide outcomes for local public health 407.33 grant funds allocated to community health boards between January 407.34 1, 2004, and December 31, 2005. 407.35 (b) At least one statewide outcome must be established in 407.36 each of the following public health areas: 408.1 (1) preventing diseases; 408.2 (2) protecting against environmental hazards; 408.3 (3) preventing injuries; 408.4 (4) promoting healthy behavior; 408.5 (5) responding to disasters; and 408.6 (6) ensuring access to health services. 408.7 (c) The commissioner shall use Minnesota's public health 408.8 goals established under section 62J.212 and the essential public 408.9 health services under section 145A.10, subdivision 5a, as a 408.10 basis for the development of statewide outcomes. 408.11 (d) The statewide maternal and child health outcomes 408.12 established under section 145.8821 shall be included as 408.13 statewide outcomes under this section. 408.14 (e) By December 31, 2004, and every five years thereafter, 408.15 the commissioner, in consultation with the state community 408.16 health advisory committee established under section 145A.10, 408.17 subdivision 10, paragraph (a), and the maternal and child health 408.18 advisory task force established under section 145.881, shall 408.19 develop statewide outcomes for the local public health grant 408.20 established under section 145A.131, based on state and local 408.21 assessment data regarding the health of Minnesota residents, the 408.22 essential public health services under section 145A.10, and 408.23 current Minnesota public health goals established under section 408.24 62J.212. 408.25 Sec. 27. Minnesota Statutes 2002, section 145A.13, is 408.26 amended by adding a subdivision to read: 408.27 Subd. 4. [EXPIRATION.] This section expires January 1, 408.28 2004. 408.29 Sec. 28. [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 408.30 Subdivision 1. [TRIBAL GOVERNMENTS.] (a) Of the funding 408.31 available for local public health grants, $2,000,000 per year is 408.32 available to tribal governments for: 408.33 (1) maternal and child health activities under section 408.34 145.882, subdivision 7; 408.35 (2) activities to reduce health disparities under section 408.36 145.928, subdivision 10; and 409.1 (3) emergency preparedness. 409.2 (b) The commissioner, in consultation with tribal 409.3 governments, shall establish a formula for distributing the 409.4 funds and developing the outcomes to be measured. Any decrease 409.5 or increase in the amount of funding available under the local 409.6 public health grant must be apportioned to reflect a 409.7 proportional change to both tribal governments and to community 409.8 health boards. 409.9 Subd. 2. [FUNDING FORMULA FOR COMMUNITY HEALTH 409.10 BOARDS.] (a) A local public health grant shall be distributed to 409.11 community health boards organized and operating under section 409.12 145A.09 to 145A.131 to achieve locally identified priorities 409.13 under section 145A.10, subdivision 5a, and statewide outcomes 409.14 under section 145A.12, subdivision 7. 409.15 (b) A community health board eligible for a local public 409.16 health grant under section 145A.09, subdivision 2, shall receive 409.17 no less for any calendar year than 95 percent of the board's 409.18 total 2002 community health services subsidy award and 95 409.19 percent of the board's total 2002 maternal and child health 409.20 special projects grant. 409.21 (c) Multicounty community health boards shall receive a 409.22 local partnership incentive of $25,000 per year for each county 409.23 included in the community health board. 409.24 (d) The remaining funds shall be distributed on a per 409.25 capita basis using the population figures established according 409.26 to section 145A.02, subdivision 16. 409.27 Subd. 3. [LOCAL MATCH.] (a) A community health board that 409.28 receives a local public health grant shall provide a 50 percent 409.29 match for the local public health grant funds described in 409.30 subdivision 2, paragraph (b), subject to paragraphs (b) to (e). 409.31 (b) Eligible funds must be used to meet match requirements. 409.32 Eligible funds include funds from local property taxes, 409.33 reimbursements from third parties, other state funds, and 409.34 donations or nonfederal grants that are used for community 409.35 health services described in section 145A.02, subdivision 6. 409.36 (c) Community health boards must provide documentation that 410.1 the 50 percent match for funds received under United States 410.2 Code, title 42, sections 701 to 709, is used for maternal and 410.3 child health activities as described in section 145.882, 410.4 subdivision 7. 410.5 (d) When the amount of local matching funds for a community 410.6 health board is less than the amount required under paragraph 410.7 (a), the local public health grant provided for that community 410.8 health board under this section shall be reduced proportionally. 410.9 (e) A city organized under the provision of sections 410.10 145A.09 to 145A.131 that levies a tax for provision of community 410.11 health services is exempt from any county levy for the same 410.12 services to the extent of the levy imposed by the city. 410.13 Subd. 4. [ADDITIONAL FUNDS.] Additional state or federal 410.14 funds distributed to community health boards to achieve specific 410.15 outcomes shall be distributed as part of the local public health 410.16 grant established in subdivision 2. These funds may be 410.17 distributed in proportion to the basic award described in 410.18 subdivision 2. Additional outcomes for these funds, if not 410.19 specified by federal or state law, shall be developed by the 410.20 commissioner in consultation with the state community health 410.21 advisory committee established under section 145A.10, 410.22 subdivision 10, and the maternal and child health advisory task 410.23 force established under section 145.881. 410.24 Subd. 5. [SPECIAL PROJECT GRANTS.] Notwithstanding other 410.25 requirements of this section, the commissioner may choose to 410.26 fund noncompetitive special project grants for projects by 410.27 select community health boards, according to state or federal 410.28 law. These special project grant funds shall be distributed as 410.29 a part of a community health board's local public health grant 410.30 established in subdivision 2. 410.31 Subd. 6. [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 410.32 STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 410.33 community health board and operates as a board of health or if a 410.34 community health board elects not to accept the local public 410.35 health grant, the commissioner shall retain the amount of 410.36 funding that would have been allocated to the community health 411.1 board using the formula described in subdivision 2 and assume 411.2 responsibility for public health activities to meet the 411.3 statewide outcomes in the geographic area served by the board of 411.4 health or community health board. The commissioner may elect to 411.5 directly provide public health activities to meet the statewide 411.6 outcomes or contract with other units of government or with 411.7 community-based organizations. If a city that is currently a 411.8 community health board withdraws from a community health board 411.9 or elects not to accept the local public health grant, the local 411.10 public health grant funds that would have been allocated to that 411.11 city shall be distributed to the county in which the city is 411.12 located, if the county is part of a community health board. 411.13 Subd. 7. [ACCOUNTABILITY.] (a) Community health boards 411.14 accepting local public health grants must demonstrate progress 411.15 towards the statewide outcomes established in section 145A.12, 411.16 subdivision 7, to maintain eligibility to receive the local 411.17 public health grant. 411.18 (b) If the commissioner determines that a community health 411.19 board has not by the applicable deadline demonstrated progress 411.20 in one or more of the statewide outcomes established under 411.21 section 145.8821 or 145A.12, subdivision 7, then the 411.22 commissioner may determine not to distribute future funds to the 411.23 community health board under subdivision 2. If the commissioner 411.24 determines not to distribute future funds, the commissioner must 411.25 give the community health board written notice of this 411.26 determination. In determining whether or not to distribute 411.27 future funds to the community health board, the commissioner 411.28 shall consider the following factors with respect to the 411.29 statewide outcomes for which the community health board did not 411.30 demonstrate sufficient progress: 411.31 (1) the difficulty of meeting the statewide outcome; 411.32 (2) the effort put forth by the community health board to 411.33 meet the statewide outcome; 411.34 (3) the number of statewide outcomes that the community 411.35 health board did not meet; 411.36 (4) whether the community health board has previously 412.1 failed to meet statewide outcomes under this section; 412.2 (5) the amount of funding received by the community health 412.3 board to address the statewide outcomes; and 412.4 (6) other factors as justice may require, if the 412.5 commissioner specifically identifies the additional factors in 412.6 the commissioner's written notice of determination. 412.7 (c) If a community health board does not demonstrate 412.8 progress towards the statewide outcomes, the commissioner may 412.9 retain local public health grant funds and assume responsibility 412.10 for directly carrying out activities to meet the statewide 412.11 outcomes or contract with other units of government or 412.12 community-based organizations to assume responsibility for the 412.13 statewide outcomes. If the community health board that does not 412.14 demonstrate progress towards the statewide outcomes is a city, 412.15 the commissioner shall distribute the local public health grant 412.16 funds that would have been allocated to that city to the county 412.17 in which the city is located, if the county is part of a 412.18 community health board. 412.19 (d) The commissioner shall establish a reporting system for 412.20 community health boards to report their progress. The system 412.21 shall be developed in consultation with the state community 412.22 health advisory committee established under section 145A.10, 412.23 subdivision 10, paragraph (a), and the maternal and child health 412.24 advisory task force established under section 145.881. 412.25 Subd. 8. [LOCAL PUBLIC HEALTH PRIORITIES.] Community 412.26 health boards may use their local public health grant to address 412.27 local public health priorities identified under section 145A.10, 412.28 subdivision 5a. 412.29 Sec. 29. Minnesota Statutes 2002, section 145A.14, 412.30 subdivision 2, is amended to read: 412.31 Subd. 2. [INDIAN HEALTH GRANTS.] (a) The commissioner may 412.32 make special grants tocommunity health boards toestablish, 412.33 operate, or subsidize clinic facilities and services to furnish 412.34 health services for American Indians who reside off reservations. 412.35 (b)To qualify for a grant under this subdivision the412.36community health plan submitted by the community health board413.1must contain a proposal for the delivery of the services and413.2documentation that representatives of the Indian community413.3affected by the plan were involved in its development.413.4(c)Applicants must submit for approval a plan and budget 413.5 for the use of the funds in the form and detail specified by the 413.6 commissioner. 413.7(d)(c) Applicants must keep records, including records of 413.8 expenditures to be audited, as the commissioner specifies. 413.9 Sec. 30. [REVISOR'S INSTRUCTION.] 413.10 (a) The revisor of statutes shall delete "145A.13" and 413.11 insert "145A.131" in Minnesota Statutes, sections 145A.03, 413.12 subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 413.13 256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 413.14 subdivision 2. 413.15 (b) For sections in Minnesota Statutes and Minnesota Rules 413.16 affected by the repealed sections in this article, the revisor 413.17 shall delete internal cross-references where appropriate and 413.18 make changes necessary to correct the punctuation, grammar, or 413.19 structure of the remaining text and preserve its meaning. 413.20 Sec. 31. [REPEALER.] 413.21 (a) Minnesota Statutes 2002, sections 144.401; 144.9507, 413.22 subdivision 3; 145.56, subdivision 2; 145.882, subdivisions 4, 413.23 5, 6, and 8; 145.883, subdivisions 4 and 7; 145.884; 145.885; 413.24 145.886; 145.888; 145.889; 145.890; 145.9266, subdivisions 2, 4, 413.25 5, 6, and 7; 145.928, subdivision 9; 145A.02, subdivisions 9, 413.26 10, 11, 12, 13, and 14; 145A.10, subdivisions 5, 6, and 8; 413.27 145A.11, subdivision 3; 145A.12, subdivisions 3, 4, and 5; 413.28 145A.14, subdivisions 3 and 4; and 145A.17, subdivision 2, are 413.29 repealed. 413.30 (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 413.31 4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 413.32 4736.0090; 4736.0120; and 4736.0130, are repealed effective 413.33 January 1, 2004. 413.34 (c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300; 413.35 4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 413.36 4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 414.1 4705.1400; 4705.1500; and 4705.1600, are repealed effective June 414.2 30, 2004. 414.3 ARTICLE 10 414.4 APPROPRIATIONS 414.5 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 414.6 The sums shown in the columns marked "APPROPRIATIONS" are 414.7 appropriated from the general fund, or any other fund named, to 414.8 the agencies and for the purposes specified in the sections of 414.9 this article, to be available for the fiscal years indicated for 414.10 each purpose. The figures "2004" and "2005" where used in this 414.11 article, mean that the appropriation or appropriations listed 414.12 under them are available for the fiscal year ending June 30, 414.13 2004, or June 30, 2005, respectively. Where a dollar amount 414.14 appears in parentheses, it means a reduction of an appropriation. 414.15 SUMMARY BY FUND 414.16 BIENNIAL 414.17 2004 2005 TOTAL 414.18 General $3,588,648,000 $3,499,118,000 $7,087,766,000 414.19 State Government 414.20 Special Revenue 45,162,000 44,899,000 90,061,000 414.21 Health Care 414.22 Access 269,351,000 339,443,000 608,794,000 414.23 Federal TANF 267,482,000 267,161,000 534,643,000 414.24 Lottery Prize 414.25 Fund 1,306,000 1,306,000 2,612,000 414.26 TOTAL $4,171,949,000 $4,151,927,000 $8,323,876,000 414.27 APPROPRIATIONS 414.28 Available for the Year 414.29 Ending June 30 414.30 2004 2005 414.31 Sec. 2. COMMISSIONER OF 414.32 HUMAN SERVICES 414.33 Subdivision 1. Total 414.34 Appropriation $ 4,021,515 $ 4,002,077 414.35 Summary by Fund 414.36 General 3,495,179 3,405,970 414.37 State Government 414.38 Special Revenue 534 534 414.39 Health Care 414.40 Access 263,014 333,106 414.41 Federal TANF 261,482 261,161 415.1 Lottery Cash 415.2 Flow 1,306 1,306 415.3 [RECEIPTS FOR SYSTEMS PROJECTS.] 415.4 Appropriations and federal receipts for 415.5 information system projects for MAXIS, 415.6 PRISM, MMIS, and SSIS must be deposited 415.7 in the state system account authorized 415.8 in Minnesota Statutes, section 415.9 256.014. Money appropriated for 415.10 computer projects approved by the 415.11 Minnesota office of technology, funded 415.12 by the legislature, and approved by the 415.13 commissioner of finance may be 415.14 transferred from one project to another 415.15 and from development to operations as 415.16 the commissioner of human services 415.17 considers necessary. Any unexpended 415.18 balance in the appropriation for these 415.19 projects does not cancel but is 415.20 available for ongoing development and 415.21 operations. 415.22 [GIFTS.] Notwithstanding Minnesota 415.23 Statutes, chapter 7, the commissioner 415.24 may accept on behalf of the state 415.25 additional funding from sources other 415.26 than state funds for the purpose of 415.27 financing the cost of assistance 415.28 program grants or nongrant 415.29 administration. All additional funding 415.30 is appropriated to the commissioner for 415.31 use as designated by the grantor of 415.32 funding. 415.33 [SYSTEMS CONTINUITY.] In the event of 415.34 disruption of technical systems or 415.35 computer operations, the commissioner 415.36 may use available grant appropriations 415.37 to ensure continuity of payments for 415.38 maintaining the health, safety, and 415.39 well-being of clients served by 415.40 programs administered by the department 415.41 of human services. Grant funds must be 415.42 used in a manner consistent with the 415.43 original intent of the appropriation. 415.44 [NONFEDERAL SHARE TRANSFERS.] The 415.45 nonfederal share of activities for 415.46 which federal administrative 415.47 reimbursement is appropriated to the 415.48 commissioner may be transferred to the 415.49 special revenue fund. 415.50 [TANF FUNDS APPROPRIATED TO OTHER 415.51 ENTITIES.] Any expenditures from the 415.52 TANF block grant shall be expended in 415.53 accordance with the requirements and 415.54 limitations of part A of title IV of 415.55 the Social Security Act, as amended, 415.56 and any other applicable federal 415.57 requirement or limitation. Prior to 415.58 any expenditure of these funds, the 415.59 commissioner shall assure that funds 415.60 are expended in compliance with the 415.61 requirements and limitations of federal 415.62 law and that any reporting requirements 415.63 of federal law are met. It shall be 415.64 the responsibility of any entity to 415.65 which these funds are appropriated to 415.66 implement a memorandum of understanding 416.1 with the commissioner that provides the 416.2 necessary assurance of compliance prior 416.3 to any expenditure of funds. The 416.4 commissioner shall receipt TANF funds 416.5 appropriated to other state agencies 416.6 and coordinate all related interagency 416.7 accounting transactions necessary to 416.8 implement these appropriations. 416.9 Unexpended TANF funds appropriated to 416.10 any state, local, or nonprofit entity 416.11 cancel at the end of the state fiscal 416.12 year unless appropriating language 416.13 permits otherwise. 416.14 [TANF FUNDS TRANSFERRED TO OTHER 416.15 FEDERAL GRANTS.] The commissioner must 416.16 authorize transfers from TANF to other 416.17 federal block grants so that funds are 416.18 available to meet the annual 416.19 expenditure needs as appropriated. 416.20 Transfers may be authorized prior to 416.21 the expenditure year with the agreement 416.22 of the receiving entity. Transferred 416.23 funds must be expended in the year for 416.24 which the funds were appropriated 416.25 unless appropriation language permits 416.26 otherwise. In accelerating transfer 416.27 authorizations, the commissioner must 416.28 aim to preserve the future potential 416.29 transfer capacity from TANF to other 416.30 block grants. 416.31 [TANF MAINTENANCE OF EFFORT.] (a) In 416.32 order to meet the basic maintenance of 416.33 effort (MOE) requirements of the TANF 416.34 block grant specified under Code of 416.35 Federal Regulations, title 45, section 416.36 263.1, the commissioner may only report 416.37 nonfederal money expended for allowable 416.38 activities listed in the following 416.39 clauses as TANF/MOE expenditures: 416.40 (1) MFIP cash, diversionary work 416.41 program, and food assistance benefits 416.42 under Minnesota Statutes, chapter 256J; 416.43 (2) the child care assistance programs 416.44 under Minnesota Statutes, sections 416.45 119B.03 and 119B.05, and county child 416.46 care administrative costs under 416.47 Minnesota Statutes, section 119B.15; 416.48 (3) state and county MFIP 416.49 administrative costs under Minnesota 416.50 Statutes, chapters 256J and 256K; 416.51 (4) state, county, and tribal MFIP 416.52 employment services under Minnesota 416.53 Statutes, chapters 256J and 256K; 416.54 (5) expenditures made on behalf of 416.55 noncitizen MFIP recipients who qualify 416.56 for the medical assistance without 416.57 federal financial participation program 416.58 under Minnesota Statutes, section 416.59 256B.06, subdivision 4, paragraphs (d), 416.60 (e), and (j). 416.61 (b) The commissioner shall ensure that 416.62 sufficient qualified nonfederal 416.63 expenditures are made each year to meet 417.1 the state's TANF/MOE requirements. For 417.2 the activities listed in paragraph (a), 417.3 clauses (2) to (5), the commissioner 417.4 may only report expenditures that are 417.5 excluded from the definition of 417.6 assistance under Code of Federal 417.7 Regulations, title 45, section 260.31. 417.8 (c) By August 31 of each year, the 417.9 commissioner shall make a preliminary 417.10 calculation to determine the likelihood 417.11 that the state will meet its annual 417.12 federal work participation requirement 417.13 under Code of Federal Regulations, 417.14 title 45, sections 261.21 and 261.23, 417.15 after adjustment for any caseload 417.16 reduction credit under Code of Federal 417.17 Regulations, title 45, section 261.41. 417.18 If the commissioner determines that the 417.19 state will meet its federal work 417.20 participation rate for the federal 417.21 fiscal year ending that September, the 417.22 commissioner may reduce the expenditure 417.23 under paragraph (a), clause (1), to the 417.24 extent allowed under Code of Federal 417.25 Regulations, title 45, section 417.26 263.1(a)(2). 417.27 (d) For fiscal years beginning with 417.28 state fiscal year 2003, the 417.29 commissioner shall assure that the 417.30 maintenance of effort used by the 417.31 commissioner of finance for the 417.32 February and November forecasts 417.33 required under Minnesota Statutes, 417.34 section 16A.103, contains expenditures 417.35 under paragraph (a), clause (1), equal 417.36 to at least 25 percent of the total 417.37 required under Code of Federal 417.38 Regulations, title 45, section 263.1. 417.39 (e) If nonfederal expenditures for the 417.40 programs and purposes listed in 417.41 paragraph (a) are insufficient to meet 417.42 the state's TANF/MOE requirements, the 417.43 commissioner shall recommend additional 417.44 allowable sources of nonfederal 417.45 expenditures to the legislature, if the 417.46 legislature is or will be in session to 417.47 take action to specify additional 417.48 sources of nonfederal expenditures for 417.49 TANF/MOE before a federal penalty is 417.50 imposed. The commissioner shall 417.51 otherwise provide notice to the 417.52 legislative commission on planning and 417.53 fiscal policy under paragraph (g). 417.54 (f) If the commissioner uses authority 417.55 granted under section 9, or similar 417.56 authority granted by a subsequent 417.57 legislature, to meet the state's 417.58 TANF/MOE requirement in a reporting 417.59 period, the commissioner shall inform 417.60 the chairs of the appropriate 417.61 legislative committees about all 417.62 transfers made under that authority for 417.63 this purpose. 417.64 (g) If the commissioner determines that 417.65 nonfederal expenditures under paragraph 417.66 (a) are insufficient to meet TANF/MOE 418.1 expenditure requirements, and if the 418.2 legislature is not or will not be in 418.3 session to take timely action to avoid 418.4 a federal penalty, the commissioner may 418.5 report nonfederal expenditures from 418.6 other allowable sources as TANF/MOE 418.7 expenditures after the requirements of 418.8 this paragraph are met. The 418.9 commissioner may report nonfederal 418.10 expenditures in addition to those 418.11 specified under paragraph (a) as 418.12 nonfederal TANF/MOE expenditures, but 418.13 only ten days after the commissioner of 418.14 finance has first submitted the 418.15 commissioner's recommendations for 418.16 additional allowable sources of 418.17 nonfederal TANF/MOE expenditures to the 418.18 members of the legislative commission 418.19 on planning and fiscal policy for their 418.20 review. 418.21 (h) The commissioner of finance shall 418.22 not incorporate any changes in federal 418.23 TANF expenditures or nonfederal 418.24 expenditures for TANF/MOE that may 418.25 result from reporting additional 418.26 allowable sources of nonfederal 418.27 TANF/MOE expenditures under the interim 418.28 procedures in paragraph (g) into the 418.29 February or November forecasts required 418.30 under Minnesota Statutes, section 418.31 16A.103, unless the commissioner of 418.32 finance has approved the additional 418.33 sources of expenditures under paragraph 418.34 (g). 418.35 (i) Minnesota Statutes, section 418.36 256.011, subdivision 3, which requires 418.37 that federal grants or aids secured or 418.38 obtained under that subdivision be used 418.39 to reduce any direct appropriations 418.40 provided by law, do not apply if the 418.41 grants or aids are federal TANF funds. 418.42 (j) Notwithstanding section 12, 418.43 paragraph (a), clauses (1) to (5), and 418.44 paragraphs (b) to (j) expire June 30, 418.45 2007. 418.46 [SHIFT COUNTY PAYMENT.] The 418.47 commissioner shall make up to 100 418.48 percent of the calendar year 2005 418.49 payments to counties for developmental 418.50 disabilities semi-independent living 418.51 services grants, developmental 418.52 disabilities family support grants, and 418.53 adult mental health grants from fiscal 418.54 year 2006 appropriations. This is a 418.55 onetime payment shift. Calendar year 418.56 2006 and future payments for these 418.57 grants are not affected by this shift. 418.58 This provision expires June 30, 2006. 418.59 [CAPITATION RATE INCREASE.] Of the 418.60 health care access fund appropriations 418.61 to the University of Minnesota in the 418.62 higher education omnibus appropriation 418.63 bill, $2,157,000 in fiscal year 2004 418.64 and $2,157,000 in fiscal year 2005 are 418.65 to be used to increase the capitation 418.66 payments under Minnesota Statutes, 419.1 section 256B.69. Notwithstanding the 419.2 provisions of section 11, this 419.3 provision shall not expire. 419.4 Subd. 2. Agency Management 419.5 Summary by Fund 419.6 General 41,473 27,868 419.7 State Government 419.8 Special Revenue 415 415 419.9 Health Care Access 3,673 3,673 419.10 Federal TANF 320 320 419.11 The amounts that may be spent from the 419.12 appropriation for each purpose are as 419.13 follows: 419.14 (a) Financial Operations 419.15 General 8,751 9,056 419.16 Health Care Access 828 828 419.17 Federal TANF 220 220 419.18 (b) Legal and 419.19 Regulation Operations 419.20 General 7,896 8,168 419.21 State Government 419.22 Special Revenue 415 415 419.23 Health Care Access 244 244 419.24 Federal TANF 100 100 419.25 (c) Management Operations 419.26 General 17,373 3,076 419.27 Health Care Access 1,623 1,623 419.28 (d) Information Technology 419.29 Operations 419.30 General 7,453 7,568 419.31 Health Care Access 978 978 419.32 Subd. 3. Revenue and Pass-Through 419.33 Federal TANF 54,845 51,221 419.34 [TANF TRANSFER TO SOCIAL SERVICES BLOCK 419.35 GRANT.] $6,000,000 in fiscal year 2004 419.36 and $9,272,000 in fiscal year 2005 are 419.37 appropriated to the commissioner for 419.38 the purposes of providing services for 419.39 families with children whose incomes 419.40 are at or below 200 percent of the 419.41 federal poverty guidelines. The 419.42 commissioner shall authorize a 419.43 sufficient transfer of funds from the 419.44 state's federal TANF block grant to the 419.45 state's federal social services block 419.46 grant to meet this appropriation. The 420.1 funds shall be distributed to counties 420.2 for the children and community services 420.3 grant according to the formula for the 420.4 state appropriations in Minnesota 420.5 Statutes, chapter 256M. 420.6 [TANF FUNDS FOR FISCAL YEAR 2006 AND 420.7 FISCAL YEAR 2007 REFINANCING.] 420.8 $16,724,000 in fiscal year 2006 and 420.9 $16,827,000 in fiscal year 2007 in TANF 420.10 funds are available to the commissioner 420.11 to replace general funds in the amount 420.12 of $16,724,000 in fiscal year 2006 and 420.13 $16,827,000 in fiscal year 2007 in 420.14 expenditures that may be counted toward 420.15 TANF maintenance of effort requirements 420.16 or as an allowable TANF expenditure. 420.17 [REDUCTION IN TANF TRANSFER TO CHILD 420.18 CARE AND DEVELOPMENT FUND.] Transfers 420.19 of TANF to the child care development 420.20 fund for the purposes of MFIP child 420.21 care assistance shall be reduced by 420.22 $1,126,000 in fiscal year 2004 and 420.23 $118,000 in fiscal year 2005. 420.24 Subd. 4. Children's Services Grants 420.25 Summary by Fund 420.26 General 111,760 94,256 420.27 Federal TANF -0- 9,272 420.28 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 420.29 Federal funds available during fiscal 420.30 year 2004 and fiscal year 2005, for 420.31 adoption incentive grants are 420.32 appropriated to the commissioner for 420.33 these purposes. 420.34 [ADOPTION ASSISTANCE AND RELATIVE 420.35 CUSTODY ASSISTANCE.] The commissioner 420.36 may transfer unencumbered appropriation 420.37 balances for adoption assistance and 420.38 relative custody assistance between 420.39 fiscal years and between programs. 420.40 Subd. 5. Children's Services Management 420.41 General 5,221 5,283 420.42 Subd. 6. Basic Health Care Grants 420.43 Summary by Fund 420.44 General 1,490,406 1,465,637 420.45 Health Care Access 243,539 313,877 420.46 [UPDATING FEDERAL POVERTY GUIDELINES.] 420.47 Annual updates to the federal poverty 420.48 guidelines are effective each July 1, 420.49 following publication by the United 420.50 States Department of Health and Human 420.51 Services for health care programs under 420.52 Minnesota Statutes, chapters 256, 256B, 420.53 256D, and 256L. 420.54 The amounts that may be spent from this 420.55 appropriation for each purpose are as 421.1 follows: 421.2 (a) MinnesotaCare Grants 421.3 Health Care Access 242,789 313,127 421.4 [MINNESOTACARE FEDERAL RECEIPTS.] 421.5 Receipts received as a result of 421.6 federal participation pertaining to 421.7 administrative costs of the Minnesota 421.8 health care reform waiver shall be 421.9 deposited as nondedicated revenue in 421.10 the health care access fund. Receipts 421.11 received as a result of federal 421.12 participation pertaining to grants 421.13 shall be deposited in the federal fund 421.14 and shall offset health care access 421.15 funds for payments to providers. 421.16 [MINNESOTACARE FUNDING.] The 421.17 commissioner may expend money 421.18 appropriated from the health care 421.19 access fund for MinnesotaCare in either 421.20 fiscal year of the biennium. 421.21 (b) MA Basic Health Care Grants - 421.22 Families and Children 421.23 General 560,470 574,389 421.24 (c) MA Basic Health Care Grants - Elderly 421.25 and Disabled 421.26 General 687,945 759,657 421.27 [DELAY MA FEE FOR SERVICE - ACUTE 421.28 CARE.] The last payment in fiscal year 421.29 2005 from the Medicaid Management 421.30 Information System that would otherwise 421.31 have been made to providers for medical 421.32 assistance and general assistance 421.33 medical care services shall be delayed 421.34 and included in the first payment in 421.35 fiscal year 2006. This payment delay 421.36 shall not include payments to skilled 421.37 nursing facilities, intermediate care 421.38 facilities for mental retardation, 421.39 prepaid health plans, home health 421.40 agencies, personal care nursing 421.41 providers, and providers of only waiver 421.42 services. The provisions of Minnesota 421.43 Statutes, section 16A.124, shall not 421.44 apply to these delayed payments. 421.45 Notwithstanding section 12, this 421.46 provision shall not expire. 421.47 (d) General Assistance Medical Care 421.48 Grants 421.49 General 228,293 115,756 421.50 (e) Health Care Grants - Other 421.51 Assistance 421.52 General 3,067 3,123 421.53 Health Care Access 750 750 421.54 (f) Prescription Drug Program 421.55 General 10,631 12,712 422.1 Subd. 7. Health Care Management 422.2 Summary by Fund 422.3 General 23,684 24,202 422.4 Health Care Access 14,395 14,179 422.5 The amounts that may be spent from this 422.6 appropriation for each purpose are as 422.7 follows: 422.8 (a) Health Care Policy Administration 422.9 General 4,532 5,226 422.10 Health Care Access 846 846 422.11 [MINNESOTACARE OUTREACH REIMBURSEMENT.] 422.12 Federal administrative reimbursement 422.13 resulting from MinnesotaCare outreach 422.14 is appropriated to the commissioner for 422.15 this activity. 422.16 [MINNESOTA SENIOR HEALTH OPTIONS 422.17 REIMBURSEMENT.] Federal administrative 422.18 reimbursement resulting from the 422.19 Minnesota senior health options project 422.20 is appropriated to the commissioner for 422.21 this activity. 422.22 [UTILIZATION REVIEW.] Federal 422.23 administrative reimbursement resulting 422.24 from prior authorization and inpatient 422.25 admission certification by a 422.26 professional review organization shall 422.27 be dedicated to the commissioner for 422.28 these purposes. A portion of these 422.29 funds must be used for activities to 422.30 decrease unnecessary pharmaceutical 422.31 costs in medical assistance. 422.32 (b) Health Care Options 422.33 General 19,152 18,976 422.34 Health Care Access 13,549 13,333 422.35 [PREPAID MEDICAL PROGRAMS.] For all 422.36 counties in which the PMAP program has 422.37 been operating for 12 or more months, 422.38 state funding for the nonfederal share 422.39 of prepaid medical assistance program 422.40 administration costs for county managed 422.41 care advocacy and enrollment operations 422.42 is eliminated. State funding will 422.43 continue for these activities for 422.44 counties and tribes establishing new 422.45 PMAP programs for a maximum of 16 422.46 months (four months prior to beginning 422.47 PMAP enrollment and through the first 422.48 12 months of their PMAP program 422.49 operation). Those counties operating 422.50 PMAP programs for less than 12 months 422.51 can continue to receive state funding 422.52 for advocacy and enrollment activities 422.53 through their first year of operation. 422.54 Subd. 8. State-operated Services 422.55 General 195,062 186,775 423.1 [MITIGATION RELATED TO STATE-OPERATED 423.2 SERVICES RESTRUCTURING.] Money 423.3 appropriated to finance mitigation 423.4 expenses related to restructuring 423.5 state-operated services programs and 423.6 administrative services may be 423.7 transferred between fiscal years within 423.8 the biennium. 423.9 [STATE-OPERATED SERVICES 423.10 RESTRUCTURING.] For purposes of 423.11 restructuring state-operated services, 423.12 any state-operated services employee 423.13 whose position is to be eliminated 423.14 shall be afforded the options provided 423.15 in applicable collective bargaining 423.16 agreements. All salary and mitigation 423.17 allocations from fiscal year 2004 shall 423.18 be carried forward into fiscal year 423.19 2005. Provided there is no conflict 423.20 with any collective bargaining 423.21 agreement, any state-operated services 423.22 position reduction must only be 423.23 accomplished through mitigation, 423.24 attrition, transfer, and other measures 423.25 as provided in state or applicable 423.26 collective bargaining agreements and in 423.27 Minnesota Statutes, section 252.50, 423.28 subdivision 11, and not through layoff. 423.29 [REPAIRS AND BETTERMENTS.] The 423.30 commissioner may transfer unencumbered 423.31 appropriation balances between fiscal 423.32 years within the biennium for the state 423.33 residential facilities repairs and 423.34 betterments account and special 423.35 equipment. 423.36 Subd. 9. Continuing Care Grants 423.37 Summary by Fund 423.38 General 1,446,139 1,425,621 423.39 Lottery Prize Fund 1,158 1,158 423.40 The amounts that may be spent from this 423.41 appropriation for each purpose are as 423.42 follows: 423.43 (a) Aging and Adult Service Grant 423.44 General 7,201 7,969 423.45 (b) Deaf and Hard-of-hearing 423.46 Service Grants 423.47 General 1,702 1,468 423.48 (c) Mental Health Grants 423.49 General 53,744 34,955 423.50 Lottery Prize Fund 1,158 1,158 423.51 [RESTRUCTURING OF ADULT MENTAL HEALTH 423.52 SERVICES.] The commissioner may make 423.53 budget neutral transfers to effectively 423.54 implement the restructuring of adult 423.55 mental health services. "Budget 423.56 neutral transfers" means transfers 424.1 which do not increase the state share 424.2 of costs. 424.3 (d) Community Support Grants 424.4 General 11,725 8,794 424.5 (e) Medical Assistance Long-term 424.6 Care Waivers and Home Care Grants 424.7 General 643,530 694,967 424.8 [RATE AND ALLOCATION DECREASES FOR 424.9 CONTINUING CARE PROGRAMS.] 424.10 Notwithstanding any law or rule to the 424.11 contrary, the commissioner of human 424.12 services shall decrease reimbursement 424.13 rates or reduce allocations to assure 424.14 the necessary reductions in state 424.15 spending for the providers or programs 424.16 listed in (A) through (D). The 424.17 decreases are effective for services 424.18 rendered on or after July 1, 2003. 424.19 (A) Effective July 1, 2003, the 424.20 commissioner shall reduce payment rates 424.21 for services and individual or service 424.22 limits by four percent. The rate 424.23 decreases described in this section 424.24 must be applied to: 424.25 (1) home and community-based waivered 424.26 services for the elderly under 424.27 Minnesota Statutes, section 256B.0915; 424.28 (2) day training and habilitation 424.29 services for adults with mental 424.30 retardation or related conditions under 424.31 Minnesota Statutes, sections 252.40 to 424.32 252.46; 424.33 (3) the group residential housing 424.34 supplementary service rate under 424.35 Minnesota Statutes, section 256I.05, 424.36 subdivision 1a; 424.37 (4) chemical dependency residential and 424.38 nonresidential service rates under 424.39 Minnesota Statutes, section 254B.03; 424.40 (5) consumer support grants under 424.41 Minnesota Statutes, section 256.476; 424.42 and 424.43 (6) home and community-based services 424.44 for alternative care services under 424.45 Minnesota Statutes, section 256B.0913. 424.46 (B) Effective July 1, 2003, the 424.47 commissioner shall reduce payment rates 424.48 for services and individual or service 424.49 limits by two percent to: 424.50 (1) home health services under 424.51 Minnesota Statutes, section 256B.0625, 424.52 subdivision 6a; 424.53 (2) personal care services and nursing 424.54 supervision of personal care services 424.55 under Minnesota Statutes, section 424.56 256B.0625, subdivision 19a; and 425.1 (3) private duty nursing services under 425.2 Minnesota Statutes, section 256B.0625, 425.3 subdivision 7. 425.4 (C) The commissioner shall reduce 425.5 allocations made available to county 425.6 agencies for home and community-based 425.7 waivered services to assure a four 425.8 percent reduction in state spending for 425.9 services rendered on or after July 1, 425.10 2003. The commissioner shall apply the 425.11 allocation decreases described in this 425.12 section to: 425.13 (1) persons with mental retardation or 425.14 related conditions under Minnesota 425.15 Statutes, section 256B.501; 425.16 (2) waivered services under community 425.17 alternatives for disabled individuals 425.18 under Minnesota Statutes, section 425.19 256B.49; 425.20 (3) community alternative care waivered 425.21 services under Minnesota Statutes, 425.22 section 256B.49; and 425.23 (4) traumatic brain injury waivered 425.24 services under Minnesota Statutes, 425.25 section 256B.49. 425.26 County agencies will be responsible for 425.27 100 percent of any spending in excess 425.28 of the allocation made by the 425.29 commissioner. Nothing in this section 425.30 shall be construed as reducing the 425.31 county's responsibility to offer and 425.32 make available feasible home and 425.33 community-based options to eligible 425.34 waiver recipients within the resources 425.35 allocated to them for that purpose. 425.36 (D) The commissioner shall reduce deaf 425.37 and hard-of-hearing grants by four 425.38 percent on July 1, 2003. 425.39 [REDUCE GROWTH IN MR/RC WAIVER.] The 425.40 commissioner shall reduce the growth in 425.41 the MR/RC waiver by not allocating the 425.42 300 additional diversion allocations 425.43 that are included in the February 2003 425.44 forecast for the fiscal years that 425.45 begin on July 1, 2003, and July 1, 2004. 425.46 [MANAGE THE GROWTH IN THE TBI WAIVER.] 425.47 During the fiscal years beginning on 425.48 July 1, 2003, and July 1, 2004, the 425.49 commissioner shall allocate money for 425.50 this program in such a way so that the 425.51 caseload growth for this program does 425.52 not exceed 150 in each year of the 425.53 biennium. Priorities for the 425.54 allocation of funds shall be for 425.55 individuals anticipated to be 425.56 discharged from institutional settings 425.57 or who are at imminent risk of a 425.58 placement in an institutional setting. 425.59 [TARGETED CASE MANAGEMENT FOR HOME CARE 425.60 RECIPIENTS.] Implementation of the 425.61 targeted case management benefit for 426.1 home care recipients, according to 426.2 Minnesota Statutes, section 256B.0621, 426.3 subdivisions 2, 3, 5, 6, 7, 9, and 10, 426.4 will be delayed until July 1, 2005. 426.5 [COMMON SERVICE MENU.] Implementation 426.6 of the common service menu option 426.7 within the home and community-based 426.8 waivers, according to Minnesota 426.9 Statutes, section 256B.49, subdivision 426.10 16, will be delayed until July 1, 2005. 426.11 (f) Medical Assistance Long-term 426.12 Care Facilities Grants 426.13 General 514,710 485,543 426.14 (g) Alternative Care Grants 426.15 General 70,705 62,930 426.16 [ALTERNATIVE CARE TRANSFER.] Any money 426.17 allocated to the alternative care 426.18 program that is not spent for the 426.19 purposes indicated does not cancel but 426.20 shall be transferred to the medical 426.21 assistance account. 426.22 [ALTERNATIVE CARE APPROPRIATION.] The 426.23 commissioner may expend the money 426.24 appropriated for the alternative care 426.25 program for that purpose in either year 426.26 of the biennium. 426.27 [ALTERNATIVE CARE IMPLEMENTATION OF 426.28 CHANGES TO PREMIUMS AND ELIGIBILITY.] 426.29 Changes to Minnesota Statutes, section 426.30 256B.0913, subdivision 4, paragraph 426.31 (d), and subdivision 12, are effective 426.32 July 1, 2003, for all persons found 426.33 eligible for the alternative care 426.34 program on or after July 1, 2003. All 426.35 recipients of alternative care funding 426.36 as of June 30, 2003, shall be subject 426.37 to Minnesota Statutes, section 426.38 256B.0913, subdivision 4, paragraph 426.39 (d), and subdivision 12, on the annual 426.40 reassessment and review of their 426.41 eligibility after July 1, 2003, but no 426.42 later than January 1, 2004. 426.43 (h) Group Residential Housing Grants 426.44 General 94,150 80,092 426.45 [GROUP RESIDENTIAL HOUSING COSTS 426.46 REFINANCED.] Effective July 1, 2004, 426.47 the commissioner shall increase the 426.48 home and community-based service rates 426.49 and county allocations provided to 426.50 programs established under section 426.51 1915(c) of the Social Security Act to 426.52 the extent that these programs will be 426.53 paying for the costs above the rate 426.54 established in Minnesota Statutes, 426.55 section 256I.05, subdivision 1. 426.56 (i) Chemical Dependency 426.57 Entitlement Grants 426.58 General 47,617 47,848 427.1 (j) Chemical Dependency Nonentitlement 427.2 Grants 427.3 General 1,055 1,055 427.4 Subd. 10. Continuing Care Management 427.5 Summary by Fund 427.6 General 21,484 21,014 427.7 State Government 427.8 Special Revenue 119 119 427.9 Lottery Prize Fund 148 148 427.10 Subd. 11. Economic Support Grants 427.11 Summary by Fund 427.12 General 120,922 116,011 427.13 Federal TANF 205,949 199,980 427.14 The amounts that may be spent from this 427.15 appropriation for each purpose are as 427.16 follows: 427.17 (a) Minnesota Family Investment Program 427.18 General 50,947 44,938 427.19 Federal TANF 104,889 92,294 427.20 [MFIP SUPPORT SERVICES COUNTY AND 427.21 TRIBAL ALLOCATION.] When determining 427.22 the funds available for the 427.23 consolidated MFIP support services 427.24 grant in the 18-month period ending 427.25 December 31, 2004, the commissioner 427.26 shall apportion the funds appropriated 427.27 for fiscal year 2005 in such manner as 427.28 necessary to provide $14,000,000 more 427.29 to counties and tribes for the period 427.30 ending December 31, 2004, than would 427.31 have been available had the funds been 427.32 evenly divided within the fiscal year 427.33 between the period before December 31, 427.34 2004, and the period after December 31, 427.35 2004. 427.36 For allocations for the calendar years 427.37 starting January 1, 2005, the 427.38 commissioner shall apportion the funds 427.39 appropriated for each fiscal year in 427.40 such manner as necessary to provide 427.41 $14,000,000 more to counties and tribes 427.42 for the period ending December 31 of 427.43 that year than would have been 427.44 available had the funds been evenly 427.45 divided within the fiscal year between 427.46 the period before December 31 and the 427.47 period after December 31. 427.48 (b) Work Grants 427.49 General 8,666 8,678 427.50 Federal TANF 101,060 107,686 427.51 (c) Economic Support Grants - Other 428.1 Assistance 428.2 General 2,858 2,963 428.3 (d) Child Support Enforcement Grants 428.4 General 3,571 3,503 428.5 (e) General Assistance Grants 428.6 General 24,651 24,482 428.7 [GENERAL ASSISTANCE STANDARD.] The 428.8 commissioner shall set the monthly 428.9 standard of assistance for general 428.10 assistance units consisting of an adult 428.11 recipient who is childless and 428.12 unmarried or living apart from parents 428.13 or a legal guardian at $203. The 428.14 commissioner may reduce this amount 428.15 according to Laws 1997, chapter 85, 428.16 article 3, section 54. 428.17 (f) Minnesota Supplemental Aid Grants 428.18 General 30,229 31,447 428.19 Subd. 12. Economic Support 428.20 Management 428.21 Summary by Fund 428.22 General 39,028 39,303 428.23 Health Care Access 1,407 1,377 428.24 Federal TANF 368 368 428.25 The amounts that may be spent from this 428.26 appropriation for each purpose are as 428.27 follows: 428.28 (a) Economic Support 428.29 Policy Administration 428.30 General 5,360 5,587 428.31 Federal TANF 368 368 428.32 (b) Economic Support 428.33 Operations 428.34 General 33,668 33,716 428.35 Health Care Access 1,407 1,377 428.36 [CHILD SUPPORT PAYMENT CENTER.] 428.37 Payments to the commissioner from other 428.38 governmental units, private 428.39 enterprises, and individuals for 428.40 services performed by the child support 428.41 payment center must be deposited in the 428.42 state systems account authorized under 428.43 Minnesota Statutes, section 256.014. 428.44 These payments are appropriated to the 428.45 commissioner for the operation of the 428.46 child support payment center or system, 428.47 according to Minnesota Statutes, 428.48 section 256.014. 428.49 [CHILD SUPPORT COST RECOVERY FEES.] The 429.1 commissioner shall transfer $247,000 of 429.2 child support cost recovery fees 429.3 collected in fiscal year 2005 to the 429.4 PRISM special revenue account to offset 429.5 PRISM system costs of implementing the 429.6 fee. 429.7 [FINANCIAL INSTITUTION DATA MATCH AND 429.8 PAYMENT OF FEES.] The commissioner is 429.9 authorized to allocate up to $310,000 429.10 each year in fiscal year 2004 and 429.11 fiscal year 2005 from the PRISM special 429.12 revenue account to make payments to 429.13 financial institutions in exchange for 429.14 performing data matches between account 429.15 information held by financial 429.16 institutions and the public authority's 429.17 database of child support obligors as 429.18 authorized by Minnesota Statutes, 429.19 section 13B.06, subdivision 7. 429.20 Sec. 3. COMMISSIONER OF HEALTH 429.21 Subdivision 1. Total 429.22 Appropriation 104,875,000 104,292,000 429.23 Summary by Fund 429.24 General 59,722,000 59,402,000 429.25 State Government 429.26 Special Revenue 32,880,000 32,617,000 429.27 Health Care Access 6,273,000 6,273,000 429.28 Federal TANF 6,000,000 6,000,000 429.29 Subd. 2. Health Improvement 429.30 Summary by Fund 429.31 General 44,750,000 44,490,000 429.32 State Government 429.33 Special Revenue 1,987,000 1,987,000 429.34 Health Care Access 3,510,000 3,510,000 429.35 Federal TANF 6,000,000 6,000,000 429.36 [TOBACCO PREVENTION ENDOWMENT FUND 429.37 TRANSFERS.] (a) On July 1, 2003, the 429.38 commissioner of finance shall transfer 429.39 $4,000,000 from the tobacco use 429.40 prevention and local public health 429.41 endowment expendable trust fund to the 429.42 general fund. 429.43 (b) Notwithstanding Minnesota Statutes, 429.44 section 16A.62, any remaining 429.45 unexpended balance in the fund after 429.46 the transfer in paragraph (a) shall be 429.47 transferred to the miscellaneous 429.48 special revenue fund and dedicated to 429.49 the commissioner of health for a youth 429.50 tobacco prevention program. These 429.51 funds are available until expended. 429.52 [TANF APPROPRIATIONS.] TANF funds 429.53 appropriated to the commissioner are 429.54 available for home visiting and 430.1 nutritional activities listed under 430.2 Minnesota Statutes, section 145.882, 430.3 subdivision 7, clauses (6) and (7), and 430.4 eliminating health disparities 430.5 activities under Minnesota Statutes, 430.6 section 145.928, subdivision 10. 430.7 Funding shall be distributed to 430.8 community health boards and tribal 430.9 governments based on the formula in 430.10 Minnesota Statutes, section 145A.131, 430.11 subdivisions 1 and 2. 430.12 [TANF CARRYFORWARD.] Any unexpended 430.13 balance of the TANF appropriation in 430.14 the first year of the biennium does not 430.15 cancel but is available for the second 430.16 year. 430.17 Subd. 3. Health Quality and 430.18 Access 430.19 Summary by Fund 430.20 General 868,000 814,000 430.21 State Government 430.22 Special Revenue 8,888,000 8,888,000 430.23 Health Care Access 2,763,000 2,763,000 430.24 [STATE GOVERNMENT SPECIAL REVENUE FUND 430.25 TRANSFERS.] On July 1, 2003, the 430.26 commissioner of finance shall transfer 430.27 $3,000,000 from the state government 430.28 special revenue fund to the general 430.29 fund. 430.30 [MEDICAL EDUCATION ENDOWMENT FUND 430.31 TRANSFERS.] Notwithstanding Minnesota 430.32 Statutes, section 16A.62, any remaining 430.33 unexpended balances in the medical 430.34 education expendable trust fund shall 430.35 be transferred to the miscellaneous 430.36 special revenue fund and dedicated to 430.37 the commissioner for the purposes 430.38 identified in Minnesota Statutes, 430.39 section 62J.692. These funds are 430.40 available until expended. 430.41 Subd. 4. Health Protection 430.42 Summary by Fund 430.43 General 8,855,000 8,855,000 430.44 State Government 430.45 Special Revenue 22,005,000 21,742,000 430.46 Subd. 5. Management and Support 430.47 Services 430.48 General 5,249,000 5,243,000 430.49 Sec. 4. VETERANS HOME BOARD 430.50 General 30,030,000 30,030,000 430.51 Sec. 5. HEALTH-RELATED BOARDS 430.52 Subdivision 1. Total 430.53 Appropriation 11,266,000 11,266,000 431.1 [STATE GOVERNMENT SPECIAL REVENUE 431.2 FUND.] The appropriations in this 431.3 section are from the state government 431.4 special revenue fund, except where 431.5 noted. 431.6 [NO SPENDING IN EXCESS OF REVENUES.] 431.7 The commissioner of finance shall not 431.8 permit the allotment, encumbrance, or 431.9 expenditure of money appropriated in 431.10 this section in excess of the 431.11 anticipated biennial revenues or 431.12 accumulated surplus revenues from fees 431.13 collected by the boards. Neither this 431.14 provision nor Minnesota Statutes, 431.15 section 214.06, applies to transfers 431.16 from the general contingent account. 431.17 [STATE GOVERNMENT SPECIAL REVENUE FUND 431.18 TRANSFERS.] On July 1, 2003, the 431.19 commissioner of finance shall transfer 431.20 $7,500,000 from the state government 431.21 special revenue fund to the general 431.22 fund. 431.23 Subd. 2. Board of Chiropractic 431.24 Examiners 384,000 384,000 431.25 Subd. 3. Board of Dentistry 431.26 State Government Special 431.27 Revenue Fund 858,000 858,000 431.28 Health Care 431.29 Access Fund 64,000 64,000 431.30 Subd. 4. Board of Dietetic and 431.31 Nutrition Practice 101,000 101,000 431.32 Subd. 5. Board of Marriage and 431.33 Family Therapy 118,000 118,000 431.34 Subd. 6. Board of Medical 431.35 Practice 3,498,000 3,498,000 431.36 Subd. 7. Board of Nursing 2,405,000 2,405,000 431.37 Subd. 8. Board of Nursing 431.38 Home Administrators 198,000 198,000 431.39 Subd. 9. Board of Optometry 96,000 96,000 431.40 Subd. 10. Board of Pharmacy 1,386,000 1,386,000 431.41 [ADMINISTRATIVE SERVICES UNIT.] Of this 431.42 appropriation, $359,000 the first year 431.43 and $359,000 the second year are for 431.44 the health boards administrative 431.45 services unit. The administrative 431.46 services unit may receive and expend 431.47 reimbursements for services performed 431.48 for other agencies. 431.49 Subd. 11. Board of Physical 431.50 Therapy 197,000 197,000 431.51 Subd. 12. Board of Podiatry 45,000 45,000 431.52 Subd. 13. Board of Psychology 680,000 680,000 432.1 Subd. 14. Board of Social 432.2 Work 1,073,000 1,073,000 432.3 Subd. 15. Board of Veterinary 432.4 Medicine 163,000 163,000 432.5 Sec. 6. EMERGENCY MEDICAL SERVICES BOARD 432.6 Subdivision 1. Total 432.7 Appropriation 2,850,000 2,850,000 432.8 Summary by Fund 432.9 General 2,304,000 2,304,000 432.10 State Government 432.11 Special Revenue 546,000 546,000 432.12 [HEALTH PROFESSIONAL SERVICES 432.13 ACTIVITY.] $546,000 each year from the 432.14 state government special revenue fund 432.15 is for the health professional services 432.16 activity. 432.17 Sec. 7. COUNCIL ON DISABILITY 432.18 General 500,000 500,000 432.19 Sec. 8. OMBUDSMAN FOR MENTAL HEALTH 432.20 AND MENTAL RETARDATION 432.21 General 1,243,000 1,242,000 432.22 Sec. 9. OMBUDSMAN FOR 432.23 FAMILIES 432.24 General 170,000 170,000 432.25 Sec. 10. [TRANSFERS.] 432.26 Subdivision 1. [GRANTS.] The commissioner of human 432.27 services, with the approval of the commissioner of finance, and 432.28 after notification of the chair of the senate health, human 432.29 services and corrections budget division and the chair of the 432.30 house health and human services finance committee, may transfer 432.31 unencumbered appropriation balances for the biennium ending June 432.32 30, 2005, within fiscal years among the MFIP, general 432.33 assistance, general assistance medical care, medical assistance, 432.34 Minnesota supplemental aid, and group residential housing 432.35 programs, and the entitlement portion of the chemical dependency 432.36 consolidated treatment fund, and between fiscal years of the 432.37 biennium. 432.38 Subd. 2. [ADMINISTRATION.] Positions, salary money, and 432.39 nonsalary administrative money may be transferred within the 432.40 departments of human services and health and within the programs 432.41 operated by the veterans nursing homes board as the 433.1 commissioners and the board consider necessary, with the advance 433.2 approval of the commissioner of finance. The commissioner or 433.3 the board shall inform the chairs of the house health and human 433.4 services finance committee and the senate health, human services 433.5 and corrections budget division quarterly about transfers made 433.6 under this provision. 433.7 Subd. 3. [PROHIBITED TRANSFERS.] Grant money shall not be 433.8 transferred to operations within the departments of human 433.9 services and health and within the programs operated by the 433.10 veterans nursing homes board without the approval of the 433.11 legislature. 433.12 Sec. 11. [INDIRECT COSTS NOT TO FUND PROGRAMS.] 433.13 The commissioners of health and of human services shall not 433.14 use indirect cost allocations to pay for the operational costs 433.15 of any program for which they are responsible. 433.16 Sec. 12. [CARRYOVER LIMITATION.] 433.17 The appropriations in this article which are allowed to be 433.18 carried forward from fiscal year 2004 to fiscal year 2005 shall 433.19 not become part of the base level funding for the 2006-2007 433.20 biennial budget, unless specifically directed by the legislature. 433.21 Sec. 13. [SUNSET OF UNCODIFIED LANGUAGE.] 433.22 All uncodified language contained in this article expires 433.23 on June 30, 2005, unless a different expiration date is explicit. 433.24 Sec. 14. [REPEALER.] 433.25 Laws 2002, chapter 374, article 9, section 8, is repealed 433.26 effective upon final enactment. 433.27 Sec. 15. [EFFECTIVE DATE.] 433.28 The provisions in this article are effective July 1, 2003, 433.29 unless a different effective date is specified.