HF 1078

1st Unofficial Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

1.1A bill for an act

1.2relating to state government; making changes to health and human services
1.3programs; changing children and family provisions; amending child welfare
1.4provisions; modifying licensing provisions; amending health care programs
1.5and policy; modifying continuing care programs and policy; amending mental
1.6and chemical health provisions; changing Department of Health provisions
1.7and policy; establishing a children's health program; changing public health
1.8provisions and policy; amending MinnesotaCare, medical assistance, and
1.9general assistance medical care; instituting health care reform; establishing the
1.10Minnesota Health Insurance Exchange; requiring Section 125 Plans; modifying
1.11health insurance provisions; establishing family supportive services; providing
1.12rate increases for certain providers and nursing facilities; changing health
1.13records information provisions; making technical changes; providing penalties;
1.14establishing task forces; changing certain fees; requiring reports; making forecast
1.15adjustments; appropriating money for human services and health; appropriating
1.16money for various state boards and councils;amending Minnesota Statutes
1.172006, sections 13.381, by adding a subdivision; 13.46, subdivision 2; 16A.10,
1.18by adding a subdivision; 16A.724, subdivision 2, by adding subdivisions;
1.1916B.61, by adding a subdivision; 16D.13, subdivision 3; 47.58, subdivision 8;
1.2062E.02, subdivision 7; 62H.02; 62J.07, subdivisions 1, 3; 62J.17, subdivisions
1.212, 4a, 6a, 7; 62J.41, subdivision 1; 62J.495; 62J.52, subdivisions 1, 2; 62J.60,
1.22subdivisions 2, 3; 62J.692, subdivisions 1, 4, 5, 8; 62J.81, subdivision 1; 62J.82;
1.2362L.02, subdivision 11; 62Q.165, subdivisions 1, 2; 62Q.80, subdivisions 3, 4,
1.2413, 14, by adding a subdivision; 69.021, subdivision 11; 103I.101, subdivision
1.256; 103I.208, subdivisions 1, 2; 103I.235, subdivision 1; 119B.011, by adding
1.26a subdivision; 119B.035, subdivision 1; 119B.05, subdivision 1; 119B.09,
1.27subdivisions 1, 7, by adding subdivisions; 119B.12; 119B.125, subdivision 2;
1.28119B.13, subdivisions 1, 3a, 6, 7; 119B.21, subdivision 5; 144.05, by adding a
1.29subdivision; 144.123; 144.125; 144.3345; 144.552; 144.553, subdivision 3;
1.30144.565; 144.651, subdivisions 9, 10, 26; 144.698, subdivision 1; 144.699, by
1.31adding a subdivision; 144.9507, by adding a subdivision; 144.9512; 144A.073,
1.32subdivision 4; 144A.351; 144D.03, subdivision 1; 144E.101, subdivision 6;
1.33144E.127; 144E.35, subdivision 1; 145A.17; 145C.05; 145C.07, by adding
1.34a subdivision; 148.235, by adding a subdivision; 148.6445, subdivisions 1,
1.352; 148B.53, subdivision 3; 148C.11, subdivision 1; 149A.52, subdivision 3;
1.36149A.97, subdivision 7; 151.19, subdivision 2; 151.37, subdivision 2; 152.11,
1.37by adding a subdivision; 157.16, subdivision 1; 169A.70, subdivision 4;
1.38179A.03, subdivision 7; 198.075; 245.462, subdivision 20; 245.465, by adding a
1.39subdivision; 245.4712, subdivision 1; 245.4874; 245.50, subdivision 5; 245.771,
2.1by adding a subdivision; 245.98, subdivision 2; 245A.035; 245A.10, subdivision
2.22; 245A.16, subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04,
2.3subdivision 1; 245C.05, subdivisions 1, 4, 5, 7, by adding a subdivision; 245C.08,
2.4subdivisions 1, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2;
2.5245C.12; 245C.16, subdivision 1; 245C.17, by adding a subdivision; 245C.21,
2.6by adding a subdivision; 245C.23, subdivision 2; 246.54, subdivisions 1, 2;
2.7252.27, subdivision 2a; 252.32, subdivision 3; 253B.185, subdivision 2, by
2.8adding a subdivision; 254A.03, subdivision 3; 254A.16, subdivision 2; 254B.02,
2.9subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06, subdivision 3; 256.01,
2.10subdivisions 2, 2b, 4, by adding subdivisions; 256.015, subdivision 7; 256.017,
2.11subdivisions 1, 9; 256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions
2.123a, 9, 27, by adding a subdivision; 256.974; 256.9741, subdivisions 1, 3;
2.13256.9742, subdivisions 3, 4, 6; 256.9744, subdivision 1; 256.975, subdivision
2.147, by adding a subdivision; 256.984, subdivision 1; 256B.04, subdivision 14,
2.15by adding a subdivision; 256B.055, subdivision 14; 256B.056, subdivisions
2.161a, 3, 10, by adding a subdivision; 256B.057, by adding a subdivision;
2.17256B.0621, subdivision 11; 256B.0622, subdivision 2; 256B.0623, subdivision
2.185; 256B.0625, subdivisions 3f, 13c, 13d, 18a, 20, 23, 47, by adding subdivisions;
2.19256B.0631, subdivisions 1, 3; 256B.0644; 256B.0651, subdivision 7; 256B.0655,
2.20subdivisions 1b, 1f, 3, 8, by adding subdivisions; 256B.0911, subdivisions 1a,
2.213a, 3b, 4b, 4c, 6, 7, by adding subdivisions; 256B.0913, subdivisions 4, 5,
2.225a, 8, 9, 10, 11, 12, 13, 14, by adding a subdivision; 256B.0915; 256B.0919,
2.23subdivision 3; 256B.0943, subdivisions 6, 8, 9, 11, 12; 256B.0945, subdivision
2.244; 256B.095; 256B.0951, subdivision 1; 256B.15, by adding a subdivision;
2.25256B.199; 256B.27, subdivision 2a; 256B.431, subdivisions 1, 2e, 3f, 17a, 17e,
2.2641; 256B.434, subdivision 4, by adding subdivisions; 256B.437, by adding a
2.27subdivision; 256B.441, subdivisions 1, 2, 5, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31,
2.2834, 38, by adding subdivisions; 256B.49, subdivision 11, by adding a subdivision;
2.29256B.5012, by adding a subdivision; 256B.69, subdivisions 4, 5g, 5h, 23;
2.30256B.75; 256B.76; 256B.763; 256D.03, subdivisions 3, 4; 256E.35, subdivision
2.312; 256I.04, subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding
2.32a subdivision; 256J.02, subdivisions 1, 4, by adding a subdivision; 256J.021;
2.33256J.08, subdivision 65; 256J.20, subdivision 3; 256J.21, subdivision 2; 256J.32,
2.34subdivision 6; 256J.37, subdivision 3a; 256J.42, subdivision 1; 256J.46, by
2.35adding a subdivision; 256J.49, subdivision 13; 256J.521, subdivisions 1, 2;
2.36256J.53, subdivision 2; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4,
2.375, 6, 7; 256J.751, subdivisions 2, 5; 256J.77; 256J.95, subdivision 3; 256K.45,
2.38by adding a subdivision; 256L.01, subdivisions 1, 4; 256L.03, subdivisions
2.391, 3, 5; 256L.04, subdivisions 1, 7, 12; 256L.05, subdivisions 1, 1b, 2, 3a;
2.40256L.07, subdivisions 1, 2, 6, by adding a subdivision; 256L.09, subdivision 4;
2.41256L.11, subdivision 7; 256L.12, subdivision 9a; 256L.15, subdivisions 1, 2, 3,
2.424; 256L.17, subdivisions 2, 3, 7; 259.20, subdivision 2; 259.24, subdivision 3;
2.43259.29, subdivision 1; 259.41; 259.53, subdivisions 1, 2; 259.57, subdivisions
2.441, 2; 259.67, subdivisions 4, 7; 259.75, subdivision 8; 260.012; 260.755,
2.45subdivisions 12, 20; 260.761, subdivision 7; 260.765, subdivision 5; 260.771,
2.46subdivisions 1, 2; 260B.157, subdivision 1; 260C.152, subdivision 5; 260C.163,
2.47subdivision 1; 260C.201, subdivision 11; 260C.209; 260C.212, subdivisions 1, 2,
2.484, 9; 260C.317, subdivision 3; 260C.331, subdivision 1; 270B.14, subdivision 1;
2.49462A.05, by adding a subdivision; 471.59, subdivision 1; 518A.32, subdivision
2.503; 518A.56, by adding a subdivision; 609.115, subdivisions 8, 9; 626.556,
2.51subdivisions 2, 3, 10, 10a, 10c, 10f, by adding subdivisions; Laws 2000, chapter
2.52340, section 19; Laws 2005, chapter 98, article 3, section 25; Laws 2005, First
2.53Special Session chapter 4, article 9, section 3, subdivision 2; Laws 2006, chapter
2.54282, article 20, section 37; proposing coding for new law in Minnesota Statutes,
2.55chapters 16C; 62J; 62Q; 144; 145; 148; 149A; 151; 152; 156; 245; 245A; 245C;
2.56252; 254A; 256; 256B; 256C; 256D; 256F; 256J; 256L; 260; repealing Minnesota
2.57Statutes 2006, sections 62A.301; 62J.052, subdivision 1; 62J.692, subdivision
2.5810; 119B.08, subdivision 4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25;
3.1252.261; 252.275, subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16;
3.2254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5;
3.3254A.175; 254A.18; 256.9743; 256B.0625, subdivisions 5a, 5b, 5c, 5d, 5e, 5f,
3.45g, 5h, 5i, 5j, 5k; 256B.0631, subdivision 4; 256B.0913, subdivisions 5b, 5c,
3.55d, 5e, 5f, 5g, 5h; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.24,
3.6subdivision 6; 256J.29; 256J.37, subdivision 3b; 256J.561, subdivision 1;
3.7256J.62, subdivision 9; 256J.626, subdivision 9; 256J.65; 256L.035; 256L.07,
3.8subdivision 2a; Laws 1997, chapter 8, section 1; Laws 2004, chapter 288,
3.9article 6, section 27; Laws 2006, chapter 249, section 6; Minnesota Rules, parts
3.104610.2800; 9503.0035, subpart 2; 9560.0102, subpart 2, item C; 9585.0030.
3.11BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.12ARTICLE 1

3.13CHILD WELFARE POLICY

3.14    Section 1. Minnesota Statutes 2006, section 256.01, subdivision 2, is amended to read:
3.15    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
3.162 , the commissioner of human services shall carry out the specific duties in paragraphs (a)
3.17through (cc):
3.18    (a) Administer and supervise all forms of public assistance provided for by state law
3.19and other welfare activities or services as are vested in the commissioner. Administration
3.20and supervision of human services activities or services includes, but is not limited to,
3.21assuring timely and accurate distribution of benefits, completeness of service, and quality
3.22program management. In addition to administering and supervising human services
3.23activities vested by law in the department, the commissioner shall have the authority to:
3.24    (1) require county agency participation in training and technical assistance programs
3.25to promote compliance with statutes, rules, federal laws, regulations, and policies
3.26governing human services;
3.27    (2) monitor, on an ongoing basis, the performance of county agencies in the
3.28operation and administration of human services, enforce compliance with statutes, rules,
3.29federal laws, regulations, and policies governing welfare services and promote excellence
3.30of administration and program operation;
3.31    (3) develop a quality control program or other monitoring program to review county
3.32performance and accuracy of benefit determinations;
3.33    (4) require county agencies to make an adjustment to the public assistance benefits
3.34issued to any individual consistent with federal law and regulation and state law and rule
3.35and to issue or recover benefits as appropriate;
3.36    (5) delay or deny payment of all or part of the state and federal share of benefits and
3.37administrative reimbursement according to the procedures set forth in section 256.017;
4.1    (6) make contracts with and grants to public and private agencies and organizations,
4.2both profit and nonprofit, and individuals, using appropriated funds; and
4.3    (7) enter into contractual agreements with federally recognized Indian tribes with
4.4a reservation in Minnesota to the extent necessary for the tribe to operate a federally
4.5approved family assistance program or any other program under the supervision of the
4.6commissioner. The commissioner shall consult with the affected county or counties in
4.7the contractual agreement negotiations, if the county or counties wish to be included,
4.8in order to avoid the duplication of county and tribal assistance program services. The
4.9commissioner may establish necessary accounts for the purposes of receiving and
4.10disbursing funds as necessary for the operation of the programs.
4.11    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
4.12regulation, and policy necessary to county agency administration of the programs.
4.13    (c) Administer and supervise all child welfare activities; promote the enforcement of
4.14laws protecting disabled, dependent, neglected and delinquent children, and children born
4.15to mothers who were not married to the children's fathers at the times of the conception
4.16nor at the births of the children; license and supervise child-caring and child-placing
4.17agencies and institutions; supervise the care of children in boarding and foster homes or
4.18in private institutions; and generally perform all functions relating to the field of child
4.19welfare now vested in the State Board of Control.
4.20    (d) Administer and supervise all noninstitutional service to disabled persons,
4.21including those who are visually impaired, hearing impaired, or physically impaired
4.22or otherwise disabled. The commissioner may provide and contract for the care and
4.23treatment of qualified indigent children in facilities other than those located and available
4.24at state hospitals when it is not feasible to provide the service in state hospitals.
4.25    (e) Assist and actively cooperate with other departments, agencies and institutions,
4.26local, state, and federal, by performing services in conformity with the purposes of Laws
4.271939, chapter 431.
4.28    (f) Act as the agent of and cooperate with the federal government in matters of
4.29mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
4.30431, including the administration of any federal funds granted to the state to aid in the
4.31performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
4.32and including the promulgation of rules making uniformly available medical care benefits
4.33to all recipients of public assistance, at such times as the federal government increases its
4.34participation in assistance expenditures for medical care to recipients of public assistance,
4.35the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
5.1    (g) Establish and maintain any administrative units reasonably necessary for the
5.2performance of administrative functions common to all divisions of the department.
5.3    (h) Act as designated guardian of both the estate and the person of all the wards of
5.4the state of Minnesota, whether by operation of law or by an order of court, without any
5.5further act or proceeding whatever, except as to persons committed as developmentally
5.6disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
5.7recognized by the Secretary of the Interior whose interests would be best served by
5.8adoptive placement, the commissioner may contract with a licensed child-placing agency
5.9or a Minnesota tribal social services agency to provide adoption services. A contract
5.10with a licensed child-placing agency must be designed to supplement existing county
5.11efforts and may not replace existing county programs or tribal social services, unless the
5.12replacement is agreed to by the county board and the appropriate exclusive bargaining
5.13representative, tribal governing body, or the commissioner has evidence that child
5.14placements of the county continue to be substantially below that of other counties. Funds
5.15encumbered and obligated under an agreement for a specific child shall remain available
5.16until the terms of the agreement are fulfilled or the agreement is terminated.
5.17    (i) Act as coordinating referral and informational center on requests for service for
5.18newly arrived immigrants coming to Minnesota.
5.19    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
5.20way be construed to be a limitation upon the general transfer of powers herein contained.
5.21    (k) Establish county, regional, or statewide schedules of maximum fees and charges
5.22which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
5.23nursing home care and medicine and medical supplies under all programs of medical
5.24care provided by the state and for congregate living care under the income maintenance
5.25programs.
5.26    (l) Have the authority to conduct and administer experimental projects to test
5.27methods and procedures of administering assistance and services to recipients or potential
5.28recipients of public welfare. To carry out such experimental projects, it is further provided
5.29that the commissioner of human services is authorized to waive the enforcement of
5.30existing specific statutory program requirements, rules, and standards in one or more
5.31counties. The order establishing the waiver shall provide alternative methods and
5.32procedures of administration, shall not be in conflict with the basic purposes, coverage, or
5.33benefits provided by law, and in no event shall the duration of a project exceed four years.
5.34It is further provided that no order establishing an experimental project as authorized by
5.35the provisions of this section shall become effective until the following conditions have
5.36been met:
6.1    (1) the secretary of health and human services of the United States has agreed, for
6.2the same project, to waive state plan requirements relative to statewide uniformity; and
6.3    (2) a comprehensive plan, including estimated project costs, shall be approved by
6.4the Legislative Advisory Commission and filed with the commissioner of administration.
6.5    (m) According to federal requirements, establish procedures to be followed by
6.6local welfare boards in creating citizen advisory committees, including procedures for
6.7selection of committee members.
6.8    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
6.9control error rates for the aid to families with dependent children program formerly
6.10codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
6.11following manner:
6.12    (1) one-half of the total amount of the disallowance shall be borne by the county
6.13boards responsible for administering the programs. For the medical assistance and the
6.14AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
6.15shared by each county board in the same proportion as that county's expenditures for the
6.16sanctioned program are to the total of all counties' expenditures for the AFDC program
6.17formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
6.18food stamp program, sanctions shall be shared by each county board, with 50 percent of
6.19the sanction being distributed to each county in the same proportion as that county's
6.20administrative costs for food stamps are to the total of all food stamp administrative costs
6.21for all counties, and 50 percent of the sanctions being distributed to each county in the
6.22same proportion as that county's value of food stamp benefits issued are to the total of
6.23all benefits issued for all counties. Each county shall pay its share of the disallowance
6.24to the state of Minnesota. When a county fails to pay the amount due hereunder, the
6.25commissioner may deduct the amount from reimbursement otherwise due the county, or
6.26the attorney general, upon the request of the commissioner, may institute civil action
6.27to recover the amount due; and
6.28    (2) notwithstanding the provisions of clause (1), if the disallowance results from
6.29knowing noncompliance by one or more counties with a specific program instruction, and
6.30that knowing noncompliance is a matter of official county board record, the commissioner
6.31may require payment or recover from the county or counties, in the manner prescribed in
6.32clause (1), an amount equal to the portion of the total disallowance which resulted from the
6.33noncompliance, and may distribute the balance of the disallowance according to clause (1).
6.34    (o) Develop and implement special projects that maximize reimbursements and
6.35result in the recovery of money to the state. For the purpose of recovering state money,
6.36the commissioner may enter into contracts with third parties. Any recoveries that result
7.1from projects or contracts entered into under this paragraph shall be deposited in the
7.2state treasury and credited to a special account until the balance in the account reaches
7.3$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
7.4transferred and credited to the general fund. All money in the account is appropriated to
7.5the commissioner for the purposes of this paragraph.
7.6    (p) Have the authority to make direct payments to facilities providing shelter
7.7to women and their children according to section 256D.05, subdivision 3. Upon
7.8the written request of a shelter facility that has been denied payments under section
7.9256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
7.10a determination within 30 days of the request for review regarding issuance of direct
7.11payments to the shelter facility. Failure to act within 30 days shall be considered a
7.12determination not to issue direct payments.
7.13    (q) Have the authority to establish and enforce the following county reporting
7.14requirements:
7.15    (1) the commissioner shall establish fiscal and statistical reporting requirements
7.16necessary to account for the expenditure of funds allocated to counties for human
7.17services programs. When establishing financial and statistical reporting requirements, the
7.18commissioner shall evaluate all reports, in consultation with the counties, to determine if
7.19the reports can be simplified or the number of reports can be reduced;
7.20    (2) the county board shall submit monthly or quarterly reports to the department
7.21as required by the commissioner. Monthly reports are due no later than 15 working days
7.22after the end of the month. Quarterly reports are due no later than 30 calendar days after
7.23the end of the quarter, unless the commissioner determines that the deadline must be
7.24shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
7.25or risking a loss of federal funding. Only reports that are complete, legible, and in the
7.26required format shall be accepted by the commissioner;
7.27    (3) if the required reports are not received by the deadlines established in clause (2),
7.28the commissioner may delay payments and withhold funds from the county board until
7.29the next reporting period. When the report is needed to account for the use of federal
7.30funds and the late report results in a reduction in federal funding, the commissioner shall
7.31withhold from the county boards with late reports an amount equal to the reduction in
7.32federal funding until full federal funding is received;
7.33    (4) a county board that submits reports that are late, illegible, incomplete, or not
7.34in the required format for two out of three consecutive reporting periods is considered
7.35noncompliant. When a county board is found to be noncompliant, the commissioner
7.36shall notify the county board of the reason the county board is considered noncompliant
8.1and request that the county board develop a corrective action plan stating how the
8.2county board plans to correct the problem. The corrective action plan must be submitted
8.3to the commissioner within 45 days after the date the county board received notice
8.4of noncompliance;
8.5    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
8.6after the date the report was originally due. If the commissioner does not receive a report
8.7by the final deadline, the county board forfeits the funding associated with the report for
8.8that reporting period and the county board must repay any funds associated with the
8.9report received for that reporting period;
8.10    (6) the commissioner may not delay payments, withhold funds, or require repayment
8.11under clause (3) or (5) if the county demonstrates that the commissioner failed to
8.12provide appropriate forms, guidelines, and technical assistance to enable the county to
8.13comply with the requirements. If the county board disagrees with an action taken by the
8.14commissioner under clause (3) or (5), the county board may appeal the action according
8.15to sections 14.57 to 14.69; and
8.16    (7) counties subject to withholding of funds under clause (3) or forfeiture or
8.17repayment of funds under clause (5) shall not reduce or withhold benefits or services to
8.18clients to cover costs incurred due to actions taken by the commissioner under clause
8.19(3) or (5).
8.20    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
8.21federal fiscal disallowances or sanctions are based on a statewide random sample for
8.22the foster care program under title IV-E of the Social Security Act, United States Code,
8.23title 42, in direct proportion to each county's title IV-E foster care maintenance claim
8.24for that period.
8.25    (s) Be responsible for ensuring the detection, prevention, investigation, and
8.26resolution of fraudulent activities or behavior by applicants, recipients, and other
8.27participants in the human services programs administered by the department.
8.28    (t) Require county agencies to identify overpayments, establish claims, and utilize
8.29all available and cost-beneficial methodologies to collect and recover these overpayments
8.30in the human services programs administered by the department.
8.31    (u) Have the authority to administer a drug rebate program for drugs purchased
8.32pursuant to the prescription drug program established under section 256.955 after the
8.33beneficiary's satisfaction of any deductible established in the program. The commissioner
8.34shall require a rebate agreement from all manufacturers of covered drugs as defined in
8.35section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
8.36or after July 1, 2002, must include rebates for individuals covered under the prescription
9.1drug program who are under 65 years of age. For each drug, the amount of the rebate shall
9.2be equal to the rebate as defined for purposes of the federal rebate program in United
9.3States Code, title 42, section 1396r-8. The manufacturers must provide full payment
9.4within 30 days of receipt of the state invoice for the rebate within the terms and conditions
9.5used for the federal rebate program established pursuant to section 1927 of title XIX of
9.6the Social Security Act. The manufacturers must provide the commissioner with any
9.7information necessary to verify the rebate determined per drug. The rebate program shall
9.8utilize the terms and conditions used for the federal rebate program established pursuant to
9.9section 1927 of title XIX of the Social Security Act.
9.10    (v) Have the authority to administer the federal drug rebate program for drugs
9.11purchased under the medical assistance program as allowed by section 1927 of title XIX
9.12of the Social Security Act and according to the terms and conditions of section 1927.
9.13Rebates shall be collected for all drugs that have been dispensed or administered in an
9.14outpatient setting and that are from manufacturers who have signed a rebate agreement
9.15with the United States Department of Health and Human Services.
9.16    (w) Have the authority to administer a supplemental drug rebate program for drugs
9.17purchased under the medical assistance program. The commissioner may enter into
9.18supplemental rebate contracts with pharmaceutical manufacturers and may require prior
9.19authorization for drugs that are from manufacturers that have not signed a supplemental
9.20rebate contract. Prior authorization of drugs shall be subject to the provisions of section
9.21256B.0625, subdivision 13 .
9.22    (x) Operate the department's communication systems account established in Laws
9.231993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
9.24communication costs necessary for the operation of the programs the commissioner
9.25supervises. A communications account may also be established for each regional
9.26treatment center which operates communications systems. Each account must be used
9.27to manage shared communication costs necessary for the operations of the programs the
9.28commissioner supervises. The commissioner may distribute the costs of operating and
9.29maintaining communication systems to participants in a manner that reflects actual usage.
9.30Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
9.31other costs as determined by the commissioner. Nonprofit organizations and state, county,
9.32and local government agencies involved in the operation of programs the commissioner
9.33supervises may participate in the use of the department's communications technology and
9.34share in the cost of operation. The commissioner may accept on behalf of the state any
9.35gift, bequest, devise or personal property of any kind, or money tendered to the state for
9.36any lawful purpose pertaining to the communication activities of the department. Any
10.1money received for this purpose must be deposited in the department's communication
10.2systems accounts. Money collected by the commissioner for the use of communication
10.3systems must be deposited in the state communication systems account and is appropriated
10.4to the commissioner for purposes of this section.
10.5    (y) Receive any federal matching money that is made available through the medical
10.6assistance program for the consumer satisfaction survey. Any federal money received for
10.7the survey is appropriated to the commissioner for this purpose. The commissioner may
10.8expend the federal money received for the consumer satisfaction survey in either year of
10.9the biennium.
10.10    (z) Designate community information and referral call centers and incorporate
10.11cost reimbursement claims from the designated community information and referral
10.12call centers into the federal cost reimbursement claiming processes of the department
10.13according to federal law, rule, and regulations. Existing information and referral centers
10.14provided by Greater Twin Cities United Way or existing call centers for which Greater
10.15Twin Cities United Way has legal authority to represent, shall be included in these
10.16designations upon review by the commissioner and assurance that these services are
10.17accredited and in compliance with national standards. Any reimbursement is appropriated
10.18to the commissioner and all designated information and referral centers shall receive
10.19payments according to normal department schedules established by the commissioner
10.20upon final approval of allocation methodologies from the United States Department of
10.21Health and Human Services Division of Cost Allocation or other appropriate authorities.
10.22    (aa) Develop recommended standards for foster care homes that address the
10.23components of specialized therapeutic services to be provided by foster care homes with
10.24those services.
10.25    (bb) Authorize the method of payment to or from the department as part of the
10.26human services programs administered by the department. This authorization includes the
10.27receipt or disbursement of funds held by the department in a fiduciary capacity as part of
10.28the human services programs administered by the department.
10.29    (cc) Have the authority to administer a drug rebate program for drugs purchased for
10.30persons eligible for general assistance medical care under section 256D.03, subdivision 3.
10.31For manufacturers that agree to participate in the general assistance medical care rebate
10.32program, the commissioner shall enter into a rebate agreement for covered drugs as
10.33defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
10.34rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
10.35United States Code, title 42, section 1396r-8. The manufacturers must provide payment
10.36within the terms and conditions used for the federal rebate program established under
11.1section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
11.2the terms and conditions used for the federal rebate program established under section
11.31927 of title XIX of the Social Security Act.
11.4    Effective January 1, 2006, drug coverage under general assistance medical care shall
11.5be limited to those prescription drugs that:
11.6    (1) are covered under the medical assistance program as described in section
11.7256B.0625, subdivisions 13 and 13d ; and
11.8    (2) are provided by manufacturers that have fully executed general assistance
11.9medical care rebate agreements with the commissioner and comply with such agreements.
11.10Prescription drug coverage under general assistance medical care shall conform to
11.11coverage under the medical assistance program according to section 256B.0625,
11.12subdivisions 13 to 13g .
11.13    The rebate revenues collected under the drug rebate program are deposited in the
11.14general fund.

11.15    Sec. 2. Minnesota Statutes 2006, section 259.24, subdivision 3, is amended to read:
11.16    Subd. 3. Child. When the child to be adopted is over 14 years of age, the child's
11.17written consent to adoption by a particular person is also shall be necessary. A child
11.18of any age who is under the guardianship of the commissioner and is legally available
11.19for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to
11.20recruit, identify, and place the child in an adoptive home required under section 260C.317,
11.21subdivision 3, paragraph (b), or sign a document relieving county social services agencies
11.22of all recruitment efforts on the child's behalf.

11.23    Sec. 3. Minnesota Statutes 2006, section 259.53, subdivision 1, is amended to read:
11.24    Subdivision 1. Notice to commissioner; referral for postplacement assessment.
11.25    (a) Upon the filing of a petition for adoption of a child who is:
11.26    (1) under the guardianship of the commissioner or a licensed child-placing agency
11.27according to section 260C.201, subdivision 11, or 260C.317;
11.28    (2) placed by the commissioner, commissioner's agent, or licensed child-placing
11.29agency after a consent to adopt according to section 259.24 or under an agreement
11.30conferring authority to place for adoption according to section 259.25; or
11.31    (3) placed by preadoptive custody order for a direct adoptive placement ordered
11.32by the district court under section 259.47,
11.33the court administrator shall immediately transmit a copy of the petition to the
11.34commissioner of human services.
12.1    (b) The court shall immediately refer the petition to the agency specified below for
12.2completion of a postplacement assessment and report as required by subdivision 2.
12.3    (1) If the child to be adopted has been committed to the guardianship of the
12.4commissioner or an agency under section 260C.317 or an agency has been given authority
12.5to place the child under section 259.25, the court shall refer the petition to that agency,
12.6unless another agency is supervising the placement, in which case the court shall refer the
12.7petition to the supervising agency.
12.8    (2) If the child to be adopted has been placed in the petitioner's home by a direct
12.9adoptive placement, the court shall refer the petition to the agency supervising the
12.10placement under section 259.47, subdivision 3, paragraph (a), clause (6).
12.11    (3) If the child is to be adopted by an individual who is related to the child as defined
12.12by section 245A.02, subdivision 13, and in all other instances not described in clause (1)
12.13or (2), the court shall refer the petition to the local social services agency of the county in
12.14which the prospective adoptive parent lives.

12.15    Sec. 4. Minnesota Statutes 2006, section 259.57, subdivision 1, is amended to read:
12.16    Subdivision 1. Findings; orders. Upon the hearing,
12.17    (a) if the court finds that it is in the best interests of the child that the petition
12.18be granted, a decree of adoption shall be made and recorded in the office of the court
12.19administrator, ordering that henceforth the child shall be the child of the petitioner. In the
12.20decree the court may change the name of the child if desired. After the decree is granted
12.21for a child who is:
12.22    (1) under the guardianship of the commissioner or a licensed child-placing agency
12.23according to section 260C.201, subdivision 11, or 260C.317;
12.24    (2) placed by the commissioner, commissioner's agent, or licensed child-placing
12.25agency after a consent to adopt according to section 259.24 or under an agreement
12.26conferring authority to place for adoption according to section 259.25; or
12.27    (3) adopted after a direct adoptive placement ordered by the district court under
12.28section 259.47,
12.29the court administrator shall immediately mail a copy of the recorded decree to the
12.30commissioner of human services;
12.31    (b) if the court is not satisfied that the proposed adoption is in the best interests
12.32of the child, the court shall deny the petition, and shall order the child returned to the
12.33custody of the person or agency legally vested with permanent custody or certify the
12.34case for appropriate action and disposition to the court having jurisdiction to determine
12.35the custody and guardianship of the child.

13.1    Sec. 5. Minnesota Statutes 2006, section 259.67, subdivision 7, is amended to read:
13.2    Subd. 7. Reimbursement of costs. (a) Subject to rules of the commissioner, and
13.3the provisions of this subdivision a child-placing agency licensed in Minnesota or any
13.4other state, or local or tribal social services agency shall receive a reimbursement from the
13.5commissioner equal to 100 percent of the reasonable and appropriate cost of providing
13.6adoption services for a child certified as eligible for adoption assistance under subdivision
13.74. Such assistance. Adoption services under this subdivision may include adoptive family
13.8recruitment, counseling, and special training when needed.
13.9    (b) An eligible child must have a goal of adoption, which may include an adoption
13.10in accordance with tribal law, and meet one of the following criteria:
13.11    (1) is a ward of the commissioner of human services or a ward of tribal court
13.12pursuant to section 260.755, subdivision 20, who meets one of the criteria in subdivision
13.134, paragraph (b), clause (1), (2), or (3); or
13.14    (2) is under the guardianship of a Minnesota-licensed child-placing agency who
13.15meets one of the criteria in subdivision 4, paragraph (b), clause (1) or (2).
13.16    (c) A child-placing agency licensed in Minnesota or any other state shall receive
13.17reimbursement for adoption services it purchases for or directly provides to an eligible
13.18child. Tribal social services shall receive reimbursement for adoption services it purchases
13.19for or directly provides to an eligible child. A local or tribal social services agency shall
13.20receive such reimbursement only for adoption services it purchases for an eligible child.
13.21    (b) A child-placing agency licensed in Minnesota or any other state or local or tribal
13.22social services agency seeking reimbursement under this subdivision shall enter into
13.23Before providing adoption services for which reimbursement will be sought under this
13.24subdivision, a reimbursement agreement, on the designated format, must be entered into
13.25with the commissioner before providing adoption services for which reimbursement
13.26is sought. No reimbursement under this subdivision shall be made to an agency for
13.27services provided prior to entering a reimbursement agreement. Separate reimbursement
13.28agreements shall be made for each child and separate records shall be kept on each child
13.29for whom a reimbursement agreement is made. The commissioner of human services shall
13.30agree that the reimbursement costs are reasonable and appropriate. The commissioner
13.31may spend up to $16,000 for each purchase of service agreement. Only one agreement per
13.32child is allowed, unless an exception is granted by the commissioner. Funds encumbered
13.33and obligated under such an agreement for the child remain available until the terms of
13.34the agreement are fulfilled or the agreement is terminated.
13.35    (c) When a local or tribal social services agency uses a purchase of service agreement
13.36to provide services reimbursable under a reimbursement agreement, The commissioner
14.1may shall make reimbursement payments directly to the agency providing the service if
14.2direct reimbursement is specified by the purchase of service agreement, and if the request
14.3for reimbursement is submitted by the local or tribal social services agency along with a
14.4verification that the service was provided.

14.5    Sec. 6. Minnesota Statutes 2006, section 259.75, subdivision 8, is amended to read:
14.6    Subd. 8. Reasons for deferral. Deferral of the listing of a child with the state
14.7adoption exchange shall be only for one or more of the following reasons:
14.8    (a) the child is in an adoptive placement but is not legally adopted;
14.9    (b) the child's foster parents or other individuals are now considering adoption;
14.10    (c) diagnostic study or testing is required to clarify the child's problem and provide
14.11an adequate description; or
14.12    (d) the child is currently in a hospital and continuing need for daily professional care
14.13will not permit placement in a family setting; or.
14.14    (e) the child is 14 years of age or older and will not consent to an adoption plan.
14.15Approval of a request to defer listing for any of the reasons specified in paragraph (b) or
14.16(c) shall be valid for a period not to exceed 90 days, with no subsequent deferrals for
14.17those reasons.

14.18    Sec. 7. Minnesota Statutes 2006, section 260.012, is amended to read:
14.19260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY
14.20REUNIFICATION; REASONABLE EFFORTS.
14.21    (a) Once a child alleged to be in need of protection or services is under the court's
14.22jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate
14.23services, by the social services agency are made to prevent placement or to eliminate the
14.24need for removal and to reunite the child with the child's family at the earliest possible
14.25time, and when a child cannot be reunified with the parent or guardian from whom the
14.26child was removed, the court must ensure that the responsible social services agency
14.27makes reasonable efforts to finalize an alternative permanent plan for the child as provided
14.28in paragraph (e). In determining reasonable efforts to be made with respect to a child and
14.29in making those reasonable efforts, the child's best interests, health, and safety must be of
14.30paramount concern. Reasonable efforts to prevent placement and for rehabilitation and
14.31reunification are always required except upon a determination by the court that a petition
14.32has been filed stating a prima facie case that:
14.33    (1) the parent has subjected a child to egregious harm as defined in section
14.34260C.007, subdivision 14 ;
15.1    (2) the parental rights of the parent to another child have been terminated
15.2involuntarily;
15.3    (3) the child is an abandoned infant under section 260C.301, subdivision 2,
15.4paragraph (a), clause (2);
15.5    (4) the parent's custodial rights to another child have been involuntarily transferred
15.6to a relative under section 260C.201, subdivision 11, paragraph (e), clause (1), or a similar
15.7law of another jurisdiction; or
15.8    (5) the provision of services or further services for the purpose of reunification is
15.9futile and therefore unreasonable under the circumstances.
15.10    (b) When the court makes one of the prima facie determinations under paragraph (a),
15.11either permanency pleadings under section 260C.201, subdivision 11, or a termination
15.12of parental rights petition under sections 260C.141 and 260C.301 must be filed. A
15.13permanency hearing under section 260C.201, subdivision 11, must be held within 30
15.14days of this determination.
15.15    (c) In the case of an Indian child, in proceedings under sections 260B.178 or
15.16260C.178 , 260C.201, and 260C.301 the juvenile court must make findings and conclusions
15.17consistent with the Indian Child Welfare Act of 1978, United States Code, title 25, section
15.181901 et seq., as to the provision of active efforts. In cases governed by the Indian Child
15.19Welfare Act of 1978, United States Code, title 25, section 1901, the responsible social
15.20services agency must provide active efforts as required under United States Code, title
15.2125, section 1911(d).
15.22    (d) "Reasonable efforts to prevent placement" means:
15.23    (1) the agency has made reasonable efforts to prevent the placement of the child in
15.24foster care; or
15.25    (2) given the particular circumstances of the child and family at the time of the
15.26child's removal, there are no services or efforts available which could allow the child to
15.27safely remain in the home.
15.28    (e) "Reasonable efforts to finalize a permanent plan for the child" means due
15.29diligence by the responsible social services agency to:
15.30    (1) reunify the child with the parent or guardian from whom the child was removed;
15.31    (2) assess a noncustodial parent's ability to provide day-to-day care for the child and,
15.32where appropriate, provide services necessary to enable the noncustodial parent to safely
15.33provide the care, as required by section 260C.212, subdivision 4;
15.34    (3) conduct a relative search as required under section 260C.212, subdivision 5; and
15.35    (4) when the child cannot return to the parent or guardian from whom the child was
15.36removed, to plan for and finalize a safe and legally permanent alternative home for the
16.1child, and considers permanent alternative homes for the child inside or outside of the
16.2state, preferably through adoption or transfer of permanent legal and physical custody of
16.3the child.
16.4    (f) Reasonable efforts are made upon the exercise of due diligence by the responsible
16.5social services agency to use culturally appropriate and available services to meet the
16.6needs of the child and the child's family. Services may include those provided by the
16.7responsible social services agency and other culturally appropriate services available in
16.8the community. At each stage of the proceedings where the court is required to review
16.9the appropriateness of the responsible social services agency's reasonable efforts as
16.10described in paragraphs (a), (d), and (e), the social services agency has the burden of
16.11demonstrating that:
16.12    (1) it has made reasonable efforts to prevent placement of the child in foster care;
16.13    (2) it has made reasonable efforts to eliminate the need for removal of the child from
16.14the child's home and to reunify the child with the child's family at the earliest possible time;
16.15    (3) it has made reasonable efforts to finalize an alternative permanent home for
16.16the child, and considers permanent alternative homes for the child inside or outside of
16.17the state; or
16.18    (4) reasonable efforts to prevent placement and to reunify the child with the parent
16.19or guardian are not required. The agency may meet this burden by stating facts in a sworn
16.20petition filed under section 260C.141, by filing an affidavit summarizing the agency's
16.21reasonable efforts or facts the agency believes demonstrate there is no need for reasonable
16.22efforts to reunify the parent and child, or through testimony or a certified report required
16.23under juvenile court rules.
16.24    (g) Once the court determines that reasonable efforts for reunification are not
16.25required because the court has made one of the prima facie determinations under paragraph
16.26(a), the court may only require reasonable efforts for reunification after a hearing according
16.27to section 260C.163, where the court finds there is not clear and convincing evidence of
16.28the facts upon which the court based its prima facie determination. In this case when there
16.29is clear and convincing evidence that the child is in need of protection or services, the
16.30court may find the child in need of protection or services and order any of the dispositions
16.31available under section 260C.201, subdivision 1. Reunification of a surviving child with a
16.32parent is not required if the parent has been convicted of:
16.33    (1) a violation of, or an attempt or conspiracy to commit a violation of, sections
16.34609.185 to 609.20; 609.222, subdivision 2; or 609.223 in regard to another child of the
16.35parent;
17.1    (2) a violation of section 609.222, subdivision 2; or 609.223, in regard to the
17.2surviving child; or
17.3    (3) a violation of, or an attempt or conspiracy to commit a violation of, United States
17.4Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent.
17.5    (h) The juvenile court, in proceedings under sections 260B.178 or 260C.178,
17.6260C.201 , and 260C.301 shall make findings and conclusions as to the provision of
17.7reasonable efforts. When determining whether reasonable efforts have been made, the
17.8court shall consider whether services to the child and family were:
17.9    (1) relevant to the safety and protection of the child;
17.10    (2) adequate to meet the needs of the child and family;
17.11    (3) culturally appropriate;
17.12    (4) available and accessible;
17.13    (5) consistent and timely; and
17.14    (6) realistic under the circumstances.
17.15    In the alternative, the court may determine that provision of services or further
17.16services for the purpose of rehabilitation is futile and therefore unreasonable under the
17.17circumstances or that reasonable efforts are not required as provided in paragraph (a).
17.18    (i) This section does not prevent out-of-home placement for treatment of a child with
17.19a mental disability when the child's diagnostic assessment or individual treatment plan
17.20indicates that appropriate and necessary treatment cannot be effectively provided outside
17.21of a residential or inpatient treatment program.
17.22    (j) If continuation of reasonable efforts to prevent placement or reunify the child
17.23with the parent or guardian from whom the child was removed is determined by the court
17.24to be inconsistent with the permanent plan for the child or upon the court making one of
17.25the prima facie determinations under paragraph (a), reasonable efforts must be made to
17.26place the child in a timely manner in a safe and permanent home and to complete whatever
17.27steps are necessary to legally finalize the permanent placement of the child.
17.28    (k) Reasonable efforts to place a child for adoption or in another permanent
17.29placement may be made concurrently with reasonable efforts to prevent placement or to
17.30reunify the child with the parent or guardian from whom the child was removed. When
17.31the responsible social services agency decides to concurrently make reasonable efforts for
17.32both reunification and permanent placement away from the parent under paragraph (a), the
17.33agency shall disclose its decision and both plans for concurrent reasonable efforts to all
17.34parties and the court. When the agency discloses its decision to proceed on both plans for
17.35reunification and permanent placement away from the parent, the court's review of the
17.36agency's reasonable efforts shall include the agency's efforts under both plans.

18.1    Sec. 8. Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:
18.2    Subd. 12. Indian tribe. "Indian tribe" means an Indian tribe, band, nation, or
18.3other organized group or community of Indians recognized as eligible for the services
18.4provided to Indians by the secretary because of their status as Indians, including any band
18.5Native group under the Alaska Native Claims Settlement Act, United States Code, title 43,
18.6section 1602, and exercising tribal governmental powers.

18.7    Sec. 9. Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:
18.8    Subd. 20. Tribal court. "Tribal court" means a court with federally recognized
18.9jurisdiction over child custody proceedings and which is either a court of Indian offenses,
18.10or a court established and operated under the code or custom of an Indian tribe, or the
18.11any other administrative body of a tribe which is vested with authority over child custody
18.12proceedings. Except as provided in section 260.771, subdivision 5, nothing in this chapter
18.13shall be construed as conferring jurisdiction on an Indian tribe.

18.14    Sec. 10. Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:
18.15    Subd. 7. Identification of extended family members. Any agency considering
18.16placement of an Indian child shall make reasonable active efforts to identify and locate
18.17extended family members.

18.18    Sec. 11. Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:
18.19    Subd. 5. Identification of extended family members. Any agency considering
18.20placement of an Indian child shall make reasonable active efforts to identify and locate
18.21extended family members.

18.22    Sec. 12. Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:
18.23    Subdivision 1. Indian tribe jurisdiction. An Indian tribe with a tribal court has
18.24exclusive jurisdiction over a child placement proceeding involving an Indian child who
18.25resides or is domiciled within the reservation of such the tribe at the commencement of
18.26the proceedings, except where jurisdiction is otherwise vested in the state by existing
18.27federal law. When an Indian child is in the legal custody of a person or agency pursuant
18.28to an order of a ward of the tribal court, the Indian tribe retains exclusive jurisdiction,
18.29notwithstanding the residence or domicile of the child.

18.30    Sec. 13. Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:
19.1    Subd. 2. Court determination of tribal affiliation of child. In any child placement
19.2proceeding, the court shall establish whether an Indian child is involved and the identity
19.3of the Indian child's tribe. This chapter and the federal Indian Child Welfare Act are
19.4applicable without exception in any child custody proceeding, as defined in the federal act,
19.5involving an Indian child. This chapter applies to child custody proceedings involving
19.6an Indian child whether the child is in the physical or legal custody of an Indian parent,
19.7Indian custodian, Indian extended family member, or other person at the commencement
19.8of the proceedings. A court shall not determine the applicability of this chapter or the
19.9federal Indian Child Welfare Act to a child custody proceeding based upon whether an
19.10Indian child is part of an existing Indian family or based upon the level of contact a child
19.11has with the child's Indian tribe, reservation, society, or off-reservation community.

19.12    Sec. 14. [260.852] PLACEMENT PROCEDURES.
19.13    Subdivision 1. Home study. The state must have procedures for the orderly and
19.14timely interstate placement of children that are implemented in accordance with an
19.15interstate compact and that, within 60 days after the state receives from another state a
19.16request to conduct a study of a home environment for purposes of assessing the safety
19.17and suitability of placing a child in the home, the state shall, directly or by contract,
19.18conduct and complete a home study and return to the other state a report on the results of
19.19the study, which shall address the extent to which placement in the home would meet the
19.20needs of the child; except in the case of a home study begun before October 1, 2008, if the
19.21state fails to comply with conducting and completing the home study within the 60-day
19.22period and this is as a result of circumstances beyond the control of the state, the state has
19.2375 days to comply if the state documents the circumstances involved and certifies that
19.24completing the home study is in the best interests of the child.
19.25    This subdivision does not require the completion within the applicable period of
19.26the parts of the home study involving the education and training of the prospective foster
19.27or adoptive parents.
19.28    Subd. 2. Effect of received report. The state shall treat any report described in
19.29subdivision 1 that is received from another state, an Indian tribe, or a private agency
19.30under contract with another state or Indian tribe as meeting any requirements imposed by
19.31the state for the completion of a home study before placing a child in the home, unless,
19.32within 14 days after receipt of the report, the state determines, based on grounds that
19.33are specific to the content of the report, that making a decision in reliance on the report
19.34would be contrary to the welfare of the child.
20.1    Subd. 3. Resources. The state shall make effective use of cross-jurisdictional
20.2resources, including through contract for the purchase of services, and shall eliminate
20.3legal barriers to facilitate timely adoptive or permanent placements for waiting children.
20.4The state shall not impose any restriction on the use of private agencies for the purpose of
20.5conducting a home study to meet the 60-day requirement.
20.6    Subd. 4. Incentive eligibility. Minnesota is an incentive-eligible state and must:
20.7    (1) have an approved plan as required by the United States Secretary of Health
20.8and Human Services;
20.9    (2) be in compliance with the data requirements of the United States Department of
20.10Health and Human Services; and
20.11    (3) have data that verify that a home study is completed within 30 days.
20.12    Subd. 5. Data requirements. The state shall provide to the United States Secretary
20.13of Health and Human Services a written report, covering the preceding fiscal year, that
20.14specifies:
20.15    (1) the total number of interstate home studies requested by the state with respect
20.16to children in foster care under the responsibility of the state, and with respect to each
20.17study, the identity of the other state involved;
20.18    (2) the total number of timely interstate home studies completed by the state with
20.19respect to children in foster care under the responsibility of other states and, with respect
20.20to each study, the identity of the other state involved; and
20.21    (3) other information the United States Secretary of Health and Human Services
20.22requires in order to determine whether Minnesota is a home study incentive-eligible state.
20.23    Subd. 6. Definitions. (a) The definitions in this subdivision apply to this section.
20.24    (b) "Home study" means an evaluation of a home environment conducted in
20.25accordance with applicable requirements of the state in which the home is located, to
20.26determine whether a proposed placement of a child would meet the individual needs of the
20.27child, including the child's safety; permanency; health; well-being; and mental, emotional,
20.28and physical development.
20.29    (c) "Interstate home study" means a home study conducted by a state at the request
20.30of another state to facilitate an adoptive or foster placement in the state of a child in foster
20.31care under the responsibility of the state.
20.32    (d) "Timely interstate home study" means an interstate home study completed by a
20.33state if the state provides to the state that requested the study, within 30 days after receipt
20.34of the request, a report on the results of the study, except that there is no requirement
20.35for completion within the 30-day period of the parts of the home study involving the
20.36education and training of the prospective foster or adoptive parents.
21.1    Subd. 7. Background study requirements for adoption and foster care. (a)
21.2Background study requirements for an adoption home study must be completed consistent
21.3with section 259.41, subdivisions 1, 2, and 3.
21.4    (b) Background study requirements for a foster care license must be completed
21.5consistent with section 245C.08.
21.6    Subd. 8. Home visits. If a child has been placed in foster care outside the state in
21.7which the home of the parents of the child is located, periodically, but at least every six
21.8months, a caseworker on the staff of the agency of the state in which the home of the
21.9parents of the child is located or the state in which the child has been placed, or a private
21.10agency under contract with either state, must visit the child in the home or institution and
21.11submit a report on each visit to the agency of the state in which the home of the parents of
21.12the child is located.

21.13    Sec. 15. Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:
21.14    Subdivision 1. Investigation. Upon request of the court the local social services
21.15agency or probation officer shall investigate the personal and family history and
21.16environment of any minor coming within the jurisdiction of the court under section
21.17260B.101 and shall report its findings to the court. The court may order any minor coming
21.18within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or
21.19psychologist appointed by the court.
21.20    The court shall have order a chemical use assessment conducted when a child is
21.21(1) found to be delinquent for violating a provision of chapter 152, or for committing a
21.22felony-level violation of a provision of chapter 609 if the probation officer determines
21.23that alcohol or drug use was a contributing factor in the commission of the offense, or
21.24(2) alleged to be delinquent for violating a provision of chapter 152, if the child is being
21.25held in custody under a detention order. The assessor's qualifications and the assessment
21.26criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under
21.27chapter 254B are to be used to pay for the recommended treatment, the assessment and
21.28placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to
21.299530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall
21.30reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.
21.31    The court shall have order a children's mental health screening conducted when
21.32a child is found to be delinquent. The screening shall be conducted with a screening
21.33instrument approved by the commissioner of human services and shall be conducted by a
21.34mental health practitioner as defined in section 245.4871, subdivision 26, or a probation
21.35officer who is trained in the use of the screening instrument. If the screening indicates
22.1a need for assessment, the local social services agency, in consultation with the child's
22.2family, shall have a diagnostic assessment conducted, including a functional assessment,
22.3as defined in section 245.4871.
22.4    With the consent of the commissioner of corrections and agreement of the county to
22.5pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction
22.6in an institution maintained by the commissioner for the detention, diagnosis, custody and
22.7treatment of persons adjudicated to be delinquent, in order that the condition of the minor
22.8be given due consideration in the disposition of the case. Any funds received under the
22.9provisions of this subdivision shall not cancel until the end of the fiscal year immediately
22.10following the fiscal year in which the funds were received. The funds are available for
22.11use by the commissioner of corrections during that period and are hereby appropriated
22.12annually to the commissioner of corrections as reimbursement of the costs of providing
22.13these services to the juvenile courts.

22.14    Sec. 16. Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:
22.15    Subd. 5. Notice to foster parents and preadoptive parents and relatives. The
22.16foster parents, if any, of a child and any preadoptive parent or relative providing care
22.17for the child must be provided notice of and an opportunity a right to be heard in any
22.18review or hearing to be held with respect to the child. Any other relative may also request,
22.19and must be granted, a notice and the opportunity to be heard under this section. This
22.20subdivision does not require that a foster parent, preadoptive parent, or relative providing
22.21care for the child be made a party to a review or hearing solely on the basis of the notice
22.22and opportunity right to be heard.

22.23    Sec. 17. Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:
22.24    Subdivision 1. General. (a) Except for hearings arising under section 260C.425,
22.25hearings on any matter shall be without a jury and may be conducted in an informal
22.26manner. In all adjudicatory proceedings involving a child alleged to be in need of
22.27protection or services, the court shall admit only evidence that would be admissible in a
22.28civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of
22.29protection or services must be proved by clear and convincing evidence.
22.30    (b) Except for proceedings involving a child alleged to be in need of protection or
22.31services and petitions for the termination of parental rights, hearings may be continued or
22.32adjourned from time to time. In proceedings involving a child alleged to be in need of
22.33protection or services and petitions for the termination of parental rights, hearings may not
22.34be continued or adjourned for more than one week unless the court makes specific findings
23.1that the continuance or adjournment is in the best interests of the child. If a hearing is held
23.2on a petition involving physical or sexual abuse of a child who is alleged to be in need of
23.3protection or services or neglected and in foster care, the court shall file the decision with
23.4the court administrator as soon as possible but no later than 15 days after the matter is
23.5submitted to the court. When a continuance or adjournment is ordered in any proceeding,
23.6the court may make any interim orders as it deems in the best interests of the minor in
23.7accordance with the provisions of sections 260C.001 to 260C.421.
23.8    (c) Except as otherwise provided in this paragraph, the court shall exclude the
23.9general public from hearings under this chapter and shall admit only those persons who, in
23.10the discretion of the court, have a direct interest in the case or in the work of the court.
23.11    (d) Adoption hearings shall be conducted in accordance with the provisions of
23.12laws relating to adoptions.
23.13    (e) In any permanency hearing, including the transition of a child from foster care
23.14to independent living, the court shall ensure that any consult with the child is in an
23.15age-appropriate manner.

23.16    Sec. 18. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to
23.17read:
23.18    Subd. 11. Review of court-ordered placements; permanent placement
23.19determination. (a) This subdivision and subdivision 11a do not apply in cases where
23.20the child is in placement due solely to the child's developmental disability or emotional
23.21disturbance, where legal custody has not been transferred to the responsible social services
23.22agency, and where the court finds compelling reasons under section 260C.007, subdivision
23.238 , to continue the child in foster care past the time periods specified in this subdivision.
23.24Foster care placements of children due solely to their disability are governed by section
23.25260C.141, subdivision 2a . In all other cases where the child is in foster care or in the care
23.26of a noncustodial parent under subdivision 1, the court shall commence proceedings
23.27to determine the permanent status of a child not later than 12 months after the child is
23.28placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing
23.29commencing such proceedings, the court shall determine whether there is a prima facie
23.30basis for finding that the agency made reasonable efforts, or in the case of an Indian
23.31child active efforts, required under section 260.012 and proceed according to the rules of
23.32juvenile court.
23.33    For purposes of this subdivision, the date of the child's placement in foster care is
23.34the earlier of the first court-ordered placement or 60 days after the date on which the
23.35child has been voluntarily placed in foster care by the child's parent or guardian. For
24.1purposes of this subdivision, time spent by a child under the protective supervision of
24.2the responsible social services agency in the home of a noncustodial parent pursuant to
24.3an order under subdivision 1 counts towards the requirement of a permanency hearing
24.4under this subdivision or subdivision 11a. Time spent on a trial home visit does not count
24.5counts towards the requirement of a permanency hearing under this subdivision or and a
24.6permanency review for a child under eight years of age under subdivision 11a.
24.7    For purposes of this subdivision, 12 months is calculated as follows:
24.8    (1) during the pendency of a petition alleging that a child is in need of protection
24.9or services, all time periods when a child is placed in foster care or in the home of a
24.10noncustodial parent are cumulated;
24.11    (2) if a child has been placed in foster care within the previous five years under one
24.12or more previous petitions, the lengths of all prior time periods when the child was placed
24.13in foster care within the previous five years are cumulated. If a child under this clause
24.14has been in foster care for 12 months or more, the court, if it is in the best interests of the
24.15child and for compelling reasons, may extend the total time the child may continue out
24.16of the home under the current petition up to an additional six months before making a
24.17permanency determination.
24.18    (b) Unless the responsible social services agency recommends return of the child
24.19to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing
24.20required under paragraph (a) and the rules of juvenile court, the responsible social services
24.21agency shall file pleadings in juvenile court to establish the basis for the juvenile court to
24.22order permanent placement of the child, including a termination of parental rights petition,
24.23according to paragraph (d). Notice of the hearing and copies of the pleadings must be
24.24provided pursuant to section 260C.152.
24.25    (c) The permanency proceedings shall be conducted in a timely fashion including
24.26that any trial required under section 260C.163 shall be commenced within 60 days of the
24.27admit-deny hearing required under paragraph (a). At the conclusion of the permanency
24.28proceedings, the court shall:
24.29    (1) order the child returned to the care of the parent or guardian from whom the
24.30child was removed; or
24.31    (2) order a permanent placement or termination of parental rights if permanent
24.32placement or termination of parental rights is in the child's best interests. The "best
24.33interests of the child" means all relevant factors to be considered and evaluated. Transfer
24.34of permanent legal and physical custody, termination of parental rights, or guardianship
24.35and legal custody to the commissioner through a consent to adopt are preferred
24.36permanency options for a child who cannot return home.
25.1    (d) If the child is not returned to the home, the court must order one of the following
25.2dispositions:
25.3    (1) permanent legal and physical custody to a relative in the best interests of the
25.4child according to the following conditions:
25.5    (i) an order for transfer of permanent legal and physical custody to a relative shall
25.6only be made after the court has reviewed the suitability of the prospective legal and
25.7physical custodian;
25.8    (ii) in transferring permanent legal and physical custody to a relative, the juvenile
25.9court shall follow the standards applicable under this chapter and chapter 260, and the
25.10procedures set out in the juvenile court rules;
25.11    (iii) an order establishing permanent legal and physical custody under this
25.12subdivision must be filed with the family court;
25.13    (iv) a transfer of legal and physical custody includes responsibility for the protection,
25.14education, care, and control of the child and decision making on behalf of the child;
25.15    (v) the social services agency may bring a petition or motion naming a fit and
25.16willing relative as a proposed permanent legal and physical custodian. The commissioner
25.17of human services shall annually prepare for counties information that must be given to
25.18proposed custodians about their legal rights and obligations as custodians together with
25.19information on financial and medical benefits for which the child is eligible; and
25.20    (vi) the juvenile court may maintain jurisdiction over the responsible social services
25.21agency, the parents or guardian of the child, the child, and the permanent legal and
25.22physical custodian for purposes of ensuring appropriate services are delivered to the child
25.23and permanent legal custodian or for the purpose of ensuring conditions ordered by the
25.24court related to the care and custody of the child are met;
25.25    (2) termination of parental rights when the requirements of sections 260C.301 to
25.26260C.328 are met or according to the following conditions:
25.27    (i) order the social services agency to file a petition for termination of parental
25.28rights in which case all the requirements of sections 260C.301 to 260C.328 remain
25.29applicable; and
25.30    (ii) an adoption completed subsequent to a determination under this subdivision may
25.31include an agreement for communication or contact under section 259.58;
25.32    (3) long-term foster care according to the following conditions:
25.33    (i) the court may order a child into long-term foster care only if it approves the
25.34responsible social service agency's compelling reasons that neither an award of permanent
25.35legal and physical custody to a relative, nor termination of parental rights is in the child's
25.36best interests;
26.1    (ii) further, the court may only order long-term foster care for the child under this
26.2section if it finds the following:
26.3    (A) the child has reached age 12 and the responsible social services agency has made
26.4reasonable efforts to locate and place the child with an adoptive family or with a fit and
26.5willing relative who will agree to a transfer of permanent legal and physical custody of
26.6the child, but such efforts have not proven successful; or
26.7    (B) the child is a sibling of a child described in subitem (A) and the siblings have
26.8a significant positive relationship and are ordered into the same long-term foster care
26.9home; and
26.10    (iii) at least annually, the responsible social services agency reconsiders its provision
26.11of services to the child and the child's placement in long-term foster care to ensure that:
26.12    (A) long-term foster care continues to be the most appropriate legal arrangement
26.13for meeting the child's need for permanency and stability, including whether there is
26.14another permanent placement option under this chapter that would better serve the child's
26.15needs and best interests;
26.16    (B) whenever possible, there is an identified long-term foster care family that is
26.17committed to being the foster family for the child as long as the child is a minor or under
26.18the jurisdiction of the court;
26.19    (C) the child is receiving appropriate services or assistance to maintain or build
26.20connections with the child's family and community;
26.21    (D) the child's physical and mental health needs are being appropriately provided
26.22for; and
26.23    (E) the child's educational needs are being met;
26.24    (4) foster care for a specified period of time according to the following conditions:
26.25    (i) foster care for a specified period of time may be ordered only if:
26.26    (A) the sole basis for an adjudication that the child is in need of protection or
26.27services is the child's behavior;
26.28    (B) the court finds that foster care for a specified period of time is in the best
26.29interests of the child; and
26.30    (C) the court approves the responsible social services agency's compelling reasons
26.31that neither an award of permanent legal and physical custody to a relative, nor termination
26.32of parental rights is in the child's best interests;
26.33    (ii) the order does not specify that the child continue in foster care for any period
26.34exceeding one year; or
26.35    (5) guardianship and legal custody to the commissioner of human services under
26.36the following procedures and conditions:
27.1    (i) there is an identified prospective adoptive home agreed to by the responsible
27.2social services agency having legal custody of the child pursuant to court order under this
27.3section that has agreed to adopt the child and the court accepts the parent's voluntary
27.4consent to adopt under section 259.24, except that such consent executed by a parent under
27.5this item, following proper notice that consent given under this provision is irrevocable
27.6upon acceptance by the court, shall be irrevocable unless fraud is established and an order
27.7issues permitting revocation as stated in item (vii);
27.8    (ii) if the court accepts a consent to adopt in lieu of ordering one of the other
27.9enumerated permanency dispositions, the court must review the matter at least every 90
27.10days. The review will address the reasonable efforts of the agency to achieve a finalized
27.11adoption;
27.12    (iii) a consent to adopt under this clause vests all legal authority regarding the child,
27.13including guardianship and legal custody of the child, with the commissioner of human
27.14services as if the child were a state ward after termination of parental rights;
27.15    (iv) the court must forward a copy of the consent to adopt, together with a certified
27.16copy of the order transferring guardianship and legal custody to the commissioner, to
27.17the commissioner;
27.18    (v) if an adoption is not finalized by the identified prospective adoptive parent within
27.1912 months of the execution of the consent to adopt under this clause, the commissioner of
27.20human services or the commissioner's delegate shall pursue adoptive placement in another
27.21home unless the commissioner certifies that the failure to finalize is not due to either an
27.22action or a failure to act by the prospective adoptive parent;
27.23    (vi) notwithstanding item (v), the commissioner of human services or the
27.24commissioner's designee must pursue adoptive placement in another home as soon as the
27.25commissioner or commissioner's designee determines that finalization of the adoption with
27.26the identified prospective adoptive parent is not possible, that the identified prospective
27.27adoptive parent is not willing to adopt the child, that the identified prospective adoptive
27.28parent is not cooperative in completing the steps necessary to finalize the adoption, or
27.29upon the commissioner's determination to withhold consent to the adoption.
27.30    (vii) unless otherwise required by the Indian Child Welfare Act, United States Code,
27.31title 25, section 1913, a consent to adopt executed under this section, following proper
27.32notice that consent given under this provision is irrevocable upon acceptance by the court,
27.33shall be irrevocable upon acceptance by the court except upon order permitting revocation
27.34issued by the same court after written findings that consent was obtained by fraud.
27.35    (e) In ordering a permanent placement of a child, the court must be governed by the
27.36best interests of the child, including a review of the relationship between the child and
28.1relatives and the child and other important persons with whom the child has resided or
28.2had significant contact. When the court has determined that permanent placement of the
28.3child away from the parent is necessary, the court shall consider permanent alternative
28.4homes that are available both inside and outside the state.
28.5    (f) Once a permanent placement determination has been made and permanent
28.6placement has been established, further court reviews are necessary if:
28.7    (1) the placement is long-term foster care or foster care for a specified period of time;
28.8    (2) the court orders further hearings because it has retained jurisdiction of a transfer
28.9of permanent legal and physical custody matter;
28.10    (3) an adoption has not yet been finalized; or
28.11    (4) there is a disruption of the permanent or long-term placement.
28.12    (g) Court reviews of an order for long-term foster care, whether under this section
28.13or section 260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and
28.14must review the child's out-of-home placement plan and the reasonable efforts of the
28.15agency to finalize the permanent plan for the child including the agency's efforts to:
28.16    (1) ensure that long-term foster care continues to be the most appropriate legal
28.17arrangement for meeting the child's need for permanency and stability or, if not, to identify
28.18and attempt to finalize another permanent placement option under this chapter that would
28.19better serve the child's needs and best interests;
28.20    (2) identify a specific long-term foster home for the child, if one has not already
28.21been identified;
28.22    (3) support continued placement of the child in the identified home, if one has been
28.23identified;
28.24    (4) ensure appropriate services are provided to address the physical health, mental
28.25health, and educational needs of the child during the period of long-term foster care and
28.26also ensure appropriate services or assistance to maintain relationships with appropriate
28.27family members and the child's community; and
28.28    (5) plan for the child's independence upon the child's leaving long-term foster care
28.29living as required under section 260C.212, subdivision 1.
28.30    (h) In the event it is necessary for a child that has been ordered into foster care for a
28.31specified period of time to be in foster care longer than one year after the permanency
28.32hearing held under this section, not later than 12 months after the time the child was
28.33ordered into foster care for a specified period of time, the matter must be returned to
28.34court for a review of the appropriateness of continuing the child in foster care and of the
28.35responsible social services agency's reasonable efforts to finalize a permanent plan for
28.36the child; if it is in the child's best interests to continue the order for foster care for a
29.1specified period of time past a total of 12 months, the court shall set objectives for the
29.2child's continuation in foster care, specify any further amount of time the child may be in
29.3foster care, and review the plan for the safe return of the child to the parent.
29.4    (i) An order permanently placing a child out of the home of the parent or guardian
29.5must include the following detailed findings:
29.6    (1) how the child's best interests are served by the order;
29.7    (2) the nature and extent of the responsible social service agency's reasonable efforts,
29.8or, in the case of an Indian child, active efforts to reunify the child with the parent or
29.9guardian where reasonable efforts are required;
29.10    (3) the parent's or parents' efforts and ability to use services to correct the conditions
29.11which led to the out-of-home placement; and
29.12    (4) that the conditions which led to the out-of-home placement have not been
29.13corrected so that the child can safely return home.
29.14    (j) An order for permanent legal and physical custody of a child may be modified
29.15under sections 518.18 and 518.185. The social services agency is a party to the proceeding
29.16and must receive notice. A parent may only seek modification of an order for long-term
29.17foster care upon motion and a showing by the parent of a substantial change in the parent's
29.18circumstances such that the parent could provide appropriate care for the child and that
29.19removal of the child from the child's permanent placement and the return to the parent's
29.20care would be in the best interest of the child. The responsible social services agency may
29.21ask the court to vacate an order for long-term foster care upon a prima facie showing
29.22that there is a factual basis for the court to order another permanency option under this
29.23chapter and that such an option is in the child's best interests. Upon a hearing where
29.24the court determines that there is a factual basis for vacating the order for long-term
29.25foster care and that another permanent order regarding the placement of the child is in
29.26the child's best interests, the court may vacate the order for long-term foster care and
29.27enter a different order for permanent placement that is in the child's best interests. The
29.28court shall not require further reasonable efforts to reunify the child with the parent or
29.29guardian as a basis for vacating the order for long-term foster care and ordering a different
29.30permanent placement in the child's best interests. The county attorney must file pleadings
29.31and give notice as required under the rules of juvenile court in order to modify an order for
29.32long-term foster care under this paragraph.
29.33    (k) The court shall issue an order required under this section within 15 days of the
29.34close of the proceedings. The court may extend issuing the order an additional 15 days
29.35when necessary in the interests of justice and the best interests of the child.
30.1    (l) This paragraph applies to proceedings required under this subdivision when
30.2the child is on a trial home visit:
30.3    (1) if the child is on a trial home visit 12 months after the child was placed in
30.4foster care or in the care of a noncustodial parent as calculated in this subdivision, the
30.5responsible social services agency may file a report with the court regarding the child's and
30.6parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe
30.7and permanent return to the care of the parent in lieu of filing the pleadings required under
30.8paragraph (b). The court shall make findings regarding reasonableness of the responsible
30.9social services efforts to finalize the child's return home as the permanent order in the best
30.10interests of the child. The court may continue the trial home visit to a total time not to
30.11exceed six months as provided in subdivision 1. If the court finds the responsible social
30.12services agency has not made reasonable efforts to finalize the child's return home as the
30.13permanent order in the best interests of the child, the court may order other or additional
30.14efforts to support the child remaining in the care of the parent; and
30.15    (2) if a trial home visit ordered or continued at proceedings under this subdivision
30.16terminates, the court shall re-commence proceedings under this subdivision to determine
30.17the permanent status of the child not later than 30 days after the child is returned to foster
30.18care.

30.19    Sec. 19. Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:
30.20    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan
30.21shall be prepared within 30 days after any child is placed in a residential facility by court
30.22order or by the voluntary release of the child by the parent or parents.
30.23    For purposes of this section, a residential facility means any group home, family
30.24foster home or other publicly supported out-of-home residential facility, including any
30.25out-of-home residential facility under contract with the state, county or other political
30.26subdivision, or any agency thereof, to provide those services or foster care as defined in
30.27section 260C.007, subdivision 18.
30.28    (b) An out-of-home placement plan means a written document which is prepared by
30.29the responsible social services agency jointly with the parent or parents or guardian of the
30.30child and in consultation with the child's guardian ad litem, the child's tribe, if the child is
30.31an Indian child, the child's foster parent or representative of the residential facility, and,
30.32where appropriate, the child. For a child in placement due solely or in part to the child's
30.33emotional disturbance, preparation of the out-of-home placement plan shall additionally
30.34include the child's mental health treatment provider. As appropriate, the plan shall be:
30.35    (1) submitted to the court for approval under section 260C.178, subdivision 7;
31.1    (2) ordered by the court, either as presented or modified after hearing, under section
31.2260C.178, subdivision 7 , or 260C.201, subdivision 6; and
31.3    (3) signed by the parent or parents or guardian of the child, the child's guardian ad
31.4litem, a representative of the child's tribe, the responsible social services agency, and, if
31.5possible, the child.
31.6    (c) The out-of-home placement plan shall be explained to all persons involved in its
31.7implementation, including the child who has signed the plan, and shall set forth:
31.8    (1) a description of the residential facility including how the out-of-home placement
31.9plan is designed to achieve a safe placement for the child in the least restrictive, most
31.10family-like, setting available which is in close proximity to the home of the parent or
31.11parents or guardian of the child when the case plan goal is reunification, and how the
31.12placement is consistent with the best interests and special needs of the child according to
31.13the factors under subdivision 2, paragraph (b);
31.14    (2) the specific reasons for the placement of the child in a residential facility, and
31.15when reunification is the plan, a description of the problems or conditions in the home of
31.16the parent or parents which necessitated removal of the child from home and the changes
31.17the parent or parents must make in order for the child to safely return home;
31.18    (3) a description of the services offered and provided to prevent removal of the child
31.19from the home and to reunify the family including:
31.20    (i) the specific actions to be taken by the parent or parents of the child to eliminate
31.21or correct the problems or conditions identified in clause (2), and the time period during
31.22which the actions are to be taken; and
31.23    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made
31.24to achieve a safe and stable home for the child including social and other supportive
31.25services to be provided or offered to the parent or parents or guardian of the child, the
31.26child, and the residential facility during the period the child is in the residential facility;
31.27    (4) a description of any services or resources that were requested by the child or the
31.28child's parent, guardian, foster parent, or custodian since the date of the child's placement
31.29in the residential facility, and whether those services or resources were provided and if
31.30not, the basis for the denial of the services or resources;
31.31    (5) the visitation plan for the parent or parents or guardian, other relatives as defined
31.32in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed
31.33together in the residential facility, and whether visitation is consistent with the best interest
31.34of the child, during the period the child is in the residential facility;
31.35    (6) documentation of steps to finalize the adoption or legal guardianship of the child
31.36if the court has issued an order terminating the rights of both parents of the child or of
32.1the only known, living parent of the child, and. At a minimum, the documentation must
32.2include child-specific recruitment efforts such as relative search and the use of state,
32.3regional, and national adoption exchanges to facilitate orderly and timely placements in
32.4and outside of the state. A copy of this documentation shall be provided to the court in the
32.5review required under section 260C.317, subdivision 3, paragraph (b);
32.6    (7) to the extent available and accessible, the health and educational records of the
32.7child including the most recent information available regarding:
32.8    (i) the names and addresses of the child's health and educational providers;
32.9    (ii) the child's grade level performance;
32.10    (iii) the child's school record;
32.11    (iv) assurances that the child's placement in foster care takes into account proximity
32.12to the school in which the child is enrolled at the time of placement;
32.13    (v) a record of the child's immunizations;
32.14    (vi) the child's known medical problems, including any known communicable
32.15diseases, as defined in section 144.4172, subdivision 2;
32.16    (vii) the child's medications; and
32.17    (viii) any other relevant health and education information;
32.18    (8) an independent living plan for a child age 16 or older who is in placement as
32.19a result of a permanency disposition. The plan should include, but not be limited to,
32.20the following objectives:
32.21    (i) educational, vocational, or employment planning;
32.22    (ii) health care planning and medical coverage;
32.23    (iii) transportation including, where appropriate, assisting the child in obtaining a
32.24driver's license;
32.25    (iv) money management;
32.26    (v) planning for housing;
32.27    (vi) social and recreational skills; and
32.28    (vii) establishing and maintaining connections with the child's family and
32.29community; and
32.30    (9) for a child in placement due solely or in part to the child's emotional disturbance,
32.31diagnostic and assessment information, specific services relating to meeting the mental
32.32health care needs of the child, and treatment outcomes.
32.33    (d) The parent or parents or guardian and the child each shall have the right to legal
32.34counsel in the preparation of the case plan and shall be informed of the right at the time
32.35of placement of the child. The child shall also have the right to a guardian ad litem.
32.36If unable to employ counsel from their own resources, the court shall appoint counsel
33.1upon the request of the parent or parents or the child or the child's legal guardian. The
33.2parent or parents may also receive assistance from any person or social services agency
33.3in preparation of the case plan.
33.4    After the plan has been agreed upon by the parties involved or approved or ordered
33.5by the court, the foster parents shall be fully informed of the provisions of the case plan
33.6and shall be provided a copy of the plan.
33.7    Upon discharge from foster care, the parent, adoptive parent, or permanent legal and
33.8physical custodian, as appropriate, and the child, if appropriate, must be provided with
33.9a current copy of the child's health and education record.

33.10    Sec. 20. Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:
33.11    Subd. 4. Responsible social service agency's duties for children in placement. (a)
33.12When a child is in placement, the responsible social services agency shall make diligent
33.13efforts to identify, locate, and, where appropriate, offer services to both parents of the child.
33.14    (1) The responsible social services agency shall assess whether a noncustodial or
33.15nonadjudicated parent is willing and capable of providing for the day-to-day care of the
33.16child temporarily or permanently. An assessment under this clause may include, but
33.17is not limited to, obtaining information under section 260C.209. If after assessment,
33.18the responsible social services agency determines that a noncustodial or nonadjudicated
33.19parent is willing and capable of providing day-to-day care of the child, the responsible
33.20social services agency may seek authority from the custodial parent or the court to have
33.21that parent assume day-to-day care of the child. If a parent is not an adjudicated parent,
33.22the responsible social services agency shall require the nonadjudicated parent to cooperate
33.23with paternity establishment procedures as part of the case plan.
33.24    (2) If, after assessment, the responsible social services agency determines that the
33.25child cannot be in the day-to-day care of either parent, the agency shall:
33.26    (i) prepare an out-of-home placement plan addressing the conditions that each parent
33.27must meet before the child can be in that parent's day-to-day care; and
33.28    (ii) provide a parent who is the subject of a background study under section
33.29260C.209 15 days' notice that it intends to use the study to recommend against putting the
33.30child with that parent, as well as the notice provided in section 260C.209, subdivision 4,
33.31and the court shall afford the parent an opportunity to be heard concerning the study.
33.32    The results of a background study of a noncustodial parent shall not be used by the
33.33agency to determine that the parent is incapable of providing day-to-day care of the child
33.34unless the agency reasonably believes that placement of the child into the home of that
33.35parent would endanger the child's health, safety, or welfare.
34.1    (3) If, after the provision of services following an out-of-home placement plan under
34.2this section, the child cannot return to the care of the parent from whom the child was
34.3removed or who had legal custody at the time the child was placed in foster care, the
34.4agency may petition on behalf of a noncustodial parent to establish legal custody with
34.5that parent under section 260C.201, subdivision 11. If paternity has not already been
34.6established, it may be established in the same proceeding in the manner provided for
34.7under chapter 257.
34.8    (4) The responsible social services agency may be relieved of the requirement to
34.9locate and offer services to both parents by the juvenile court upon a finding of good cause
34.10after the filing of a petition under section 260C.141.
34.11    (b) The responsible social services agency shall give notice to the parent or parents
34.12or guardian of each child in a residential facility, other than a child in placement due
34.13solely to that child's developmental disability or emotional disturbance, of the following
34.14information:
34.15    (1) that residential care of the child may result in termination of parental rights or an
34.16order permanently placing the child out of the custody of the parent, but only after notice
34.17and a hearing as required under chapter 260C and the juvenile court rules;
34.18    (2) time limits on the length of placement and of reunification services, including
34.19the date on which the child is expected to be returned to and safely maintained in the
34.20home of the parent or parents or placed for adoption or otherwise permanently removed
34.21from the care of the parent by court order;
34.22    (3) the nature of the services available to the parent;
34.23    (4) the consequences to the parent and the child if the parent fails or is unable to use
34.24services to correct the circumstances that led to the child's placement;
34.25    (5) the first consideration for placement with relatives;
34.26    (6) the benefit to the child in getting the child out of residential care as soon as
34.27possible, preferably by returning the child home, but if that is not possible, through a
34.28permanent legal placement of the child away from the parent;
34.29    (7) when safe for the child, the benefits to the child and the parent of maintaining
34.30visitation with the child as soon as possible in the course of the case and, in any event,
34.31according to the visitation plan under this section; and
34.32    (8) the financial responsibilities and obligations, if any, of the parent or parents for
34.33the support of the child during the period the child is in the residential facility.
34.34    (c) The responsible social services agency shall inform a parent considering
34.35voluntary placement of a child who is not developmentally disabled or emotionally
34.36disturbed of the following information:
35.1    (1) the parent and the child each has a right to separate legal counsel before signing a
35.2voluntary placement agreement, but not to counsel appointed at public expense;
35.3    (2) the parent is not required to agree to the voluntary placement, and a parent
35.4who enters a voluntary placement agreement may at any time request that the agency
35.5return the child. If the parent so requests, the child must be returned within 24 hours of
35.6the receipt of the request;
35.7    (3) evidence gathered during the time the child is voluntarily placed may be used
35.8at a later time as the basis for a petition alleging that the child is in need of protection
35.9or services or as the basis for a petition seeking termination of parental rights or other
35.10permanent placement of the child away from the parent;
35.11    (4) if the responsible social services agency files a petition alleging that the child is
35.12in need of protection or services or a petition seeking the termination of parental rights
35.13or other permanent placement of the child away from the parent, the parent would have
35.14the right to appointment of separate legal counsel and the child would have a right to the
35.15appointment of counsel and a guardian ad litem as provided by law, and that counsel will
35.16be appointed at public expense if they are unable to afford counsel; and
35.17    (5) the timelines and procedures for review of voluntary placements under
35.18subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a
35.19permanent placement determination hearing under section 260C.201, subdivision 11.
35.20    (d) When an agency accepts a child for placement, the agency shall determine
35.21whether the child has had a physical examination by or under the direction of a licensed
35.22physician within the 12 months immediately preceding the date when the child came into
35.23the agency's care. If there is documentation that the child has had an examination within
35.24the last 12 months, the agency is responsible for seeing that the child has another physical
35.25examination within one year of the documented examination and annually in subsequent
35.26years. If the agency determines that the child has not had a physical examination within
35.27the 12 months immediately preceding placement, the agency shall ensure that the child
35.28has an examination within 30 days of coming into the agency's care and once a year
35.29in subsequent years.
35.30    (e) If a child leaves foster care by reason of having attained the age of majority
35.31under state law, the child must be given at no cost a copy of the child's health and
35.32education report.

35.33    Sec. 21. Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:
35.34    Subd. 9. Review of certain child placements. (a) When a developmentally
35.35disabled child or emotionally disturbed child needs placement in a residential facility for
36.1the sole reason of accessing services or a level of skilled care that cannot be provided in
36.2the parent's home, the child must be placed pursuant to a voluntary placement agreement
36.3between the responsible social services agency and the child's parent. The voluntary
36.4placement agreement must give the responsible social services agency legal responsibility
36.5for the child's physical care, custody, and control, but must not transfer legal custody of
36.6the child to the agency. The voluntary placement agreement must be executed in a form
36.7developed and promulgated by the commissioner of human services. The responsible
36.8social services agency shall report to the commissioner the number of children who are the
36.9subject of a voluntary placement agreement under this subdivision and other information
36.10regarding these children as the commissioner may require.
36.11    (b) If a developmentally disabled child or a child diagnosed as emotionally disturbed
36.12has been placed in a residential facility pursuant to a voluntary release by the child's parent
36.13or parents because of the child's disabling conditions or need for long-term residential
36.14treatment or supervision, the social services agency responsible for the placement shall
36.15report to the court and bring a petition for review of the child's foster care status as
36.16required in section 260C.141, subdivision 2a.
36.17    (b) (c) If a child is in placement due solely to the child's developmental disability or
36.18emotional disturbance, and the court finds compelling reasons not to proceed under section
36.19260C.201, subdivision 11 , and custody of the child is not transferred to the responsible
36.20social services agency under section 260C.201, subdivision 1, paragraph (a), clause (2),
36.21and no petition is required by section 260C.201, subdivision 11.
36.22    (c) (d) Whenever a petition for review is brought pursuant to this subdivision, a
36.23guardian ad litem shall be appointed for the child.

36.24    Sec. 22. Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:
36.25    Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and
36.26the order terminating parental rights, and a summary of the court's information concerning
36.27the child shall be furnished by the court to the commissioner or the agency to which
36.28guardianship is transferred. The orders shall be on a document separate from the findings.
36.29The court shall furnish the individual to whom guardianship is transferred a copy of the
36.30order terminating parental rights.
36.31    (b) The court shall retain jurisdiction in a case where adoption is the intended
36.32permanent placement disposition until the child's adoption is finalized, the child is 18 years
36.33of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The
36.34guardian ad litem and counsel for the child shall continue on the case until an adoption
36.35decree is entered. A hearing must be held every 90 days following termination of parental
37.1rights for the court to review progress toward an adoptive placement and the specific
37.2recruitment efforts the agency has taken to find an adoptive family or other placement
37.3living arrangement for the child and to finalize the adoption or other permanency plan.
37.4    (c) The responsible social services agency may make a determination of compelling
37.5reasons for a child to be in long-term foster care when the agency has made exhaustive
37.6efforts to recruit, identify, and place the child in an adoptive home, and the child continues
37.7in foster care for at least 24 months after the court has issued the order terminating
37.8parental rights. A child of any age who is under the guardianship of the commissioner of
37.9the Department of Human Services and is legally available for adoption may not refuse
37.10or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the
37.11child in an adoptive home required under paragraph (b) or sign a document relieving
37.12county social services agencies of all recruitment efforts on the child's behalf. Upon
37.13approving the agency's determination of compelling reasons, the court may order the
37.14child placed in long-term foster care. At least every 12 months thereafter as long as the
37.15child continues in out-of-home placement, the court shall conduct a permanency review
37.16hearing to determine the future status of the child using the review requirements of section
37.17260C.201, subdivision 11 , paragraph (g).
37.18    (d) The court shall retain jurisdiction through the child's minority in a case where
37.19long-term foster care is the permanent disposition whether under paragraph (c) or section
37.20260C.201, subdivision 11 .

37.21    Sec. 23. Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:
37.22    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights
37.23are terminated,
37.24    (1) whenever legal custody of a child is transferred by the court to a responsible
37.25social services agency,
37.26    (2) whenever legal custody is transferred to a person other than the responsible social
37.27services agency, but under the supervision of the responsible social services agency, or
37.28    (3) whenever a child is given physical or mental examinations or treatment under
37.29order of the court, and no provision is otherwise made by law for payment for the care,
37.30examination, or treatment of the child, these costs are a charge upon the welfare funds of
37.31the county in which proceedings are held upon certification of the judge of juvenile court.
37.32    (b) The court shall order, and the responsible social services agency shall require,
37.33the parents or custodian of a child, while the child is under the age of 18, to use the
37.34total income and resources attributable to the child for the period of care, examination,
37.35or treatment, except for clothing and personal needs allowance as provided in section
38.1256B.35 , to reimburse the county for the cost of care, examination, or treatment. Income
38.2and resources attributable to the child include, but are not limited to, Social Security
38.3benefits, supplemental security income (SSI), veterans benefits, railroad retirement
38.4benefits and child support. When the child is over the age of 18, and continues to receive
38.5care, examination, or treatment, the court shall order, and the responsible social services
38.6agency shall require, reimbursement from the child for the cost of care, examination, or
38.7treatment from the income and resources attributable to the child less the clothing and
38.8personal needs allowance. Income does not include earnings from a child over the age of
38.918 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c),
38.10clause (8), to transition from foster care.
38.11    (c) If the income and resources attributable to the child are not enough to reimburse
38.12the county for the full cost of the care, examination, or treatment, the court shall inquire
38.13into the ability of the parents to support the child and, after giving the parents a reasonable
38.14opportunity to be heard, the court shall order, and the responsible social services agency
38.15shall require, the parents to contribute to the cost of care, examination, or treatment of
38.16the child. When determining the amount to be contributed by the parents, the court shall
38.17use a fee schedule based upon ability to pay that is established by the responsible social
38.18services agency and approved by the commissioner of human services. The income of
38.19a stepparent who has not adopted a child shall be excluded in calculating the parental
38.20contribution under this section.
38.21    (d) The court shall order the amount of reimbursement attributable to the parents
38.22or custodian, or attributable to the child, or attributable to both sources, withheld under
38.23chapter 518A from the income of the parents or the custodian of the child. A parent or
38.24custodian who fails to pay without good reason may be proceeded against for contempt, or
38.25the court may inform the county attorney, who shall proceed to collect the unpaid sums,
38.26or both procedures may be used.
38.27    (e) If the court orders a physical or mental examination for a child, the examination
38.28is a medically necessary service for purposes of determining whether the service is
38.29covered by a health insurance policy, health maintenance contract, or other health
38.30coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan
38.31requirements for medical necessity. Nothing in this paragraph changes or eliminates
38.32benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions,
38.33or other requirements in the policy, contract, or plan that relate to coverage of other
38.34medically necessary services.

38.35    Sec. 24. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:
39.1    Subd. 2. Definitions. As used in this section, the following terms have the meanings
39.2given them unless the specific content indicates otherwise:
39.3    (a) "Family assessment" means a comprehensive assessment of child safety, risk
39.4of subsequent child maltreatment, and family strengths and needs that is applied to a
39.5child maltreatment report that does not allege substantial child endangerment. Family
39.6assessment does not include a determination as to whether child maltreatment occurred
39.7but does determine the need for services to address the safety of family members and the
39.8risk of subsequent maltreatment.
39.9    (b) "Investigation" means fact gathering related to the current safety of a child
39.10and the risk of subsequent maltreatment that determines whether child maltreatment
39.11occurred and whether child protective services are needed. An investigation must be used
39.12when reports involve substantial child endangerment, and for reports of maltreatment in
39.13facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
39.14144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
39.1513, and 124D.10; or in a nonlicensed personal care provider association as defined in
39.16sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
39.17    (c) "Substantial child endangerment" means a person responsible for a child's care,
39.18and in the case of sexual abuse includes a person who has a significant relationship to the
39.19child as defined in section 609.341, or a person in a position of authority as defined in
39.20section 609.341, who by act or omission commits or attempts to commit an act against a
39.21child under their care that constitutes any of the following:
39.22    (1) egregious harm as defined in section 260C.007, subdivision 14;
39.23    (2) sexual abuse as defined in paragraph (d);
39.24    (3) abandonment under section 260C.301, subdivision 2;
39.25    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
39.26child's physical or mental health, including a growth delay, which may be referred to as
39.27failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
39.28    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
39.29609.195;
39.30    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
39.31    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
39.32609.223;
39.33    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
39.34    (9) criminal sexual conduct under sections 609.342 to 609.3451;
39.35    (10) solicitation of children to engage in sexual conduct under section 609.352;
40.1    (11) malicious punishment or neglect or endangerment of a child under section
40.2609.377 or 609.378;
40.3    (12) use of a minor in sexual performance under section 617.246; or
40.4    (13) parental behavior, status, or condition which mandates that the county attorney
40.5file a termination of parental rights petition under section 260C.301, subdivision 3,
40.6paragraph (a).
40.7    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
40.8child's care, by a person who has a significant relationship to the child, as defined in
40.9section 609.341, or by a person in a position of authority, as defined in section 609.341,
40.10subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
40.11conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
40.12609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
40.13in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
40.14abuse also includes any act which involves a minor which constitutes a violation of
40.15prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
40.16threatened sexual abuse.
40.17    (e) "Person responsible for the child's care" means (1) an individual functioning
40.18within the family unit and having responsibilities for the care of the child such as a
40.19parent, guardian, or other person having similar care responsibilities, or (2) an individual
40.20functioning outside the family unit and having responsibilities for the care of the child
40.21such as a teacher, school administrator, other school employees or agents, or other lawful
40.22custodian of a child having either full-time or short-term care responsibilities including,
40.23but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
40.24and coaching.
40.25    (f) "Neglect" means:
40.26    (1) failure by a person responsible for a child's care to supply a child with necessary
40.27food, clothing, shelter, health, medical, or other care required for the child's physical or
40.28mental health when reasonably able to do so;
40.29    (2) failure to protect a child from conditions or actions that seriously endanger the
40.30child's physical or mental health when reasonably able to do so, including a growth delay,
40.31which may be referred to as a failure to thrive, that has been diagnosed by a physician and
40.32is due to parental neglect;
40.33    (3) failure to provide for necessary supervision or child care arrangements
40.34appropriate for a child after considering factors as the child's age, mental ability, physical
40.35condition, length of absence, or environment, when the child is unable to care for the
40.36child's own basic needs or safety, or the basic needs or safety of another child in their care;
41.1    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
41.2260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
41.3child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
41.4    (5) nothing in this section shall be construed to mean that a child is neglected solely
41.5because the child's parent, guardian, or other person responsible for the child's care in
41.6good faith selects and depends upon spiritual means or prayer for treatment or care of
41.7disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
41.8or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
41.9if a lack of medical care may cause serious danger to the child's health. This section does
41.10not impose upon persons, not otherwise legally responsible for providing a child with
41.11necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
41.12    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
41.13subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
41.14symptoms in the child at birth, results of a toxicology test performed on the mother at
41.15delivery or the child at birth, or medical effects or developmental delays during the child's
41.16first year of life that medically indicate prenatal exposure to a controlled substance;
41.17    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
41.18    (8) chronic and severe use of alcohol or a controlled substance by a parent or
41.19person responsible for the care of the child that adversely affects the child's basic needs
41.20and safety; or
41.21    (9) emotional harm from a pattern of behavior which contributes to impaired
41.22emotional functioning of the child which may be demonstrated by a substantial and
41.23observable effect in the child's behavior, emotional response, or cognition that is not
41.24within the normal range for the child's age and stage of development, with due regard to
41.25the child's culture.
41.26    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
41.27inflicted by a person responsible for the child's care on a child other than by accidental
41.28means, or any physical or mental injury that cannot reasonably be explained by the child's
41.29history of injuries, or any aversive or deprivation procedures, or regulated interventions,
41.30that have not been authorized under section 121A.67 or 245.825. Abuse does not include
41.31reasonable and moderate physical discipline of a child administered by a parent or legal
41.32guardian which does not result in an injury. Abuse does not include the use of reasonable
41.33force by a teacher, principal, or school employee as allowed by section 121A.582. Actions
41.34which are not reasonable and moderate include, but are not limited to, any of the following
41.35that are done in anger or without regard to the safety of the child:
41.36    (1) throwing, kicking, burning, biting, or cutting a child;
42.1    (2) striking a child with a closed fist;
42.2    (3) shaking a child under age three;
42.3    (4) striking or other actions which result in any nonaccidental injury to a child
42.4under 18 months of age;
42.5    (5) unreasonable interference with a child's breathing;
42.6    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
42.7    (7) striking a child under age one on the face or head;
42.8    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
42.9substances which were not prescribed for the child by a practitioner, in order to control or
42.10punish the child; or other substances that substantially affect the child's behavior, motor
42.11coordination, or judgment or that results in sickness or internal injury, or subjects the
42.12child to medical procedures that would be unnecessary if the child were not exposed
42.13to the substances;
42.14    (9) unreasonable physical confinement or restraint not permitted under section
42.15609.379, including but not limited to tying, caging, or chaining; or
42.16    (10) in a school facility or school zone, an act by a person responsible for the child's
42.17care that is a violation under section 121A.58.
42.18    (h) "Report" means any report received by the local welfare agency, police
42.19department, county sheriff, or agency responsible for assessing or investigating
42.20maltreatment pursuant to this section.
42.21    (i) "Facility" means:
42.22    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
42.23sanitarium, or other facility or institution required to be licensed under sections 144.50 to
42.24144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B;
42.25    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
42.26124D.10; or
42.27    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
42.28subdivision 16, and 256B.0625, subdivision 19a.
42.29    (j) "Operator" means an operator or agency as defined in section 245A.02.
42.30    (k) "Commissioner" means the commissioner of human services.
42.31    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
42.32not limited to employee assistance counseling and the provision of guardian ad litem and
42.33parenting time expeditor services.
42.34    (m) "Mental injury" means an injury to the psychological capacity or emotional
42.35stability of a child as evidenced by an observable or substantial impairment in the child's
43.1ability to function within a normal range of performance and behavior with due regard to
43.2the child's culture.
43.3    (n) "Threatened injury" means a statement, overt act, condition, or status that
43.4represents a substantial risk of physical or sexual abuse or mental injury. Threatened
43.5injury includes, but is not limited to, exposing a child to a person responsible for the
43.6child's care, as defined in paragraph (e), clause (1), who has:
43.7    (1) subjected a child to, or failed to protect a child from, an overt act or condition
43.8that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
43.9similar law of another jurisdiction;
43.10    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
43.11(4), or a similar law of another jurisdiction;
43.12    (3) committed an act that has resulted in an involuntary termination of parental rights
43.13under section 260C.301, or a similar law of another jurisdiction; or
43.14    (4) committed an act that has resulted in the involuntary transfer of permanent legal
43.15and physical custody of a child to a relative under section 260C.201, subdivision 11,
43.16paragraph (d), clause (1), or a similar law of another jurisdiction.
43.17    (o) Persons who conduct assessments or investigations under this section shall take
43.18into account accepted child-rearing practices of the culture in which a child participates
43.19and accepted teacher discipline practices, which are not injurious to the child's health,
43.20welfare, and safety.

43.21    Sec. 25. Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:
43.22    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
43.23to believe a child is being neglected or physically or sexually abused, as defined in
43.24subdivision 2, or has been neglected or physically or sexually abused within the preceding
43.25three years, shall immediately report the information to the local welfare agency, agency
43.26responsible for assessing or investigating the report, police department, or the county
43.27sheriff if the person is:
43.28    (1) a professional or professional's delegate who is engaged in the practice of
43.29the healing arts, social services, hospital administration, psychological or psychiatric
43.30treatment, child care, education, correctional supervision, probation and correctional
43.31services, or law enforcement; or
43.32    (2) employed as a member of the clergy and received the information while
43.33engaged in ministerial duties, provided that a member of the clergy is not required by
43.34this subdivision to report information that is otherwise privileged under section 595.02,
43.35subdivision 1 , paragraph (c).
44.1    The police department or the county sheriff, upon receiving a report, shall
44.2immediately notify the local welfare agency or agency responsible for assessing or
44.3investigating the report, orally and in writing. The local welfare agency, or agency
44.4responsible for assessing or investigating the report, upon receiving a report, shall
44.5immediately notify the local police department or the county sheriff orally and in writing.
44.6The county sheriff and the head of every local welfare agency, agency responsible
44.7for assessing or investigating reports, and police department shall each designate a
44.8person within their agency, department, or office who is responsible for ensuring that
44.9the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
44.10this subdivision shall be construed to require more than one report from any institution,
44.11facility, school, or agency.
44.12    (b) Any person may voluntarily report to the local welfare agency, agency
44.13responsible for assessing or investigating the report, police department, or the county
44.14sheriff if the person knows, has reason to believe, or suspects a child is being or has been
44.15neglected or subjected to physical or sexual abuse. The police department or the county
44.16sheriff, upon receiving a report, shall immediately notify the local welfare agency or
44.17agency responsible for assessing or investigating the report, orally and in writing. The
44.18local welfare agency or agency responsible for assessing or investigating the report, upon
44.19receiving a report, shall immediately notify the local police department or the county
44.20sheriff orally and in writing.
44.21    (c) A person mandated to report physical or sexual child abuse or neglect occurring
44.22within a licensed facility shall report the information to the agency responsible for
44.23licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
44.24chapter 245B; or a nonlicensed personal care provider organization as defined in sections
44.25256B.04, subdivision 16 ; and 256B.0625, subdivision 19. A health or corrections agency
44.26receiving a report may request the local welfare agency to provide assistance pursuant
44.27to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work
44.28within a school facility, upon receiving a complaint of alleged maltreatment, shall provide
44.29information about the circumstances of the alleged maltreatment to the commissioner of
44.30education. Section 13.03, subdivision 4, applies to data received by the commissioner of
44.31education from a licensing entity.
44.32    (d) Any person mandated to report shall receive a summary of the disposition of
44.33any report made by that reporter, including whether the case has been opened for child
44.34protection or other services, or if a referral has been made to a community organization,
44.35unless release would be detrimental to the best interests of the child. Any person who is
44.36not mandated to report shall, upon request to the local welfare agency, receive a concise
45.1summary of the disposition of any report made by that reporter, unless release would be
45.2detrimental to the best interests of the child.
45.3    (e) For purposes of this subdivision section, "immediately" means as soon as
45.4possible but in no event longer than 24 hours.

45.5    Sec. 26. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
45.6to read:
45.7    Subd. 3e. Agency responsibility for assessing or investigating reports of sexual
45.8abuse. The local welfare agency is the agency responsible for investigating allegations
45.9of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual
45.10functioning within the family unit as a person responsible for the child's care, or a person
45.11with a significant relationship to the child if that person resides in the child's household.

45.12    Sec. 27. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
45.13to read:
45.14    Subd. 3f. Law enforcement agency responsibility for investigating
45.15maltreatment. The local law enforcement agency has responsibility for investigating any
45.16report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement
45.17and the responsible agency must coordinate their investigations or assessments as required
45.18under subdivision 10.

45.19    Sec. 28. Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:
45.20    Subd. 10. Duties of local welfare agency and local law enforcement agency upon
45.21receipt of a report. (a) Upon receipt of a report, the local welfare agency shall determine
45.22whether to conduct a family assessment or an investigation as appropriate to prevent or
45.23provide a remedy for child maltreatment. The local welfare agency:
45.24    (1) shall conduct an investigation on reports involving substantial child
45.25endangerment;
45.26    (2) shall begin an immediate investigation if, at any time when it is using a family
45.27assessment response, it determines that there is reason to believe that substantial child
45.28endangerment or a serious threat to the child's safety exists;
45.29    (3) may conduct a family assessment for reports that do not allege substantial child
45.30endangerment. In determining that a family assessment is appropriate, the local welfare
45.31agency may consider issues of child safety, parental cooperation, and the need for an
45.32immediate response; and
46.1    (4) may conduct a family assessment on a report that was initially screened and
46.2assigned for an investigation. In determining that a complete investigation is not required,
46.3the local welfare agency must document the reason for terminating the investigation and
46.4notify the local law enforcement agency if the local law enforcement agency is conducting
46.5a joint investigation.
46.6    If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian,
46.7or individual functioning within the family unit as a person responsible for the child's
46.8care, or sexual abuse by a person with a significant relationship to the child when that
46.9person resides in the child's household or by a sibling, the local welfare agency shall
46.10immediately conduct a family assessment or investigation as identified in clauses (1) to
46.11(4). In conducting a family assessment or investigation, the local welfare agency shall
46.12gather information on the existence of substance abuse and domestic violence and offer
46.13services for purposes of preventing future child maltreatment, safeguarding and enhancing
46.14the welfare of the abused or neglected minor, and supporting and preserving family
46.15life whenever possible. If the report alleges a violation of a criminal statute involving
46.16sexual abuse, physical abuse, or neglect or endangerment, under section 609.378, the
46.17local law enforcement agency and local welfare agency shall coordinate the planning and
46.18execution of their respective investigation and assessment efforts to avoid a duplication of
46.19fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of
46.20the results of its investigation. In cases of alleged child maltreatment resulting in death,
46.21the local agency may rely on the fact-finding efforts of a law enforcement investigation
46.22to make a determination of whether or not maltreatment occurred. When necessary the
46.23local welfare agency shall seek authority to remove the child from the custody of a parent,
46.24guardian, or adult with whom the child is living. In performing any of these duties, the
46.25local welfare agency shall maintain appropriate records.
46.26    If the family assessment or investigation indicates there is a potential for abuse of
46.27alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
46.28the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota
46.29Rules, part 9530.6615. The local welfare agency shall report the determination of the
46.30chemical use assessment, and the recommendations and referrals for alcohol and other
46.31drug treatment services to the state authority on alcohol and drug abuse.
46.32    (b) When a local agency receives a report or otherwise has information indicating
46.33that a child who is a client, as defined in section 245.91, has been the subject of physical
46.34abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section
46.35245.91 , it shall, in addition to its other duties under this section, immediately inform the
46.36ombudsman established under sections 245.91 to 245.97. The commissioner of education
47.1shall inform the ombudsman established under sections 245.91 to 245.97 of reports
47.2regarding a child defined as a client in section 245.91 that maltreatment occurred at a
47.3school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.
47.4    (c) Authority of the local welfare agency responsible for assessing or investigating
47.5the child abuse or neglect report, the agency responsible for assessing or investigating
47.6the report, and of the local law enforcement agency for investigating the alleged abuse or
47.7neglect includes, but is not limited to, authority to interview, without parental consent,
47.8the alleged victim and any other minors who currently reside with or who have resided
47.9with the alleged offender. The interview may take place at school or at any facility or
47.10other place where the alleged victim or other minors might be found or the child may be
47.11transported to, and the interview conducted at, a place appropriate for the interview of a
47.12child designated by the local welfare agency or law enforcement agency. The interview
47.13may take place outside the presence of the alleged offender or parent, legal custodian,
47.14guardian, or school official. For family assessments, it is the preferred practice to request
47.15a parent or guardian's permission to interview the child prior to conducting the child
47.16interview, unless doing so would compromise the safety assessment. Except as provided in
47.17this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible
47.18local welfare or law enforcement agency no later than the conclusion of the investigation
47.19or assessment that this interview has occurred. Notwithstanding rule 49.02 32 of the
47.20Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on
47.21an ex parte motion by the local welfare agency, order that, where reasonable cause exists,
47.22the agency withhold notification of this interview from the parent, legal custodian, or
47.23guardian. If the interview took place or is to take place on school property, the order shall
47.24specify that school officials may not disclose to the parent, legal custodian, or guardian the
47.25contents of the notification of intent to interview the child on school property, as provided
47.26under this paragraph, and any other related information regarding the interview that may
47.27be a part of the child's school record. A copy of the order shall be sent by the local welfare
47.28or law enforcement agency to the appropriate school official.
47.29    (d) When the local welfare, local law enforcement agency, or the agency responsible
47.30for assessing or investigating a report of maltreatment determines that an interview should
47.31take place on school property, written notification of intent to interview the child on school
47.32property must be received by school officials prior to the interview. The notification
47.33shall include the name of the child to be interviewed, the purpose of the interview, and
47.34a reference to the statutory authority to conduct an interview on school property. For
47.35interviews conducted by the local welfare agency, the notification shall be signed by the
47.36chair of the local social services agency or the chair's designee. The notification shall be
48.1private data on individuals subject to the provisions of this paragraph. School officials
48.2may not disclose to the parent, legal custodian, or guardian the contents of the notification
48.3or any other related information regarding the interview until notified in writing by the
48.4local welfare or law enforcement agency that the investigation or assessment has been
48.5concluded, unless a school employee or agent is alleged to have maltreated the child.
48.6Until that time, the local welfare or law enforcement agency or the agency responsible
48.7for assessing or investigating a report of maltreatment shall be solely responsible for any
48.8disclosures regarding the nature of the assessment or investigation.
48.9    Except where the alleged offender is believed to be a school official or employee,
48.10the time and place, and manner of the interview on school premises shall be within the
48.11discretion of school officials, but the local welfare or law enforcement agency shall have
48.12the exclusive authority to determine who may attend the interview. The conditions as to
48.13time, place, and manner of the interview set by the school officials shall be reasonable and
48.14the interview shall be conducted not more than 24 hours after the receipt of the notification
48.15unless another time is considered necessary by agreement between the school officials and
48.16the local welfare or law enforcement agency. Where the school fails to comply with the
48.17provisions of this paragraph, the juvenile court may order the school to comply. Every
48.18effort must be made to reduce the disruption of the educational program of the child, other
48.19students, or school staff when an interview is conducted on school premises.
48.20    (e) Where the alleged offender or a person responsible for the care of the alleged
48.21victim or other minor prevents access to the victim or other minor by the local welfare
48.22agency, the juvenile court may order the parents, legal custodian, or guardian to produce
48.23the alleged victim or other minor for questioning by the local welfare agency or the local
48.24law enforcement agency outside the presence of the alleged offender or any person
48.25responsible for the child's care at reasonable places and times as specified by court order.
48.26    (f) Before making an order under paragraph (e), the court shall issue an order to
48.27show cause, either upon its own motion or upon a verified petition, specifying the basis for
48.28the requested interviews and fixing the time and place of the hearing. The order to show
48.29cause shall be served personally and shall be heard in the same manner as provided in
48.30other cases in the juvenile court. The court shall consider the need for appointment of a
48.31guardian ad litem to protect the best interests of the child. If appointed, the guardian ad
48.32litem shall be present at the hearing on the order to show cause.
48.33    (g) The commissioner of human services, the ombudsman for mental health and
48.34developmental disabilities, the local welfare agencies responsible for investigating reports,
48.35the commissioner of education, and the local law enforcement agencies have the right to
48.36enter facilities as defined in subdivision 2 and to inspect and copy the facility's records,
49.1including medical records, as part of the investigation. Notwithstanding the provisions of
49.2chapter 13, they also have the right to inform the facility under investigation that they are
49.3conducting an investigation, to disclose to the facility the names of the individuals under
49.4investigation for abusing or neglecting a child, and to provide the facility with a copy of
49.5the report and the investigative findings.
49.6    (h) The local welfare agency responsible for conducting a family assessment or
49.7investigation shall collect available and relevant information to determine child safety,
49.8risk of subsequent child maltreatment, and family strengths and needs and share not public
49.9information with an Indian's tribal social services agency without violating any law of the
49.10state that may otherwise impose duties of confidentiality on the local welfare agency in
49.11order to implement the tribal state agreement. The local welfare agency or the agency
49.12responsible for investigating the report shall collect available and relevant information
49.13to ascertain whether maltreatment occurred and whether protective services are needed.
49.14Information collected includes, when relevant, information with regard to the person
49.15reporting the alleged maltreatment, including the nature of the reporter's relationship to the
49.16child and to the alleged offender, and the basis of the reporter's knowledge for the report;
49.17the child allegedly being maltreated; the alleged offender; the child's caretaker; and other
49.18collateral sources having relevant information related to the alleged maltreatment. The
49.19local welfare agency or the agency responsible for assessing or investigating the report
49.20may make a determination of no maltreatment early in an assessment, and close the case
49.21and retain immunity, if the collected information shows no basis for a full assessment or
49.22investigation.
49.23    Information relevant to the assessment or investigation must be asked for, and
49.24may include:
49.25    (1) the child's sex and age, prior reports of maltreatment, information relating
49.26to developmental functioning, credibility of the child's statement, and whether the
49.27information provided under this clause is consistent with other information collected
49.28during the course of the assessment or investigation;
49.29    (2) the alleged offender's age, a record check for prior reports of maltreatment, and
49.30criminal charges and convictions. The local welfare agency or the agency responsible for
49.31assessing or investigating the report must provide the alleged offender with an opportunity
49.32to make a statement. The alleged offender may submit supporting documentation relevant
49.33to the assessment or investigation;
49.34    (3) collateral source information regarding the alleged maltreatment and care of the
49.35child. Collateral information includes, when relevant: (i) a medical examination of the
49.36child; (ii) prior medical records relating to the alleged maltreatment or the care of the
50.1child maintained by any facility, clinic, or health care professional and an interview with
50.2the treating professionals; and (iii) interviews with the child's caretakers, including the
50.3child's parent, guardian, foster parent, child care provider, teachers, counselors, family
50.4members, relatives, and other persons who may have knowledge regarding the alleged
50.5maltreatment and the care of the child; and
50.6    (4) information on the existence of domestic abuse and violence in the home of
50.7the child, and substance abuse.
50.8    Nothing in this paragraph precludes the local welfare agency, the local law
50.9enforcement agency, or the agency responsible for assessing or investigating the report
50.10from collecting other relevant information necessary to conduct the assessment or
50.11investigation. Notwithstanding section 13.384 or 144.335, the local welfare agency has
50.12access to medical data and records for purposes of clause (3). Notwithstanding the data's
50.13classification in the possession of any other agency, data acquired by the local welfare
50.14agency or the agency responsible for assessing or investigating the report during the course
50.15of the assessment or investigation are private data on individuals and must be maintained
50.16in accordance with subdivision 11. Data of the commissioner of education collected
50.17or maintained during and for the purpose of an investigation of alleged maltreatment
50.18in a school are governed by this section, notwithstanding the data's classification as
50.19educational, licensing, or personnel data under chapter 13.
50.20    In conducting an assessment or investigation involving a school facility as defined
50.21in subdivision 2, paragraph (i), the commissioner of education shall collect investigative
50.22reports and data that are relevant to a report of maltreatment and are from local law
50.23enforcement and the school facility.
50.24    (i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face
50.25contact with the child reported to be maltreated and with the child's primary caregiver
50.26sufficient to complete a safety assessment and ensure the immediate safety of the child.
50.27The face-to-face contact with the child and primary caregiver shall occur immediately
50.28if substantial child endangerment is alleged and within five calendar days for all other
50.29reports. If the alleged offender was not already interviewed as the primary caregiver, the
50.30local welfare agency shall also conduct a face-to-face interview with the alleged offender
50.31in the early stages of the assessment or investigation. At the initial contact, the local child
50.32welfare agency or the agency responsible for assessing or investigating the report must
50.33inform the alleged offender of the complaints or allegations made against the individual in
50.34a manner consistent with laws protecting the rights of the person who made the report.
50.35The interview with the alleged offender may be postponed if it would jeopardize an active
50.36law enforcement investigation.
51.1    (j) When conducting an investigation, the local welfare agency shall use a question
51.2and answer interviewing format with questioning as nondirective as possible to elicit
51.3spontaneous responses. For investigations only, the following interviewing methods and
51.4procedures must be used whenever possible when collecting information:
51.5    (1) audio recordings of all interviews with witnesses and collateral sources; and
51.6    (2) in cases of alleged sexual abuse, audio-video recordings of each interview with
51.7the alleged victim and child witnesses.
51.8    (k) In conducting an assessment or investigation involving a school facility as
51.9defined in subdivision 2, paragraph (i), the commissioner of education shall collect
51.10available and relevant information and use the procedures in paragraphs (i), (k), and
51.11subdivision 3d, except that the requirement for face-to-face observation of the child
51.12and face-to-face interview of the alleged offender is to occur in the initial stages of the
51.13assessment or investigation provided that the commissioner may also base the assessment
51.14or investigation on investigative reports and data received from the school facility and
51.15local law enforcement, to the extent those investigations satisfy the requirements of
51.16paragraphs (i) and (k), and subdivision 3d.

51.17    Sec. 29. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to
51.18read:
51.19    Subd. 10a. Abuse outside family unit Law enforcement agency responsibility
51.20for investigation; welfare agency reliance on law enforcement fact-finding; welfare
51.21agency offer of services. (a) If the report alleges neglect, physical abuse, or sexual abuse
51.22by a person who is not a parent, guardian, sibling, person responsible for the child's care
51.23functioning outside within the family unit, or a person who lives in the child's household
51.24and who has a significant relationship to the child, in a setting other than a facility as
51.25defined in subdivision 2, the local welfare agency shall immediately notify the appropriate
51.26law enforcement agency, which shall conduct an investigation of the alleged abuse or
51.27neglect if a violation of a criminal statute is alleged.
51.28    (b) The local agency may rely on the fact-finding efforts of the law enforcement
51.29investigation conducted under this subdivision to make a determination whether or not
51.30threatened harm or other maltreatment has occurred under subdivision 2 if an alleged
51.31offender has minor children or lives with minors.
51.32    (c) The local welfare agency shall offer appropriate social services for the purpose of
51.33safeguarding and enhancing the welfare of the abused or neglected minor.

52.1    Sec. 30. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to
52.2read:
52.3    Subd. 10c. Duties of local social service agency upon receipt of a report of
52.4medical neglect. If the report alleges medical neglect as defined in section 260C.007,
52.5subdivision 4 6 , clause (5), the local welfare agency shall, in addition to its other duties
52.6under this section, immediately consult with designated hospital staff and with the parents
52.7of the infant to verify that appropriate nutrition, hydration, and medication are being
52.8provided; and shall immediately secure an independent medical review of the infant's
52.9medical charts and records and, if necessary, seek a court order for an independent medical
52.10examination of the infant. If the review or examination leads to a conclusion of medical
52.11neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings
52.12under section 260C.141 and by filing an expedited motion to prevent the withholding
52.13of medically indicated treatment.

52.14    Sec. 31. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:
52.15    Subd. 10f. Notice of determinations. Within ten working days of the conclusion
52.16of a family assessment, the local welfare agency shall notify the parent or guardian of
52.17the child of the need for services to address child safety concerns or significant risk of
52.18subsequent child maltreatment. The local welfare agency and the family may also jointly
52.19agree that family support and family preservation services are needed. Within ten working
52.20days of the conclusion of an investigation, the local welfare agency or agency responsible
52.21for assessing or investigating the report shall notify the parent or guardian of the child, the
52.22person determined to be maltreating the child, and if applicable, the director of the facility,
52.23of the determination and a summary of the specific reasons for the determination. The
52.24notice must also include a certification that the information collection procedures under
52.25subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a
52.26data subject to obtain access to other private data on the subject collected, created, or
52.27maintained under this section. In addition, the notice shall include the length of time that
52.28the records will be kept under subdivision 11c. The investigating agency shall notify the
52.29parent or guardian of the child who is the subject of the report, and any person or facility
52.30determined to have maltreated a child, of their appeal or review rights under this section
52.31or section 256.022. The notice must also state that a finding of maltreatment may result
52.32in denial of a license application or background study disqualification under chapter
52.33245C related to employment or services that are licensed by the Department of Human
52.34Services under chapter 245A, the Department of Health under chapter 144 or 144A, the
53.1Department of Corrections under section 241.021, and from providing services related to
53.2an unlicensed personal care provider organization under chapter 256B.

53.3    Sec. 32. REVISOR'S INSTRUCTION.
53.4    (a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d,
53.5as Minnesota Statutes, section 626.556, subdivision 3g.
53.6    (b) The revisor shall change references to Minnesota Statutes, section 260.851,
53.7to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to
53.8section 260.853, article 4, wherever those references appear in Minnesota Statutes and
53.9Minnesota Rules.

53.10ARTICLE 2

53.11CHILDREN AND FAMILY

53.12    Section 1. Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:
53.13    Subd. 2. General. (a) Unless the data is summary data or a statute specifically
53.14provides a different classification, data on individuals collected, maintained, used, or
53.15disseminated by the welfare system is private data on individuals, and shall not be
53.16disclosed except:
53.17    (1) according to section 13.05;
53.18    (2) according to court order;
53.19    (3) according to a statute specifically authorizing access to the private data;
53.20    (4) to an agent of the welfare system, including a law enforcement person, attorney,
53.21or investigator acting for it in the investigation or prosecution of a criminal or civil
53.22proceeding relating to the administration of a program;
53.23    (5) to personnel of the welfare system who require the data to verify an individual's
53.24identity; determine eligibility, amount of assistance, and the need to provide services to
53.25an individual or family across programs; evaluate the effectiveness of programs; and
53.26investigate suspected fraud;
53.27    (6) to administer federal funds or programs;
53.28    (7) between personnel of the welfare system working in the same program;
53.29    (8) to the Department of Revenue to administer and evaluate tax refund or tax credit
53.30programs and to identify individuals who may benefit from these programs. The following
53.31information may be disclosed under this paragraph: an individual's and their dependent's
53.32names, dates of birth, Social Security numbers, income, addresses, and other data as
53.33required, upon request by the Department of Revenue. Disclosures by the commissioner
53.34of revenue to the commissioner of human services for the purposes described in this clause
54.1are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
54.2but are not limited to, the dependent care credit under section 290.067, the Minnesota
54.3working family credit under section 290.0671, the property tax refund and rental credit
54.4under section 290A.04, and the Minnesota education credit under section 290.0674;
54.5    (9) between the Department of Human Services, the Department of Education, and
54.6the Department of Employment and Economic Development for the purpose of monitoring
54.7the eligibility of the data subject for unemployment benefits, for any employment or
54.8training program administered, supervised, or certified by that agency, for the purpose of
54.9administering any rehabilitation program or child care assistance program, whether alone
54.10or in conjunction with the welfare system, or to monitor and evaluate the Minnesota
54.11family investment program or the child care assistance program by exchanging data on
54.12recipients and former recipients of food support, cash assistance under chapter 256, 256D,
54.13256J, or 256K, child care assistance under chapter 119B, or medical programs under
54.14chapter 256B, 256D, or 256L;
54.15    (10) to appropriate parties in connection with an emergency if knowledge of
54.16the information is necessary to protect the health or safety of the individual or other
54.17individuals or persons;
54.18    (11) data maintained by residential programs as defined in section 245A.02 may
54.19be disclosed to the protection and advocacy system established in this state according
54.20to Part C of Public Law 98-527 to protect the legal and human rights of persons with
54.21developmental disabilities or other related conditions who live in residential facilities for
54.22these persons if the protection and advocacy system receives a complaint by or on behalf
54.23of that person and the person does not have a legal guardian or the state or a designee of
54.24the state is the legal guardian of the person;
54.25    (12) to the county medical examiner or the county coroner for identifying or locating
54.26relatives or friends of a deceased person;
54.27    (13) data on a child support obligor who makes payments to the public agency
54.28may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
54.29determine eligibility under section 136A.121, subdivision 2, clause (5);
54.30    (14) participant Social Security numbers and names collected by the telephone
54.31assistance program may be disclosed to the Department of Revenue to conduct an
54.32electronic data match with the property tax refund database to determine eligibility under
54.33section 237.70, subdivision 4a;
54.34    (15) the current address of a Minnesota family investment program participant
54.35may be disclosed to law enforcement officers who provide the name of the participant
54.36and notify the agency that:
55.1    (i) the participant:
55.2    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
55.3conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
55.4jurisdiction from which the individual is fleeing; or
55.5    (B) is violating a condition of probation or parole imposed under state or federal law;
55.6    (ii) the location or apprehension of the felon is within the law enforcement officer's
55.7official duties; and
55.8    (iii) the request is made in writing and in the proper exercise of those duties;
55.9    (16) the current address of a recipient of general assistance or general assistance
55.10medical care may be disclosed to probation officers and corrections agents who are
55.11supervising the recipient and to law enforcement officers who are investigating the
55.12recipient in connection with a felony level offense;
55.13    (17) information obtained from food support applicant or recipient households may
55.14be disclosed to local, state, or federal law enforcement officials, upon their written request,
55.15for the purpose of investigating an alleged violation of the Food Stamp Act, according
55.16to Code of Federal Regulations, title 7, section 272.1(c);
55.17    (18) the address, Social Security number, and, if available, photograph of any
55.18member of a household receiving food support shall be made available, on request, to a
55.19local, state, or federal law enforcement officer if the officer furnishes the agency with the
55.20name of the member and notifies the agency that:
55.21    (i) the member:
55.22    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
55.23crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
55.24    (B) is violating a condition of probation or parole imposed under state or federal
55.25law; or
55.26    (C) has information that is necessary for the officer to conduct an official duty related
55.27to conduct described in subitem (A) or (B);
55.28    (ii) locating or apprehending the member is within the officer's official duties; and
55.29    (iii) the request is made in writing and in the proper exercise of the officer's official
55.30duty;
55.31    (19) the current address of a recipient of Minnesota family investment program,
55.32general assistance, general assistance medical care, or food support may be disclosed to
55.33law enforcement officers who, in writing, provide the name of the recipient and notify the
55.34agency that the recipient is a person required to register under section 243.166, but is not
55.35residing at the address at which the recipient is registered under section 243.166;
56.1    (20) certain information regarding child support obligors who are in arrears may be
56.2made public according to section 518A.74;
56.3    (21) data on child support payments made by a child support obligor and data on
56.4the distribution of those payments excluding identifying information on obligees may be
56.5disclosed to all obligees to whom the obligor owes support, and data on the enforcement
56.6actions undertaken by the public authority, the status of those actions, and data on the
56.7income of the obligor or obligee may be disclosed to the other party;
56.8    (22) data in the work reporting system may be disclosed under section 256.998,
56.9subdivision 7 ;
56.10    (23) to the Department of Education for the purpose of matching Department of
56.11Education student data with public assistance data to determine students eligible for free
56.12and reduced price meals, meal supplements, and free milk according to United States
56.13Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
56.14state funds that are distributed based on income of the student's family; and to verify
56.15receipt of energy assistance for the telephone assistance plan;
56.16    (24) the current address and telephone number of program recipients and emergency
56.17contacts may be released to the commissioner of health or a local board of health as
56.18defined in section 145A.02, subdivision 2, when the commissioner or local board of health
56.19has reason to believe that a program recipient is a disease case, carrier, suspect case, or at
56.20risk of illness, and the data are necessary to locate the person;
56.21    (25) to other state agencies, statewide systems, and political subdivisions of this
56.22state, including the attorney general, and agencies of other states, interstate information
56.23networks, federal agencies, and other entities as required by federal regulation or law for
56.24the administration of the child support enforcement program;
56.25    (26) to personnel of public assistance programs as defined in section 256.741, for
56.26access to the child support system database for the purpose of administration, including
56.27monitoring and evaluation of those public assistance programs;
56.28    (27) to monitor and evaluate the Minnesota family investment program by
56.29exchanging data between the Departments of Human Services and Education, on
56.30recipients and former recipients of food support, cash assistance under chapter 256, 256D,
56.31256J, or 256K, child care assistance under chapter 119B, or medical programs under
56.32chapter 256B, 256D, or 256L;
56.33    (28) to evaluate child support program performance and to identify and prevent
56.34fraud in the child support program by exchanging data between the Department of Human
56.35Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
56.36and (b), without regard to the limitation of use in paragraph (c), Department of Health,
57.1Department of Employment and Economic Development, and other state agencies as is
57.2reasonably necessary to perform these functions; or
57.3    (29) counties operating child care assistance programs under chapter 119B may
57.4disseminate data on program participants, applicants, and providers to the commissioner
57.5of education.
57.6    (b) Information on persons who have been treated for drug or alcohol abuse may
57.7only be disclosed according to the requirements of Code of Federal Regulations, title
57.842, sections 2.1 to 2.67.
57.9    (c) Data provided to law enforcement agencies under paragraph (a), clause (15),
57.10(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected
57.11nonpublic while the investigation is active. The data are private after the investigation
57.12becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
57.13    (d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but is
57.14not subject to the access provisions of subdivision 10, paragraph (b).
57.15    For the purposes of this subdivision, a request will be deemed to be made in writing
57.16if made through a computer interface system.

57.17    Sec. 2. Minnesota Statutes 2006, section 16D.13, subdivision 3, is amended to read:
57.18    Subd. 3. Exclusion. A state agency may not charge interest under this section on
57.19overpayments of assistance benefits under the programs formerly codified in sections
57.20256.031 to 256.0361, 256.72 to 256.87, and under chapters 119B, 256D, and 256I, or the
57.21federal food stamp program. Notwithstanding this prohibition, any debts that have been
57.22reduced to judgment under these programs are subject to the interest charges provided
57.23under section 549.09.

57.24    Sec. 3. Minnesota Statutes 2006, section 119B.011, is amended by adding a subdivision
57.25to read:
57.26    Subd. 13a. Family stabilization services. "Family stabilization services" means the
57.27services under section 256J.575.

57.28    Sec. 4. Minnesota Statutes 2006, section 119B.035, subdivision 1, is amended to read:
57.29    Subdivision 1. Establishment. A family in which a parent provides care for the
57.30family's infant child may receive a subsidy in lieu of assistance if the family is eligible for
57.31or is receiving assistance under the basic sliding fee program. An eligible family must
57.32meet the eligibility factors under section 119B.09, except as provided in subdivision 4,
57.33and the requirements of this section. Subject to federal match and maintenance of effort
58.1requirements for the child care and development fund, and up to available appropriations,
58.2the commissioner shall establish a pool of up to three percent of the annual state
58.3appropriation for the basic sliding fee program to provide assistance under the at-home
58.4infant child care program and for administrative costs associated with the program. At
58.5the end of a fiscal year, the commissioner may carry forward any unspent funds under
58.6this section to the next fiscal year within the same biennium for assistance under the
58.7basic sliding fee program.

58.8    Sec. 5. Minnesota Statutes 2006, section 119B.05, subdivision 1, is amended to read:
58.9    Subdivision 1. Eligible participants. Families eligible for child care assistance
58.10under the MFIP child care program are:
58.11    (1) MFIP participants who are employed or in job search and meet the requirements
58.12of section 119B.10;
58.13    (2) persons who are members of transition year families under section 119B.011,
58.14subdivision 20 , and meet the requirements of section 119B.10;
58.15    (3) families who are participating in employment orientation or job search, or
58.16other employment or training activities that are included in an approved employability
58.17development plan under section 256J.95;
58.18    (4) MFIP families who are participating in work job search, job support,
58.19employment, or training activities as required in their employment plan, or in appeals,
58.20hearings, assessments, or orientations according to chapter 256J;
58.21    (5) MFIP families who are participating in social services activities under chapter
58.22256J as required in their employment plan approved according to chapter 256J;
58.23    (6) families who are participating in services or activities that are included in an
58.24approved family stabilization plan under section 256J.575;
58.25    (7) families who are participating in programs as required in tribal contracts under
58.26section 119B.02, subdivision 2, or 256.01, subdivision 2; and
58.27    (7) (8) families who are participating in the transition year extension under section
58.28119B.011, subdivision 20a .

58.29    Sec. 6. Minnesota Statutes 2006, section 119B.09, subdivision 1, is amended to read:
58.30    Subdivision 1. General Eligibility requirements for all applicants for child
58.31care assistance. (a) Child care services must be available to families who need child
58.32care to find or keep employment or to obtain the training or education necessary to find
58.33employment and who:
59.1    (1) have household income less than or equal to 250 percent of the federal poverty
59.2guidelines, adjusted for family size, and meet the requirements of section 119B.05;
59.3receive MFIP assistance; and are participating in employment and training services under
59.4chapter 256J or 256K; or
59.5    (2) have household income less than or equal to 175 percent of the federal poverty
59.6guidelines, adjusted for family size, at program entry and less than 250 percent of the
59.7federal poverty guidelines, adjusted for family size, at program exit.; or
59.8    (3) have household income less than or equal to 250 percent of the federal poverty
59.9guidelines, adjusted for family size, and were a family whose child care assistance was
59.10terminated due to insufficient funds under Minnesota Rules, part 3400.0183.
59.11    (b) Child care services must be made available as in-kind services.
59.12    (c) All applicants for child care assistance and families currently receiving child care
59.13assistance must be assisted and required to cooperate in establishment of paternity and
59.14enforcement of child support obligations for all children in the family as a condition
59.15of program eligibility. For purposes of this section, a family is considered to meet the
59.16requirement for cooperation when the family complies with the requirements of section
59.17256.741 .
59.18EFFECTIVE DATE.This section is effective July 1, 2008.

59.19    Sec. 7. Minnesota Statutes 2006, section 119B.09, subdivision 7, is amended to read:
59.20    Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child
59.21care assistance under this chapter is the later of the date the application was signed; the
59.22beginning date of employment, education, or training; the date the infant is born for
59.23applicants to the at-home infant care program; or the date a determination has been made
59.24that the applicant is a participant in employment and training services under Minnesota
59.25Rules, part 3400.0080, subpart 2a, or chapter 256J.
59.26    (b) Payment ceases for a family under the at-home infant child care program when a
59.27family has used a total of 12 months of assistance as specified under section 119B.035.
59.28Payment of child care assistance for employed persons on MFIP is effective the date of
59.29employment or the date of MFIP eligibility, whichever is later. Payment of child care
59.30assistance for MFIP or DWP participants in employment and training services is effective
59.31the date of commencement of the services or the date of MFIP or DWP eligibility,
59.32whichever is later. Payment of child care assistance for transition year child care must be
59.33made retroactive to the date of eligibility for transition year child care.
60.1    (c) Notwithstanding paragraph (b), payment of child care assistance for participants
60.2eligible under section 119B.05, may only be made retroactively for a maximum of six
60.3months from the date of application for child care assistance.
60.4EFFECTIVE DATE.This section is effective July 1, 2008.

60.5    Sec. 8. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision
60.6to read:
60.7    Subd. 11. Payment of other child care expenses. Payment by a source other
60.8than the family, of part or all of a family's child care expenses not payable under this
60.9chapter, does not affect the family's eligibility for child care assistance, and the amount
60.10paid is excluded from the family's income, if the funds are paid directly to the family's
60.11child care provider on behalf of the family. Child care providers who accept third-party
60.12payments must maintain family-specific documentation of payment source, amount, type
60.13of expenses, and time period covered by the payment.

60.14    Sec. 9. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision
60.15to read:
60.16    Subd. 12. Sliding fee. Child care services to families must be made available on a
60.17sliding fee basis. The commissioner shall convert eligibility requirements in section
60.18119B.09 and parent fee schedules in 119B.12 to state median income, based on a family
60.19size of three, adjusted for family size, by July 1, 2008. The commissioner shall report
60.20to the 2008 legislature with the necessary statutory changes to codify this conversion
60.21to state median income.

60.22    Sec. 10. Minnesota Statutes 2006, section 119B.12, is amended to read:
60.23119B.12 SLIDING FEE SCALE.
60.24    Subdivision 1. Fee schedule. In setting the sliding fee schedule, the commissioner
60.25shall exclude from the amount of income used to determine eligibility an amount for
60.26federal and state income and Social Security taxes attributable to that income level
60.27according to federal and state standardized tax tables. The commissioner shall base the
60.28parent fee on the ability of the family to pay for child care. The fee schedule must be
60.29designed to use any available tax credits.
60.30    PARENT FEE SCHEDULE. The parent fee schedule is as follows:

60.31 60.32	Income Range (as a percent of the federal poverty guidelines)	Co-payment (as a percentage of adjusted gross income)
60.33	0-74.99%	$0/month
61.1	75.00-99.99%	$5/month
61.2	100.00-104.99%	2.61%
61.3	105.00-109.99%	2.61%
61.4	110.00-114.99%	2.61%
61.5	115.00-119.99%	2.61%
61.6	120.00-124.99%	2.91%
61.7	125.00-129.99%	2.91%
61.8	130.00-134.99%	2.91%
61.9	135.00-139.99%	2.91%
61.10	140.00-144.99%	3.21%
61.11	145.00-149.99%	3.21%
61.12	150.00-154.99%	3.21%
61.13	155.00-159.99%	3.84%
61.14	160.00-164.99%	3.84%
61.15	165.00-169.99%	4.46%
61.16	170.00-174.99%	4.76%
61.17	175.00-179.99%	5.05%
61.18	180.00-184.99%	5.65%
61.19	185.00-189.99%	5.95%
61.20	190.00-194.99%	6.24%
61.21	195.00-199.99%	6.84%
61.22	200.00-204.99%	7.58%
61.23	205.00-209.99%	8.33%
61.24	210.00-214.99%	9.20%
61.25	215.00-219.99%	10.07%
61.26	220.00-224.99%	10.94%
61.27	225.00-229.99%	11.55%
61.28	230.00-234.99%	12.16%
61.29	235.00-239.99%	12.77%
61.30	240.00-244.99%	13.38%
61.31	245.00-249.99%	14.00%
61.32	250%	ineligible

61.33    A family's monthly co-payment fee is the fixed percentage established for the
61.34income range multiplied by the highest possible income within that income range.
61.35    Subd. 2. Parent fee. A family must be assessed a parent fee for each service period.
61.36A family's parent fee must be a fixed percentage of its annual gross income. Parent fees
61.37must apply to families eligible for child care assistance under sections 119B.03 and
61.38119B.05 . Income must be as defined in section 119B.011, subdivision 15. The fixed
61.39percent is based on the relationship of the family's annual gross income to 100 percent
61.40of the annual federal poverty guidelines. Parent fees must begin at 75 percent of the
61.41poverty level. The minimum parent fees for families between 75 percent and 100 percent
62.1of poverty level must be $10 $5 per month. Parent fees must provide for graduated
62.2movement to full payment. Payment of part or all of a family's parent fee directly to the
62.3family's child care provider on behalf of the family by a source other than the family shall
62.4not affect the family's eligibility for child care assistance, and the amount paid shall be
62.5excluded from the family's income. Child care providers who accept third-party payments
62.6must maintain family specific documentation of payment source, amount, and time period
62.7covered by the payment.
62.8EFFECTIVE DATE.(a) This section is effective July 1, 2007.
62.9    (b) Effective July 1, 2008, the parent fee scale for families with incomes greater than
62.10or equal to 100 percent of FPG shall be converted to state median income for a family size
62.11of three, adjusted for family size, as directed in section 119B.09, subdivision 12.

62.12    Sec. 11. Minnesota Statutes 2006, section 119B.125, subdivision 2, is amended to read:
62.13    Subd. 2. Persons who cannot be authorized. (a) A person who meets any of the
62.14conditions under paragraphs (b) to (n) must not be authorized as a legal nonlicensed
62.15family child care provider. To determine whether any of the listed conditions exist,
62.16the county must request information about the provider from the Bureau of Criminal
62.17Apprehension, the juvenile courts, and social service agencies. When one of the listed
62.18entities does not maintain information on a statewide basis, the county must contact the
62.19entity in the county where the provider resides and any other county in which the provider
62.20previously resided in the past year. For purposes of this subdivision, a finding that a
62.21delinquency petition is proven in juvenile court must be considered a conviction in state
62.22district court. If a county has determined that a provider is able to be authorized in that
62.23county, and a family in another county later selects that provider, the provider is able to
62.24be authorized in the second county without undergoing a new background investigation
62.25unless one of the following conditions exists:
62.26    (1) two years have passed since the first authorization;
62.27    (2) another person age 13 or older has joined the provider's household since the
62.28last authorization;
62.29    (3) a current household member has turned 13 since the last authorization; or
62.30    (4) there is reason to believe that a household member has a factor that prevents
62.31authorization.
62.32    (b) The person has been convicted of one of the following offenses or has admitted to
62.33committing or a preponderance of the evidence indicates that the person has committed an
62.34act that meets the definition of one of the following offenses: sections 609.185 to 609.195,
62.35murder in the first, second, or third degree; 609.2661 to 609.2663, murder of an unborn
63.1child in the first, second, or third degree; 609.322, solicitation, inducement, promotion
63.2of prostitution, or receiving profit from prostitution; 609.342 to 609.345, criminal sexual
63.3conduct in the first, second, third, or fourth degree; 609.352, solicitation of children to
63.4engage in sexual conduct; 609.365, incest; 609.377, felony malicious punishment of a
63.5child; 617.246, use of minors in sexual performance; 617.247, possession of pictorial
63.6representation of a minor; 609.2242 to 609.2243, felony domestic assault; a felony offense
63.7of spousal abuse; a felony offense of child abuse or neglect; a felony offense of a crime
63.8against children; or an attempt or conspiracy to commit any of these offenses as defined in
63.9Minnesota Statutes; or an offense in any other state or country where the elements are
63.10substantially similar to any of the offenses listed in this paragraph.
63.11    (c) Less than 15 years have passed since the discharge of the sentence imposed for
63.12the offense and the person has received a felony conviction for one of the following
63.13offenses, or the person has admitted to committing or a preponderance of the evidence
63.14indicates that the person has committed an act that meets the definition of a felony
63.15conviction for one of the following offenses: sections 609.20 to 609.205, manslaughter in
63.16the first or second degree; 609.21, criminal vehicular homicide; 609.215, aiding suicide
63.17or aiding attempted suicide; 609.221 to 609.2231, assault in the first, second, third, or
63.18fourth degree; 609.224, repeat offenses of fifth degree assault; 609.228, great bodily
63.19harm caused by distribution of drugs; 609.2325, criminal abuse of a vulnerable adult;
63.20609.2335 , financial exploitation of a vulnerable adult; 609.235, use of drugs to injure or
63.21facilitate a crime; 609.24, simple robbery; 617.241, repeat offenses of obscene materials
63.22and performances; 609.245, aggravated robbery; 609.25, kidnapping; 609.255, false
63.23imprisonment; 609.2664 to 609.2665, manslaughter of an unborn child in the first or
63.24second degree; 609.267 to 609.2672, assault of an unborn child in the first, second, or third
63.25degree; 609.268, injury or death of an unborn child in the commission of a crime; 609.27,
63.26coercion; 609.275, attempt to coerce; 609.324, subdivision 1, other prohibited acts, minor
63.27engaged in prostitution; 609.3451, repeat offenses of criminal sexual conduct in the fifth
63.28degree; 609.378, neglect or endangerment of a child; 609.52, theft; 609.521, possession of
63.29shoplifting gear; 609.561 to 609.563, arson in the first, second, or third degree; 609.582,
63.30burglary in the first, second, third, or fourth degree; 609.625, aggravated forgery; 609.63,
63.31forgery; 609.631, check forgery, offering a forged check; 609.635, obtaining signature
63.32by false pretenses; 609.66, dangerous weapon; 609.665, setting a spring gun; 609.67,
63.33unlawfully owning, possessing, or operating a machine gun; 609.687, adulteration; 609.71,
63.34riot; 609.713, terrorist threats; 609.749, harassment, stalking; 260C.301, termination of
63.35parental rights; 152.021 to 152.022 and 152.0262, controlled substance crime in the first
63.36or second degree; 152.023, subdivision 1, clause (3) or (4), or 152.023, subdivision 2,
64.1clause (4), controlled substance crime in third degree; 152.024, subdivision 1, clause
64.2(2), (3), or (4), controlled substance crime in fourth degree; 617.23, repeat offenses of
64.3indecent exposure; an attempt or conspiracy to commit any of these offenses as defined in
64.4Minnesota Statutes; or an offense in any other state or country where the elements are
64.5substantially similar to any of the offenses listed in this paragraph.
64.6    (d) Less than ten years have passed since the discharge of the sentence imposed for
64.7the offense and the person has received a gross misdemeanor conviction for one of the
64.8following offenses or the person has admitted to committing or a preponderance of the
64.9evidence indicates that the person has committed an act that meets the definition of a gross
64.10misdemeanor conviction for one of the following offenses: sections 609.224, fifth degree
64.11assault; 609.2242 to 609.2243, domestic assault; 518B.01, subdivision 14, violation of
64.12an order for protection; 609.3451, fifth degree criminal sexual conduct; 609.746, repeat
64.13offenses of interference with privacy; 617.23, repeat offenses of indecent exposure;
64.14617.241 , obscene materials and performances; 617.243, indecent literature, distribution;
64.15617.293 , disseminating or displaying harmful material to minors; 609.71, riot; 609.66,
64.16dangerous weapons; 609.749, harassment, stalking; 609.224, subdivision 2, paragraph
64.17(c), fifth degree assault against a vulnerable adult by a caregiver; 609.23, mistreatment
64.18of persons confined; 609.231, mistreatment of residents or patients; 609.2325, criminal
64.19abuse of a vulnerable adult; 609.2335, financial exploitation of a vulnerable adult;
64.20609.233 , criminal neglect of a vulnerable adult; 609.234, failure to report maltreatment of
64.21a vulnerable adult; 609.72, subdivision 3, disorderly conduct against a vulnerable adult;
64.22609.265 , abduction; 609.378, neglect or endangerment of a child; 609.377, malicious
64.23punishment of a child; 609.324, subdivision 1a, other prohibited acts, minor engaged
64.24in prostitution; 609.33, disorderly house; 609.52, theft; 609.582, burglary in the first,
64.25second, third, or fourth degree; 609.631, check forgery, offering a forged check; 609.275,
64.26attempt to coerce; an attempt or conspiracy to commit any of these offenses as defined in
64.27Minnesota Statutes; or an offense in any other state or country where the elements are
64.28substantially similar to any of the offenses listed in this paragraph.
64.29    (e) Less than seven years have passed since the discharge of the sentence imposed
64.30for the offense and the person has received a misdemeanor conviction for one of the
64.31following offenses or the person has admitted to committing or a preponderance of
64.32the evidence indicates that the person has committed an act that meets the definition
64.33of a misdemeanor conviction for one of the following offenses: sections 609.224, fifth
64.34degree assault; 609.2242, domestic assault; 518B.01, violation of an order for protection;
64.35609.3232 , violation of an order for protection; 609.746, interference with privacy; 609.79,
64.36obscene or harassing telephone calls; 609.795, letter, telegram, or package opening,
65.1harassment; 617.23, indecent exposure; 609.2672, assault of an unborn child, third degree;
65.2617.293 , dissemination and display of harmful materials to minors; 609.66, dangerous
65.3weapons; 609.665, spring guns; an attempt or conspiracy to commit any of these offenses
65.4as defined in Minnesota Statutes; or an offense in any other state or country where the
65.5elements are substantially similar to any of the offenses listed in this paragraph.
65.6    (f) The person has been identified by the child protection agency in the county where
65.7the provider resides or a county where the provider has resided or by the statewide child
65.8protection database as a person found by a preponderance of evidence under section
65.9626.556 to be responsible for physical or sexual abuse of a child within the last seven years.
65.10    (g) The person has been identified by the adult protection agency in the county
65.11where the provider resides or a county where the provider has resided or by the statewide
65.12adult protection database as the person responsible for abuse or neglect of a vulnerable
65.13adult within the last seven years.
65.14    (h) The person has refused to give written consent for disclosure of criminal history
65.15records.
65.16    (i) The person has been denied a family child care license or has received a fine or a
65.17sanction as a licensed child care provider that has not been reversed on appeal.
65.18    (j) The person has a family child care licensing disqualification that has not been
65.19set aside.
65.20    (k) The person has admitted or a county has found that there is a preponderance of
65.21evidence that fraudulent information was given to the county for child care assistance
65.22application purposes or was used in submitting child care assistance bills for payment.
65.23    (l) The person has been convicted of the crime of theft by wrongfully obtaining
65.24public assistance or has been found guilty of wrongfully obtaining public assistance by a
65.25federal court, state court, or an administrative hearing determination or waiver, through a
65.26disqualification consent agreement, as part of an approved diversion plan under section
65.27401.065, or a court-ordered stay with probationary or other conditions.
65.28    (m) The person has a household member age 13 or older who has access to children
65.29during the hours that care is provided and who meets one of the conditions listed in
65.30paragraphs (b) to (l).
65.31    (n) The person has a household member ages ten to 12 who has access to children
65.32during the hours that care is provided; information or circumstances exist which provide
65.33the county with articulable suspicion that further pertinent information may exist showing
65.34the household member meets one of the conditions listed in paragraphs (b) to (l); and the
65.35household member actually meets one of the conditions listed in paragraphs (b) to (l).

66.1    Sec. 12. Minnesota Statutes 2006, section 119B.13, subdivision 1, is amended to read:
66.2    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006, the maximum rate
66.3paid for child care assistance in any county or multicounty region under the child care
66.4fund shall be the rate for like-care arrangements in the county effective January 1, 2006,
66.5increased by six percent.
66.6    (b) Rate changes shall be implemented for services provided in September 2006
66.7unless a participant eligibility redetermination or a new provider agreement is completed
66.8between July 1, 2006, and August 31, 2006.
66.9    As necessary, appropriate notice of adverse action must be made according to
66.10Minnesota Rules, part 3400.0185, subparts 3 and 4.
66.11    New cases approved on or after July 1, 2006, shall have the maximum rates under
66.12paragraph (a), implemented immediately.
66.13    (c) Not less than once every two years Every year, the commissioner shall survey
66.14rates charged by child care providers in Minnesota to determine the 75th percentile for
66.15like-care arrangements in counties. When the commissioner determines that, using the
66.16commissioner's established protocol, the number of providers responding to the survey is
66.17too small to determine the 75th percentile rate for like-care arrangements in a county or
66.18multicounty region, the commissioner may establish the 75th percentile maximum rate
66.19based on like-care arrangements in a county, region, or category that the commissioner
66.20deems to be similar.
66.21    (d) A rate which includes a special needs rate paid under subdivision 3 or under
66.22a school readiness service agreement paid under section 61 may be in excess of the
66.23maximum rate allowed under this subdivision.
66.24    (e) The department shall monitor the effect of this paragraph on provider rates. The
66.25county shall pay the provider's full charges for every child in care up to the maximum
66.26established. The commissioner shall determine the maximum rate for each type of care on
66.27an hourly, full-day, and weekly basis, including special needs and disability care.
66.28    (f) When the provider charge is greater than the maximum provider rate allowed,
66.29the parent is responsible for payment of the difference in the rates in addition to any
66.30family co-payment fee.

66.31    Sec. 13. Minnesota Statutes 2006, section 119B.13, subdivision 3a, is amended to read:
66.32    Subd. 3a. Provider rate differential for accreditation. A family child care
66.33provider or child care center shall be paid a 15 percent differential above the maximum
66.34rate established in subdivision 1, up to the actual provider rate, if the provider or center
66.35holds a current early childhood development credential or is accredited. For a family
67.1child care provider, early childhood development credential and accreditation includes
67.2an individual who has earned a child development associate degree, a child development
67.3associate credential, a diploma in child development from a Minnesota state technical
67.4college, or a bachelor's or post baccalaureate degree in early childhood education from
67.5an accredited college or university, or who is accredited by the National Association for
67.6Family Child Care or the Competency Based Training and Assessment Program. For a
67.7child care center, accreditation includes accreditation by the National Association for the
67.8Education of Young Children, the Council on Accreditation, the National Early Childhood
67.9Program Accreditation, the National School-Age Care Association, or the National Head
67.10Start Association Program of Excellence. For Montessori programs, accreditation includes
67.11the American Montessori Society, Association of Montessori International-USA, or the
67.12National Center for Montessori Education.

67.13    Sec. 14. Minnesota Statutes 2006, section 119B.13, subdivision 6, is amended to read:
67.14    Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments
67.15to the child care provider or pay the parent directly for eligible child care expenses.
67.16    (b) If payments for child care assistance are made to providers, the provider shall
67.17bill the county for services provided within ten days of the end of the service period. If
67.18bills are submitted within ten days of the end of the service period, a county or the state
67.19shall issue payment to the provider of child care under the child care fund within 30 days
67.20of receiving a bill from the provider. Counties or the state may establish policies that
67.21make payments on a more frequent basis.
67.22    (c) All bills If a provider has received an authorization of care and has been issued a
67.23billing form for an eligible family, the bill must be submitted within 60 days of the last
67.24date of service on the bill. A county may pay a bill submitted more than 60 days after
67.25the last date of service if the provider shows good cause why the bill was not submitted
67.26within 60 days. Good cause must be defined in the county's child care fund plan under
67.27section 119B.08, subdivision 3, and the definition of good cause must include county
67.28error. A county may not pay any bill submitted more than a year after the last date of
67.29service on the bill.
67.30    (d) If a provider provided care for a time period without receiving an authorization
67.31of care and a billing form for an eligible family, payment of child care assistance may only
67.32be made retroactively for a maximum of six months from the date the provider is issued an
67.33authorization of care and a billing form.
67.34    (d) (e) A county may stop payment issued to a provider or may refuse to pay a
67.35bill submitted by a provider if:
68.1    (1) the provider admits to intentionally giving the county materially false information
68.2on the provider's billing forms; or
68.3    (2) a county finds by a preponderance of the evidence that the provider intentionally
68.4gave the county materially false information on the provider's billing forms.
68.5    (e) (f) A county's payment policies must be included in the county's child care plan
68.6under section 119B.08, subdivision 3. If payments are made by the state, in addition to
68.7being in compliance with this subdivision, the payments must be made in compliance
68.8with section 16A.124.

68.9    Sec. 15. Minnesota Statutes 2006, section 119B.13, subdivision 7, is amended to read:
68.10    Subd. 7. Absent days. (a) Child care providers may not be reimbursed for more
68.11than 25 full-day absent days per child, excluding holidays, in a fiscal year, or for more
68.12than ten consecutive full-day absent days, unless the child has a documented medical
68.13condition that causes more frequent absences. Absences due to a documented medical
68.14condition of a parent or sibling who lives in the same residence as the child receiving
68.15child care assistance do not count against the 25-day absent day limit in a fiscal year.
68.16Documentation of medical conditions must be on the forms and submitted according to
68.17the timelines established by the commissioner. A public health nurse or school nurse
68.18may verify the illness in lieu of a medical practitioner. If a provider sends a child home
68.19early due to a medical reason, including, but not limited to, fever or contagious illness,
68.20the child care center director or lead teacher may verify the illness in lieu of a medical
68.21practitioner. If a child attends for part of the time authorized to be in care in a day, but is
68.22absent for part of the time authorized to be in care in that same day, the absent time will be
68.23reimbursed but the time will not count toward the ten consecutive or 25 cumulative absent
68.24day limits. Children in families where at least one parent is under the age of 21, does not
68.25have a high school or general equivalency diploma, and is a student in a school district
68.26or another similar program that provides or arranges for child care, as well as parenting,
68.27social services, career and employment supports, and academic support to achieve high
68.28school graduation, may be exempt from the absent day limits upon request of the program
68.29and approval of the county. If a child attends part of an authorized day, payment to the
68.30provider must be for the full amount of care authorized for that day. Child care providers
68.31may only be reimbursed for absent days if the provider has a written policy for child
68.32absences and charges all other families in care for similar absences.
68.33    (b) Child care providers must be reimbursed for up to ten federal or state holidays
68.34or designated holidays per year when the provider charges all families for these days
68.35and the holiday or designated holiday falls on a day when the child is authorized to be
69.1in attendance. Parents may substitute other cultural or religious holidays for the ten
69.2recognized state and federal holidays. Holidays do not count toward the ten consecutive or
69.325 cumulative absent day limits.
69.4    (c) A family or child care provider may not be assessed an overpayment for an
69.5absent day payment unless (1) there was an error in the amount of care authorized for the
69.6family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
69.7the family or provider did not timely report a change as required under law.
69.8    (d) The provider and family must receive notification of the number of absent days
69.9used upon initial provider authorization for a family and when the family has used 15
69.10cumulative absent days. Upon statewide implementation of the Minnesota Electronic
69.11Child Care System, the provider and family authorization for a family and ongoing
69.12notification of the number of absent days used as of the date of the notification.
69.13    (e) A county may pay for more absent days than the statewide absent day policy
69.14established under this subdivision if current market practice in the county justifies payment
69.15for those additional days. County policies for payment of absent days in excess of the
69.16statewide absent day policy and justification for these county policies must be included in
69.17the county's child care fund plan under section 119B.08, subdivision 3. This paragraph
69.18may be implemented by counties on or after July 1, 2008.

69.19    Sec. 16. Minnesota Statutes 2006, section 119B.21, subdivision 5, is amended to read:
69.20    Subd. 5. Child care services grants. (a) A child care resource and referral program
69.21designated under section 119B.19, subdivision 1a, may award child care services grants
69.22for:
69.23    (1) creating new licensed child care facilities and expanding existing facilities,
69.24including, but not limited to, supplies, equipment, facility renovation, and remodeling;
69.25    (2) improving licensed child care facility programs;
69.26    (3) staff training and development services including, but not limited to, in-service
69.27training, curriculum development, accreditation, certification, consulting, resource centers,
69.28and program and resource materials, supporting effective teacher-child interactions,
69.29child-focused teaching, and content-driven classroom instruction;
69.30    (4) interim financing;
69.31    (5) capacity building through the purchase of appropriate technology to create,
69.32enhance, and maintain business management systems;
69.33    (6) emergency assistance for child care programs;
69.34    (7) new programs or projects for the creation, expansion, or improvement of
69.35programs that serve ethnic immigrant and refugee communities; and
70.1    (8) targeted recruitment initiatives to expand and build the capacity of the child
70.2care system and to improve the quality of care provided by legal nonlicensed child care
70.3providers.
70.4    (b) A child care resource and referral program designated under section 119B.19,
70.5subdivision 1a , may award child care services grants to:
70.6    (1) licensed providers;
70.7    (2) providers in the process of being licensed;
70.8    (3) corporations or public agencies that develop or provide child care services;
70.9    (4) school-age care programs; or
70.10    (5) any combination of clauses (1) to (4).
70.11Unlicensed providers are only eligible for grants under paragraph (a), clause (7).
70.12    (c) A recipient of a child care services grant for facility improvements, interim
70.13financing, or staff training and development must provide a 25 percent local match.

70.14    Sec. 17. Minnesota Statutes 2006, section 256.01, subdivision 4, is amended to read:
70.15    Subd. 4. Duties as state agency. (a) The state agency shall:
70.16    (1) supervise the administration of assistance to dependent children under Laws
70.171937, chapter 438, by the county agencies in an integrated program with other service for
70.18dependent children maintained under the direction of the state agency;
70.19    (2) may subpoena witnesses and administer oaths, make rules, and take such action
70.20as may be necessary, or desirable for carrying out the provisions of Laws 1937, chapter
70.21438. All rules made by the state agency shall be binding on the counties and shall be
70.22complied with by the respective county agencies;
70.23    (3) (2) establish adequate standards for personnel employed by the counties and the
70.24state agency in the administration of Laws 1937, chapter 438, and make the necessary
70.25rules to maintain such standards;
70.26    (4) (3) prescribe the form of and print and supply to the county agencies blanks
70.27for applications, reports, affidavits, and such other forms as it may deem necessary and
70.28advisable;
70.29    (5) (4) cooperate with the federal government and its public welfare agencies
70.30in any reasonable manner as may be necessary to qualify for federal aid for temporary
70.31assistance for needy families and in conformity with title I of Public Law 104-193, the
70.32Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and successor
70.33amendments, including the making of such reports and such forms and containing such
70.34information as the Federal Social Security Board may from time to time require, and
71.1comply with such provisions as such board may from time to time find necessary to assure
71.2the correctness and verification of such reports;
71.3    (6) may cooperate with other state agencies in establishing reciprocal agreements in
71.4instances where a child receiving Minnesota family investment program assistance moves
71.5or contemplates moving into or out of the state, in order that such child may continue to
71.6receive supervised aid from the state moved from until the child shall have resided for
71.7one year in the state moved to;
71.8    (7) (5) on or before October 1 in each even-numbered year make a biennial report
71.9to the governor concerning the activities of the agency;
71.10    (8) (6) enter into agreements with other departments of the state as necessary to meet
71.11all requirements of the federal government; and
71.12    (9) (7) cooperate with the commissioner of education to enforce the requirements
71.13for program integrity and fraud prevention for investigation for child care assistance
71.14under chapter 119B.
71.15    (b) The state agency may:
71.16    (1) subpoena witnesses and administer oaths, make rules, and take such action as
71.17may be necessary or desirable for carrying out the provisions of Laws 1937, chapter 438.
71.18All rules made by the state agency shall be binding on the counties and shall be complied
71.19with by the respective county agencies;
71.20    (2) cooperate with other state agencies in establishing reciprocal agreements in
71.21instances where a child receiving Minnesota family investment program assistance moves
71.22or contemplates moving into or out of the state, in order that the child may continue
71.23to receive supervised aid from the state moved from until the child has resided for one
71.24year in the state moved to; and
71.25    (3) administer oaths and affirmations, take depositions, certify to official acts, and
71.26issue subpoenas to compel the attendance of individuals and the production of documents
71.27and other personal property necessary in connection with the administration of programs
71.28administered by the Department of Human Services.
71.29    (c) The fees for service of a subpoena in paragraph (b), clause (3), must be paid in
71.30the same manner as prescribed by law for a service of process issued by a district court.
71.31Witnesses must receive the same fees and mileage as in civil actions.
71.32    (d) The subpoena in paragraph (b), clause (3), shall be enforceable through the
71.33district court in the district where the subpoena is issued.

71.34    Sec. 18. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
71.35to read:
72.1    Subd. 23. Administrative simplification; county cost study. (a) The commissioner
72.2shall establish and convene the first meeting of an advisory committee to identify ways
72.3to simplify and streamline human services laws and administrative requirements. The
72.4advisory committee shall select its chair from its membership at the first meeting.
72.5    (b) The committee shall consist of three senators appointed by the senate
72.6Subcommittee on Committees of the Committee on Rules and Administration, three
72.7state representatives appointed by the speaker of the house of representatives, and
72.8nine department staff and county representatives appointed by the commissioner. The
72.9appointments required under this paragraph must be completed by September 1, 2007.
72.10    (c) The committee shall discuss methods of reducing inconsistency between
72.11programs and complexity within programs in order to improve administrative efficiency
72.12and reduce the risk of recipient noncompliance. Topics for discussion may include child
72.13support enforcement, adoption services, child care licensing, child care assistance, and
72.14other programs. The state senators and state representatives on the advisory committee,
72.15in consultation with the advisory committee, shall report annually to the chairs of the
72.16legislative committees and divisions with jurisdiction over the Department of Human
72.17Services, beginning January 15, 2008, with recommendations developed by the advisory
72.18group.
72.19    (d) The commissioner, in consultation with the advisory committee, shall study
72.20and report to the legislature by January 15, 2009, on the transfer of any responsibilities
72.21between the department and counties that would result in more efficient and effective
72.22administration of human services programs.
72.23    (e) This section expires on June 30, 2012.

72.24    Sec. 19. Minnesota Statutes 2006, section 256.015, subdivision 7, is amended to read:
72.25    Subd. 7. Cooperation required. Upon the request of the Department of Human
72.26Services, any state agency or third party payer shall cooperate with the department in
72.27furnishing information to help establish a third party liability. Upon the request of the
72.28Department of Human Services or county child support or human service agencies, any
72.29employer or third party payer shall cooperate in furnishing information about group health
72.30insurance plans or medical benefit plans available to its employees. For purposes of
72.31section 176.191, subdivision 4, the Department of Labor and Industry may allow the
72.32Department of Human Services and county agencies direct access and data matching on
72.33information relating to workers' compensation claims in order to determine whether the
72.34claimant has reported the fact of a pending claim and the amount paid to or on behalf of
72.35the claimant to the Department of Human Services. The Department of Human Services
73.1and county agencies shall limit its use of information gained from agencies, third party
73.2payers, and employers to purposes directly connected with the administration of its public
73.3assistance and child support programs. The provision of information by agencies, third
73.4party payers, and employers to the department under this subdivision is not a violation of
73.5any right of confidentiality or data privacy.

73.6    Sec. 20. Minnesota Statutes 2006, section 256.017, subdivision 1, is amended to read:
73.7    Subdivision 1. Authority and purpose. The commissioner shall administer a
73.8compliance system for the Minnesota family investment program, the food stamp or food
73.9support program, emergency assistance, general assistance, medical assistance, general
73.10assistance medical care, emergency general assistance, Minnesota supplemental assistance,
73.11preadmission screening, and alternative care grants, and the child care assistance program
73.12under the powers and authorities named in section 256.01, subdivision 2. The purpose of
73.13the compliance system is to permit the commissioner to supervise the administration of
73.14public assistance programs and to enforce timely and accurate distribution of benefits,
73.15completeness of service and efficient and effective program management and operations,
73.16to increase uniformity and consistency in the administration and delivery of public
73.17assistance programs throughout the state, and to reduce the possibility of sanctions and
73.18fiscal disallowances for noncompliance with federal regulations and state statutes.
73.19    The commissioner shall utilize training, technical assistance, and monitoring
73.20activities, as specified in section 256.01, subdivision 2, to encourage county agency
73.21compliance with written policies and procedures.

73.22    Sec. 21. Minnesota Statutes 2006, section 256.017, subdivision 9, is amended to read:
73.23    Subd. 9. Timing and disposition of penalty and case disallowance funds. Quality
73.24control case penalty and administrative penalty amounts shall be disallowed or withheld
73.25from the next regular reimbursement made to the county agency for state and federal
73.26benefit reimbursements and federal administrative reimbursements for all programs
73.27covered in this section, according to procedures established in statute, but shall not be
73.28imposed sooner than 30 calendar days from the date of written notice of such penalties.
73.29Except for penalties withheld under the child care assistance program, all penalties
73.30must be deposited in the county incentive fund provided in section 256.018. Penalties
73.31withheld under the child care assistance program shall be reallocated to counties using the
73.32allocation formula under section 119B.03, subdivision 5. All penalties must be imposed
73.33according to this provision until a decision is made regarding the status of a written
74.1exception. Penalties must be returned to county agencies when a review of a written
74.2exception results in a decision in their favor.

74.3    Sec. 22. Minnesota Statutes 2006, section 256.984, subdivision 1, is amended to read:
74.4    Subdivision 1. Declaration. Every application for public assistance under this
74.5chapter or chapters 256B, 256D, 256J, and 256L; child care programs under chapter 119B;
74.6and food stamps or food support under chapter 393 shall be in writing or reduced to
74.7writing as prescribed by the state agency and shall contain the following declaration which
74.8shall be signed by the applicant:
74.9"I declare under the penalties of perjury that this application has been examined
74.10by me and to the best of my knowledge is a true and correct statement of every
74.11material point. I understand that a person convicted of perjury may be sentenced
74.12to imprisonment of not more than five years or to payment of a fine of not more
74.13than $10,000, or both."

74.14    Sec. 23. [256D.0516] EXPIRATION OF FOOD SUPPORT BENEFITS AND
74.15REPORTING REQUIREMENTS.
74.16    Subdivision 1. Expiration of food support benefits. Food support benefits shall
74.17not be stored off line or expunged from a recipient's account unless the benefits have not
74.18been accessed for 12 months after the month they were issued.
74.19    Subd. 2. Food support reporting requirements. The commissioner of human
74.20services shall implement simplified reporting as permitted under the Food Stamp Act of
74.211977, as amended, and the food stamp regulations in Code of Federal Regulations, title
74.227, part 273. Food support recipient households required to report periodically shall not
74.23be required to report more often than one time every six months. This provision shall
74.24not apply to households receiving food benefits under the Minnesota family investment
74.25program waiver.
74.26EFFECTIVE DATE.Subdivision 1 is effective February 1, 2008, and subdivision
74.272 is effective May 1, 2008.

74.28    Sec. 24. [256F.15] GRANT PROGRAM FOR CRISIS NURSERIES.
74.29    Subdivision 1. Crisis nurseries. The commissioner of human services shall
74.30establish a grant program to assist private and public agencies and organizations to
74.31provide crisis nurseries to offer services and temporary care to families experiencing crisis
74.32situations including children who are at high risk of abuse and neglect, children who have
74.33been abused and neglected, and children who are in families receiving child protective
75.1services. This service shall be provided without a fee for a maximum of 30 days in any
75.2year. Crisis nurseries shall provide short-term case management, family support services,
75.3parent education, crisis intervention, referrals, and resources, as needed.
75.4    (a) The crisis nurseries must provide a spectrum of services that may include, but
75.5are not limited to:
75.6    (1) being available 24 hours a day, seven days a week;
75.7    (2) providing services for children up to 72 hours at any one time;
75.8    (3) providing short-term case management to bridge the gap between crisis and
75.9successful living;
75.10    (4) making referrals for parents to counseling services and other community
75.11resources to help alleviate the underlying cause of the precipitating stress or crisis;
75.12    (5) providing services without a fee for a maximum of 30 days in any year;
75.13    (6) providing services to families with children from birth through 12 years of age,
75.14as services are available;
75.15    (7) providing an immediate response to family needs and strengths with an initial
75.16assessment and intake interview, making referrals to appropriate agencies or programs,
75.17and providing temporary care of children, as needed;
75.18    (8) maintaining the clients' confidentiality to the extent required by law, and also
75.19complying with statutory reporting requirements which may mandate a report to child
75.20protective services;
75.21    (9) providing a volunteer component and support for volunteers;
75.22    (10) providing preservice training and ongoing training to providers and volunteers;
75.23    (11) evaluating the services provided by documenting use of services, the result of
75.24family referrals made to community resources, and how the services reduced the risk of
75.25maltreatment;
75.26    (12) providing developmental assessments;
75.27    (13) providing medical assessments as determined by using a risk screening tool;
75.28    (14) providing parent education classes or programs that include parent-child
75.29interaction either on site or in collaboration with other community agencies; and
75.30    (15) having a multidisciplinary advisory board which may include one or more
75.31parents who have used the crisis nursery services.
75.32    (b) The crisis nurseries are encouraged to provide opportunities for parents to
75.33volunteer, if appropriate.
75.34    (c) Parents shall retain custody of their children during placement in a crisis facility.
75.35    Subd. 2. Fund distribution. In distributing funds, the commissioner shall give
75.36priority consideration to agencies and organizations with experience in working with
76.1abused or neglected children and their families, and with children at high risk of abuse and
76.2neglect and their families, and serve communities which demonstrate the greatest need
76.3for these services. Funds shall be distributed to crisis nurseries according to a formula
76.4developed by the commissioner in consultation with the Minnesota Crisis Nursery
76.5Association. The formula shall include funding for all existing crisis nursery programs
76.6that have been previously funded through the Department of Human Services and that
76.7meet program requirements as specified in subdivision 1, paragraph (a), and consideration
76.8of factors reflecting the need for services in each service area, including but not limited to
76.9the number of children 18 years of age and under living in the service area, the percent
76.10of children 18 years of age and under living in poverty in the service area, and factors
76.11reflecting the cost of providing services, including but not limited to the number of hours
76.12of service provided in the previous year.

76.13    Sec. 25. Minnesota Statutes 2006, section 256J.01, is amended by adding a subdivision
76.14to read:
76.15    Subd. 6. Legislative approval to move programs or activities. The commissioner
76.16shall not move programs or activities funded with MFIP or TANF maintenance of effort
76.17funds to other funding sources without legislative approval.

76.18    Sec. 26. Minnesota Statutes 2006, section 256J.02, subdivision 1, is amended to read:
76.19    Subdivision 1. Commissioner's authority to administer block grant funds. The
76.20commissioner of human services is authorized to receive, administer, and expend funds
76.21available under the TANF block grant authorized under title I of Public Law 104-193, the
76.22Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and under
76.23Public Law 109-171, the Deficit Reduction Act of 2005.

76.24    Sec. 27. Minnesota Statutes 2006, section 256J.02, subdivision 4, is amended to read:
76.25    Subd. 4. Authority to transfer. Subject to limitations of title I of Public Law
76.26104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
76.27as amended, and under Public Law 109-171, the Deficit Reduction Act of 2005, the
76.28legislature may transfer money from the TANF block grant to the child care fund under
76.29chapter 119B, or the Title XX block grant.

76.30    Sec. 28. Minnesota Statutes 2006, section 256J.021, is amended to read:
76.31256J.021 SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.
77.1    (a) Until October 1, 2006, the commissioner of human services must treat MFIP
77.2expenditures made to or on behalf of any minor child under section 256J.02, subdivision
77.32 , clause (1), who is a resident of this state under section 256J.12, and who is part of a
77.4two-parent eligible household as expenditures under a separately funded state program
77.5and report those expenditures to the federal Department of Health and Human Services as
77.6separate state program expenditures under Code of Federal Regulations, title 45, section
77.7263.5. Families receiving assistance under this section shall comply with all applicable
77.8requirements in this chapter.
77.9    (b) Beginning October 1, 2006, the commissioner of human services must treat
77.10MFIP expenditures made to or on behalf of any minor child under section 256J.02,
77.11subdivision 2, clause (1), who is a resident of this state under section 256J.12, and who is
77.12part of a two-parent eligible household, as expenditures under a separately funded state
77.13program. These expenditures shall not count toward the state's maintenance of effort
77.14(MOE) requirements under the federal Temporary Assistance to Needy Families (TANF)
77.15program except if counting certain families would allow the commissioner to avoid a
77.16federal penalty. Families receiving assistance under this section must comply with all
77.17applicable requirements in this chapter.
77.18    (c) Beginning July 1, 2007, the commissioner of human services shall treat MFIP
77.19expenditures made to or on behalf of any minor child who is part of a household that meets
77.20criteria in section 256J.575, subdivision 3, as expenditures under a separately funded state
77.21program under section 256J.575, subdivision 8.

77.22    Sec. 29. Minnesota Statutes 2006, section 256J.08, subdivision 65, is amended to read:
77.23    Subd. 65. Participant. (a) "Participant" means includes any of the following:
77.24    (1) a person who is currently receiving cash assistance or the food portion available
77.25through MFIP. A person who fails to withdraw or access electronically any portion of the
77.26person's cash and food assistance payment by the end of the payment month, who makes a
77.27written request for closure before the first of a payment month and repays cash and food
77.28assistance electronically issued for that payment month within that payment month, or
77.29who returns any uncashed assistance check and food coupons and withdraws from the
77.30program is not a participant.;
77.31    (2) a person who withdraws a cash or food assistance payment by electronic transfer
77.32or receives and cashes an MFIP assistance check or food coupons and is subsequently
77.33determined to be ineligible for assistance for that period of time is a participant, regardless
77.34whether that assistance is repaid. The term "participant" includes;
78.1    (3) the caregiver relative and the minor child whose needs are included in the
78.2assistance payment.;
78.3    (4) a person in an assistance unit who does not receive a cash and food assistance
78.4payment because the case has been suspended from MFIP is a participant.;
78.5    (5) a person who receives cash payments under the diversionary work program
78.6under section 256J.95 is a participant.; and
78.7    (6) a person who receives cash payments under family stabilization services under
78.8section 256J.575.
78.9    (b) "Participant" does not include a person who fails to withdraw or access
78.10electronically any portion of the person's cash and food assistance payment by the end of
78.11the payment month, who makes a written request for closure before the first of a payment
78.12month and repays cash and food assistance electronically issued for that payment month
78.13within that payment month, or who returns any uncashed assistance check and food
78.14coupons and withdraws from the program.
78.15EFFECTIVE DATE.This section is effective the day following final enactment.

78.16    Sec. 30. Minnesota Statutes 2006, section 256J.20, subdivision 3, is amended to read:
78.17    Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of
78.18all nonexcluded real and personal property of the assistance unit must not exceed $2,000
78.19for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
78.20(19) must be excluded when determining the equity value of real and personal property:
78.21    (1) a licensed vehicle up to a loan value of less than or equal to $7,500. The county
78.22agency shall apply any excess loan value as if it were equity value to the asset limit
78.23described in this section. If the assistance unit owns more than one licensed vehicle, the
78.24county agency shall determine the vehicle with the highest loan value and count only the
78.25loan value over $7,500, the loan value of all additional vehicles and exclude the combined
78.26loan value of less than or equal to $7,500. The county agency shall apply any excess loan
78.27value as if it were equity value to the asset limit described in this section, excluding: (i)
78.28the value of one vehicle per physically disabled person when the vehicle is needed to
78.29transport the disabled unit member; this exclusion does not apply to mentally disabled
78.30people; (ii) the value of special equipment for a disabled member of the assistance unit;
78.31and (iii) any vehicle used for long-distance travel, other than daily commuting, for the
78.32employment of a unit member.
78.33    The county agency shall count the loan value of all other vehicles and apply this
78.34amount as if it were equity value to the asset limit described in this section. To establish the
78.35loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide,
79.1Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook,
79.2or when the applicant or participant disputes the loan value listed in the guidebook as
79.3unreasonable given the condition of the particular vehicle, the county agency may require
79.4the applicant or participant document the loan value by securing a written statement from
79.5a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer
79.6would pay to purchase the vehicle. The county agency shall reimburse the applicant or
79.7participant for the cost of a written statement that documents a lower loan value;
79.8    (2) the value of life insurance policies for members of the assistance unit;
79.9    (3) one burial plot per member of an assistance unit;
79.10    (4) the value of personal property needed to produce earned income, including
79.11tools, implements, farm animals, inventory, business loans, business checking and
79.12savings accounts used at least annually and used exclusively for the operation of a
79.13self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
79.14is to produce income and if the vehicles are essential for the self-employment business;
79.15    (5) the value of personal property not otherwise specified which is commonly
79.16used by household members in day-to-day living such as clothing, necessary household
79.17furniture, equipment, and other basic maintenance items essential for daily living;
79.18    (6) the value of real and personal property owned by a recipient of Supplemental
79.19Security Income or Minnesota supplemental aid;
79.20    (7) the value of corrective payments, but only for the month in which the payment
79.21is received and for the following month;
79.22    (8) a mobile home or other vehicle used by an applicant or participant as the
79.23applicant's or participant's home;
79.24    (9) money in a separate escrow account that is needed to pay real estate taxes or
79.25insurance and that is used for this purpose;
79.26    (10) money held in escrow to cover employee FICA, employee tax withholding,
79.27sales tax withholding, employee worker compensation, business insurance, property rental,
79.28property taxes, and other costs that are paid at least annually, but less often than monthly;
79.29    (11) monthly assistance payments for the current month's or short-term emergency
79.30needs under section 256J.626, subdivision 2;
79.31    (12) the value of school loans, grants, or scholarships for the period they are
79.32intended to cover;
79.33    (13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
79.34in escrow for a period not to exceed three months to replace or repair personal or real
79.35property;
79.36    (14) income received in a budget month through the end of the payment month;
80.1    (15) savings from earned income of a minor child or a minor parent that are set aside
80.2in a separate account designated specifically for future education or employment costs;
80.3    (16) the federal earned income credit, Minnesota working family credit, state and
80.4federal income tax refunds, state homeowners and renters credits under chapter 290A,
80.5property tax rebates and other federal or state tax rebates in the month received and the
80.6following month;
80.7    (17) payments excluded under federal law as long as those payments are held in a
80.8separate account from any nonexcluded funds;
80.9    (18) the assets of children ineligible to receive MFIP benefits because foster care or
80.10adoption assistance payments are made on their behalf; and
80.11    (19) the assets of persons whose income is excluded under section 256J.21,
80.12subdivision 2 , clause (43).

80.13    Sec. 31. Minnesota Statutes 2006, section 256J.21, subdivision 2, is amended to read:
80.14    Subd. 2. Income exclusions. The following must be excluded in determining a
80.15family's available income:
80.16    (1) payments for basic care, difficulty of care, and clothing allowances received for
80.17providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
80.18to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used
80.19for care and maintenance of a third-party beneficiary who is not a household member;
80.20    (2) reimbursements for employment training received through the Workforce
80.21Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
80.22    (3) reimbursement for out-of-pocket expenses incurred while performing volunteer
80.23services, jury duty, employment, or informal carpooling arrangements directly related to
80.24employment;
80.25    (4) all educational assistance, except the county agency must count graduate student
80.26teaching assistantships, fellowships, and other similar paid work as earned income and,
80.27after allowing deductions for any unmet and necessary educational expenses, shall
80.28count scholarships or grants awarded to graduate students that do not require teaching
80.29or research as unearned income;
80.30    (5) loans, regardless of purpose, from public or private lending institutions,
80.31governmental lending institutions, or governmental agencies;
80.32    (6) loans from private individuals, regardless of purpose, provided an applicant or
80.33participant documents that the lender expects repayment;
80.34    (7)(i) state income tax refunds; and
80.35    (ii) federal income tax refunds;
81.1    (8)(i) federal earned income credits;
81.2    (ii) Minnesota working family credits;
81.3    (iii) state homeowners and renters credits under chapter 290A; and
81.4    (iv) federal or state tax rebates;
81.5    (9) funds received for reimbursement, replacement, or rebate of personal or real
81.6property when these payments are made by public agencies, awarded by a court, solicited
81.7through public appeal, or made as a grant by a federal agency, state or local government,
81.8or disaster assistance organizations, subsequent to a presidential declaration of disaster;
81.9    (10) the portion of an insurance settlement that is used to pay medical, funeral, and
81.10burial expenses, or to repair or replace insured property;
81.11    (11) reimbursements for medical expenses that cannot be paid by medical assistance;
81.12    (12) payments by a vocational rehabilitation program administered by the state
81.13under chapter 268A, except those payments that are for current living expenses;
81.14    (13) in-kind income, including any payments directly made by a third party to a
81.15provider of goods and services;
81.16    (14) assistance payments to correct underpayments, but only for the month in which
81.17the payment is received;
81.18    (15) payments for short-term emergency needs under section 256J.626, subdivision
81.192 ;
81.20    (16) funeral and cemetery payments as provided by section 256.935;
81.21    (17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
81.22a calendar month;
81.23    (18) any form of energy assistance payment made through Public Law 97-35,
81.24Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
81.25providers by other public and private agencies, and any form of credit or rebate payment
81.26issued by energy providers;
81.27    (19) Supplemental Security Income (SSI), including retroactive SSI payments and
81.28other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
81.29    (20) Minnesota supplemental aid, including retroactive payments;
81.30    (21) proceeds from the sale of real or personal property;
81.31    (22) state adoption assistance payments under section 259.67, and up to an equal
81.32amount of county adoption assistance payments;
81.33    (23) state-funded family subsidy program payments made under section 252.32
81.34to help families care for children with developmental disabilities, consumer support
81.35grant funds under section 256.476, and resources and services for a disabled household
82.1member under one of the home and community-based waiver services programs under
82.2chapter 256B;
82.3    (24) interest payments and dividends from property that is not excluded from and
82.4that does not exceed the asset limit;
82.5    (25) rent rebates;
82.6    (26) income earned by a minor caregiver, minor child through age 6, or a minor
82.7child who is at least a half-time student in an approved elementary or secondary education
82.8program;
82.9    (27) income earned by a caregiver under age 20 who is at least a half-time student in
82.10an approved elementary or secondary education program;
82.11    (28) MFIP child care payments under section 119B.05;
82.12    (29) all other payments made through MFIP to support a caregiver's pursuit of
82.13greater economic stability;
82.14    (30) income a participant receives related to shared living expenses;
82.15    (31) reverse mortgages;
82.16    (32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
82.1742, chapter 13A, sections 1771 to 1790;
82.18    (33) benefits provided by the women, infants, and children (WIC) nutrition program,
82.19United States Code, title 42, chapter 13A, section 1786;
82.20    (34) benefits from the National School Lunch Act, United States Code, title 42,
82.21chapter 13, sections 1751 to 1769e;
82.22    (35) relocation assistance for displaced persons under the Uniform Relocation
82.23Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
82.2442, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
82.25Code, title 12, chapter 13, sections 1701 to 1750jj;
82.26    (36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
82.2712, part 2, sections 2271 to 2322;
82.28    (37) war reparations payments to Japanese Americans and Aleuts under United
82.29States Code, title 50, sections 1989 to 1989d;
82.30    (38) payments to veterans or their dependents as a result of legal settlements
82.31regarding Agent Orange or other chemical exposure under Public Law 101-239, section
82.3210405, paragraph (a)(2)(E);
82.33    (39) income that is otherwise specifically excluded from MFIP consideration in
82.34federal law, state law, or federal regulation;
82.35    (40) security and utility deposit refunds;
83.1    (41) American Indian tribal land settlements excluded under Public Laws 98-123,
83.298-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
83.3Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
83.4under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
83.5    (42) all income of the minor parent's parents and stepparents when determining the
83.6grant for the minor parent in households that include a minor parent living with parents or
83.7stepparents on MFIP with other children;
83.8    (43) income of the minor parent's parents and stepparents equal to 200 percent of the
83.9federal poverty guideline for a family size not including the minor parent and the minor
83.10parent's child in households that include a minor parent living with parents or stepparents
83.11not on MFIP when determining the grant for the minor parent. The remainder of income is
83.12deemed as specified in section 256J.37, subdivision 1b;
83.13    (44) payments made to children eligible for relative custody assistance under section
83.14257.85 ;
83.15    (45) vendor payments for goods and services made on behalf of a client unless the
83.16client has the option of receiving the payment in cash; and
83.17    (46) the principal portion of a contract for deed payment.; and
83.18    (47) cash payments to individuals enrolled for full-time service as a volunteer under
83.19AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
83.20National, and AmeriCorps NCCC.

83.21    Sec. 32. Minnesota Statutes 2006, section 256J.32, subdivision 6, is amended to read:
83.22    Subd. 6. Recertification. The county agency shall recertify eligibility in an annual
83.23face-to-face interview with the participant and verify the following:
83.24    (1) presence of the minor child in the home, if questionable;
83.25    (2) income, unless excluded, including self-employment expenses used as a
83.26deduction or deposits or withdrawals from business accounts;
83.27    (3) assets when the value is within $200 of the asset limit;
83.28    (4) information to establish an exception under section 256J.24, subdivision 9,
83.29if questionable; and
83.30    (5) inconsistent information, if related to eligibility; and
83.31    (6) whether a single caregiver household meets requirements in section 256J.575,
83.32subdivision 3.

83.33    Sec. 33. Minnesota Statutes 2006, section 256J.37, subdivision 3a, is amended to read:
84.1    Subd. 3a. Rental subsidies; unearned income. (a) Effective July 1, 2003, the
84.2county agency shall count $50 $25 of the value of public and assisted rental subsidies
84.3provided through the Department of Housing and Urban Development (HUD) as unearned
84.4income to the cash portion of the MFIP grant. The full amount of the subsidy must be
84.5counted as unearned income when the subsidy is less than $50 $25. The income from this
84.6subsidy shall be budgeted according to section 256J.34.
84.7    (b) The provisions of this subdivision shall not apply to an MFIP assistance unit
84.8which includes a participant who is:
84.9    (1) age 60 or older;
84.10    (2) a caregiver who is suffering from an illness, injury, or incapacity that has been
84.11certified by a qualified professional when the illness, injury, or incapacity is expected
84.12to continue for more than 30 days and prevents the person from obtaining or retaining
84.13employment; or
84.14    (3) a caregiver whose presence in the home is required due to the illness or
84.15incapacity of another member in the assistance unit, a relative in the household, or a foster
84.16child in the household when the illness or incapacity and the need for the participant's
84.17presence in the home has been certified by a qualified professional and is expected to
84.18continue for more than 30 days.
84.19    (c) The provisions of this subdivision shall not apply to an MFIP assistance unit
84.20where the parental caregiver is an SSI recipient.
84.21    (d) Prior to implementing this provision, the commissioner must identify the MFIP
84.22participants subject to this provision and provide written notice to these participants at
84.23least 30 days before the first grant reduction. The notice must inform the participant of the
84.24basis for the potential grant reduction, the exceptions to the provision, if any, and inform
84.25the participant of the steps necessary to claim an exception. A person who is found not to
84.26meet one of the exceptions to the provision must be notified and informed of the right to a
84.27fair hearing under section 256J.40. The notice must also inform the participant that the
84.28participant may be eligible for a rent reduction resulting from a reduction in the MFIP
84.29grant and encourage the participant to contact the local housing authority.

84.30    Sec. 34. Minnesota Statutes 2006, section 256J.42, subdivision 1, is amended to read:
84.31    Subdivision 1. Time limit. (a) Except as otherwise provided for in this section, an
84.32assistance unit in which any adult caregiver has received 60 months of cash assistance
84.33funded in whole or in part by the TANF block grant in this or any other state or
84.34United States territory, or from a tribal TANF program, MFIP, the AFDC program
84.35formerly codified in sections 256.72 to 256.87, or the family general assistance program
85.1formerly codified in sections 256D.01 to 256D.23, funded in whole or in part by state
85.2appropriations, is ineligible to receive MFIP. Any cash assistance funded with TANF
85.3dollars in this or any other state or United States territory, or from a tribal TANF program,
85.4or MFIP assistance funded in whole or in part by state appropriations, that was received
85.5by the unit on or after the date TANF was implemented, including any assistance received
85.6in states or United States territories of prior residence, counts toward the 60-month
85.7limitation. Months during which any cash assistance is received by an assistance unit
85.8with a mandatory member who is disqualified for wrongfully obtaining public assistance
85.9under section 256.98, subdivision 8, counts toward the time limit for the disqualified
85.10member. The 60-month limit applies to a minor caregiver except under subdivision 5. The
85.1160-month time period does not need to be consecutive months for this provision to apply.
85.12    (b) The months before July 1998 in which individuals received assistance as part of
85.13the field trials as an MFIP, MFIP-R, or MFIP or MFIP-R comparison group family are
85.14not included in the 60-month time limit.
85.15EFFECTIVE DATE.This section is effective October 1, 2007.

85.16    Sec. 35. Minnesota Statutes 2006, section 256J.46, is amended by adding a subdivision
85.17to read:
85.18    Subd. 3. Restrictions on sanctions. A participant shall not be sanctioned for
85.19failure to meet the agreed upon hours in a participant's employment plan under section
85.20256J.521, subdivision 2, when the participant fails to meet the agreed upon hours of
85.21participation in paid employment because the participant is not eligible for holiday pay
85.22and the participant's place of employment is closed for a holiday.

85.23    Sec. 36. Minnesota Statutes 2006, section 256J.49, subdivision 13, is amended to read:
85.24    Subd. 13. Work activity. "Work activity" means any activity in a participant's
85.25approved employment plan that leads to employment. For purposes of the MFIP program,
85.26this includes activities that meet the definition of work activity under the participation
85.27requirements of TANF. Work activity includes:
85.28    (1) unsubsidized employment, including work study and paid apprenticeships or
85.29internships;
85.30    (2) subsidized private sector or public sector employment, including grant diversion
85.31as specified in section 256J.69, on-the-job training as specified in section 256J.66,
85.32the self-employment investment demonstration program (SEID) as specified in section
85.33256J.65 , paid work experience, and supported work when a wage subsidy is provided;
86.1    (3) unpaid work experience, including community service, volunteer work,
86.2the community work experience program as specified in section 256J.67, unpaid
86.3apprenticeships or internships, and supported work when a wage subsidy is not provided;.
86.4Unpaid work experience is only an option if the participant has been unable to obtain or
86.5maintain paid employment in the competitive labor market, and no paid work experience
86.6programs are available to the participant. Unless a participant consents to participating
86.7in unpaid work experience, the participant's employment plan may only include unpaid
86.8work experience if including the unpaid work experience in the plan will meet the
86.9following criteria:
86.10    (i) the unpaid work experience will provide the participant specific skills or
86.11experience that cannot be obtained through other work activity options where the
86.12participant resides or is willing to reside; and
86.13    (ii) the skills or experience gained through the unpaid work experience will result
86.14in higher wages for the participant than the participant could earn without the unpaid
86.15work experience;
86.16    (4) job search including job readiness assistance, job clubs, job placement,
86.17job-related counseling, and job retention services;
86.18    (5) job readiness education, including English as a second language (ESL) or
86.19functional work literacy classes as limited by the provisions of section 256J.531,
86.20subdivision 2 , general educational development (GED) course work, high school
86.21completion, and adult basic education as limited by the provisions of section 256J.531,
86.22subdivision 1 ;
86.23    (6) job skills training directly related to employment, including education and
86.24training that can reasonably be expected to lead to employment, as limited by the
86.25provisions of section 256J.53;
86.26    (7) providing child care services to a participant who is working in a community
86.27service program;
86.28    (8) activities included in the employment plan that is developed under section
86.29256J.521, subdivision 3 ; and
86.30    (9) preemployment activities including chemical and mental health assessments,
86.31treatment, and services; learning disabilities services; child protective services; family
86.32stabilization services; or other programs designed to enhance employability.

86.33    Sec. 37. Minnesota Statutes 2006, section 256J.521, subdivision 1, is amended to read:
86.34    Subdivision 1. Assessments. (a) For purposes of MFIP employment services,
86.35assessment is a continuing process of gathering information related to employability
87.1for the purpose of identifying both participant's strengths and strategies for coping with
87.2issues that interfere with employment. The job counselor must use information from the
87.3assessment process to develop and update the employment plan under subdivision 2 or 3,
87.4as appropriate, and to determine whether the participant qualifies for a family violence
87.5waiver including an employment plan under subdivision 3, and to determine whether the
87.6participant should be referred to family stabilization services under section 256J.575.
87.7    (b) The scope of assessment must cover at least the following areas:
87.8    (1) basic information about the participant's ability to obtain and retain employment,
87.9including: a review of the participant's education level; interests, skills, and abilities; prior
87.10employment or work experience; transferable work skills; child care and transportation
87.11needs;
87.12    (2) identification of personal and family circumstances that impact the participant's
87.13ability to obtain and retain employment, including: any special needs of the children, the
87.14level of English proficiency, family violence issues, and any involvement with social
87.15services or the legal system;
87.16    (3) the results of a mental and chemical health screening tool designed by the
87.17commissioner and results of the brief screening tool for special learning needs. Screening
87.18tools for mental and chemical health and special learning needs must be approved by the
87.19commissioner and may only be administered by job counselors or county staff trained in
87.20using such screening tools. The commissioner shall work with county agencies to develop
87.21protocols for referrals and follow-up actions after screens are administered to participants,
87.22including guidance on how employment plans may be modified based upon outcomes
87.23of certain screens. Participants must be told of the purpose of the screens and how the
87.24information will be used to assist the participant in identifying and overcoming barriers to
87.25employment. Screening for mental and chemical health and special learning needs must
87.26be completed by participants who are unable to find suitable employment after six weeks
87.27of job search under subdivision 2, paragraph (b), and participants who are determined to
87.28have barriers to employment under subdivision 2, paragraph (d). Failure to complete the
87.29screens will result in sanction under section 256J.46; and
87.30    (4) a comprehensive review of participation and progress for participants who have
87.31received MFIP assistance and have not worked in unsubsidized employment during the
87.32past 12 months. The purpose of the review is to determine the need for additional services
87.33and supports, including placement in subsidized employment or unpaid work experience
87.34under section 256J.49, subdivision 13, or referral to family stabilization services under
87.35section 256J.575 .
88.1    (c) Information gathered during a caregiver's participation in the diversionary work
88.2program under section 256J.95 must be incorporated into the assessment process.
88.3    (d) The job counselor may require the participant to complete a professional chemical
88.4use assessment to be performed according to the rules adopted under section 254A.03,
88.5subdivision 3 , including provisions in the administrative rules which recognize the cultural
88.6background of the participant, or a professional psychological assessment as a component
88.7of the assessment process, when the job counselor has a reasonable belief, based on
88.8objective evidence, that a participant's ability to obtain and retain suitable employment
88.9is impaired by a medical condition. The job counselor may assist the participant with
88.10arranging services, including child care assistance and transportation, necessary to meet
88.11needs identified by the assessment. Data gathered as part of a professional assessment
88.12must be classified and disclosed according to the provisions in section 13.46.

88.13    Sec. 38. Minnesota Statutes 2006, section 256J.521, subdivision 2, is amended to read:
88.14    Subd. 2. Employment plan; contents. (a) Based on the assessment under
88.15subdivision 1, the job counselor and the participant must develop an employment plan
88.16that includes participation in activities and hours that meet the requirements of section
88.17256J.55, subdivision 1 . The purpose of the employment plan is to identify for each
88.18participant the most direct path to unsubsidized employment and any subsequent steps that
88.19support long-term economic stability. The employment plan should be developed using
88.20the highest level of activity appropriate for the participant. Activities must be chosen from
88.21clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of
88.22preference for activities, priority must be given for activities related to a family violence
88.23waiver when developing the employment plan. The employment plan must also list the
88.24specific steps the participant will take to obtain employment, including steps necessary
88.25for the participant to progress from one level of activity to another, and a timetable for
88.26completion of each step. Levels of activity include:
88.27    (1) unsubsidized employment;
88.28    (2) job search;
88.29    (3) subsidized employment or unpaid work experience;
88.30    (4) unsubsidized employment and job readiness education or job skills training;
88.31    (5) unsubsidized employment or unpaid work experience and activities related to
88.32a family violence waiver or preemployment needs; and
88.33    (6) activities related to a family violence waiver or preemployment needs.
88.34    (b) Participants who are determined to possess sufficient skills such that the
88.35participant is likely to succeed in obtaining unsubsidized employment must job search at
89.1least 30 hours per week for up to six weeks and accept any offer of suitable employment.
89.2The remaining hours necessary to meet the requirements of section 256J.55, subdivision
89.31 , may be met through participation in other work activities under section 256J.49,
89.4subdivision 13 . The participant's employment plan must specify, at a minimum: (1)
89.5whether the job search is supervised or unsupervised; (2) support services that will
89.6be provided; and (3) how frequently the participant must report to the job counselor.
89.7Participants who are unable to find suitable employment after six weeks must meet
89.8with the job counselor to determine whether other activities in paragraph (a) should be
89.9incorporated into the employment plan. Job search activities which are continued after six
89.10weeks must be structured and supervised.
89.11    (c) Beginning July 1, 2004, activities and hourly requirements in the employment
89.12plan may be adjusted as necessary to accommodate the personal and family circumstances
89.13of participants identified under section 256J.561, subdivision 2, paragraph (d). Participants
89.14who no longer meet the provisions of section 256J.561, subdivision 2, paragraph (d),
89.15must meet with the job counselor within ten days of the determination to revise the
89.16employment plan.
89.17    (d) Participants who are determined to have barriers to obtaining or retaining
89.18employment that will not be overcome during six weeks of job search under paragraph (b)
89.19must work with the job counselor to develop an employment plan that addresses those
89.20barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6).
89.21The employment plan must include enough hours to meet the participation requirements
89.22in section 256J.55, subdivision 1, unless a compelling reason to require fewer hours
89.23is noted in the participant's file.
89.24    (e) The job counselor and the participant must sign the employment plan to indicate
89.25agreement on the contents.
89.26    (f) Except as provided under paragraph (g), failure to develop or comply with
89.27activities in the plan, or voluntarily quitting suitable employment without good cause, will
89.28result in the imposition of a sanction under section 256J.46.
89.29    (g) When a participant fails to meet the agreed upon hours of participation in paid
89.30employment because the participant is not eligible for holiday pay and the participant's
89.31place of employment is closed for a holiday, the job counselor shall not impose a sanction
89.32or increase the hours of participation in any other activity, including paid employment, to
89.33offset the hours that were missed due to the holiday.
89.34    (f) (h) Employment plans must be reviewed at least every three months to determine
89.35whether activities and hourly requirements should be revised. The job counselor is
89.36encouraged to allow participants who are participating in at least 20 hours of work
90.1activities to also participate in education and training activities in order to meet the federal
90.2hourly participations rates.

90.3    Sec. 39. Minnesota Statutes 2006, section 256J.53, subdivision 2, is amended to read:
90.4    Subd. 2. Approval of postsecondary education or training. (a) In order for a
90.5postsecondary education or training program to be an approved activity in an employment
90.6plan, the participant must be working in unsubsidized employment at least 20 hours per
90.7week. plan must include additional work activities if the education and training activities
90.8do not meet the minimum hours required to meet the federal work participation rate under
90.9Code of Federal Regulations, title 45, sections 261.31 and 261.35.
90.10    (b) Participants seeking approval of a postsecondary education or training plan
90.11must provide documentation that:
90.12    (1) the employment goal can only be met with the additional education or training;
90.13    (2) there are suitable employment opportunities that require the specific education or
90.14training in the area in which the participant resides or is willing to reside;
90.15    (3) the education or training will result in significantly higher wages for the
90.16participant than the participant could earn without the education or training;
90.17    (4) the participant can meet the requirements for admission into the program; and
90.18    (5) there is a reasonable expectation that the participant will complete the training
90.19program based on such factors as the participant's MFIP assessment, previous education,
90.20training, and work history; current motivation; and changes in previous circumstances.
90.21    (c) The hourly unsubsidized employment requirement does not apply for intensive
90.22education or training programs lasting 12 weeks or less when full-time attendance is
90.23required.
90.24    (d) Participants with an approved employment plan in place on July 1, 2003, which
90.25includes more than 12 months of postsecondary education or training shall be allowed to
90.26complete that plan provided that hourly requirements in section 256J.55, subdivision 1,
90.27and conditions specified in paragraph (b), and subdivisions 3 and 5 are met. A participant
90.28whose case is subsequently closed for three months or less for reasons other than
90.29noncompliance with program requirements and who returns to MFIP shall be allowed to
90.30complete that plan provided that hourly requirements in section 256J.55, subdivision 1,
90.31and conditions specified in paragraph (b) and subdivisions 3 and 5 are met.

90.32    Sec. 40. Minnesota Statutes 2006, section 256J.55, subdivision 1, is amended to read:
91.1    Subdivision 1. Participation requirements. (a) All caregivers must participate
91.2in employment services under sections 256J.515 to 256J.57 concurrent with receipt of
91.3MFIP assistance.
91.4    (b) Until July 1, 2004, participants who meet the requirements of section 256J.56 are
91.5exempt from participation requirements.
91.6    (c) Participants under paragraph (a) must develop and comply with an employment
91.7plan under section 256J.521 or section 256J.54 in the case of a participant under the age of
91.820 who has not obtained a high school diploma or its equivalent.
91.9    (d) With the exception of participants under the age of 20 who must meet the
91.10education requirements of section 256J.54, all participants must meet the hourly
91.11participation requirements of TANF or the hourly requirements listed in clauses (1) to
91.12(3), whichever is higher.
91.13    (1) In single-parent families with no children under six years of age, the job
91.14counselor and the caregiver must develop an employment plan that includes 30 to 35 hours
91.15per week of work activities 130 hours per month of work activities.
91.16    (2) In single-parent families with a child under six years of age, the job counselor
91.17and the caregiver must develop an employment plan that includes 20 to 35 hours per week
91.18of work activities 87 hours per month of work activities.
91.19    (3) In two-parent families, the job counselor and the caregivers must develop
91.20employment plans which result in a combined total of at least 55 hours per week of work
91.21activities.
91.22    (e) Failure to participate in employment services, including the requirement to
91.23develop and comply with an employment plan, including hourly requirements, without
91.24good cause under section 256J.57, shall result in the imposition of a sanction under section
91.25256J.46 .

91.26    Sec. 41. [256J.575] FAMILY STABILIZATION SERVICES.
91.27    Subdivision 1. Purpose. (a) The family stabilization services serve families who are
91.28not making significant progress within the Minnesota family investment program (MFIP)
91.29due to a variety of barriers to employment.
91.30    (b) The goal of the services is to stabilize and improve the lives of families at risk
91.31of long-term welfare dependency or family instability due to employment barriers such
91.32as physical disability, mental disability, age, or providing care for a disabled household
91.33member. These services promote and support families to achieve the greatest possible
91.34degree of self-sufficiency.
92.1    Subd. 2. Definitions. The terms used in this section have the meanings given them
92.2in paragraphs (a) to (d).
92.3    (a) "Case manager" means the county-designated staff person or employment
92.4services counselor.
92.5    (b) "Case management" means the services provided by or through the county
92.6agency or through the employment services agency to participating families, including
92.7assessment, information, referrals, and assistance in the preparation and implementation
92.8of a family stabilization plan under subdivision 5.
92.9    (c) "Family stabilization plan" means a plan developed by a case manager and
92.10the participant, which identifies the participant's most appropriate path to unsubsidized
92.11employment, family stability, and barrier reduction, taking into account the family's
92.12circumstances.
92.13    (d) "Family stabilization services" means programs, activities, and services in this
92.14section that provide participants and their family members with assistance regarding,
92.15but not limited to:
92.16    (1) obtaining and retaining unsubsidized employment;
92.17    (2) family stability;
92.18    (3) economic stability; and
92.19    (4) barrier reduction.
92.20    The goal of the services is to achieve the greatest degree of economic self-sufficiency
92.21and family well-being possible for the family under the circumstances.
92.22    Subd. 3. Eligibility. (a) The following MFIP or diversionary work program (DWP)
92.23participants are eligible for the services under this section:
92.24    (1) a participant who meets the requirements for or has been granted a hardship
92.25extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for
92.26the participant to have reached or be approaching 60 months of eligibility for this section
92.27to apply;
92.28    (2) a participant who is applying for supplemental security income or Social Security
92.29disability insurance; and
92.30    (3) a participant who is a noncitizen who has been in the United States for 12 or
92.31fewer months.
92.32    (b) Families must meet all other eligibility requirements for MFIP established in
92.33this chapter. Families are eligible for financial assistance to the same extent as if they
92.34were participating in MFIP.
92.35    (c) A participant under paragraph (a), clause (3), must be provided with English as a
92.36second language opportunities and skills training for up to 12 months. After 12 months,
93.1the case manager and participant must determine whether the participant should continue
93.2with English as a second language classes or skills training, or both, and continue to
93.3receive family stabilization services.
93.4    Subd. 4. Universal participation. All caregivers must participate in family
93.5stabilization services as defined in subdivision 2.
93.6    Subd. 5. Case management; family stabilization plans; coordinated services.
93.7    (a) The county agency or employment services provider shall provide family stabilization
93.8services to families through a case management model. A case manager shall be assigned
93.9to each participating family within 30 days after the family is determined to be eligible
93.10for family stabilization services. The case manager, with the full involvement of the
93.11participant, shall recommend, and the county agency shall establish and modify as
93.12necessary, a family stabilization plan for each participating family. If a participant is
93.13already assigned to a county case manager or a county-designated case manager in social
93.14services, disability services, or housing services that case manager already assigned may
93.15be the case manager for purposes of these services.
93.16    (b) The family stabilization plan must include:
93.17    (1) each participant's plan for long-term self-sufficiency, including an employment
93.18goal where applicable;
93.19    (2) an assessment of each participant's strengths and barriers, and any special
93.20circumstances of the participant's family that impact, or are likely to impact, the
93.21participant's progress towards the goals in the plan; and
93.22    (3) an identification of the services, supports, education, training, and
93.23accommodations needed to reduce or overcome any barriers to enable the family to
93.24achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.
93.25    (c) The case manager and the participant shall meet within 30 days of the family's
93.26referral to the case manager. The initial family stabilization plan must be completed within
93.2730 days of the first meeting with the case manager. The case manager shall establish a
93.28schedule for periodic review of the family stabilization plan that includes personal contact
93.29with the participant at least once per month. In addition, the case manager shall review
93.30and, if necessary, modify the plan under the following circumstances:
93.31    (1) there is a lack of satisfactory progress in achieving the goals of the plan;
93.32    (2) the participant has lost unsubsidized or subsidized employment;
93.33    (3) a family member has failed or is unable to comply with a family stabilization
93.34plan requirement;
93.35    (4) services, supports, or other activities required by the plan are unavailable;
93.36    (5) changes to the plan are needed to promote the well-being of the children; or
94.1    (6) the participant and case manager determine that the plan is no longer appropriate
94.2for any other reason.
94.3    Subd. 6. Cooperation with services requirements. (a) To be eligible, a participant
94.4shall comply with paragraphs (b) to (d).
94.5    (b) Participants shall engage in family stabilization plan services for the appropriate
94.6number of hours per week that the activities are scheduled and available, unless good
94.7cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate
94.8number of hours must be based on the participant's plan.
94.9    (c) The case manager shall review the participant's progress toward the goals in the
94.10family stabilization plan every six months to determine whether conditions have changed,
94.11including whether revisions to the plan are needed.
94.12    (d) A participant's requirement to comply with any or all family stabilization plan
94.13requirements under this subdivision is excused when the case management services,
94.14training and educational services, or family support services identified in the participant's
94.15family stabilization plan are unavailable for reasons beyond the control of the participant,
94.16including when money appropriated is not sufficient to provide the services.
94.17    Subd. 7. Sanctions. (a) The financial assistance grant of a participating family is
94.18reduced according to section 256J.46, if a participating adult fails without good cause to
94.19comply or continue to comply with the family stabilization plan requirements in this
94.20subdivision, unless compliance has been excused under subdivision 6, paragraph (e).
94.21    (b) Given the purpose of the family stabilization services in this section and the
94.22nature of the underlying family circumstances that act as barriers to both employment and
94.23full compliance with program requirements, there must be a review by the county agency
94.24prior to imposing a sanction to determine whether the plan was appropriated to the needs
94.25of the participant and family, and that the participant in all ways had the ability to comply
94.26with the plan, as confirmed by a behavioral health or medical professional.
94.27    (c) Prior to the imposition of a sanction, the county agency or employment services
94.28provider shall review the participant's case to determine if the family stabilization plan
94.29is still appropriate and meet with the participant face-to-face. The participant may bring
94.30an advocate to the face-to-face meeting.
94.31    During the face-to-face meeting, the county agency shall:
94.32    (1) determine whether the continued noncompliance can be explained and mitigated
94.33by providing a needed family stabilization service, as defined in subdivision 2, paragraph
94.34(d);
94.35    (2) determine whether the participant qualifies for a good cause exception under
94.36section 256J.57, or if the sanction is for noncooperation with child support requirements,
95.1determine if the participant qualifies for a good cause exemption under section 256.741,
95.2subdivision 10;
95.3    (3) determine whether activities in the family stabilization plan are appropriate
95.4based on the family's circumstances;
95.5    (4) explain the consequences of continuing noncompliance;
95.6    (5) identify other resources that may be available to the participant to meet the
95.7needs of the family; and
95.8    (6) inform the participant of the right to appeal under section 256J.40.
95.9    If the lack of an identified activity or service can explain the noncompliance, the
95.10county shall work with the participant to provide the identified activity.
95.11    (d) If the participant fails to come to the face-to-face meeting, the case manager or a
95.12designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
95.13the county agency shall send the participant a written notice that includes the information
95.14under paragraph (c).
95.15    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
95.16of a sanction, the county agency shall provide a notice of intent to sanction under section
95.17256J.57, subdivision 2, and, when applicable, a notice of adverse action under section
95.18256J.31.
95.19    (f) Section 256J.57 applies to this section except to the extent that it is modified
95.20by this subdivision.
95.21    Subd. 8. Funding. (a) The commissioner of human services shall treat MFIP
95.22expenditures made to or on behalf of any minor child under this section, who is part of a
95.23household that meets criteria in subdivision 3, as expenditures under a separately funded
95.24state program. These expenditures shall not count toward the state's maintenance of effort
95.25requirements under the federal TANF program.
95.26    (b) A family is no longer part of a separately funded program under this section if
95.27the caregiver no longer meets the criteria for family stabilization services in subdivision 3,
95.28or if it is determined at recertification that a caregiver with a child under the age of six
95.29is working at least 87 hours per month in paid or unpaid employment, or a caregiver
95.30without a child under the age of six is working at least 130 hours per month in paid or
95.31unpaid employment, whichever occurs sooner.

95.32    Sec. 42. [256J.621] WORK PARTICIPATION BONUS.
95.33    (a) Upon exiting the diversionary work program (DWP) or upon terminating
95.34MFIP cash assistance with earnings, a participant who is employed may be eligible for
96.1transitional assistance of $100 per month to assist in meeting the family's basic needs as
96.2the participant continues to move toward self-sufficiency.
96.3    (b) To be eligible for a transitional assistance payment, the participant shall not
96.4receive MFIP cash assistance or diversionary work program assistance during the month
96.5and the participant or participants must meet the following work requirements:
96.6    (1) if the participant is a single caregiver and has a child under six years of age, the
96.7participant must be employed at least 87 hours per month;
96.8    (2) if the participant is a single caregiver and does not have a child under six years of
96.9age, the participant must be employed at least 130 hours per month; or
96.10    (3) if the household is a two-parent family, at least one of the parents must be
96.11employed an average of at least 130 hours per month.
96.12    Whenever a participant exits the diversionary work program or is terminated from
96.13MFIP cash assistance and meets the other criteria in this section, transitional assistance is
96.14available for up to 24 consecutive months.
96.15    (c) Expenditures on the program are maintenance of effort state funds for participants
96.16under paragraph (b), clauses (1) and (2). Expenditures for participants under paragraph
96.17(b), clause (3), are nonmaintenance of effort funds. Months in which a participant
96.18receives transitional assistance under this section do not count toward the participant's
96.19MFIP 60-month time limit.
96.20EFFECTIVE DATE.This section is effective February 1, 2009.

96.21    Sec. 43. Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:
96.22    Subdivision 1. Consolidated fund. The consolidated fund is established to support
96.23counties and tribes in meeting their duties under this chapter. Counties and tribes must use
96.24funds from the consolidated fund to develop programs and services that are designed to
96.25improve participant outcomes as measured in section 256J.751, subdivision 2. Counties
96.26may use the funds for any allowable expenditures under subdivision 2, including case
96.27management. Tribes may use the funds for any allowable expenditures under subdivision
96.282, including case management, except those in subdivision 2, paragraph (a), clauses (1)
96.29and (6).

96.30    Sec. 44. Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:
96.31    Subd. 2. Allowable expenditures. (a) The commissioner must restrict expenditures
96.32under the consolidated fund to benefits and services allowed under title IV-A of the federal
96.33Social Security Act. Allowable expenditures under the consolidated fund may include, but
96.34are not limited to:
97.1    (1) short-term, nonrecurring shelter and utility needs that are excluded from the
97.2definition of assistance under Code of Federal Regulations, title 45, section 260.31, for
97.3families who meet the residency requirement in section 256J.12, subdivisions 1 and 1a.
97.4Payments under this subdivision are not considered TANF cash assistance and are not
97.5counted towards the 60-month time limit;
97.6    (2) transportation needed to obtain or retain employment or to participate in other
97.7approved work activities or activities under a family stabilization plan;
97.8    (3) direct and administrative costs of staff to deliver employment services for
97.9MFIP or, the diversionary work program, or family stabilization services; to administer
97.10financial assistance,; and to provide specialized services intended to assist hard-to-employ
97.11participants to transition to work or transition from family stabilization services to MFIP;
97.12    (4) costs of education and training including functional work literacy and English as
97.13a second language;
97.14    (5) cost of work supports including tools, clothing, boots, telephone service, and
97.15other work-related expenses;
97.16    (6) county administrative expenses as defined in Code of Federal Regulations, title
97.1745, section 260(b);
97.18    (7) services to parenting and pregnant teens;
97.19    (8) supported work;
97.20    (9) wage subsidies;
97.21    (10) child care needed for MFIP or, the diversionary work program, or family
97.22stabilization services participants to participate in social services;
97.23    (11) child care to ensure that families leaving MFIP or diversionary work program
97.24will continue to receive child care assistance from the time the family no longer qualifies
97.25for transition year child care until an opening occurs under the basic sliding fee child
97.26care program; and
97.27    (12) services to help noncustodial parents who live in Minnesota and have minor
97.28children receiving MFIP or DWP assistance, but do not live in the same household as the
97.29child, obtain or retain employment; and
97.30    (13) services to help families participating in family stabilization services achieve
97.31the greatest possible degree of self-sufficiency.
97.32    (b) Administrative costs that are not matched with county funds as provided in
97.33subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation
97.34under this section. The commissioner shall define administrative costs for purposes of
97.35this subdivision.
98.1    (c) The commissioner may waive the cap on administrative costs for a county or tribe
98.2that elects to provide an approved supported employment, unpaid work, or community
98.3work experience program for a major segment of the county's or tribe's MFIP population.
98.4The county or tribe must apply for the waiver on forms provided by the commissioner. In
98.5no case shall total administrative costs exceed the TANF limits.

98.6    Sec. 45. Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:
98.7    Subd. 3. Eligibility for services. Families with a minor child, a pregnant woman,
98.8or a noncustodial parent of a minor child receiving assistance, with incomes below 200
98.9percent of the federal poverty guideline for a family of the applicable size, are eligible
98.10for services funded under the consolidated fund. Counties and tribes must give priority
98.11to families currently receiving MFIP or, the diversionary work program, or family
98.12stabilization services, and families at risk of receiving MFIP or diversionary work program.

98.13    Sec. 46. Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:
98.14    Subd. 4. County and tribal biennial service agreements. (a) Effective January 1,
98.152004, and each two-year period thereafter, each county and tribe must have in place an
98.16approved biennial service agreement related to the services and programs in this chapter.
98.17In counties with a city of the first class with a population over 300,000, the county must
98.18consider a service agreement that includes a jointly developed plan for the delivery of
98.19employment services with the city. Counties may collaborate to develop multicounty,
98.20multitribal, or regional service agreements.
98.21    (b) The service agreements will be completed in a form prescribed by the
98.22commissioner. The agreement must include:
98.23    (1) a statement of the needs of the service population and strengths and resources
98.24in the community;
98.25    (2) numerical goals for participant outcomes measures to be accomplished during
98.26the biennial period. The commissioner may identify outcomes from section 256J.751,
98.27subdivision 2 , as core outcomes for all counties and tribes;
98.28    (3) strategies the county or tribe will pursue to achieve the outcome targets.
98.29Strategies must include specification of how funds under this section will be used and may
98.30include community partnerships that will be established or strengthened; and
98.31    (4) strategies the county or tribe will pursue under family stabilization services ; and
98.32    (5) other items prescribed by the commissioner in consultation with counties and
98.33tribes.
99.1    (c) The commissioner shall provide each county and tribe with information needed
99.2to complete an agreement, including: (1) information on MFIP cases in the county or
99.3tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome
99.4measures; and (4) promising program practices.
99.5    (d) The service agreement must be submitted to the commissioner by October 15,
99.62003, and October 15 of each second year thereafter. The county or tribe must allow
99.7a period of not less than 30 days prior to the submission of the agreement to solicit
99.8comments from the public on the contents of the agreement.
99.9    (e) The commissioner must, within 60 days of receiving each county or tribal service
99.10agreement, inform the county or tribe if the service agreement is approved. If the service
99.11agreement is not approved, the commissioner must inform the county or tribe of any
99.12revisions needed prior to approval.
99.13    (f) The service agreement in this subdivision supersedes the plan requirements
99.14of section 116L.88.

99.15    Sec. 47. Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:
99.16    Subd. 5. Innovation projects. Beginning January 1, 2005, no more than $3,000,000
99.17of the funds annually appropriated to the commissioner for use in the consolidated fund
99.18shall be available to the commissioner for projects testing innovative approaches to
99.19improving outcomes for MFIP participants, family stabilization services participants,
99.20and persons at risk of receiving MFIP as detailed in subdivision 3, and for providing
99.21incentives to counties and tribes that exceed performance. Projects shall be targeted to
99.22geographic areas with poor outcomes as specified in section 256J.751, subdivision 5, or to
99.23subgroups within the MFIP case load who are experiencing poor outcomes. For purposes
99.24of an incentive, a county or tribe exceeds performance if the county or tribe is above the
99.25top of the county or tribe's annualized range of expected performance on the three-year
99.26self-support index under section 256J.751, subdivision 2, clause (6), and achieves a 50
99.27percent MFIP participation rate under section 256J.751, subdivision 2, clause (7), as
99.28averaged across the four quarterly measurements for the most recent year for which the
99.29measurements are available.

99.30    Sec. 48. Minnesota Statutes 2006, section 256J.626, subdivision 6, is amended to read:
99.31    Subd. 6. Base allocation to counties and tribes; definitions. (a) For purposes of
99.32this section, the following terms have the meanings given.
99.33    (1) "2002 historic spending base" means the commissioner's determination of
99.34the sum of the reimbursement related to fiscal year 2002 of county or tribal agency
100.1expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings
100.2related to calendar year 2002 in the base program listed in clause (6), item (v), and the
100.3amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi),
100.4issued to or on behalf of persons residing in the county or tribal service delivery area.
100.5    (2) "Adjusted caseload factor" means a factor weighted:
100.6    (i) 47 percent on the MFIP cases in each county at four points in time in the most
100.7recent 12-month period for which data is available multiplied by the county's caseload
100.8difficulty factor; and
100.9    (ii) 53 percent on the count of adults on MFIP in each county and tribe at four points
100.10in time in the most recent 12-month period for which data is available multiplied by the
100.11county or tribe's caseload difficulty factor.
100.12    (3) "Caseload difficulty factor" means a factor determined by the commissioner for
100.13each county and tribe based upon the self-support index described in section 256J.751,
100.14subdivision 2 , clause (7) (6).
100.15    (4) "Initial allocation" means the amount potentially available to each county or tribe
100.16based on the formula in paragraphs (b) through (h) (d).
100.17    (5) "Final allocation" means the amount available to each county or tribe based on
100.18the formula in paragraphs (b) through (h) (d), after adjustment by subdivision 7.
100.19    (6) "Base programs" means the:
100.20    (i) MFIP employment and training services under Minnesota Statutes 2002, section
100.21256J.62, subdivision 1 , in effect June 30, 2002;
100.22    (ii) bilingual employment and training services to refugees under Minnesota Statutes
100.232002, section 256J.62, subdivision 6, in effect June 30, 2002;
100.24    (iii) work literacy language programs under Minnesota Statutes 2002, section
100.25256J.62, subdivision 7 , in effect June 30, 2002;
100.26    (iv) supported work program authorized in Laws 2001, First Special Session chapter
100.279, article 17, section 2, in effect June 30, 2002;
100.28    (v) administrative aid program under section 256J.76 in effect December 31, 2002;
100.29and
100.30    (vi) emergency assistance program under Minnesota Statutes 2002, section 256J.48,
100.31in effect June 30, 2002.
100.32    (b) The commissioner shall:
100.33    (1) beginning July 1, 2003, determine the initial allocation of funds available under
100.34this section according to clause (2);
101.1    (2) allocate all of the funds available for the period beginning July 1, 2003, and
101.2ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's
101.3share of the statewide 2002 historic spending base;
101.4    (3) determine for calendar year 2005 the initial allocation of funds to be made
101.5available under this section in proportion to the county or tribe's initial allocation for the
101.6period of July 1, 2003, to December 31, 2004;
101.7    (4) determine for calendar year 2006 the initial allocation of funds to be made
101.8available under this section based 90 percent on the proportion of the county or tribe's
101.9share of the statewide 2002 historic spending base and ten percent on the proportion of
101.10the county or tribe's share of the adjusted caseload factor;
101.11    (5) determine for calendar year 2007 the initial allocation of funds to be made
101.12available under this section based 70 percent on the proportion of the county or tribe's
101.13share of the statewide 2002 historic spending base and 30 percent on the proportion of the
101.14county or tribe's share of the adjusted caseload factor; and
101.15    (6) determine for calendar year 2008 and subsequent years the initial allocation of
101.16funds to be made available under this section based 50 percent on the proportion of the
101.17county or tribe's share of the statewide 2002 historic spending base and 50 percent on the
101.18proportion of the county or tribe's share of the adjusted caseload factor.
101.19    (c) With the commencement of a new or expanded tribal TANF program or an
101.20agreement under section 256.01, subdivision 2, paragraph (g), in which some or all of
101.21the responsibilities of particular counties under this section are transferred to a tribe,
101.22the commissioner shall:
101.23    (1) in the case where all responsibilities under this section are transferred to a tribal
101.24program, determine the percentage of the county's current caseload that is transferring to a
101.25tribal program and adjust the affected county's allocation accordingly; and
101.26    (2) in the case where a portion of the responsibilities under this section are
101.27transferred to a tribal program, the commissioner shall consult with the affected county or
101.28counties to determine an appropriate adjustment to the allocation.
101.29    (d) Effective January 1, 2005, counties and tribes will have their final allocations
101.30adjusted based on the performance provisions of subdivision 7.

101.31    Sec. 49. Minnesota Statutes 2006, section 256J.626, subdivision 7, is amended to read:
101.32    Subd. 7. Performance base funds. (a) Beginning calendar year 2005 2008, each
101.33county and tribe will be allocated 95 percent of their initial calendar year allocation.
101.34Counties and tribes will be allocated additional funds based on performance as follows:
102.1    (1) for calendar year 2005, a county or tribe that achieves a 30 percent rate or higher
102.2on the MFIP participation rate under section 256J.751, subdivision 2, clause (8), as
102.3averaged across the four quarterly measurements for the most recent year for which the
102.4measurements are available, will receive an additional allocation equal to 2.5 percent of
102.5its initial allocation; and
102.6    (2) for calendar year 2006, a county or tribe that achieves a 40 percent rate or a
102.7five percentage point improvement over the previous year's MFIP participation rate
102.8under section 256J.751, subdivision 2, clause (8), as averaged across the four quarterly
102.9measurements for the most recent year for which the measurements are available, will
102.10receive an additional allocation equal to 2.5 percent of its initial allocation; and
102.11    (3) for calendar year 2007, a county or tribe that achieves a 50 percent rate or a
102.12five percentage point improvement over the previous year's MFIP participation rate
102.13under section 256J.751, subdivision 2, clause (8), as averaged across the four quarterly
102.14measurements for the most recent year for which the measurements are available, will
102.15receive an additional allocation equal to 2.5 percent of its initial allocation; and
102.16    (4) for calendar year 2008 and yearly thereafter, a county or tribe that achieves a 50
102.17percent MFIP participation rate or a five percentage point improvement over the previous
102.18year's MFIP participation rate under section 256J.751, subdivision 2, clause (8) (7), as
102.19averaged across the four quarterly measurements for the most recent year for which the
102.20measurements are available, will receive an additional allocation equal to 2.5 percent of
102.21its initial allocation; and
102.22    (5) (2) for calendar years 2005 and thereafter, a county or tribe that performs above
102.23the top of its annualized range of expected performance on the three-year self-support
102.24index under section 256J.751, subdivision 2, clause (7) (6), will receive an additional
102.25allocation equal to five percent of its initial allocation; or and
102.26    (6) (3) for calendar years 2005 and thereafter, a county or tribe that performs within
102.27its range of expected performance on the annualized three-year self-support index under
102.28section 256J.751, subdivision 2, clause (7) (6), will receive an additional allocation equal
102.29to 2.5 percent of its initial allocation; and
102.30    (4) for calendar years 2008 and thereafter, a county or tribe that does not achieve
102.31a 50 percent MFIP participation rate or a five percentage point improvement over the
102.32previous year's MFIP participation rate under section 256J.751, subdivision 2, clause (7),
102.33as averaged across the four quarterly measurements for the most recent year for which
102.34the measurements are available, will not receive an additional 2.5 percent of its initial
102.35allocation until after negotiating a multiyear improvement plan with the commissioner; or
103.1    (5) for calendar years 2008 and thereafter, a county or tribe that does not perform
103.2within its range of expected performance on the annualized three-year self-support index
103.3under section 256J.751, subdivision 2, clause (6), will not receive an additional allocation
103.4equal to 2.5 percent of its initial allocation until after negotiating a multiyear improvement
103.5plan with the commissioner.
103.6    (b) Performance-based funds for a federally approved tribal TANF program in which
103.7the state and tribe have in place a contract under section 256.01, addressing consolidated
103.8funding, will be allocated as follows:
103.9    (1) for calendar year 2006 and yearly thereafter, a tribe that achieves the participation
103.10rate approved in its federal TANF plan using the average of four quarterly measurements
103.11for the most recent year for which the measurements are available, will receive an
103.12additional allocation equal to 2.5 percent of its initial allocation; and
103.13    (2) for calendar years 2006 and thereafter, a tribe that performs above the top of its
103.14annualized range of expected performance on the three-year self-support index under
103.15section 256J.751, subdivision 2, clause (7) (6), will receive an additional allocation equal
103.16to five percent of its initial allocation; or
103.17    (3) for calendar years 2006 and thereafter, a tribe that performs within its range
103.18of expected performance on the annualized three-year self-support index under section
103.19256J.751, subdivision 2 , clause (7) (6), will receive an additional allocation equal to 2.5
103.20percent of its initial allocation; or
103.21    (4) for calendar year 2008 and yearly thereafter, a tribe that does not achieve the
103.22participation rate approved in its federal TANF plan using the average of four quarterly
103.23measurements for the most recent year for which the measurements are available, will
103.24not receive an additional allocation equal to 2.5 percent of its initial allocation until after
103.25negotiating a multiyear improvement plan with the commissioner; or
103.26    (5) for calendar year 2008 and yearly thereafter, a tribe that does not perform within
103.27its range of expected performance on the annualized three-year self-support index under
103.28section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal
103.29to 2.5 percent until after negotiating a multiyear improvement plan with the commissioner.
103.30    (c) Funds remaining unallocated after the performance-based allocations in
103.31paragraph (a) are available to the commissioner for innovation projects under subdivision
103.325.
103.33    (d)(1) If available funds are insufficient to meet county and tribal allocations
103.34under paragraph (a), the commissioner may make available for allocation funds that are
103.35unobligated and available from the innovation projects through the end of the current
103.36biennium.
104.1    (2) If after the application of clause (1) funds remain insufficient to meet county and
104.2tribal allocations under paragraph (a), the commissioner must proportionally reduce the
104.3allocation of each county and tribe with respect to their maximum allocation available
104.4under paragraph (a).

104.5    Sec. 50. Minnesota Statutes 2006, section 256J.751, subdivision 2, is amended to read:
104.6    Subd. 2. Quarterly comparison report. The commissioner shall report quarterly to
104.7all counties on each county's performance on the following measures:
104.8    (1) percent of MFIP caseload working in paid employment;
104.9    (2) percent of MFIP caseload receiving only the food portion of assistance;
104.10    (3) number of MFIP cases that have left assistance;
104.11    (4) median placement wage rate;
104.12    (5) caseload by months of TANF assistance;
104.13    (6) percent of MFIP and diversionary work program (DWP) cases off cash assistance
104.14or working 30 or more hours per week at one-year, two-year, and three-year follow-up
104.15points from a baseline quarter. This measure is called the self-support index. The
104.16commissioner shall report quarterly an expected range of performance for each county,
104.17county grouping, and tribe on the self-support index. The expected range shall be derived
104.18by a statistical methodology developed by the commissioner in consultation with the
104.19counties and tribes. The statistical methodology shall control differences across counties
104.20in economic conditions and demographics of the MFIP and DWP case load; and
104.21    (7) the MFIP TANF work participation rate, defined as the participation requirements
104.22specified in title 1 of Public Law 104-193 applied to all MFIP cases except child only
104.23cases under Public Law 109-171, the Deficit Reduction Act of 2005.

104.24    Sec. 51. Minnesota Statutes 2006, section 256J.751, subdivision 5, is amended to read:
104.25    Subd. 5. Failure to meet federal performance standards. (a) If sanctions occur
104.26for failure to meet the performance standards specified in title 1 of Public Law 104-193
104.27of the Personal Responsibility and Work Opportunity Act of 1996, and under Public
104.28Law 109-171, the Deficit Reduction Act of 2005, the state shall pay 88 percent of the
104.29sanction. The remaining 12 percent of the sanction will be paid by the counties. The
104.30county portion of the sanction will be distributed across all counties in proportion to each
104.31county's percentage of the MFIP average monthly caseload during the period for which
104.32the sanction was applied.
104.33    (b) If a county fails to meet the performance standards specified in title 1 of Public
104.34Law 104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and
105.1Public Law 109-171, the Deficit Reduction Act of 2005, for any year, the commissioner
105.2shall work with counties to organize a joint state-county technical assistance team to work
105.3with the county. The commissioner shall coordinate any technical assistance with other
105.4departments and agencies including the Departments of Employment and Economic
105.5Development and Education as necessary to achieve the purpose of this paragraph.
105.6    (c) For state performance measures, a low-performing county is one that:
105.7    (1) performs below the bottom of their expected range for the measure in subdivision
105.82, clause (7) (6), in an annualized measurement reported in October of each year; or
105.9    (2) performs below 40 percent for the measure in subdivision 2, clause (8) (7), as
105.10averaged across the four quarterly measurements for the year, or the ten counties with the
105.11lowest rates if more than ten are below 40 percent.
105.12    (d) Low-performing counties under paragraph (c) must engage in corrective action
105.13planning as defined by the commissioner. The commissioner may coordinate technical
105.14assistance as specified in paragraph (b) for low-performing counties under paragraph (c).

105.15    Sec. 52. Minnesota Statutes 2006, section 256J.95, subdivision 3, is amended to read:
105.16    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories
105.17of family units listed below, all family units who apply for cash benefits and who
105.18meet MFIP eligibility as required in sections 256J.11 to 256J.15 are eligible and must
105.19participate in the diversionary work program. Family units that are not eligible for the
105.20diversionary work program include:
105.21    (1) child only cases;
105.22    (2) a single-parent family unit that includes a child under 12 weeks of age. A parent
105.23is eligible for this exception once in a parent's lifetime and is not eligible if the parent
105.24has already used the previously allowed child under age one exemption from MFIP
105.25employment services;
105.26    (3) a minor parent without a high school diploma or its equivalent;
105.27    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent
105.28who chooses to have an employment plan with an education option;
105.29    (5) a caregiver age 60 or over;
105.30    (6) family units with a caregiver who received DWP benefits in the 12 months prior
105.31to the month the family applied for DWP, except as provided in paragraph (c);
105.32    (7) family units with a caregiver who received MFIP within the 12 months prior to
105.33the month the family unit applied for DWP;
105.34    (8) a family unit with a caregiver who received 60 or more months of TANF
105.35assistance; and
106.1    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to
106.2fraud.; and
106.3    (10) refugees as defined in Code of Federal Regulations, title 45, chapter IV, section
106.4444.43, who arrived in the United States in the 12 months prior to the date of application
106.5for family cash assistance.
106.6    (b) A two-parent family must participate in DWP unless both caregivers meet the
106.7criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit
106.8includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), or (9).
106.9    (c) Once DWP eligibility is determined, the four months run consecutively. If a
106.10participant leaves the program for any reason and reapplies during the four-month period,
106.11the county must redetermine eligibility for DWP.
106.12EFFECTIVE DATE.This section is effective the day following final enactment.

106.13    Sec. 53. Minnesota Statutes 2006, section 256K.45, is amended by adding a
106.14subdivision to read:
106.15    Subd. 6. Funding. Any funds appropriated for this section may be expended on
106.16programs described under subdivisions 3 to 5, technical assistance, and capacity building.
106.17Up to four percent of funds appropriated may be used for the purpose of monitoring and
106.18evaluating runaway and homeless youth programs receiving funding under this section.
106.19Funding shall be directed to meet the greatest need, with a significant share of the funding
106.20focused on homeless youth providers in greater Minnesota.

106.21    Sec. 54. Minnesota Statutes 2006, section 259.67, subdivision 4, is amended to read:
106.22    Subd. 4. Eligibility conditions. (a) The placing agency shall use the AFDC
106.23requirements as specified in federal law as of July 16, 1996, when determining the child's
106.24eligibility for adoption assistance under title IV-E of the Social Security Act. If the child
106.25does not qualify, the placing agency shall certify a child as eligible for state funded
106.26adoption assistance only if the following criteria are met:
106.27    (1) Due to the child's characteristics or circumstances it would be difficult to provide
106.28the child an adoptive home without adoption assistance.
106.29    (2)(i) A placement agency has made reasonable efforts to place the child for adoption
106.30without adoption assistance, but has been unsuccessful; or
106.31    (ii) the child's licensed foster parents desire to adopt the child and it is determined by
106.32the placing agency that the adoption is in the best interest of the child.
106.33    (3)(i) The child has been a ward of the commissioner, a Minnesota-licensed
106.34child-placing agency, or a tribal social service agency of Minnesota recognized by the
107.1Secretary of the Interior; or (ii) the child will be adopted according to tribal law without a
107.2termination of parental rights or relinquishment, provided that the tribe has documented
107.3the valid reason why the child cannot or should not be returned to the home of the child's
107.4parent. The placing agency shall not certify a child who remains under the jurisdiction
107.5of the sending agency pursuant to section 260.851, article 5, for state-funded adoption
107.6assistance when Minnesota is the receiving state.
107.7    (b) For purposes of this subdivision, the characteristics or circumstances that may
107.8be considered in determining whether a child is a child with special needs under United
107.9States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of
107.10paragraph (a), clause (1), are the following:
107.11    (1) The child is a member of a sibling group to be placed as one unit in which at
107.12least one sibling is older than 15 months of age or is described in clause (2) or (3).
107.13    (2) The child has documented physical, mental, emotional, or behavioral disabilities.
107.14    (3) The child has a high risk of developing physical, mental, emotional, or behavioral
107.15disabilities.
107.16    (4) The child is adopted according to tribal law without a termination of parental
107.17rights or relinquishment, provided that the tribe has documented the valid reason why the
107.18child cannot or should not be returned to the home of the child's parent.
107.19    (4) The child is five years of age or older.
107.20    (c) When a child's eligibility for adoption assistance is based upon the high risk of
107.21developing physical, mental, emotional, or behavioral disabilities, payments shall not be
107.22made under the adoption assistance agreement unless and until the potential disability
107.23manifests itself as documented by an appropriate health care professional.

107.24    Sec. 55. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:
107.25    Subdivision 1. Disclosure to commissioner of human services. (a) On the request
107.26of the commissioner of human services, the commissioner shall disclose return information
107.27regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to
107.28the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).
107.29    (b) Data that may be disclosed are limited to data relating to the identity,
107.30whereabouts, employment, income, and property of a person owing or alleged to be owing
107.31an obligation of child support.
107.32    (c) The commissioner of human services may request data only for the purposes of
107.33carrying out the child support enforcement program and to assist in the location of parents
107.34who have, or appear to have, deserted their children. Data received may be used only
107.35as set forth in section 256.978.
108.1    (d) The commissioner shall provide the records and information necessary to
108.2administer the supplemental housing allowance to the commissioner of human services.
108.3    (e) At the request of the commissioner of human services, the commissioner of
108.4revenue shall electronically match the Social Security numbers and names of participants
108.5in the telephone assistance plan operated under sections 237.69 to 237.711, with those of
108.6property tax refund filers, and determine whether each participant's household income is
108.7within the eligibility standards for the telephone assistance plan.
108.8    (f) The commissioner may provide records and information collected under sections
108.9295.50 to 295.59 to the commissioner of human services for purposes of the Medicaid
108.10Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law
108.11102-234. Upon the written agreement by the United States Department of Health and
108.12Human Services to maintain the confidentiality of the data, the commissioner may provide
108.13records and information collected under sections 295.50 to 295.59 to the Centers for
108.14Medicare and Medicaid Services section of the United States Department of Health and
108.15Human Services for purposes of meeting federal reporting requirements.
108.16    (g) The commissioner may provide records and information to the commissioner of
108.17human services as necessary to administer the early refund of refundable tax credits.
108.18    (h) The commissioner may disclose information to the commissioner of human
108.19services necessary to verify income for eligibility and premium payment under the
108.20MinnesotaCare program, under section 256L.05, subdivision 2.
108.21    (i) The commissioner may disclose information to the commissioner of human
108.22services necessary to verify whether applicants or recipients for the Minnesota family
108.23investment program, general assistance, food support, and Minnesota supplemental aid
108.24program, and child care assistance have claimed refundable tax credits under chapter 290
108.25and the property tax refund under chapter 290A, and the amounts of the credits.

108.26    Sec. 56. MFIP PILOT PROGRAM; WORKFORCE U.
108.27    Subdivision 1. Establishment. A pilot program is established in Stearns and
108.28Benton Counties to expand the Workforce U program administered by the Stearns-Benton
108.29Employment and Training Council.
108.30    Subd. 2. Evaluation. The Workforce U pilot program must be evaluated by a
108.31research and evaluation organization with experience evaluating welfare programs. The
108.32evaluation must include information on the total number of persons served, percentage
108.33of participants exiting the program, percentage of former participants reentering the
108.34program, average wages of program participants, and recommendations to the legislature
109.1for possible statewide implementation of the program. The evaluation must be presented
109.2to the legislature by February 15, 2011.
109.3    Subd. 3. Expiration. The Workforce U pilot program expires on June 30, 2011.

109.4    Sec. 57. LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.
109.5    (a) The commissioner of human services shall provide a planning grant to address
109.6the unmet need for local, effective, culturally relevant alcohol and drug treatment for
109.7American Indian youth, and develop a plan for a family-based youth treatment center in
109.8the Leech Lake area. The planning grant must be provided to a volunteer board consisting
109.9of at least four members appointed by the commissioner, to include at least the following:
109.10    (1) two members of the Leech Lake Tribal Council or their designees;
109.11    (2) one member appointed by the Cass County Social Services administrator; and
109.12    (3) one member appointed by the Cass Lake-Bena Public School superintendent.
109.13    (b) The plan must include:
109.14    (1) an interest, feasibility, and suitability of location study;
109.15    (2) defining scope of programs and services to be offered;
109.16    (3) defining site use limitations and restrictions, including physical and capacity;
109.17    (4) defining facilities required for programs and services offered;
109.18    (5) identifying partners, partnership roles, and partner resources;
109.19    (6) developing proposed operating and maintenance budgets;
109.20    (7) identifying funding sources;
109.21    (8) developing a long-term funding plan; and
109.22    (9) developing a formal steering committee, structure, and bylaws.
109.23    (c) The plan is due to the legislative committees having jurisdiction over chemical
109.24health issues no later than September 2008 in order to provide the 12 months necessary to
109.25complete the plan.

109.26    Sec. 58. MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED
109.27APPLICATION.
109.28    The commissioner of human services shall implement a simplified application form
109.29and process for the food support program by January 1, 2008. The commissioner shall
109.30consult with counties and representatives of persons served by the program to develop the
109.31simplified application form and process. The application process shall:
109.32    (1) include a simple, short form that can be completed by individuals with limited
109.33literacy skills;
109.34    (2) include an application form for individuals without dependents;
110.1    (3) include a process that does not require individuals to take time off work for a
110.2face-to-face interview; and
110.3    (4) minimize demands on county staff in assisting applicants.
110.4EFFECTIVE DATE.This section is effective January 1, 2008.

110.5    Sec. 59. INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.
110.6    The commissioner of human services, in consultation with the commissioner of
110.7health and the counties, shall develop and present recommendations to the legislature in
110.8January 2008 in order for each legally unlicensed child care provider receiving child
110.9care assistance funds to receive a onetime home visit to receive information on health
110.10and safety, and school readiness.

110.11    Sec. 60. COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY
110.12CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT
110.13TRAINING.
110.14    Subdivision 1. Development and implementation of an early childhood and
110.15school-age professional development system. (a) The commissioner of human services,
110.16in cooperation with the commissioners of education and health, shall develop and phase-in
110.17the implementation of a professional development system for practitioners serving
110.18children in early childhood and school-age programs. The system shall provide training
110.19options and supports for practitioners to voluntarily choose, as they complete or exceed
110.20existing licensing requirements.
110.21    The system must, at a minimum, include the following features:
110.22    (1) a continuum of training content based on the early childhood and school-age
110.23care practitioner core competencies that translates knowledge into improved practice to
110.24support children's school success;
110.25    (2) training strategies that provide direct feedback about practice to practitioners
110.26through ongoing consultation, mentoring, or coaching with special emphasis on early
110.27literacy and early mathematics;
110.28    (3) an approval process for trainers;
110.29    (4) a professional development registry for early childhood and school-age care
110.30practitioners that will provide tracking and recognition of practitioner training/career
110.31development progress;
110.32    (5) a career lattice that includes a range of professional development and educational
110.33opportunities that provide appropriate coursework and degree pathways;
111.1    (6) development of a plan with public higher education institutions for an articulated
111.2system of education, training, and professional development that includes credit for prior
111.3learning and development of equivalences to two- and four-year degrees;
111.4    (7) incentives and supports for early childhood and school-age care practitioners
111.5to seek additional training and education, including TEACH, other scholarships, and
111.6career guidance; and
111.7    (8) coordinated and accessible delivery of training to early childhood and school-age
111.8care practitioners.
111.9    (b) By January 1, 2008, the commissioner, in consultation with the organizations
111.10named in subdivision 2 shall develop additional opportunities in order to qualify more
111.11licensed family child care providers under section 119B.13, subdivision 3a.
111.12    (c) The commissioner of human services must evaluate the professional development
111.13system and make continuous improvements.
111.14    (d) Beginning July 1, 2007, as appropriations permit, the commissioner shall
111.15phase-in the professional development system.
111.16    Subd. 2. Two-hour early childhood training. By January 15, 2008, the
111.17commissioner of human services, with input from the Minnesota Licensed Family Child
111.18Care Association and the Minnesota Professional Development Council, shall identify
111.19trainings that qualify for the two-hour early childhood development training requirement
111.20for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision
111.219a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also
111.22seek the input of labor unions that serve licensed family child care providers, if the union
111.23has been recognized by a county to serve licensed family child care providers.

111.24    Sec. 61. SCHOOL READINESS SERVICE AGREEMENTS.
111.25    Subdivision 1. Overview. (a) Effective July 1, 2007, funds must be made available
111.26to allow the commissioner to pay higher rates to up to 50 child care providers who are
111.27deemed by the commissioner to meet the requirements of a school readiness service
111.28agreement (SRSA) provider and perform services that support school readiness for
111.29children and economic stability for parents.
111.30    (b) A provider may be paid a rate above that currently allowed under Minnesota
111.31Statutes, section 119B.13, if:
111.32    (1) the provider has entered into an SRSA with the commissioner;
111.33    (2) a family using that provider receives child care assistance under any provision in
111.34Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
111.35    (3) the family using that provider meets the criteria in this section; and
112.1    (4) funding is available under this section.
112.2    Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall
112.3apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:
112.4    (1) be eligible for child care assistance payments under Minnesota Statutes, chapter
112.5119B;
112.6    (2) have at least 25 percent of the children enrolled with the provider subsidized
112.7through the child care assistance program;
112.8    (3) provide full-time, full-year child care services; and
112.9    (4) serve at least one child who is subsidized through the child care assistance
112.10program and who is expected to enter kindergarten within the following 30 months.
112.11    (b) The commissioner may waive the 25 percent requirement in paragraph (a), clause
112.12(2), if necessary to achieve geographic distribution of SRSA providers and diversity of
112.13types of care provided by SRSA providers.
112.14    (c) An eligible provider who would like to enter into an SRSA with the commissioner
112.15shall submit an SRSA application. To determine whether to enter into an SRSA with a
112.16provider, the commissioner shall evaluate the following factors:
112.17    (1) the qualifications of the provider and the provider's staff;
112.18    (2) the provider's staff-child ratios;
112.19    (3) the provider's curriculum;
112.20    (4) the provider's current or planned parent education activities;
112.21    (5) the provider's current or planned social service and employment linkages;
112.22    (6) the provider's child development assessment plan;
112.23    (7) the geographic distribution needed for SRSA providers;
112.24    (8) the inclusion of a variety of child care delivery models; and
112.25    (9) other related factors determined by the commissioner.
112.26    Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA
112.27provider for their children shall:
112.28    (1) be eligible to receive child care assistance under any provision in Minnesota
112.29Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
112.30    (2) be in an authorized activity for an average of at least 35 hours per week when
112.31initial eligibility is determined; and
112.32    (3) include a child who has not yet entered kindergarten.
112.33    (b) A family who is determined to be eligible to choose an SRSA provider remains
112.34eligible to be paid at a higher rate through the SRSA provider when the following
112.35conditions exist:
113.1    (1) the child attends child care with the SRSA provider a minimum of 25 hours per
113.2week, on average;
113.3    (2) the family has a child who has not yet entered kindergarten; and
113.4    (3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except
113.5Minnesota Statutes, section 119B.035.
113.6    (c) For the 12 months after initial eligibility has been determined, a decrease in
113.7the family's authorized activities to an average of less than 35 hours per week does not
113.8result in ineligibility for the SRSA rate.
113.9    (d) A family that moves between counties but continues to use the same SRSA
113.10provider shall continue to receive SRSA funding for the increased payments.
113.11    Subd. 4. Requirements of providers. An SRSA must include assessment,
113.12evaluation, and reporting requirements that promote the goals of improved school
113.13readiness and movement toward appropriate child development milestones. A provider
113.14who enters into an SRSA shall comply with the assessment, evaluation, and reporting
113.15requirements in the SRSA.
113.16    Subd. 5. Relationship to current law. (a) The following provisions in Minnesota
113.17Statutes, chapter 119B, must be waived or modified for families receiving services under
113.18this section.
113.19    (b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a,
113.20maximum weekly rates under this section are 125 percent of the existing maximum
113.21weekly rate for like-care. Providers eligible for a differential rate under Minnesota
113.22Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the
113.23rate identified in this section. Only care for children who have not yet entered kindergarten
113.24may be paid at the maximum rate under this section. The provider's charge for service
113.25provided through an SRSA may not exceed the rate that the provider charges a private-pay
113.26family for like-care arrangements.
113.27    (c) A family or child care provider may not be assessed an overpayment for care
113.28provided through an SRSA unless:
113.29    (1) there was an error in the amount of care authorized for the family; or
113.30    (2) the family or provider did not timely report a change as required under the law.
113.31    (d) Care provided through an SRSA is authorized on a weekly basis.
113.32    (e) Funds appropriated under this section to serve families eligible under Minnesota
113.33Statutes, section 119B.03, are not allocated through the basic sliding fee formula under
113.34Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to
113.35offset increased costs when payments are made under SRSA's.
114.1    (f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the
114.2maximum amount of child care assistance that may be authorized for a child receiving
114.3care through an SRSA in a two-week period is 160 hours per child.
114.4    Subd. 6. Establishment of service agreements. (a) The commissioner shall
114.5approve SRSA's for up to 50 providers that represent diverse parts of the state and a
114.6variety of child care delivery models. Entering into a service agreement does not guarantee
114.7that a provider will receive payment at a higher rate for families receiving child care
114.8assistance. A family eligible under this section shall choose a provider participating in an
114.9SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by
114.10the availability of SRSA funds.
114.11    (b) Nothing in this section shall be construed to limit parent choice as defined in
114.12Minnesota Statutes, section 119B.09, subdivision 5.
114.13    (c) The commissioner may allow for startup time for some providers if failing to
114.14do so would limit geographic diversity of SRSA providers or a variety of child care
114.15delivery models.

114.16    Sec. 62. FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.
114.17    Subdivision 1. Establishment. A family, friend, and neighbor (FFN) grant program
114.18is established to promote children's early literacy, healthy development, and school
114.19readiness, and to foster community partnerships to promote children's school readiness.
114.20The commissioner shall attempt to ensure that grants are made in all areas of the state. The
114.21commissioner of human services shall make grants available to fund: community-based
114.22organizations, nonprofit organizations, and Indian tribes working with FFN caregivers
114.23under subdivision 2, paragraph (a); and community-based partnerships to implement early
114.24literacy programs under subdivision 2, paragraph (b).
114.25    Subd. 2. Program components. (a)(1) Grants that the commissioner awards under
114.26this section must be used by community-based organizations, nonprofit organizations, and
114.27Indian tribes working with FFN caregivers in local communities, cultural communities,
114.28and Indian tribes to:
114.29    (i) provide training, support, and resources to FFN caregivers in order to improve
114.30and promote children's health, safety, nutrition, and school readiness;
114.31    (ii) connect FFN caregivers and children's families with appropriate community
114.32resources that support the families' health, mental health, economic, and developmental
114.33needs;
114.34    (iii) connect FFN caregivers and children's families to early childhood screening
114.35programs and facilitate referrals where appropriate;
115.1    (iv) provide FFN caregivers and children's families with information about early
115.2learning guidelines from the Departments of Human Services and Education;
115.3    (v) provide FFN caregivers and children's families with information about becoming
115.4a licensed family child care provider; and
115.5    (vi) provide FFN caregivers and children's families with information about early
115.6learning allowances and enrollment opportunities in high quality community-based
115.7child-care and preschool programs.
115.8    (2) Grants that the commissioner awards under this paragraph also may be used for:
115.9    (i) health and safety and early learning kits for FFN caregivers;
115.10    (ii) play-and-learn groups with FFN caregivers;
115.11    (iii) culturally appropriate early childhood training for FFN caregivers;
115.12    (iv) transportation for FFN caregivers and children's families to school readiness and
115.13other early childhood training activities;
115.14    (v) other activities that promote school readiness;
115.15    (vi) data collection and evaluation;
115.16    (vii) staff outreach and outreach activities;
115.17    (viii) translation needs; or
115.18    (ix) administrative costs that equal up to 12 percent of the recipient's grant award.
115.19    (b) Grants that the commissioner awards under this section also must be used to fund
115.20partnerships among Minnesota public and regional library systems, community-based
115.21organizations, nonprofit organizations, and Indian tribes to implement early literacy
115.22programs in low-income communities, including tribal communities, to:
115.23    (1) purchase and equip early childhood read-mobiles that provide FFN caregivers
115.24and children's families with books, training, and early literacy activities;
115.25    (2) provide FFN caregivers and children's families with translations of early
115.26childhood books, training, and early literacy activities in native languages; or
115.27    (3) provide FFN caregivers and children's families with early literacy activities in
115.28local libraries.
115.29    Subd. 3. Grant awards. Interested entities eligible to receive a grant under
115.30this section may apply to the commissioner in the form and manner the commissioner
115.31determines. The commissioner shall awards grants to eligible entities consistent with
115.32the requirements of this section.
115.33    Subd. 4. Evaluation. The commissioner, in consultation with early childhood
115.34care and education experts at the University of Minnesota, must evaluate the impact of
115.35the grants under subdivision 2 on children's school readiness and submit a written report
116.1to the human services and education finance and policy committees of the legislature by
116.2February 15, 2010.
116.3EFFECTIVE DATE.This section is effective the day following final enactment.

116.4    Sec. 63. CHILD CARE PROVIDER STUDY.
116.5    If sufficient resources to support the costs are provided by one or more
116.6nongovernmental entities, the commissioner of human services is directed to study the
116.7implications of restricting the use of state subsidies in center-based child care to centers
116.8meeting state quality standards under Minnesota Statutes, section 124D.175, paragraph
116.9(c), and to publish the results no later than January 1, 2010. The study must include:
116.10    (1) the likelihood of there being sufficient child care providers meeting the standards;
116.11    (2) the cost to bring providers up to the standards and how this cost would be funded;
116.12    (3) how the standards and the ratings would be communicated to both parents and
116.13the general public; and
116.14    (4) a determination whether a similar system could be implemented for
116.15non-center-based care.

116.16    Sec. 64. DIRECTION TO COMMISSIONER.
116.17    (a) The commissioner of human services shall offer a request for proposals to
116.18identify a research and evaluation firm with experience working with:
116.19    (1) homeless youth providers;
116.20    (2) data; and
116.21    (3) the topics of housing, homelessness, and a continuum of care for youth.
116.22    (b) The research and evaluation firm identified under paragraph (a) shall monitor and
116.23evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.

116.24    Sec. 65. NOT ASSESSING TANF PENALTIES AGAINST COUNTIES.
116.25    From October 2006 through October 2007, if the state does not meet the federal
116.26work participation requirements, and the state is penalized by a reduction in the TANF
116.27grant, the state shall not assess penalties against the counties.

116.28    Sec. 66. REPEALER.
116.29(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.24, subdivision
116.306; 256J.29; 256J.37, subdivision 3b; and 256J.626, subdivision 9, are repealed.
116.31(b) Laws 1997, chapter 8, section 1, is repealed.
116.32(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed.

117.1ARTICLE 3

117.2LICENSING

117.3    Section 1. Minnesota Statutes 2006, section 245A.035, is amended to read:
117.4245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY
117.5LICENSE RELATIVE PLACEMENT.
117.6    Subdivision 1. Grant of Emergency license placement. Notwithstanding section
117.7245A.03, subdivision 2a , or 245C.13, subdivision 2, a county agency may place a child
117.8for foster care with a relative who is not licensed to provide foster care, provided the
117.9requirements of subdivision 2 this section are met. As used in this section, the term
117.10"relative" has the meaning given it under section 260C.007, subdivision 27.
117.11    Subd. 2. Cooperation with emergency licensing placement process. (a) A county
117.12agency that places a child with a relative who is not licensed to provide foster care must
117.13begin the process of securing an emergency license for the relative as soon as possible
117.14and must conduct the initial inspection required by subdivision 3, clause (1), whenever
117.15possible, prior to placing the child in the relative's home, but no later than three working
117.16days after placing the child in the home. A child placed in the home of a relative who is
117.17not licensed to provide foster care must be removed from that home if the relative fails
117.18to cooperate with the county agency in securing an emergency foster care license. The
117.19commissioner may issue an emergency foster care license to a relative with whom the
117.20county agency wishes to place or has placed a child for foster care, or to a relative with
117.21whom a child has been placed by court order.
117.22    (b) If a child is to be placed in the home of a relative not licensed to provide foster
117.23care, either the placing agency or the county agency in the county in which the relative
117.24lives shall conduct the emergency licensing placement process as required in this section.
117.25    Subd. 3. Requirements for emergency license placement. Before an emergency
117.26license placement may be issued made, the following requirements must be met:
117.27    (1) the county agency must conduct an initial inspection of the premises where
117.28the foster care placement is to be provided made to ensure the health and safety of any
117.29child placed in the home. The county agency shall conduct the inspection using a form
117.30developed by the commissioner;
117.31    (2) at the time of the inspection or placement, whichever is earlier, the county
117.32agency must provide the relative being considered for an emergency license shall receive
117.33placement an application form for a child foster care license;
118.1    (3) whenever possible, prior to placing the child in the relative's home, the relative
118.2being considered for an emergency license placement shall provide the information
118.3required by section 245C.05; and
118.4    (4) if the county determines, prior to the issuance of an emergency license
118.5placement, that anyone requiring a background study may be prior to licensure of the
118.6home is disqualified under section 245C.14 and chapter 245C, and the disqualification
118.7is one which the commissioner cannot set aside, an emergency license shall placement
118.8must not be issued made.
118.9    Subd. 4. Applicant study. When the county agency has received the information
118.10required by section 245C.05, the county agency shall begin an applicant study according to
118.11the procedures in chapter 245C. The commissioner may issue an emergency license upon
118.12recommendation of the county agency once the initial inspection has been successfully
118.13completed and the information necessary to begin the applicant background study has been
118.14provided. If the county agency does not recommend that the emergency license be granted,
118.15the agency shall notify the relative in writing that the agency is recommending denial to the
118.16commissioner; shall remove any child who has been placed in the home prior to licensure;
118.17and shall inform the relative in writing of the procedure to request review pursuant to
118.18subdivision 6. An emergency license shall be effective until a child foster care license is
118.19granted or denied, but shall in no case remain in effect more than 120 days from the date
118.20of placement submit the information to the commissioner according to section 245C.05.
118.21    Subd. 5. Child foster care license application. (a) The relatives with whom the
118.22emergency license holder placement has been made shall complete the child foster care
118.23license application and necessary paperwork within ten days of the placement. The county
118.24agency shall assist the emergency license holder applicant to complete the application.
118.25The granting of a child foster care license to a relative shall be under the procedures in this
118.26chapter and according to the standards set forth by foster care rule in Minnesota Rules,
118.27chapter 2960. In licensing a relative, the commissioner shall consider the importance of
118.28maintaining the child's relationship with relatives as an additional significant factor in
118.29determining whether to a background study disqualification should be set aside a licensing
118.30disqualifier under section 245C.22, or to grant a variance of licensing requirements should
118.31be granted under sections 245C.21 to 245C.27 section 245C.30.
118.32    (b) When the county or private child-placing agency is processing an application
118.33for child foster care licensure of a relative as defined in section 260B.007, subdivision
118.3412 , or 260C.007, subdivision 27, the county agency or child-placing agency must explain
118.35the licensing process to the prospective licensee, including the background study process
118.36and the procedure for reconsideration of an initial disqualification for licensure. The
119.1county or private child-placing agency must also provide the prospective relative licensee
119.2with information regarding appropriate options for legal representation in the pertinent
119.3geographic area. If a relative is initially disqualified under section 245C.14, the county
119.4or child-placing agency commissioner must provide written notice of the reasons for the
119.5disqualification and the right to request a reconsideration by the commissioner as required
119.6under section 245C.17.
119.7    (c) The commissioner shall maintain licensing data so that activities related to
119.8applications and licensing actions for relative foster care providers may be distinguished
119.9from other child foster care settings.
119.10    Subd. 6. Denial of emergency license. If the commissioner denies an application
119.11for an emergency foster care license under this section, that denial must be in writing and
119.12must include reasons for the denial. Denial of an emergency license is not subject to
119.13appeal under chapter 14. The relative may request a review of the denial by submitting
119.14to the commissioner a written statement of the reasons an emergency license should be
119.15granted. The commissioner shall evaluate the request for review and determine whether
119.16to grant the emergency license. The commissioner's review shall be based on a review
119.17of the records submitted by the county agency and the relative. Within 15 working
119.18days of the receipt of the request for review, the commissioner shall notify the relative
119.19requesting review in written form whether the emergency license will be granted. The
119.20commissioner's review shall be based on a review of the records submitted by the county
119.21agency and the relative. A child shall not be placed or remain placed in the relative's home
119.22while the request for review is pending. Denial of an emergency license shall not preclude
119.23an individual from reapplying for an emergency license or from applying for a child foster
119.24care license. The decision of the commissioner is the final administrative agency action.

119.25    Sec. 2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:
119.26    Subd. 2. County fees for background studies and licensing inspections. (a) For
119.27purposes of family and group family child care licensing under this chapter, a county
119.28agency may charge a fee to an applicant or license holder to recover the actual cost of
119.29background studies, but in any case not to exceed $100 annually. A county agency may
119.30also charge a license fee to an applicant or license holder to recover the actual cost of
119.31licensing inspections, but in any case not to exceed $150 annually $50 for a one-year
119.32license or $100 for a two-year license.
119.33    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
119.34applicant for authorization to recover the actual cost of background studies completed
119.35under section 119B.125, but in any case not to exceed $100 annually.
120.1    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
120.2    (1) in cases of financial hardship;
120.3    (2) if the county has a shortage of providers in the county's area;
120.4    (3) for new providers; or
120.5    (4) for providers who have attained at least 16 hours of training before seeking
120.6initial licensure.
120.7    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
120.8an installment basis for up to one year. If the provider is receiving child care assistance
120.9payments from the state, the provider may have the fees under paragraph (a) or (b)
120.10deducted from the child care assistance payments for up to one year and the state shall
120.11reimburse the county for the county fees collected in this manner.
120.12EFFECTIVE DATE.This section is effective January 1, 2008.

120.13    Sec. 3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:
120.14    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
120.15private agencies that have been designated or licensed by the commissioner to perform
120.16licensing functions and activities under section 245A.04 and background studies for adult
120.17foster care, family adult day services, and until December 31, 2007, family child care,
120.18under chapter 245C,; to recommend denial of applicants under section 245A.05,; to issue
120.19correction orders, to issue variances, and recommend a conditional license under section
120.20245A.06 , or to recommend suspending or revoking a license or issuing a fine under section
120.21245A.07 , shall comply with rules and directives of the commissioner governing those
120.22functions and with this section. The following variances are excluded from the delegation
120.23of variance authority and may be issued only by the commissioner:
120.24    (1) dual licensure of family child care and child foster care, dual licensure of child
120.25and adult foster care, and adult foster care and family child care;
120.26    (2) adult foster care maximum capacity;
120.27    (3) adult foster care minimum age requirement;
120.28    (4) child foster care maximum age requirement;
120.29    (5) variances regarding disqualified individuals except that county agencies may
120.30issue variances under section 245C.30 regarding disqualified individuals when the county
120.31is responsible for conducting a consolidated reconsideration according to sections 245C.25
120.32and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
120.33and a disqualification based on serious or recurring maltreatment; and
120.34    (6) the required presence of a caregiver in the adult foster care residence during
120.35normal sleeping hours.
121.1    (b) County agencies must report:
121.2    (1) information about disqualification reconsiderations under sections 245C.25 and
121.3245C.27, subdivision 2 , clauses paragraphs (a) and (b), and variances granted under
121.4paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by
121.5the commissioner; and.
121.6    (2) for relative child foster care applicants and license holders, the number of
121.7relatives, as defined in section 260C.007, subdivision 27, and household members of
121.8relatives who are disqualified under section 245C.14; the disqualifying characteristics
121.9under section 245C.15; the number of these individuals who requested reconsideration
121.10under section 245C.21; the number of set-asides under section 245C.22; and variances
121.11under section 245C.30 issued. This information shall be reported to the commissioner
121.12annually by January 15 of each year in a format prescribed by the commissioner.
121.13    (c) For family day care programs, the commissioner may authorize licensing reviews
121.14every two years after a licensee has had at least one annual review.
121.15    (d) For family adult day services programs, the commissioner may authorize
121.16licensing reviews every two years after a licensee has had at least one annual review.
121.17    (e) A license issued under this section may be issued for up to two years.

121.18    Sec. 4. Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:
121.19    Subd. 3. Recommendations to the commissioner. The county or private agency
121.20shall not make recommendations to the commissioner regarding licensure without
121.21first conducting an inspection, and for adult foster care, family adult day services, and
121.22until December 31, 2007, family child care, a background study of the applicant, and
121.23evaluation pursuant to under chapter 245C. The county or private agency must forward its
121.24recommendation to the commissioner regarding the appropriate licensing action within 20
121.25working days of receipt of a completed application.

121.26    Sec. 5. Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision
121.27to read:
121.28    Subd. 14a. Private agency. "Private agency" has the meaning given in section
121.29245A.02, subdivision 12.

121.30    Sec. 6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:
121.31    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
121.32background study of an individual required to be studied under section 245C.03,
121.33subdivision 1 , at least upon application for initial license for all license types.
122.1    (b) The commissioner shall conduct a background study of an individual required
122.2to be studied under section 245C.03, subdivision 1, at reapplication for a license for
122.3family child care, child foster care, and adult foster care, family adult day services, and
122.4until January 1, 2008, family child care.
122.5    (c) The commissioner is not required to conduct a study of an individual at the time
122.6of reapplication for a license if the individual's background study was completed by the
122.7commissioner of human services for an adult foster care license holder that is also:
122.8    (1) registered under chapter 144D; or
122.9    (2) licensed to provide home and community-based services to people with
122.10disabilities at the foster care location and the license holder does not reside in the foster
122.11care residence; and
122.12    (3) the following conditions are met:
122.13    (i) a study of the individual was conducted either at the time of initial licensure or
122.14when the individual became affiliated with the license holder;
122.15    (ii) the individual has been continuously affiliated with the license holder since
122.16the last study was conducted; and
122.17    (iii) the last study of the individual was conducted on or after October 1, 1995.
122.18    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
122.19conduct a study of an individual required to be studied under section 245C.03, at the
122.20time of reapplication for a child foster care license. The county or private agency shall
122.21collect and forward to the commissioner the information required under section 245C.05,
122.22subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
122.23study conducted by the commissioner of human services under this paragraph must
122.24include a review of the information required under section 245C.08, subdivisions 1,
122.25paragraph (a), clauses (1) to (5), 3, and 4.
122.26    (e) From January 1, 2008, to December 31, 2009, the commissioner shall conduct
122.27a study of an individual required to be studied under section 245C.03, at the time of
122.28reapplication for a family child care license. The county shall collect and forward to the
122.29commissioner the information required under section 245C.05, subdivisions 1, paragraphs
122.30(a) and (b), and 5, paragraphs (a) and (b). The background study conducted by the
122.31commissioner under this paragraph must include a review of the information required
122.32under section 245C.08, subdivisions 1, paragraph (a), clauses (1) to (5), 3, and 4.
122.33    (f) The commissioner of human services shall conduct a background study of an
122.34individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6),
122.35who is newly affiliated with a child foster care license holder, and beginning January 1,
122.362008, a family child care license. The county or private agency shall collect and forward
123.1to the commissioner the information required under section 245C.05, subdivisions 1 and
123.25. The background study conducted by the commissioner of human services under this
123.3paragraph must include a review of the information required under section 245C.08,
123.4subdivisions 1, 3, and 4.
123.5    (g) Applicants for licensure, license holders, and other entities as provided in this
123.6chapter must submit completed background study forms to the commissioner before
123.7individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
123.8contact in any licensed program.
123.9    (e) (h) For purposes of this section, a physician licensed under chapter 147 is
123.10considered to be continuously affiliated upon the license holder's receipt from the
123.11commissioner of health or human services of the physician's background study results.

123.12    Sec. 7. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:
123.13    Subdivision 1. Individual studied. (a) The individual who is the subject of the
123.14background study must provide the applicant, license holder, or other entity under section
123.15245C.04 with sufficient information to ensure an accurate study, including:
123.16    (1) the individual's first, middle, and last name and all other names by which the
123.17individual has been known;
123.18    (2) home address, city, and state of residence;
123.19    (3) zip code;
123.20    (4) sex;
123.21    (5) date of birth; and
123.22    (6) Minnesota driver's license number or state identification number.
123.23    (b) Every subject of a background study conducted or initiated by counties or private
123.24agencies under this chapter must also provide the home address, city, county, and state of
123.25residence for the past five years.
123.26    (c) Every subject of a background study related to private agency adoptions or
123.27related to child foster care licensed through a private agency, who is 18 years of age
123.28or older, shall also provide the commissioner a signed consent for the release of any
123.29information received from national crime information databases to the private agency that
123.30initiated the background study.
123.31    (d) The subject of a background study shall provide fingerprints as required in
123.32subdivision 5, paragraph (c).

123.33    Sec. 8. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision
123.34to read:
124.1    Subd. 2a. County or private agency. For background studies related to child
124.2foster care, and beginning January 1, 2008, for studies related to family child care, county
124.3and private agencies must collect the information under subdivision 1 and forward it to
124.4the commissioner.

124.5    Sec. 9. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:
124.6    Subd. 4. Electronic transmission. For background studies conducted by the
124.7Department of Human Services, the commissioner shall implement a system for the
124.8electronic transmission of:
124.9    (1) background study information to the commissioner; and
124.10    (2) background study results to the license holder.; and
124.11    (3) background study results to county and private agencies for background studies
124.12conducted by the commissioner for child foster care, and beginning January 1, 2008,
124.13also for family child care.

124.14    Sec. 10. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:
124.15    Subd. 5. Fingerprints. (a) Except as provided in paragraph (c), for any background
124.16study completed under this chapter, when the commissioner has reasonable cause to
124.17believe that further pertinent information may exist on the subject of the background
124.18study, the subject shall provide the commissioner with a set of classifiable fingerprints
124.19obtained from an authorized law enforcement agency.
124.20    (b) For purposes of requiring fingerprints, the commissioner has reasonable cause
124.21when, but not limited to, the:
124.22    (1) information from the Bureau of Criminal Apprehension indicates that the subject
124.23is a multistate offender;
124.24    (2) information from the Bureau of Criminal Apprehension indicates that multistate
124.25offender status is undetermined; or
124.26    (3) commissioner has received a report from the subject or a third party indicating
124.27that the subject has a criminal history in a jurisdiction other than Minnesota.
124.28    (c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for
124.29background studies conducted by the commissioner for child foster care or adoptions,
124.30the subject of the background study, who is 18 years of age or older, shall provide the
124.31commissioner with a set of classifiable fingerprints obtained from an authorized agency.

124.32    Sec. 11. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:
125.1    Subd. 7. Probation officer and corrections agent. (a) A probation officer or
125.2corrections agent shall notify the commissioner of an individual's conviction if the
125.3individual is:
125.4    (1) affiliated with a program or facility regulated by the Department of Human
125.5Services or Department of Health, a facility serving children or youth licensed by the
125.6Department of Corrections, or any type of home care agency or provider of personal care
125.7assistance services; and
125.8    (2) convicted of a crime constituting a disqualification under section 245C.14.
125.9    (b) For the purpose of this subdivision, "conviction" has the meaning given it
125.10in section 609.02, subdivision 5.
125.11    (c) The commissioner, in consultation with the commissioner of corrections, shall
125.12develop forms and information necessary to implement this subdivision and shall provide
125.13the forms and information to the commissioner of corrections for distribution to local
125.14probation officers and corrections agents.
125.15    (d) The commissioner shall inform individuals subject to a background study that
125.16criminal convictions for disqualifying crimes will be reported to the commissioner by the
125.17corrections system.
125.18    (e) A probation officer, corrections agent, or corrections agency is not civilly or
125.19criminally liable for disclosing or failing to disclose the information required by this
125.20subdivision.
125.21    (f) Upon receipt of disqualifying information, the commissioner shall provide the
125.22notice required under section 245C.17, as appropriate, to agencies on record as having
125.23initiated a background study or making a request for documentation of the background
125.24study status of the individual.
125.25    (g) This subdivision does not apply to family child care and child foster care
125.26programs until January 1, 2008.

125.27    Sec. 12. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:
125.28    Subdivision 1. Background studies conducted by commissioner of human
125.29services. (a) For a background study conducted by the commissioner, the commissioner
125.30shall review:
125.31    (1) information related to names of substantiated perpetrators of maltreatment of
125.32vulnerable adults that has been received by the commissioner as required under section
125.33626.557, subdivision 9c , paragraph (i);
126.1    (2) the commissioner's records relating to the maltreatment of minors in licensed
126.2programs, and from county agency findings of maltreatment of minors as indicated
126.3through the social service information system;
126.4    (3) information from juvenile courts as required in subdivision 4 for individuals
126.5listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and
126.6    (4) information from the Bureau of Criminal Apprehension.;
126.7    (5) except as provided in clause (6), information from the national crime information
126.8system when the commissioner has reasonable cause as defined under section 245C.05,
126.9subdivision 5; and
126.10    (6) for a background study related to a child foster care application for licensure or
126.11adoptions, the commissioner shall also review:
126.12    (i) information from the child abuse and neglect registry for any state in which the
126.13background study subject has resided for the past five years; and
126.14    (ii) information from national crime information databases, when the background
126.15study object is 18 years of age or older.
126.16    (b) Notwithstanding expungement by a court, the commissioner may consider
126.17information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
126.18received notice of the petition for expungement and the court order for expungement is
126.19directed specifically to the commissioner.

126.20    Sec. 13. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:
126.21    Subd. 2. Background studies conducted by a county or private agency. (a) For
126.22a background study conducted by a county or private agency for child foster care, adult
126.23foster care, family adult day services, and until January 1, 2008, family child care homes
126.24services, the commissioner shall review:
126.25    (1) information from the county agency's record of substantiated maltreatment
126.26of adults and the maltreatment of minors;
126.27    (2) information from juvenile courts as required in subdivision 4 for individuals
126.28listed in section 245C.03, subdivision 1, clauses (2), (5), and (6);
126.29    (3) information from the Bureau of Criminal Apprehension; and
126.30    (4) arrest and investigative records maintained by the Bureau of Criminal
126.31Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the
126.32National Criminal Records Repository, and criminal records from other states.
126.33    (b) If the individual has resided in the county for less than five years, the study shall
126.34include the records specified under paragraph (a) for the previous county or counties of
126.35residence for the past five years.
127.1    (c) Notwithstanding expungement by a court, the county or private agency may
127.2consider information obtained under paragraph (a), clauses (3) and (4), unless the
127.3commissioner received notice of the petition for expungement and the court order for
127.4expungement is directed specifically to the commissioner.

127.5    Sec. 14. Minnesota Statutes 2006, section 245C.10, is amended by adding a
127.6subdivision to read:
127.7    Subd. 4. Temporary personnel agencies, educational programs, and professional
127.8services agencies. The commissioner shall recover the cost of the background studies
127.9initiated by temporary personnel agencies, educational programs, and professional
127.10services agencies that initiate background studies under section 245C.03, subdivision 4,
127.11through a fee of no more than $20 per study charged to the agency. The fees collected
127.12under this subdivision are appropriated to the commissioner for the purpose of conducting
127.13background studies.

127.14    Sec. 15. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:
127.15    Subdivision 1. Adult foster care; criminal conviction data. For individuals who
127.16are required to have background studies under section 245C.03, subdivisions 1 and 2, and
127.17who have been continuously affiliated with a an adult foster care provider that is licensed
127.18in more than one county, criminal conviction data may be shared among those counties in
127.19which the adult foster care programs are licensed. A county agency's receipt of criminal
127.20conviction data from another county agency shall meet the criminal data background
127.21study requirements of this chapter.

127.22    Sec. 16. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:
127.23    Subd. 2. Jointly licensed programs. A county agency may accept a background
127.24study completed by the commissioner under this chapter in place of the background study
127.25required under section 245A.16, subdivision 3, in programs with joint licensure as home
127.26and community-based services and adult foster care for people with developmental
127.27disabilities when the license holder does not reside in the adult foster care residence and
127.28the subject of the study has been continuously affiliated with the license holder since the
127.29date of the commissioner's study.

127.30    Sec. 17. Minnesota Statutes 2006, section 245C.12, is amended to read:
127.31245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.
128.1    (a) For the purposes of background studies completed by tribal organizations
128.2performing licensing activities otherwise required of the commissioner under this chapter,
128.3after obtaining consent from the background study subject, tribal licensing agencies shall
128.4have access to criminal history data in the same manner as county licensing agencies and
128.5private licensing agencies under this chapter.
128.6    (b) Tribal organizations may contract with the commissioner to obtain background
128.7study data on individuals under tribal jurisdiction related to adoptions according to
128.8section 245C.34. Tribal organizations may also contract with the commissioner to obtain
128.9background study data on individuals under tribal jurisdiction related to child foster care
128.10according to section 245C.34.

128.11    Sec. 18. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:
128.12    Subdivision 1. Determining immediate risk of harm. (a) If the commissioner
128.13determines that the individual studied has a disqualifying characteristic, the commissioner
128.14shall review the information immediately available and make a determination as to the
128.15subject's immediate risk of harm to persons served by the program where the individual
128.16studied will have direct contact.
128.17    (b) The commissioner shall consider all relevant information available, including the
128.18following factors in determining the immediate risk of harm:
128.19    (1) the recency of the disqualifying characteristic;
128.20    (2) the recency of discharge from probation for the crimes;
128.21    (3) the number of disqualifying characteristics;
128.22    (4) the intrusiveness or violence of the disqualifying characteristic;
128.23    (5) the vulnerability of the victim involved in the disqualifying characteristic;
128.24    (6) the similarity of the victim to the persons served by the program where the
128.25individual studied will have direct contact; and
128.26    (7) whether the individual has a disqualification from a previous background study
128.27that has not been set aside.
128.28    (c) This section does not apply when the subject of a background study is regulated
128.29by a health-related licensing board as defined in chapter 214, and the subject is determined
128.30to be responsible for substantiated maltreatment under section 626.556 or 626.557.
128.31    (d) This section does not apply to a background study related to an initial application
128.32for a child foster care license.
128.33    (e) If the commissioner has reason to believe, based on arrest information or an
128.34active maltreatment investigation, that an individual poses an imminent risk of harm to
128.35persons receiving services, the commissioner may order that the person be continuously
129.1supervised or immediately removed pending the conclusion of the maltreatment
129.2investigation or criminal proceedings.

129.3    Sec. 19. Minnesota Statutes 2006, section 245C.17, is amended by adding a
129.4subdivision to read:
129.5    Subd. 5. Notice to county or private agency. For studies on individuals related
129.6to a license to provide child foster care, and beginning January 1, 2008, for family child
129.7care, the commissioner shall also provide a notice of the background study results to the
129.8county or private agency that initiated the background study.

129.9    Sec. 20. Minnesota Statutes 2006, section 245C.21, is amended by adding a
129.10subdivision to read:
129.11    Subd. 1a. Submission of reconsideration request to county or private agency.
129.12    (a) For disqualifications related to studies conducted by county agencies, and for
129.13disqualifications related to studies conducted by the commissioner for child foster care, and
129.14beginning January 1, 2008, for family child care, the individual shall submit the request
129.15for reconsideration to the county or private agency that initiated the background study.
129.16    (b) A reconsideration request shall be submitted within 30 days of the individual's
129.17receipt of the disqualification notice or the time frames specified in subdivision 2,
129.18whichever time frame is shorter.
129.19    (c) The county or private agency shall forward the individual's request for
129.20reconsideration and provide the commissioner with a recommendation whether to set aside
129.21the individual's disqualification.

129.22    Sec. 21. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:
129.23    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The
129.24commissioner shall notify the license holder of the disqualification and order the license
129.25holder to immediately remove the individual from any position allowing direct contact
129.26with persons receiving services from the license holder if:
129.27    (1) the individual studied does not submit a timely request for reconsideration
129.28under section 245C.21;
129.29    (2) the individual submits a timely request for reconsideration, but the commissioner
129.30does not set aside the disqualification for that license holder under section 245C.22;
129.31    (3) an individual who has a right to request a hearing under sections 245C.27 and
129.32256.045 , or 245C.28 and chapter 14 for a disqualification that has not been set aside, does
129.33not request a hearing within the specified time; or
130.1    (4) an individual submitted a timely request for a hearing under sections 245C.27
130.2and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
130.3disqualification under section 245A.08, subdivision 5, or 256.045.
130.4    (b) If the commissioner does not set aside the disqualification under section 245C.22,
130.5and the license holder was previously ordered under section 245C.17 to immediately
130.6remove the disqualified individual from direct contact with persons receiving services or
130.7to ensure that the individual is under continuous, direct supervision when providing direct
130.8contact services, the order remains in effect pending the outcome of a hearing under
130.9sections 245C.27 and 256.045, or 245C.28 and chapter 14.
130.10    (c) For background studies related to child foster care, and beginning January
130.111, 2008, for family child care, the commissioner shall also notify the county or private
130.12agency that initiated the study of the results of the reconsideration.

130.13    Sec. 22. [245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.
130.14    Subdivision 1. Background studies conducted by commissioner. Before
130.15placement of a child for purposes of adoption, the commissioner shall conduct a
130.16background study on individuals listed in section 259.41, subdivision 3, for county
130.17agencies and private agencies licensed to place children for adoption.
130.18    Subd. 2. Information and data provided to county or private agency. The subject
130.19of the background study shall provide the information specified in section 245C.05.
130.20    Subd. 3. Information and data provided to commissioner. The county or private
130.21agency shall forward the data collected under subdivision 2 to the commissioner.
130.22    Subd. 4. Information commissioner reviews. (a) The commissioner shall review
130.23the following information regarding the background study subject:
130.24    (1) the information under section 245C.08, subdivisions 1, 3, and 4;
130.25    (2) information from the child abuse and neglect registry for any state in which the
130.26subject has resided for the past five years; and
130.27    (3) information from national crime information databases, when required under
130.28section 245C.08.
130.29    (b) The commissioner shall provide any information collected under this subdivision
130.30to the county or private agency that initiated the background study. The commissioner
130.31shall indicate if the information collected shows that the subject of the background study
130.32has a conviction listed in United States Code, title 42, section 671(a)(20)(A).

130.33    Sec. 23. [245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND
130.34STUDIES; TRIBAL ORGANIZATIONS.
131.1    Subdivision 1. Background studies may be conducted by commissioner. (a)
131.2Tribal organizations may contract with the commissioner under section 245C.12 to obtain
131.3background study data on individuals under tribal jurisdiction related to adoptions.
131.4    (b) Tribal organizations may contract with the commissioner under section 245C.12
131.5to obtain background study data on individuals under tribal jurisdiction related to child
131.6foster care.
131.7    (c) Background studies initiated by tribal organizations under paragraphs (a) and (b)
131.8must be conducted as provided in subdivisions 2 and 3.
131.9    Subd. 2. Information and data provided to tribal organization. The background
131.10study subject must provide the information specified in section 245C.05.
131.11    Subd. 3. Information and data provided to commissioner. The tribal organization
131.12shall forward the data collected under subdivision 2 to the commissioner.
131.13    Subd. 4. Information commissioner reviews. (a) The commissioner shall review
131.14the following information regarding the background study subject:
131.15    (1) the information under section 245C.08, subdivisions 1, 3, and 4;
131.16    (2) information from the child abuse and neglect registry for any state in which the
131.17subject has resided for the past five years; and
131.18    (3) information from national crime information databases, when required under
131.19section 245C.08.
131.20    (b) The commissioner shall provide any information collected under this subdivision
131.21to the tribal organization that initiated the background study. The commissioner shall
131.22indicate if the information collected shows that the subject of the background study has a
131.23conviction listed in United States Code, title 42, section 671(a)(20)(A).

131.24    Sec. 24. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:
131.25    Subd. 2. Other applicable law. (a) Portions of chapters 245A, 245C, 257, 260, and
131.26317A may also affect the adoption of a particular child.
131.27    (b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter
131.2821, sections 1901-1923, may also apply in the adoption of an Indian child, and may
131.29preempt specific provisions of this chapter.
131.30    (c) Consistent with section 245C.33 and Public Law 109-248, a completed
131.31background study is required before the approval of any foster or adoptive placement in
131.32a related or an unrelated home.

131.33    Sec. 25. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:
132.1    Subdivision 1. Best interests of the child. (a) The policy of the state of Minnesota
132.2is to ensure that the best interests of the child are met by requiring individualized
132.3determination of the needs of the child and of how the adoptive placement will serve the
132.4needs of the child.
132.5    (b) Among the factors the agency shall consider in determining the needs of the child
132.6are those specified under section 260C.193, subdivision 3, paragraph (b).
132.7    (c) Except for emergency placements provided for in section 245A.035, a completed
132.8background study is required under section 245C.33 before the approval of an adoptive
132.9placement in a home.

132.10    Sec. 26. Minnesota Statutes 2006, section 259.41, is amended to read:
132.11259.41 ADOPTION STUDY.
132.12    Subdivision 1. Study required before placement; certain relatives excepted. (a)
132.13An approved adoption study; completed background study, as required under section
132.14245C.33; and written report must be completed before the child is placed in a prospective
132.15adoptive home under this chapter, except as allowed by section 259.47, subdivision 6.
132.16In an agency placement, the report must be filed with the court at the time the adoption
132.17petition is filed. In a direct adoptive placement, the report must be filed with the court in
132.18support of a motion for temporary preadoptive custody under section 259.47, subdivision
132.193 , or, if the study and report are complete, in support of an emergency order under section
132.20259.47, subdivision 6 . The study and report shall be completed by a licensed child-placing
132.21agency and must be thorough and comprehensive. The study and report shall be paid for
132.22by the prospective adoptive parent, except as otherwise required under section 259.67
132.23or 259.73.
132.24    (b) A placement for adoption with an individual who is related to the child, as
132.25defined by section 245A.02, subdivision 13, is not subject to this section except as required
132.26by section sections 245C.33 and 259.53, subdivision 2, paragraph (c).
132.27    (c) In the case of a licensed foster parent seeking to adopt a child who is in the foster
132.28parent's care, any portions of the foster care licensing process that duplicate requirements
132.29of the home study may be submitted in satisfaction of the relevant requirements of this
132.30section.
132.31    Subd. 2. Form of study. (a) The adoption study must include at least one in-home
132.32visit with the prospective adoptive parent. At a minimum, the study must include
132.33document the following information about the prospective adoptive parent:
132.34    (1) a background check study as required by subdivision 3 and section 245C.33,
132.35and including:
133.1    (i) an evaluation assessment of the data and information provided by section
133.2245C.33, subdivision 4, to determine if the prospective adoptive parent and any other
133.3person over the age of 13 living in the home has a felony conviction consistent with
133.4subdivision 3 and section 471(a)(2) of the Social Security Act; and
133.5    (ii) an assessment of the effect of a any conviction or finding of substantiated
133.6maltreatment on the ability to capacity of the prospective adoptive parent to safely care
133.7for and parent a child;
133.8    (2) a medical and social history and assessment of current health;
133.9    (3) an assessment of potential parenting skills;
133.10    (4) an assessment of ability to provide adequate financial support for a child; and
133.11    (5) an assessment of the level of knowledge and awareness of adoption issues
133.12including, where appropriate, matters relating to interracial, cross-cultural, and special
133.13needs adoptions.
133.14    (b) The adoption study is the basis for completion of a written report. The report
133.15must be in a format specified by the commissioner and must contain recommendations
133.16regarding the suitability of the subject of the study to be an adoptive parent.
133.17    Subd. 3. Background check; affidavit of history study. (a) At the time an adoption
133.18study is commenced, each prospective adoptive parent must:
133.19    (1) authorize access by the agency to any private data needed to complete the study;
133.20    (2) provide all addresses at which the prospective adoptive parent and anyone in the
133.21household over the age of 13 has resided in the previous five years; and
133.22    (3) disclose any names used previously other than the name used at the time of
133.23the study.
133.24    (b) When the requirements of paragraph (a) have been met, the agency shall
133.25immediately begin initiate a background check, study under section 245C.33 to be
133.26completed by the commissioner on each person over the age of 13 living in the home,
133.27consisting, at a minimum, of the following:. As required under section 245C.33 and Public
133.28Law 109-248, a completed background study is required before the approval of any foster
133.29or adoptive placement in a related or an unrelated home. The required background study
133.30must be completed as part of the home study.
133.31    (1) a check of criminal conviction data with the Bureau of Criminal Apprehension
133.32and local law enforcement authorities;
133.33    (2) a check for data on substantiated maltreatment of a child or vulnerable adult
133.34and domestic violence data with local law enforcement and social services agencies and
133.35district courts; and
133.36    (3) for those persons under the age of 25, a check of juvenile court records.
134.1    Notwithstanding the provisions of section 260B.171 or 260C.171, the Bureau of
134.2Criminal Apprehension, local law enforcement and social services agencies, district courts,
134.3and juvenile courts shall release the requested information to the agency completing
134.4the adoption study.
134.5    (c) When paragraph (b) requires checking the data or records of local law
134.6enforcement and social services agencies and district and juvenile courts, the agency
134.7shall check with the law enforcement and social services agencies and courts whose
134.8jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the
134.9agency is unable to complete any of the record checks required by paragraph (b), the
134.10agency shall document the fact and the agency's efforts to obtain the information.
134.11    (d) For a study completed under this section, when the agency has reasonable
134.12cause to believe that further information may exist on the prospective adoptive parent or
134.13household member over the age of 13 that may relate to the health, safety, or welfare of
134.14the child, the prospective adoptive parent or household member over the age of 13 shall
134.15provide the agency with a set of classifiable fingerprints obtained from an authorized law
134.16enforcement agency and the agency may obtain criminal history data from the National
134.17Criminal Records Repository by submitting fingerprints to the Bureau of Criminal
134.18Apprehension. The agency has reasonable cause when, but not limited to, the:
134.19    (1) information from the Bureau of Criminal Apprehension indicates that the
134.20prospective adoptive parent or household member over the age of 13 is a multistate
134.21offender;
134.22    (2) information from the Bureau of Criminal Apprehension indicates that multistate
134.23offender status is undetermined;
134.24    (3) the agency has received a report from the prospective adoptive parent or
134.25household member over the age of 13 or a third party indicating that the prospective
134.26adoptive parent or household member over the age of 13 has a criminal history in a
134.27jurisdiction other than Minnesota; or
134.28    (4) the prospective adoptive parent or household member over the age of 13 is or has
134.29been a resident of a state other than Minnesota in the prior five years.
134.30    (e) At any time prior to completion of the background check required under
134.31paragraph (b), a prospective adoptive parent may submit to the agency conducting the
134.32study a sworn affidavit stating whether they or any person residing in the household have
134.33been convicted of a crime. The affidavit shall also state whether the adoptive parent or any
134.34other person residing in the household is the subject of an open investigation of, or have
134.35been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment
134.36within the past ten years. A complete description of the crime, open investigation, or
135.1substantiated abuse, and a complete description of any sentence, treatment, or disposition
135.2must be included. The affidavit must contain an acknowledgment that if, at any time
135.3before the adoption is final, a court receives evidence leading to a conclusion that a
135.4prospective adoptive parent knowingly gave false information in the affidavit, it shall be
135.5determined that the adoption of the child by the prospective adoptive parent is not in the
135.6best interests of the child.
135.7    (f) For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an
135.8adoption study is complete for placement, even though the background checks required by
135.9paragraph (b) have not been completed, if each prospective adoptive parent has completed
135.10the affidavit allowed by paragraph (e) and the other requirements of this section have been
135.11met. The background checks required by paragraph (b) must be completed before an
135.12adoption petition is filed. If an adoption study has been submitted to the court under section
135.13259.47, subdivision 3 or 6, before the background checks required by paragraph (b) were
135.14complete, an updated adoption study report which includes the results of the background
135.15check must be filed with the adoption petition. In the event that an agency is unable to
135.16complete any of the records checks required by paragraph (b), the agency shall submit with
135.17the petition to adopt an affidavit documenting the agency's efforts to complete the checks.
135.18    (c) A home study under paragraph (b) used to consider placement of any child
135.19on whose behalf Title IV-E adoption assistance payments are to be made must not be
135.20approved if a background study reveals a felony conviction at any time for:
135.21    (1) child abuse or neglect;
135.22    (2) spousal abuse;
135.23    (3) a crime against children, including child pornography; or
135.24    (4) a crime involving violence, including rape, sexual assault, or homicide, but not
135.25including other physical assault or battery.
135.26    (d) A home study under paragraph (b) used to consider placement of any child
135.27on whose behalf Title IV-E adoption assistance payments are to be made must not be
135.28approved if a background study reveals a felony conviction within the past five years for:
135.29    (1) physical assault or battery; or
135.30    (2) a drug-related offense.
135.31    Subd. 4. Updates to adoption study; period of validity. An agency may update
135.32an adoption study and report as needed, regardless of when the original study and report
135.33or most recent update was completed. An update must be in a format specified by the
135.34commissioner and must verify the continuing accuracy of the elements of the original
135.35report and document any changes to elements of the original report. An update to a study
135.36and report not originally completed under this section must ensure that the study and
136.1report, as updated, meet the requirements of this section. An adoption study is valid if the
136.2report has been completed or updated within the previous 12 months.

136.3    Sec. 27. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:
136.4    Subd. 2. Adoption agencies; postplacement assessment and report. (a) The
136.5agency to which the petition has been referred under subdivision 1 shall conduct a
136.6postplacement assessment and file a report with the court within 90 days of receipt
136.7of a copy of the adoption petition. The agency shall send a copy of the report to the
136.8commissioner at the time it files the report with the court. The assessment and report
136.9must evaluate the environment and antecedents of the child to be adopted, the home of
136.10the petitioners, whether placement with the petitioners meets the needs of the child as
136.11described in section 259.57, subdivision 2. The report must include a recommendation to
136.12the court as to whether the petition should or should not be granted.
136.13    In making evaluations and recommendations, the postplacement assessment and
136.14report must, at a minimum, address the following:
136.15    (1) the level of adaptation by the prospective adoptive parents to parenting the child;
136.16    (2) the health and well-being of the child in the prospective adoptive parents' home;
136.17    (3) the level of incorporation by the child into the prospective adoptive parents'
136.18home, extended family, and community; and
136.19    (4) the level of inclusion of the child's previous history into the prospective adoptive
136.20home, such as cultural or ethnic practices, or contact with former foster parents or
136.21biological relatives.
136.22    (b) A postplacement adoption report is valid for 12 months following its date
136.23of completion.
136.24    (c) If the petitioner is an individual who is related to the child, as defined by section
136.25245A.02, subdivision 13, the agency, as part of its postplacement assessment and report
136.26under paragraph (a), shall conduct a background check meeting the requirements of
136.27section 259.41, subdivision 3, paragraph (b). The prospective adoptive parent shall
136.28cooperate in the completion of the background check by supplying the information and
136.29authorizations described in section 259.41, subdivision 3, paragraph (a).
136.30    (d) (c) If the report recommends that the court not grant the petition to adopt the
136.31child, the provisions of this paragraph apply. Unless the assessment and report were
136.32completed by the local social services agency, the agency completing the report, at the
136.33time it files the report with the court under paragraph (a), must provide a copy of the report
136.34to the local social services agency in the county where the prospective adoptive parent
136.35lives. The agency or local social services agency may recommend that the court dismiss
137.1the petition. If the local social services agency determines that continued placement in the
137.2home endangers the child's physical or emotional health, the agency shall seek a court
137.3order to remove the child from the home.
137.4    (e) (d) If, through no fault of the petitioner, the agency to whom the petition was
137.5referred under subdivision 1, paragraph (b), fails to complete the assessment and file the
137.6report within 90 days of the date it received a copy of the adoption petition, the court may
137.7hear the petition upon giving the agency and the local social services agency, if different,
137.8five days' notice by mail of the time and place of the hearing.

137.9    Sec. 28. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:
137.10    Subd. 2. Protection of child's best interests. (a) The policy of the state of
137.11Minnesota is to ensure that the best interests of children are met by requiring an
137.12individualized determination of the needs of the child and how the adoptive placement
137.13will serve the needs of the child.
137.14    (b) Among the factors the court shall consider in determining the needs of the child
137.15are those specified under section 260C.193, subdivision 3, paragraph (b). Consistent with
137.16section 245C.33 and Public Law 109-248, a complete background study is required before
137.17the approval of an adoptive placement in a home.
137.18    (c) In reviewing adoptive placement and in determining appropriate adoption,
137.19the court shall consider placement, consistent with the child's best interests and in the
137.20following order, with (1) a relative or relatives of the child, or (2) an important friend with
137.21whom the child has resided or had significant contact. Placement of a child cannot be
137.22delayed or denied based on race, color, or national origin of the adoptive parent or the
137.23child. Whenever possible, siblings should be placed together unless it is determined
137.24not to be in the best interests of a sibling.
137.25    (d) If the child's birth parent or parents explicitly request that relatives and important
137.26friends not be considered, the court shall honor that request consistent with the best
137.27interests of the child.
137.28    If the child's birth parent or parents express a preference for placing the child in an
137.29adoptive home of the same or a similar religious background to that of the birth parent
137.30or parents, the court shall place the child with a family that also meets the birth parent's
137.31religious preference. Only if no family is available as described in clause (a) or (b)
137.32may the court give preference to a family described in clause (c) that meets the parent's
137.33religious preference.
138.1    (e) This subdivision does not affect the Indian Child Welfare Act, United States
138.2Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation
138.3Act, sections 260.751 to 260.835.

138.4    Sec. 29. Minnesota Statutes 2006, section 260C.209, is amended to read:
138.5260C.209 BACKGROUND CHECKS.
138.6    Subdivision 1. Subjects. The responsible social services agency must conduct
138.7initiate a background check study to be completed by the commissioner under this section
138.8of chapter 245C on the following individuals:
138.9    (1) a noncustodial parent or nonadjudicated parent who is being assessed for
138.10purposes of providing day-to-day care of a child temporarily or permanently under section
138.11260C.212, subdivision 4 , and any member of the parent's household who is over the age of
138.1213 when there is a reasonable cause to believe that the parent or household member over
138.13age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult
138.14which would endanger the child's health, safety, or welfare;
138.15    (2) an individual whose suitability for relative placement under section 260C.212,
138.16subdivision 5 , is being determined and any member of the relative's household who is
138.17over the age of 13 when:
138.18    (i) the relative must be licensed for foster care; or
138.19    (ii) the agency must conduct a background study is required under section 259.53,
138.20subdivision 2 ; or
138.21    (iii) the agency or the commissioner has reasonable cause to believe the relative
138.22or household member over the age of 13 has a criminal history which would not make
138.23transfer of permanent legal and physical custody to the relative under section 260C.201,
138.24subdivision 11 , in the child's best interest; and
138.25    (3) a parent, following an out-of-home placement, when the responsible social
138.26services agency has reasonable cause to believe that the parent has been convicted of a
138.27crime directly related to the parent's capacity to maintain the child's health, safety, or
138.28welfare or the parent is the subject of an open investigation of, or has been the subject
138.29of a substantiated allegation of, child or vulnerable-adult maltreatment within the past
138.30ten years.
138.31"Reasonable cause" means that the agency has received information or a report from the
138.32subject or a third person that creates an articulable suspicion that the individual has a
138.33history that may pose a risk to the health, safety, or welfare of the child. The information
138.34or report must be specific to the potential subject of the background check and shall not
139.1be based on the race, religion, ethnic background, age, class, or lifestyle of the potential
139.2subject.
139.3    Subd. 2. General procedures. (a) When conducting initiating a background check
139.4under subdivision 1, the agency may shall require the individual being assessed to provide
139.5sufficient information to ensure an accurate assessment under this section, including:
139.6    (1) the individual's first, middle, and last name and all other names by which the
139.7individual has been known;
139.8    (2) home address, zip code, city, county, and state of residence for the past ten five
139.9years;
139.10    (3) sex;
139.11    (4) date of birth; and
139.12    (5) driver's license number or state identification number.
139.13    (b) When notified by the commissioner or the responsible social services agency that
139.14it is conducting an assessment under this section, the Bureau of Criminal Apprehension,
139.15commissioners of health and human services, law enforcement, and county agencies must
139.16provide the commissioner or the responsible social services agency or county attorney
139.17with the following information on the individual being assessed: criminal history data,
139.18reports about the maltreatment of adults substantiated under section 626.557, and reports
139.19of maltreatment of minors substantiated under section 626.556.
139.20    Subd. 3. Multistate information. (a) For any assessment every background study
139.21completed under this section, if the responsible social services agency has reasonable
139.22cause to believe that the individual is a multistate offender, the individual must the subject
139.23of the background study shall provide the responsible social services agency or the
139.24county attorney with a set of classifiable fingerprints obtained from an authorized law
139.25enforcement agency. The responsible social services agency or county attorney may shall
139.26provide the fingerprints to the commissioner, and the commissioner shall obtain criminal
139.27history data from the National Criminal Records Repository by submitting the fingerprints
139.28to the Bureau of Criminal Apprehension.
139.29    (b) For purposes of this subdivision, the responsible social services agency has
139.30reasonable cause when, but not limited to:
139.31    (1) information from the Bureau of Criminal Apprehension indicates that the
139.32individual is a multistate offender;
139.33    (2) information from the Bureau of Criminal Apprehension indicates that multistate
139.34offender status is undetermined;
140.1    (3) the social services agency has received a report from the individual or a third
140.2party indicating that the individual has a criminal history in a jurisdiction other than
140.3Minnesota; or
140.4    (4) the individual is or has been a resident of a state other than Minnesota at any
140.5time during the prior ten years.
140.6    Subd. 4. Notice upon receipt. The responsible social services agency commissioner
140.7must provide the subject of the background study with the results of the study as required
140.8under this section within 15 business days of receipt or at least 15 days prior to the hearing
140.9at which the results will be presented, whichever comes first. The subject may provide
140.10written information to the agency that the results are incorrect and may provide additional
140.11or clarifying information to the agency and to the court through a party to the proceeding.
140.12This provision does not apply to any background study conducted under chapters 245A
140.13and chapter 245C.

140.14    Sec. 30. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:
140.15    Subd. 2. Placement decisions based on best interest of the child. (a) The policy
140.16of the state of Minnesota is to ensure that the child's best interests are met by requiring an
140.17individualized determination of the needs of the child and of how the selected placement
140.18will serve the needs of the child being placed. The authorized child-placing agency shall
140.19place a child, released by court order or by voluntary release by the parent or parents, in
140.20a family foster home selected by considering placement with relatives and important
140.21friends in the following order:
140.22    (1) with an individual who is related to the child by blood, marriage, or adoption; or
140.23    (2) with an individual who is an important friend with whom the child has resided or
140.24had significant contact.
140.25    (b) Among the factors the agency shall consider in determining the needs of the
140.26child are the following:
140.27    (1) the child's current functioning and behaviors;
140.28    (2) the medical, educational, and developmental needs of the child;
140.29    (3) the child's history and past experience;
140.30    (4) the child's religious and cultural needs;
140.31    (5) the child's connection with a community, school, and church;
140.32    (6) the child's interests and talents;
140.33    (7) the child's relationship to current caretakers, parents, siblings, and relatives; and
141.1    (8) the reasonable preference of the child, if the court, or the child-placing agency
141.2in the case of a voluntary placement, deems the child to be of sufficient age to express
141.3preferences.
141.4    (c) Placement of a child cannot be delayed or denied based on race, color, or national
141.5origin of the foster parent or the child.
141.6    (d) Siblings should be placed together for foster care and adoption at the earliest
141.7possible time unless it is determined not to be in the best interests of a sibling or unless it
141.8is not possible after appropriate efforts by the responsible social services agency.
141.9    (e) Except for emergency placement as provided for in section 245A.035, a
141.10completed background study is required under section 245C.08 before the approval of a
141.11foster placement in a related or unrelated home.

141.12    Sec. 31. LICENSING MORATORIUM.
141.13    A program operated by a nonpublic school for children 33 months or older is
141.14exempt from the human services licensing requirements in Minnesota Statutes, chapter
141.15245A, until July 1, 2009. Nothing in this section prohibits an already licensed nonpublic
141.16school program from continuing its licensure or a nonpublic school program from seeking
141.17licensure.
141.18EFFECTIVE DATE.This moratorium is effective the day following final
141.19enactment.

141.20    Sec. 32. ANNUAL LICENSE REVIEW.
141.21    The commissioner of human services shall work with counties to determine the cost
141.22and propose an ongoing funding allocation from the general fund to cover the cost to
141.23counties to implement an annual license review for licensed family child care providers.
141.24The commissioner shall solicit input from counties to determine the outcome. The
141.25commissioner shall report to the house and senate committees having jurisdiction over
141.26early childhood programs by January 15, 2008, as to the costs and the funding allocation
141.27recommended for future use.
141.28EFFECTIVE DATE.This section is effective the day following final enactment.

141.29    Sec. 33. EFFECTIVE DATE.
141.30    Changes made to sections in this article related to family child care are effective
141.31January 1, 2008.

142.1ARTICLE 4

142.2HEALTH CARE POLICY

142.3    Section 1. Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to
142.4read:
142.5    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
142.6resources in the health care access fund exceed expenditures in that fund, effective with
142.7for the biennium beginning July 1, 2007, the commissioner of finance shall transfer the
142.8excess funds from the health care access fund to the general fund on June 30 of each year,
142.9provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000.
142.10The purpose of this transfer is to meet the rate increase required under Laws 2003, First
142.11Special Session chapter 14, article 13C, section 2, subdivision 6.
142.12    (b) For fiscal years 2006 to 2009, MinnesotaCare shall be a forecasted program, and,
142.13if necessary, the commissioner shall reduce these transfers from the health care access
142.14fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
142.15transfer sufficient funds from the general fund to the health care access fund to meet
142.16annual MinnesotaCare expenditures.

142.17    Sec. 2. [254A.171] INTERVENTION AND ADVOCACY PROGRAM.
142.18    Within the limit of money available, the commissioner shall fund voluntary outreach
142.19programs targeted at women who deliver children affected by prenatal alcohol or drug use.
142.20The programs shall help women obtain treatment, stay in recovery, and plan any future
142.21pregnancies. An advocate shall be assigned to each woman in the program to provide
142.22guidance and advice with respect to treatment programs, child safety and parenting,
142.23housing, family planning, and any other personal issues that are barriers to remaining free
142.24of chemical dependency.

142.25    Sec. 3. Minnesota Statutes 2006, section 256B.055, subdivision 14, is amended to read:
142.26    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
142.27inmate of a correctional facility who is conditionally released as authorized under section
142.28241.26 , 244.065, or 631.425, if the individual does not require the security of a public
142.29detention facility and is housed in a halfway house or community correction center, or
142.30under house arrest and monitored by electronic surveillance in a residence approved
142.31by the commissioner of corrections, and if the individual meets the other eligibility
142.32requirements of this chapter.
143.1    (b) An individual who is enrolled in medical assistance, and who is charged with a
143.2crime and incarcerated for less than 12 months shall be suspended from eligibility at the
143.3time of incarceration until the individual is released. Upon release, medical assistance
143.4eligibility is reinstated without reapplication using a reinstatement process and form, if the
143.5individual is otherwise eligible.
143.6    (c) An individual, regardless of age, who is considered an inmate of a public
143.7institution as defined in Code of Federal Regulations, title 42, section 435.1009, is not
143.8eligible for medical assistance.

143.9    Sec. 4. Minnesota Statutes 2006, section 256B.056, is amended by adding a
143.10subdivision to read:
143.11    Subd. 1d. Treatment of certain monetary gifts. The commissioner shall disregard
143.12as income any portion of a monetary gift received by an applicant or enrollee that is
143.13designated to purchase a prosthetic device not covered by insurance, other third-party
143.14payers, or medical assistance.

143.15    Sec. 5. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to
143.16read:
143.17    Subd. 13c. Formulary committee. The commissioner, after receiving
143.18recommendations from professional medical associations and professional pharmacy
143.19associations, and consumer groups shall designate a Formulary Committee to carry
143.20out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be
143.21comprised of four licensed physicians actively engaged in the practice of medicine in
143.22Minnesota one of whom must be actively engaged in the treatment of persons with mental
143.23illness; at least three licensed pharmacists actively engaged in the practice of pharmacy
143.24in Minnesota; and one consumer representative; the remainder to be made up of health
143.25care professionals who are licensed in their field and have recognized knowledge in the
143.26clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs.
143.27Members of the Formulary Committee shall not be employed by the Department of
143.28Human Services, but the committee shall be staffed by an employee of the department
143.29who shall serve as an ex officio, nonvoting member of the board committee. The
143.30department's medical director shall also serve as an ex officio, nonvoting member for the
143.31committee. Committee members shall serve three-year terms and may be reappointed
143.32by the commissioner. The Formulary Committee shall meet at least quarterly. The
143.33commissioner may require more frequent Formulary Committee meetings as needed. An
144.1honorarium of $100 per meeting and reimbursement for mileage shall be paid to each
144.2committee member in attendance.

144.3    Sec. 6. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to
144.4read:
144.5    Subd. 13d. Drug formulary. (a) The commissioner shall establish a drug
144.6formulary. Its establishment and publication shall not be subject to the requirements of the
144.7Administrative Procedure Act, but the Formulary Committee shall review and comment
144.8on the formulary contents.
144.9    (b) The formulary shall not include:
144.10    (1) drugs or products for which there is no federal funding;
144.11    (2) over-the-counter drugs, except as provided in subdivision 13;
144.12    (3) drugs used for weight loss, except that medically necessary lipase inhibitors may
144.13be covered for a recipient with type II diabetes;
144.14    (4) drugs when used for the treatment of impotence or erectile dysfunction;
144.15    (5) drugs for which medical value has not been established; and
144.16    (6) drugs from manufacturers who have not signed a rebate agreement with the
144.17Department of Health and Human Services pursuant to section 1927 of title XIX of the
144.18Social Security Act.
144.19    (c) If a single-source drug used by at least two percent of the fee-for-service
144.20medical assistance recipients is removed from the formulary due to the failure of the
144.21manufacturer to sign a rebate agreement with the Department of Health and Human
144.22Services, the commissioner shall notify prescribing practitioners within 30 days of
144.23receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a
144.24rebate agreement was not signed.
144.25EFFECTIVE DATE.This section is effective the day following final enactment.

144.26    Sec. 7. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
144.27subdivision to read:
144.28    Subd. 49. Community health worker. (a) Medical assistance covers the care
144.29coordination and patient education services provided by a community health worker if
144.30the community health worker has:
144.31    (1) received a certificate from the Minnesota State Colleges and Universities System
144.32approved community health worker curriculum; or
144.33    (2) at least five years of supervised experience with an enrolled physician, registered
144.34nurse, or advanced practice registered nurse.
145.1Community health workers eligible for payment under clause (2) must complete the
145.2certification program by January 1, 2010, to continue to be eligible for payment.
145.3    (b) Community health workers must work under the supervision of a medical
145.4assistance enrolled physician, registered nurse, or advanced practice registered nurse.

145.5    Sec. 8. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
145.6    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
145.7and (c), the MinnesotaCare benefit plan shall include the following co-payments and
145.8coinsurance requirements for all enrollees:
145.9    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
145.10subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
145.11$3,000 per family;
145.12    (2) $3 per prescription for adult enrollees;
145.13    (3) $25 for eyeglasses for adult enrollees;
145.14    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
145.15episode of service which is required because of a recipient's symptoms, diagnosis, or
145.16established illness, and which is delivered in an ambulatory setting by a physician or
145.17physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
145.18audiologist, optician, or optometrist; and
145.19    (5) $6 for nonemergency visits to a hospital-based emergency room.
145.20    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
145.21children under the age of 21 in households with family income equal to or less than 175
145.22percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
145.23parents and relative caretakers of children under the age of 21 in households with family
145.24income greater than 175 percent of the federal poverty guidelines for inpatient hospital
145.25admissions occurring on or after January 1, 2001.
145.26    (c) Paragraph (a), clauses (1) to (4), do does not apply to pregnant women and
145.27children under the age of 21.
145.28    (d) Adult enrollees with family gross income that exceeds 175 percent of the
145.29federal poverty guidelines and who are not pregnant shall be financially responsible for
145.30the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
145.31hospital benefit limit.
145.32    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
145.33or changes from one prepaid health plan to another during a calendar year, any charges
145.34submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
146.1expenses incurred by the enrollee for inpatient services, that were submitted or incurred
146.2prior to enrollment, or prior to the change in health plans, shall be disregarded.

146.3    Sec. 9. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:
146.4    Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing
146.5in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee
146.6residing in a correctional or detention facility is not eligible at renewal of eligibility under
146.7section 256L.05, subdivision 3b 3a.

146.8    Sec. 10. Minnesota Statutes 2006, section 256L.17, subdivision 3, is amended to read:
146.9    Subd. 3. Documentation. (a) The commissioner of human services shall require
146.10individuals and families, at the time of application or renewal, to indicate on a checkoff
146.11form developed by the commissioner whether they satisfy the MinnesotaCare asset
146.12requirement. This form must include the following or similar language: "To be eligible for
146.13MinnesotaCare, individuals and families must not own net assets in excess of $30,000
146.14for a household of two or more persons or $15,000 for a household of one person, not
146.15including a homestead, household goods and personal effects, assets owned by children,
146.16vehicles used for employment, court-ordered settlements up to $10,000, individual
146.17retirement accounts, and capital and operating assets of a trade or business up to $200,000.
146.18Do you and your household own net assets in excess of these limits?"
146.19    (b) The commissioner may require individuals and families to provide any
146.20information the commissioner determines necessary to verify compliance with the asset
146.21requirement, if the commissioner determines that there is reason to believe that an
146.22individual or family has assets that exceed the program limit.

146.23ARTICLE 5

146.24HEALTH CARE

146.25    Section 1. Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to
146.26read:
146.27    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
146.28resources in the health care access fund exceed expenditures in that fund, effective with
146.29for the biennium beginning July 1, 2007, the commissioner of finance shall transfer the
146.30excess funds from the health care access fund to the general fund on June 30 of each year,
146.31provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000.
146.32The purpose of this transfer is to meet the rate increase required under Laws 2003, First
146.33Special Session chapter 14, article 13C, section 2, subdivision 6.
147.1    (b) For fiscal years 2006 to 2009 2011, MinnesotaCare shall be a forecasted
147.2program, and, if necessary, the commissioner shall reduce these transfers from the health
147.3care access fund to the general fund to meet annual MinnesotaCare expenditures or, if
147.4necessary, transfer sufficient funds from the general fund to the health care access fund to
147.5meet annual MinnesotaCare expenditures.

147.6    Sec. 2. [256.962] MINNESOTA HEALTH CARE PROGRAMS OUTREACH.
147.7    Subdivision 1. Public awareness and education. The commissioner, in consultation
147.8with community organizations, health plans, and other public entities experienced in
147.9outreach to the uninsured, shall design and implement a statewide campaign to raise public
147.10awareness on the availability of health coverage through medical assistance, general
147.11assistance medical care, and MinnesotaCare and to educate the public on the importance of
147.12obtaining and maintaining health care coverage. The campaign shall include multimedia
147.13messages directed to the general population.
147.14    Subd. 2. Outreach grants. (a) The commissioner shall award grants to public and
147.15private organizations, regional collaboratives, and regional health care outreach centers
147.16for outreach activities, including, but not limited to:
147.17    (1) providing information, applications, and assistance in obtaining coverage
147.18through Minnesota public health care programs;
147.19    (2) collaborating with public and private entities such as hospitals, providers, health
147.20plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to
147.21develop outreach activities and partnerships to ensure the distribution of information
147.22and applications and provide assistance in obtaining coverage through Minnesota health
147.23care programs; and
147.24    (3) providing or collaborating with public and private entities to provide multilingual
147.25and culturally specific information and assistance to applicants in areas of high
147.26uninsurance in the state or populations with high rates of uninsurance.
147.27    (b) The commissioner shall ensure that all outreach materials are available in
147.28languages other than English.
147.29    (c) The commissioner shall establish an outreach trainer program to provide
147.30training to designated individuals from the community and public and private entities on
147.31application assistance in order for these individuals to provide training to others in the
147.32community on an as-needed basis.
147.33    Subd. 3. Application and assistance. (a) The Minnesota health care programs
147.34application must be made available at provider offices, local human services agencies,
147.35school districts, public and private elementary schools in which 25 percent or more of
148.1the students receive free or reduced price lunches, community health offices, Women,
148.2Infants and Children (WIC) program sites, Head Start program sites, public housing
148.3councils, child care centers, early childhood education and preschool program sites, legal
148.4aid offices, and libraries. The commissioner shall ensure that applications are available
148.5in languages other than English.
148.6    (b) Local human service agencies, hospitals, and health care community clinics
148.7receiving state funds must provide direct assistance in completing the application
148.8form, including the free use of a copy machine and a drop box for applications. These
148.9locations must ensure that the drop box is checked at least weekly and any applications
148.10are submitted to the commissioner. The commissioner shall provide these entities with
148.11an identification number to stamp on each application to identify the entity that provided
148.12assistance. Other locations where applications are required to be available shall either
148.13provide direct assistance in completing the application form or provide information on
148.14where an applicant can receive application assistance.
148.15    (c) Counties must offer applications and application assistance when providing
148.16child support collection services.
148.17    (d) Local public health agencies and counties that provide immunization clinics must
148.18offer applications and application assistance during these clinics.
148.19    (e) The commissioner shall coordinate with the commissioner of health to ensure
148.20that maternal and child health outreach efforts include information on Minnesota health
148.21care programs and application assistance, when needed.
148.22    Subd. 4. Statewide toll-free telephone number. The commissioner shall provide
148.23funds for a statewide toll-free telephone number to provide information on public and
148.24private health coverage options and sources of free and low-cost health care. The
148.25statewide telephone number must provide the option of obtaining this information in
148.26languages other than English.
148.27    Subd. 5. Incentive program. Beginning January 1, 2008, the commissioner
148.28shall establish an incentive program for organizations that directly identify and assist
148.29potential enrollees in filling out and submitting an application. For each applicant who is
148.30successfully enrolled in MinnesotaCare, medical assistance, or general assistance medical
148.31care, the commissioner shall pay the organization a $25 application assistance bonus. The
148.32organization may provide an applicant a gift certificate or other incentive upon enrollment.
148.33    Subd. 6. School districts. (a) At the beginning of each school year, a school district
148.34shall provide information to each student on the availability of health care coverage
148.35through the Minnesota health care programs.
149.1    (b) For each child who is determined to be eligible for a free or reduced priced lunch,
149.2the district shall provide the child's family with an application for the Minnesota health
149.3care programs and information on how to obtain application assistance.
149.4    (c) A district shall also ensure that applications and information on application
149.5assistance are available at early childhood education sites and public schools located
149.6within the district's jurisdiction.
149.7    (d) Each district shall designate an enrollment specialist to provide application
149.8assistance and follow-up services with families who are eligible for the reduced or free
149.9lunch program or who have indicated an interest in receiving information or an application
149.10for the Minnesota health care program.
149.11    (e) Each school district shall provide on their Web site a link to information on how
149.12to obtain an application and application assistance.
149.13    Subd. 7. Renewal notice. (a) Beginning December 1, 2007, the commissioner shall
149.14mail a renewal notice to enrollees notifying the enrollees that the enrollees eligibility must
149.15be renewed. A notice shall be sent at least 90 days prior to the renewal date and at least
149.1660 days prior to the renewal date.
149.17    (b) For enrollees who are receiving services through managed care plans, the
149.18managed care plan must provide a follow-up renewal call at least 60 days prior to the
149.19enrollees' renewal dates.
149.20    (c) The commissioner shall include the end of coverage dates on the monthly rosters
149.21of enrollees provided to managed care organizations.
149.22    Subd. 8. MinnesotaCare small employer buy-in option. The commissioner shall
149.23provide information on the small employer buy-in option for MinnesotaCare to insurance
149.24agents and local chambers of commerce.

149.25    Sec. 3. [256.963] PRIMARY CARE ACCESS INITIATIVE.
149.26    Subdivision 1. Establishment. (a) The commissioner shall award a grant to
149.27implement in Hennepin and Ramsey Counties a Web-based primary care access pilot
149.28project designed as a collaboration between private and public sectors to connect, where
149.29appropriate, a patient with a primary care medical home, and schedule patients into
149.30available community-based appointments as an alternative to nonemergency use of the
149.31hospital emergency room. The grantee must establish a program that diverts patients
149.32presenting at an emergency room for nonemergency care to more appropriate outpatient
149.33settings. The program must refer the patient to an appropriate health care professional
149.34based on the patient's health care needs and situation. The program must provide the
149.35patient with a scheduled appointment that is timely, with an appropriate provider who is
150.1conveniently located. If the patient is uninsured and potentially eligible for a Minnesota
150.2health care program, the program must connect the patient to a primary care provider,
150.3community clinic, or agency that can assist the patient with the application process. The
150.4program must also ensure that discharged patients are connected with a community-based
150.5primary care provider and assist in scheduling any necessary follow-up visits before
150.6the patient is discharged.
150.7    (b) The program must not require a provider to pay a fee for accepting charity care
150.8patients or patients enrolled in a Minnesota public health care program.
150.9    Subd. 2. Evaluation. (a) The grantee must report to the commissioner on a quarterly
150.10basis the following information:
150.11    (1) the total number of appointments available for scheduling by specialty;
150.12    (2) the average length of time between scheduling and actual appointment;
150.13    (3) the total number of patients referred and whether the patient was insured or
150.14uninsured; and
150.15    (4) the total number of appointments resulting in visits completed and number of
150.16patients continuing services with the referring clinic.
150.17    (b) The commissioner, in consultation with the Minnesota Hospital Association,
150.18shall conduct an evaluation of the emergency room diversion pilot project and submit the
150.19results to the legislature by January 15, 2009. The evaluation shall compare the number of
150.20nonemergency visits and repeat visits to hospital emergency rooms for the period before
150.21the commencement of the project and one year after the commencement, and an estimate
150.22of the costs saved from any documented reductions.

150.23    Sec. 4. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to read:
150.24    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
150.25assistance program must not be submitted until the recipient is discharged. However,
150.26the commissioner shall establish monthly interim payments for inpatient hospitals that
150.27have individual patient lengths of stay over 30 days regardless of diagnostic category.
150.28Except as provided in section 256.9693, medical assistance reimbursement for treatment
150.29of mental illness shall be reimbursed based on diagnostic classifications. Individual
150.30hospital payments established under this section and sections 256.9685, 256.9686, and
150.31256.9695 , in addition to third party and recipient liability, for discharges occurring during
150.32the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
150.33inpatient services paid for the same period of time to the hospital. This payment limitation
150.34shall be calculated separately for medical assistance and general assistance medical
150.35care services. The limitation on general assistance medical care shall be effective for
151.1admissions occurring on or after July 1, 1991. Services that have rates established under
151.2subdivision 11 or 12, must be limited separately from other services. After consulting with
151.3the affected hospitals, the commissioner may consider related hospitals one entity and
151.4may merge the payment rates while maintaining separate provider numbers. The operating
151.5and property base rates per admission or per day shall be derived from the best Medicare
151.6and claims data available when rates are established. The commissioner shall determine
151.7the best Medicare and claims data, taking into consideration variables of recency of the
151.8data, audit disposition, settlement status, and the ability to set rates in a timely manner.
151.9The commissioner shall notify hospitals of payment rates by December 1 of the year
151.10preceding the rate year. The rate setting data must reflect the admissions data used to
151.11establish relative values. Base year changes from 1981 to the base year established for the
151.12rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
151.13to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
151.141. The commissioner may adjust base year cost, relative value, and case mix index data
151.15to exclude the costs of services that have been discontinued by the October 1 of the year
151.16preceding the rate year or that are paid separately from inpatient services. Inpatient stays
151.17that encompass portions of two or more rate years shall have payments established based
151.18on payment rates in effect at the time of admission unless the date of admission preceded
151.19the rate year in effect by six months or more. In this case, operating payment rates for
151.20services rendered during the rate year in effect and established based on the date of
151.21admission shall be adjusted to the rate year in effect by the hospital cost index.
151.22    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
151.23payment, before third-party liability and spenddown, made to hospitals for inpatient
151.24services is reduced by .5 percent from the current statutory rates.
151.25    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
151.26admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
151.27before third-party liability and spenddown, is reduced five percent from the current
151.28statutory rates. Mental health services within diagnosis related groups 424 to 432, and
151.29facilities defined under subdivision 16, and, effective for admissions occurring on or after
151.30July 1, 2007, a long-term hospital as designated by the Medicare program that is located in
151.31a city of the first class as defined in section 410.01, are excluded from this paragraph.
151.32    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
151.33fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for
151.34inpatient services before third-party liability and spenddown, is reduced 6.0 percent from
151.35the current statutory rates. Mental health services within diagnosis related groups 424 to
151.36432 and, facilities defined under subdivision 16, and, effective for admissions occurring
152.1on or after July 1, 2007, a long-term hospital as designated by the Medicare program
152.2that is located in a city of the first class as defined in section 410.01, are excluded from
152.3this paragraph. Notwithstanding section 256.9686, subdivision 7, for purposes of this
152.4paragraph, medical assistance does not include general assistance medical care. Payments
152.5made to managed care plans shall be reduced for services provided on or after January
152.61, 2006, to reflect this reduction.

152.7    Sec. 5. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:
152.8    Subd. 9. Disproportionate numbers of low-income patients served. (a) For
152.9admissions occurring on or after October 1, 1992, through December 31, 1992, the
152.10medical assistance disproportionate population adjustment shall comply with federal law
152.11and shall be paid to a hospital, excluding regional treatment centers and facilities of the
152.12federal Indian Health Service, with a medical assistance inpatient utilization rate in excess
152.13of the arithmetic mean. The adjustment must be determined as follows:
152.14    (1) for a hospital with a medical assistance inpatient utilization rate above the
152.15arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
152.16federal Indian Health Service but less than or equal to one standard deviation above the
152.17mean, the adjustment must be determined by multiplying the total of the operating and
152.18property payment rates by the difference between the hospital's actual medical assistance
152.19inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
152.20treatment centers and facilities of the federal Indian Health Service; and
152.21    (2) for a hospital with a medical assistance inpatient utilization rate above one
152.22standard deviation above the mean, the adjustment must be determined by multiplying
152.23the adjustment that would be determined under clause (1) for that hospital by 1.1. If
152.24federal matching funds are not available for all adjustments under this subdivision, the
152.25commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for
152.26federal match. The commissioner may establish a separate disproportionate population
152.27operating payment rate adjustment under the general assistance medical care program.
152.28For purposes of this subdivision medical assistance does not include general assistance
152.29medical care. The commissioner shall report annually on the number of hospitals likely to
152.30receive the adjustment authorized by this paragraph. The commissioner shall specifically
152.31report on the adjustments received by public hospitals and public hospital corporations
152.32located in cities of the first class.
152.33    (b) For admissions occurring on or after July 1, 1993, the medical assistance
152.34disproportionate population adjustment shall comply with federal law and shall be paid to
152.35a hospital, excluding regional treatment centers and facilities of the federal Indian Health
153.1Service, with a medical assistance inpatient utilization rate in excess of the arithmetic
153.2mean. The adjustment must be determined as follows:
153.3    (1) for a hospital with a medical assistance inpatient utilization rate above the
153.4arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
153.5federal Indian Health Service but less than or equal to one standard deviation above the
153.6mean, the adjustment must be determined by multiplying the total of the operating and
153.7property payment rates by the difference between the hospital's actual medical assistance
153.8inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
153.9treatment centers and facilities of the federal Indian Health Service;
153.10    (2) for a hospital with a medical assistance inpatient utilization rate above one
153.11standard deviation above the mean, the adjustment must be determined by multiplying
153.12the adjustment that would be determined under clause (1) for that hospital by 1.1. The
153.13commissioner may establish a separate disproportionate population operating payment
153.14rate adjustment under the general assistance medical care program. For purposes of this
153.15subdivision, medical assistance does not include general assistance medical care. The
153.16commissioner shall report annually on the number of hospitals likely to receive the
153.17adjustment authorized by this paragraph. The commissioner shall specifically report on
153.18the adjustments received by public hospitals and public hospital corporations located
153.19in cities of the first class;
153.20    (3) for a hospital that had medical assistance fee-for-service payment volume during
153.21calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service
153.22payment volume, a medical assistance disproportionate population adjustment shall be
153.23paid in addition to any other disproportionate payment due under this subdivision as
153.24follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995.
153.25For a hospital that had medical assistance fee-for-service payment volume during calendar
153.26year 1991 in excess of eight percent of total medical assistance fee-for-service payment
153.27volume and was the primary hospital affiliated with the University of Minnesota, a
153.28medical assistance disproportionate population adjustment shall be paid in addition to any
153.29other disproportionate payment due under this subdivision as follows: $505,000 due on
153.30the 15th of each month after noon, beginning July 15, 1995; and
153.31    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be
153.32reduced to zero.
153.33    (c) The commissioner shall adjust rates paid to a health maintenance organization
153.34under contract with the commissioner to reflect rate increases provided in paragraph (b),
153.35clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those
153.36rates to reflect payments provided in clause (3).
154.1    (d) If federal matching funds are not available for all adjustments under paragraph
154.2(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a
154.3pro rata basis so that all adjustments under paragraph (b) qualify for federal match.
154.4    (e) For purposes of this subdivision, medical assistance does not include general
154.5assistance medical care.
154.6    (f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, :
154.7    (1) general assistance medical care expenditures for fee-for-service inpatient
154.8and outpatient hospital payments made by the department and by prepaid health
154.9plans participating in general assistance medical care shall be considered Medicaid
154.10disproportionate share hospital payments, except as limited below:
154.11    (1) (i) only the portion of Minnesota's disproportionate share hospital allotment
154.12under section 1923(f) of the Social Security Act that is not spent on the disproportionate
154.13population adjustments in paragraph (b), clauses (1) and (2), may be used for general
154.14assistance medical care expenditures;
154.15    (2) (ii) only those general assistance medical care expenditures made to hospitals that
154.16qualify for disproportionate share payments under section 1923 of the Social Security Act
154.17and the Medicaid state plan may be considered disproportionate share hospital payments;
154.18    (3) (iii) only those general assistance medical care expenditures made to an
154.19individual hospital that would not cause the hospital to exceed its individual hospital limits
154.20under section 1923 of the Social Security Act may be considered; and
154.21    (4) (iv) general assistance medical care expenditures may be considered only to the
154.22extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
154.23All hospitals and prepaid health plans participating in general assistance medical care
154.24must provide any necessary expenditure, cost, and revenue information required by the
154.25commissioner as necessary for purposes of obtaining federal Medicaid matching funds for
154.26general assistance medical care expenditures; and
154.27    (2) certified public expenditures made by Hennepin County Medical Center shall
154.28be considered Medicaid disproportionate share hospital payments. Hennepin County
154.29and Hennepin County Medical Center shall report by June 15, 2007, on payments made
154.30beginning July 1, 2005, or another date specified by the commissioner, that may qualify
154.31for reimbursement under federal law. Based on these reports, the commissioner shall
154.32apply for federal matching funds.
154.33    (g) Upon federal approval of the related state plan amendment, paragraph (f) is
154.34effective retroactively from July 1, 2005, or the earliest effective date approved by the
154.35Centers for Medicare and Medicaid Services.
155.1EFFECTIVE DATE.This section is effective retroactively from July 1, 2005.

155.2    Sec. 6. Minnesota Statutes 2006, section 256.969, subdivision 27, is amended to read:
155.3    Subd. 27. Quarterly payment adjustment. (a) In addition to any other payment
155.4under this section, the commissioner shall make the following payments effective July
155.51, 2007:
155.6    (1) for a hospital located in Minnesota and not eligible for payments under
155.7subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8
155.8percent of total patient days as of the base year in effect on July 1, 2005, a payment equal
155.9to 13 percent of the total of the operating and property payment rates;
155.10    (2) for a hospital located in Minnesota in a specified urban area outside of the
155.11seven-county metropolitan area and not eligible for payments under subdivision 20, with
155.12a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total
155.13patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent
155.14of the total of the operating and property payment rates. For purposes of this clause, the
155.15following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria,
155.16Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
155.17Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena; and
155.18    (3) for a hospital located in Minnesota but not located in a specified urban area under
155.19clause (2), with a medical assistance inpatient utilization rate less than or equal to 17.8
155.20percent of total patient days as of the base year in effect on July 1, 2005, a payment equal to
155.21four percent of the total of the operating and property payment rates. A hospital located in
155.22Woodbury and not in existence during the base year shall be reimbursed under this clause.
155.23    (b) The state share of payments under paragraph (a) shall be equal to federal
155.24reimbursements to the commissioner to reimburse nonstate expenditures reported under
155.25section 256B.199. The commissioner shall ratably reduce or increase payments under this
155.26subdivision in order to ensure that these payments equal the amount of reimbursement
155.27received by the commissioner under section 256B.199, except that payments shall be
155.28ratably reduced by an amount equivalent to the state share of a four percent reduction in
155.29MinnesotaCare and medical assistance payments for inpatient hospital services. Effective
155.30July 1, 2009, the ratable reduction shall be equivalent to the state share of a three percent
155.31reduction in these payments.
155.32    (c) The payments under paragraph (a) shall be paid quarterly based on each hospital's
155.33operating and property payments from the second previous quarter, beginning on July
155.3415, 2007, or upon federal approval of federal reimbursements under section 256B.199,
155.35whichever occurs later.
156.1    (d) The commissioner shall not adjust rates paid to a prepaid health plan under
156.2contract with the commissioner to reflect payments provided in paragraph (a).
156.3    (e) The commissioner shall maximize the use of available federal money for
156.4disproportionate share hospital payments and shall maximize payments to qualifying
156.5hospitals. In order to accomplish these purposes, the commissioner may, in consultation
156.6with the nonstate entities identified in section 256B.199, adjust, on a pro rata basis
156.7if feasible, the amounts reported by nonstate entities under section 256B.199 when
156.8application for reimbursement is made to the federal government, and otherwise adjust
156.9the provisions of this subdivision. The commissioner shall utilize a settlement process
156.10based on finalized data to maximize revenue under section 256B.199 and payments
156.11under this section.
156.12    (f) By January 15 of each year, beginning January 15, 2006, the commissioner
156.13shall report to the chairs of the house and senate finance committees and divisions with
156.14jurisdiction over funding for the Department of Human Services the following estimates
156.15for the current and upcoming federal and state fiscal years:
156.16    (1) the difference between the Medicare upper payment limit and actual or
156.17anticipated medical assistance payments for hospital services;
156.18    (2) the amount of federal disproportionate share hospital funding available to
156.19Minnesota and the amount expected to be claimed by the state; and
156.20    (3) the methodology used to calculate the results reported for clauses (1) and (2).
156.21    (g) For purposes of this subdivision, medical assistance does not include general
156.22assistance medical care.
156.23    (h) This section sunsets on June 30, 2009. The commissioner shall report to
156.24the legislature by December 15, 2008, with recommendations for maximizing federal
156.25disproportionate share hospital payments after June 30, 2009.

156.26    Sec. 7. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision
156.27to read:
156.28    Subd. 28. Long-term hospital payment adjustment. For admissions occurring on
156.29or after July 1, 2007, the commissioner shall increase the medical assistance payments
156.30to a long-term hospital with a medical assistance inpatient utilization rate of 17.95
156.31percent of total patient days as of the base year in effect on July 1, 2005, by an amount
156.32equal to 13 percent of the total of the operating and property payment rates. Payments
156.33made to managed care plans shall not reflect this payment increase. For purposes of
156.34this subdivision, medical assistance does not include general assistance medical care.
157.1Payments to a hospital under this subdivision shall be reduced by the amount of any
157.2payments made under subdivision 27.

157.3    Sec. 8. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:
157.4    Subd. 14. Competitive bidding. (a) When determined to be effective, economical,
157.5and feasible, the commissioner may utilize volume purchase through competitive bidding
157.6and negotiation under the provisions of chapter 16C, to provide items under the medical
157.7assistance program including but not limited to the following:
157.8    (1) eyeglasses;
157.9    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency
157.10situation on a short-term basis, until the vendor can obtain the necessary supply from
157.11the contract dealer;
157.12    (3) hearing aids and supplies; and
157.13    (4) durable medical equipment, including but not limited to:
157.14    (i) hospital beds;
157.15    (ii) commodes;
157.16    (iii) glide-about chairs;
157.17    (iv) patient lift apparatus;
157.18    (v) wheelchairs and accessories;
157.19    (vi) oxygen administration equipment;
157.20    (vii) respiratory therapy equipment;
157.21    (viii) electronic diagnostic, therapeutic and life support systems;
157.22    (5) special nonemergency medical transportation services level of need
157.23determinations, disbursement of public transportation passes and tokens, and volunteer
157.24and recipient mileage and parking reimbursements; and
157.25    (6) drugs.
157.26    (b) Rate changes under this chapter and chapters 256D and 256L do not affect
157.27contract payments under this subdivision unless specifically identified.
157.28    (c) The commissioner may not utilize volume purchase through competitive bidding
157.29and negotiation for special transportation services under the provisions of chapter 16C.

157.30    Sec. 9. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision
157.31to read:
157.32    Subd. 14a. Level of need determination. Nonemergency medical transportation
157.33level of need determinations must be performed by a physician, a registered nurse working
157.34under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
158.1licensed practical nurse, or a discharge planner. Nonemergency medical transportation
158.2level of need determinations must not be performed more than semiannually on any
158.3individual, unless the individual's circumstances have sufficiently changed so as to require
158.4a new level of need determination. Individuals residing in licensed nursing facilities are
158.5exempt from a level of need determination and are eligible for special transportation
158.6services until the individual no longer resides in a licensed nursing facility. If a person
158.7authorized by this subdivision to perform a level of need determination determines that an
158.8individual requires stretcher transportation, the individual is presumed to maintain that
158.9level of need until otherwise determined by a person authorized to perform a level of need
158.10determination, or for six months, whichever is sooner.

158.11    Sec. 10. Minnesota Statutes 2006, section 256B.056, subdivision 10, is amended to
158.12read:
158.13    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
158.14are applying for the continuation of medical assistance coverage following the end of the
158.1560-day postpartum period to update their income and asset information and to submit
158.16any required income or asset verification.
158.17    (b) The commissioner shall determine the eligibility of private-sector health care
158.18coverage for infants less than one year of age eligible under section 256B.055, subdivision
158.1910 , or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
158.20if this is determined to be cost-effective.
158.21    (c) The commissioner shall modify the application for Minnesota health care
158.22programs to require more detailed information related to verification of assets and income,
158.23and shall verify assets and income for all applicants, and for all recipients upon renewal.
158.24    (d) The commissioner shall require Minnesota health care program recipients to
158.25report new or an increase in earned income within ten days of the change, and to verify new
158.26or an increase in earned income that affects eligibility within ten days of notification by
158.27the agency that the new or increased earned income affects eligibility. Recipients who fail
158.28to verify new or an increase in earned income that affects eligibility shall be disenrolled.

158.29    Sec. 11. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to
158.30read:
158.31    Subd. 3f. Circumcision for newborns. Newborn Circumcision is not covered,
158.32unless the procedure is medically necessary or required because of a well-established
158.33religious practice.

159.1    Sec. 12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
159.2subdivision to read:
159.3    Subd. 13i. Medicare Part D. Notwithstanding subdivision 13, paragraph (d), for
159.4recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare
159.5Advantage special needs plan, medical assistance covers co-payments which the recipient
159.6is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage
159.7special needs plan, once the recipient has paid $12 per month in prescription drug
159.8co-payments, and according to the requirements of the plan.
159.9EFFECTIVE DATE.This section is effective January 1, 2008, or upon federal
159.10approval, whichever is later.

159.11    Sec. 13. Minnesota Statutes 2006, section 256B.0631, subdivision 1, is amended to
159.12read:
159.13    Subdivision 1. Co-payments. (a) Except as provided in subdivision 2, the medical
159.14assistance benefit plan shall include the following co-payments for all recipients, effective
159.15for services provided on or after October 1, 2003, and before January 1, 2008:
159.16    (1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an
159.17episode of service which is required because of a recipient's symptoms, diagnosis, or
159.18established illness, and which is delivered in an ambulatory setting by a physician or
159.19physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
159.20audiologist, optician, or optometrist;
159.21    (2) $3 for eyeglasses;
159.22    (3) $6 for nonemergency visits to a hospital-based emergency room; and
159.23    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
159.24subject to a $12 per month maximum for prescription drug co-payments. No co-payments
159.25shall apply to antipsychotic drugs when used for the treatment of mental illness.
159.26    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall
159.27include the following co-payments for all recipients, effective for services provided on
159.28or after January 1, 2008:
159.29    (1) $6 for nonemergency visits to a hospital-based emergency room; and
159.30    (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
159.31subject to a $7 per month maximum for prescription drug co-payments. No co-payments
159.32shall apply to antipsychotic drugs when used for the treatment of mental illness.
159.33    (c) Recipients of medical assistance are responsible for all co-payments in this
159.34subdivision.

160.1    Sec. 14. Minnesota Statutes 2006, section 256B.0631, subdivision 3, is amended to
160.2read:
160.3    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider shall
160.4be reduced by the amount of the co-payment, except that reimbursement for prescription
160.5drugs shall not be reduced once a recipient has reached the $12 per month maximum or
160.6the $7 per month maximum effective January 1, 2008, for prescription drug co-payments.
160.7    (b) The provider collects the co-payment from the recipient. Providers may not
160.8deny services to recipients who are unable to pay the co-payment, except as provided in
160.9subdivision 4.
160.10    (c) Medical assistance reimbursement to fee-for-service providers and payments to
160.11managed care plans shall not be increased as a result of the removal of the co-payments
160.12effective January 1, 2008.

160.13    Sec. 15. Minnesota Statutes 2006, section 256B.0644, is amended to read:
160.14256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
160.15PROGRAMS.
160.16    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
160.17health maintenance organization, as defined in chapter 62D, must participate as a provider
160.18or contractor in the medical assistance program, general assistance medical care program,
160.19and MinnesotaCare as a condition of participating as a provider in health insurance plans
160.20and programs or contractor for state employees established under section 43A.18, the
160.21public employees insurance program under section 43A.316, for health insurance plans
160.22offered to local statutory or home rule charter city, county, and school district employees,
160.23the workers' compensation system under section 176.135, and insurance plans provided
160.24through the Minnesota Comprehensive Health Association under sections 62E.01 to
160.2562E.19 . The limitations on insurance plans offered to local government employees shall
160.26not be applicable in geographic areas where provider participation is limited by managed
160.27care contracts with the Department of Human Services.
160.28    (b) For providers other than health maintenance organizations, participation in the
160.29medical assistance program means that:
160.30     (1) the provider accepts new medical assistance, general assistance medical care,
160.31and MinnesotaCare patients or;
160.32    (2) for providers other than dental service providers, at least 20 percent of the
160.33provider's patients are covered by medical assistance, general assistance medical care, and
160.34MinnesotaCare as their primary source of coverage, or; or
161.1    (3) for dental service providers, at least ten percent of the provider's patients are
161.2covered by medical assistance, general assistance medical care, and MinnesotaCare as
161.3their primary source of coverage, or the provider accepts new medical assistance and
161.4MinnesotaCare patients who are children with special health care needs. For purposes
161.5of this section, "children with special health care needs" means children up to age 18
161.6who: (i) require health and related services beyond that required by children generally;
161.7and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
161.8condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
161.9cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
161.10neurological diseases; visual impairment or deafness; Down syndrome and other genetic
161.11disorders; autism; fetal alcohol syndrome; and other conditions designated by the
161.12commissioner after consultation with representatives of pediatric dental providers and
161.13consumers.
161.14    (c) Patients seen on a volunteer basis by the provider at a location other than the
161.15provider's usual place of practice may be considered in meeting this the participation
161.16requirement in this section. The commissioner shall establish participation requirements
161.17for health maintenance organizations. The commissioner shall provide lists of
161.18participating medical assistance providers on a quarterly basis to the commissioner of
161.19employee relations, the commissioner of labor and industry, and the commissioner of
161.20commerce. Each of the commissioners shall develop and implement procedures to exclude
161.21as participating providers in the program or programs under their jurisdiction those
161.22providers who do not participate in the medical assistance program. The commissioner
161.23of employee relations shall implement this section through contracts with participating
161.24health and dental carriers.

161.25    Sec. 16. Minnesota Statutes 2006, section 256B.199, is amended to read:
161.26256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
161.27    (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds
161.28for the expenditures in paragraphs (b) and (c).
161.29    (b) The commissioner shall apply for federal matching funds for certified public
161.30expenditures as follows:
161.31     (1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions
161.32Hospital, the University of Minnesota, and Fairview-University Medical Center shall
161.33report quarterly to the commissioner beginning June 1, 2007, payments made during the
161.34second previous quarter that may qualify for reimbursement under federal law.;
162.1    (b) (2) based on these reports, the commissioner shall apply for federal matching
162.2funds. These funds are appropriated to the commissioner for the payments under section
162.3256.969, subdivision 27 .; and
162.4    (c) (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
162.5the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
162.6hospital payment money expected to be available in the current federal fiscal year.
162.7    (c) The commissioner shall apply for federal matching funds for general assistance
162.8medical care expenditures as follows:
162.9    (1) for hospital services occurring on or after July 1, 2007, general assistance medical
162.10care expenditures for fee-for-service inpatient and outpatient hospital payments made by
162.11the department shall be used to apply for federal matching funds, except as limited below:
162.12    (i) only those general assistance medical care expenditures made to an individual
162.13hospital that would not cause the hospital to exceed its individual hospital limits under
162.14section 1923 of the Social Security Act may be considered; and
162.15    (ii) general assistance medical care expenditures may be considered only to the extent
162.16of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
162.17    (2) all hospitals must provide any necessary expenditure, cost, and revenue
162.18information required by the commissioner as necessary for purposes of obtaining federal
162.19Medicaid matching funds for general assistance medical care expenditures.
162.20    (d) This section sunsets on June 30, 2009. The commissioner shall report to
162.21the legislature by December 15, 2008, with recommendations for maximizing federal
162.22disproportionate share hospital payments after June 30, 2009.
162.23EFFECTIVE DATE.This section is effective the day following final enactment.

162.24    Sec. 17. Minnesota Statutes 2006, section 256B.75, is amended to read:
162.25256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
162.26    (a) For outpatient hospital facility fee payments for services rendered on or after
162.27October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
162.28charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
162.29services for which there is a federal maximum allowable payment. Effective for services
162.30rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
162.31facility fees and emergency room facility fees shall be increased by eight percent over the
162.32rates in effect on December 31, 1999, except for those services for which there is a federal
162.33maximum allowable payment. Services for which there is a federal maximum allowable
162.34payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
163.1allowable payment. Total aggregate payment for outpatient hospital facility fee services
163.2shall not exceed the Medicare upper limit. If it is determined that a provision of this
163.3section conflicts with existing or future requirements of the United States government with
163.4respect to federal financial participation in medical assistance, the federal requirements
163.5prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
163.6avoid reduced federal financial participation resulting from rates that are in excess of
163.7the Medicare upper limitations.
163.8    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
163.9ambulatory surgery hospital facility fee services for critical access hospitals designated
163.10under section 144.1483, clause (10), shall be paid on a cost-based payment system that is
163.11based on the cost-finding methods and allowable costs of the Medicare program. Effective
163.12for services provided on or after July 1, 2007, a children's hospital that was formerly
163.13a state hospital must be paid for the services in this paragraph using the methodology
163.14established for critical access hospitals at a rate equal to 71 percent of allowable costs.
163.15    (c) Effective for services provided on or after July 1, 2003, rates that are based
163.16on the Medicare outpatient prospective payment system shall be replaced by a budget
163.17neutral prospective payment system that is derived using medical assistance data. The
163.18commissioner shall provide a proposal to the 2003 legislature to define and implement
163.19this provision.
163.20    (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
163.21before third-party liability and spenddown, made to hospitals for outpatient hospital
163.22facility services is reduced by .5 percent from the current statutory rate.
163.23    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
163.24services provided on or after July 1, 2003, made to hospitals for outpatient hospital
163.25facility services before third-party liability and spenddown, is reduced five percent from
163.26the current statutory rates. Facilities defined under section 256.969, subdivision 16, are
163.27excluded from this paragraph.

163.28    Sec. 18. Minnesota Statutes 2006, section 256B.76, is amended to read:
163.29256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
163.30    (a) Effective for services rendered on or after October 1, 1992, the commissioner
163.31shall make payments for physician services as follows:
163.32    (1) payment for level one Centers for Medicare and Medicaid Services' common
163.33procedural coding system codes titled "office and other outpatient services," "preventive
163.34medicine new and established patient," "delivery, antepartum, and postpartum care,"
163.35"critical care," cesarean delivery and pharmacologic management provided to psychiatric
164.1patients, and level three codes for enhanced services for prenatal high risk, shall be paid
164.2at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
164.330, 1992. If the rate on any procedure code within these categories is different than the
164.4rate that would have been paid under the methodology in section 256B.74, subdivision 2,
164.5then the larger rate shall be paid;
164.6    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
164.7or (ii) 15.4 percent above the rate in effect on June 30, 1992;
164.8    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
164.9percentile of 1989, less the percent in aggregate necessary to equal the above increases
164.10except that payment rates for home health agency services shall be the rates in effect
164.11on September 30, 1992;
164.12    (4) effective for services rendered on or after January 1, 2000, payment rates for
164.13physician and professional services shall be increased by three percent over the rates in
164.14effect on December 31, 1999, except for home health agency and family planning agency
164.15services; and
164.16    (5) the increases in clause (4) shall be implemented January 1, 2000, for managed
164.17care.
164.18    (b) Effective for services rendered on or after October 1, 1992, the commissioner
164.19shall make payments for dental services as follows:
164.20    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
164.21percent above the rate in effect on June 30, 1992;
164.22    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
164.23percentile of 1989, less the percent in aggregate necessary to equal the above increases;
164.24    (3) effective for services rendered on or after January 1, 2000, payment rates for
164.25dental services shall be increased by three percent over the rates in effect on December
164.2631, 1999;
164.27    (4) the commissioner shall award grants to community clinics or other nonprofit
164.28community organizations, political subdivisions, professional associations, or other
164.29organizations that demonstrate the ability to provide dental services effectively to public
164.30program recipients. Grants may be used to fund the costs related to coordinating access for
164.31recipients, developing and implementing patient care criteria, upgrading or establishing
164.32new facilities, acquiring furnishings or equipment, recruiting new providers, or other
164.33development costs that will improve access to dental care in a region. In awarding grants,
164.34the commissioner shall give priority to applicants that plan to serve areas of the state in
164.35which the number of dental providers is not currently sufficient to meet the needs of
165.1recipients of public programs or uninsured individuals. The commissioner shall consider
165.2the following in awarding the grants:
165.3    (i) potential to successfully increase access to an underserved population;
165.4    (ii) the ability to raise matching funds;
165.5    (iii) the long-term viability of the project to improve access beyond the period
165.6of initial funding;
165.7    (iv) the efficiency in the use of the funding; and
165.8    (v) the experience of the proposers in providing services to the target population.
165.9    The commissioner shall monitor the grants and may terminate a grant if the grantee
165.10does not increase dental access for public program recipients. The commissioner shall
165.11consider grants for the following:
165.12    (i) implementation of new programs or continued expansion of current access
165.13programs that have demonstrated success in providing dental services in underserved
165.14areas;
165.15    (ii) a pilot program for utilizing hygienists outside of a traditional dental office to
165.16provide dental hygiene services; and
165.17    (iii) a program that organizes a network of volunteer dentists, establishes a system to
165.18refer eligible individuals to volunteer dentists, and through that network provides donated
165.19dental care services to public program recipients or uninsured individuals;
165.20    (5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
165.21shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
165.22    (6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000,
165.23for managed care; and
165.24    (7) effective for services provided on or after January 1, 2002, payment for
165.25diagnostic examinations and dental x-rays provided to children under age 21 shall be the
165.26lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.
165.27    (c) Effective for dental services rendered on or after January 1, 2002, the
165.28commissioner may, within the limits of available appropriation, shall increase
165.29reimbursements to dentists and dental clinics deemed by the commissioner to be critical
165.30access dental providers. Reimbursement to a critical access dental provider may be
165.31increased by not more than 50 percent above the reimbursement rate that would otherwise
165.32be paid to the provider. Payments to health plan companies shall be adjusted to For dental
165.33services rendered on or after July 1, 2007, the commissioner shall increase reimbursement
165.34by 30 percent above the reimbursement rate that would otherwise be paid to the critical
165.35access dental provider. The commissioner shall pay the health plan companies in amounts
165.36sufficient to reflect increased reimbursements to critical access dental providers as
166.1approved by the commissioner. In determining which dentists and dental clinics shall be
166.2deemed critical access dental providers, the commissioner shall review:
166.3    (1) the utilization rate in the service area in which the dentist or dental clinic operates
166.4for dental services to patients covered by medical assistance, general assistance medical
166.5care, or MinnesotaCare as their primary source of coverage;
166.6    (2) the level of services provided by the dentist or dental clinic to patients covered
166.7by medical assistance, general assistance medical care, or MinnesotaCare as their primary
166.8source of coverage; and
166.9    (3) whether the level of services provided by the dentist or dental clinic is critical to
166.10maintaining adequate levels of patient access within the service area.
166.11In the absence of a critical access dental provider in a service area, the commissioner may
166.12designate a dentist or dental clinic as a critical access dental provider if the dentist or
166.13dental clinic is willing to provide care to patients covered by medical assistance, general
166.14assistance medical care, or MinnesotaCare at a level which significantly increases access
166.15to dental care in the service area.
166.16    The commissioner shall annually establish a reimbursement schedule for critical
166.17access dental providers and provider-specific limits on total reimbursement received
166.18under the reimbursement schedule, and shall notify each critical access dental provider
166.19of the schedule and limit.
166.20    (d) An entity that operates both a Medicare certified comprehensive outpatient
166.21rehabilitation facility and a facility which was certified prior to January 1, 1993, that is
166.22licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33
166.23percent of the clients receiving rehabilitation services in the most recent calendar year are
166.24medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation
166.25services at rates that are 38 percent greater than the maximum reimbursement rate
166.26allowed under paragraph (a), clause (2), when those services are (1) provided within the
166.27comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing
166.28facilities owned by the entity.
166.29    (e) Effective for services rendered on or after January 1, 2007, the commissioner
166.30shall make payments for physician and professional services based on the Medicare
166.31relative value units (RVU's). This change shall be budget neutral and the cost of
166.32implementing RVU's will be incorporated in the established conversion factor.

166.33    Sec. 19. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
166.34    Effective for services rendered on or after July 1, 2007, payment rates for family
166.35planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
167.1when these services are provided by a community clinic as defined in section 145.9268,
167.2subdivision 1.

167.3    Sec. 20. Minnesota Statutes 2006, section 256D.03, subdivision 3, is amended to read:
167.4    Subd. 3. General assistance medical care; eligibility. (a) General assistance
167.5medical care may be paid for any person who is not eligible for medical assistance under
167.6chapter 256B, including eligibility for medical assistance based on a spenddown of excess
167.7income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in
167.8paragraph (b), except as provided in paragraph (c), and:
167.9    (1) who is receiving assistance under section 256D.05, except for families with
167.10children who are eligible under Minnesota family investment program (MFIP), or who is
167.11having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
167.12    (2) who is a resident of Minnesota; and
167.13    (i) who has gross countable income not in excess of 75 percent of the federal poverty
167.14guidelines for the family size, using a six-month budget period and whose equity in assets
167.15is not in excess of $1,000 per assistance unit. General assistance medical care is not
167.16available for applicants or enrollees who are otherwise eligible for medical assistance but
167.17fail to verify their assets. Enrollees who become eligible for medical assistance shall be
167.18terminated and transferred to medical assistance. Exempt assets, the reduction of excess
167.19assets, and the waiver of excess assets must conform to the medical assistance program in
167.20section 256B.056, subdivision 3, with the following exception: the maximum amount of
167.21undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by
167.22the trustee, assuming the full exercise of the trustee's discretion under the terms of the
167.23trust, must be applied toward the asset maximum;
167.24    (ii) who has gross countable income above 75 percent of the federal poverty
167.25guidelines but not in excess of 175 percent of the federal poverty guidelines for the
167.26family size, using a six-month budget period, whose equity in assets is not in excess
167.27of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
167.28hospitalization; or
167.29    (iii) the commissioner shall adjust the income standards under this section each July
167.301 by the annual update of the federal poverty guidelines following publication by the
167.31United States Department of Health and Human Services.
167.32    (b) Effective for applications and renewals processed on or after September 1, 2006,
167.33general assistance medical care may not be paid for applicants or recipients who are adults
167.34with dependent children under 21 whose gross family income is equal to or less than 275
167.35percent of the federal poverty guidelines who are not described in paragraph (e).
168.1    (c) Effective for applications and renewals processed on or after September 1, 2006,
168.2general assistance medical care may be paid for applicants and recipients who meet all
168.3eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
168.4beginning the date of application. Immediately following approval of general assistance
168.5medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
168.6subdivision 7 , with covered services as provided in section 256L.03 for the rest of the
168.7six-month general assistance medical care eligibility period, until their six-month renewal.
168.8    (d) To be eligible for general assistance medical care following enrollment in
168.9MinnesotaCare as required by paragraph (c), an individual must complete a new
168.10application.
168.11    (e) Applicants and recipients eligible under paragraph (a), clause (1); who have
168.12applied for and are awaiting a determination of blindness or disability by the state medical
168.13review team or a determination of eligibility for Supplemental Security Income or Social
168.14Security Disability Insurance by the Social Security Administration; who fail to meet the
168.15requirements of section 256L.09, subdivision 2; who are homeless as defined by United
168.16States Code, title 42, section 11301, et seq.; who are classified as end-stage renal disease
168.17beneficiaries in the Medicare program; who are enrolled in private health care coverage as
168.18defined in section 256B.02, subdivision 9; who are eligible under paragraph (j); or who
168.19receive treatment funded pursuant to section 254B.02 are exempt from the MinnesotaCare
168.20enrollment requirements of this subdivision.
168.21    (f) For applications received on or after October 1, 2003, eligibility may begin no
168.22earlier than the date of application. For individuals eligible under paragraph (a), clause
168.23(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
168.24eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
168.25may reapply if there is a subsequent period of inpatient hospitalization.
168.26    (g) Beginning September 1, 2006, Minnesota health care program applications and
168.27renewals completed by recipients and applicants who are persons described in paragraph
168.28(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
168.29by the county agency. If all other eligibility requirements of this subdivision are met,
168.30eligibility for general assistance medical care shall be available in any month during which
168.31MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
168.32notice of termination for eligibility for general assistance medical care shall be sent to
168.33an applicant or recipient. If all other eligibility requirements of this subdivision are
168.34met, eligibility for general assistance medical care shall be available until enrollment in
168.35MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
169.1    (h) The date of an initial Minnesota health care program application necessary to
169.2begin a determination of eligibility shall be the date the applicant has provided a name,
169.3address, and Social Security number, signed and dated, to the county agency or the
169.4Department of Human Services. If the applicant is unable to provide a name, address,
169.5Social Security number, and signature when health care is delivered due to a medical
169.6condition or disability, a health care provider may act on an applicant's behalf to establish
169.7the date of an initial Minnesota health care program application by providing the county
169.8agency or Department of Human Services with provider identification and a temporary
169.9unique identifier for the applicant. The applicant must complete the remainder of the
169.10application and provide necessary verification before eligibility can be determined. The
169.11county agency must assist the applicant in obtaining verification if necessary.
169.12    (i) County agencies are authorized to use all automated databases containing
169.13information regarding recipients' or applicants' income in order to determine eligibility for
169.14general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
169.15in order to determine eligibility and premium payments by the county agency.
169.16    (j) General assistance medical care is not available for a person in a correctional
169.17facility unless the person is detained by law for less than one year in a county correctional
169.18or detention facility as a person accused or convicted of a crime, or admitted as an
169.19inpatient to a hospital on a criminal hold order, and the person is a recipient of general
169.20assistance medical care at the time the person is detained by law or admitted on a criminal
169.21hold order and as long as the person continues to meet other eligibility requirements
169.22of this subdivision.
169.23    (k) General assistance medical care is not available for applicants or recipients who
169.24do not cooperate with the county agency to meet the requirements of medical assistance.
169.25    (l) In determining the amount of assets of an individual eligible under paragraph
169.26(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
169.27an asset excluded under paragraph (a), that was given away, sold, or disposed of for
169.28less than fair market value within the 60 months preceding application for general
169.29assistance medical care or during the period of eligibility. Any transfer described in this
169.30paragraph shall be presumed to have been for the purpose of establishing eligibility for
169.31general assistance medical care, unless the individual furnishes convincing evidence to
169.32establish that the transaction was exclusively for another purpose. For purposes of this
169.33paragraph, the value of the asset or interest shall be the fair market value at the time it
169.34was given away, sold, or disposed of, less the amount of compensation received. For any
169.35uncompensated transfer, the number of months of ineligibility, including partial months,
169.36shall be calculated by dividing the uncompensated transfer amount by the average monthly
170.1per person payment made by the medical assistance program to skilled nursing facilities
170.2for the previous calendar year. The individual shall remain ineligible until this fixed period
170.3has expired. The period of ineligibility may exceed 30 months, and a reapplication for
170.4benefits after 30 months from the date of the transfer shall not result in eligibility unless
170.5and until the period of ineligibility has expired. The period of ineligibility begins in the
170.6month the transfer was reported to the county agency, or if the transfer was not reported,
170.7the month in which the county agency discovered the transfer, whichever comes first. For
170.8applicants, the period of ineligibility begins on the date of the first approved application.
170.9    (m) When determining eligibility for any state benefits under this subdivision,
170.10the income and resources of all noncitizens shall be deemed to include their sponsor's
170.11income and resources as defined in the Personal Responsibility and Work Opportunity
170.12Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
170.13subsequently set out in federal rules.
170.14    (n) Undocumented noncitizens and nonimmigrants are ineligible for general
170.15assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
170.16in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
170.17an undocumented noncitizen is an individual who resides in the United States without the
170.18approval or acquiescence of the Immigration and Naturalization Service.
170.19    (o) Notwithstanding any other provision of law, a noncitizen who is ineligible for
170.20medical assistance due to the deeming of a sponsor's income and resources, is ineligible
170.21for general assistance medical care.
170.22    (p) Effective July 1, 2003, general assistance medical care emergency services end.
170.23EFFECTIVE DATE.This section is effective July 1, 2007.

170.24    Sec. 21. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
170.25    Subd. 4. General assistance medical care; services. (a)(i) For a person who is
170.26eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
170.27care covers, except as provided in paragraph (c):
170.28    (1) inpatient hospital services;
170.29    (2) outpatient hospital services;
170.30    (3) services provided by Medicare certified rehabilitation agencies;
170.31    (4) prescription drugs and other products recommended through the process
170.32established in section 256B.0625, subdivision 13;
170.33    (5) equipment necessary to administer insulin and diagnostic supplies and equipment
170.34for diabetics to monitor blood sugar level;
170.35    (6) eyeglasses and eye examinations provided by a physician or optometrist;
171.1    (7) hearing aids;
171.2    (8) prosthetic devices;
171.3    (9) laboratory and X-ray services;
171.4    (10) physician's services;
171.5    (11) medical transportation except special transportation;
171.6    (12) chiropractic services as covered under the medical assistance program;
171.7    (13) podiatric services;
171.8    (14) dental services as covered under the medical assistance program;
171.9    (15) outpatient services provided by a mental health center or clinic that is under
171.10contract with the county board and is established under section 245.62;
171.11    (16) day treatment services for mental illness provided under contract with the
171.12county board;
171.13    (17) prescribed medications for persons who have been diagnosed as mentally ill as
171.14necessary to prevent more restrictive institutionalization;
171.15    (18) psychological services, medical supplies and equipment, and Medicare
171.16premiums, coinsurance and deductible payments;
171.17    (19) medical equipment not specifically listed in this paragraph when the use of
171.18the equipment will prevent the need for costlier services that are reimbursable under
171.19this subdivision;
171.20    (20) services performed by a certified pediatric nurse practitioner, a certified family
171.21nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
171.22nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
171.23practitioner in independent practice, if (1) the service is otherwise covered under this
171.24chapter as a physician service, (2) the service provided on an inpatient basis is not included
171.25as part of the cost for inpatient services included in the operating payment rate, and (3) the
171.26service is within the scope of practice of the nurse practitioner's license as a registered
171.27nurse, as defined in section 148.171;
171.28    (21) services of a certified public health nurse or a registered nurse practicing in
171.29a public health nursing clinic that is a department of, or that operates under the direct
171.30authority of, a unit of government, if the service is within the scope of practice of the
171.31public health nurse's license as a registered nurse, as defined in section 148.171;
171.32    (22) telemedicine consultations, to the extent they are covered under section
171.33256B.0625, subdivision 3b ; and
171.34    (23) mental health telemedicine and psychiatric consultation as covered under
171.35section 256B.0625, subdivisions 46 and 48.;
172.1    (24) care coordination and patient education services provided by a community
172.2health worker according to section 256B.0625, subdivision 49; and
172.3    (25) regardless of the number of employees that an enrolled health care provider
172.4may have, sign language interpreter services when provided by an enrolled health care
172.5provider during the course of providing a direct, person-to-person covered health care
172.6service to an enrolled recipient who has a hearing loss and uses interpreting services.
172.7    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
172.8paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
172.9to inpatient hospital services, including physician services provided during the inpatient
172.10hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
172.11    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
172.12subdivision.
172.13    (c) In order to contain costs, the commissioner of human services shall select
172.14vendors of medical care who can provide the most economical care consistent with high
172.15medical standards and shall where possible contract with organizations on a prepaid
172.16capitation basis to provide these services. The commissioner shall consider proposals by
172.17counties and vendors for prepaid health plans, competitive bidding programs, block grants,
172.18or other vendor payment mechanisms designed to provide services in an economical
172.19manner or to control utilization, with safeguards to ensure that necessary services are
172.20provided. Before implementing prepaid programs in counties with a county operated or
172.21affiliated public teaching hospital or a hospital or clinic operated by the University of
172.22Minnesota, the commissioner shall consider the risks the prepaid program creates for the
172.23hospital and allow the county or hospital the opportunity to participate in the program in a
172.24manner that reflects the risk of adverse selection and the nature of the patients served by
172.25the hospital, provided the terms of participation in the program are competitive with the
172.26terms of other participants considering the nature of the population served. Payment for
172.27services provided pursuant to this subdivision shall be as provided to medical assistance
172.28vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
172.29payments made during fiscal year 1990 and later years, the commissioner shall consult
172.30with an independent actuary in establishing prepayment rates, but shall retain final control
172.31over the rate methodology.
172.32    (d) Effective January 1, 2008, drug coverage under general assistance medical care
172.33is limited to prescription drugs that:
172.34    (i) are covered under the medical assistance program as described in section
172.35256B.0625, subdivisions 13 and 13d; and
173.1    (ii) are provided by manufacturers that have fully executed general assistance
173.2medical care rebate agreements with the commissioner and comply with the agreements.
173.3Prescription drug coverage under general assistance medical care must conform to
173.4coverage under the medical assistance program according to section 256B.0625,
173.5subdivisions 13 to 13g.
173.6    (d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
173.7co-payments for services provided on or after October 1, 2003, and before January 1, 2008:
173.8    (1) $25 for eyeglasses;
173.9    (2) $25 for nonemergency visits to a hospital-based emergency room;
173.10    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
173.11subject to a $12 per month maximum for prescription drug co-payments. No co-payments
173.12shall apply to antipsychotic drugs when used for the treatment of mental illness; and
173.13    (4) 50 percent coinsurance on restorative dental services.
173.14    (e) (f) Recipients eligible under subdivision 3, paragraph (a), shall include the
173.15following co-payments for services provided on or after January 1, 2008:
173.16    (1) $25 for nonemergency visits to a hospital-based emergency room; and
173.17    (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
173.18subject to a $7 per month maximum for prescription drug co-payments. No co-payments
173.19shall apply to antipsychotic drugs when used for the treatment of mental illness.
173.20    (g) Co-payments shall be limited to one per day per provider for nonpreventive visits,
173.21eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of
173.22general assistance medical care are responsible for all co-payments in this subdivision.
173.23The general assistance medical care reimbursement to the provider shall be reduced by the
173.24amount of the co-payment, except that reimbursement for prescription drugs shall not be
173.25reduced once a recipient has reached the $12 per month maximum for prescription drug
173.26co-payments. The provider collects the co-payment from the recipient. Providers may
173.27not deny services to recipients who are unable to pay the co-payment, except as provided
173.28in paragraph (f). This paragraph expires January 1, 2008.
173.29    (f) If it is the routine business practice of a provider to refuse service to an individual
173.30with uncollected debt, the provider may include uncollected co-payments under this
173.31section. A provider must give advance notice to a recipient with uncollected debt before
173.32services can be denied.
173.33    (h) Effective January 1, 2008, co-payments shall be limited to one per day per
173.34provider for nonemergency visits to a hospital-based emergency room. Recipients of
173.35general assistance medical care are responsible for all co-payments in this subdivision.
173.36The general assistance medical care reimbursement to the provider shall be reduced by the
174.1amount of the co-payment, except that reimbursement for prescription drugs shall not be
174.2reduced once a recipient has reached the $7 per month maximum for prescription drug
174.3co-payments. The provider collects the co-payment from the recipient. Providers may not
174.4deny services to recipients who are unable to pay the co-payment.
174.5    (i) General assistance medical care reimbursement to fee-for-service providers
174.6and payments to managed care plans shall not be increased as a result of the removal of
174.7the co-payments effective January 1, 2008.
174.8    (g) (j) Any county may, from its own resources, provide medical payments for
174.9which state payments are not made.
174.10    (h) (k) Chemical dependency services that are reimbursed under chapter 254B must
174.11not be reimbursed under general assistance medical care.
174.12    (i) (l) The maximum payment for new vendors enrolled in the general assistance
174.13medical care program after the base year shall be determined from the average usual and
174.14customary charge of the same vendor type enrolled in the base year.
174.15    (j) (m) The conditions of payment for services under this subdivision are the same
174.16as the conditions specified in rules adopted under chapter 256B governing the medical
174.17assistance program, unless otherwise provided by statute or rule.
174.18    (k) (n) Inpatient and outpatient payments shall be reduced by five percent, effective
174.19July 1, 2003. This reduction is in addition to the five percent reduction effective July 1,
174.202003, and incorporated by reference in paragraph (i) (l).
174.21    (l) (o) Payments for all other health services except inpatient, outpatient, and
174.22pharmacy services shall be reduced by five percent, effective July 1, 2003.
174.23    (m) (p) Payments to managed care plans shall be reduced by five percent for services
174.24provided on or after October 1, 2003, or upon federal approval, whichever is later.
174.25    (n) (q) A hospital receiving a reduced payment as a result of this section may apply
174.26the unpaid balance toward satisfaction of the hospital's bad debts.
174.27    (o) (r) Fee-for-service payments for nonpreventive visits shall be reduced by $3
174.28for services provided on or after January 1, 2006. For purposes of this subdivision, a
174.29visit means an episode of service which is required because of a recipient's symptoms,
174.30diagnosis, or established illness, and which is delivered in an ambulatory setting by
174.31a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
174.32audiologist, optician, or optometrist.
174.33    (p) (s) Payments to managed care plans shall not be increased as a result of the
174.34removal of the $3 nonpreventive visit co-payment effective January 1, 2006.
174.35EFFECTIVE DATE.This section is effective July 1, 2007, unless another effective
174.36date is explicit.

175.1    Sec. 22. Minnesota Statutes 2006, section 256L.01, subdivision 1, is amended to read:
175.2    Subdivision 1. Scope. For purposes of sections 256L.01 to 256L.18 this chapter,
175.3the following terms shall have the meanings given them.

175.4    Sec. 23. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:
175.5    Subd. 4. Gross individual or gross family income. (a) "Gross individual or gross
175.6family income" for nonfarm self-employed means income calculated for the six-month
175.712-month period of eligibility using the net profit or loss reported on the applicant's
175.8federal income tax form for the previous year and using the medical assistance families
175.9with children methodology for determining allowable and nonallowable self-employment
175.10expenses and countable income.
175.11    (b) "Gross individual or gross family income" for farm self-employed means income
175.12calculated for the six-month 12-month period of eligibility using as the baseline the
175.13adjusted gross income reported on the applicant's federal income tax form for the previous
175.14year and adding back in reported depreciation amounts that apply to the business in which
175.15the family is currently engaged.
175.16    (c) "Gross individual or gross family income" means the total income for all family
175.17members, calculated for the six-month 12-month period of eligibility.
175.18EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
175.19approval, whichever is later.

175.20    Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
175.21    Subdivision 1. Covered health services. For individuals under section 256L.04,
175.22subdivision 7 , with income no greater than 75 percent of the federal poverty guidelines
175.23or for families with children under section 256L.04, subdivision 1, all subdivisions of
175.24this section apply. "Covered health services" means the health services reimbursed
175.25under chapter 256B, with the exception of inpatient hospital services, special education
175.26services, private duty nursing services, adult dental care services other than services
175.27covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
175.28medical transportation services, personal care assistant and case management services,
175.29nursing home or intermediate care facilities services, inpatient mental health services,
175.30and chemical dependency services. Outpatient mental health services covered under the
175.31MinnesotaCare program are limited to diagnostic assessments, psychological testing,
175.32explanation of findings, mental health telemedicine, psychiatric consultation, medication
175.33management by a physician, day treatment, partial hospitalization, and individual, family,
175.34and group psychotherapy.
176.1    No public funds shall be used for coverage of abortion under MinnesotaCare
176.2except where the life of the female would be endangered or substantial and irreversible
176.3impairment of a major bodily function would result if the fetus were carried to term; or
176.4where the pregnancy is the result of rape or incest.
176.5    Covered health services shall be expanded as provided in this section.
176.6EFFECTIVE DATE.This section is effective January 1, 2008.

176.7    Sec. 25. Minnesota Statutes 2006, section 256L.03, subdivision 3, is amended to read:
176.8    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
176.9inpatient hospital services, including inpatient hospital mental health services and inpatient
176.10hospital and residential chemical dependency treatment, subject to those limitations
176.11necessary to coordinate the provision of these services with eligibility under the medical
176.12assistance spenddown. Prior to July 1, 1997, the inpatient hospital benefit for adult
176.13enrollees is subject to an annual benefit limit of $10,000. The inpatient hospital benefit
176.14for adult enrollees who qualify under section 256L.04, subdivision 7, or who qualify
176.15under section 256L.04, subdivisions 1 and 2, with family gross income that exceeds
176.16175 200 percent of the federal poverty guidelines or 215 percent of the federal poverty
176.17guidelines on or after July 1, 2009, and who are not pregnant, is subject to an annual
176.18limit of $10,000 $20,000.
176.19    (b) Admissions for inpatient hospital services paid for under section 256L.11,
176.20subdivision 3 , must be certified as medically necessary in accordance with Minnesota
176.21Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
176.22    (1) all admissions must be certified, except those authorized under rules established
176.23under section 254A.03, subdivision 3, or approved under Medicare; and
176.24    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
176.25for admissions for which certification is requested more than 30 days after the day of
176.26admission. The hospital may not seek payment from the enrollee for the amount of the
176.27payment reduction under this clause.
176.28EFFECTIVE DATE.For parents and relative caretakers, this section is effective
176.29July 1, 2008, or upon federal approval, whichever is later. For single adults and households
176.30with no children, this section is effective January 1, 2008.

176.31    Sec. 26. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
177.1    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
177.2and (c), the MinnesotaCare benefit plan shall include the following co-payments and
177.3coinsurance requirements for all enrollees:
177.4    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
177.5subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
177.6$3,000 per family;
177.7    (2) $3 per prescription for adult enrollees;
177.8    (3) $25 for eyeglasses for adult enrollees;
177.9    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
177.10episode of service which is required because of a recipient's symptoms, diagnosis, or
177.11established illness, and which is delivered in an ambulatory setting by a physician or
177.12physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
177.13audiologist, optician, or optometrist; and
177.14    (5) $6 for nonemergency visits to a hospital-based emergency room.
177.15    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
177.16children under the age of 21 in households with family income equal to or less than 175
177.17percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
177.18parents and relative caretakers of children under the age of 21 in households with family
177.19income greater than 175 percent of the federal poverty guidelines for inpatient hospital
177.20admissions occurring on or after January 1, 2001.
177.21    (c) Paragraph (a), clauses (1) to (4), do does not apply to pregnant women and
177.22children under the age of 21.
177.23    (d) Adult enrollees with family gross income that exceeds 175 200 percent of the
177.24federal poverty guidelines or 215 percent of the federal poverty guidelines on or after July
177.251, 2009, and who are not pregnant shall be financially responsible for the coinsurance
177.26amount, if applicable, and amounts which exceed the $10,000 $20,000 inpatient hospital
177.27benefit limit.
177.28    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health
177.29plan, or changes from one prepaid health plan to another during a calendar year, any
177.30charges submitted towards the $10,000 $20,000 annual inpatient benefit limit, and any
177.31out-of-pocket expenses incurred by the enrollee for inpatient services, that were submitted
177.32or incurred prior to enrollment, or prior to the change in health plans, shall be disregarded.
177.33EFFECTIVE DATE.For parents and relative caretakers, this section is effective
177.34July 1, 2008, or upon federal approval, whichever is later. For single adults and households
177.35with no children, this section is effective January 1, 2008.

178.1    Sec. 27. Minnesota Statutes 2006, section 256L.04, subdivision 7, is amended to read:
178.2    Subd. 7. Single adults and households with no children. The definition of eligible
178.3persons includes all individuals and households with no children who have gross family
178.4incomes that are equal to or less than 175 200 percent of the federal poverty guidelines.
178.5Effective July 1, 2009, the definition of eligible persons includes all individuals and
178.6households with no children who have gross family incomes that are equal to or less than
178.7215 percent of the federal poverty guidelines.
178.8EFFECTIVE DATE.This section is effective January 1, 2008.

178.9    Sec. 28. Minnesota Statutes 2006, section 256L.05, subdivision 1, is amended to read:
178.10    Subdivision 1. Application and information availability. Applications and other
178.11information application assistance must be made available to at provider offices, local
178.12human services agencies, school districts, public and private elementary schools in which
178.1325 percent or more of the students receive free or reduced price lunches, community health
178.14offices, and Women, Infants and Children (WIC) program sites, Head Start program sites,
178.15public housing councils, crisis nurseries, child care centers, early childhood education
178.16and preschool program sites, legal aid offices, and libraries. These sites may accept
178.17applications and forward the forms to the commissioner or local county human services
178.18agencies that choose to participate as an enrollment site. Otherwise, applicants may apply
178.19directly to the commissioner or to participating local county human services agencies.
178.20Beginning January 1, 2000, MinnesotaCare enrollment sites will be expanded to include
178.21local county human services agencies which choose to participate.

178.22    Sec. 29. Minnesota Statutes 2006, section 256L.05, subdivision 1b, is amended to read:
178.23    Subd. 1b. MinnesotaCare enrollment by county agencies. Beginning September
178.241, 2006, county agencies shall enroll single adults and households with no children
178.25formerly enrolled in general assistance medical care in MinnesotaCare according to
178.26section 256D.03, subdivision 3. County agencies shall perform all duties necessary
178.27to administer the MinnesotaCare program ongoing for these enrollees, including the
178.28redetermination of MinnesotaCare eligibility at six-month renewal.

178.29    Sec. 30. Minnesota Statutes 2006, section 256L.05, subdivision 2, is amended to read:
178.30    Subd. 2. Commissioner's duties. (a) The commissioner or county agency shall
178.31use electronic verification as the primary method of income verification. If there is a
178.32discrepancy between reported income and electronically verified income, an individual
178.33may be required to submit additional verification. In addition, the commissioner shall
179.1perform random audits to verify reported income and eligibility. The commissioner
179.2may execute data sharing arrangements with the Department of Revenue and any other
179.3governmental agency in order to perform income verification related to eligibility and
179.4premium payment under the MinnesotaCare program.
179.5    (b) In determining eligibility for MinnesotaCare, the commissioner shall require
179.6applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
179.7income. The commissioner shall also require applicants and enrollees to submit the names
179.8of their employers and a contact name with a telephone number for each employer for
179.9purposes of verifying whether the applicant or enrollee, and any dependents, are eligible
179.10for employer-subsidized coverage. Data collected is nonpublic data as defined in section
179.1113.02, subdivision 9.

179.12    Sec. 31. Minnesota Statutes 2006, section 256L.05, subdivision 3a, is amended to read:
179.13    Subd. 3a. Renewal of eligibility. (a) Beginning January 1, 1999 July 1, 2007, an
179.14enrollee's eligibility must be renewed every 12 months. The 12-month period begins in
179.15the month after the month the application is approved.
179.16    (b) Beginning October 1, 2004, an enrollee's eligibility must be renewed every
179.17six months. The first six-month period of eligibility begins the month the application is
179.18received by the commissioner. The effective date of coverage within the first six-month
179.19period of eligibility is as provided in subdivision 3. Each new period of eligibility must
179.20take into account any changes in circumstances that impact eligibility and premium
179.21amount. An enrollee must provide all the information needed to redetermine eligibility by
179.22the first day of the month that ends the eligibility period. The premium for the new period
179.23of eligibility must be received as provided in section 256L.06 in order for eligibility to
179.24continue.
179.25    (c) For single adults and households with no children formerly enrolled in general
179.26assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
179.27subdivision 3 , the first six-month period of eligibility begins the month the enrollee
179.28submitted the application or renewal for general assistance medical care.
179.29EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
179.30approval, whichever is later.

179.31    Sec. 32. Minnesota Statutes 2006, section 256L.07, subdivision 1, is amended to read:
179.32    Subdivision 1. General requirements. (a) Children enrolled in the original
179.33children's health plan as of September 30, 1992, children who enrolled in the
179.34MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
180.1article 4, section 17, and children who have family gross incomes that are equal to or
180.2less than 150 percent of the federal poverty guidelines are eligible without meeting
180.3the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
180.4long as they maintain continuous coverage in the MinnesotaCare program or medical
180.5assistance. Children who apply for MinnesotaCare on or after the implementation date
180.6of the employer-subsidized health coverage program as described in Laws 1998, chapter
180.7407, article 5, section 45, who have family gross incomes that are equal to or less than 150
180.8percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
180.9be eligible for MinnesotaCare.
180.10    (b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
180.11income increases above 275 percent of the federal poverty guidelines, are no longer
180.12eligible for the program and shall be disenrolled by the commissioner. Beginning January
180.131, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7,
180.14whose income increases above 175 200 percent of the federal poverty guidelines or 215
180.15percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
180.16the program and shall be disenrolled by the commissioner. For persons disenrolled under
180.17this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
180.18following the month in which the commissioner determines that the income of a family or
180.19individual exceeds program income limits.
180.20    (c) (b) Notwithstanding paragraph (b) (a), children may remain enrolled in
180.21MinnesotaCare if ten percent of their gross individual or gross family income as defined
180.22in section 256L.01, subdivision 4, is less than the annual premium for a six-month
180.23policy with a $500 deductible available through the Minnesota Comprehensive Health
180.24Association. Children who are no longer eligible for MinnesotaCare under this clause shall
180.25be given a 12-month notice period from the date that ineligibility is determined before
180.26disenrollment. The premium for children remaining eligible under this clause shall be the
180.27maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
180.28    (d) (c) Notwithstanding paragraphs (b) (a) and (c) (b), parents are not eligible for
180.29MinnesotaCare if gross household income exceeds $25,000 for the six-month period
180.30of eligibility.
180.31EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
180.32approval, whichever is later.

180.33    Sec. 33. Minnesota Statutes 2006, section 256L.07, subdivision 2, is amended to read:
180.34    Subd. 2. Must not have access to employer-subsidized coverage. (a) To be
180.35eligible, a family or individual an adult must not have access to subsidized health coverage
181.1through an employer and must not have had access to employer-subsidized coverage
181.2through a current employer for 18 months prior to application or reapplication. A family
181.3or individual An adult whose employer-subsidized coverage is lost due to an employer
181.4terminating health care coverage as an employee benefit during the previous 18 months
181.5is not eligible.
181.6    (b) This subdivision does not apply to a family or individual an adult who was
181.7enrolled in MinnesotaCare within six months or less of reapplication and who no longer
181.8has employer-subsidized coverage due to the employer terminating health care coverage
181.9as an employee benefit.
181.10    (c) For purposes of this requirement, subsidized health coverage means health
181.11coverage for which the employer pays at least 50 percent of the cost of coverage for
181.12the employee or dependent, or a higher percentage as specified by the commissioner.
181.13Children are eligible for employer-subsidized coverage through either parent, including
181.14the noncustodial parent. The commissioner must treat employer contributions to Internal
181.15Revenue Code Section 125 plans and any other employer benefits intended to pay
181.16health care costs as qualified employer subsidies toward the cost of health coverage for
181.17employees for purposes of this subdivision.
181.18    (d) This subdivision does not apply to children.
181.19EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
181.20approval, whichever is later.

181.21    Sec. 34. Minnesota Statutes 2006, section 256L.07, subdivision 6, is amended to read:
181.22    Subd. 6. Exception for certain adults. Single adults and households with
181.23no children formerly enrolled in general assistance medical care and enrolled in
181.24MinnesotaCare according to section 256D.03, subdivision 3, are eligible without meeting
181.25the requirements of this section until six-month renewal.

181.26    Sec. 35. Minnesota Statutes 2006, section 256L.09, subdivision 4, is amended to read:
181.27    Subd. 4. Eligibility as Minnesota resident. (a) For purposes of this section, a
181.28permanent Minnesota resident is a person who has demonstrated, through persuasive and
181.29objective evidence, that the person is domiciled in the state and intends to live in the
181.30state permanently.
181.31    (b) To be eligible as a permanent resident, an applicant must demonstrate the
181.32requisite intent to live in the state permanently by:
182.1    (1) showing that the applicant maintains a residence at a verified address other than a
182.2place of public accommodation, through the use of evidence of residence described in
182.3section 256D.02, subdivision 12a, paragraph (b), clause (1) (2);
182.4    (2) demonstrating that the applicant has been continuously domiciled in the state for
182.5no less than 180 days immediately before the application; and
182.6    (3) signing an affidavit declaring that (A) the applicant currently resides in the state
182.7and intends to reside in the state permanently; and (B) the applicant did not come to the
182.8state for the primary purpose of obtaining medical coverage or treatment.
182.9    (c) A person who is temporarily absent from the state does not lose eligibility for
182.10MinnesotaCare. "Temporarily absent from the state" means the person is out of the state
182.11for a temporary purpose and intends to return when the purpose of the absence has been
182.12accomplished. A person is not temporarily absent from the state if another state has
182.13determined that the person is a resident for any purpose. If temporarily absent from the
182.14state, the person must follow the requirements of the health plan in which the person is
182.15enrolled to receive services.

182.16    Sec. 36. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:
182.17    Subd. 7. Critical access dental providers. Effective for dental services provided
182.18to MinnesotaCare enrollees on or after January 1, 2007, the commissioner shall increase
182.19payment rates to dentists and dental clinics deemed by the commissioner to be critical
182.20access providers under section 256B.76, paragraph (c), by 50 percent above the payment
182.21rate that would otherwise be paid to the provider. The commissioner shall adjust the rates
182.22paid on or after January 1, 2007, to pay the prepaid health plans under contract with the
182.23commissioner amounts sufficient to reflect this rate increase. The prepaid health plan must
182.24pass this rate increase to providers who have been identified by the commissioner as
182.25critical access dental providers under section 256B.76, paragraph (c).

182.26    Sec. 37. Minnesota Statutes 2006, section 256L.15, subdivision 1, is amended to read:
182.27    Subdivision 1. Premium determination. (a) Families with children and individuals
182.28shall pay a premium determined according to subdivision 2.
182.29    (b) Pregnant women and children under age two are exempt from the provisions
182.30of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
182.31for failure to pay premiums. For pregnant women, this exemption continues until the
182.32first day of the month following the 60th day postpartum. Women who remain enrolled
182.33during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
183.1disenrolled on the first of the month following the 60th day postpartum for the penalty
183.2period that otherwise applies under section 256L.06, unless they begin paying premiums.
183.3    (c) Members of the military and their families who meet the eligibility criteria
183.4for MinnesotaCare upon eligibility approval made within 24 months following the end
183.5of the member's tour of active duty shall have their premiums paid by the commissioner.
183.6The effective date of coverage for an individual or family who meets the criteria of this
183.7paragraph shall be the first day of the month following the month in which eligibility is
183.8approved. This exemption applies for 12 months.
183.9EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
183.10approval, whichever is later. The commissioner of human services shall notify the Office
183.11of the Revisor of Statutes when federal approval is obtained.

183.12    Sec. 38. Minnesota Statutes 2006, section 256L.15, subdivision 2, is amended to read:
183.13    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
183.14commissioner shall establish a sliding fee scale to determine the percentage of monthly
183.15gross individual or family income that households at different income levels must pay
183.16to obtain coverage through the MinnesotaCare program. The sliding fee scale must be
183.17based on the enrollee's monthly gross individual or family income. The sliding fee scale
183.18must contain separate tables based on enrollment of one, two, or three or more persons.
183.19The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or
183.20family income for individuals or families with incomes below the limits for the medical
183.21assistance program for families and children in effect on January 1, 1999, and proceeds
183.22through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent.
183.23These percentages are matched to evenly spaced income steps ranging from the medical
183.24assistance income limit for families and children in effect on January 1, 1999, to 275
183.25percent of the federal poverty guidelines for the applicable family size, up to a family size
183.26of five. The sliding fee scale for a family of five must be used for families of more than
183.27five. Effective October 1, 2003, the commissioner shall increase each percentage by 0.5
183.28percentage points for enrollees with income greater than 100 percent but not exceeding
183.29200 percent of the federal poverty guidelines and shall increase each percentage by 1.0
183.30percentage points for families and children with incomes greater than 200 percent of
183.31the federal poverty guidelines. The sliding fee scale and percentages are not subject to
183.32the provisions of chapter 14. If a family or individual reports increased income after
183.33enrollment, premiums shall be adjusted at the time the change in income is reported.
183.34    (b) Children in Families whose gross income is above 275 percent of the federal
183.35poverty guidelines shall pay the maximum premium. The maximum premium is defined
184.1as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
184.2cases paid the maximum premium, the total revenue would equal the total cost of
184.3MinnesotaCare medical coverage and administration. In this calculation, administrative
184.4costs shall be assumed to equal ten percent of the total. The costs of medical coverage
184.5for pregnant women and children under age two and the enrollees in these groups shall
184.6be excluded from the total. The maximum premium for two enrollees shall be twice the
184.7maximum premium for one, and the maximum premium for three or more enrollees shall
184.8be three times the maximum premium for one.
184.9    (c) After calculating the percentage of premium each enrollee shall pay under
184.10paragraph (a), eight percent shall be added to the premium.
184.11EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
184.12approval, whichever is later.

184.13    Sec. 39. Minnesota Statutes 2006, section 256L.15, subdivision 3, is amended to read:
184.14    Subd. 3. Exceptions to sliding scale. Children in families with income at or below
184.15150 200 percent of the federal poverty guidelines pay a monthly premium of $4.
184.16EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
184.17approval, whichever is later.

184.18    Sec. 40. Minnesota Statutes 2006, section 256L.15, subdivision 4, is amended to read:
184.19    Subd. 4. Exception for transitioned adults. County agencies shall pay premiums
184.20for single adults and households with no children formerly enrolled in general assistance
184.21medical care and enrolled in MinnesotaCare according to section 256D.03, subdivision 3,
184.22until six-month renewal. The county agency has the option of continuing to pay premiums
184.23for these enrollees past the first six-month renewal period.
184.24EFFECTIVE DATE.This section is effective July 1, 2007.

184.25    Sec. 41. Minnesota Statutes 2006, section 256L.17, subdivision 2, is amended to read:
184.26    Subd. 2. Limit on total assets. (a) Effective July 1, 2002, or upon federal approval,
184.27whichever is later, in order to be eligible for the MinnesotaCare program, a household of
184.28two or more persons must not own more than $20,000 in total net assets, and a household
184.29of one person must not own more than $10,000 in total net assets.
184.30    (b) For purposes of this subdivision, assets are determined according to section
184.31256B.056, subdivision 3c , except that workers' compensation settlements received due to
184.32a work-related injury shall not be considered.
185.1    (c) State-funded MinnesotaCare is not available for applicants or enrollees who are
185.2otherwise eligible for medical assistance but fail to verify assets. Enrollees who become
185.3eligible for federally funded medical assistance shall be terminated from state-funded
185.4MinnesotaCare and transferred to medical assistance.
185.5EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
185.6approval, whichever is later.

185.7    Sec. 42. Minnesota Statutes 2006, section 256L.17, subdivision 7, is amended to read:
185.8    Subd. 7. Exception for certain adults. Single adults and households with
185.9no children formerly enrolled in general assistance medical care and enrolled in
185.10MinnesotaCare according to section 256D.03, subdivision 3, are exempt from the
185.11requirements of this section until six-month renewal.

185.12    Sec. 43. [256L.20] MINNESOTACARE OPTION FOR SMALL EMPLOYERS.
185.13    Subdivision 1. Definitions. (a) For the purposes of this section, the following terms
185.14have the meanings given them.
185.15    (b) "Dependent" means an unmarried child who is under the age of 21 and who is
185.16not eligible for employer-subsidized health coverage.
185.17    (c) "Eligible employee" means an employee who works at least 20 hours per week
185.18for an eligible employer. Eligible employee does not include an employee who works
185.19on a temporary or substitute basis or who does not work more than 26 weeks annually.
185.20Coverage of an eligible employee includes the employee's spouse if the spouse does not
185.21have access to employer-subsidized health coverage.
185.22    (d) "Eligible employer" means a business that employs at least two, but not more
185.23than 50, eligible employees, the majority of whom are employed in the state, and includes
185.24a municipality that has 50 or fewer employees.
185.25    (e) "Employer-subsidized health coverage" has the meaning given under section
185.26256L.07, subdivision 2, paragraph (c).
185.27    (f) "Maximum premium" has the meaning given under section 256L.15, subdivision
185.282, paragraph (b), except that the cost of medical coverage for single adults and households
185.29without children formerly enrolled in general assistance medical care and enrolled in
185.30MinnesotaCare in accordance with section 256D.03, subdivision 3, paragraph (c), are
185.31excluded from the total cost when determining the maximum premium.
185.32    (g) "Participating employer" means an eligible employer who meets the requirements
185.33in subdivision 3 and applies to the commissioner to enroll its eligible employees and their
185.34dependents in the MinnesotaCare program.
186.1    (h) "Program" means the MinnesotaCare program.
186.2    Subd. 2. Application and renewal procedures. (a) Eligible employees and their
186.3dependents may enroll in MinnesotaCare through their employer if their employer meets
186.4the requirements of subdivision 3. The commissioner shall establish procedures for an
186.5eligible employer to participate in the program. The commissioner shall provide an
186.6employer with applications for each eligible employee. The employee must fill out the
186.7application and submit it to the employer. The employer must submit the completed
186.8applications to the commissioner. The commissioner shall determine eligibility for the
186.9program and determine the premiums owed by the employer for each eligible employee.
186.10The commissioner may require eligible employees to provide income verification to
186.11determine premiums.
186.12    (b) The effective date of coverage is according to section 256L.05, subdivision 3.
186.13    (c) An employer's eligibility must be renewed every 12 months. At that time, all
186.14eligible employees enrolled in the program regardless of their enrollment date must
186.15reapply.
186.16    (d) A participating employer must inform the commissioner of any changes in its
186.17employees and premiums must be adjusted accordingly beginning the first day of the
186.18month following the month in which the change is reported. An employer's premiums
186.19shall not be adjusted due to a change in an employee's income until the next renewal
186.20period. Eligible employees hired after enrollment must fill out an application and submit
186.21the application to the commissioner. Employees who terminate their employment with
186.22the participating employer shall remain enrolled in the program until the last day of the
186.23month in which employment is terminated. A terminating employee may remain in the
186.24MinnesotaCare program if the employee meets the eligibility requirements of enrollment
186.25described in sections 256L.01 to 256L.18.
186.26    Subd. 3. Employer requirements. In order to participate, an eligible employer
186.27must meet the following requirements:
186.28    (1) agree to contribute toward the cost of the premium for the employee, the
186.29employee's spouse, and the employee's dependents according to subdivision 4;
186.30    (2) certify that each eligible employee was informed of the availability of coverage
186.31through the program and that at least 75 percent of its eligible employees are planning to
186.32or are enrolled in the program; and
186.33    (3) have not provided employer-subsidized health coverage as an employee benefit
186.34during the previous 12 months, as defined in section 256L.07, subdivision 2, paragraph (c).
187.1    Subd. 4. Premiums. (a) The premium for coverage provided under this section is
187.2equal to the maximum premium as defined in subdivision 1 regardless of the income
187.3of the eligible employee.
187.4    (b) For eligible employees without dependents with a gross family income equal to
187.5or less than 200 percent of the federal poverty guidelines or 215 percent of the federal
187.6poverty guidelines on or after July 1, 2009, and for eligible employees with dependents
187.7whose gross family income is equal to or less than 275 percent of the federal poverty
187.8guidelines, the participating employer shall pay 50 percent of the premium established
187.9under paragraph (a) for the eligible employee, the employee's spouse, and any dependents,
187.10if applicable.
187.11    (c) For eligible employees without dependents with a gross family income over 200
187.12percent of the federal poverty guidelines or 215 percent of the federal poverty guidelines
187.13on or after July 1, 2009, and for eligible employees with dependents with a gross family
187.14income over 275 percent of the federal poverty guidelines, the participating employer shall
187.15pay the full cost of the premium established under paragraph (a) for the eligible employee,
187.16the employee's spouse, and any dependents, if applicable. The participating employer may
187.17require the employee to pay a portion of the cost of the premium so long as the employer
187.18pays at least 50 percent. If the employer requires the employee to pay a portion of the
187.19premium, the employee shall pay the portion of the cost to the employer.
187.20    (d) The commissioner shall collect premium payments from participating employers
187.21for eligible employees, spouses, and dependents who are covered by the program as
187.22provided under this section. All premiums collected shall be deposited in the health care
187.23access fund.
187.24    (e) Nonpayment of premiums by a participating employer will result in the
187.25disenrollment of all eligible employees, spouses, and dependents from the program
187.26effective the end of the month in which the premium was due.
187.27    Subd. 5. Coverage. (a) The coverage offered to those enrolled in the program under
187.28this section shall include all health services described under section 256L.03 and all
187.29co-payments and coinsurance requirements under section 256L.03 shall apply except for
187.30as provided under paragraph (b).
187.31    (b) Notwithstanding paragraph (a), the inpatient hospital benefit annual limit in
187.32section 256L.03, subdivision 3, does not apply to adult enrollees enrolled in the program
187.33under this section.
187.34    Subd. 6. Enrollment. For purposes of enrollment under this section, income
187.35eligibility limits established under sections 256L.04 and 256L.07, asset limits established
187.36under section 256L.17, and the barriers established under section 256L.07, subdivision 2
188.1or 3, do not apply to applicants eligible for this program unless specified in this section.
188.2The residency requirement under section 256L.09 applies to this section.
188.3    Subd. 7. Outreach. The commissioner shall provide information on the availability
188.4of this buy-in option for small employers and application forms to entities that provide
188.5insurance information to small employers, including, but not limited to, insurance agents
188.6and chambers of commerce. The commissioner shall establish an assistance fee of $25 per
188.7enrolled employee for such entities that assist eligible employers and their employees in
188.8applying to the program.
188.9    Subd. 8. Provider payment. (a) Payment to providers under this section shall be
188.10the same rates and conditions under section 256L.12 except that payments for inpatient
188.11hospital services for employees without dependents and for the adult employees with
188.12dependents with gross family incomes greater than 200 percent of the federal poverty
188.13guidelines shall be paid according to paragraph (b).
188.14    (b) The commissioner shall pay hospitals the medical assistance rate for inpatient
188.15hospital services established under section 256.969 minus the $20,000 annual inpatient
188.16benefit limit and any applicable co-payments or coinsurance requirements.
188.17EFFECTIVE DATE.This section is effective January 1, 2009.

188.18    Sec. 44. HENNEPIN COUNTY PILOT PROJECT.
188.19    The commissioner of human services shall support a pilot project in Hennepin
188.20County to demonstrate the effectiveness of alternative strategies to redetermine eligibility
188.21for certain recipient populations in the medical assistance program. The target populations
188.22for the demonstration are persons who are eligible based upon disability or age, who have
188.23chronic medical conditions, and who are expected to experience minimal change in income
188.24or assets from month to month. The commissioner and the county shall analyze the issues
188.25and strategies employed and the outcomes to determine reasonable efforts to streamline
188.26eligibility statewide. The duration of the pilot project shall be no more than two years.
188.27The commissioner shall apply for any federal waivers needed to implement this section.

188.28    Sec. 45. PHARMACY REPORT ON DRA IMPACT.
188.29    Subdivision 1. Fiscal impact of deficit reduction act. The commissioner of
188.30human services shall report to the legislature by January 15, 2008, on the fiscal impact of
188.31Deficit Reduction Act reforms on the Minnesota Medicaid pharmacy program, including
188.32but not limited to:
188.33    (1) overall cost reductions to the Minnesota Medicaid pharmacy program as a result
188.34of the Deficit Reduction Act of 2005;
189.1    (2) the impact of reforms on the federal upper limit on pharmacy reimbursement,
189.2and the amount that the dispensing fee for multiple-source generic drugs would have to
189.3be adjusted to offset any reductions resulting from federal upper limits implemented as a
189.4result of the Deficit Reduction Act of 2005;
189.5    (3) the change in federal rebates received from pharmaceutical manufacturers
189.6as a result of Deficit Reduction Act reforms, and strategies that could be employed in
189.7administering the Medicaid drug formulary to compensate for lost manufacturer rebates;
189.8    (4) a comparison of published federal upper limits and state maximum allowable
189.9cost (MAC) prices prior to and following implementation of the Deficit Reduction Act
189.10federal upper limit reforms;
189.11    (5) the number of participating pharmacies in the program as of January 1, 2007,
189.12July 1, 2007, and November 1, 2007; and
189.13    (6) the Minnesota Medicaid fee-for-service pharmacy program rate of generic
189.14dispensing before and after state implementation of Deficit Reduction Act of 2005 generic
189.15reimbursement reform.
189.16EFFECTIVE DATE.This section is effective the day following final enactment.

189.17    Sec. 46. CHIROPRACTIC COVERAGE.
189.18    The commissioner of human services, through the Health Services Policy
189.19Committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, and
189.20using existing funding, shall study whether medical assistance coverage for chiropractic
189.21services should be expanded to include initial and progress exams, and shall report
189.22recommendations to the legislature by January 15, 2008.

189.23    Sec. 47. MINNESOTACARE APPLICATION PROCESSING CENTERS.
189.24    If the commissioner of human services establishes regional out-state processing
189.25centers for MinnesotaCare application processing, one of the centers must be located in
189.26Granite Falls to provide processing services to the southern portion of the state.

189.27    Sec. 48. IMPLEMENTATION.
189.28    The commissioner of human services shall implement the amendments to Minnesota
189.29Statutes, sections 256.969, subdivision 9; 256.969, subdivision 27; and 256B.199, on the
189.30earliest date for which the Centers for Medicare and Medicaid Services grants approval.
189.31The commissioner may alter the reporting date for Hennepin County and Hennepin
189.32County Medical Center in Minnesota Statutes, section 256.969, subdivision 9, paragraph
189.33(f), clause (2), to reflect the approved effective date.

190.1    Sec. 49. REPEALER.
190.2(a) Minnesota Statutes 2006, sections 256B.0631, subdivision 4; and 256L.035, are
190.3repealed effective January 1, 2008.
190.4(b) Minnesota Statutes 2006, sections 256B.0625, subdivisions 5a, 5b, 5c, 5d, 5e, 5f,
190.55g, 5h, 5i, 5j, and 5k; and 256L.07, subdivision 2a, are repealed effective July 1, 2007.

190.6ARTICLE 6

190.7CONTINUING CARE POLICY

190.8    Section 1. Minnesota Statutes 2006, section 144A.351, is amended to read:
190.9144A.351 BALANCING LONG-TERM CARE: REPORT REQUIRED.
190.10    The commissioners of health and human services, with the cooperation of counties
190.11and regional entities, shall prepare a report to the legislature by January August 15, 2004,
190.12and biennially thereafter, regarding the status of the full range of long-term care services
190.13for the elderly in Minnesota. The report shall address:
190.14    (1) demographics and need for long-term care in Minnesota;
190.15    (2) summary of county and regional reports on long-term care gaps, surpluses,
190.16imbalances, and corrective action plans;
190.17    (3) status of long-term care services by county and region including:
190.18    (i) changes in availability of the range of long-term care services and housing
190.19options;
190.20    (ii) access problems regarding long-term care; and
190.21    (iii) comparative measures of long-term care availability and progress over time; and
190.22    (4) recommendations regarding goals for the future of long-term care services,
190.23policy changes, and resource needs.

190.24    Sec. 2. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:
190.25    Subd. 3. Amount of support grant; use. Support grant amounts shall be
190.26determined by the county social service agency. Services and items purchased with a
190.27support grant must:
190.28    (1) be over and above the normal costs of caring for the dependent if the dependent
190.29did not have a disability;
190.30    (2) be directly attributable to the dependent's disabling condition; and
190.31    (3) enable the family to delay or prevent the out-of-home placement of the dependent.
190.32    The design and delivery of services and items purchased under this section must
190.33suit the dependent's chronological age and be provided in the least restrictive environment
190.34possible, consistent with the needs identified in the individual service plan.
191.1    Items and services purchased with support grants must be those for which there
191.2are no other public or private funds available to the family. Fees assessed to parents
191.3for health or human services that are funded by federal, state, or county dollars are not
191.4reimbursable through this program.
191.5    In approving or denying applications, the county shall consider the following factors:
191.6    (1) the extent and areas of the functional limitations of the disabled child;
191.7    (2) the degree of need in the home environment for additional support; and
191.8    (3) the potential effectiveness of the grant to maintain and support the person in
191.9the family environment.
191.10    The maximum monthly grant amount shall be $250 per eligible dependent, or
191.11$3,000 per eligible dependent per state fiscal year, within the limits of available funds and
191.12as adjusted by any legislatively authorized cost of living adjustment. The county social
191.13service agency may consider the dependent's supplemental security income in determining
191.14the amount of the support grant.
191.15    Any adjustments to their monthly grant amount must be based on the needs of the
191.16family and funding availability.

191.17    Sec. 3. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:
191.18    Subdivision 1. Purpose and goals. The commissioner of human services shall
191.19establish a consumer support grant program for individuals with functional limitations and
191.20their families who wish to purchase and secure their own supports. The commissioner and
191.21local agencies shall jointly develop an implementation plan which must include a way to
191.22resolve the issues related to county liability. The program shall:
191.23    (1) make support grants available to individuals or families as an effective alternative
191.24to the developmental disability family support program, personal care attendant services,
191.25home health aide services, and private duty nursing services;
191.26    (2) provide consumers more control, flexibility, and responsibility over their services
191.27and supports;
191.28    (3) promote local program management and decision making; and
191.29    (4) encourage the use of informal and typical community supports.

191.30    Sec. 4. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:
191.31    Subd. 2. Definitions. For purposes of this section, the following terms have the
191.32meanings given them:
191.33    (a) "County board" means the county board of commissioners for the county of
191.34financial responsibility as defined in section 256G.02, subdivision 4, or its designated
192.1representative. When a human services board has been established under sections 402.01
192.2to 402.10, it shall be considered the county board for the purposes of this section.
192.3    (b) "Family" means the person's birth parents, adoptive parents or stepparents,
192.4siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece,
192.5nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is
192.6at least 18 years of age.
192.7    (c) "Functional limitations" means the long-term inability to perform an activity or
192.8task in one or more areas of major life activity, including self-care, understanding and use
192.9of language, learning, mobility, self-direction, and capacity for independent living. For the
192.10purpose of this section, the inability to perform an activity or task results from a mental,
192.11emotional, psychological, sensory, or physical disability, condition, or illness.
192.12    (d) "Informed choice" means a voluntary decision made by the person or,
192.13the person's legal representative, or other authorized representative after becoming
192.14familiarized with the alternatives to:
192.15    (1) select a preferred alternative from a number of feasible alternatives;
192.16    (2) select an alternative which may be developed in the future; and
192.17    (3) refuse any or all alternatives.
192.18    (e) "Local agency" means the local agency authorized by the county board or,
192.19for counties not participating in the consumer grant program by July 1, 2002, the
192.20commissioner, to carry out the provisions of this section.
192.21    (f) "Person" or "persons" means a person or persons meeting the eligibility criteria in
192.22subdivision 3.
192.23    (g) "Authorized representative" means an individual designated by the person or
192.24their legal representative to act on their behalf. This individual may be a family member,
192.25guardian, representative payee, or other individual designated by the person or their legal
192.26representative, if any, to assist in purchasing and arranging for supports. For the purposes
192.27of this section, an authorized representative is at least 18 years of age.
192.28    (h) "Screening" means the screening of a person's service needs under sections
192.29256B.0911 and 256B.092.
192.30    (i) "Supports" means services, care, aids, environmental modifications, or assistance
192.31purchased by the person or the person's family, the person's legal representative, or other
192.32authorized representative. Examples of supports include respite care, assistance with daily
192.33living, and assistive technology. For the purpose of this section, notwithstanding the
192.34provisions of section 144A.43, supports purchased under the consumer support program
192.35are not considered home care services.
193.1    (j) "Program of origination" means the program the individual transferred from
193.2when approved for the consumer support grant program.

193.3    Sec. 5. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:
193.4    Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a
193.5consumer support grant if the person meets all of the following criteria:
193.6    (1) the person is eligible for and has been approved to receive services under
193.7medical assistance as determined under sections 256B.055 and 256B.056 or the person
193.8has been approved to receive a grant under the developmental disability family support
193.9program under section 252.32;
193.10    (2) the person is able to direct and purchase the person's own care and supports, or
193.11the person has a family member, legal representative, or other authorized representative
193.12who can purchase and arrange supports on the person's behalf;
193.13    (3) the person has functional limitations, requires ongoing supports to live in the
193.14community, and is at risk of or would continue institutionalization without such supports;
193.15and
193.16    (4) the person will live in a home. For the purpose of this section, "home" means the
193.17person's own home or home of a person's family member. These homes are natural home
193.18settings and are not licensed by the Department of Health or Human Services.
193.19    (b) Persons may not concurrently receive a consumer support grant if they are:
193.20    (1) receiving personal care attendant and home health aide services, or private duty
193.21nursing under section 256B.0625; a developmental disability family support grant; or
193.22alternative care services under section 256B.0913; or
193.23    (2) residing in an institutional or congregate care setting.
193.24    (c) A person or person's family receiving a consumer support grant shall not be
193.25charged a fee or premium by a local agency for participating in the program.
193.26    (d) Individuals receiving home and community-based waivers under United States
193.27Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except
193.28for individuals receiving consumer support grants before July 1, 2003, as long as other
193.29eligibility criteria are met.
193.30    (e) The commissioner shall establish a budgeted appropriation each fiscal year
193.31for the consumer support grant program. The number of individuals participating in
193.32the program will be adjusted so the total amount allocated to counties does not exceed
193.33the amount of the budgeted appropriation. The budgeted appropriation will be adjusted
193.34annually to accommodate changes in demand for the consumer support grants.

194.1    Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:
194.2    Subd. 4. Support grants; criteria and limitations. (a) A county board may
194.3choose to participate in the consumer support grant program. If a county has not chosen
194.4to participate by July 1, 2002, the commissioner shall contract with another county or
194.5other entity to provide access to residents of the nonparticipating county who choose
194.6the consumer support grant option. The commissioner shall notify the county board
194.7in a county that has declined to participate of the commissioner's intent to enter into
194.8a contract with another county or other entity at least 30 days in advance of entering
194.9into the contract. The local agency shall establish written procedures and criteria to
194.10determine the amount and use of support grants. These procedures must include, at least,
194.11the availability of respite care, assistance with daily living, and adaptive aids. The local
194.12agency may establish monthly or annual maximum amounts for grants and procedures
194.13where exceptional resources may be required to meet the health and safety needs of the
194.14person on a time-limited basis, however, the total amount awarded to each individual may
194.15not exceed the limits established in subdivision 11.
194.16    (b) Support grants to a person or a person's family, a person's legal representative,
194.17or other authorized representative will be provided through a monthly subsidy payment
194.18and be in the form of cash, voucher, or direct county payment to vendor. Support grant
194.19amounts must be determined by the local agency. Each service and item purchased with a
194.20support grant must meet all of the following criteria:
194.21    (1) it must be over and above the normal cost of caring for the person if the person
194.22did not have functional limitations;
194.23    (2) it must be directly attributable to the person's functional limitations;
194.24    (3) it must enable the person or the person's family, a person's legal representative,
194.25or other authorized representative to delay or prevent out-of-home placement of the
194.26person; and
194.27    (4) it must be consistent with the needs identified in the service agreement, when
194.28applicable.
194.29    (c) Items and services purchased with support grants must be those for which there
194.30are no other public or private funds available to the person or the person's family, a person's
194.31legal representative, or other authorized representative. Fees assessed to the person or the
194.32person's family for health and human services are not reimbursable through the grant.
194.33    (d) In approving or denying applications, the local agency shall consider the
194.34following factors:
194.35    (1) the extent and areas of the person's functional limitations;
194.36    (2) the degree of need in the home environment for additional support; and
195.1    (3) the potential effectiveness of the grant to maintain and support the person in the
195.2family environment or the person's own home.
195.3    (e) At the time of application to the program or screening for other services,
195.4the person or the person's family, a person's legal representative, or other authorized
195.5representative shall be provided sufficient information to ensure an informed choice
195.6of alternatives by the person, the person's legal representative, or other authorized
195.7representative, if any, or the person's family. The application shall be made to the local
195.8agency and shall specify the needs of the person and family, the form and amount of
195.9grant requested, the items and services to be reimbursed, and evidence of eligibility for
195.10medical assistance.
195.11    (f) Upon approval of an application by the local agency and agreement on a support
195.12plan for the person or person's family, the local agency shall make grants to the person or
195.13the person's family. The grant shall be in an amount for the direct costs of the services or
195.14supports outlined in the service agreement.
195.15    (g) Reimbursable costs shall not include costs for resources already available, such as
195.16special education classes, day training and habilitation, case management, other services to
195.17which the person is entitled, medical costs covered by insurance or other health programs,
195.18or other resources usually available at no cost to the person or the person's family.
195.19    (h) The state of Minnesota, the county boards participating in the consumer
195.20support grant program, or the agencies acting on behalf of the county boards in the
195.21implementation and administration of the consumer support grant program shall not be
195.22liable for damages, injuries, or liabilities sustained through the purchase of support by
195.23the individual, the individual's family, or the authorized representative under this section
195.24with funds received through the consumer support grant program. Liabilities include but
195.25are not limited to: workers' compensation liability, the Federal Insurance Contributions
195.26Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section,
195.27participating county boards and agencies acting on behalf of county boards are exempt
195.28from the provisions of section 268.04.

195.29    Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:
195.30    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of
195.31transferring persons to the consumer support grant program from the developmental
195.32disability family support program and personal care assistant services, home health
195.33aide services, or private duty nursing services, the amount of funds transferred by the
195.34commissioner between the developmental disability family support program account, the
195.35medical assistance account, or the consumer support grant account shall be based on each
196.1county's participation in transferring persons to the consumer support grant program
196.2from those programs and services.
196.3    (b) At the beginning of each fiscal year, county allocations for consumer support
196.4grants shall be based on:
196.5    (1) the number of persons to whom the county board expects to provide consumer
196.6supports grants;
196.7    (2) their eligibility for current program and services;
196.8    (3) the amount of nonfederal dollars allowed under subdivision 11; and
196.9    (4) projected dates when persons will start receiving grants. County allocations shall
196.10be adjusted periodically by the commissioner based on the actual transfer of persons or
196.11service openings, and the nonfederal dollars associated with those persons or service
196.12openings, to the consumer support grant program.
196.13    (c) The amount of funds transferred by the commissioner from the medical
196.14assistance account for an individual may be changed if it is determined by the county or its
196.15agent that the individual's need for support has changed.
196.16    (d) The authority to utilize funds transferred to the consumer support grant account
196.17for the purposes of implementing and administering the consumer support grant program
196.18will not be limited or constrained by the spending authority provided to the program
196.19of origination.
196.20    (e) The commissioner may use up to five percent of each county's allocation, as
196.21adjusted, for payments for administrative expenses, to be paid as a proportionate addition
196.22to reported direct service expenditures.
196.23    (f) The county allocation for each individual or individual's family cannot exceed
196.24the amount allowed under subdivision 11.
196.25    (g) The commissioner may recover, suspend, or withhold payments if the county
196.26board, local agency, or grantee does not comply with the requirements of this section.
196.27    (h) Grant funds unexpended by consumers shall return to the state once a year. The
196.28annual return of unexpended grant funds shall occur in the quarter following the end of
196.29the state fiscal year.

196.30    Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:
196.31    Subd. 10. Consumer responsibilities. Persons receiving grants under this section
196.32shall:
196.33    (1) spend the grant money in a manner consistent with their agreement with the
196.34local agency;
197.1    (2) notify the local agency of any necessary changes in the grant or the items on
197.2which it is spent;
197.3    (3) notify the local agency of any decision made by the person, the a person's legal
197.4representative, or the person's family or other authorized representative that would change
197.5their eligibility for consumer support grants;
197.6    (4) arrange and pay for supports; and
197.7    (5) inform the local agency of areas where they have experienced difficulty securing
197.8or maintaining supports.

197.9    Sec. 9. Minnesota Statutes 2006, section 256.974, is amended to read:
197.10256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS
197.11LONG-TERM CARE; LOCAL PROGRAMS.
197.12    The ombudsman for older Minnesotans long-term care serves in the classified service
197.13under section 256.01, subdivision 7, in an office within the Minnesota Board on Aging that
197.14incorporates the long-term care ombudsman program required by the Older Americans
197.15Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12)
197.16(9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota
197.17Board on Aging may make grants to and designate local programs for the provision of
197.18ombudsman services to clients in county or multicounty areas. The local program may not
197.19be an agency engaged in the provision of nursing home care, hospital care, or home care
197.20services either directly or by contract, or have the responsibility for planning, coordinating,
197.21funding, or administering nursing home care, hospital care, or home care services.

197.22    Sec. 10. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:
197.23    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing
197.24home licensed under sections 144A.02 to 144A.10 or; a boarding care home licensed
197.25under sections 144.50 to 144.56; or a licensed or registered residential setting that provides
197.26or arranges for the provision of home care services.

197.27    Sec. 11. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:
197.28    Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a
197.29request is made for, ombudsman services and is (a) a resident of a long-term care facility
197.30or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or
197.31denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or
197.32requesting a home care service.

198.1    Sec. 12. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:
198.2    Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a
198.3conspicuous place the address and telephone number of the office. A home care service
198.4provider shall provide all recipients, including those in elderly housing with services
198.5under chapter 144D, with the address and telephone number of the office. Counties shall
198.6provide clients receiving a consumer support grant or a service allowance long-term care
198.7consultation services under section 256B.0911 or home and community-based services
198.8through a state or federally funded program with the name, address, and telephone number
198.9of the office. The posting or notice is subject to approval by the ombudsman.

198.10    Sec. 13. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:
198.11    Subd. 4. Access to long-term care and acute care facilities and clients. The
198.12ombudsman or designee may:
198.13    (1) enter any long-term care facility without notice at any time;
198.14    (2) enter any acute care facility without notice during normal business hours;
198.15    (3) enter any acute care facility without notice at any time to interview a patient or
198.16observe services being provided to the patient as part of an investigation of a matter that is
198.17within the scope of the ombudsman's authority, but only if the ombudsman's or designee's
198.18presence does not intrude upon the privacy of another patient or interfere with routine
198.19hospital services provided to any patient in the facility;
198.20    (4) communicate privately and without restriction with any client in accordance
198.21with section 144.651, as long as the ombudsman has the client's consent for such
198.22communication;
198.23    (5) inspect records of a long-term care facility, home care service provider, or acute
198.24care facility that pertain to the care of the client according to sections section 144.335 and
198.25144.651; and
198.26    (6) with the consent of a client or client's legal guardian, the ombudsman or
198.27designated staff shall have access to review records pertaining to the care of the client
198.28according to sections section 144.335 and 144.651. If a client cannot consent and has no
198.29legal guardian, access to the records is authorized by this section.
198.30    A person who denies access to the ombudsman or designee in violation of this
198.31subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a
198.32misdemeanor.

198.33    Sec. 14. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:
199.1    Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take
199.2discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a
199.3patient, resident, or guardian or family member of a patient, resident, or guardian for filing
199.4in good faith a complaint with or providing information to the ombudsman or designee
199.5including volunteers. A person who violates this subdivision or who aids, abets, invites,
199.6compels, or coerces another to do so is guilty of a misdemeanor.
199.7    (b) There shall be a rebuttable presumption that any adverse action, as defined below,
199.8within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose
199.9of this clause, the term "adverse action" refers to action taken by the entity involved in a
199.10report against the person making the report or the person with respect to whom the report
199.11was made because of the report, and includes, but is not limited to:
199.12    (1) discharge or transfer from a facility;
199.13    (2) termination of service;
199.14    (3) restriction or prohibition of access to the facility or its residents;
199.15    (4) discharge from or termination of employment;
199.16    (5) demotion or reduction in remuneration for services; and
199.17    (6) any restriction of rights set forth in section 144.651 or, 144A.44, or 144A.751.

199.18    Sec. 15. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:
199.19    Subdivision 1. Classification. Except as provided in this section, data maintained
199.20by the office under sections 256.974 to 256.9744 are private data on individuals or
199.21nonpublic data as defined in section 13.02, subdivision 9 or 12, and must be maintained
199.22in accordance with the requirements of Public Law 100-75 the Older Americans Act, as
199.23amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).

199.24    Sec. 16. Minnesota Statutes 2006, section 256.975, is amended by adding a subdivision
199.25to read:
199.26    Subd. 2a. Electronic meetings. (a) Notwithstanding section 13D.01, the Minnesota
199.27Board on Aging may conduct a meeting of its members by telephone or other electronic
199.28means so long as the following conditions are met:
199.29    (1) all members of the board participating in the meeting, wherever their physical
199.30location, can hear one another and can hear all discussion and testimony;
199.31    (2) members of the public present at the regular meeting location of the board can
199.32hear all discussion and testimony and all votes of members of the board;
199.33    (3) at least one member of the board is physically present at the regular meeting
199.34location; and
200.1    (4) all votes are conducted by roll call, so that each member's vote on each issue
200.2can be identified and recorded.
200.3    (b) Each member of the board participating in a meeting by telephone or other
200.4electronic means is considered present at the meeting for purposes of determining a
200.5quorum and participating in all proceedings.
200.6    (c) If telephone or other electronic means is used to conduct a meeting, the board,
200.7to the extent practical, shall allow a person to monitor the meeting electronically from
200.8a remote location. The board may require the person making a connection to pay for
200.9documented marginal costs that the board incurs as a result of the additional connection.
200.10    (d) If telephone or other electronic means is used to conduct a regular, special, or
200.11emergency meeting, the board shall provide notice of the regular meeting location, of the
200.12fact that some members may participate by telephone or other electronic means, and of
200.13the provisions of paragraph (c). The timing and method of providing notice is governed
200.14by section 13D.04.

200.15    Sec. 17. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to
200.16read:
200.17    Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner
200.18shall execute a data use agreement with the Centers for Medicare and Medicaid Services
200.19to obtain the long-term care minimum data set data to assist residents of nursing facilities
200.20who have establish a process with the Centers for Independent Living that allows a person
200.21residing in a Minnesota nursing facility to receive needed information, consultation, and
200.22assistance from one of the centers about the available community support options that may
200.23enable the person to relocate to the community, if the person: (1) is under the age of 65,
200.24(2) has indicated a desire to live in the community. The commissioner shall in turn enter
200.25into agreements with the Centers for Independent Living to provide information about
200.26assistance for persons who want to move to the community. The commissioner shall work
200.27with the Centers for Independent Living on both the content of the information to be
200.28provided and privacy protections for the individual residents, and (3) has signed a release
200.29of information authorized by the person or the person's appointed legal representative.
200.30The process established under this subdivision shall be coordinated with the long-term
200.31care consultation service activities established in section 256B.0911.

200.32    Sec. 18. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to
200.33read:
201.1    Subd. 23. Day treatment services. Medical assistance covers day treatment
201.2services as specified in sections 245.462, subdivision 8, and 245.4871, subdivision 10, that
201.3are provided under contract with the county board. Notwithstanding Minnesota Rules,
201.4part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day
201.5treatment for adults according to section 256B.0625, subdivision 25. Notwithstanding
201.6Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance
201.7covers day treatment services for children as specified under section 256B.0943.

201.8    Sec. 19. Minnesota Statutes 2006, section 256B.0655, subdivision 1f, is amended to
201.9read:
201.10    Subd. 1f. Personal care assistant. (a) "Personal care assistant" means a person who:
201.11    (1) is at least 18 years old, except for persons 16 to 18 years of age who participated
201.12in a related school-based job training program or have completed a certified home health
201.13aide competency evaluation;
201.14    (2) is able to effectively communicate with the recipient and personal care provider
201.15organization;
201.16    (3) effective July 1, 1996, has completed one of the training requirements as
201.17specified in Minnesota Rules, part 9505.0335, subpart 3, items A to E paragraph (b);
201.18    (4) has the ability to, and provides covered personal care assistant services according
201.19to the recipient's care plan, responds appropriately to recipient needs, and reports changes
201.20in the recipient's condition to the supervising qualified professional or physician;
201.21    (5) is not a consumer of personal care assistant services;
201.22    (6) maintains daily written records detailing:
201.23    (i) the actual services provided to the recipient; and
201.24    (ii) the amount of time spent providing the services; and
201.25    (7) is subject to criminal background checks and procedures specified in chapter
201.26245C.
201.27    (b) Personal care assistant training must include successful completion of one or
201.28more training requirements in:
201.29    (1) a nursing assistant training program or its equivalent for which competency as a
201.30nursing assistant is determined according to a test administered by the Minnesota State
201.31Board of Technical Colleges;
201.32    (2) a homemaker home health aide preservice training program using a curriculum
201.33recommended by the Department of Health;
201.34    (3) an accredited educational program for registered nurses or licensed practical
201.35nurses;
202.1    (4) a training program that provides the assistant with skills required to perform
202.2personal care assistant services specified in subdivision 2; or
202.3    (5) a determination by the personal care provider that the assistant has, through
202.4training or experience, the skills required to perform the personal care services specified in
202.5subdivision 2.

202.6    Sec. 20. Minnesota Statutes 2006, section 256B.0655, is amended by adding a
202.7subdivision to read:
202.8    Subd. 12. Personal care provider responsibilities. The personal care provider
202.9shall:
202.10    (1) employ or contract with services staff to provide personal care services and to
202.11train services staff as necessary;
202.12    (2) supervise the personal care services as provided in subdivision 2, paragraph (f);
202.13    (3) employ a personal care assistant that a qualified recipient brings to the personal
202.14care provider as the recipient's choice of assistant and who meets the employment
202.15qualifications of the provider, except that a personal care provider who must comply with
202.16the requirements of a governmental personnel administration system is exempt from
202.17this clause;
202.18    (4) bill the medical assistance program for a personal care service by the personal
202.19care assistant and a visit by the qualified professional supervising the personal care
202.20assistant;
202.21    (5) establish a grievance mechanism to resolve consumer complaints about personal
202.22care services, including the personal care provider's decision whether to employ the
202.23qualified recipient's choice of a personal care assistant;
202.24    (6) keep records as required in Minnesota Rules, parts 9505.2160 to 9505.2195;
202.25    (7) perform functions and provide services specified in the personal care provider's
202.26contract;
202.27    (8) comply with applicable rules and statutes; and
202.28    (9) perform other functions as necessary to carry out the responsibilities in clauses
202.29(1) to (8).

202.30    Sec. 21. Minnesota Statutes 2006, section 256B.0655, is amended by adding a
202.31subdivision to read:
202.32    Subd. 13. Personal care provider; employment prohibition. A personal care
202.33provider shall not employ a person to provide personal care service for a qualified
202.34recipient if the person:
203.1    (1) refuses to provide full disclosure of criminal history records as specified in
203.2subdivision 1g, clause (1);
203.3    (2) has been convicted of a crime that directly relates to the occupation of providing
203.4personal care services to a qualified recipient;
203.5    (3) has jeopardized the health or welfare of a vulnerable adult through physical
203.6abuse, sexual abuse, or neglect as defined in section 626.557; or
203.7    (4) is misusing or is dependent on mood-altering chemicals, including alcohol, to
203.8the extent that the personal care provider knows or has reason to believe that the use of
203.9chemicals has a negative effect on the person's ability to provide personal care services
203.10or the use of chemicals is apparent during the hours the person is providing personal
203.11care services.

203.12    Sec. 22. Minnesota Statutes 2006, section 256B.0655, is amended by adding a
203.13subdivision to read:
203.14    Subd. 14. Supervision of personal care services. A personal care service to a
203.15qualified recipient as described in subdivision 4 shall be under the supervision of a
203.16qualified professional who shall have the following duties:
203.17    (1) ensure that the personal care assistant is capable of providing the required
203.18personal care services through direct observation of the assistant's work or through
203.19consultation with the qualified recipient;
203.20    (2) ensure that the personal care assistant is knowledgeable about the plan of
203.21personal care services before the personal care assistant performs personal care services;
203.22    (3) ensure that the personal care assistant is knowledgeable about essential
203.23observations of the recipient's health, and about any conditions that should be immediately
203.24brought to the attention of either the qualified professional or the attending physician;
203.25    (4) evaluate the personal care services of a recipient through direct observation of
203.26the personal care assistant's work or through consultation with the qualified recipient.
203.27Evaluation shall be made:
203.28    (i) within 14 days after the placement of a personal care assistant with the qualified
203.29recipient;
203.30    (ii) at least once every 30 days during the first 90 days after the qualified recipient
203.31first receives personal care services according to the plan of personal care service; and
203.32    (iii) at least once every 120 days following the period of evaluations in item (ii). The
203.33qualified professional shall record in writing the results of the evaluation and actions taken
203.34to correct any deficiencies in the work of the personal care assistant;
204.1    (5) review, together with the recipient, and revise, as necessary, the plan of
204.2personal care services at least once every 120 days after a plan of personal care services
204.3is developed;
204.4    (6) ensure that the personal care assistant and recipient are knowledgeable about a
204.5change in the plan of personal care services;
204.6    (7) ensure that records are kept, showing the services provided to the recipient
204.7by the personal care assistant as described in subdivision 2, paragraph (f), and the time
204.8spent providing the services;
204.9    (8) determine that a qualified recipient is still capable of directing the recipient's
204.10own care or has a responsible party; and
204.11    (9) determine with a physician that a recipient is a qualified recipient.

204.12    Sec. 23. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to
204.13read:
204.14    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall
204.15provide assistance to persons residing in a nursing facility, hospital, regional treatment
204.16center, or intermediate care facility for persons with developmental disabilities who
204.17request or are referred for assistance. Transition assistance must include assessment,
204.18community support plan development, referrals to Minnesota health care programs,
204.19and referrals to programs that provide assistance with housing. Transition assistance
204.20must also include information about the Centers for Independent Living and about other
204.21organizations that can provide assistance with relocation efforts, and information about
204.22contacting these organizations to obtain their assistance and support.
204.23    (b) The county shall develop transition processes with institutional social workers
204.24and discharge planners to ensure that:
204.25    (1) persons admitted to facilities receive information about transition assistance
204.26that is available;
204.27    (2) the assessment is completed for persons within ten working days of the date of
204.28request or recommendation for assessment; and
204.29    (3) there is a plan for transition and follow-up for the individual's return to the
204.30community. The plan must require notification of other local agencies when a person
204.31who may require assistance is screened by one county for admission to a facility located
204.32in another county.
204.33    (c) If a person who is eligible for a Minnesota health care program is admitted to a
204.34nursing facility, the nursing facility must include a consultation team member or the case
204.35manager in the discharge planning process.

205.1    Sec. 24. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to
205.2read:
205.3    Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the
205.4federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are
205.5limited to:
205.6    (1) a person who, having entered an acute care facility from a certified nursing
205.7facility, is returning to a certified nursing facility;
205.8    (2) a person transferring from one certified nursing facility in Minnesota to another
205.9certified nursing facility in Minnesota; and
205.10    (3) a person, 21 years of age or older, who satisfies the following criteria, as specified
205.11in Code of Federal Regulations, title 42, section 483.106(b)(2):
205.12    (i) the person is admitted to a nursing facility directly from a hospital after receiving
205.13acute inpatient care at the hospital;
205.14    (ii) the person requires nursing facility services for the same condition for which
205.15care was provided in the hospital; and
205.16    (iii) the attending physician has certified before the nursing facility admission that
205.17the person is likely to receive less than 30 days of nursing facility services.
205.18    (b) Persons who are exempt from preadmission screening for purposes of level of
205.19care determination include:
205.20    (1) persons described in paragraph (a);
205.21    (2) an individual who has a contractual right to have nursing facility care paid for
205.22indefinitely by the veterans' administration;
205.23    (3) an individual enrolled in a demonstration project under section 256B.69,
205.24subdivision 8 , at the time of application to a nursing facility; and
205.25    (4) an individual currently being served under the alternative care program or under
205.26a home and community-based services waiver authorized under section 1915(c) of the
205.27federal Social Security Act; and.
205.28    (5) individuals admitted to a certified nursing facility for a short-term stay, which
205.29is expected to be 14 days or less in duration based upon a physician's certification, and
205.30who have been assessed and approved for nursing facility admission within the previous
205.31six months. This exemption applies only if the consultation team member determines at
205.32the time of the initial assessment of the six-month period that it is appropriate to use the
205.33nursing facility for short-term stays and that there is an adequate plan of care for return to
205.34the home or community-based setting. If a stay exceeds 14 days, the individual must be
205.35referred no later than the first county working day following the 14th resident day for a
205.36screening, which must be completed within five working days of the referral. The payment
206.1limitations in subdivision 7 apply to an individual found at screening to not meet the level
206.2of care criteria for admission to a certified nursing facility.
206.3    (c) Persons admitted to a Medicaid-certified nursing facility from the community
206.4on an emergency basis as described in paragraph (d) or from an acute care facility on a
206.5nonworking day must be screened the first working day after admission.
206.6    (d) Emergency admission to a nursing facility prior to screening is permitted when
206.7all of the following conditions are met:
206.8    (1) a person is admitted from the community to a certified nursing or certified
206.9boarding care facility during county nonworking hours;
206.10    (2) a physician has determined that delaying admission until preadmission screening
206.11is completed would adversely affect the person's health and safety;
206.12    (3) there is a recent precipitating event that precludes the client from living safely in
206.13the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
206.14inability to continue to provide care;
206.15    (4) the attending physician has authorized the emergency placement and has
206.16documented the reason that the emergency placement is recommended; and
206.17    (5) the county is contacted on the first working day following the emergency
206.18admission.
206.19Transfer of a patient from an acute care hospital to a nursing facility is not considered
206.20an emergency except for a person who has received hospital services in the following
206.21situations: hospital admission for observation, care in an emergency room without hospital
206.22admission, or following hospital 24-hour bed care.
206.23    (e) A nursing facility must provide a written notice to persons who satisfy the criteria
206.24in paragraph (a), clause (3), information to all persons admitted regarding the person's
206.25right to request and receive long-term care consultation services as defined in subdivision
206.261a. The notice information must be provided prior to the person's discharge from the
206.27facility and in a format specified by the commissioner.

206.28    Sec. 25. Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to
206.29read:
206.30    Subd. 4c. Screening requirements. (a) A person may be screened for nursing
206.31facility admission by telephone or in a face-to-face screening interview. Consultation team
206.32members shall identify each individual's needs using the following categories:
206.33    (1) the person needs no face-to-face screening interview to determine the need
206.34for nursing facility level of care based on information obtained from other health care
206.35professionals;
207.1    (2) the person needs an immediate face-to-face screening interview to determine the
207.2need for nursing facility level of care and complete activities required under subdivision
207.34a; or
207.4    (3) the person may be exempt from screening requirements as outlined in subdivision
207.54b, but will need transitional assistance after admission or in-person follow-along after
207.6a return home.
207.7    (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
207.8facility must be screened prior to admission.
207.9    (c) The long-term care consultation team shall recommend a case mix classification
207.10for persons admitted to a certified nursing facility when sufficient information is received
207.11to make that classification. The nursing facility is authorized to conduct all case mix
207.12assessments for persons who have been screened prior to admission for whom the county
207.13did not recommend a case mix classification. The nursing facility is authorized to conduct
207.14all case mix assessments for persons admitted to the facility prior to a preadmission
207.15screening. The county retains the responsibility of distributing appropriate case mix
207.16forms to the nursing facility.
207.17    (d) (c) The county screening or intake activity must include processes to identify
207.18persons who may require transition assistance as described in subdivision 3b.

207.19    Sec. 26. Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to
207.20read:
207.21    Subd. 6. Payment for long-term care consultation services. (a) The total payment
207.22for each county must be paid monthly by certified nursing facilities in the county. The
207.23monthly amount to be paid by each nursing facility for each fiscal year must be determined
207.24by dividing the county's annual allocation for long-term care consultation services by 12
207.25to determine the monthly payment and allocating the monthly payment to each nursing
207.26facility based on the number of licensed beds in the nursing facility. Payments to counties
207.27in which there is no certified nursing facility must be made by increasing the payment
207.28rate of the two facilities located nearest to the county seat.
207.29    (b) The commissioner shall include the total annual payment determined under
207.30paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
207.31according to section 256B.431, subdivision 2b, paragraph (g), or 256B.435.
207.32    (c) In the event of the layaway, delicensure and decertification, or removal from
207.33layaway of 25 percent or more of the beds in a facility, the commissioner may adjust
207.34the per diem payment amount in paragraph (b) and may adjust the monthly payment
207.35amount in paragraph (a). The effective date of an adjustment made under this paragraph
208.1shall be on or after the first day of the month following the effective date of the layaway,
208.2delicensure and decertification, or removal from layaway.
208.3    (d) Payments for long-term care consultation services are available to the county
208.4or counties to cover staff salaries and expenses to provide the services described in
208.5subdivision 1a. The county shall employ, or contract with other agencies to employ, within
208.6the limits of available funding, sufficient personnel to provide long-term care consultation
208.7services while meeting the state's long-term care outcomes and objectives as defined in
208.8section 256B.0917, subdivision 1. The county shall be accountable for meeting local
208.9objectives as approved by the commissioner in the biennial home and community-based
208.10services quality assurance plan on a form provided by the commissioner.
208.11    (e) Notwithstanding section 256B.0641, overpayments attributable to payment of the
208.12screening costs under the medical assistance program may not be recovered from a facility.
208.13    (f) The commissioner of human services shall amend the Minnesota medical
208.14assistance plan to include reimbursement for the local consultation teams.
208.15    (g) The county may bill, as case management services, assessments, support
208.16planning, and follow-along provided to persons determined to be eligible for case
208.17management under Minnesota health care programs. No individual or family member
208.18shall be charged for an initial assessment or initial support plan development provided
208.19under subdivision 3a or 3b.

208.20    Sec. 27. Minnesota Statutes 2006, section 256B.0911, is amended by adding a
208.21subdivision to read:
208.22    Subd. 6a. Withholding. If any provider obligated to pay the long-term care
208.23consultation amount as described in subdivision 6 is more than two months delinquent in
208.24the timely payment of the monthly installment, the commissioner may withhold payments,
208.25penalties, and interest in accordance with the methods outlined in section 256.9657,
208.26subdivision 7a. Any amount withheld under this provision must be returned to the county
208.27to whom the delinquent payments were due.

208.28    Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to
208.29read:
208.30    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
208.31reimbursement for nursing facilities shall be authorized for a medical assistance recipient
208.32only if a preadmission screening has been conducted prior to admission or the county has
208.33authorized an exemption. Medical assistance reimbursement for nursing facilities shall
208.34not be provided for any recipient who the local screener has determined does not meet the
209.1level of care criteria for nursing facility placement or, if indicated, has not had a level II
209.2OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of
209.31987 completed unless an admission for a recipient with mental illness is approved by the
209.4local mental health authority or an admission for a recipient with developmental disability
209.5is approved by the state developmental disability authority.
209.6    (b) The nursing facility must not bill a person who is not a medical assistance
209.7recipient for resident days that preceded the date of completion of screening activities as
209.8required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed
209.9resident days in the nursing facility resident day totals reported to the commissioner.
209.10    (c) The commissioner shall make a request to the Centers for Medicare and Medicaid
209.11Services for a waiver allowing team approval of Medicaid payments for certified nursing
209.12facility care. An individual has a choice and makes the final decision between nursing
209.13facility placement and community placement after the screening team's recommendation,
209.14except as provided in subdivision 4a, paragraph (c).

209.15    Sec. 29. Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to
209.16read:
209.17    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
209.18    (a) Funding for services under the alternative care program is available to persons who
209.19meet the following criteria:
209.20    (1) the person has been determined by a community assessment under section
209.21256B.0911 to be a person who would require the level of care provided in a nursing
209.22facility, but for the provision of services under the alternative care program;
209.23    (2) the person is age 65 or older;
209.24    (3) the person would be eligible for medical assistance within 135 days of admission
209.25to a nursing facility;
209.26    (4) the person is not ineligible for the payment of long-term care services by the
209.27medical assistance program due to an asset transfer penalty under section 256B.0595 or
209.28equity interest in the home exceeding $500,000 as stated in section 256B.056;
209.29    (5) the person needs long-term care services that are not funded through other state
209.30or federal funding;
209.31    (6) the monthly cost of the alternative care services funded by the program for
209.32this person does not exceed 75 percent of the monthly limit described under section
209.33256B.0915, subdivision 3a . This monthly limit does not prohibit the alternative care client
209.34from payment for additional services, but in no case may the cost of additional services
209.35purchased under this section exceed the difference between the client's monthly service
210.1limit defined under section 256B.0915, subdivision 3, and the alternative care program
210.2monthly service limit defined in this paragraph. If medical care-related supplies and
210.3equipment or environmental modifications and adaptations are or will be purchased for
210.4an alternative care services recipient, the costs may be prorated on a monthly basis for
210.5up to 12 consecutive months beginning with the month of purchase. If the monthly cost
210.6of a recipient's other alternative care services exceeds the monthly limit established in
210.7this paragraph, the annual cost of the alternative care services shall be determined. In this
210.8event, the annual cost of alternative care services shall not exceed 12 times the monthly
210.9limit described in this paragraph; and
210.10    (7) the person is making timely payments of the assessed monthly fee.
210.11A person is ineligible if payment of the fee is over 60 days past due, unless the person
210.12agrees to:
210.13    (i) the appointment of a representative payee;
210.14    (ii) automatic payment from a financial account;
210.15    (iii) the establishment of greater family involvement in the financial management of
210.16payments; or
210.17    (iv) another method acceptable to the county lead agency to ensure prompt fee
210.18payments.
210.19    The county shall lead agency may extend the client's eligibility as necessary while
210.20making arrangements to facilitate payment of past-due amounts and future premium
210.21payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall
210.22not be reinstated for a period of 30 days.
210.23    (b) Alternative care funding under this subdivision is not available for a person
210.24who is a medical assistance recipient or who would be eligible for medical assistance
210.25without a spenddown or waiver obligation. A person whose initial application for medical
210.26assistance and the elderly waiver program is being processed may be served under the
210.27alternative care program for a period up to 60 days. If the individual is found to be eligible
210.28for medical assistance, medical assistance must be billed for services payable under the
210.29federally approved elderly waiver plan and delivered from the date the individual was
210.30found eligible for the federally approved elderly waiver plan. Notwithstanding this
210.31provision, alternative care funds may not be used to pay for any service the cost of which:
210.32(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
210.33or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
210.34to participate in the federally approved elderly waiver program under the special income
210.35standard provision.
211.1    (c) Alternative care funding is not available for a person who resides in a licensed
211.2nursing home, certified boarding care home, hospital, or intermediate care facility, except
211.3for case management services which are provided in support of the discharge planning
211.4process for a nursing home resident or certified boarding care home resident to assist with
211.5a relocation process to a community-based setting.
211.6    (d) Alternative care funding is not available for a person whose income is greater
211.7than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
211.8to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
211.9year for which alternative care eligibility is determined, who would be eligible for the
211.10elderly waiver with a waiver obligation.

211.11    Sec. 30. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to
211.12read:
211.13    Subd. 5. Services covered under alternative care. Alternative care funding may
211.14be used for payment of costs of:
211.15    (1) adult day care;
211.16    (2) home health aide;
211.17    (3) homemaker services;
211.18    (4) personal care;
211.19    (5) case management;
211.20    (6) respite care;
211.21    (7) care-related supplies and equipment;
211.22    (8) meals delivered to the home;
211.23    (9) nonmedical transportation;
211.24    (10) nursing services;
211.25    (11) chore services;
211.26    (12) companion services;
211.27    (13) nutrition services;
211.28    (14) training for direct informal caregivers;
211.29    (15) telehome care to provide services in their own homes in conjunction with
211.30in-home visits;
211.31    (16) discretionary services, for which counties may make payment from their
211.32alternative care program allocation or services not otherwise defined in this section
211.33or section 256B.0625, following approval by the commissioner consumer-directed
211.34community services under the alternative care programs which are available statewide and
211.35limited to the average monthly expenditures representative of all alternative care program
212.1participants for the same case mix resident class assigned in the most recent fiscal year for
212.2which complete expenditure data is available;
212.3    (17) environmental modifications and adaptations; and
212.4    (18) direct cash payments for which counties may make payment from their
212.5alternative care program allocation to clients for the purpose of purchasing services,
212.6following approval by the commissioner, and subject to the provisions of subdivision 5h,
212.7until approval and implementation of consumer-directed services through the federally
212.8approved elderly waiver plan. Upon implementation, consumer-directed services under
212.9the alternative care program are available statewide and limited to the average monthly
212.10expenditures representative of all alternative care program participants for the same case
212.11mix resident class assigned in the most recent fiscal year for which complete expenditure
212.12data is available discretionary services, for which lead agencies may make payment from
212.13their alternative care program allocation for services not otherwise defined in this section
212.14or section 256B.0625, following approval by the commissioner.
212.15    Total annual payments for discretionary services and direct cash payments, until
212.16the federally approved consumer-directed service option is implemented statewide, for
212.17all clients within a county may served by a lead agency must not exceed 25 percent of
212.18that county's lead agency's annual alternative care program base allocation. Thereafter,
212.19discretionary services are limited to 25 percent of the county's annual alternative care
212.20program base allocation.

212.21    Sec. 31. Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to
212.22read:
212.23    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in
212.24statute, the services, service definitions, and standards for alternative care services shall
212.25be the same as the services, service definitions, and standards specified in the federally
212.26approved elderly waiver plan, except for alternative care does not cover transitional
212.27support services, assisted living services, adult foster care services, and residential care
212.28services and benefits defined under section 256B.0625 that meet primary and acute
212.29health care needs.
212.30    (b) The county lead agency must ensure that the funds are not used to supplant
212.31or supplement services available through other public assistance or services programs.,
212.32including supplementation of client co-pays, deductibles, premiums, or other cost-sharing
212.33arrangements for health-related benefits and services or entitlement programs and services
212.34that are available to the person, but in which they have elected not to enroll. For a provider
212.35of supplies and equipment when the monthly cost of the supplies and equipment is less
213.1than $250, persons or agencies must be employed by or under a contract with the county
213.2lead agency or the public health nursing agency of the local board of health in order to
213.3receive funding under the alternative care program. Supplies and equipment may be
213.4purchased from a vendor not certified to participate in the Medicaid program if the cost for
213.5the item is less than that of a Medicaid vendor.
213.6    (c) Personal care services must meet the service standards defined in the federally
213.7approved elderly waiver plan, except that a county lead agency may contract with a
213.8client's relative who meets the relative hardship waiver requirements or a relative who
213.9meets the criteria and is also the responsible party under an individual service plan that
213.10ensures the client's health and safety and supervision of the personal care services by a
213.11qualified professional as defined in section 256B.0625, subdivision 19c. Relative hardship
213.12is established by the county lead agency when the client's care causes a relative caregiver
213.13to do any of the following: resign from a paying job, reduce work hours resulting in lost
213.14wages, obtain a leave of absence resulting in lost wages, incur substantial client-related
213.15expenses, provide services to address authorized, unstaffed direct care time, or meet
213.16special needs of the client unmet in the formal service plan.

213.17    Sec. 32. Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to
213.18read:
213.19    Subd. 8. Requirements for individual care plan. (a) The case manager shall
213.20implement the plan of care for each alternative care client and ensure that a client's
213.21service needs and eligibility are reassessed at least every 12 months. The plan shall
213.22include any services prescribed by the individual's attending physician as necessary to
213.23allow the individual to remain in a community setting. In developing the individual's care
213.24plan, the case manager should include the use of volunteers from families and neighbors,
213.25religious organizations, social clubs, and civic and service organizations to support the
213.26formal home care services. The county lead agency shall be held harmless for damages or
213.27injuries sustained through the use of volunteers under this subdivision including workers'
213.28compensation liability. The county of service case manager shall provide documentation
213.29in each individual's plan of care and, if requested, to the commissioner that the most
213.30cost-effective alternatives available have been offered to the individual and that the
213.31individual was free to choose among available qualified providers, both public and private,
213.32including qualified case management or service coordination providers other than those
213.33employed by any county; however, the county or tribe maintains responsibility for prior
213.34authorizing services in accordance with statutory and administrative requirements. The
214.1case manager must give the individual a ten-day written notice of any denial, termination,
214.2or reduction of alternative care services.
214.3    (b) The county of service or tribe must provide access to and arrange for case
214.4management services, including assuring implementation of the plan. "County of service"
214.5has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The county of
214.6service must notify the county of financial responsibility of the approved care plan and
214.7the amount of encumbered funds.

214.8    Sec. 33. Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to
214.9read:
214.10    Subd. 9. Contracting provisions for providers. Alternative care funds paid to
214.11service providers are subject to audit by the commissioner for fiscal and utilization control.
214.12    The lead agency must select providers for contracts or agreements using the
214.13following criteria and other criteria established by the county lead agency:
214.14    (1) the need for the particular services offered by the provider;
214.15    (2) the population to be served, including the number of clients, the length of time
214.16services will be provided, and the medical condition of clients;
214.17    (3) the geographic area to be served;
214.18    (4) quality assurance methods, including appropriate licensure, certification, or
214.19standards, and supervision of employees when needed;
214.20    (5) rates for each service and unit of service exclusive of county lead agency
214.21administrative costs;
214.22    (6) evaluation of services previously delivered by the provider; and
214.23    (7) contract or agreement conditions, including billing requirements, cancellation,
214.24and indemnification.
214.25    The county lead agency must evaluate its own agency services under the criteria
214.26established for other providers.

214.27    Sec. 34. Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to
214.28read:
214.29    Subd. 10. Allocation formula. (a) The alternative care appropriation for fiscal
214.30years 1992 and beyond shall cover only alternative care eligible clients. By July 1 15 of
214.31each year, the commissioner shall allocate to county agencies the state funds available for
214.32alternative care for persons eligible under subdivision 2.
214.33    (b) The adjusted base for each county lead agency is the county's lead agency's
214.34current fiscal year base allocation plus any targeted funds approved during the current
215.1fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each
215.2county lead agency, the determination of alternative care program expenditures shall be
215.3based on payments for services rendered from April 1 through March 31 in the base year,
215.4to the extent that claims have been submitted and paid by June 1 of that year.
215.5    (c) If the alternative care program expenditures as defined in paragraph (b) are 95
215.6percent or more of the county's lead agency's adjusted base allocation, the allocation for
215.7the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that
215.8inflation is included in the state budget.
215.9    (d) If the alternative care program expenditures as defined in paragraph (b) are less
215.10than 95 percent of the county's lead agency's adjusted base allocation, the allocation
215.11for the next fiscal year is the adjusted base allocation less the amount of unspent funds
215.12below the 95 percent level.
215.13    (e) If the annual legislative appropriation for the alternative care program is
215.14inadequate to fund the combined county lead agency allocations for a biennium, the
215.15commissioner shall distribute to each county lead agency the entire annual appropriation
215.16as that county's lead agency's percentage of the computed base as calculated in paragraphs
215.17(c) and (d).
215.18    (f) On agreement between the commissioner and the lead agency, the commissioner
215.19may have discretion to reallocate alternative care base allocations distributed to lead
215.20agencies in which the base amount exceeds program expenditures.

215.21    Sec. 35. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to
215.22read:
215.23    Subd. 11. Targeted funding. (a) The purpose of targeted funding is to make
215.24additional money available to counties lead agencies with the greatest need. Targeted
215.25funds are not intended to be distributed equitably among all counties lead agencies, but
215.26rather, allocated to those with long-term care strategies that meet state goals.
215.27    (b) The funds available for targeted funding shall be the total appropriation for each
215.28fiscal year minus county lead agency allocations determined under subdivision 10 as
215.29adjusted for any inflation increases provided in appropriations for the biennium.
215.30    (c) The commissioner shall allocate targeted funds to counties lead agencies that
215.31demonstrate to the satisfaction of the commissioner that they have developed feasible
215.32plans to increase alternative care spending. In making targeted funding allocations, the
215.33commissioner shall use the following priorities:
216.1    (1) counties lead agencies that received a lower allocation in fiscal year 1991 than in
216.2fiscal year 1990. Counties remain in this priority until they have been restored to their
216.3fiscal year 1990 level plus inflation;
216.4    (2) counties lead agencies that sustain a base allocation reduction for failure to spend
216.595 percent of the allocation if they demonstrate that the base reduction should be restored;
216.6    (3) counties lead agencies that propose projects to divert community residents from
216.7nursing home placement or convert nursing home residents to community living; and
216.8    (4) counties lead agencies that can otherwise justify program growth by
216.9demonstrating the existence of waiting lists, demographically justified needs, or other
216.10unmet needs.
216.11    (d) Counties Lead agencies that would receive targeted funds according to
216.12paragraph (c) must demonstrate to the commissioner's satisfaction that the funds
216.13would be appropriately spent by showing how the funds would be used to further the
216.14state's alternative care goals as described in subdivision 1, and that the county has the
216.15administrative and service delivery capability to use them.
216.16    (e) The commissioner shall request applications make applications available for
216.17targeted funds by November 1 of each year. The counties lead agencies selected for
216.18targeted funds shall be notified of the amount of their additional funding. Targeted funds
216.19allocated to a county lead agency in one year shall be treated as part of the county's lead
216.20agency's base allocation for that year in determining allocations for subsequent years. No
216.21reallocations between counties lead agencies shall be made.

216.22    Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to
216.23read:
216.24    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients
216.25to help pay for the cost of participating in the program. The amount of the fee for the
216.26alternative care client shall be determined as follows:
216.27    (1) when the alternative care client's income less recurring and predictable medical
216.28expenses is less than 100 percent of the federal poverty guideline effective on July 1 of
216.29the state fiscal year in which the fee is being computed, and total assets are less than
216.30$10,000, the fee is zero;
216.31    (2) when the alternative care client's income less recurring and predictable medical
216.32expenses is equal to or greater than 100 percent but less than 150 percent of the federal
216.33poverty guideline effective on July 1 of the state fiscal year in which the fee is being
216.34computed, and total assets are less than $10,000, the fee is five percent of the cost of
216.35alternative care services;
217.1    (3) when the alternative care client's income less recurring and predictable medical
217.2expenses is equal to or greater than 150 percent but less than 200 percent of the federal
217.3poverty guidelines effective on July 1 of the state fiscal year in which the fee is being
217.4computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative
217.5care services;
217.6    (4) when the alternative care client's income less recurring and predictable medical
217.7expenses is equal to or greater than 200 percent of the federal poverty guidelines effective
217.8on July 1 of the state fiscal year in which the fee is being computed and assets are less than
217.9$10,000, the fee is 30 percent of the cost of alternative care services; and
217.10    (5) when the alternative care client's assets are equal to or greater than $10,000, the
217.11fee is 30 percent of the cost of alternative care services.
217.12    For married persons, total assets are defined as the total marital assets less the
217.13estimated community spouse asset allowance, under section 256B.059, if applicable. For
217.14married persons, total income is defined as the client's income less the monthly spousal
217.15allotment, under section 256B.058.
217.16    All alternative care services shall be included in the estimated costs for the purpose
217.17of determining the fee.
217.18    Fees are due and payable each month alternative care services are received unless the
217.19actual cost of the services is less than the fee, in which case the fee is the lesser amount.
217.20    (b) The fee shall be waived by the commissioner when:
217.21    (1) a person who is residing in a nursing facility is receiving case management only;
217.22    (2) a married couple is requesting an asset assessment under the spousal
217.23impoverishment provisions;
217.24    (3) a person is found eligible for alternative care, but is not yet receiving alternative
217.25care services including case management services; or
217.26    (4) a person has chosen to participate in a consumer-directed service plan for which
217.27the cost is no greater than the total cost of the person's alternative care service plan less
217.28the monthly fee amount that would otherwise be assessed.
217.29    (c) The county agency must record in the state's receivable system the client's
217.30assessed fee amount or the reason the fee has been waived. The commissioner will bill
217.31and collect the fee from the client. Money collected must be deposited in the general fund
217.32and is appropriated to the commissioner for the alternative care program. The client must
217.33supply the county lead agency with the client's Social Security number at the time of
217.34application. The county lead agency shall supply the commissioner with the client's Social
217.35Security number and other information the commissioner requires to collect the fee from
217.36the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in
218.1chapter 270A and other methods available to the commissioner. The commissioner may
218.2require counties lead agencies to inform clients of the collection procedures that may be
218.3used by the state if a fee is not paid. This paragraph does not apply to alternative care
218.4pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section
218.5133, if a county operating under the pilot project reports the following dollar amounts
218.6to the commissioner quarterly:
218.7    (1) total fees billed to clients;
218.8    (2) total collections of fees billed; and
218.9    (3) balance of fees owed by clients.
218.10If a county lead agency does not adhere to these reporting requirements, the commissioner
218.11may terminate the billing, collecting, and remitting portions of the pilot project and require
218.12the county lead agency involved to operate under the procedures set forth in this paragraph.

218.13    Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to
218.14read:
218.15    Subd. 13. County Lead agency biennial plan. The county lead agency biennial
218.16plan for long-term care consultation services under section 256B.0911, the alternative
218.17care program under this section, and waivers for the elderly under section 256B.0915,
218.18shall be submitted by the lead agency as the home and community-based services quality
218.19assurance plan on a form provided by the commissioner.

218.20    Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to
218.21read:
218.22    Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless
218.23otherwise specified in statute, providers must be enrolled as Minnesota health care
218.24program providers and abide by the requirements for provider participation according to
218.25Minnesota Rules, part 9505.0195.
218.26    (b) Payment for provided alternative care services as approved by the client's
218.27case manager shall occur through the invoice processing procedures of the department's
218.28Medicaid Management Information System (MMIS). To receive payment, the county lead
218.29agency or vendor must submit invoices within 12 months following the date of service.
218.30The county lead agency and its vendors under contract shall not be reimbursed for services
218.31which exceed the county allocation.
218.32    (c) The county lead agency shall negotiate individual rates with vendors and may
218.33authorize service payment for actual costs up to the county's current approved rate.
218.34Notwithstanding any other rule or statutory provision to the contrary, the commissioner
219.1shall not be authorized to increase rates by an annual inflation factor, unless so authorized
219.2by the legislature. To improve access to community services and eliminate payment
219.3disparities between the alternative care program and the elderly waiver program, the
219.4commissioner shall establish statewide maximum service rate limits and eliminate
219.5county-specific service rate limits.
219.6    (1) Effective July 1, 2001, for service rate limits, except those in subdivision 5,
219.7paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative
219.8care statewide maximum rate or the elderly waiver statewide maximum rate.
219.9    (2) Counties Lead agencies may negotiate individual service rates with vendors for
219.10actual costs up to the statewide maximum service rate limit.

219.11    Sec. 39. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to
219.12read:
219.13    Subd. 3. County certification of persons providing adult foster care to related
219.14persons. A person exempt from licensure under section 245A.03, subdivision 2, who
219.15provides adult foster care to a related individual age 65 and older, and who meets the
219.16requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the
219.17county to provide adult foster care. A person certified by the county to provide adult foster
219.18care may be reimbursed for services provided and eligible for funding under sections
219.19256B.0913 and section 256B.0915, if the relative would suffer a financial hardship as
219.20a result of providing care. For purposes of this subdivision, financial hardship refers
219.21to a situation in which a relative incurs a substantial reduction in income as a result of
219.22resigning from a full-time job or taking a leave of absence without pay from a full-time
219.23job to care for the client.

219.24    Sec. 40. Minnesota Statutes 2006, section 256B.27, subdivision 2a, is amended to read:
219.25    Subd. 2a. On-site Cost and statistical data audits. Each year The commissioner
219.26shall provide for the on-site an audit of the cost reports and statistical data of nursing homes
219.27facilities participating as vendors of medical assistance. The commissioner shall select for
219.28audit at least 15 percent of these the nursing homes facilities' data reported at random or
219.29using factors including, but not limited to: data reported to the public as criteria for rating
219.30nursing facilities; data used to set limits for other medical assistance programs or vendors
219.31of services to nursing facilities; change in ownership; frequent changes in administration
219.32in excess of normal turnover rates; complaints to the commissioner of health about care,
219.33safety, or rights; where previous inspections or reinspections under section 144A.10 have
220.1resulted in correction orders related to care, safety, or rights; or where persons involved in
220.2ownership or administration of the facility have been indicted for alleged criminal activity.
220.3    The commissioner shall meet the 15 percent requirement by either conducting an
220.4audit focused on an individual nursing facility, a group of facilities, or targeting specific
220.5data categories in multiple nursing facilities. These audits may be conducted on site
220.6at the nursing facility, at office space used by a nursing facility or a nursing facility's
220.7parent organization, or at the commissioner's office. Data being audited may be collected
220.8electronically, in person, or by any other means the commissioner finds acceptable.

220.9    Sec. 41. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:
220.10    Subdivision 1. In general. The commissioner shall determine prospective
220.11payment rates for resident care costs. For rates established on or after July 1, 1985, the
220.12commissioner shall develop procedures for determining operating cost payment rates that
220.13take into account the mix of resident needs, geographic location, and other factors as
220.14determined by the commissioner. The commissioner shall consider whether the fact that a
220.15facility is attached to a hospital or has an average length of stay of 180 days or less should
220.16be taken into account in determining rates. The commissioner shall consider the use of the
220.17standard metropolitan statistical areas when developing groups by geographic location.
220.18The commissioner shall provide notice to each nursing facility on or before May 1 August
220.1915 of the rates effective for the following rate year except that if legislation is pending on
220.20May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the
220.21rates after the legislation is enacted and provide notice to each facility as soon as possible.
220.22    Compensation for top management personnel shall continue to be categorized as a
220.23general and administrative cost and is subject to any limits imposed on that cost category.

220.24    Sec. 42. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to
220.25read:
220.26    Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the
220.27rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571
220.28per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom.
220.29For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a
220.30single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060,
220.31subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per
220.32bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060,
220.33subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per
220.34bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060,
221.1subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the
221.2Census: Composite fixed-weighted price index as published in the C30 Report, Value
221.3of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed
221.4Investments in Structures; Special Care.
221.5    (b) Rental factor. For the rate year beginning July 1, 1988, the commissioner shall
221.6increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8,
221.7item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing
221.8nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation
221.9services used by the state's contracted appraisers. For rate years beginning on or after July
221.101, 1989, the rental factor is the amount determined under this paragraph for the rate year
221.11beginning July 1, 1988.
221.12    (c) Occupancy factor. For rate years beginning on or after July 1, 1988, in order
221.13to determine property-related payment rates under Minnesota Rules, part 9549.0060,
221.14for all nursing facilities except those whose average length of stay in a skilled level of
221.15care within a nursing facility is 180 days or less, the commissioner shall use 95 percent
221.16of capacity days. For a nursing facility whose average length of stay in a skilled level of
221.17care within a nursing facility is 180 days or less, the commissioner shall use the greater of
221.18resident days or 80 percent of capacity days but in no event shall the divisor exceed 95
221.19percent of capacity days.
221.20    (d) Equipment allowance. For rate years beginning on July 1, 1988, and July 1,
221.211989, the commissioner shall add ten cents per resident per day to each nursing facility's
221.22property-related payment rate. The ten-cent property-related payment rate increase is not
221.23cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the
221.24commissioner shall increase each nursing facility's equipment allowance as established
221.25in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For
221.26rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be
221.27adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E.
221.28For the rate period beginning October 1, 1992, the equipment allowance for each nursing
221.29facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the
221.30allowance must be adjusted annually for inflation.
221.31    (e) Post chapter 199 related-organization debts and interest expense. For rate
221.32years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item
221.33E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983,
221.34provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010
221.35to 9510.0480, the debt is subject to repayment through annual principal payments, and
221.36the nursing facility demonstrates to the commissioner's satisfaction that the interest rate
222.1on the debt was less than market interest rates for similar arm's-length transactions at
222.2the time the debt was incurred. If the debt was incurred due to a sale between family
222.3members, the nursing facility must also demonstrate that the seller no longer participates
222.4in the management or operation of the nursing facility. Debts meeting the conditions of
222.5this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010
222.6to 9549.0080.
222.7    (f) Building capital allowance for nursing facilities with operating leases. For
222.8rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs
222.9incurred for the nursing facility's buildings shall receive its building capital allowance
222.10computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating
222.11lease provides that the lessee's rent is adjusted to recognize improvements made by the
222.12lessor and related debt, the costs for capital improvements and related debt shall be allowed
222.13in the computation of the lessee's building capital allowance, provided that reimbursement
222.14for these costs under an operating lease shall not exceed the rate otherwise paid.

222.15    Sec. 43. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to
222.16read:
222.17    Subd. 17e. Replacement-costs-new per bed limit effective July October 1, 2001
222.182007. Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem
222.19(2), for a total replacement, as defined in paragraph (f) subdivision 17d, authorized
222.20under section 144A.071 or 144A.073 after July 1, 1999, or any building project that is a
222.21relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, or
222.22any building project eligible for reimbursement under section 256B.434, subdivision 4f,
222.23the replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
222.24rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
222.25the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
222.269549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
222.27adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000.

222.28    Sec. 44. Minnesota Statutes 2006, section 256B.431, subdivision 41, is amended to
222.29read:
222.30    Subd. 41. Rate increases for October 1, 2005, and October 1, 2006. (a) For the
222.31rate period beginning October 1, 2005, the commissioner shall make available to each
222.32nursing facility reimbursed under this section or section 256B.434 an adjustment equal to
222.332.2553 percent of the total operating payment rate, and for the rate year beginning October
222.341, 2006, the commissioner shall make available to each nursing facility reimbursed
223.1under this section or section 256B.434 an adjustment equal to 1.2553 percent of the total
223.2operating payment rate.
223.3    (b) 75 percent of the money resulting from the rate adjustment under paragraph (a)
223.4must be used to increase wages and benefits and pay associated costs for all employees,
223.5except management fees, the administrator, and central office staff. Except as provided
223.6in paragraph (c), 75 percent of the money received by a facility as a result of the rate
223.7adjustment provided in paragraph (a) must be used only for wage, benefit, and staff
223.8increases implemented on or after the effective date of the rate increase each year, and
223.9must not be used for increases implemented prior to that date.
223.10    (c) With respect only to the October 1, 2005, rate increase, a nursing facility that
223.11incurred costs for salary and employee benefit increases first provided after July 1, 2003,
223.12may count those costs towards the amount required to be spent on salaries and benefits
223.13under paragraph (b). These costs must be reported to the commissioner in the form and
223.14manner specified by the commissioner.
223.15    (d) Nursing facilities may apply for the portion of the rate adjustment under
223.16paragraph (a) for employee wages and benefits and associated costs. The application
223.17must be made to the commissioner and contain a plan by which the nursing facility
223.18will distribute the funds according to paragraph (b). For nursing facilities in which the
223.19employees are represented by an exclusive bargaining representative, an agreement
223.20negotiated and agreed to by the employer and the exclusive bargaining representative
223.21constitutes the plan. A negotiated agreement may constitute the plan only if the agreement
223.22is finalized after the date of enactment of all increases for the rate year and signed by both
223.23parties prior to submission to the commissioner. The commissioner shall review the
223.24plan to ensure that the rate adjustments are used as provided in paragraph (b). To be
223.25eligible, a facility must submit its distribution plan by March 31, 2006, and March 31,
223.262007, respectively. The commissioner may approve distribution plans on or before June
223.2730, 2006, and June 30, 2007, respectively. The commissioner may waive the deadlines in
223.28this paragraph under extraordinary circumstances, either retroactively or prospectively, to
223.29be determined at the sole discretion of the commissioner. If a facility's distribution plan is
223.30effective after the first day of the applicable rate period that the funds are available, the
223.31rate adjustments are effective the same date as the facility's plan.
223.32    (e) A copy of the approved distribution plan must be made available to all employees
223.33by giving each employee a copy or by posting a copy in an area of the nursing facility
223.34to which all employees have access. If an employee does not receive the wage and
223.35benefit adjustment described in the facility's approved plan and is unable to resolve the
223.36problem with the facility's management or through the employee's union representative,
224.1the employee may contact the commissioner at an address or telephone number provided
224.2by the commissioner and included in the approved plan.
224.3EFFECTIVE DATE.This section is effective upon enactment and is retroactive
224.4from October 1, 2005.

224.5    Sec. 45. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:
224.6    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and
224.7community-based service waivers, as authorized under section 1915(c) of the Social
224.8Security Act to serve persons under the age of 65 who are determined to require the level
224.9of care provided in a nursing home and persons who require the level of care provided in a
224.10hospital. The commissioner shall apply for the home and community-based waivers in
224.11order to:
224.12    (i) promote the support of persons with disabilities in the most integrated settings;
224.13    (ii) expand the availability of services for persons who are eligible for medical
224.14assistance;
224.15    (iii) promote cost-effective options to institutional care; and
224.16    (iv) obtain federal financial participation.
224.17    (b) The provision of waivered services to medical assistance recipients with
224.18disabilities shall comply with the requirements outlined in the federally approved
224.19applications for home and community-based services and subsequent amendments,
224.20including provision of services according to a service plan designed to meet the needs of
224.21the individual. For purposes of this section, the approved home and community-based
224.22application is considered the necessary federal requirement.
224.23    (c) The commissioner shall provide interested persons serving on agency advisory
224.24committees and, task forces, the Centers for Independent Living, and others upon who
224.25request, with to be on a list to receive, notice of, and an opportunity to comment on,
224.26at least 30 days before any effective dates, (1) any substantive changes to the state's
224.27disability services program manual, or (2) changes or amendments to the federally
224.28approved applications for home and community-based waivers, prior to their submission
224.29to the federal Centers for Medicare and Medicaid Services.
224.30    (d) The commissioner shall seek approval, as authorized under section 1915(c) of
224.31the Social Security Act, to allow medical assistance eligibility under this section for
224.32children under age 21 without deeming of parental income or assets.
224.33    (e) The commissioner shall seek approval, as authorized under section 1915(c) of
224.34the Social Act, to allow medical assistance eligibility under this section for individuals
224.35under age 65 without deeming the spouse's income or assets.

225.1    Sec. 46. Laws 2000, chapter 340, section 19, is amended to read:
225.2    Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.
225.3    (a) Expenditures for housing with services and adult foster care shall be excluded
225.4when determining average monthly expenditures per client for alternative care pilot
225.5projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.
225.6    (b) Alternative care pilot projects shall not expire on June 30, 2001, but shall
225.7continue until June 30, 2005 2007.
225.8EFFECTIVE DATE.This section is effective retroactively from June 29, 2005, for
225.9activities related to discontinuing pilot projects under this section.

225.10    Sec. 47. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.
225.11    (a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon
225.12the recommendation of a county agency, the commissioner of human services shall
225.13grant a license with any necessary variances to a nonresidential program for youth
225.14that provides services to youth with disabilities under age 21 during nonschool hours
225.15established to ensure health and safety, prevent out-of-home placement, and increase
225.16community inclusion of youth with disabilities. The nonresidential youth program is
225.17subject to the conditions of any variances granted and to consumer rights standards under
225.18Minnesota Statutes, section 245B.04; consumer protection standards under Minnesota
225.19Statutes, section 245B.05; service standards under Minnesota Statutes, section 245B.06;
225.20management standards under Minnesota Statutes, section 245B.07; and fire marshal
225.21inspections under Minnesota Statutes, section 245A.151, until the commissioner develops
225.22other licensure requirements for this type of program.
225.23    (b) By February 1, 2008, the commissioner shall recommend amendments to
225.24licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of
225.25appropriate services for school-age youth with disabilities under age 21 who need
225.26supervision and services to develop skills necessary to maintain personal safety and
225.27increase their independence, productivity, and participation in their communities during
225.28nonschool hours. As part of developing the recommendations, the commissioner shall
225.29survey county agencies to determine how the needs of youth with disabilities under age 21
225.30who require supervision and support services are being met and the funding sources used.
225.31The recommendations must be provided to the house and senate chairs of the committees
225.32with jurisdiction over licensing of programs for youth with disabilities.

226.1ARTICLE 7

226.2CONTINUING CARE

226.3    Section 1. Minnesota Statutes 2006, section 47.58, subdivision 8, is amended to read:
226.4    Subd. 8. Counseling; requirement; penalty. A lender, mortgage banking company,
226.5or other mortgage lender not related to the mortgagor must keep a certificate on file
226.6documenting that the borrower, prior to entering into the reverse mortgage loan, received
226.7counseling as defined in this subdivision from an organization that meets the requirements
226.8of section 462A.209 and is a housing counseling agency approved by the Department of
226.9Housing and Urban Development. The certificate must be signed by the mortgagor and
226.10the counselor and include the date of the counseling, the name, address, and telephone
226.11number of both the mortgagor and the organization providing counseling. A failure by
226.12the lender to comply with this subdivision results in a $1,000 civil penalty payable to
226.13the mortgagor. For the purposes of this subdivision, "counseling" means the following
226.14services are provided to the borrower:
226.15    (1) a review of the advantages and disadvantages of reverse mortgage programs;
226.16    (2) an explanation of how the reverse mortgage affects the borrower's estate and
226.17public benefits;
226.18    (3) an explanation of the lending process;
226.19    (4) a discussion of the borrower's supplemental income needs; and
226.20    (5) an explanation of the provisions of sections 256B.0913, subdivision 17, and
226.21462A.05, subdivision 42; and
226.22    (6) an opportunity to ask questions of the counselor.

226.23    Sec. 2. Minnesota Statutes 2006, section 144A.073, subdivision 4, is amended to read:
226.24    Subd. 4. Criteria for review. The following criteria shall be used in a consistent
226.25manner to compare, evaluate, and rank all proposals submitted. Except for the criteria
226.26specified in clause (3), the application of criteria listed under this subdivision shall not
226.27reflect any distinction based on the geographic location of the proposed project:
226.28    (1) the extent to which the proposal furthers state long-term care goals, including
226.29the goal of enhancing the availability and use of alternative care services and the goal of
226.30reducing the number of long-term care resident rooms with more than two beds;
226.31    (2) the proposal's long-term effects on state costs including the cost estimate of the
226.32project according to section 144A.071, subdivision 5a;
226.33    (3) the extent to which the proposal promotes equitable access to long-term care
226.34services in nursing homes through redistribution of the nursing home bed supply, as
227.1measured by the number of beds relative to the population 85 or older, projected to the
227.2year 2000 by the state demographer, and according to items (i) to (iv):
227.3    (i) reduce beds in counties where the supply is high, relative to the statewide mean,
227.4and increase beds in counties where the supply is low, relative to the statewide mean;
227.5    (ii) adjust the bed supply so as to create the greatest benefits in improving the
227.6distribution of beds;
227.7    (iii) adjust the existing bed supply in counties so that the bed supply in a county
227.8moves toward the statewide mean; and
227.9    (iv) adjust the existing bed supply so that the distribution of beds as projected for the
227.10year 2020 would be consistent with projected need, based on the methodology outlined in
227.11the Interagency Long-Term Care Committee's nursing home bed distribution study;
227.12    (4) the extent to which the project improves conditions that affect the health or
227.13safety of residents, such as narrow corridors, narrow door frames, unenclosed fire exits,
227.14and wood frame construction, and similar provisions contained in fire and life safety
227.15codes and licensure and certification rules;
227.16    (5) the extent to which the project improves conditions that affect the comfort or
227.17quality of life of residents in a facility or the ability of the facility to provide efficient
227.18care, such as a relatively high number of residents in a room; inadequate lighting or
227.19ventilation; poor access to bathing or toilet facilities; a lack of available ancillary space for
227.20dining rooms, day rooms, or rooms used for other activities; problems relating to heating,
227.21cooling, or energy efficiency; inefficient location of nursing stations; narrow corridors; or
227.22other provisions contained in the licensure and certification rules;
227.23    (6) the extent to which the applicant demonstrates the delivery of quality care, as
227.24defined in state and federal statutes and rules, to residents as evidenced by the two most
227.25recent state agency certification surveys and the applicants' response to those surveys;
227.26    (7) the extent to which the project removes the need for waivers or variances
227.27previously granted by either the licensing agency, certifying agency, fire marshal, or
227.28local government entity;
227.29    (8) the extent to which the project increases the number of private or single bed
227.30rooms; and
227.31    (9) the extent to which the applicant demonstrates the continuing need for nursing
227.32facility care in the community and adjacent communities; and
227.33    (10) other factors that may be developed in permanent rule by the commissioner of
227.34health that evaluate and assess how the proposed project will further promote or protect
227.35the health, safety, comfort, treatment, or well-being of the facility's residents.
227.36EFFECTIVE DATE.This section is effective July 1, 2007.

228.1    Sec. 3. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:
228.2    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
228.3child, including a child determined eligible for medical assistance without consideration of
228.4parental income, must contribute to the cost of services used by making monthly payments
228.5on a sliding scale based on income, unless the child is married or has been married,
228.6parental rights have been terminated, or the child's adoption is subsidized according to
228.7section 259.67 or through title IV-E of the Social Security Act. The parental contribution
228.8is a partial or full payment for medical services provided for diagnostic, therapeutic,
228.9curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
228.10defined in United States Code, title 26, section 213, needed by the child with a chronic
228.11illness or disability.
228.12    (b) For households with adjusted gross income equal to or greater than 100 percent
228.13of federal poverty guidelines, the parental contribution shall be computed by applying the
228.14following schedule of rates to the adjusted gross income of the natural or adoptive parents:
228.15    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
228.16poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
228.17contribution is $4 per month;
228.18    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
228.19poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
228.20the parental contribution shall be determined using a sliding fee scale established by the
228.21commissioner of human services which begins at one percent of adjusted gross income
228.22at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
228.23gross income for those with adjusted gross income up to 545 percent of federal poverty
228.24guidelines;
228.25    (3) if the adjusted gross income is greater than 545 percent of federal poverty
228.26guidelines and less than 675 percent of federal poverty guidelines, the parental
228.27contribution shall be 7.5 percent of adjusted gross income;
228.28    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
228.29poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
228.30contribution shall be determined using a sliding fee scale established by the commissioner
228.31of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
228.32federal poverty guidelines and increases to ten percent of adjusted gross income for those
228.33with adjusted gross income up to 975 percent of federal poverty guidelines; and
228.34    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
228.35poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
228.36income.
229.1    If the child lives with the parent, the annual adjusted gross income is reduced by
229.2$2,400 prior to calculating the parental contribution. If the child resides in an institution
229.3specified in section 256B.35, the parent is responsible for the personal needs allowance
229.4specified under that section in addition to the parental contribution determined under this
229.5section. The parental contribution is reduced by any amount required to be paid directly to
229.6the child pursuant to a court order, but only if actually paid.
229.7    (c) The household size to be used in determining the amount of contribution under
229.8paragraph (b) includes natural and adoptive parents and their dependents, including the
229.9child receiving services. Adjustments in the contribution amount due to annual changes
229.10in the federal poverty guidelines shall be implemented on the first day of July following
229.11publication of the changes.
229.12    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
229.13natural or adoptive parents determined according to the previous year's federal tax form,
229.14except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
229.15have been used to purchase a home shall not be counted as income.
229.16    (e) The contribution shall be explained in writing to the parents at the time eligibility
229.17for services is being determined. The contribution shall be made on a monthly basis
229.18effective with the first month in which the child receives services. Annually upon
229.19redetermination or at termination of eligibility, if the contribution exceeded the cost of
229.20services provided, the local agency or the state shall reimburse that excess amount to
229.21the parents, either by direct reimbursement if the parent is no longer required to pay
229.22a contribution, or by a reduction in or waiver of parental fees until the excess amount
229.23is exhausted.
229.24    (f) The monthly contribution amount must be reviewed at least every 12 months;
229.25when there is a change in household size; and when there is a loss of or gain in income
229.26from one month to another in excess of ten percent. The local agency shall mail a written
229.27notice 30 days in advance of the effective date of a change in the contribution amount.
229.28A decrease in the contribution amount is effective in the month that the parent verifies a
229.29reduction in income or change in household size.
229.30    (g) Parents of a minor child who do not live with each other shall each pay the
229.31contribution required under paragraph (a). An amount equal to the annual court-ordered
229.32child support payment actually paid on behalf of the child receiving services shall be
229.33deducted from the adjusted gross income of the parent making the payment prior to
229.34calculating the parental contribution under paragraph (b).
229.35    (h) The contribution under paragraph (b) shall be increased by an additional five
229.36percent if the local agency determines that insurance coverage is available but not
230.1obtained for the child. For purposes of this section, "available" means the insurance is a
230.2benefit of employment for a family member at an annual cost of no more than five percent
230.3of the family's annual income. For purposes of this section, "insurance" means health
230.4and accident insurance coverage, enrollment in a nonprofit health service plan, health
230.5maintenance organization, self-insured plan, or preferred provider organization.
230.6    Parents who have more than one child receiving services shall not be required
230.7to pay more than the amount for the child with the highest expenditures. There shall
230.8be no resource contribution from the parents. The parent shall not be required to pay
230.9a contribution in excess of the cost of the services provided to the child, not counting
230.10payments made to school districts for education-related services. Notice of an increase in
230.11fee payment must be given at least 30 days before the increased fee is due.
230.12    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
230.13in the 12 months prior to July 1:
230.14    (1) the parent applied for insurance for the child;
230.15    (2) the insurer denied insurance;
230.16    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
230.17a complaint or appeal, in writing, to the commissioner of health or the commissioner of
230.18commerce, or litigated the complaint or appeal; and
230.19    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
230.20    For purposes of this section, "insurance" has the meaning given in paragraph (h).
230.21    A parent who has requested a reduction in the contribution amount under this
230.22paragraph shall submit proof in the form and manner prescribed by the commissioner or
230.23county agency, including, but not limited to, the insurer's denial of insurance, the written
230.24letter or complaint of the parents, court documents, and the written response of the insurer
230.25approving insurance. The determinations of the commissioner or county agency under this
230.26paragraph are not rules subject to chapter 14.

230.27    Sec. 4. [252.295] LICENSING EXCEPTION.
230.28    (a) Notwithstanding section 252.294, the commissioner may license two six-bed,
230.29level B intermediate care facilities for persons with developmental disabilities (ICF's/MR)
230.30to replace a 15-bed level A facility in Minneapolis that is not accessible to persons with
230.31disabilities. The new facilities must be accessible to persons with disabilities and must
230.32be located on a different site or sites in Hennepin County. Notwithstanding section
230.33256B.5012, the payment rate at the new facilities is $200.47 plus any rate adjustments for
230.34ICF's/MR effective on or after July 1, 2007.
231.1    (b) Notwithstanding section 252.294, the commissioner may license one six-bed
231.2level B intermediate care facility for persons with developmental disabilities to replace
231.3a downsized 21-bed facility attached to a day training and habilitation program in
231.4Chisholm. Notwithstanding section 256B.5012, the facility must serve persons who
231.5require substantial nursing care and are able to leave the facility to receive day training
231.6and habilitation services. The payment rate at this facility is $274.50.
231.7    (c) Notwithstanding section 256B.5012, the payment rate of a six-bed level B
231.8intermediate care facility for persons with developmental disabilities in Hibbing, with a
231.9per diem rate of $164.13 as of March 1, 2007, for persons who require substantial nursing
231.10care and are able to leave the facility to receive day training and habilitation services shall
231.11be increased to $250.84.
231.12    (d) The payment rates in paragraphs (b) and (c) are effective October 1, 2009.

231.13    Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
231.14to read:
231.15    Subd. 23. Reverse mortgage information and referral. The commissioner, in
231.16cooperation with the commissioner of the Minnesota Housing Finance Agency, shall:
231.17    (1) establish an information and referral system to inform eligible persons regarding
231.18the availability of reverse mortgages and state incentives available to persons who take
231.19out certain reverse mortgages. The information and referral system shall be established
231.20involving the Senior LinkAge Line, county and tribal agencies, community housing
231.21agencies and organizations, Minnesota-certified reverse mortgage counselors, reverse
231.22mortgage lenders, senior and elder community organizations, and other relevant entities;
231.23and
231.24    (2) coordinate necessary training for Senior LinkAge Line employees, mortgage
231.25counselors, and lenders regarding the provisions of sections 256B.0913, subdivision
231.2617, and 462A.05, subdivision 42.

231.27    Sec. 6. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
231.28to read:
231.29    Subd. 24. Disability linkage line. The commissioner shall establish the disability
231.30linkage line, a statewide consumer information, referral, and assistance system for people
231.31with disabilities and chronic illnesses that:
231.32    (1) provides information about state and federal eligibility requirements, benefits,
231.33and service options;
231.34    (2) makes referrals to appropriate support entities;
232.1    (3) delivers information and assistance based on national and state standards;
232.2    (4) assists people to make well-informed decisions; and
232.3    (5) supports the timely resolution of service access and benefit issues.

232.4    Sec. 7. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:
232.5    Subd. 7. Consumer information and assistance; senior linkage. (a) The
232.6Minnesota Board on Aging shall operate a statewide information and assistance service
232.7to aid older Minnesotans and their families in making informed choices about long-term
232.8care options and health care benefits. Language services to persons with limited English
232.9language skills may be made available. The service, known as Senior LinkAge Line, must
232.10be available during business hours through a statewide toll-free number and must also
232.11be available through the Internet.
232.12    (b) The service must assist older adults, caregivers, and providers in accessing
232.13information about choices in long-term care services that are purchased through private
232.14providers or available through public options. The service must:
232.15    (1) develop a comprehensive database that includes detailed listings in both
232.16consumer- and provider-oriented formats;
232.17    (2) make the database accessible on the Internet and through other telecommunication
232.18and media-related tools;
232.19    (3) link callers to interactive long-term care screening tools and make these tools
232.20available through the Internet by integrating the tools with the database;
232.21    (4) develop community education materials with a focus on planning for long-term
232.22care and evaluating independent living, housing, and service options;
232.23    (5) conduct an outreach campaign to assist older adults and their caregivers in
232.24finding information on the Internet and through other means of communication;
232.25    (6) implement a messaging system for overflow callers and respond to these callers
232.26by the next business day;
232.27    (7) link callers with county human services and other providers to receive more
232.28in-depth assistance and consultation related to long-term care options; and
232.29    (8) link callers with quality profiles for nursing facilities and other providers
232.30developed by the commissioner of health.;
232.31    (9) provide information and assistance to inform older adults about reverse
232.32mortgages, including the provisions of sections 47.58, 256B.0913, subdivision 17, and
232.33462A.05, subdivision 42; and
232.34    (10) incorporate information about housing with services and consumer rights
232.35within the MinnesotaHelp.info network long-term care database to facilitate consumer
233.1comparison of services and costs among housing with services establishments and with
233.2other in-home services and to support financial self-sufficiency as long as possible.
233.3Housing with services establishments and their arranged home care providers shall provide
233.4information to the commissioner of human services that is consistent with information
233.5required by the commissioner of health under section 144G.06, the Uniform Consumer
233.6Information Guide. The commissioner of human services shall provide the data to the
233.7Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term
233.8care database.
233.9    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness
233.10of the statewide information and assistance, and submit this evaluation to the legislature
233.11by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps
233.12in service delivery, continuity in information between the service and identified linkages,
233.13and potential use of private funding to enhance the service.
233.14EFFECTIVE DATE.This section is effective the day following final enactment.

233.15    Sec. 8. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to read:
233.16    Subd. 1a. Income and assets generally. Unless specifically required by state law or
233.17rule or federal law or regulation, the methodologies used in counting income and assets
233.18to determine eligibility for medical assistance for persons whose eligibility category is
233.19based on blindness, disability, or age of 65 or more years, the methodologies for the
233.20supplemental security income program shall be used, except as provided under subdivision
233.213, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be
233.22counted as income for purposes of this subdivision until July 1 of each year. Effective
233.23upon federal approval, for children eligible under section 256B.055, subdivision 12, or
233.24for home and community-based waiver services whose eligibility for medical assistance
233.25is determined without regard to parental income, child support payments, including any
233.26payments made by an obligor in satisfaction of or in addition to a temporary or permanent
233.27order for child support, and Social Security payments are not counted as income. For
233.28families and children, which includes all other eligibility categories, the methodologies
233.29under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal
233.30Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
233.31Law 104-193, shall be used, except that effective October 1, 2003, the earned income
233.32disregards and deductions are limited to those in subdivision 1c. For these purposes, a
233.33"methodology" does not include an asset or income standard, or accounting method,
233.34or method of determining effective dates.

234.1    Sec. 9. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:
234.2    Subd. 3. Asset limitations for aged, blind, or disabled individuals and families.
234.3    To be eligible for medical assistance, a person must not individually own more than $3,000
234.4in assets, or if a member of a household with two family members, husband and wife,
234.5or parent and child, the household must not own more than $6,000 in assets, plus $200
234.6for each additional legal dependent. In addition to these maximum amounts, an eligible
234.7individual or family may accrue interest on these amounts, but they must be reduced to the
234.8maximum at the time of an eligibility redetermination. The accumulation of the clothing
234.9and personal needs allowance according to section 256B.35 must also be reduced to the
234.10maximum at the time of the eligibility redetermination. The value of assets that are not
234.11considered in determining eligibility for medical assistance is the value of those assets
234.12excluded under the supplemental security income program for aged, blind, and disabled
234.13persons, with the following exceptions:
234.14    (a) Household goods and personal effects are not considered.
234.15    (b) Capital and operating assets of a trade or business that the local agency
234.16determines are necessary to the person's ability to earn an income are not considered.
234.17    (c) Motor vehicles are excluded to the same extent excluded by the supplemental
234.18security income program.
234.19    (d) Assets designated as burial expenses are excluded to the same extent excluded by
234.20the supplemental security income program. Burial expenses funded by annuity contracts
234.21or life insurance policies must irrevocably designate the individual's estate as contingent
234.22beneficiary to the extent proceeds are not used for payment of selected burial expenses.
234.23    (e) Effective upon federal approval, for a person who no longer qualifies as an
234.24employed person with a disability due to loss of earnings, assets allowed while eligible
234.25for medical assistance under section 256B.057, subdivision 9, are not considered for 12
234.26months, beginning with the first month of ineligibility as an employed person with a
234.27disability, to the extent that the person's total assets remain within the allowed limits of
234.28section 256B.057, subdivision 9, paragraph (b).
234.29    (f) When a person enrolled in medical assistance under section 256B.057,
234.30subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive
234.31months before the person's 65th birthday, the assets owned by the person and the person's
234.32spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph
234.33(b), when determining eligibility for medical assistance under section 256B.055,
234.34subdivision 7. The income of a spouse of a person enrolled in medical assistance under
234.35section 256B.057, subdivision 9, during each of the 24 consecutive months before the
234.36person's 65th birthday must be disregarded when determining eligibility for medical
235.1assistance under section 256B.055, subdivision 7, when the person reaches age 65. This
235.2paragraph does not apply at the time the person or the person's spouse requests medical
235.3assistance payment for long-term care services.
235.4EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
235.5approval, whichever is later.

235.6    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to
235.7read:
235.8    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
235.9meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
235.10$6.50 for lunch, or $8 for dinner.
235.11    (b) Medical assistance reimbursement for lodging for persons traveling to receive
235.12medical care may not exceed $50 per day unless prior authorized by the local agency.
235.13    (c) Medical assistance direct mileage reimbursement to the eligible person or the
235.14eligible person's driver may not exceed 20 cents per mile.
235.15    (d) Regardless of the number of employees that an enrolled health care provider
235.16may have, medical assistance covers sign and oral language interpreter services when
235.17provided by an enrolled health care provider during the course of providing a direct,
235.18person-to-person covered health care service to an enrolled recipient with limited English
235.19proficiency or who has a hearing loss and uses interpreting services.

235.20    Sec. 11. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
235.21subdivision to read:
235.22    Subd. 49. Self-directed supports option. Upon federal approval, medical
235.23assistance covers the self-directed supports option as defined under section 256B.0657 and
235.24section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.
235.25EFFECTIVE DATE.This section is effective upon federal approval of the state
235.26Medicaid plan amendment. The commissioner of human services shall inform the Office
235.27of the Revisor of Statutes when approval is obtained.

235.28    Sec. 12. Minnesota Statutes 2006, section 256B.0651, subdivision 7, is amended to
235.29read:
235.30    Subd. 7. Prior authorization; time limits. The commissioner or the commissioner's
235.31designee shall determine the time period for which a prior authorization shall be effective
235.32and, if flexible use has been requested, whether to allow the flexible use option. If
236.1the recipient continues to require home care services beyond the duration of the prior
236.2authorization, the home care provider must request a new prior authorization. A personal
236.3care provider agency must request a new personal care assistant services assessment, or
236.4service update if allowed, at least 60 days prior to the end of the current prior authorization
236.5time period. The request for the assessment must be made on a form approved by the
236.6commissioner. Under no circumstances, other than the exceptions in subdivision 4, shall a
236.7prior authorization be valid prior to the date the commissioner receives the request or for
236.8more than 12 months. A recipient who appeals a reduction in previously authorized home
236.9care services may continue previously authorized services, other than temporary services
236.10under subdivision 8, pending an appeal under section 256.045. The commissioner must
236.11provide a detailed explanation of why the authorized services are reduced in amount from
236.12those requested by the home care provider.

236.13    Sec. 13. Minnesota Statutes 2006, section 256B.0655, subdivision 1b, is amended to
236.14read:
236.15    Subd. 1b. Assessment. "Assessment" means a review and evaluation of a recipient's
236.16need for home care services conducted in person. Assessments for personal care assistant
236.17services shall be conducted by the county public health nurse or a certified public
236.18health nurse under contract with the county. A face-to-face assessment must include:
236.19documentation of health status, determination of need, evaluation of service effectiveness,
236.20identification of appropriate services, service plan development or modification,
236.21coordination of services, referrals and follow-up to appropriate payers and community
236.22resources, completion of required reports, recommendation of service authorization, and
236.23consumer education. Once the need for personal care assistant services is determined
236.24under this section or sections 256B.0651, 256B.0653, 256B.0654, and 256B.0656, the
236.25county public health nurse or certified public health nurse under contract with the county
236.26is responsible for communicating this recommendation to the commissioner and the
236.27recipient. A face-to-face assessment for personal care assistant services is conducted
236.28on those recipients who have never had a county public health nurse assessment. A
236.29face-to-face assessment must occur at least annually or when there is a significant change
236.30in the recipient's condition or when there is a change in the need for personal care assistant
236.31services. A service update may substitute for the annual face-to-face assessment when
236.32there is not a significant change in recipient condition or a change in the need for personal
236.33care assistant service. A service update may be completed by telephone, used when there
236.34is no need for an increase in personal care assistant services, and used for two consecutive
236.35assessments if followed by a face-to-face assessment. A service update must be completed
237.1on a form approved by the commissioner. A service update or review for temporary
237.2increase includes a review of initial baseline data, evaluation of service effectiveness,
237.3redetermination of service need, modification of service plan and appropriate referrals,
237.4update of initial forms, obtaining service authorization, and on going consumer education.
237.5Assessments must be completed on forms provided by the commissioner within 30 days
237.6of a request for home care services by a recipient or responsible party or personal care
237.7provider agency.

237.8    Sec. 14. Minnesota Statutes 2006, section 256B.0655, subdivision 3, is amended to
237.9read:
237.10    Subd. 3. Assessment and service plan. Assessments under subdivision 1b
237.11and sections 256B.0651, subdivision 1, paragraph (b), and 256B.0654, subdivision 1,
237.12paragraph (a), shall be conducted initially, and at least annually thereafter, in person
237.13with the recipient and result in a completed service plan using forms specified by
237.14the commissioner. A personal care provider agency must use a form approved by
237.15the commissioner to request a county public health nurse to conduct a personal care
237.16assistant services assessment. When requesting a reassessment, the personal care provider
237.17agency must notify the county and the recipient at least 60 days prior to the end of the
237.18current prior authorization for personal care assistant services. The recipient notice
237.19shall include information on the recipient's appeal rights. Within 30 days of recipient
237.20or responsible party or personal care assistant provider agency request for home care
237.21services, the assessment, the service plan, and other information necessary to determine
237.22medical necessity such as diagnostic or testing information, social or medical histories,
237.23and hospital or facility discharge summaries shall be submitted to the commissioner.
237.24Notwithstanding the provisions of subdivision 8, the commissioner shall maximize
237.25federal financial participation to pay for public health nurse assessments for personal care
237.26services. For personal care assistant services:
237.27    (1) The amount and type of service authorized based upon the assessment and
237.28service plan will follow the recipient if the recipient chooses to change providers.
237.29    (2) If the recipient's need changes, the recipient's provider may assess the need for
237.30a change in service authorization and request the change from the county public health
237.31nurse. The request must be made on a form approved by the commissioner. Within 30
237.32days of the request, the public health nurse will determine whether to request the change
237.33in services based upon the provider assessment, or conduct a home visit to assess the need
237.34and determine whether the change is appropriate. If the change in service need is due to
238.1a change in medical condition, a new physician's statement of need required by section
238.2256B.0625, subdivision 19c , must be obtained.
238.3    (3) To continue to receive personal care assistant services after the first year,
238.4the recipient or the responsible party, in conjunction with the public health nurse,
238.5may complete a service update on forms developed by the commissioner according to
238.6criteria and procedures in subdivisions 1a to 1i and sections 256B.0651, subdivision 1;
238.7256B.0653, subdivision 1 ; and 256B.0654, subdivision 1.

238.8    Sec. 15. Minnesota Statutes 2006, section 256B.0655, subdivision 8, is amended to
238.9read:
238.10    Subd. 8. Public health nurse assessment rate. (a) The reimbursement rates for
238.11public health nurse visits that relate to the provision of personal care services under this
238.12section and section 256B.0625, subdivision 19a, are:
238.13    (i) $210.50 for a face-to-face assessment visit;
238.14    (ii) $105.25 for each service update; and
238.15    (iii) $105.25 for each request for a temporary service increase.
238.16    (b) The rates specified in paragraph (a) must be adjusted to reflect provider rate
238.17increases for personal care assistant services that are approved by the legislature for the
238.18fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied
238.19by the legislature to provider rate increases for personal care assistant services also apply
238.20to adjustments under this paragraph.
238.21    (c) Effective July 1, 2008, the payment rate for an assessment under this section and
238.22section 256B.0651 shall be reduced by 25 percent when the assessment is not completed
238.23on time or the service agreement documentation is not submitted in time to continue
238.24services. The commissioner shall recoup these amounts on a retroactive basis.

238.25    Sec. 16. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.
238.26    Subdivision 1. Definition. "Self-directed supports option" means personal
238.27assistance, supports, items, and related services purchased under an approved budget
238.28plan and budget by a recipient.
238.29    Subd. 2. Eligibility. (a) The self-directed supports option is available to a person
238.30who:
238.31    (1) is a recipient of medical assistance as determined under sections 256B.055,
238.32256B.056, and 256B.057, subdivision 9;
238.33    (2) is eligible for personal care assistant services under section 256B.0655;
239.1    (3) lives in the person's own apartment or home, which is not owned, operated, or
239.2controlled by a provider of services not related by blood or marriage;
239.3    (4) has the ability to hire, fire, supervise, establish staff compensation for, and
239.4manage the individuals providing services, and to choose and obtain items, related
239.5services, and supports as described in the participant's plan. If the recipient is not able to
239.6carry out these functions but has a legal guardian or parent to carry them out, the guardian
239.7or parent may fulfill these functions on behalf of the recipient; and
239.8    (5) has not been excluded or disenrolled by the commissioner.
239.9    (b) The commissioner may disenroll or exclude recipients, including guardians and
239.10parents, under the following circumstances:
239.11    (1) recipients who have been restricted by the Primary Care Utilization Review
239.12Committee may be excluded for a specified time period;
239.13    (2) recipients who exit the self-directed supports option during the recipient's
239.14service plan year shall not access the self-directed supports option for the remainder of
239.15that service plan year; and
239.16    (3) when the department determines that the recipient cannot manage recipient
239.17responsibilities under the program.
239.18    Subd. 3. Eligibility for other services. Selection of the self-directed supports
239.19option by a recipient shall not restrict access to other medically necessary care and
239.20services furnished under the state plan medical assistance benefit, including home care
239.21targeted case management, except that a person receiving home and community-based
239.22waiver services, a family support grant or a consumer support grant is not eligible for
239.23funding under the self-directed supports option.
239.24    Subd. 4. Assessment requirements. (a) The self-directed supports option
239.25assessment must meet the following requirements:
239.26    (1) it shall be conducted by the county public health nurse or a certified public
239.27health nurse under contract with the county;
239.28    (2) it shall be conducted face-to-face in the recipient's home initially, and at least
239.29annually thereafter; when there is a significant change in the recipient's condition; and
239.30when there is a change in the need for personal care assistant services. A recipient who is
239.31residing in a facility may be assessed for the self-directed support option for the purpose
239.32of returning to the community using this option; and
239.33    (3) it shall be completed using the format established by the commissioner.
239.34    (b) The results of the assessment and recommendations shall be communicated to
239.35the commissioner and the recipient by the county public health nurse or certified public
239.36health nurse under contract with the county.
240.1    Subd. 5. Self-directed supports option plan requirements. (a) The plan for the
240.2self-directed supports option must meet the following requirements:
240.3    (1) the plan must be completed using a person-centered process that:
240.4    (i) builds upon the recipient's capacity to engage in activities that promote
240.5community life;
240.6    (ii) respects the recipient's preferences, choices, and abilities;
240.7    (iii) involves families, friends, and professionals in the planning or delivery of
240.8services or supports as desired or required by the recipient; and
240.9    (iv) addresses the need for personal care assistant services identified in the recipient's
240.10self-directed supports option assessment;
240.11    (2) the plan shall be developed by the recipient or by the guardian of an adult
240.12recipient or by a parent or guardian of a minor child, with the assistance of an enrolled
240.13medical assistance home care targeted case manager provider who meets the requirements
240.14established for using a person-centered planning process and shall be reviewed at least
240.15annually upon reassessment or when there is a significant change in the recipient's
240.16condition; and
240.17    (3) the plan must include the total budget amount available divided into monthly
240.18amounts that cover the number of months of personal care assistant services authorization
240.19included in the budget. The amount used each month may vary, but additional funds shall
240.20not be provided above the annual personal care assistant services authorized amount
240.21unless a change in condition is documented.
240.22    (b) The commissioner shall:
240.23    (1) establish the format and criteria for the plan as well as the requirements for
240.24providers who assist with plan development;
240.25    (2) review the assessment and plan and, within 30 days after receiving the
240.26assessment and plan, make a decision on approval of the plan;
240.27    (3) notify the recipient, parent, or guardian of approval or denial of the plan and
240.28provide notice of the right to appeal under section 256.045; and
240.29    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.
240.30    Subd. 6. Services covered. (a) Services covered under the self-directed supports
240.31option include:
240.32    (1) personal care assistant services under section 256B.0655; and
240.33    (2) items, related services, and supports, including assistive technology, that increase
240.34independence or substitute for human assistance to the extent expenditures would
240.35otherwise be used for human assistance.
241.1    (b) Items, supports, and related services purchased under this option shall not be
241.2considered home care services for the purposes of section 144A.43.
241.3    Subd. 7. Noncovered services. Services or supports that are not eligible for
241.4payment under the self-directed supports option include:
241.5    (1) services, goods, or supports that do not benefit the recipient;
241.6    (2) any fees incurred by the recipient, such as Minnesota health care program fees
241.7and co-pays, legal fees, or costs related to advocate agencies;
241.8    (3) insurance, except for insurance costs related to employee coverage or fiscal
241.9support entity payments;
241.10    (4) room and board and personal items that are not related to the disability, except
241.11that medically prescribed specialized diet items may be covered if they reduce the need for
241.12human assistance;
241.13    (5) home modifications that add square footage;
241.14    (6) home modifications for a residence other than the primary residence of the
241.15recipient, or in the event of a minor with parents not living together, the primary residences
241.16of the parents;
241.17    (7) expenses for travel, lodging, or meals related to training the recipient, the parent
241.18or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or
241.19unpaid caregivers that exceed $500 in a 12-month period;
241.20    (8) experimental treatment;
241.21    (9) any service or item covered by other medical assistance state plan services,
241.22including prescription and over-the-counter medications, compounds, and solutions and
241.23related fees, including premiums and co-payments;
241.24    (10) membership dues or costs, except when the service is necessary and appropriate
241.25to treat a physical condition or to improve or maintain the recipient's physical condition.
241.26The condition must be identified in the recipient's plan of care and monitored by a
241.27Minnesota health care program enrolled physician;
241.28    (11) vacation expenses other than the cost of direct services;
241.29    (12) vehicle maintenance or modifications not related to the disability;
241.30    (13) tickets and related costs to attend sporting or other recreational events; and
241.31    (14) costs related to Internet access, except when necessary for operation of assistive
241.32technology, to increase independence, or to substitute for human assistance.
241.33    Subd. 8. Self-directed budget requirements. The budget for the provision of the
241.34self-directed service option shall be equal to the greater of either:
241.35    (1) the annual amount of personal care assistant services under section 256B.0655
241.36that the recipient has used in the most recent 12-month period; or
242.1    (2) the amount determined using the consumer support grant methodology under
242.2section 256.476, subdivision 11, except that the budget amount shall include the federal
242.3and nonfederal share of the average service costs.
242.4    Subd. 9. Quality assurance and risk management. (a) The commissioner
242.5shall establish quality assurance and risk management measures for use in developing
242.6and implementing self-directed plans and budgets that (1) recognize the roles and
242.7responsibilities involved in obtaining services in a self-directed manner, and (2) assure
242.8the appropriateness of such plans and budgets based upon a recipient's resources and
242.9capabilities. These measures must include (i) background studies, and (ii) backup and
242.10emergency plans, including disaster planning.
242.11    (b) The commissioner shall provide ongoing technical assistance and resource and
242.12educational materials for families and recipients selecting the self-directed option.
242.13    (c) Performance assessments measures, such as of a recipient's satisfaction with the
242.14services and supports, and ongoing monitoring of health and well-being shall be identified
242.15in consultation with the stakeholder group.
242.16    Subd. 10. Fiscal support entity. (a) Each recipient shall choose a fiscal support
242.17entity provider certified by the commissioner to make payments for services, items,
242.18supports, and administrative costs related to managing a self-directed service plan
242.19authorized for payment in the approved plan and budget. Recipients shall also choose
242.20the payroll, agency with choice, or the fiscal conduit model of financial and service
242.21management.
242.22    (b) The fiscal support entity:
242.23    (1) may not limit or restrict the recipient's choice of service or support providers,
242.24including use of the payroll, agency with choice, or fiscal conduit model of financial
242.25and service management;
242.26    (2) must have a written agreement with the recipient or the recipient's representative
242.27that identifies the duties and responsibilities to be performed and the specific related
242.28charges;
242.29    (3) must provide the recipient and the home care targeted case manager with a
242.30monthly written summary of the self-directed supports option services that were billed,
242.31including charges from the fiscal support entity;
242.32    (4) must be knowledgeable of and comply with Internal Revenue Service
242.33requirements necessary to process employer and employee deductions, provide appropriate
242.34and timely submission of employer tax liabilities, and maintain documentation to support
242.35medical assistance claims;
243.1    (5) must have current and adequate liability insurance and bonding and sufficient
243.2cash flow and have on staff or under contract a certified public accountant or an individual
243.3with a baccalaureate degree in accounting; and
243.4    (6) must maintain records to track all self-directed supports option services
243.5expenditures, including time records of persons paid to provide supports and receipts for
243.6any goods purchased. The records must be maintained for a minimum of five years from
243.7the claim date and be available for audit or review upon request. Claims submitted by
243.8the fiscal support entity must correspond with services, amounts, and time periods as
243.9authorized in the recipient's self-directed supports option plan.
243.10    (c) The commissioner shall have authority to:
243.11    (1) set or negotiate rates with fiscal support entities;
243.12    (2) limit the number of fiscal support entities;
243.13    (3) identify a process to certify and recertify fiscal support entities and assure fiscal
243.14support entities are available to recipients throughout the state; and
243.15    (4) establish a uniform format and protocol to be used by eligible fiscal support
243.16entities.
243.17    Subd. 11. Stakeholder consultation. The commissioner shall consult with a
243.18statewide consumer-directed services stakeholder group, including representatives of
243.19all types of consumer-directed service users, advocacy organizations, counties, and
243.20consumer-directed service providers. The commissioner shall seek recommendations
243.21from this stakeholder group in developing:
243.22    (1) the self-directed plan format;
243.23    (2) requirements and guidelines for the person-centered plan assessment and
243.24planning process;
243.25    (3) implementation of the option and the quality assurance and risk management
243.26techniques; and
243.27    (4) standards and requirements, including rates for the personal support plan
243.28development provider and the fiscal support entity; policies; training; and implementation.
243.29The stakeholder group shall provide recommendations on the repeal of the personal care
243.30assistant choice option, transition issues, and whether the consumer support grant program
243.31under section 256.476 should be modified. The stakeholder group shall meet at least
243.32three times each year to provide advice on policy, implementation, and other aspects of
243.33consumer and self-directed services.
243.34EFFECTIVE DATE.Subdivisions 1 to 10 are effective upon federal approval of
243.35the state Medicaid plan amendment. The commissioner of human services shall inform
244.1the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11
244.2is effective July 1, 2007.

244.3    Sec. 17. Minnesota Statutes 2006, section 256B.0911, subdivision 1a, is amended to
244.4read:
244.5    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
244.6    (a) "Long-term care consultation services" means:
244.7    (1) providing information and education to the general public regarding availability
244.8of the services authorized under this section;
244.9    (2) an intake process that provides access to the services described in this section;
244.10    (3) assessment of the health, psychological, and social needs of referred individuals;
244.11    (4) assistance in identifying services needed to maintain an individual in the least
244.12restrictive environment;
244.13    (5) providing recommendations on cost-effective community services that are
244.14available to the individual;
244.15    (6) development of an individual's community support plan, which may include the
244.16use of reverse mortgage payments to pay for services needed to maintain the individual in
244.17the person's home;
244.18    (7) providing information regarding eligibility for Minnesota health care programs;
244.19    (8) preadmission screening to determine the need for a nursing facility level of care;
244.20    (9) preliminary determination of Minnesota health care programs eligibility for
244.21individuals who need a nursing facility level of care, with appropriate referrals for final
244.22determination;
244.23    (10) providing recommendations for nursing facility placement when there are no
244.24cost-effective community services available; and
244.25    (11) assistance to transition people back to community settings after facility
244.26admission.
244.27    (b) "Minnesota health care programs" means the medical assistance program under
244.28chapter 256B and the alternative care program under section 256B.0913.

244.29    Sec. 18. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to
244.30read:
244.31    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
244.32services planning, or other assistance intended to support community-based living,
244.33including persons who need assessment in order to determine waiver or alternative care
244.34program eligibility, must be visited by a long-term care consultation team within ten
245.1working days after the date on which an assessment was requested or recommended.
245.2Assessments must be conducted according to paragraphs (b) to (g) (i).
245.3    (b) The county may utilize a team of either the social worker or public health nurse,
245.4or both, to conduct the assessment in a face-to-face interview. The consultation team
245.5members must confer regarding the most appropriate care for each individual screened or
245.6assessed.
245.7    (c) The long-term care consultation team must assess the health and social needs of
245.8the person, using an assessment form provided by the commissioner.
245.9    (d) The team must conduct the assessment in a face-to-face interview with the
245.10person being assessed and the person's legal representative, if applicable.
245.11    (e) The team must provide the person, or the person's legal representative, with
245.12written recommendations for facility- or community-based services. The team must
245.13document that the most cost-effective alternatives available were offered to the individual.
245.14For purposes of this requirement, "cost-effective alternatives" means community services
245.15and living arrangements that cost the same as or less than nursing facility care.
245.16    (f) If the person chooses to use community-based services, the team must provide
245.17the person or the person's legal representative with a written community support plan,
245.18regardless of whether the individual is eligible for Minnesota health care programs.
245.19The person may request assistance in developing a community support plan without
245.20participating in a complete assessment. If the person chooses to obtain a reverse mortgage
245.21under section 47.58 as part of the community support plan, the plan must include a
245.22spending plan for the reverse mortgage payments.
245.23    (g) The person has the right to make the final decision between nursing facility
245.24placement and community placement after the screening team's recommendation, except
245.25as provided in subdivision 4a, paragraph (c).
245.26    (h) The team must give the person receiving assessment or support planning, or
245.27the person's legal representative, materials, and forms supplied by the commissioner
245.28containing the following information:
245.29    (1) the need for and purpose of preadmission screening and assessment if the person
245.30selects nursing facility placement;
245.31    (2) the role of the long-term care consultation assessment and support planning in
245.32waiver and alternative care program eligibility determination;
245.33    (2) (3) information about Minnesota health care programs and about reverse
245.34mortgages, including the provisions of sections 47.58; 256B.0913, subdivision 17; and
245.35462A.05, subdivision 42;
245.36    (3) (4) the person's freedom to accept or reject the recommendations of the team;
246.1    (4) (5) the person's right to confidentiality under the Minnesota Government Data
246.2Practices Act, chapter 13; and
246.3    (6) the long-term care consultant's decision regarding the person's need for nursing
246.4facility level of care;
246.5    (5) (7) the person's right to appeal the decision regarding the need for nursing facility
246.6level of care or the county's final decisions regarding public programs eligibility according
246.7to section 256.045, subdivision 3.
246.8    (i) Face-to-face assessment completed as part of eligibility determination for
246.9the alternative care, elderly waiver, community alternatives for disabled individuals,
246.10community alternative care, and traumatic brain injury waiver programs under sections
246.11256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
246.12than 60 calendar days after the date of assessment. The effective eligibility start date
246.13for these programs can never be prior to the date of assessment. If an assessment was
246.14completed more than 60 days before the effective waiver or alternative care program
246.15eligibility start date, assessment and support plan information must be updated in a
246.16face-to-face visit and documented in the department's Medicaid Management Information
246.17System (MMIS). The effective date of program eligibility in this case cannot be prior to
246.18the date the updated assessment is completed.

246.19    Sec. 19. Minnesota Statutes 2006, section 256B.0911, is amended by adding a
246.20subdivision to read:
246.21    Subd. 3c. Transition to housing with services. (a) Housing with services
246.22establishments offering or providing assisted living under chapter 144G shall inform
246.23all prospective residents of the availability of and contact information for transitional
246.24consultation services under this subdivision prior to executing a lease or contract with the
246.25prospective resident. The purpose of transitional long-term care consultation is to support
246.26persons with current or anticipated long-term care needs in making informed choices
246.27among options that include the most cost-effective and least restrictive settings, and to
246.28delay spenddown to eligibility for publicly funded programs by connecting people to
246.29alternative services in their homes before transition to housing with services. Regardless
246.30of the consultation, prospective residents maintain the right to choose housing with
246.31services or assisted living if that option is their preference.
246.32    (b) Transitional consultation services are provided as determined by the
246.33commissioner of human services in partnership with county long-term care consultation
246.34units, and the Area Agencies on Aging, and are a combination of telephone-based
246.35and in-person assistance provided under models developed by the commissioner. The
247.1consultation shall be performed in a manner that provides objective and complete
247.2information. Transitional consultation must be provided within five working days of the
247.3request of the prospective resident as follows:
247.4    (1) the consultation must be provided by a qualified professional as determined by
247.5the commissioner;
247.6    (2) the consultation must include a review of the prospective resident's reasons for
247.7considering assisted living, the prospective resident's personal goals, a discussion of the
247.8prospective resident's immediate and projected long-term care needs, and alternative
247.9community services or assisted living settings that may meet the prospective resident's
247.10needs; and
247.11    (3) the prospective resident shall be informed of the availability of long-term care
247.12consultation services described in subdivision 3a that are available at no charge to the
247.13prospective resident to assist the prospective resident in assessment and planning to meet
247.14the prospective resident's long-term care needs.
247.15EFFECTIVE DATE.This section is effective October 1, 2008.

247.16    Sec. 20. Minnesota Statutes 2006, section 256B.0913, is amended by adding a
247.17subdivision to read:
247.18    Subd. 17. Services for persons using reverse mortgages. (a) Alternative care
247.19services are available to a person if:
247.20    (1) the person qualifies for the reverse mortgage incentive program under section
247.21462A.05, subdivision 42, and has received the final payment on a qualifying reverse
247.22mortgage, or the person satisfies the criteria in section 462A.05, subdivision 42, paragraph
247.23(b), clauses (1) to (5), and has otherwise obtained a reverse mortgage and payments from
247.24the reverse mortgage for a period of at least 24 months or in an amount of at least $15,000
247.25are used for services and supports, including basic shelter needs, home maintenance, and
247.26modifications or adaptations, necessary to allow the person to remain in the home as an
247.27alternative to a nursing facility placement; and
247.28    (2) the person satisfies the eligibility criteria under this section, other than age,
247.29income, and assets, and verifies that reverse mortgage expenditures were made according
247.30to the spending plan established under section 256B.0911, if one has been established.
247.31    (b) In addition to the other services provided under this section, a person who
247.32qualifies under this subdivision shall not be assessed a monthly participation fee under
247.33subdivision 12 nor be subject to an estate claim under section 256B.15 for services
247.34received under this section.
248.1    (c) The commissioner shall require a certification of loan satisfaction or other
248.2documentation that the person qualifies under this subdivision.

248.3    Sec. 21. Minnesota Statutes 2006, section 256B.0915, is amended to read:
248.4256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.
248.5    Subdivision 1. Authority. The commissioner is authorized to apply for a home
248.6and community-based services waiver for the elderly, authorized under section 1915(c)
248.7of the Social Security Act, in order to obtain federal financial participation to expand
248.8the availability of services for persons who are eligible for medical assistance. The
248.9commissioner may apply for additional waivers or pursue other federal financial
248.10participation which is advantageous to the state for funding home care services for the
248.11frail elderly who are eligible for medical assistance. The provision of waivered services
248.12to elderly and disabled medical assistance recipients must comply with the criteria for
248.13service definitions and provider standards approved in the waiver.
248.14    Subd. 1a. Elderly waiver case management services. (a) Elderly case management
248.15services under the home and community-based services waiver for elderly individuals are
248.16available from providers meeting qualification requirements and the standards specified
248.17in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case
248.18management services.
248.19    Case management services assist individuals who receive waiver services in gaining
248.20access to needed waiver and other state plan services, as well as needed medical, social,
248.21educational, and other services regardless of the funding source for the services to which
248.22access is gained.
248.23    A case aide shall provide assistance to the case manager in carrying out
248.24administrative activities of the case management function. The case aide may not assume
248.25responsibilities that require professional judgment including assessments, reassessments,
248.26and care plan development. The case manager is responsible for providing oversight of
248.27the case aide.
248.28    Case managers shall be responsible for ongoing monitoring of the provision of
248.29services included in the individual's plan of care. Case managers shall initiate and oversee
248.30the process of assessment and reassessment of the individual's care and review plan of
248.31care at intervals specified in the federally approved waiver plan.
248.32    (b) The county of service or tribe must provide access to and arrange for case
248.33management services. County of service has the meaning given it in Minnesota Rules,
248.34part 9505.0015, subpart 11.
249.1    Subd. 1b. Provider qualifications and standards. The commissioner must
249.2enroll qualified providers of elderly case management services under the home
249.3and community-based waiver for the elderly under section 1915(c) of the Social
249.4Security Act. The enrollment process shall ensure the provider's ability to meet the
249.5qualification requirements and standards in this subdivision and other federal and state
249.6requirements of this service. An elderly case management provider is an enrolled medical
249.7assistance provider who is determined by the commissioner to have all of the following
249.8characteristics:
249.9    (1) the demonstrated capacity and experience to provide the components of
249.10case management to coordinate and link community resources needed by the eligible
249.11population;
249.12    (2) administrative capacity and experience in serving the target population for
249.13whom it will provide services and in ensuring quality of services under state and federal
249.14requirements;
249.15    (3) a financial management system that provides accurate documentation of services
249.16and costs under state and federal requirements;
249.17    (4) the capacity to document and maintain individual case records under state and
249.18federal requirements; and
249.19    (5) the county lead agency may allow a case manager employed by the county lead
249.20agency to delegate certain aspects of the case management activity to another individual
249.21employed by the county lead agency provided there is oversight of the individual by
249.22the case manager. The case manager may not delegate those aspects which require
249.23professional judgment including assessments, reassessments, and care plan development.
249.24Lead agencies include counties, health plans, and federally recognized tribes who
249.25authorize services under this section.
249.26    Subd. 1c. Case management activities under the state plan. The commissioner
249.27shall seek an amendment to the home and community-based services waiver for the
249.28elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner
249.29is unable to secure the approval of the secretary of health and human services for the
249.30requested waiver amendment by December 31, 1993, the commissioner shall amend
249.31the medical assistance state plan to provide that case management provided under the
249.32home and community-based services waiver for the elderly is performed by counties
249.33as an administrative function for the proper and effective administration of the state
249.34medical assistance plan. The state shall reimburse counties for the nonfederal share of
249.35costs for case management performed as an administrative function under the home and
249.36community-based services waiver for the elderly.
250.1    Subd. 1d. Posteligibility treatment of income and resources for elderly waiver.
250.2    Notwithstanding the provisions of section 256B.056, the commissioner shall make the
250.3following amendment to the medical assistance elderly waiver program effective July 1,
250.41999, or upon federal approval, whichever is later.
250.5    A recipient's maintenance needs will be an amount equal to the Minnesota
250.6supplemental aid equivalent rate as defined in section 256I.03, subdivision 5, plus the
250.7medical assistance personal needs allowance as defined in section 256B.35, subdivision
250.81 , paragraph (a), when applying posteligibility treatment of income rules to the gross
250.9income of elderly waiver recipients, except for individuals whose income is in excess of
250.10the special income standard according to Code of Federal Regulations, title 42, section
250.11435.236 . Recipient maintenance needs shall be adjusted under this provision each July 1.
250.12    Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend
250.13the federal waiver and the medical assistance state plan to allow apply:
250.14    (1) the spousal impoverishment criteria as authorized under United States Code, title
250.1542, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059,
250.16except that the amendment shall seek to add to;
250.17    (2) the personal needs allowance permitted in section 256B.0575,; and
250.18    (3) an amount equivalent to the group residential housing rate as set by section
250.19256I.03, subdivision 5 , and according to the approved federal waiver and medical
250.20assistance state plan.
250.21    Subd. 3. Limits of cases. The number of medical assistance waiver recipients that
250.22a county lead agency may serve must be allocated according to the number of medical
250.23assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be
250.24served with the approval of the commissioner.
250.25    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered
250.26services to an individual elderly waiver client shall be the weighted average monthly
250.27nursing facility rate of the case mix resident class to which the elderly waiver client would
250.28be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's
250.29maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first
250.30day of the state fiscal year in which the resident assessment system as described in section
250.31256B.437 for nursing home rate determination is implemented. Effective on the first day
250.32of the state fiscal year in which the resident assessment system as described in section
250.33256B.437 for nursing home rate determination is implemented and the first day of each
250.34subsequent state fiscal year, the monthly limit for the cost of waivered services to an
250.35individual elderly waiver client shall be the rate of the case mix resident class to which the
250.36waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
251.1in effect on the last day of the previous state fiscal year, adjusted by the greater of any
251.2legislatively adopted home and community-based services percentage rate increase or the
251.3average statewide percentage increase in nursing facility payment rates.
251.4    (b) If extended medical supplies and equipment or environmental modifications are
251.5or will be purchased for an elderly waiver client, the costs may be prorated for up to
251.612 consecutive months beginning with the month of purchase. If the monthly cost of a
251.7recipient's waivered services exceeds the monthly limit established in paragraph (a), the
251.8annual cost of all waivered services shall be determined. In this event, the annual cost of
251.9all waivered services shall not exceed 12 times the monthly limit of waivered services as
251.10described in paragraph (a).
251.11    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
251.12facility. (a) For a person who is a nursing facility resident at the time of requesting a
251.13determination of eligibility for elderly waivered services, a monthly conversion limit
251.14for the cost of elderly waivered services may be requested. The monthly conversion
251.15limit for the cost of elderly waiver services shall be the resident class assigned under
251.16Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility
251.17where the resident currently resides until July 1 of the state fiscal year in which the
251.18resident assessment system as described in section 256B.437 256B.438 for nursing home
251.19rate determination is implemented. Effective on July 1 of the state fiscal year in which
251.20the resident assessment system as described in section 256B.437 256B.438 for nursing
251.21home rate determination is implemented, the monthly conversion limit for the cost of
251.22elderly waiver services shall be the per diem nursing facility rate as determined by the
251.23resident assessment system as described in section 256B.437 256B.438 for that resident in
251.24the nursing facility where the resident currently resides multiplied by 365 and divided
251.25by 12, less the recipient's maintenance needs allowance as described in subdivision 1d.
251.26The initially approved conversion rate may be adjusted by the greater of any subsequent
251.27legislatively adopted home and community-based services percentage rate increase or
251.28the average statewide percentage increase in nursing facility payment rates. The limit
251.29under this subdivision only applies to persons discharged from a nursing facility after a
251.30minimum 30-day stay and found eligible for waivered services on or after July 1, 1997.
251.31For conversions from the nursing home to the elderly waiver with consumer directed
251.32community support services, the conversion rate limit is equal to the nursing facility rate
251.33reduced by a percentage equal to the percentage difference between the consumer directed
251.34services budget limit that would be assigned according to the federally approved waiver
251.35plan and the corresponding community case mix cap, but not to exceed 50 percent.
252.1    (b) The following costs must be included in determining the total monthly costs
252.2for the waiver client:
252.3    (1) cost of all waivered services, including extended medical supplies and equipment
252.4and environmental modifications and adaptations; and
252.5    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
252.6by medical assistance.
252.7    Subd. 3c. Service approval and contracting provisions. (a) Medical assistance
252.8funding for skilled nursing services, private duty nursing, home health aide, and personal
252.9care services for waiver recipients must be approved by the case manager and included in
252.10the individual care plan.
252.11    (b) A county lead agency is not required to contract with a provider of supplies and
252.12equipment if the monthly cost of the supplies and equipment is less than $250.
252.13    Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered
252.14a difficulty of care payment and shall not include room and board. The adult foster
252.15care service rate shall be negotiated between the county lead agency and the foster care
252.16provider. The elderly waiver payment for the foster care service in combination with
252.17the payment for all other elderly waiver services, including case management, must not
252.18exceed the limit specified in subdivision 3a, paragraph (a).
252.19    Subd. 3e. Assisted living Customized living service rate. (a) Payment for assisted
252.20living service customized living services shall be a monthly rate negotiated and authorized
252.21by the county agency based on an individualized service plan for each resident and may
252.22not cover direct rent or food costs. lead agency within the parameters established by
252.23the commissioner. The payment agreement must delineate the services that have been
252.24customized for each recipient and specify the amount of each service to be provided. The
252.25lead agency shall ensure that there is a documented need for all services authorized.
252.26Customized living services must not include rent or raw food costs. The negotiated
252.27payment rate must be based on services to be provided. Negotiated rates must not exceed
252.28payment rates for comparable elderly waiver or medical assistance services and must
252.29reflect economies of scale.
252.30    (b) The individualized monthly negotiated payment for assisted living customized
252.31living services as described in section 256B.0913, subdivisions 5d to 5f, and residential
252.32care services as described in section 256B.0913, subdivision 5c, shall not exceed the
252.33nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit
252.34is being calculated, of the greater of either the statewide or any of the geographic
252.35groups' weighted average monthly nursing facility rate of the case mix resident class
252.36to which the elderly waiver eligible client would be assigned under Minnesota Rules,
253.1parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in
253.2subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident
253.3assessment system as described in section 256B.437 for nursing home rate determination
253.4is implemented. Effective on July 1 of the state fiscal year in which the resident
253.5assessment system as described in section 256B.437 for nursing home rate determination
253.6is implemented and July 1 of each subsequent state fiscal year, the individualized monthly
253.7negotiated payment for the services described in this clause shall not exceed the limit
253.8described in this clause which was in effect on June 30 of the previous state fiscal year
253.9and which has been adjusted by the greater of any legislatively adopted home and
253.10community-based services cost-of-living percentage increase or any legislatively adopted
253.11statewide percent rate increase for nursing facilities.
253.12    (c) The individualized monthly negotiated payment for assisted Customized living
253.13services described in section 144A.4605 and are delivered by a provider licensed by the
253.14Department of Health as a class A or class F home care provider or an assisted living
253.15home care provider and provided in a building that is registered as a housing with services
253.16establishment under chapter 144D and that provides 24-hour supervision in combination
253.17with the payment for other elderly waiver services, including case management, must not
253.18exceed the limit specified in subdivision 3a.
253.19    Subd. 3f. Individual service rates; expenditure forecasts. (a) The county lead
253.20agency shall negotiate individual service rates with vendors and may authorize payment
253.21for actual costs up to the county's lead agency's current approved rate. Persons or agencies
253.22must be employed by or under a contract with the county lead agency or the public health
253.23nursing agency of the local board of health in order to receive funding under the elderly
253.24waiver program, except as a provider of supplies and equipment when the monthly cost of
253.25the supplies and equipment is less than $250.
253.26    (b) Reimbursement for the medical assistance recipients under the approved waiver
253.27shall be made from the medical assistance account through the invoice processing
253.28procedures of the department's Medicaid Management Information System (MMIS),
253.29only with the approval of the client's case manager. The budget for the state share of the
253.30Medicaid expenditures shall be forecasted with the medical assistance budget, and shall
253.31be consistent with the approved waiver.
253.32    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access
253.33to community services and eliminate payment disparities between the alternative care
253.34program and the elderly waiver, the commissioner shall establish statewide maximum
253.35service rate limits and eliminate county-specific lead agency-specific service rate limits.
254.1    (b) Effective July 1, 2001, for service rate limits, except those described or defined in
254.2subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative
254.3care statewide maximum rate or the elderly waiver statewide maximum rate.
254.4    (c) Counties Lead agencies may negotiate individual service rates with vendors for
254.5actual costs up to the statewide maximum service rate limit.
254.6    Subd. 3h. Service rate limits; 24-hour customized living services. The payment
254.7rates for 24-hour customized living services is a monthly rate negotiated and authorized by
254.8the lead agency within the parameters established by the commissioner of human services.
254.9The payment agreement must delineate the services that have been customized for each
254.10recipient and specify the amount of each service to be provided. The lead agency shall
254.11ensure that there is a documented need for all services authorized. The lead agency shall
254.12not authorize 24-hour customized living services unless there is a documented need for
254.1324-hour supervision. For purposes of this section, "24-hour supervision" means that the
254.14recipient requires assistance due to needs related to one or more of the following:
254.15    (1) intermittent assistance with toileting or transferring;
254.16    (2) cognitive or behavioral issues;
254.17    (3) a medical condition that requires clinical monitoring; or
254.18    (4) other conditions or needs as defined by the commissioner of human services.
254.19The lead agency shall ensure that the frequency and mode of supervision of the recipient
254.20and the qualifications of staff providing supervision are described and meet the needs
254.21of the recipient. Customized living services must not include rent or raw food costs.
254.22The negotiated payment rate for 24-hour customized living services must be based on
254.23services to be provided. Negotiated rates must not exceed payment rates for comparable
254.24elderly waiver or medical assistance services and must reflect economies of scale. The
254.25individually negotiated 24-hour customized living payments, in combination with the
254.26payment for other elderly waiver services, including case management, must not exceed
254.27the recipient's community budget cap specified in subdivision 3a.
254.28    Subd. 4. Termination notice. The case manager must give the individual a ten-day
254.29written notice of any denial, reduction, or termination of waivered services.
254.30    Subd. 5. Assessments and reassessments for waiver clients. Each client shall
254.31receive an initial assessment of strengths, informal supports, and need for services in
254.32accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
254.33client served under the elderly waiver must be conducted at least every 12 months and
254.34at other times when the case manager determines that there has been significant change
254.35in the client's functioning. This may include instances where the client is discharged
254.36from the hospital.
255.1    Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided
255.2a copy of a written care plan that meets the requirements outlined in section 256B.0913,
255.3subdivision 8 . The care plan must be implemented by the county administering waivered
255.4services of service when it is different than the county of financial responsibility. The
255.5county of service administering waivered services must notify the county of financial
255.6responsibility of the approved care plan.
255.7    Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health
255.8plan is liable for nursing home services or elderly waiver services according to section
255.9256B.69, subdivision 6a , is not eligible to also receive county-administered elderly waiver
255.10services under this section.
255.11    Subd. 8. Services and supports. (a) Services and supports shall meet the
255.12requirements set out in United States Code, title 42, section 1396n.
255.13    (b) Services and supports shall promote consumer choice and be arranged and
255.14provided consistent with individualized, written care plans.
255.15    (c) The state of Minnesota, county, managed care organization, or tribal government
255.16under contract to administer the elderly waiver shall not be liable for damages, injuries,
255.17or liabilities sustained through the purchase of direct supports or goods by the person,
255.18the person's family, or the authorized representatives with funds received through
255.19consumer-directed community support services under the federally approved waiver plan.
255.20Liabilities include, but are not limited to, workers' compensation liability, the Federal
255.21Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).
255.22    Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary
255.23provisions of this section, or those in other state laws or rules, the commissioner may
255.24develop a model for tribal management of the elderly waiver program and implement this
255.25model through a contract between the state and any of the state's federally recognized tribal
255.26governments. The model shall include the provision of tribal waiver case management,
255.27assessment for personal care assistance, and administrative requirements otherwise carried
255.28out by counties lead agencies but shall not include tribal financial eligibility determination
255.29for medical assistance.
255.30EFFECTIVE DATE.Subdivision 3h is effective the day following final enactment.

255.31    Sec. 22. Minnesota Statutes 2006, section 256B.095, is amended to read:
255.32256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
255.33    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
255.34disabilities, which includes an alternative quality assurance licensing system for programs,
256.1is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
256.2Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
256.3services provided to persons with developmental disabilities. A county, at its option, may
256.4choose to have all programs for persons with developmental disabilities located within
256.5the county licensed under chapter 245A using standards determined under the alternative
256.6quality assurance licensing system or may continue regulation of these programs under
256.7the licensing system operated by the commissioner. The project expires on June 30,
256.82009 2014.
256.9    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
256.10participate in the quality assurance system established under paragraph (a). The
256.11commission established under section 256B.0951 may, at its option, allow additional
256.12counties to participate in the system.
256.13    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
256.14may establish a quality assurance system under this section. A new system established
256.15under this section shall have the same rights and duties as the system established
256.16under paragraph (a). A new system shall be governed by a commission under section
256.17256B.0951 . The commissioner shall appoint the initial commission members based
256.18on recommendations from advocates, families, service providers, and counties in the
256.19geographic area included in the new system. Counties that choose to participate in a
256.20new system shall have the duties assigned under section 256B.0952. The new system
256.21shall establish a quality assurance process under section 256B.0953. The provisions of
256.22section 256B.0954 shall apply to a new system established under this paragraph. The
256.23commissioner shall delegate authority to a new system established under this paragraph
256.24according to section 256B.0955.
256.25    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
256.26programs for persons with disabilities and older adults.

256.27    Sec. 23. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to
256.28read:
256.29    Subdivision 1. Membership. The Quality Assurance Commission is established.
256.30The commission consists of at least 14 but not more than 21 members as follows: at
256.31least three but not more than five members representing advocacy organizations; at
256.32least three but not more than five members representing consumers, families, and their
256.33legal representatives; at least three but not more than five members representing service
256.34providers; at least three but not more than five members representing counties; and the
256.35commissioner of human services or the commissioner's designee. The first commission
257.1shall establish membership guidelines for the transition and recruitment of membership for
257.2the commission's ongoing existence. Members of the commission who do not receive a
257.3salary or wages from an employer for time spent on commission duties may receive a per
257.4diem payment when performing commission duties and functions. All members may be
257.5reimbursed for expenses related to commission activities. Notwithstanding the provisions
257.6of section 15.059, subdivision 5, the commission expires on June 30, 2009 2014.

257.7    Sec. 24. [256B.096] QUALITY MANAGEMENT, ASSURANCE, AND
257.8IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY
257.9SERVICES.
257.10    Subdivision 1. Scope. In order to improve the quality of services provided to
257.11Minnesotans with disabilities and to meet the requirements of the federally approved home
257.12and community-based waivers under section 1915c of the Social Security Act, a statewide
257.13quality assurance and improvement system for Minnesotans receiving disability services
257.14shall be developed. The disability services included are the home and community-based
257.15services waiver programs for persons with developmental disabilities under section
257.16256B.092, subdivision 4, and for persons with disabilities under section 256B.49.
257.17    Subd. 2. Stakeholder advisory group. The commissioner shall consult with a
257.18stakeholder advisory group on the development and implementation of the state quality
257.19management, assurance, and improvement system, including representatives of disability
257.20service recipients, disability service providers, disability advocacy groups, county human
257.21service agencies, and state agency staff from the Departments of Human Services and
257.22Health, and the ombudsman for mental health and developmental disabilities on the
257.23development of a statewide quality assurance and improvement system.
257.24    Subd. 3. Annual survey of service recipients. The commissioner, in consultation
257.25with the stakeholder advisory group, shall develop an annual independent random
257.26statewide survey of between five and ten percent of service recipients to determine the
257.27effectiveness and quality of disability services. The survey shall be consistent with the
257.28system performance expectations of the Centers for Medicare and Medicaid Services
257.29quality management requirements and framework. The survey shall analyze whether
257.30desired outcomes have been achieved for persons with different demographic, diagnostic,
257.31health, and functional needs receiving different types of services, in different settings,
257.32with different costs. The survey shall be field tested during 2008. The biennial report
257.33established in subdivision 5 shall include recommendations on statewide and regional
257.34reports of the survey results that, if published, would be useful to regions, counties, and
257.35providers to plan and measure the impact of quality improvement activities.
258.1    Subd. 4. Improvements for incident reporting, investigation, analysis, and
258.2follow-up. In consultation with the stakeholder advisory group, the commissioner shall
258.3identify the information, data sources, and technology needed to improve the system
258.4of incident reporting, including:
258.5    (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and
258.6    (2) investigation, analysis, and follow-up for disability services.
258.7The commissioner must ensure that the federal home and community-based waiver
258.8requirements are met and that incidents that may have jeopardized safety and health or
258.9violated service-related assurances, civil and human rights, and other protections designed
258.10to prevent abuse, neglect, and exploitation, are reviewed, investigated, and acted upon
258.11in a timely manner.
258.12    Subd. 5. Biennial report. The commissioner shall provide a biennial report to the
258.13chairs of the legislative committees with jurisdiction over health and human services
258.14policy and funding beginning January 15, 2009, on the development and activities of the
258.15quality management, assurance, and improvement system designed to meet the federal
258.16requirements under the home and community-based services waiver programs for persons
258.17with disabilities. By January 15, 2008, the commissioner shall provide a preliminary
258.18report on priorities for meeting the federal requirements, progress on development and
258.19field testing of the annual survey, appropriations necessary to implement an annual survey
258.20of service recipients once field testing is completed, recommendations for improvements
258.21in the incident reporting system, and a plan for incorporating quality assurance efforts
258.22under section 256B.095 and other regional efforts into the statewide system.

258.23    Sec. 25. Minnesota Statutes 2006, section 256B.15, is amended by adding a
258.24subdivision to read:
258.25    Subd. 9. Recovery of alternative care and certain reverse mortgages. The state
258.26and a county agency shall not recover alternative care paid for a person under section
258.27256B.0913, subdivision 17, under this section.

258.28    Sec. 26. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to
258.29read:
258.30    Subd. 2e. Contracts for services for ventilator-dependent persons. (a)
258.31The commissioner may negotiate with a nursing facility eligible to receive medical
258.32assistance payments to provide services to a ventilator-dependent person identified by the
258.33commissioner according to criteria developed by the commissioner, including:
259.1    (1) nursing facility care has been recommended for the person by a preadmission
259.2screening team;
259.3    (2) the person has been hospitalized and no longer requires inpatient acute care
259.4hospital services; and
259.5    (3) the commissioner has determined that necessary services for the person cannot
259.6be provided under existing nursing facility rates.
259.7    The commissioner may negotiate an adjustment to the operating cost payment
259.8rate for a nursing facility with a resident who is ventilator-dependent, for that resident.
259.9The negotiated adjustment must reflect only the actual additional cost of meeting the
259.10specialized care needs of a ventilator-dependent person identified by the commissioner
259.11for whom necessary services cannot be provided under existing nursing facility rates and
259.12which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or
259.139505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before
259.14July 1, 2001, and have their payment rate under this subdivision negotiated after July 1,
259.152001, the negotiated payment rate must not exceed 200 percent of the highest multiple
259.16bedroom payment rate for the facility, as initially established by the commissioner for the
259.17rate year for case mix classification K; or, upon implementation of the RUG's-based case
259.18mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a
259.19nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300
259.20percent of the facility's multiple bedroom payment rate for case mix classification K; or,
259.21upon implementation of the RUG's-based case mix system, 300 percent of the highest
259.22RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private
259.23paying residents under the provisions of section 256B.48, subdivision 1.
259.24    (b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to
259.25care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever
259.26is later, the operating payment rates for residents determined eligible under paragraph (a)
259.27of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds
259.28and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300
259.29percent of the facility's highest RUG rate.

259.30    Sec. 27. Minnesota Statutes 2006, section 256B.431, subdivision 17a, is amended to
259.31read:
259.32    Subd. 17a. Allowable interest expense. (a) Notwithstanding Minnesota Rules, part
259.339549.0060, subparts 5, item A, subitems (1) and (3), and 7, item D, allowable interest
259.34expense on debt shall include:
260.1    (1) interest expense on debt related to the cost of purchasing or replacing depreciable
260.2equipment, excluding vehicles, not to exceed six ten percent of the total historical cost
260.3of the project; and
260.4    (2) interest expense on debt related to financing or refinancing costs, including costs
260.5related to points, loan origination fees, financing charges, legal fees, and title searches; and
260.6issuance costs including bond discounts, bond counsel, underwriter's counsel, corporate
260.7counsel, printing, and financial forecasts. Allowable debt related to items in this clause
260.8shall not exceed seven percent of the total historical cost of the project. To the extent
260.9these costs are financed, the straight-line amortization of the costs in this clause is not an
260.10allowable cost; and
260.11    (3) interest on debt incurred for the establishment of a debt reserve fund, net of the
260.12interest earned on the debt reserve fund.
260.13    (b) Debt incurred for costs under paragraph (a) is not subject to Minnesota Rules,
260.14part 9549.0060, subpart 5, item A, subitem (5) or (6).
260.15EFFECTIVE DATE.This section is effective October 1, 2007.

260.16    Sec. 28. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:
260.17    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
260.18have their payment rates determined under this section rather than section 256B.431, the
260.19commissioner shall establish a rate under this subdivision. The nursing facility must enter
260.20into a written contract with the commissioner.
260.21    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
260.22contract under this section is the payment rate the facility would have received under
260.23section 256B.431.
260.24    (c) A nursing facility's case mix payment rates for the second and subsequent years
260.25of a facility's contract under this section are the previous rate year's contract payment
260.26rates plus an inflation adjustment and, for facilities reimbursed under this section or
260.27section 256B.431, an adjustment to include the cost of any increase in Health Department
260.28licensing fees for the facility taking effect on or after July 1, 2001. The index for the
260.29inflation adjustment must be based on the change in the Consumer Price Index-All Items
260.30(United States City average) (CPI-U) forecasted by the commissioner of finance's national
260.31economic consultant, as forecasted in the fourth quarter of the calendar year preceding
260.32the rate year. The inflation adjustment must be based on the 12-month period from the
260.33midpoint of the previous rate year to the midpoint of the rate year for which the rate is
260.34being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1,
260.352001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007,
261.1and July 1, 2008, October 1, 2009, and October 1, 2010,this paragraph shall apply only
261.2to the property-related payment rate, except that adjustments to include the cost of any
261.3increase in Health Department licensing fees taking effect on or after July 1, 2001, shall
261.4be provided. Beginning in 2005, adjustment to the property payment rate under this
261.5section and section 256B.431 shall be effective on October 1. In determining the amount
261.6of the property-related payment rate adjustment under this paragraph, the commissioner
261.7shall determine the proportion of the facility's rates that are property-related based on the
261.8facility's most recent cost report.
261.9    (d) The commissioner shall develop additional incentive-based payments of up to
261.10five percent above a facility's operating payment rate for achieving outcomes specified
261.11in a contract. The commissioner may solicit contract amendments and implement those
261.12which, on a competitive basis, best meet the state's policy objectives. The commissioner
261.13shall limit the amount of any incentive payment and the number of contract amendments
261.14under this paragraph to operate the incentive payments within funds appropriated for this
261.15purpose. The contract amendments may specify various levels of payment for various
261.16levels of performance. Incentive payments to facilities under this paragraph may be in the
261.17form of time-limited rate adjustments or onetime supplemental payments. In establishing
261.18the specified outcomes and related criteria, the commissioner shall consider the following
261.19state policy objectives:
261.20    (1) successful diversion or discharge of residents to the residents' prior home or other
261.21community-based alternatives;
261.22    (2) adoption of new technology to improve quality or efficiency;
261.23    (3) improved quality as measured in the Nursing Home Report Card;
261.24    (4) reduced acute care costs; and
261.25    (5) any additional outcomes proposed by a nursing facility that the commissioner
261.26finds desirable.
261.27    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
261.28take action to come into compliance with existing or pending requirements of the life
261.29safety code provisions or federal regulations governing sprinkler systems must receive
261.30reimbursement for the costs associated with compliance if all of the following conditions
261.31are met:
261.32    (1) the expenses associated with compliance occurred on or after January 1, 2005,
261.33and before December 31, 2008;
261.34    (2) the costs were not otherwise reimbursed under subdivision 4f or section
261.35144A.071 or 144A.073; and
262.1    (3) the total allowable costs reported under this paragraph are less than the minimum
262.2threshold established under section 256B.431, subdivision 15, paragraph (e), and
262.3subdivision 16.
262.4The commissioner shall use money appropriated for this purpose to provide to qualifying
262.5nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
262.62008. Nursing facilities that have spent money or anticipate the need to spend money
262.7to satisfy the most recent life safety code requirements by (1) installing a sprinkler
262.8system or (2) replacing all or portions of an existing sprinkler system may submit to the
262.9commissioner by June 30, 2007, on a form provided by the commissioner the actual
262.10costs of a completed project or the estimated costs, based on a project bid, of a planned
262.11project. The commissioner shall calculate a rate adjustment equal to the allowable
262.12costs of the project divided by the resident days reported for the report year ending
262.13September 30, 2006. If the costs from all projects exceed the appropriation for this
262.14purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
262.15qualifying facilities by reducing the rate adjustment determined for each facility by an
262.16equal percentage. Facilities that used estimated costs when requesting the rate adjustment
262.17shall report to the commissioner by January 31, 2009, on the use of this money on a
262.18form provided by the commissioner. If the nursing facility fails to provide the report, the
262.19commissioner shall recoup the money paid to the facility for this purpose. If the facility
262.20reports expenditures allowable under this subdivision that are less than the amount received
262.21in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

262.22    Sec. 29. Minnesota Statutes 2006, section 256B.434, is amended by adding a
262.23subdivision to read:
262.24    Subd. 4j. Rate increase for facilities in Chisago County. Effective October 1,
262.252007, to September 30, 2008, operating payment rates of all nursing facilities in Chisago
262.26County that are reimbursed under this section or section 256B.441 shall be increased to be
262.27equal, for a RUG's rate with a weight of 1.00, to the geographic group III median rate for
262.28the same RUG's weight. The percentage of the operating payment rate for each facility
262.29to be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that
262.30facility's September 30, 2007, operating payment rate. This subdivision applies only if it
262.31results in a rate increase. Increases provided by this subdivision shall be added to the rate
262.32determined under any new reimbursement system established under section 256B.441.

262.33    Sec. 30. Minnesota Statutes 2006, section 256B.434, is amended by adding a
262.34subdivision to read:
263.1    Subd. 19. Nursing facility rate increases beginning October 1, 2007. (a) For the
263.2rate year beginning October 1, 2007, the commissioner shall make available to each
263.3nursing facility reimbursed under this section operating payment rate adjustments equal to
263.42.62 percent of the operating payment rates in effect on September 30, 2007.
263.5    (b) Seventy-five percent of the money resulting from the rate adjustment under
263.6paragraph (a) must be used for increases in compensation-related costs for employees
263.7directly employed by the nursing facility on or after the effective date of the rate
263.8adjustment, except:
263.9    (1) the administrator;
263.10    (2) persons employed in the central office of a corporation that has an ownership
263.11interest in the nursing facility or exercises control over the nursing facility; and
263.12    (3) persons paid by the nursing facility under a management contract.
263.13    (c) Two-thirds of the money available under paragraph (b) must be used for wage
263.14increases for all employees directly employed by the nursing facility on or after the
263.15effective date of the rate adjustment, except those listed in paragraph (b), clauses (1) to
263.16(3). The wage adjustment that employees receive under this paragraph must be paid as
263.17an equal hourly percentage wage increase for all eligible employees. All wage increases
263.18under this paragraph must be effective on the same date. Only costs associated with the
263.19portion of the equal hourly percentage wage increase that goes to all employees shall
263.20qualify under this paragraph. Costs associated with wage increases in excess of the
263.21amount of the equal hourly percentage wage increase provided to all employees shall be
263.22allowed only for meeting the requirements in paragraph (b). This paragraph shall not
263.23apply to employees covered by a collective bargaining agreement.
263.24    (d) The commissioner shall allow as compensation-related costs all costs for:
263.25    (1) wages and salaries;
263.26    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
263.27compensation;
263.28    (3) the employer's share of health and dental insurance, life insurance, disability
263.29insurance, long-term care insurance, uniform allowance, and pensions; and
263.30    (4) other benefits provided, subject to the approval of the commissioner.
263.31    (e) The portion of the rate adjustment under paragraph (a) that is not subject to the
263.32requirements in paragraphs (b) and (c) shall be provided to nursing facilities effective
263.33October 1, 2007.
263.34    (f) Nursing facilities may apply for the portion of the rate adjustment under
263.35paragraph (a) that is subject to the requirements in paragraphs (b) and (c). The application
263.36must be submitted to the commissioner within six months of the effective date of the
264.1rate adjustment, and the nursing facility must provide additional information required
264.2by the commissioner within nine months of the effective date of the rate adjustment.
264.3The commissioner must respond to all applications within three weeks of receipt.
264.4The commissioner may waive the deadlines in this paragraph under extraordinary
264.5circumstances, to be determined at the sole discretion of the commissioner. The
264.6application must contain:
264.7    (1) an estimate of the amounts of money that must be used as specified in paragraphs
264.8(b) and (c);
264.9    (2) a detailed distribution plan specifying the allowable compensation-related and
264.10wage increases the nursing facility will implement to use the funds available in clause (1);
264.11    (3) a description of how the nursing facility will notify eligible employees of
264.12the contents of the approved application, which must provide for giving each eligible
264.13employee a copy of the approved application, excluding the information required in clause
264.14(1), or posting a copy of the approved application, excluding the information required in
264.15clause (1), for a period of at least six weeks in an area of the nursing facility to which all
264.16eligible employees have access; and
264.17    (4) instructions for employees who believe they have not received the
264.18compensation-related or wage increases specified in clause (2), as approved by the
264.19commissioner, and which must include a mailing address, e-mail address, and the
264.20telephone number that may be used by the employee to contact the commissioner or the
264.21commissioner's representative.
264.22    (g) The commissioner shall ensure that cost increases in distribution plans under
264.23paragraph (f), clause (2), that may be included in approved applications, comply with the
264.24following requirements:
264.25    (1) costs to be incurred during the applicable rate year resulting from wage and
264.26salary increases effective after October 1, 2006, and prior to the first day of the nursing
264.27facility's payroll period that includes October 1, 2007, shall be allowed if they were not
264.28used in the prior year's application;
264.29    (2) a portion of the costs resulting from tenure-related wage or salary increases
264.30may be considered to be allowable wage increases, according to formulas that the
264.31commissioner shall provide, where employee retention is above the average statewide
264.32rate of retention of direct care employees;
264.33    (3) the annualized amount of increases in costs for the employer's share of health
264.34and dental insurance, life insurance, disability insurance, and workers' compensation
264.35shall be allowable compensation-related increases if they are effective on or after April
264.361, 2007, and prior to April 1, 2008; and
265.1    (4) for nursing facilities in which employees are represented by an exclusive
265.2bargaining representative, the commissioner shall approve the application only upon
265.3receipt of a letter of acceptance of the distribution plan, in regard to members of the
265.4bargaining unit, signed by the exclusive bargaining agent and dated after enactment of
265.5this subdivision. Upon receipt of the letter of acceptance, the commissioner shall deem
265.6all requirements of this section as having been met in regard to the members of the
265.7bargaining unit.
265.8    (h) The commissioner shall review applications received under paragraph (f) and
265.9shall provide the portion of the rate adjustment under paragraphs (b) and (c) if the
265.10requirements of this subdivision have been met. The rate adjustment shall be effective
265.11October 1. Notwithstanding paragraph (a), if the approved application distributes less
265.12money than is available, the amount of the rate adjustment shall be reduced so that the
265.13amount of money made available is equal to the amount to be distributed.

265.14    Sec. 31. Minnesota Statutes 2006, section 256B.434, is amended by adding a
265.15subdivision to read:
265.16    Subd. 20. Payment of Public Employees Retirement Association costs. Nursing
265.17facilities that participate in the Public Employees Retirement Association (PERA) shall
265.18have the component of their payment rate associated with the costs of PERA determined
265.19for each rate year. Effective for rate years beginning on and after October 1, 2007, the
265.20commissioner shall determine the portion of the payment rate in effect on September 30
265.21each year and shall subtract that amount from the payment rate to be effective on the
265.22following October 1. The portion that shall be deemed to be included in the September 30,
265.232007, rate that is associated with PERA costs shall be the allowed costs in the facility's
265.24base for determining rates under this section, divided by the resident days reported for that
265.25year. The commissioner shall add to the payment rate to be effective on October 1 each
265.26year an amount equal to the reported costs associated with PERA, for the year ended on
265.27the most recent September 30 for which data is available, divided by total resident days
265.28for that year, as reported by the facility and audited under section 256B.441.

265.29    Sec. 32. Minnesota Statutes 2006, section 256B.437, is amended by adding a
265.30subdivision to read:
265.31    Subd. 10. Big Stone County rate adjustment. Notwithstanding the requirements
265.32of this section, the commissioner shall approve a planned closure rate adjustment in Big
265.33Stone County for an eight-bed facility in Clinton for reassignment to a 50-bed facility in
265.34Graceville. The adjustment shall be calculated according to subdivisions 3 and 6.

266.1    Sec. 33. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:
266.2    Subdivision 1. Rate determination Rebasing of nursing facility operating cost
266.3payment rates. (a) The commissioner shall establish a value-based nursing facility
266.4reimbursement system which will provide facility-specific, prospective rates for nursing
266.5facilities participating in the medical assistance program. The rates shall be determined
266.6using an annual statistical and cost report filed by each nursing facility. The total payment
266.7rate shall be composed of four rate components: direct care services, support services,
266.8external fixed, and property-related rate components. The payment rate shall be derived
266.9from statistical measures of actual costs incurred in facility operation of nursing facilities.
266.10From this cost basis, the components of the total payment rate shall be adjusted for quality
266.11of services provided, recognition of staffing levels, geographic variation in labor costs, and
266.12resident acuity. The commissioner shall rebase nursing facility operating cost payment
266.13rates to align payments to facilities with the cost of providing care. The rebased operating
266.14cost payment rates shall be calculated using the statistical and cost report filed by each
266.15nursing facility for the report period ending one year prior to the rate year.
266.16    (b) Rates shall be rebased annually. The new operating cost payment rates based on
266.17this section shall take effect beginning with the rate year beginning October 1, 2008, and
266.18shall be phased in over five rate years through October 1, 2012.
266.19    (c) Operating cost payment rates shall be rebased on October 1, 2013, and every
266.20two years after that date.
266.21    (d) Each cost reporting year shall begin on October 1 and end on the following
266.22September 30. Beginning in 2006, a statistical and cost report shall be filed by each
266.23nursing facility by January 15. Notice of rates shall be distributed by August 15 and the
266.24rates shall go into effect on October 1 for one year.
266.25    (c) The commissioner shall begin to phase in the new reimbursement system
266.26beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.
266.27    (e) Effective October 1, 2011, property rates shall be rebased in accordance with
266.28section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine
266.29what the property payment rate for a nursing facility would be had the facility not had its
266.30property rate determined under section 256B.434. The commissioner shall allow nursing
266.31facilities to provide information affecting this rate determination that would have been
266.32filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report
266.33information necessary to determine allowable debt. The commissioner shall use this
266.34information to determine the property payment rate.

266.35    Sec. 34. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:
267.1    Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to
267.242 42a have the meanings given unless otherwise provided for in this section.

267.3    Sec. 35. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:
267.4    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for
267.5administering the overall activities of the nursing home. These costs include salaries and
267.6wages of the administrator, assistant administrator, business office employees, security
267.7guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases
267.8related to business office functions, licenses, and permits except as provided in the
267.9external fixed costs category, employee recognition, travel including meals and lodging,
267.10training, voice and data communication or transmission, office supplies, liability insurance
267.11and other forms of insurance not designated to other areas, personnel recruitment, legal
267.12services, accounting services, management or business consultants, data processing,
267.13information technology, Web site, central or home office costs, business meetings and
267.14seminars, postage, fees for professional organizations, subscriptions, security services,
267.15advertising, board of director's fees, working capital interest expense, and bad debts and
267.16bad debt collection fees.

267.17    Sec. 36. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:
267.18    Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the
267.19facility which are necessary for the operation of the facility and the care of residents
267.20and which are reviewed by the department for accuracy,; reasonableness, in accordance
267.21with the requirements set forth in Title XVIII of the federal Social Security Act and the
267.22interpretations in the provider reimbursement manual; and compliance with this section
267.23and generally accepted accounting principles. All references to costs in this section shall
267.24be assumed to refer to allowed costs.

267.25    Sec. 37. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to
267.26read:
267.27    Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages
267.28of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees
267.29assigned to the kitchen and dining room, and associated fringe benefits and payroll
267.30taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs
267.31of raw food (both normal and special diet food), dietary supplies, and food preparation
267.32and serving. Also included are special dietary supplements used for tube feeding or oral
268.1feeding, such as elemental high nitrogen diet, even if written as a prescription item by a
268.2physician.

268.3    Sec. 38. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to
268.4read:
268.5    Subd. 11. Direct care costs category. "Direct care costs category" "Direct care
268.6costs" means costs for nursing services, activities, and social services the wages of nursing
268.7administration, staff education, direct care registered nurses, licensed practical nurses,
268.8certified nursing assistants, trained medication aides, and associated fringe benefits and
268.9payroll taxes; services from a supplemental nursing services agency; supplies that are
268.10stocked at nursing stations or on the floor and distributed or used individually, including,
268.11but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice
268.12bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas,
268.13enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products,
268.14thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic
268.15agents, drugs that are not paid on a separate fee schedule by the medical assistance
268.16program or any other payer, and technology related to the provision of nursing care to
268.17residents, such as electronic charting systems.

268.18    Sec. 39. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to
268.19read:
268.20    Subd. 13. External fixed costs category. "External fixed costs category" "External
268.21fixed costs" means costs related to the nursing home surcharge under section 256.9657,
268.22subdivision 1 ; licensure fees under section 144.122; long-term care consultation fees
268.23under section 256B.0911, subdivision 6; family advisory council fee under section
268.24 144A.33 ; scholarships under section 256B.431, subdivision 36; planned closure rate
268.25adjustments under section 256B.436 or 256B.437; or single bed room incentives under
268.26section 256B.431, subdivision 42; property taxes and property insurance; and PERA.

268.27    Sec. 40. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to
268.28read:
268.29    Subd. 14. Facility average case mix index. "Facility average case mix index" or
268.30"CMI" means a numerical value score that describes the relative resource use for all
268.31residents within the groups under the resource utilization group (RUG-III) classification
268.32system prescribed by the commissioner based on an assessment of each resident. The
268.33facility average CMI shall be computed as the standardized days divided by total days for
269.1all residents in the facility. The RUG's weights used in this section shall be as follows
269.2for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB
269.31.109; RAA 0.957; SSC 1.453; SSB 1.224; SSA 1.047; CC2 1.292; CC1 1.200; CB2
269.41.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676;
269.5BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023;
269.6PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1
269.70.651; and DDF 1.000.

269.8    Sec. 41. Minnesota Statutes 2006, section 256B.441, is amended by adding a
269.9subdivision to read:
269.10    Subd. 14a. Facility type groups. Facilities shall be classified into two groups,
269.11called "facility type groups," which shall consist of:
269.12    (1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota
269.13Rules, parts 9570.2000 to 9570.3400; and
269.14    (2) freestanding: all other facilities.

269.15    Sec. 42. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to
269.16read:
269.17    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group
269.18life, health, dental, workers' compensation, and other employee insurances and pension,
269.19profit-sharing, and retirement plans for which the employer pays all or a portion of the
269.20costs and that are available to at least all employees who work at least 20 hours per week.

269.21    Sec. 43. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to
269.22read:
269.23    Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the
269.24salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning
269.25employees and associated fringe benefits and payroll taxes. It also includes the cost of
269.26housekeeping supplies, including, but not limited to, cleaning and lavatory supplies and
269.27contract services.

269.28    Sec. 44. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to
269.29read:
269.30    Subd. 24. Maintenance and plant operations costs. "Maintenance and plant
269.31operations costs" means the costs for the salaries and wages of the maintenance supervisor,
269.32engineers, heating-plant employees, and other maintenance employees and associated
270.1fringe benefits and payroll taxes. It also includes direct costs for maintenance and
270.2operation of the building and grounds, including, but not limited to, fuel, electricity,
270.3medical waste and garbage removal, water, sewer, supplies, tools, and repairs.

270.4    Sec. 45. Minnesota Statutes 2006, section 256B.441, is amended by adding a
270.5subdivision to read:
270.6    Subd. 28a. Other direct care costs. "Other direct care costs" means the costs
270.7for the salaries and wages and associated fringe benefits and payroll taxes of mental
270.8health workers, religious personnel, and other direct care employees not specified in
270.9the definition of direct care costs.

270.10    Sec. 46. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to
270.11read:
270.12    Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer
270.13groups," which by county. The groups shall consist of:
270.14    (1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed
270.15per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000
270.16to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota,
270.17Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott,
270.18Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;
270.19    (2) boarding care homes - facilities that have more than 50 percent of their beds
270.20licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth,
270.21Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard,
270.22Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod,
270.23Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca,
270.24Watonwan, or Wilkin County; and
270.25    (3) standard - all other facilities group three: facilities in all other counties.

270.26    Sec. 47. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to
270.27read:
270.28    Subd. 31. Prior rate-setting method system operating cost payment rate. "Prior
270.29rate-setting method" "Prior system operating cost payment rate" means the operating cost
270.30payment rate determination process in effect prior to October 1, 2006 on September 30,
270.312008, under Minnesota Rules and Minnesota Statutes, not including planned closure rate
270.32adjustments under section 256B.436 or 256B.437, or single bed room incentives under
270.33section 256B.431, subdivision 42.

271.1    Sec. 48. Minnesota Statutes 2006, section 256B.441, is amended by adding a
271.2subdivision to read:
271.3    Subd. 33a. Raw food costs. "Raw food costs" means the cost of food provided to
271.4nursing facility residents. Also included are special dietary supplements used for tube
271.5feeding or oral feeding, such as elemental high nitrogen diet.

271.6    Sec. 49. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to
271.7read:
271.8    Subd. 34. Related organization. "Related organization" means a person that
271.9furnishes goods or services to a nursing facility and that is a close relative of a nursing
271.10facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility,
271.11or an affiliate of a close relative of an affiliate of a nursing facility. As used in this
271.12subdivision, paragraphs (a) to (d) apply:
271.13    (a) "Affiliate" means a person that directly, or indirectly through one or more
271.14intermediaries, controls or is controlled by, or is under common control with another
271.15person.
271.16    (b) "Person" means an individual, a corporation, a partnership, an association, a
271.17trust, an unincorporated organization, or a government or political subdivision.
271.18    (c) "Close relative of an affiliate of a nursing facility" means an individual whose
271.19relationship by blood, marriage, or adoption to an individual who is an affiliate of a
271.20nursing facility is no more remote than first cousin.
271.21    (d) "Control" including the terms "controlling," "controlled by," and "under common
271.22control with" means the possession, direct or indirect, of the power to direct or cause the
271.23direction of the management, operations, or policies of a person, whether through the
271.24ownership of voting securities, by contract, or otherwise, or to influence in any manner
271.25other than through an arms length, legal transaction.

271.26    Sec. 50. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to
271.27read:
271.28    Subd. 38. Social services costs. "Social services costs" means the costs for the
271.29salaries and wages of the supervisor and other social work employees, associated fringe
271.30benefits and payroll taxes, supplies, services, and consultants. This category includes the
271.31cost of those employees who manage and process admission to the nursing facility.

271.32    Sec. 51. Minnesota Statutes 2006, section 256B.441, is amended by adding a
271.33subdivision to read:
272.1    Subd. 42a. Therapy costs. "Therapy costs" means any costs related to medical
272.2assistance therapy services provided to residents that are not billed separately from the
272.3daily operating rate.

272.4    Sec. 52. Minnesota Statutes 2006, section 256B.441, is amended by adding a
272.5subdivision to read:
272.6    Subd. 46a. Calculation of quality add-on for the rate year beginning October
272.71, 2007. (a) The payment rate for the rate year beginning October 1, 2007, for the
272.8quality add-on, is a variable amount based on each facility's quality score. For the rate
272.9year, the maximum quality add-on is .3 percent of the operating payment rate in effect
272.10on September 30, 2007. The commissioner shall determine the quality add-on for each
272.11facility according to paragraphs (b) to (d).
272.12    (b) For each facility, the commissioner shall determine the operating payment rate
272.13in effect on September 30, 2007.
272.14    (c) For each facility, the commissioner shall determine a ratio of the quality score of
272.15the facility determined in subdivision 44, subtract 40, and then divide by 60. If this value
272.16is less than zero, the commissioner shall use the value zero.
272.17    (d) For each facility, the quality add-on is the value determined in paragraph (b),
272.18multiplied by the value determined in paragraph (c), multiplied by .3 percent.

272.19    Sec. 53. Minnesota Statutes 2006, section 256B.441, is amended by adding a
272.20subdivision to read:
272.21    Subd. 48. Calculation of operating per diems. The direct care per diem for
272.22each facility shall be the facility's direct care costs divided by its standardized days.
272.23The other care-related per diem shall be the sum of the facility's activities costs, other
272.24direct care costs, raw food costs, therapy costs, and social services costs, divided by the
272.25facility's resident days. The other operating per diem shall be the sum of the facility's
272.26administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance
272.27and plant operations costs divided by the facility's resident days.

272.28    Sec. 54. Minnesota Statutes 2006, section 256B.441, is amended by adding a
272.29subdivision to read:
272.30    Subd. 49. Determination of total care-related per diem. The total care-related
272.31per diem for each facility shall be the sum of the direct care per diem and the other
272.32care-related per diem.

273.1    Sec. 55. Minnesota Statutes 2006, section 256B.441, is amended by adding a
273.2subdivision to read:
273.3    Subd. 50. Determination of total care-related limit. (a) The limit on the total
273.4care-related per diem shall be determined for each peer group and facility type group
273.5combination. A facility's total care-related per diems shall be limited to 120 percent of the
273.6median for the facility's peer and facility type group. The facility-specific direct care costs
273.7used in making this comparison and in the calculation of the median shall be based on a
273.8RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per
273.9diem reduced to the limit. If a reduction of the total care-related per diem is necessary
273.10because of this limit, the reduction shall be made proportionally to both the direct care per
273.11diem and the other care-related per diem.
273.12    (b) Beginning with rates determined for October 1, 2013, the total care-related limit
273.13shall be a variable amount based on each facility's quality score, as determined under
273.14section 256B.441, subdivision 44, in accordance with clauses (1) to (4):
273.15    (1) for each facility, the commissioner shall determine the quality score, subtract 40,
273.16divide by 40, and convert to a percentage;
273.17    (2) if the value determined in clause (1) is less than zero, the total care-related limit
273.18shall be 105 percent of the median for the facility's peer and facility type group;
273.19    (3) if the value determined in clause (1) is greater than 100 percent, the total
273.20care-related limit shall be 125 percent of the median for the facility's peer and facility
273.21type group; and
273.22    (4) if the value determined in clause (1) is greater than zero and less than 100
273.23percent, the total care-related limit shall be 105 percent of the median for the facility's peer
273.24and facility type group plus one-fifth of the percentage determined in clause (1).

273.25    Sec. 56. Minnesota Statutes 2006, section 256B.441, is amended by adding a
273.26subdivision to read:
273.27    Subd. 50a. Determination of proximity adjustments. For a nursing facility
273.28located in close proximity to another nursing facility of the same facility group type but in
273.29a different peer group and that has higher limits for care-related or other operating costs,
273.30the commissioner shall adjust the limits in accordance with clauses (1) to (4):
273.31    (1) determine the difference between the limits;
273.32    (2) determine the distance between the two facilities, by the shortest driving route. If
273.33the distance exceeds 20 miles, no adjustment shall be made;
273.34    (3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a
273.35percentage; and
274.1    (4) increase the limits for the nursing facility with the lower limits by the value
274.2determined in clause (1) multiplied by the value determined in clause (3).

274.3    Sec. 57. Minnesota Statutes 2006, section 256B.441, is amended by adding a
274.4subdivision to read:
274.5    Subd. 51. Determination of other operating limit. The limit on the other operating
274.6per diem shall be determined for each peer group. A facility's other operating per diem
274.7shall be limited to 105 percent of the median for its peer group. A facility that is above
274.8that limit shall have its other operating per diem reduced to the limit.

274.9    Sec. 58. Minnesota Statutes 2006, section 256B.441, is amended by adding a
274.10subdivision to read:
274.11    Subd. 51a. Exception allowing contracting for specialized care. (a) For rate years
274.12beginning on or after October 1, 2013, the commissioner may negotiate increases to
274.13the care-related limit for nursing facilities that provide specialized care, at a cost to the
274.14general fund not to exceed $600,000 per year. The commissioner shall publish a request
274.15for proposals annually, and may negotiate increases to the limits that shall apply for either
274.16one or two years before the increase shall be subject to a new proposal and negotiation.
274.17The care-related limit may be increased by up to 50 percent.
274.18    (b) In selecting facilities with which to negotiate, the commissioner shall consider:
274.19    (1) the diagnoses or other circumstances of residents in the specialized program that
274.20require care that costs substantially more than the RUG's rates associated with those
274.21residents;
274.22    (2) the nature of the specialized program or programs offered to meet the needs
274.23of these individuals; and
274.24    (3) outcomes achieved by the specialized program.

274.25    Sec. 59. Minnesota Statutes 2006, section 256B.441, is amended by adding a
274.26subdivision to read:
274.27    Subd. 52. Determination of efficiency incentive. Each facility shall be eligible
274.28for an efficiency incentive based on its other operating per diem. A facility with an other
274.29operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency
274.30incentive. All other facilities shall receive an incentive calculated as 50 percent times the
274.31difference between the facility's other operating per diem and its other operating per diem
274.32limit, up to a maximum incentive of $3.

275.1    Sec. 60. Minnesota Statutes 2006, section 256B.441, is amended by adding a
275.2subdivision to read:
275.3    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
275.4shall calculate a payment rate for external fixed costs.
275.5    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
275.6shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
275.7home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
275.8result of its number of nursing home beds divided by its total number of licensed beds.
275.9    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
275.10shall be the amount of the fee divided by actual resident days.
275.11    (c) The portion related to scholarships shall be determined under section 256B.431,
275.12subdivision 36.
275.13    (d) The portion related to long-term care consultation shall be determined according
275.14to section 256B.0911, subdivision 6.
275.15    (e) The portion related to development and education of resident and family advisory
275.16councils under section 144A.33 shall be $5 divided by 365.
275.17    (f) The portion related to planned closure rate adjustments shall be as determined
275.18under sections 256B.436 and 256B.437, subdivision 6. Planned closure rate adjustments
275.19that take effect before October 1, 2011, shall no longer be included in the payment rate
275.20for external fixed costs beginning October 1, 2013. Planned closure rate adjustments that
275.21take effect on or after October 1, 2011, shall no longer be included in the payment rate
275.22for external fixed costs beginning on October 1 of the first year not less than two years
275.23after their effective date.
275.24    (g) The portions related to property insurance, real estate taxes, special assessments,
275.25and payments made in lieu of real estate taxes directly identified or allocated to the nursing
275.26facility shall be the actual amounts divided by actual resident days.
275.27    (h) The portion related to the Public Employees Retirement Association shall be
275.28actual costs divided by resident days.
275.29    (i) The single bed room incentives shall be as determined under section 256B.431,
275.30subdivision 42. Single bed room incentives that take effect before October 1, 2011, shall
275.31no longer be included in the payment rate for external fixed costs beginning October 1,
275.322013. Single bed room incentives that take effect on or after October 1, 2011, shall no
275.33longer be included in the payment rate for external fixed costs beginning on October 1 of
275.34the first year not less than two years after their effective date.
275.35    (j) The payment rate for external fixed costs shall be the sum of the amounts in
275.36paragraphs (a) to (i).

276.1    Sec. 61. Minnesota Statutes 2006, section 256B.441, is amended by adding a
276.2subdivision to read:
276.3    Subd. 54. Determination of total payment rates. In rate years when rates are
276.4rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total
276.5care-related payment rate, other operating payment rate, efficiency incentive, external
276.6fixed cost rate, and the property rate determined under section 256B.434. To determine
276.7a total payment rate for each RUG's level, the total care-related payment rate shall be
276.8divided into the direct care payment rate and the other care-related payment rate, and the
276.9direct care payment rate multiplied by the RUG's weight for each RUG's level using the
276.10weights in subdivision 14.

276.11    Sec. 62. Minnesota Statutes 2006, section 256B.441, is amended by adding a
276.12subdivision to read:
276.13    Subd. 55. Phase-in of rebased operating cost payment rates. (a) For the rate years
276.14beginning October 1, 2008, to October 1, 2012, the operating cost payment rate calculated
276.15under this section shall be phased in by blending the operating cost rate with the operating
276.16cost payment rate determined under section 256B.434. For the rate year beginning
276.17October 1, 2008, the operating cost payment rate for each facility shall be 24.9 percent of
276.18the operating cost payment rate from this section, and 75.1 percent of the operating cost
276.19payment rate from section 256B.434. For the rate year beginning October 1, 2009, the
276.20operating cost payment rate for each facility shall be 57.6 percent of the operating cost
276.21payment rate from this section, and 42.4 percent of the operating cost payment rate from
276.22section 256B.434. For the rate year beginning October 1, 2010, the operating cost payment
276.23rate for each facility shall be 92.1 percent of the operating cost payment rate from this
276.24section, and 7.9 percent of the operating cost payment rate from section 256B.434. For
276.25the rate year beginning October 1, 2011, the operating cost payment rate for each facility
276.26shall be 96 percent of the operating cost payment rate from this section, and 4 percent
276.27of the operating cost payment rate from section 256B.434. For the rate year beginning
276.28October 1, 2012, the operating cost payment rate for each facility shall be the operating
276.29cost payment rate determined under this section. The blending of operating cost payment
276.30rates under this section shall be performed separately for each RUG's class.
276.31    (b) A portion of the funds received under this subdivision that are in excess of
276.32operating cost payment rates that a facility would have received under section 256B.434,
276.33as determined in accordance with clauses (1) to (3), shall be subject to the requirements in
276.34section 256B.434, subdivision 19, paragraphs (b) to (h).
277.1    (1) Determine the amount of additional funding available to a facility, which shall be
277.2equal to total medical assistance resident days from the most recent reporting year times
277.3the difference between the blended rate determined in paragraph (a) for the rate year being
277.4computed and the blended rate for the prior year.
277.5    (2) Determine the portion of all operating costs, for the most recent reporting year,
277.6that are compensation related. If this value exceeds 75 percent, use 75 percent.
277.7    (3) Subtract the amount determined in clause (2) from 75 percent.
277.8    (4) The portion of the fund received under this subdivision that shall be subject to
277.9the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal
277.10the amount determined in clause (1) times the amount determined in clause (3).

277.11    Sec. 63. Minnesota Statutes 2006, section 256B.441, is amended by adding a
277.12subdivision to read:
277.13    Subd. 56. Hold harmless. For the rate years beginning October 1, 2008, to October
277.141, 2012, no nursing facility shall receive an operating cost payment rate less than its
277.15operating cost payment rate under section 256B.434. The comparison of operating cost
277.16payment rates under this section shall be made for a RUG's rate with a weight of 1.00.

277.17    Sec. 64. Minnesota Statutes 2006, section 256B.441, is amended by adding a
277.18subdivision to read:
277.19    Subd. 57. Appeals. Nursing facilities may appeal, as described under section
277.20256B.50, the determination of a payment rate established under this chapter.

277.21    Sec. 65. Minnesota Statutes 2006, section 256B.441, is amended by adding a
277.22subdivision to read:
277.23    Subd. 58. Implementation delay. Within six months prior to the effective date of
277.24(1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits
277.25under subdivision 50; and (3) the removal of planned closure rate adjustments and single
277.26bed room incentives from external fixed costs under subdivision 53, the commissioner
277.27shall compare the average operating cost for all facilities combined from the most recent
277.28cost reports to the average medical assistance operating payment rates for all facilities
277.29combined from the same time period. Each provision shall not go into effect until the
277.30average medical assistance operating payment rate is at least 92 percent of the average
277.31operating cost.

278.1    Sec. 66. Minnesota Statutes 2006, section 256B.49, is amended by adding a
278.2subdivision to read:
278.3    Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
278.4seek federal approval for medical assistance reimbursement of independent living skills
278.5services, foster care waiver service, supported employment, prevocational service,
278.6structured day service, and adult day care under the home and community-based waiver
278.7for persons with a traumatic brain injury, the community alternatives for disabled
278.8individuals waivers, and the community alternative care waivers.
278.9    (b) Medical reimbursement shall be made only when the provider demonstrates
278.10evidence of its capacity to meet basic health, safety, and protection standards through
278.11one of the methods in paragraphs (c) to (e).
278.12    (c) The provider is licensed to provide services under chapter 245B and agrees to
278.13apply these standards to services funded through the traumatic brain injury, community
278.14alternatives for disabled, or community alternative care home and community-based
278.15waivers.
278.16    (d) The local agency contracting for the services certifies on a form provided by the
278.17commissioner that the provider has the capacity to meet the individual needs as identified
278.18in each person's individual service plan. When certifying that the service provider meets
278.19the necessary provider qualifications, the local agency shall verify that the provider has
278.20policies and procedures governing the following:
278.21    (1) protection of the consumer's rights and privacy;
278.22    (2) risk assessment and planning;
278.23    (3) record keeping and reporting of incidents and emergencies with documentation
278.24of corrective action if needed;
278.25    (4) service outcomes, regular reviews of progress, and periodic reports;
278.26    (5) complaint and grievance procedures;
278.27    (6) service termination or suspension;
278.28    (7) necessary training and supervision of direct care staff that includes:
278.29    (i) documentation in personnel files of 20 hours of orientation training in providing
278.30training related to service provision;
278.31    (ii) training in recognizing the symptoms and effects of certain disabilities, health
278.32conditions, and positive behavioral supports and interventions; and
278.33    (iii) a minimum of five hours of related training annually; and
278.34    (iv) when applicable:
278.35    (A) safe medication administration;
278.36    (B) proper handling of consumer funds; and
279.1    (C) compliance with prohibitions and standards developed by the commissioner to
279.2satisfy federal requirements regarding the use of restraints and restrictive interventions.
279.3The local agency shall review at least annually each service provider's continued
279.4compliance with the standards governing basic health, safety, and protection of rights.
279.5    (h) The commissioner shall seek federal approval for Medicaid reimbursement
279.6of foster care services under the home and community-based waiver for persons with
279.7a traumatic brain injury, the community alternatives for disabled individuals waiver,
279.8and community alternative care waiver when the provider demonstrates evidence of its
279.9capacity to meet basic health, safety, and protection standards. The local agency shall
279.10verify that the provider is licensed under Minnesota Rules, parts 9555.5105 to 9555.6265,
279.11and certify that the provider has policies and procedures that govern:
279.12    (1) compliance with prohibitions and standards developed by the commissioner to
279.13meet federal requirements regarding the use of restraints and restrictive interventions; and
279.14    (2) documentation of service needs and outcomes, regular reviews of progress,
279.15and periodic reports.
279.16The local agency shall review at least annually each service provider's continued
279.17compliance with the standards governing basic health, safety, and protection of rights
279.18standards.
279.19EFFECTIVE DATE.This section is effective the day following final enactment.

279.20    Sec. 67. Minnesota Statutes 2006, section 256B.5012, is amended by adding a
279.21subdivision to read:
279.22    Subd. 7. ICF/MR rate increases effective October 1, 2007, and October 1, 2008.
279.23    (a) For the rate year beginning October 1, 2007, the commissioner shall make available to
279.24each facility reimbursed under this section operating payment rate adjustments equal to
279.252.75 percent of the operating payment rates in effect on September 30, 2007. For the rate
279.26year beginning October 1, 2008, the commissioner shall make available to each facility
279.27reimbursed under this section operating payment rate adjustments equal to 3.0 percent
279.28of the operating payment rates in effect on September 30, 2008. For each facility, the
279.29commissioner shall make available an adjustment, based on occupied beds, using the
279.30percentage specified in this paragraph multiplied by the total payment rate, including the
279.31variable rate but excluding the property-related payment rate, in effect on the preceding
279.32day. The total payment rate shall include the adjustment provided in section 256B.501,
279.33subdivision 12. A facility whose payment rates are governed by closure agreements,
280.1receivership agreements, or Minnesota Rules, part 9553.0075, is not eligible for an
280.2adjustment otherwise granted under this subdivision.
280.3    (b) Seventy-five percent of the money resulting from the rate adjustments under
280.4paragraph (a) must be used for increases in compensation-related costs for employees
280.5directly employed by the facility on or after the effective date of the rate adjustments,
280.6except:
280.7    (1) the administrator;
280.8    (2) persons employed in the central office of a corporation that has an ownership
280.9interest in the facility or exercises control over the facility; and
280.10    (3) persons paid by the facility under a management contract.
280.11    (c) Two-thirds of the money available under paragraph (b) must be used for wage
280.12increases for all employees directly employed by the facility on or after the effective
280.13date of the rate adjustments, except those listed in paragraph (b), clauses (1) to (3). The
280.14wage adjustment that employees receive under this paragraph must be paid as an equal
280.15hourly percentage wage increase for all eligible employees. All wage increases under this
280.16paragraph must be effective on the same date. Only costs associated with the portion of
280.17the equal hourly percentage wage increase that goes to all employees shall qualify under
280.18this paragraph. Costs associated with wage increases in excess of the amount of the equal
280.19hourly percentage wage increase provided to all employees shall be allowed only for
280.20meeting the requirements in paragraph (b). This paragraph shall not apply to employees
280.21covered by a collective bargaining agreement.
280.22    (d) The commissioner shall allow as compensation-related costs all costs for:
280.23    (1) wages and salaries;
280.24    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
280.25compensation;
280.26    (3) the employer's share of health and dental insurance, life insurance, disability
280.27insurance, long-term care insurance, uniform allowance, and pensions; and
280.28    (4) other benefits provided, subject to the approval of the commissioner.
280.29    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the
280.30requirements in paragraphs (b) and (c) shall be provided to facilities effective October
280.311 of each year.
280.32    (f) Facilities may apply for the portion of the rate adjustments under paragraph
280.33(a) that is subject to the requirements in paragraphs (b) and (c). The application
280.34must be submitted to the commissioner within six months of the effective date of the
280.35rate adjustments, and the facility must provide additional information required by
280.36the commissioner within nine months of the effective date of the rate adjustments.
281.1The commissioner must respond to all applications within three weeks of receipt.
281.2The commissioner may waive the deadlines in this paragraph under extraordinary
281.3circumstances, to be determined at the sole discretion of the commissioner. The
281.4application must contain:
281.5    (1) an estimate of the amounts of money that must be used as specified in paragraphs
281.6(b) and (c);
281.7    (2) a detailed distribution plan specifying the allowable compensation-related and
281.8wage increases the facility will implement to use the funds available in clause (1);
281.9    (3) a description of how the facility will notify eligible employees of the contents of
281.10the approved application, which must provide for giving each eligible employee a copy of
281.11the approved application, excluding the information required in clause (1), or posting a
281.12copy of the approved application, excluding the information required in clause (1), for
281.13a period of at least six weeks in an area of the facility to which all eligible employees
281.14have access; and
281.15    (4) instructions for employees who believe they have not received the
281.16compensation-related or wage increases specified in clause (2), as approved by the
281.17commissioner, and which must include a mailing address, e-mail address, and the
281.18telephone number that may be used by the employee to contact the commissioner or the
281.19commissioner's representative.
281.20    (g) The commissioner shall ensure that cost increases in distribution plans under
281.21paragraph (f), clause (2), that may be included in approved applications, comply with
281.22requirements in clauses (1) to (4):
281.23    (1) costs to be incurred during the applicable rate year resulting from wage and
281.24salary increases effective after October 1, 2006, and prior to the first day of the facility's
281.25payroll period that includes October 1 of each year shall be allowed if they were not used
281.26in the prior year's application and they meet the requirements of paragraphs (b) and (c);
281.27    (2) a portion of the costs resulting from tenure-related wage or salary increases
281.28may be considered to be allowable wage increases, according to formulas that the
281.29commissioner shall provide, where employee retention is above the average statewide
281.30rate of retention of direct care employees;
281.31    (3) the annualized amount of increases in costs for the employer's share of health
281.32and dental insurance, life insurance, disability insurance, and workers' compensation shall
281.33be allowable compensation-related increases if they are effective on or after April 1 of
281.34the year in which the rate adjustments are effective and prior to April 1 of the following
281.35year; and
282.1    (4) for facilities in which employees are represented by an exclusive bargaining
282.2representative, the commissioner shall approve the application only upon receipt of a letter
282.3of acceptance of the distribution plan, as regards members of the bargaining unit, signed
282.4by the exclusive bargaining agent and dated after enactment of this subdivision. Upon
282.5receipt of the letter of acceptance, the commissioner shall deem all requirements of this
282.6section as having been met in regard to the members of the bargaining unit.
282.7    (h) The commissioner shall review applications received under paragraph (f) and
282.8shall provide the portion of the rate adjustments under paragraphs (b) and (c) if the
282.9requirements of this subdivision have been met. The rate adjustments shall be effective
282.10October 1 of each year. Notwithstanding paragraph (a), if the approved application
282.11distributes less money than is available, the amount of the rate adjustment shall be reduced
282.12so that the amount of money made available is equal to the amount to be distributed.

282.13    Sec. 68. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to read:
282.14    Subd. 23. Alternative services; elderly and disabled persons. (a) The
282.15commissioner may implement demonstration projects to create alternative integrated
282.16delivery systems for acute and long-term care services to elderly persons and persons
282.17with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
282.18coordination, improve access to quality services, and mitigate future cost increases.
282.19The commissioner may seek federal authority to combine Medicare and Medicaid
282.20capitation payments for the purpose of such demonstrations and may contract with
282.21Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
282.22services shall be administered according to the terms and conditions of the federal contract
282.23and demonstration provisions. For the purpose of administering medical assistance funds,
282.24demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
282.25of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
282.26with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
282.27items B and C, which do not apply to persons enrolling in demonstrations under this
282.28section. An initial open enrollment period may be provided. Persons who disenroll from
282.29demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
282.30to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
282.31the health plan's participation is subsequently terminated for any reason, the person shall
282.32be provided an opportunity to select a new health plan and shall have the right to change
282.33health plans within the first 60 days of enrollment in the second health plan. Persons
282.34required to participate in health plans under this section who fail to make a choice of
282.35health plan shall not be randomly assigned to health plans under these demonstrations.
283.1Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
283.2subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
283.3the commissioner may contract with managed care organizations, including counties, to
283.4serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
283.5disabled persons only. For persons with a primary diagnosis of developmental disability,
283.6serious and persistent mental illness, or serious emotional disturbance, the commissioner
283.7must ensure that the county authority has approved the demonstration and contracting
283.8design. Enrollment in these projects for persons with disabilities shall be voluntary. The
283.9commissioner shall not implement any demonstration project under this subdivision for
283.10persons with a primary diagnosis of developmental disabilities, serious and persistent
283.11mental illness, or serious emotional disturbance, without approval of the county board of
283.12the county in which the demonstration is being implemented.
283.13    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
283.14to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
283.159525.1330 , 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
283.16under this section projects for persons with developmental disabilities. The commissioner
283.17may capitate payments for ICF/MR services, waivered services for developmental
283.18disabilities, including case management services, day training and habilitation and
283.19alternative active treatment services, and other services as approved by the state and by
283.20the federal government. Case management and active treatment must be individualized
283.21and developed in accordance with a person-centered plan. Costs under these projects may
283.22not exceed costs that would have been incurred under fee-for-service. Beginning July 1,
283.232003, and until two four years after the pilot project implementation date, subcontractor
283.24participation in the long-term care developmental disability pilot is limited to a nonprofit
283.25long-term care system providing ICF/MR services, home and community-based waiver
283.26services, and in-home services to no more than 120 consumers with developmental
283.27disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the
283.28legislature prior to expansion of the developmental disability pilot project. This paragraph
283.29expires two four years after the implementation date of the pilot project.
283.30    (c) Before implementation of a demonstration project for disabled persons, the
283.31commissioner must provide information to appropriate committees of the house of
283.32representatives and senate and must involve representatives of affected disability groups
283.33in the design of the demonstration projects.
283.34    (d) A nursing facility reimbursed under the alternative reimbursement methodology
283.35in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
284.1provide services under paragraph (a). The commissioner shall amend the state plan and
284.2seek any federal waivers necessary to implement this paragraph.
284.3    (e) The commissioner, in consultation with the commissioners of commerce and
284.4health, may approve and implement programs for all-inclusive care for the elderly (PACE)
284.5according to federal laws and regulations governing that program and state laws or rules
284.6applicable to participating providers. The process for approval of these programs shall
284.7begin only after the commissioner receives grant money in an amount sufficient to cover
284.8the state share of the administrative and actuarial costs to implement the programs during
284.9state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
284.10account in the special revenue fund and are appropriated to the commissioner to be used
284.11solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
284.12not required to be licensed or certified as a health plan company as defined in section
284.1362Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county
284.14and found to be eligible for services under the elderly waiver or community alternatives
284.15for disabled individuals or who are already eligible for Medicaid but meet level of
284.16care criteria for receipt of waiver services may choose to enroll in the PACE program.
284.17Medicare and Medicaid services will be provided according to this subdivision and
284.18federal Medicare and Medicaid requirements governing PACE providers and programs.
284.19PACE enrollees will receive Medicaid home and community-based services through the
284.20PACE provider as an alternative to services for which they would otherwise be eligible
284.21through home and community-based waiver programs and Medicaid State Plan Services.
284.22The commissioner shall establish Medicaid rates for PACE providers that do not exceed
284.23costs that would have been incurred under fee-for-service or other relevant managed care
284.24programs operated by the state.
284.25    (f) The commissioner shall seek federal approval to expand the Minnesota disability
284.26health options (MnDHO) program established under this subdivision in stages, first to
284.27regional population centers outside the seven-county metro area and then to all areas
284.28of the state. Until January 1, 2008 July 1, 2009, expansion for MnDHO projects that
284.29include home and community-based services is limited to the two projects and service
284.30areas in effect on March 1, 2006. Enrollment in integrated MnDHO programs that
284.31include home and community-based services shall remain voluntary. Costs for home
284.32and community-based services included under MnDHO must not exceed costs that
284.33would have been incurred under the fee-for-service program. In developing program
284.34specifications for expansion of integrated programs, the commissioner shall involve and
284.35consult the state-level stakeholder group established in subdivision 28, paragraph (d),
284.36including consultation on whether and how to include home and community-based waiver
285.1programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
285.2of the house and senate committees with jurisdiction over health and human services
285.3policy and finance by February 1, 2007.
285.4    (g) Notwithstanding section 256B.0261, health plans providing services under this
285.5section are responsible for home care targeted case management and relocation targeted
285.6case management. Services must be provided according to the terms of the waivers and
285.7contracts approved by the federal government.

285.8    Sec. 69. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.
285.9     (a) The commissioner of human services shall combine the existing biennial base
285.10level funding for deaf-blind services into a single grant program. At least 35 percent
285.11of the total funding is awarded for services and other supports to deaf-blind children
285.12and their families and at least 25 percent is awarded for services and other supports to
285.13deaf-blind adults.
285.14    The commissioner shall award grants for the purposes of:
285.15    (1) providing services and supports to individuals who are deaf-blind; and
285.16    (2) developing and providing training to counties and the network of senior citizen
285.17service providers. The purpose of the training grants is to teach counties how to use
285.18existing programs that capture federal financial participation to meet the needs of eligible
285.19deaf-blind persons and to build capacity of senior service programs to meet the needs of
285.20seniors with a dual sensory hearing and vision loss.
285.21    (b) The commissioner may make grants:
285.22    (1) for services and training provided by organizations; and
285.23    (2) to develop and administer consumer-directed services.
285.24    (c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant
285.25under paragraph (a).
285.26    (d) Deaf-blind service providers may, but are not required to, provide intervenor
285.27services as part of the service package provided with grant funds under this section.

285.28    Sec. 70. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:
285.29    Subd. 3. Moratorium on the development of group residential housing beds. (a)
285.30County agencies shall not enter into agreements for new group residential housing beds
285.31with total rates in excess of the MSA equivalent rate except: (1) for group residential
285.32housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355,
285.33provided the facility is needed to meet the census reduction targets for persons with
285.34developmental disabilities at regional treatment centers; (2) to ensure compliance with
286.1the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements
286.2for inappropriately placed persons with developmental disabilities or mental illness;
286.3(3) up to 80 beds in a single, specialized facility located in Hennepin County that will
286.4provide housing for chronic inebriates who are repetitive users of detoxification centers
286.5and are refused placement in emergency shelters because of their state of intoxication,
286.6and planning for the specialized facility must have been initiated before July 1, 1991, in
286.7anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
286.8subdivision 20a , paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for
286.9up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County
286.10for homeless adults with a mental illness, a history of substance abuse, or human
286.11immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this
286.12section, "homeless adult" means a person who is living on the street or in a shelter or
286.13discharged from a regional treatment center, community hospital, or residential treatment
286.14program and has no appropriate housing available and lacks the resources and support
286.15necessary to access appropriate housing. At least 70 percent of the supportive housing
286.16units must serve homeless adults with mental illness, substance abuse problems, or human
286.17immunodeficiency virus or acquired immunodeficiency syndrome who are about to be
286.18or, within the previous six months, has been discharged from a regional treatment center,
286.19or a state-contracted psychiatric bed in a community hospital, or a residential mental
286.20health or chemical dependency treatment program. If a person meets the requirements of
286.21subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group
286.22residential housing rate for that person is limited to the supplementary rate under section
286.23256I.05, subdivision 1a , and is determined by subtracting the amount of the person's
286.24countable income that exceeds the MSA equivalent rate from the group residential housing
286.25supplementary rate. A resident in a demonstration project site who no longer participates
286.26in the demonstration program shall retain eligibility for a group residential housing
286.27payment in an amount determined under section 256I.06, subdivision 8, using the MSA
286.28equivalent rate. Service funding under section 256I.05, subdivision 1a, will end June 30,
286.291997, if federal matching funds are available and the services can be provided through a
286.30managed care entity. If federal matching funds are not available, then service funding will
286.31continue under section 256I.05, subdivision 1a; or (6) (5) for group residential housing
286.32beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which
286.33are used exclusively for recipients receiving home and community-based waiver services
286.34under sections 256B.0915, 256B.092, subdivision 5, 256B.093, and 256B.49, and who
286.35resided in a nursing facility for the six months immediately prior to the month of entry
286.36into the group residential housing setting. The group residential housing rate for these
287.1beds must be set so that the monthly group residential housing payment for an individual
287.2occupying the bed when combined with the nonfederal share of services delivered under
287.3the waiver for that person does not exceed the nonfederal share of the monthly medical
287.4assistance payment made for the person to the nursing facility in which the person resided
287.5prior to entry into the group residential housing establishment. The rate may not exceed
287.6the MSA equivalent rate plus $426.37 for any case.; (6) for an additional two beds,
287.7resulting in a total of 32 beds, for a facility located in Hennepin County providing services
287.8for recovering and chemically dependent men that has had a group residential housing
287.9contract with the county and has been licensed as a board and lodge facility with special
287.10services since 1980; (7) for a group residential housing provider located in Stearns County
287.11that operates a 40-bed facility, that received financing through the Minnesota Housing
287.12Finance Agency Ending Long-Term Homelessness Initiative and serves chemically
287.13dependent clientele, providing 24-hour-a-day supervision; (8) for a new 65-bed facility in
287.14Crow Wing County that will serve chemically dependent persons, operated by a group
287.15residential housing provider that currently operates a 304-bed facility in Minneapolis, and
287.16a 44-bed facility in Duluth; and (9) for a group residential housing provider that operates
287.17two ten-bed facilities, one located in Hennepin County and one located in Ramsey County,
287.18that provide community support and 24-hour-a-day supervision to serve the mental health
287.19needs of individuals who have chronically lived unsheltered.
287.20    (b) A county agency may enter into a group residential housing agreement for beds
287.21with rates in excess of the MSA equivalent rate in addition to those currently covered
287.22under a group residential housing agreement if the additional beds are only a replacement
287.23of beds with rates in excess of the MSA equivalent rate which have been made available
287.24due to closure of a setting, a change of licensure or certification which removes the beds
287.25from group residential housing payment, or as a result of the downsizing of a group
287.26residential housing setting. The transfer of available beds from one county to another can
287.27only occur by the agreement of both counties.

287.28    Sec. 71. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
287.29to read:
287.30    Subd. 1h. Supplementary rate for certain facilities serving chemically
287.31dependent males. Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a
287.32county agency shall negotiate a supplementary rate in addition to the rate specified in
287.33subdivision 1, not to exceed $737.87 per month, including any legislatively authorized
287.34inflationary adjustments, for a group residential housing provider that:
288.1    (1) is located in Ramsey County and has had a group residential housing contract
288.2with the county since 1982 and has been licensed as a board and lodge facility with special
288.3services since 1979; and
288.4    (2) serves recovering and chemically dependent males, providing 24-hour-a-day
288.5supervision.

288.6    Sec. 72. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
288.7to read:
288.8    Subd. 1i. Supplementary rate for certain facilities; Hennepin County.
288.9    Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate
288.10a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
288.11per month, including any legislatively authorized inflationary adjustments, up to the
288.12available appropriation, for a facility located in Hennepin County with a capacity of up to
288.1348 beds that has been licensed since 1978 as a board and lodging facility and that until
288.14August 1, 2007, operated as a licensed chemical dependency treatment program.
288.15EFFECTIVE DATE.This section is effective the day following final enactment.

288.16    Sec. 73. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
288.17to read:
288.18    Subd. 1j. Supplementary rate for certain facilities; Crow Wing County.
288.19    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a
288.20county agency shall negotiate a supplementary rate in addition to the rate specified in
288.21subdivision 1, not to exceed $700 per month, including any legislatively authorized
288.22inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve
288.23chemically dependent persons operated by a group residential housing provider that
288.24currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which
288.25opened in January of 2006.

288.26    Sec. 74. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
288.27to read:
288.28    Subd. 1k. Supplementary rate for certain facilities; Stearns County.
288.29    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
288.30shall negotiate a supplementary service rate in addition to the rate specified in subdivision
288.311, not to exceed $700 per month, including any legislatively authorized inflationary
288.32adjustments, for a group residential housing provider located in Stearns County that
288.33operates a 40-bed facility, that received financing through the Minnesota Housing Finance
289.1Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
289.2clientele, providing 24-hour-a-day supervision.

289.3    Sec. 75. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
289.4to read:
289.5    Subd. 1l. Supplementary rate for certain facilities; St. Louis County.
289.6    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
289.7shall negotiate a supplementary service rate in addition to the rate specified in subdivision
289.81, not to exceed $700 per month, including any legislatively authorized inflationary
289.9adjustments, for a group residential housing provider located in St. Louis County that
289.10operates a 30-bed facility, that received financing through the Minnesota Housing Finance
289.11Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
289.12clientele, providing 24-hour-a-day supervision.

289.13    Sec. 76. Minnesota Statutes 2006, section 256I.05, is amended by adding a subdivision
289.14to read:
289.15    Subd. 1m. Supplemental rate for certain facilities; Hennepin and Ramsey
289.16Counties. (a) Notwithstanding the provisions of this section, beginning July 1, 2007, a
289.17county agency shall negotiate a supplemental service rate in addition to the rate specified
289.18in subdivision 1, not to exceed $700 per month or the existing monthly rate, whichever
289.19is higher, including any legislatively authorized inflationary adjustments, for a group
289.20residential housing provider that operates two ten-bed facilities, one located in Hennepin
289.21County and one located in Ramsey County, which provide community support and serve
289.22the mental health needs of individuals who have chronically lived unsheltered, providing
289.2324-hour per day supervision.
289.24    (b) An individual who has lived in one of the facilities under paragraph (a), who
289.25is being transitioned to independent living as part of the program plan continues to be
289.26eligible for group residential housing and the supplemental service rate negotiated with
289.27the county under paragraph (a).
289.28EFFECTIVE DATE.This section is effective July 1, 2008.

289.29    Sec. 77. Minnesota Statutes 2006, section 462A.05, is amended by adding a
289.30subdivision to read:
289.31    Subd. 42. Reverse mortgage incentive program. (a) The agency shall, within the
289.32limits of appropriations made available for this purpose, establish, in cooperation with
289.33the commissioner of human services, a program to encourage eligible persons to obtain
290.1reverse mortgages to pay for eligible costs of maintaining the person in the home as an
290.2alternative to a nursing facility placement.
290.3    (b) The incentive program shall be made available to a person who has been
290.4determined by the commissioner of human services or the commissioner's designated
290.5agent to meet all of the following criteria:
290.6    (1) is age 62 or older;
290.7    (2) would be eligible for medical assistance within 365 days of admission to a
290.8nursing home;
290.9    (3) is not a medical assistance recipient, is not eligible for medical assistance without
290.10a spenddown or waiver obligation, is not ineligible for the medical assistance program due
290.11to an asset transfer penalty, and does not have income greater than the maintenance needs
290.12allowance under section 256B.0915, subdivision 1d, but equal to or less than 120 percent
290.13of the federal poverty guidelines effective July 1 in the year for which program eligibility
290.14is established, who would be eligible for the elderly waiver with a waiver obligation;
290.15    (4) needs services that are not funded through other state or federal funding for
290.16which the person qualifies;
290.17    (5) obtains a reverse mortgage loan under section 47.58 on a home with an estimated
290.18market value not to exceed $156,000. This limit shall be adjusted annually on April 1
290.19by the percentage change for the previous calendar year in the housing component of the
290.20United States Consumer Price Index - all urban consumers; and
290.21    (6) agrees to make expenditures of reverse mortgage payments according to a
290.22spending plan established under section 256B.0911, subdivision 3a, in which payments,
290.23services, and supports meet the following standards:
290.24    (i) payments received under the loan for a period of at least 24 months or in an
290.25amount of at least $15,000 are used for services and supports, including basic shelter
290.26needs, home maintenance, and modifications or adaptations, necessary to allow the person
290.27to remain in the home as an alternative to a nursing facility placement;
290.28    (ii) reimbursements for services, supplies, and equipment shall not exceed the
290.29market rate; and
290.30    (iii) if the person's spouse qualifies under section 256B.0913, subdivisions 1 to 14,
290.31the reverse mortgage payments may be used to pay client fees under that section.
290.32    (c) The incentives available under this program shall include:
290.33    (1) payment of the initial mortgage insurance premium for a reverse mortgage.
290.34The maximum payment under this clause shall be limited to $1,560. This limit shall be
290.35adjusted annually on April 1 by the percentage change for the previous calendar year in
290.36the housing component of the United States Consumer Price Index - all urban consumers;
291.1    (2) with federal approval, payments to reduce service fee set-asides, through an
291.2advance payment to the lender, an agreement to guarantee fee payments after 60 months
291.3if the set-aside is limited to 60 months, or through other mechanisms approved by the
291.4commissioner; and
291.5    (3) other incentives approved by the commissioner.
291.6    (d) After calculating the adjusted maximum payment limits under paragraphs (b)
291.7and (c), the commissioner shall annually notify the Office of the Revisor of Statutes in
291.8writing, on or before May 1, of the adjusted limits. The revisor shall annually publish in
291.9the Minnesota Statutes the adjusted maximum payment limits under paragraph (b).

291.10    Sec. 78. Laws 2006, chapter 282, article 20, section 37, is amended to read:
291.11    Sec. 37. REPAYMENT DELAY.
291.12    (a) A county that overspent its allowed amounts in calendar year 2004 or 2005 under
291.13the waivered services program for persons with developmental disabilities shall not be
291.14required to pay back the amount of overspending until May 31, 2007. This section applies
291.15to Fillmore, Steele, and St. Louis Counties.
291.16    (b) Carver County is not required to pay back the amount of overspending under
291.17the waivered services program for persons with developmental disabilities for calendar
291.18years 2004 and 2005 until June 30, 2009.
291.19EFFECTIVE DATE.This section is effective the day following final enactment.

291.20    Sec. 79. ASSISTIVE TECHNOLOGY RECOMMENDATIONS.
291.21    Subdivision 1. Review. During the biennium ending June 30, 2009, the Council on
291.22Disability shall facilitate a statewide review of the assistive technology needs of people
291.23with disabling conditions, and seniors. The council shall identify community-based
291.24service providers, state agencies, and other entities involved in providing assistive
291.25technology supports.
291.26    Subd. 2. Recommendations. The council shall present to the chairs of the house
291.27and senate committees having jurisdiction over human services, by January 1, 2009,
291.28recommendations, including proposed legislation creating a statewide comprehensive plan
291.29to meet the assistive technology needs of people with disabling conditions and seniors.
291.30The statewide plan must include steps to coordinate and streamline assistive technology
291.31services.

291.32    Sec. 80. PROVIDER RATE INCREASES.
292.1    (a) The commissioner of human services shall increase allocations, reimbursement
292.2rates, or rate limits, as applicable, by 2.75 percent beginning October 1, 2007, and by 3.00
292.3percent beginning October 1, 2008, effective for services rendered on or after those dates.
292.4County contracts for services specified in this section must be amended to pass through
292.5these rate adjustments within 60 days of the effective date of the increase and must be
292.6retroactive from the effective date of the rate adjustment.
292.7    (b) The annual rate increases described in this section must be provided to:
292.8    (1) home and community-based waivered services for persons with developmental
292.9disabilities or related conditions, including consumer-directed community supports, under
292.10Minnesota Statutes, section 256B.501;
292.11    (2) home and community-based waivered services for the elderly, including
292.12consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
292.13    (3) waivered services under community alternatives for disabled individuals,
292.14including consumer-directed community supports, under Minnesota Statutes, section
292.15256B.49;
292.16    (4) community alternative care waivered services, including consumer-directed
292.17community supports, under Minnesota Statutes, section 256B.49;
292.18    (5) traumatic brain injury waivered services, including consumer-directed
292.19community supports, under Minnesota Statutes, section 256B.49;
292.20    (6) nursing services and home health services under Minnesota Statutes, section
292.21256B.0625, subdivision 6a;
292.22    (7) personal care services and qualified professional supervision of personal care
292.23services under Minnesota Statutes, section 256B.0625, subdivision 19a;
292.24    (8) private duty nursing services under Minnesota Statutes, section 256B.0625,
292.25subdivision 7 ;
292.26    (9) day training and habilitation services for adults with developmental disabilities
292.27or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
292.28additional cost of rate adjustments on day training and habilitation services, provided as a
292.29social service under Minnesota Statutes, section 256M.60 ;
292.30    (10) alternative care services under Minnesota Statutes, section 256B.0913;
292.31    (11) adult residential program grants under Minnesota Statutes, section 245.73;
292.32    (12) children's community-based mental health services grants and adult community
292.33support and case management services grants under Minnesota Rules, parts 9535.1700
292.34to 9535.1760;
292.35    (13) the group residential housing supplementary service rate under Minnesota
292.36Statutes, section 256I.05, subdivision 1a;
293.1    (14) adult mental health integrated fund grants under Minnesota Statutes, section
293.2245.4661;
293.3    (15) semi-independent living services (SILS) under Minnesota Statutes, section
293.4252.275, including SILS funding under county social services grants formerly funded
293.5under Minnesota Statutes, chapter 256I;
293.6    (16) community support services for deaf and hard-of-hearing adults with mental
293.7illness who use or wish to use sign language as their primary means of communication
293.8under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
293.9grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9,
293.10article 1; and Laws 1997, First Special Session chapter 5, section 20;
293.11    (17) living skills training programs for persons with intractable epilepsy who need
293.12assistance in the transition to independent living under Laws 1988, chapter 689;
293.13    (18) physical therapy services under sections 256B.0625, subdivision 8, and
293.14256D.03, subdivision 4;
293.15    (19) occupational therapy services under sections 256B.0625, subdivision 8a, and
293.16256D.03, subdivision 4;
293.17    (20) speech-language therapy services under section 256D.03, subdivision 4, and
293.18Minnesota Rules, part 9505.0390;
293.19    (21) respiratory therapy services under section 256D.03, subdivision 4, and
293.20Minnesota Rules, part 9505.0295;
293.21    (22) adult rehabilitative mental health services under section 256B.0623;
293.22    (23) children's therapeutic services and support services under section 256B.0943;
293.23    (24) tier I chemical health services under Minnesota Statutes, chapter 254B;
293.24    (25) consumer support grants under Minnesota Statutes, section 256.476;
293.25    (26) family support grants under Minnesota Statutes, section 252.32;
293.26    (27) grants for case management services to persons with HIV or AIDS under
293.27Minnesota Statutes, section 256.01, subdivision 19; and
293.28    (28) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
293.29and 256B.0928.
293.30    (c) For services funded through Minnesota disability health options, the rate
293.31increases under this section apply to all medical assistance payments, including former
293.32group residential housing supplementary rates under Minnesota Statutes, chapter 256I.
293.33    (d) The commissioner may recoup payments made under this section from a provider
293.34that does not comply with paragraphs (f) and (g).
294.1    (e) A managed care plan receiving state payments for the services in this section
294.2must include these increases in their payments to providers on a prospective basis,
294.3effective on January 1 following the effective date of the rate increase.
294.4    (f) Providers that receive a rate increase under this section shall use 75 percent of
294.5the additional revenue to increase compensation-related costs for employees directly
294.6employed by the program on or after the effective date of the rate adjustments, except:
294.7    (1) the administrator;
294.8    (2) persons employed in the central office of a corporation or entity that has an
294.9ownership interest in the provider or exercises control over the provider; and
294.10    (3) persons paid by the provider under a management contract.
294.11Compensation-related costs include: wages and salaries; FICA taxes, Medicare taxes,
294.12state and federal unemployment taxes, and workers' compensation; and the employer's
294.13share of health and dental insurance, life insurance, disability insurance, long-term care
294.14insurance, uniform allowance, and pensions.
294.15    (g) Two-thirds of the money available under paragraph (f) must be used for wage
294.16increases for all employees directly employed by the provider on or after the effective
294.17date of the rate adjustments, except those listed in paragraph (f), clauses (1) to (3). The
294.18wage adjustment that employees receive under this paragraph must be paid as an equal
294.19hourly percentage wage increase for all eligible employees. All wage increases under this
294.20paragraph must be effective on the same date. This paragraph shall not apply to employees
294.21covered by a collective bargaining agreement.
294.22    (h) For public employees, the increase for wages and benefits for certain staff is
294.23available and pay rates must be increased only to the extent that they comply with laws
294.24governing public employees collective bargaining. Money received by a provider for pay
294.25increases under this section may be used only for increases implemented on or after the
294.26first day of the rate period in which the increase is available and must not be used for
294.27increases implemented prior to that date.
294.28    (i) The commissioner shall amend state grant contracts that include direct
294.29personnel-related grant expenditures to include the allocation for the portion of the contract
294.30that is employee compensation related. Grant contracts for compensation-related services
294.31must be amended to pass through these adjustments within 60 days of the effective date of
294.32the increase and must be retroactive to the effective date of the rate adjustment.
294.33    (j) The Board on Aging and its Area Agencies on Aging shall amend their
294.34grants that include direct personnel-related grant expenditures to include the rate
294.35adjustment for the portion of the grant that is employee compensation related. Grants
294.36for compensation-related services must be amended to pass through these adjustments
295.1within 60 days of the effective date of the increase and must be retroactive to the effective
295.2date of the rate adjustment.
295.3    (k) The calendar year 2008 rate for vendors reimbursed under Minnesota Statutes,
295.4chapter 254B, shall be at least 2.75 percent above the rate in effect on January 1, 2007.
295.5The calendar year 2009 rate shall be at least 3.0 percent above the rate in effect on January
295.61, 2008.
295.7    (l) Providers that receive a rate adjustment under paragraph (a) that is subject to
295.8paragraphs (f) and (g) shall provide to the commissioner, and those counties with whom
295.9they have a contract, within six months after the effective date of each rate adjustment, a
295.10letter, in a format specified by the commissioner, that provides assurances that the provider
295.11has developed and implemented a compensation plan and complied with paragraphs (f)
295.12and (g). The provider shall keep on file, and produce for the commissioner or county
295.13upon request, its plan, which must specify:
295.14    (1) an estimate of the amounts of money that must be used as specified in paragraphs
295.15(f) and (g); and
295.16    (2) a detailed distribution plan specifying the allowable compensation-related and
295.17wage increases the provider will implement to use the funds available in clause (1).
295.18    (m) Within six months after the effective date of each rate adjustment, the provider
295.19shall post this plan, excluding the information required in paragraph (l), clause (1), for
295.20a period of at least six weeks in an area of the provider's operation to which all eligible
295.21employees have access and provide instructions for employees who believe they have
295.22not received the wage and other compensation-related increases specified in paragraph
295.23(l), clause (2). Instructions must include a mailing address, e-mail address, and the
295.24telephone number that may be used by the employee to contact the commissioner or the
295.25commissioner's representative. Providers shall also make assurances to the commissioner
295.26and counties with whom they have a contract that they have complied with the requirement
295.27in this paragraph.

295.28    Sec. 81. MINNESOTA RULES.
295.29    The Department of Administration shall publish adopted rules in the State Register
295.30making the terminology changes specified in section 84 in Minnesota Rules. Upon
295.31publication in the State Register, the terminology changes for Minnesota Rules are
295.32adopted without further administrative action.

295.33    Sec. 82. HOUSING WITH SERVICES AND HOME CARE PROVIDERS
295.34STUDY; REPORT.
296.1    The commissioner of human services shall conduct a study of how the state of
296.2Minnesota can most effectively assist persons age 65 and older in selecting long-term care
296.3services that meet their needs, reflect their preferences, and enable them to maintain
296.4financial self-sufficiency as long as possible. The study shall include surveys of both
296.5consumers and providers of housing with services, assisted living, and in-home services,
296.6as well as an evaluation of what role the long-term care consultation program under
296.7Minnesota Statutes, section 256B.0911, does or could play in helping consumers to
296.8evaluate their options. Upon request of the commissioner, providers covered by the
296.9study shall provide data that the commissioner determines is reasonably necessary to
296.10achieve study outcomes. The preliminary results of this study shall be reported to the
296.11senate and house of representatives committees with jurisdiction over health and human
296.12services policy and finance issues by February 15, 2008, with a final report completed
296.13by December 15, 2008.

296.14    Sec. 83. PROVIDER RATE INCREASE.
296.15    Effective July 1, 2007, a day training and habilitation provider in St. Louis County
296.16providing services for up to 80 individuals shall have a reimbursement rate that equals 94
296.17percent of 125 percent of the statewide median per diem.

296.18    Sec. 84. REVISOR'S INSTRUCTION.
296.19    The revisor of statutes shall change the terms in column A to the terms in column B
296.20wherever they appear in Minnesota Statutes:

296.21		Column A		Column B
296.22 296.23 296.24 296.25 296.26		"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans"		"Office of Ombudsman for Long-Term Care"
296.27 296.28		"ombudsman for older Minnesotans"		"ombudsman for long-term care"

296.29    Sec. 85. REPEALER.
296.30Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261;
296.31252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h;
296.32and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.

297.1ARTICLE 8

297.2MENTAL HEALTH

297.3    Section 1. [16C.155] JANITORIAL CONTRACTS FOR REHABILITATION
297.4PROGRAMS AND EXTENDED EMPLOYMENT PROVIDERS.
297.5    The commissioner of administration shall ensure that a portion of all janitorial
297.6services contracts be awarded by the state to rehabilitation programs and extended
297.7employment providers listed under section 16C.15. The total value of the contracts under
297.8this section must exceed 19 percent of the total value of janitorial services contracts
297.9entered into in the previous fiscal year. The amount of each contract awarded under this
297.10section may exceed the estimated fair market price for the same goods and services by
297.11up to five percent.

297.12    Sec. 2. Minnesota Statutes 2006, section 148C.11, subdivision 1, is amended to read:
297.13    Subdivision 1. Other professionals. (a) Nothing in this chapter prevents members
297.14of other professions or occupations from performing functions for which they are qualified
297.15or licensed. This exception includes, but is not limited to: licensed physicians; registered
297.16nurses; licensed practical nurses; licensed psychological practitioners; members of
297.17the clergy; American Indian medicine men and women; licensed attorneys; probation
297.18officers; licensed marriage and family therapists; licensed social workers; social workers
297.19employed by city, county, or state agencies; licensed professional counselors; licensed
297.20school counselors; registered occupational therapists or occupational therapy assistants;
297.21city, county, or state employees when providing assessments or case management under
297.22Minnesota Rules, chapter 9530; and until July 1, 2007 2009, individuals providing
297.23integrated dual-diagnosis treatment in adult mental health rehabilitative programs certified
297.24by the Department of Human Services under section 256B.0622 or 256B.0623.
297.25    (b) Nothing in this chapter prohibits technicians and resident managers in programs
297.26licensed by the Department of Human Services from discharging their duties as provided
297.27in Minnesota Rules, chapter 9530.
297.28    (c) Any person who is exempt under this subdivision but who elects to obtain a
297.29license under this chapter is subject to this chapter to the same extent as other licensees.
297.30The board shall issue a license without examination to an applicant who is licensed or
297.31registered in a profession identified in paragraph (a) if the applicant:
297.32    (1) shows evidence of current licensure or registration; and
298.1    (2) has submitted to the board a plan for supervision during the first 2,000 hours of
298.2professional practice or has submitted proof of supervised professional practice that is
298.3acceptable to the board.
298.4    (d) Any person who is exempt from licensure under this section must not use a
298.5title incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
298.6counselor" or otherwise hold themselves out to the public by any title or description
298.7stating or implying that they are engaged in the practice of alcohol and drug counseling,
298.8or that they are licensed to engage in the practice of alcohol and drug counseling unless
298.9that person is also licensed as an alcohol and drug counselor. Persons engaged in the
298.10practice of alcohol and drug counseling are not exempt from the board's jurisdiction
298.11solely by the use of one of the above titles.

298.12    Sec. 3. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to read:
298.13    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the
298.14brain or a clinically significant disorder of thought, mood, perception, orientation,
298.15memory, or behavior that is listed in the clinical manual of the International Classification
298.16of Diseases (ICD-9-CM), current edition, code range 290.0 to 302.99 or 306.0 to 316.0
298.17or the corresponding code in the American Psychiatric Association's Diagnostic and
298.18Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and
298.19that seriously limits a person's capacity to function in primary aspects of daily living such
298.20as personal relations, living arrangements, work, and recreation.
298.21    (b) An "adult with acute mental illness" means an adult who has a mental illness that
298.22is serious enough to require prompt intervention.
298.23    (c) For purposes of case management and community support services, a "person
298.24with serious and persistent mental illness" means an adult who has a mental illness and
298.25meets at least one of the following criteria:
298.26    (1) the adult has undergone two or more episodes of inpatient care for a mental
298.27illness within the preceding 24 months;
298.28    (2) the adult has experienced a continuous psychiatric hospitalization or residential
298.29treatment exceeding six months' duration within the preceding 12 months;
298.30    (3) the adult has been treated by a crisis team two or more times within the preceding
298.3124 months;
298.32    (4) the adult:
298.33    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline
298.34personality disorder;
298.35    (ii) indicates a significant impairment in functioning; and
299.1    (iii) has a written opinion from a mental health professional, in the last three years,
299.2stating that the adult is reasonably likely to have future episodes requiring inpatient or
299.3residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
299.4management or community support services are provided;
299.5    (4) (5) the adult has, in the last three years, been committed by a court as a person
299.6who is mentally ill under chapter 253B, or the adult's commitment has been stayed or
299.7continued; or
299.8    (5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time
299.9period has expired or the adult was eligible as a child under section 245.4871, subdivision
299.106 ; and (ii) has a written opinion from a mental health professional, in the last three years,
299.11stating that the adult is reasonably likely to have future episodes requiring inpatient or
299.12residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
299.13management or community support services are provided.

299.14    Sec. 4. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision
299.15to read:
299.16    Subd. 3. Responsibility not duplicated. For individuals who have health care
299.17coverage, the county board is not responsible for providing mental health services which
299.18are within the limits of the individual's health care coverage.

299.19    Sec. 5. [245.4682] MENTAL HEALTH SERVICE DELIVERY AND FINANCE
299.20REFORM.
299.21    Subdivision 1. Policy. The commissioner of human services shall undertake a series
299.22of reforms to address the underlying structural, financial, and organizational problems in
299.23Minnesota's mental health system with the goal of improving the availability, quality, and
299.24accountability of mental health care within the state.
299.25    Subd. 2. General provisions. (a) In the design and implementation of reforms to
299.26the mental health system, the commissioner shall:
299.27    (1) consult with consumers, families, counties, tribes, advocates, providers, and
299.28other stakeholders;
299.29    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
299.30January 15, 2008, recommendations for legislation to update the role of counties and to
299.31clarify the case management roles, functions, and decision-making authority of health
299.32plans and counties, and to clarify county retention of the responsibility for the delivery of
299.33social services as required under subdivision 3, paragraph (a);
300.1    (3) withhold implementation of any recommended changes in case management
300.2roles, functions, and decision-making authority until after the release of the report due
300.3January 15, 2008;
300.4    (4) ensure continuity of care for persons affected by these reforms including
300.5ensuring client choice of provider by requiring broad provider networks and developing
300.6mechanisms to facilitate a smooth transition of service responsibilities;
300.7    (5) provide accountability for the efficient and effective use of public and private
300.8resources in achieving positive outcomes for consumers;
300.9    (6) ensure client access to applicable protections and appeals; and
300.10    (7) make budget transfers necessary to implement the reallocation of services and
300.11client responsibilities between counties and health care programs that do not increase the
300.12state and county costs and efficiently allocate state funds.
300.13    (b) When making transfers under paragraph (a) necessary to implement movement
300.14of responsibility for clients and services between counties and health care programs,
300.15the commissioner, in consultation with counties, shall ensure that any transfer of state
300.16grants to health care programs, including the value of case management transfer grants
300.17under section 256B.0625, subdivision 20, does not exceed the value of the services being
300.18transferred for the latest 12-month period for which data is available. The commissioner
300.19may make quarterly adjustments based on the availability of additional data during the
300.20first four quarters after the transfers first occur. If case management transfer grants under
300.21section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
300.22to repeal, exceeds the value of the services being transferred, the difference becomes an
300.23ongoing part of each county's adult and children's mental health grants under sections
300.24245.4661, 245.4889, and 256E.12.
300.25    (c) This appropriation is not authorized to be expended after December 31, 2010,
300.26unless approved by the legislature.
300.27    Subd. 3. Projects for coordination of care. (a) Consistent with section 256B.69
300.28and chapters 256D and 256L, the commissioner is authorized to solicit, approve, and
300.29implement up to three projects to demonstrate the integration of physical and mental
300.30health services within prepaid health plans and their coordination with social services.
300.31The commissioner shall require that each project be based on locally defined partnerships
300.32that include at least one health maintenance organization, community integrated service
300.33network, or accountable provider network authorized and operating under chapter 62D,
300.3462N, or 62T, or county-based purchasing entity under section 256B.692 that is eligible to
300.35contract with the commissioner as a prepaid health plan, and the county or counties within
301.1the service area. Counties shall retain responsibility and authority for social services in
301.2these locally defined partnerships.
301.3    (b) The commissioner, in consultation with consumers, families, and their
301.4representatives, shall:
301.5    (1) determine criteria for approving the projects and use those criteria to solicit
301.6proposals for preferred integrated networks. The commissioner must develop criteria to
301.7evaluate the partnership proposed by the county and prepaid health plan to coordinate
301.8access and delivery of services. The proposal must at a minimum address how the
301.9partnership will coordinate the provision of:
301.10    (i) client outreach and identification of health and social service needs paired with
301.11expedited access to appropriate resources;
301.12    (ii) activities to maintain continuity of health care coverage;
301.13    (iii) children's residential mental health treatment and treatment foster care;
301.14    (iv) court-ordered assessments and treatments;
301.15    (v) prepetition screening and commitments under chapter 253B;
301.16    (vi) assessment and treatment of children identified through mental health screening
301.17of child welfare and juvenile corrections cases;
301.18    (vii) home and community-based waiver services;
301.19    (viii) assistance with finding and maintaining employment;
301.20    (ix) housing; and
301.21    (x) transportation;
301.22    (2) determine specifications for contracts with prepaid health plans to improve the
301.23plan's ability to serve persons with mental health conditions, including specifications
301.24addressing:
301.25    (i) early identification and intervention of physical and behavioral health problems;
301.26    (ii) communication between the enrollee and the health plan;
301.27    (iii) facilitation of enrollment for persons who are also eligible for a Medicare
301.28special needs plan offered by the health plan;
301.29    (iv) risk screening procedures;
301.30    (v) health care coordination;
301.31    (vi) member services and access to applicable protections and appeal processes;
301.32    (vii) specialty provider networks;
301.33    (viii) transportation services;
301.34    (ix) treatment planning; and
301.35    (x) administrative simplification for providers;
302.1    (3) begin implementation of the projects no earlier than January 1, 2009, with not
302.2more than 40 percent of the statewide population included during calendar year 2009 and
302.3additional counties included in subsequent years;
302.4    (4) waive any administrative rule not consistent with the implementation of the
302.5projects;
302.6    (5) allow potential bidders at least 90 days to respond to the request for proposals;
302.7and
302.8    (6) conduct an independent evaluation to determine if mental health outcomes have
302.9improved in that county or counties according to measurable standards designed in
302.10consultation with the advisory body established under this subdivision and reviewed by
302.11the State Advisory Council on Mental Health.
302.12    (c) Notwithstanding any statute or administrative rule to the contrary, the
302.13commissioner may enroll all persons eligible for medical assistance with serious mental
302.14illness or emotional disturbance in the prepaid plan of their choice within the project
302.15service area unless:
302.16    (1) the individual is eligible for home and community-based services for persons
302.17with developmental disabilities and related conditions under section 256B.092; or
302.18    (2) the individual has a basis for exclusion from the prepaid plan under section
302.19256B.69, subdivision 4, other than disability, mental illness, or emotional disturbance.
302.20    (d) The commissioner shall involve organizations representing persons with mental
302.21illness and their families in the development and distribution of information used to
302.22educate potential enrollees regarding their options for health care and mental health
302.23service delivery under this subdivision.
302.24    (e) If the person described in paragraph (c) does not elect to remain in fee-for-service
302.25medical assistance, or declines to choose a plan, the commissioner may preferentially
302.26assign that person to the prepaid plan participating in the preferred integrated network.
302.27The commissioner shall implement the enrollment changes within a project's service area
302.28on the timeline specified in that project's approved application.
302.29    (f) A person enrolled in a prepaid health plan under paragraphs (c) and (d) may
302.30disenroll from the plan at any time.
302.31    (g) The commissioner, in consultation with consumers, families, and their
302.32representatives, shall evaluate the projects begun in 2009, and shall refine the design of the
302.33service integration projects before expanding the projects. The commissioner shall report
302.34to the chairs of the legislative committees with jurisdiction over mental health services
302.35by March 1, 2008, on plans for evaluation of preferred integrated networks established
302.36under this subdivision.
303.1    (h) The commissioner shall apply for any federal waivers necessary to implement
303.2these changes.
303.3    (i) Payment for Medicaid service providers under this subdivision for the months of
303.4May and June will be made no earlier than July 1 of the same calendar year.

303.5    Sec. 6. Minnesota Statutes 2006, section 245.4712, subdivision 1, is amended to read:
303.6    Subdivision 1. Availability of community support services. (a) County boards
303.7must provide or contract for sufficient community support services within the county to
303.8meet the needs of adults with serious and persistent mental illness who are residents of the
303.9county. Adults may be required to pay a fee according to section 245.481. The community
303.10support services program must be designed to improve the ability of adults with serious
303.11and persistent mental illness to:
303.12    (1) work in a regular or supported work environment;
303.13    (2) handle basic activities of daily living;
303.14    (3) participate in leisure time activities;
303.15    (4) set goals and plans; and
303.16    (5) obtain and maintain appropriate living arrangements.
303.17    The community support services program must also be designed to reduce the
303.18need for and use of more intensive, costly, or restrictive placements both in number of
303.19admissions and length of stay.
303.20    (b) Community support services are those services that are supportive in nature and
303.21not necessarily treatment oriented, and include:
303.22    (1) conducting outreach activities such as home visits, health and wellness checks,
303.23and problem solving;
303.24    (2) connecting people to resources to meet their basic needs;
303.25    (3) finding, securing, and supporting people in their housing;
303.26    (4) attaining and maintaining health insurance benefits;
303.27    (5) assisting with job applications, finding and maintaining employment, and
303.28securing a stable financial situation;
303.29    (6) fostering social support, including support groups, mentoring, peer support, and
303.30other efforts to prevent isolation and promote recovery; and
303.31    (7) educating about mental illness, treatment, and recovery.
303.32    (c) Community support services shall use all available funding streams. The county
303.33shall maintain the level of expenditures for this program, as required under section
303.34245.4835. County boards must continue to provide funds for those services not covered
303.35by other funding streams and to maintain an infrastructure to carry out these services.
304.1    (d) The commissioner shall collect data on community support services programs,
304.2including, but not limited to, demographic information such as age, sex, race, the number
304.3of people served, and information related to housing, employment, hospitalization,
304.4symptoms, and satisfaction with services.

304.5    Sec. 7. Minnesota Statutes 2006, section 245.4874, is amended to read:
304.6245.4874 DUTIES OF COUNTY BOARD.
304.7    Subdivision 1. Duties of the county board. (a) The county board must:
304.8    (1) develop a system of affordable and locally available children's mental health
304.9services according to sections 245.487 to 245.4887;
304.10    (2) establish a mechanism providing for interagency coordination as specified in
304.11section 245.4875, subdivision 6;
304.12    (3) consider the assessment of unmet needs in the county as reported by the local
304.13children's mental health advisory council under section 245.4875, subdivision 5, paragraph
304.14(b), clause (3). The county shall provide, upon request of the local children's mental health
304.15advisory council, readily available data to assist in the determination of unmet needs;
304.16    (4) assure that parents and providers in the county receive information about how to
304.17gain access to services provided according to sections 245.487 to 245.4887;
304.18    (5) coordinate the delivery of children's mental health services with services
304.19provided by social services, education, corrections, health, and vocational agencies to
304.20improve the availability of mental health services to children and the cost-effectiveness of
304.21their delivery;
304.22    (6) assure that mental health services delivered according to sections 245.487
304.23to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
304.24assessment and individual treatment plan;
304.25    (7) provide the community with information about predictors and symptoms of
304.26emotional disturbances and how to access children's mental health services according to
304.27sections 245.4877 and 245.4878;
304.28    (8) provide for case management services to each child with severe emotional
304.29disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
304.30subdivisions 1, 3, and 5 ;
304.31    (9) provide for screening of each child under section 245.4885 upon admission
304.32to a residential treatment facility, acute care hospital inpatient treatment, or informal
304.33admission to a regional treatment center;
305.1    (10) prudently administer grants and purchase-of-service contracts that the county
305.2board determines are necessary to fulfill its responsibilities under sections 245.487 to
305.3245.4887 ;
305.4    (11) assure that mental health professionals, mental health practitioners, and case
305.5managers employed by or under contract to the county to provide mental health services
305.6are qualified under section 245.4871;
305.7    (12) assure that children's mental health services are coordinated with adult mental
305.8health services specified in sections 245.461 to 245.486 so that a continuum of mental
305.9health services is available to serve persons with mental illness, regardless of the person's
305.10age;
305.11    (13) assure that culturally informed competent mental health consultants are used as
305.12necessary to assist the county board in assessing and providing appropriate treatment for
305.13children of cultural or racial minority heritage; and
305.14    (14) consistent with section 245.486, arrange for or provide a children's mental
305.15health screening to a child receiving child protective services or a child in out-of-home
305.16placement, a child for whom parental rights have been terminated, a child found to be
305.17delinquent, and a child found to have committed a juvenile petty offense for the third or
305.18subsequent time, unless a screening has been performed within the previous 180 days, or
305.19the child is currently under the care of a mental health professional. The court or county
305.20agency must notify a parent or guardian whose parental rights have not been terminated of
305.21the potential mental health screening and the option to prevent the screening by notifying
305.22the court or county agency in writing. The screening shall be conducted with a screening
305.23instrument approved by the commissioner of human services according to criteria that
305.24are updated and issued annually to ensure that approved screening instruments are valid
305.25and useful for child welfare and juvenile justice populations, and shall be conducted
305.26by a mental health practitioner as defined in section 245.4871, subdivision 26, or a
305.27probation officer or local social services agency staff person who is trained in the use of
305.28the screening instrument. Training in the use of the instrument shall include training in the
305.29administration of the instrument, the interpretation of its validity given the child's current
305.30circumstances, the state and federal data practices laws and confidentiality standards, the
305.31parental consent requirement, and providing respect for families and cultural values.
305.32If the screen indicates a need for assessment, the child's family, or if the family lacks
305.33mental health insurance, the local social services agency, in consultation with the child's
305.34family, shall have conducted a diagnostic assessment, including a functional assessment,
305.35as defined in section 245.4871. The administration of the screening shall safeguard the
305.36privacy of children receiving the screening and their families and shall comply with the
306.1Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance
306.2Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be
306.3considered private data and the commissioner shall not collect individual screening results.
306.4    (b) When the county board refers clients to providers of children's therapeutic
306.5services and supports under section 256B.0943, the county board must clearly identify
306.6the desired services components not covered under section 256B.0943 and identify the
306.7reimbursement source for those requested services, the method of payment, and the
306.8payment rate to the provider.
306.9    Subd. 2. Responsibility not duplicated. For individuals who have health care
306.10coverage, the county board is not responsible for providing mental health services which
306.11are within the limits of the individual's health care coverage.

306.12    Sec. 8. [245.4889] CHILDREN'S MENTAL HEALTH GRANTS.
306.13    Subdivision 1. Establishment and authority. (a) The commissioner is authorized
306.14to make grants from available appropriations to assist:
306.15    (1) counties;
306.16    (2) Indian tribes;
306.17    (3) children's collaboratives under section 124D.23 or 245.493; or
306.18    (4) mental health service providers
306.19for providing services to children with emotional disturbances as defined in section
306.20245.4871, subdivision 15, and their families. The commissioner may also authorize
306.21grants to young adults meeting the criteria for transition services in section 245.4875,
306.22subdivision 8, and their families.
306.23    (b) Services under paragraph (a) must be designed to help each child to function and
306.24remain with the child's family in the community and delivered consistent with the child's
306.25treatment plan. Transition services to eligible young adults under paragraph (a) must be
306.26designed to foster independent living in the community.
306.27    Subd. 2. Grant application and reporting requirements. To apply for a grant,
306.28an applicant organization shall submit an application and budget for the use of the
306.29money in the form specified by the commissioner. The commissioner shall make grants
306.30only to entities whose applications and budgets are approved by the commissioner. In
306.31awarding grants, the commissioner shall give priority to applications that indicate plans
306.32to collaborate in the development, funding, and delivery of services with other agencies
306.33in the local system of care. The commissioner shall specify requirements for reports,
306.34including quarterly fiscal reports under section 256.01, subdivision 2, paragraph (q). The
307.1commissioner shall require collection of data and periodic reports that the commissioner
307.2deems necessary to demonstrate the effectiveness of each service.

307.3    Sec. 9. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:
307.4    Subd. 5. Special contracts; bordering states. (a) An individual who is detained,
307.5committed, or placed on an involuntary basis under chapter 253B may be confined or
307.6treated in a bordering state pursuant to a contract under this section. An individual who is
307.7detained, committed, or placed on an involuntary basis under the civil law of a bordering
307.8state may be confined or treated in Minnesota pursuant to a contract under this section. A
307.9peace or health officer who is acting under the authority of the sending state may transport
307.10an individual to a receiving agency that provides services pursuant to a contract under
307.11this section and may transport the individual back to the sending state under the laws
307.12of the sending state. Court orders valid under the law of the sending state are granted
307.13recognition and reciprocity in the receiving state for individuals covered by a contract
307.14under this section to the extent that the court orders relate to confinement for treatment
307.15or care of mental illness or chemical dependency. Such treatment or care may address
307.16other conditions that may be co-occurring with the mental illness or chemical dependency.
307.17These court orders are not subject to legal challenge in the courts of the receiving state.
307.18Individuals who are detained, committed, or placed under the law of a sending state and
307.19who are transferred to a receiving state under this section continue to be in the legal
307.20custody of the authority responsible for them under the law of the sending state. Except
307.21in emergencies, those individuals may not be transferred, removed, or furloughed from
307.22a receiving agency without the specific approval of the authority responsible for them
307.23under the law of the sending state.
307.24    (b) While in the receiving state pursuant to a contract under this section, an
307.25individual shall be subject to the sending state's laws and rules relating to length of
307.26confinement, reexaminations, and extensions of confinement. No individual may be sent
307.27to another state pursuant to a contract under this section until the receiving state has
307.28enacted a law recognizing the validity and applicability of this section.
307.29    (c) If an individual receiving services pursuant to a contract under this section leaves
307.30the receiving agency without permission and the individual is subject to involuntary
307.31confinement under the law of the sending state, the receiving agency shall use all
307.32reasonable means to return the individual to the receiving agency. The receiving agency
307.33shall immediately report the absence to the sending agency. The receiving state has the
307.34primary responsibility for, and the authority to direct, the return of these individuals
308.1within its borders and is liable for the cost of the action to the extent that it would be
308.2liable for costs of its own resident.
308.3    (d) Responsibility for payment for the cost of care remains with the sending agency.
308.4    (e) This subdivision also applies to county contracts under subdivision 2 which
308.5include emergency care and treatment provided to a county resident in a bordering state.
308.6    (f) If a Minnesota resident is admitted to a facility in a bordering state under this
308.7chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or
308.8an advance practice registered nurse certified in mental health, who is licensed in the
308.9bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092,
308.10253B.12, and 253B.17 subject to the same requirements and limitations in section
308.11253B.02, subdivision 7.

308.12    Sec. 10. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:
308.13    Subd. 2. Program. The commissioner of human services shall establish a program
308.14for the treatment of compulsive gamblers. The commissioner may contract with an
308.15entity with expertise regarding the treatment of compulsive gambling to operate the
308.16program. The program may include the establishment of a statewide toll-free number,
308.17resource library, public education programs; regional in-service training programs and
308.18conferences for health care professionals, educators, treatment providers, employee
308.19assistance programs, and criminal justice representatives; and the establishment of
308.20certification standards for programs and service providers. The commissioner may enter
308.21into agreements with other entities and may employ or contract with consultants to
308.22facilitate the provision of these services or the training of individuals to qualify them to
308.23provide these services. The program may also include inpatient and outpatient treatment
308.24and rehabilitation services and for residents in different settings, including a temporary or
308.25permanent residential setting for mental health or chemical dependency, and individuals
308.26in jails or correctional facilities. The program may also include research studies. The
308.27research studies must include baseline and prevalence studies for adolescents and adults to
308.28identify those at the highest risk. The program must be approved by the commissioner
308.29before it is established.

308.30    Sec. 11. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.
308.31    Prior to a nonemergency placement of a child in a foster care home, the child
308.32foster care provider, licensed after July 1, 2007, must complete two hours of training
308.33that addresses the causes, symptoms, and key warning signs of mental health disorders;
308.34cultural considerations; and effective approaches for dealing with a child's behaviors. At
309.1least one hour of the annual 12-hour training requirement for foster parents must be on
309.2children's mental health issues and treatment. Training curriculum shall be approved
309.3by the commissioner of human services.

309.4    Sec. 12. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:
309.5    Subdivision 1. County portion for cost of care. (a) Except for chemical
309.6dependency services provided under sections 254B.01 to 254B.09, the client's county
309.7shall pay to the state of Minnesota a portion of the cost of care provided in a regional
309.8treatment center or a state nursing facility to a client legally settled in that county. A
309.9county's payment shall be made from the county's own sources of revenue and payments
309.10shall be paid as follows: payments to the state from the county shall equal 20 percent a
309.11percentage of the cost of care, as determined by the commissioner, for each day, or the
309.12portion thereof, that the client spends at a regional treatment center or a state nursing
309.13facility. according to the following schedule:
309.14    (1) zero percent for the first 30 days;
309.15    (2) 20 percent for days 31 to 60; and
309.16    (3) 50 percent for any days over 60.
309.17    (b) The increase in the county portion for cost of care under paragraph (a), clause
309.18(3), shall be imposed when the treatment facility has determined that it is clinically
309.19appropriate for the client to be discharged.
309.20     (c) If payments received by the state under sections 246.50 to 246.53 exceed 80
309.21percent of the cost of care for days 31 to 60, or 50 percent for days over 60, the county
309.22shall be responsible for paying the state only the remaining amount. The county shall
309.23not be entitled to reimbursement from the client, the client's estate, or from the client's
309.24relatives, except as provided in section 246.53. No such payments shall be made for any
309.25client who was last committed prior to July 1, 1947.
309.26EFFECTIVE DATE.This section is effective January 1, 2008.

309.27    Sec. 13. Minnesota Statutes 2006, section 246.54, subdivision 2, is amended to read:
309.28    Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
309.29Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota
309.30extended treatment options program. For services at these facilities, a county's payment
309.31shall be made from the county's own sources of revenue and payments shall be paid as
309.32follows: payments to the state from the county shall equal ten percent of the cost of care,
309.33as determined by the commissioner, for each day, or the portion thereof, that the client
309.34spends at the facility. If payments received by the state under sections 246.50 to 246.53
310.1exceed 90 percent of the cost of care, the county shall be responsible for paying the state
310.2only the remaining amount. The county shall not be entitled to reimbursement from the
310.3client, the client's estate, or from the client's relatives, except as provided in section 246.53.
310.4    (b) Regardless of the facility to which the client is committed, subdivision 1 does not
310.5apply to the following individuals:
310.6    (1) clients who are committed as mentally ill and dangerous under section 253B.02,
310.7subdivision 17;
310.8    (2) clients who are committed as sexual psychopathic personalities under section
310.9253B.02, subdivision 18b; and
310.10    (3) clients who are committed as sexually dangerous persons under section 253B.02,
310.11subdivision 18c.
310.12    For each of the individuals in clauses (1) to (3), the payment by the county to the state
310.13shall equal ten percent of the cost of care for each day as determined by the commissioner.

310.14    Sec. 14. Minnesota Statutes 2006, section 253B.185, is amended by adding a
310.15subdivision to read:
310.16    Subd. 8. Petition and report required. (a) Within 120 days of receipt of a
310.17preliminary determination from a court under section 609.1351, or a referral from the
310.18commissioner of corrections pursuant to section 244.05, subdivision 7, a county attorney
310.19shall determine whether good cause under this section exists to file a petition, and if good
310.20cause exists, the county attorney or designee shall file the petition with the court.
310.21    (b) Failure to meet the requirements of paragraph (a) does not bar filing a petition
310.22under subdivision 1 any time the county attorney determines pursuant to subdivision 1
310.23that good cause for such a petition exists.
310.24    (c) By February 1 of each year, the commissioner of human services shall annually
310.25report to the respective chairs of the divisions or committees of the senate and house
310.26of representatives that oversee human services finance regarding compliance with this
310.27subdivision.

310.28    Sec. 15. [254A.25] DUTIES OF COMMISSIONER RELATED TO CHEMICAL
310.29HEALTH.
310.30    The commissioner shall:
310.31    (1) annually distribute information to chemical health assessors on best practices in
310.32assessments, including model instruments for adults and adolescents;
310.33    (2) monitor the compliance of local agencies with assessment and referral rules;
311.1    (3) develop a directory that identifies key characteristics of each licensed chemical
311.2dependency treatment program;
311.3    (4) work with the commissioner of health to develop guidelines and training
311.4materials for health care organizations on the use of brief interventions for alcohol and
311.5chemical substance abuse;
311.6    (5) provide local agencies with examples of best practices for addressing needs of
311.7persons being considered for repeat placements into publicly funded treatment;
311.8    (6) identify best practices to help local agencies monitor the progress of clients
311.9placed in treatment;
311.10    (7) periodically provide local agencies with statewide information on treatment
311.11outcomes; and
311.12    (8) post copies of state licensing reviews at an online location where they may be
311.13reviewed by agencies that make client placements.

311.14    Sec. 16. [256B.0615] MENTAL HEALTH CERTIFIED PEER SPECIALIST.
311.15    Subdivision 1. Scope. Medical assistance covers mental health certified peers
311.16specialists services, as established in subdivision 2, subject to federal approval, if provided
311.17to recipients who are eligible for services under sections 256B.0622 and 256B.0623,
311.18and are provided by a certified peer specialist who has completed the training under
311.19subdivision 5.
311.20    Subd. 2. Establishment. The commissioner of human services shall establish a
311.21certified peer specialists program model, which:
311.22    (1) provides nonclinical peer support counseling by certified peer specialists;
311.23    (2) provides a part of a wraparound continuum of services in conjunction with
311.24other community mental health services;
311.25    (3) is individualized to the consumer; and
311.26    (4) promotes socialization, recovery, self-sufficiency, self-advocacy, development of
311.27natural supports, and maintenance of skills learned in other support services.
311.28    Subd. 3. Eligibility. Peer support services may be made available to consumers
311.29of the intensive rehabilitative mental health services under section 256B.0622 and adult
311.30rehabilitative mental health services under section 256B.0623.
311.31    Subd. 4. Peer support specialist program providers. The commissioner shall
311.32develop a process to certify peer support specialist programs, in accordance with the
311.33federal guidelines, in order for the program to bill for reimbursable services. Peer support
311.34programs may be freestanding or within existing mental health community provider
311.35centers.
312.1    Subd. 5. Certified peer specialist training and certification. The commissioner
312.2of human services shall develop a training and certification process for certified peer
312.3specialists, who must be at least 21 years of age and have a high school diploma or its
312.4equivalent. The candidates must have had a primary diagnosis of mental illness, be a
312.5current or former consumer of mental health services, and must demonstrate leadership
312.6and advocacy skills and a strong dedication to recovery. The training curriculum must
312.7teach participating consumers specific skills relevant to providing peer support to other
312.8consumers. In addition to initial training and certification, the commissioner shall develop
312.9ongoing continuing educational workshops on pertinent issues related to peer support
312.10counseling.

312.11    Sec. 17. Minnesota Statutes 2006, section 256B.0622, subdivision 2, is amended to
312.12read:
312.13    Subd. 2. Definitions. For purposes of this section, the following terms have the
312.14meanings given them.
312.15    (a) "Intensive nonresidential rehabilitative mental health services" means adult
312.16rehabilitative mental health services as defined in section 256B.0623, subdivision 2,
312.17paragraph (a), except that these services are provided by a multidisciplinary staff using
312.18a total team approach consistent with assertive community treatment, the Fairweather
312.19Lodge treatment model, as defined by the standards established by the National Coalition
312.20for Community Living, and other evidence-based practices, and directed to recipients with
312.21a serious mental illness who require intensive services.
312.22    (b) "Intensive residential rehabilitative mental health services" means short-term,
312.23time-limited services provided in a residential setting to recipients who are in need of
312.24more restrictive settings and are at risk of significant functional deterioration if they do
312.25not receive these services. Services are designed to develop and enhance psychiatric
312.26stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more
312.27independent setting. Services must be directed toward a targeted discharge date with
312.28specified client outcomes and must be consistent with the Fairweather Lodge treatment
312.29model as defined in paragraph (a), and other evidence-based practices.
312.30    (c) "Evidence-based practices" are nationally recognized mental health services that
312.31are proven by substantial research to be effective in helping individuals with serious
312.32mental illness obtain specific treatment goals.
312.33    (d) "Overnight staff" means a member of the intensive residential rehabilitative
312.34mental health treatment team who is responsible during hours when recipients are
312.35typically asleep.
313.1    (e) "Treatment team" means all staff who provide services under this section
313.2to recipients. At a minimum, this includes the clinical supervisor, mental health
313.3professionals, as defined in section 245.462, subdivision 18, clauses (1) to (5); mental
313.4health practitioners, and as defined in section 245.462, subdivision 17; mental health
313.5rehabilitation workers under section 256B.0623, subdivision 5, clause (3); and certified
313.6peer specialists under section 256B.0615.

313.7    Sec. 18. Minnesota Statutes 2006, section 256B.0623, subdivision 5, is amended to
313.8read:
313.9    Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health
313.10services must be provided by qualified individual provider staff of a certified provider
313.11entity. Individual provider staff must be qualified under one of the following criteria:
313.12    (1) a mental health professional as defined in section 245.462, subdivision 18,
313.13clauses (1) to (5). If the recipient has a current diagnostic assessment by a licensed
313.14mental health professional as defined in section 245.462, subdivision 18, clauses (1) to
313.15(5), recommending receipt of adult mental health rehabilitative services, the definition of
313.16mental health professional for purposes of this section includes a person who is qualified
313.17under section 245.462, subdivision 18, clause (6), and who holds a current and valid
313.18national certification as a certified rehabilitation counselor or certified psychosocial
313.19rehabilitation practitioner;
313.20    (2) a mental health practitioner as defined in section 245.462, subdivision 17. The
313.21mental health practitioner must work under the clinical supervision of a mental health
313.22professional; or
313.23    (3) a certified peer specialist under section 256B.0615. The certified peer specialist
313.24must work under the clinical supervision of a mental health professional; or
313.25    (3) (4) a mental health rehabilitation worker. A mental health rehabilitation worker
313.26means a staff person working under the direction of a mental health practitioner or mental
313.27health professional and under the clinical supervision of a mental health professional in
313.28the implementation of rehabilitative mental health services as identified in the recipient's
313.29individual treatment plan who:
313.30    (i) is at least 21 years of age;
313.31    (ii) has a high school diploma or equivalent;
313.32    (iii) has successfully completed 30 hours of training during the past two years in all
313.33of the following areas: recipient rights, recipient-centered individual treatment planning,
313.34behavioral terminology, mental illness, co-occurring mental illness and substance abuse,
314.1psychotropic medications and side effects, functional assessment, local community
314.2resources, adult vulnerability, recipient confidentiality; and
314.3    (iv) meets the qualifications in subitem (A) or (B):
314.4    (A) has an associate of arts degree in one of the behavioral sciences or human
314.5services, or is a registered nurse without a bachelor's degree, or who within the previous
314.6ten years has:
314.7    (1) three years of personal life experience with serious and persistent mental illness;
314.8    (2) three years of life experience as a primary caregiver to an adult with a serious
314.9mental illness or traumatic brain injury; or
314.10    (3) 4,000 hours of supervised paid work experience in the delivery of mental health
314.11services to adults with a serious mental illness or traumatic brain injury; or
314.12    (B)(1) is fluent in the non-English language or competent in the culture of the
314.13ethnic group to which at least 20 percent of the mental health rehabilitation worker's
314.14clients belong;
314.15    (2) receives during the first 2,000 hours of work, monthly documented individual
314.16clinical supervision by a mental health professional;
314.17    (3) has 18 hours of documented field supervision by a mental health professional
314.18or practitioner during the first 160 hours of contact work with recipients, and at least six
314.19hours of field supervision quarterly during the following year;
314.20    (4) has review and cosignature of charting of recipient contacts during field
314.21supervision by a mental health professional or practitioner; and
314.22    (5) has 40 hours of additional continuing education on mental health topics during
314.23the first year of employment.

314.24    Sec. 19. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
314.25subdivision to read:
314.26    Subd. 5l. Intensive mental health outpatient treatment. Medical assistance
314.27covers intensive mental health outpatient treatment for dialectical behavioral therapy for
314.28adults. The commissioner shall establish:
314.29    (1) certification procedures to ensure that providers of these services are qualified;
314.30and
314.31    (2) treatment protocols including required service components and criteria for
314.32admission, continued treatment, and discharge.
314.33EFFECTIVE DATE.This section is effective July 1, 2008, and subject to federal
314.34approval. The commissioner shall notify the revisor of statutes when federal approval is
314.35obtained.

315.1    Sec. 20. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to
315.2read:
315.3    Subd. 20. Mental health case management. (a) To the extent authorized by rule
315.4of the state agency, medical assistance covers case management services to persons with
315.5serious and persistent mental illness and children with severe emotional disturbance.
315.6Services provided under this section must meet the relevant standards in sections 245.461
315.7to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
315.8Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
315.9    (b) Entities meeting program standards set out in rules governing family community
315.10support services as defined in section 245.4871, subdivision 17, are eligible for medical
315.11assistance reimbursement for case management services for children with severe
315.12emotional disturbance when these services meet the program standards in Minnesota
315.13Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
315.14    (c) Medical assistance and MinnesotaCare payment for mental health case
315.15management shall be made on a monthly basis. In order to receive payment for an eligible
315.16child, the provider must document at least a face-to-face contact with the child, the child's
315.17parents, or the child's legal representative. To receive payment for an eligible adult, the
315.18provider must document:
315.19    (1) at least a face-to-face contact with the adult or the adult's legal representative; or
315.20    (2) at least a telephone contact with the adult or the adult's legal representative and
315.21document a face-to-face contact with the adult or the adult's legal representative within
315.22the preceding two months.
315.23    (d) Payment for mental health case management provided by county or state staff
315.24shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
315.25paragraph (b), with separate rates calculated for child welfare and mental health, and
315.26within mental health, separate rates for children and adults.
315.27    (e) Payment for mental health case management provided by Indian health services
315.28or by agencies operated by Indian tribes may be made according to this section or other
315.29relevant federally approved rate setting methodology.
315.30    (f) Payment for mental health case management provided by vendors who contract
315.31with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
315.32or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
315.33service to other payers. If the service is provided by a team of contracted vendors, the
315.34county or tribe may negotiate a team rate with a vendor who is a member of the team. The
315.35team shall determine how to distribute the rate among its members. No reimbursement
316.1received by contracted vendors shall be returned to the county or tribe, except to reimburse
316.2the county or tribe for advance funding provided by the county or tribe to the vendor.
316.3    (g) If the service is provided by a team which includes contracted vendors, tribal
316.4staff, and county or state staff, the costs for county or state staff participation in the team
316.5shall be included in the rate for county-provided services. In this case, the contracted
316.6vendor, the tribal agency, and the county may each receive separate payment for services
316.7provided by each entity in the same month. In order to prevent duplication of services,
316.8each entity must document, in the recipient's file, the need for team case management and
316.9a description of the roles of the team members.
316.10    (h) The commissioner shall calculate the nonfederal share of actual medical
316.11assistance and general assistance medical care payments for each county, based on the
316.12higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999,
316.13and transfer one-half of the result from medical assistance and general assistance medical
316.14care to each county's mental health grants under section 256E.12 for calendar year 1999.
316.15The annualized minimum amount added to each county's mental health grant shall be
316.16$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce
316.17the statewide growth factor in order to fund these minimums. The annualized total amount
316.18transferred shall become part of the base for future mental health grants for each county.
316.19    (i) (h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of
316.20costs for mental health case management shall be provided by the recipient's county of
316.21responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
316.22funds or funds used to match other federal funds. If the service is provided by a tribal
316.23agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this
316.24service is paid by the state without a federal share through fee-for-service, 50 percent of
316.25the cost shall be provided by the recipient's county of responsibility.
316.26    (i) Notwithstanding any administrative rule to the contrary, prepaid medical
316.27assistance, general assistance medical care, and MinnesotaCare include mental health case
316.28management. When the service is provided through prepaid capitation, the nonfederal
316.29share is paid by the state and the county pays no share.
316.30    (j) The commissioner may suspend, reduce, or terminate the reimbursement to a
316.31provider that does not meet the reporting or other requirements of this section. The county
316.32of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal
316.33agency, is responsible for any federal disallowances. The county or tribe may share this
316.34responsibility with its contracted vendors.
317.1    (k) The commissioner shall set aside a portion of the federal funds earned for county
317.2expenditures under this section to repay the special revenue maximization account under
317.3section 256.01, subdivision 2, clause (15). The repayment is limited to:
317.4    (1) the costs of developing and implementing this section; and
317.5    (2) programming the information systems.
317.6    (l) Payments to counties and tribal agencies for case management expenditures
317.7under this section shall only be made from federal earnings from services provided
317.8under this section. When this service is paid by the state without a federal share through
317.9fee-for-service, 50 percent of the cost shall be provided by the state. Payments to
317.10county-contracted vendors shall include both the federal earnings, the state share, and the
317.11county share.
317.12    (m) Notwithstanding section 256B.041, county payments for the cost of mental
317.13health case management services provided by county or state staff shall not be made
317.14to the commissioner of finance. For the purposes of mental health case management
317.15services provided by county or state staff under this section, the centralized disbursement
317.16of payments to counties under section 256B.041 consists only of federal earnings from
317.17services provided under this section.
317.18    (n) (m) Case management services under this subdivision do not include therapy,
317.19treatment, legal, or outreach services.
317.20    (o) (n) If the recipient is a resident of a nursing facility, intermediate care facility,
317.21or hospital, and the recipient's institutional care is paid by medical assistance, payment
317.22for case management services under this subdivision is limited to the last 180 days of
317.23the recipient's residency in that facility and may not exceed more than six months in a
317.24calendar year.
317.25    (p) (o) Payment for case management services under this subdivision shall not
317.26duplicate payments made under other program authorities for the same purpose.
317.27    (q) By July 1, 2000, the commissioner shall evaluate the effectiveness of the changes
317.28required by this section, including changes in number of persons receiving mental health
317.29case management, changes in hours of service per person, and changes in caseload size.
317.30    (r) For each calendar year beginning with the calendar year 2001, the annualized
317.31amount of state funds for each county determined under paragraph (h) shall be adjusted by
317.32the county's percentage change in the average number of clients per month who received
317.33case management under this section during the fiscal year that ended six months prior to
317.34the calendar year in question, in comparison to the prior fiscal year.
318.1    (s) For counties receiving the minimum allocation of $3,000 or $5,000 described
318.2in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county
318.3receives the higher of the following amounts:
318.4    (1) a continuation of the minimum allocation in paragraph (h); or
318.5    (2) an amount based on that county's average number of clients per month who
318.6received case management under this section during the fiscal year that ended six months
318.7prior to the calendar year in question, times the average statewide grant per person per
318.8month for counties not receiving the minimum allocation.
318.9    (t) The adjustments in paragraphs (s) and (t) shall be calculated separately for
318.10children and adults.
318.11EFFECTIVE DATE.This section is effective January 1, 2009, except the
318.12amendments to paragraphs (h), (r), (s), and (t) are effective January 1, 2008.

318.13    Sec. 21. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to
318.14read:
318.15    Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject
318.16to federal approval, medical assistance covers treatment foster care services according to
318.17section 256B.0946.

318.18    Sec. 22. Minnesota Statutes 2006, section 256B.0943, subdivision 8, is amended to
318.19read:
318.20    Subd. 8. Required preservice and continuing education. (a) A provider entity
318.21shall establish a plan to provide preservice and continuing education for staff. The plan
318.22must clearly describe the type of training necessary to maintain current skills and obtain
318.23new skills and that relates to the provider entity's goals and objectives for services offered.
318.24    (b) A provider that employs a mental health behavioral aide under this section must
318.25require the mental health behavioral aide to complete 30 hours of preservice training. The
318.26preservice training must include topics specified in Minnesota Rules, part 9535.4068,
318.27subparts 1 and 2, and parent team training. The preservice training must include 15 hours
318.28of in-person training of a mental health behavioral aide in mental health services delivery
318.29and eight hours of parent team training. Curricula for parent team training must be
318.30approved in advance by the commissioner. Components of parent team training include:
318.31    (1) partnering with parents;
318.32    (2) fundamentals of family support;
318.33    (3) fundamentals of policy and decision making;
318.34    (4) defining equal partnership;
319.1    (5) complexities of the parent and service provider partnership in multiple service
319.2delivery systems due to system strengths and weaknesses;
319.3    (6) sibling impacts;
319.4    (7) support networks; and
319.5    (8) community resources.
319.6    (c) A provider entity that employs a mental health practitioner and a mental health
319.7behavioral aide to provide children's therapeutic services and supports under this section
319.8must require the mental health practitioner and mental health behavioral aide to complete
319.920 hours of continuing education every two calendar years. The continuing education
319.10must be related to serving the needs of a child with emotional disturbance in the child's
319.11home environment and the child's family. The topics covered in orientation and training
319.12must conform to Minnesota Rules, part 9535.4068.
319.13    (d) The provider entity must document the mental health practitioner's or mental
319.14health behavioral aide's annual completion of the required continuing education. The
319.15documentation must include the date, subject, and number of hours of the continuing
319.16education, and attendance records, as verified by the staff member's signature, job
319.17title, and the instructor's name. The provider entity must keep documentation for each
319.18employee, including records of attendance at professional workshops and conferences,
319.19at a central location and in the employee's personnel file.

319.20    Sec. 23. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to
319.21read:
319.22    Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041,
319.23payments to counties for residential services provided by a residential facility shall only
319.24be made of federal earnings for services provided under this section, and the nonfederal
319.25share of costs for services provided under this section shall be paid by the county from
319.26sources other than federal funds or funds used to match other federal funds. Payment to
319.27counties for services provided according to this section shall be a proportion of the per
319.28day contract rate that relates to rehabilitative mental health services and shall not include
319.29payment for costs or services that are billed to the IV-E program as room and board.
319.30    (b) Per diem rates paid to providers under this section by prepaid plans shall be the
319.31proportion of the per-day contract rate that relates to rehabilitative mental health services
319.32and shall not include payment for group foster care costs or services that are billed to the
319.33county of financial responsibility.
319.34    (c) The commissioner shall set aside a portion not to exceed five percent of the
319.35federal funds earned for county expenditures under this section to cover the state costs of
320.1administering this section. Any unexpended funds from the set-aside shall be distributed
320.2to the counties in proportion to their earnings under this section.
320.3EFFECTIVE DATE.This section is effective January 1, 2009.

320.4    Sec. 24. Minnesota Statutes 2006, section 256B.69, subdivision 4, is amended to read:
320.5    Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to
320.6determine when limitation of choice may be implemented in the experimental counties.
320.7The criteria shall ensure that all eligible individuals in the county have continuing access
320.8to the full range of medical assistance services as specified in subdivision 6.
320.9    (b) The commissioner shall exempt the following persons from participation in the
320.10project, in addition to those who do not meet the criteria for limitation of choice:
320.11    (1) persons eligible for medical assistance according to section 256B.055,
320.12subdivision 1 ;
320.13    (2) persons eligible for medical assistance due to blindness or disability as
320.14determined by the Social Security Administration or the state medical review team, unless:
320.15    (i) they are 65 years of age or older; or
320.16    (ii) they reside in Itasca County or they reside in a county in which the commissioner
320.17conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
320.18Security Act;
320.19    (3) recipients who currently have private coverage through a health maintenance
320.20organization;
320.21    (4) recipients who are eligible for medical assistance by spending down excess
320.22income for medical expenses other than the nursing facility per diem expense;
320.23    (5) recipients who receive benefits under the Refugee Assistance Program,
320.24established under United States Code, title 8, section 1522(e);
320.25    (6) children who are both determined to be severely emotionally disturbed and
320.26receiving case management services according to section 256B.0625, subdivision 20,
320.27except children who are eligible for and who decline enrollment in an approved preferred
320.28integrated network under section 245.4682;
320.29    (7) adults who are both determined to be seriously and persistently mentally ill and
320.30received case management services according to section 256B.0625, subdivision 20;
320.31    (8) persons eligible for medical assistance according to section 256B.057,
320.32subdivision 10 ; and
320.33    (9) persons with access to cost-effective employer-sponsored private health
320.34insurance or persons enrolled in a non-Medicare individual health plan determined to be
320.35cost-effective according to section 256B.0625, subdivision 15.
321.1Children under age 21 who are in foster placement may enroll in the project on an elective
321.2basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an
321.3elective basis. The commissioner may enroll recipients in the prepaid medical assistance
321.4program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by
321.5spending down excess income.
321.6    (c) The commissioner may allow persons with a one-month spenddown who are
321.7otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay
321.8their monthly spenddown to the state.
321.9    (d) The commissioner may require those individuals to enroll in the prepaid medical
321.10assistance program who otherwise would have been excluded under paragraph (b), clauses
321.11(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
321.12    (e) Before limitation of choice is implemented, eligible individuals shall be notified
321.13and after notification, shall be allowed to choose only among demonstration providers.
321.14The commissioner may assign an individual with private coverage through a health
321.15maintenance organization, to the same health maintenance organization for medical
321.16assistance coverage, if the health maintenance organization is under contract for medical
321.17assistance in the individual's county of residence. After initially choosing a provider,
321.18the recipient is allowed to change that choice only at specified times as allowed by the
321.19commissioner. If a demonstration provider ends participation in the project for any reason,
321.20a recipient enrolled with that provider must select a new provider but may change providers
321.21without cause once more within the first 60 days after enrollment with the second provider.
321.22    (f) An infant born to a woman who is eligible for and receiving medical assistance
321.23and who is enrolled in the prepaid medical assistance program shall be retroactively
321.24enrolled to the month of birth in the same managed care plan as the mother once the
321.25child is enrolled in medical assistance unless the child is determined to be excluded from
321.26enrollment in a prepaid plan under this section.
321.27EFFECTIVE DATE.This section is effective January 1, 2009.

321.28    Sec. 25. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:
321.29    Subd. 5g. Payment for covered services. For services rendered on or after January
321.301, 2003, the total payment made to managed care plans for providing covered services
321.31under the medical assistance and general assistance medical care programs is reduced by
321.32.5 percent from their current statutory rates. This provision excludes payments for nursing
321.33home services, home and community-based waivers, and payments to demonstration
321.34projects for persons with disabilities, and mental health services added as covered benefits
321.35after December 31, 2007.

322.1    Sec. 26. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:
322.2    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g,
322.3the total payment made to managed care plans under the medical assistance program is
322.4reduced 1.0 percent for services provided on or after October 1, 2003, and an additional
322.51.0 percent for services provided on or after January 1, 2004. This provision excludes
322.6payments for nursing home services, home and community-based waivers, and payments
322.7to demonstration projects for persons with disabilities, and mental health services added as
322.8covered benefits after December 31, 2007.

322.9    Sec. 27. Minnesota Statutes 2006, section 256B.763, is amended to read:
322.10256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
322.11    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007,
322.12payment rates shall be increased by 23.7 percent over the rates in effect on January 1,
322.132006, for:
322.14    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
322.15    (2) community mental health centers under section 256B.0625, subdivision 5; and
322.16    (3) mental health clinics and centers certified under Minnesota Rules, parts
322.179520.0750 to 9520.0870, or hospital outpatient psychiatric departments that are designated
322.18as essential community providers under section 62Q.19.
322.19    (b) This increase applies to group skills training when provided as a component of
322.20children's therapeutic services and support, psychotherapy, medication management,
322.21evaluation and management, diagnostic assessment, explanation of findings, psychological
322.22testing, neuropsychological services, direction of behavioral aides, and inpatient
322.23consultation.
322.24    (c) This increase does not apply to rates that are governed by section 256B.0625,
322.25subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are
322.26negotiated with the county, rates that are established by the federal government, or rates
322.27that increased between January 1, 2004, and January 1, 2005.
322.28    (d) The commissioner shall adjust rates paid to prepaid health plans under contract
322.29with the commissioner to reflect the rate increases provided in paragraph paragraphs (a),
322.30(e), and (f). The prepaid health plan must pass this rate increase to the providers identified
322.31in paragraph paragraphs (a), (e), (f), and (g).
322.32    (e) Payment rates shall be increased by 23.7 percent over the rates in effect on
322.33December 31, 2007, for:
322.34    (1) medication education services provided on or after January 1, 2008, by adult
322.35rehabilitative mental health services providers certified under section 256B.0623; and
323.1    (2) mental health behavioral aide services provided on or after January 1, 2008, by
323.2children's therapeutic services and support providers certified under section 256B.0943.
323.3    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
323.4children's therapeutic services and support providers certified under section 256B.0943
323.5and not already included in paragraph (a), payment rates shall be increased by 23.7 percent
323.6over the rates in effect on December 31, 2007.
323.7    (g) Payment rates shall be increased by 2.3 percent over the rates in effect on
323.8December 31, 2007, for individual and family skills training provided on or after January
323.91, 2008, by children's therapeutic services and support providers certified under section
323.10256B.0943.
323.11EFFECTIVE DATE.This section is effective January 1, 2008.

323.12    Sec. 28. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
323.13    Subd. 4. General assistance medical care; services. (a)(i) For a person who is
323.14eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
323.15care covers, except as provided in paragraph (c):
323.16    (1) inpatient hospital services;
323.17    (2) outpatient hospital services;
323.18    (3) services provided by Medicare certified rehabilitation agencies;
323.19    (4) prescription drugs and other products recommended through the process
323.20established in section 256B.0625, subdivision 13;
323.21    (5) equipment necessary to administer insulin and diagnostic supplies and equipment
323.22for diabetics to monitor blood sugar level;
323.23    (6) eyeglasses and eye examinations provided by a physician or optometrist;
323.24    (7) hearing aids;
323.25    (8) prosthetic devices;
323.26    (9) laboratory and X-ray services;
323.27    (10) physician's services;
323.28    (11) medical transportation except special transportation;
323.29    (12) chiropractic services as covered under the medical assistance program;
323.30    (13) podiatric services;
323.31    (14) dental services as covered under the medical assistance program;
323.32    (15) outpatient services provided by a mental health center or clinic that is under
323.33contract with the county board and is established under section 245.62 mental health
323.34services covered under chapter 256B;
324.1    (16) day treatment services for mental illness provided under contract with the
324.2county board;
324.3    (17) (16) prescribed medications for persons who have been diagnosed as mentally
324.4ill as necessary to prevent more restrictive institutionalization;
324.5    (18) psychological services, (17) medical supplies and equipment, and Medicare
324.6premiums, coinsurance and deductible payments;
324.7    (19) (18) medical equipment not specifically listed in this paragraph when the use
324.8of the equipment will prevent the need for costlier services that are reimbursable under
324.9this subdivision;
324.10    (20) (19) services performed by a certified pediatric nurse practitioner, a
324.11certified family nurse practitioner, a certified adult nurse practitioner, a certified
324.12obstetric/gynecological nurse practitioner, a certified neonatal nurse practitioner, or a
324.13certified geriatric nurse practitioner in independent practice, if (1) the service is otherwise
324.14covered under this chapter as a physician service, (2) the service provided on an inpatient
324.15basis is not included as part of the cost for inpatient services included in the operating
324.16payment rate, and (3) the service is within the scope of practice of the nurse practitioner's
324.17license as a registered nurse, as defined in section 148.171;
324.18    (21) (20) services of a certified public health nurse or a registered nurse practicing
324.19in a public health nursing clinic that is a department of, or that operates under the direct
324.20authority of, a unit of government, if the service is within the scope of practice of the
324.21public health nurse's license as a registered nurse, as defined in section 148.171; and
324.22    (22) (21) telemedicine consultations, to the extent they are covered under section
324.23256B.0625, subdivision 3b ; and.
324.24    (23) mental health telemedicine and psychiatric consultation as covered under
324.25section 256B.0625, subdivisions 46 and 48.
324.26    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
324.27paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
324.28to inpatient hospital services, including physician services provided during the inpatient
324.29hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
324.30    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
324.31subdivision.
324.32    (c) In order to contain costs, the commissioner of human services shall select
324.33vendors of medical care who can provide the most economical care consistent with high
324.34medical standards and shall where possible contract with organizations on a prepaid
324.35capitation basis to provide these services. The commissioner shall consider proposals by
324.36counties and vendors for prepaid health plans, competitive bidding programs, block grants,
325.1or other vendor payment mechanisms designed to provide services in an economical
325.2manner or to control utilization, with safeguards to ensure that necessary services are
325.3provided. Before implementing prepaid programs in counties with a county operated or
325.4affiliated public teaching hospital or a hospital or clinic operated by the University of
325.5Minnesota, the commissioner shall consider the risks the prepaid program creates for the
325.6hospital and allow the county or hospital the opportunity to participate in the program in a
325.7manner that reflects the risk of adverse selection and the nature of the patients served by
325.8the hospital, provided the terms of participation in the program are competitive with the
325.9terms of other participants considering the nature of the population served. Payment for
325.10services provided pursuant to this subdivision shall be as provided to medical assistance
325.11vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
325.12payments made during fiscal year 1990 and later years, the commissioner shall consult
325.13with an independent actuary in establishing prepayment rates, but shall retain final control
325.14over the rate methodology.
325.15    (d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
325.16co-payments for services provided on or after October 1, 2003:
325.17    (1) $25 for eyeglasses;
325.18    (2) $25 for nonemergency visits to a hospital-based emergency room;
325.19    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
325.20subject to a $12 per month maximum for prescription drug co-payments. No co-payments
325.21shall apply to antipsychotic drugs when used for the treatment of mental illness; and
325.22    (4) 50 percent coinsurance on restorative dental services.
325.23    (e) Co-payments shall be limited to one per day per provider for nonpreventive visits,
325.24eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of
325.25general assistance medical care are responsible for all co-payments in this subdivision.
325.26The general assistance medical care reimbursement to the provider shall be reduced by
325.27the amount of the co-payment, except that reimbursement for prescription drugs shall not
325.28be reduced once a recipient has reached the $12 per month maximum for prescription
325.29drug co-payments. The provider collects the co-payment from the recipient. Providers
325.30may not deny services to recipients who are unable to pay the co-payment, except as
325.31provided in paragraph (f).
325.32    (f) If it is the routine business practice of a provider to refuse service to an individual
325.33with uncollected debt, the provider may include uncollected co-payments under this
325.34section. A provider must give advance notice to a recipient with uncollected debt before
325.35services can be denied.
326.1    (g) Any county may, from its own resources, provide medical payments for which
326.2state payments are not made.
326.3    (h) Chemical dependency services that are reimbursed under chapter 254B must not
326.4be reimbursed under general assistance medical care.
326.5    (i) The maximum payment for new vendors enrolled in the general assistance
326.6medical care program after the base year shall be determined from the average usual and
326.7customary charge of the same vendor type enrolled in the base year.
326.8    (j) The conditions of payment for services under this subdivision are the same as the
326.9conditions specified in rules adopted under chapter 256B governing the medical assistance
326.10program, unless otherwise provided by statute or rule.
326.11    (k) Inpatient and outpatient payments shall be reduced by five percent, effective July
326.121, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
326.13and incorporated by reference in paragraph (i).
326.14    (l) Payments for all other health services except inpatient, outpatient, and pharmacy
326.15services shall be reduced by five percent, effective July 1, 2003.
326.16    (m) Payments to managed care plans shall be reduced by five percent for services
326.17provided on or after October 1, 2003.
326.18    (n) A hospital receiving a reduced payment as a result of this section may apply the
326.19unpaid balance toward satisfaction of the hospital's bad debts.
326.20    (o) Fee-for-service payments for nonpreventive visits shall be reduced by $3
326.21for services provided on or after January 1, 2006. For purposes of this subdivision, a
326.22visit means an episode of service which is required because of a recipient's symptoms,
326.23diagnosis, or established illness, and which is delivered in an ambulatory setting by
326.24a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
326.25audiologist, optician, or optometrist.
326.26    (p) Payments to managed care plans shall not be increased as a result of the removal
326.27of the $3 nonpreventive visit co-payment effective January 1, 2006.
326.28    (q) Payments for mental health services added as covered benefits after December
326.2931, 2007, are not subject to the reductions in paragraphs (i), (k), (l), and (m).
326.30EFFECTIVE DATE.This section is effective January 1, 2008, except mental health
326.31case management under paragraph (a), clause (i), item (15), is effective January 1, 2009.

326.32    Sec. 29. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
326.33    Subdivision 1. Covered health services. For individuals under section 256L.04,
326.34subdivision 7 , with income no greater than 75 percent of the federal poverty guidelines
326.35or for families with children under section 256L.04, subdivision 1, all subdivisions of
327.1this section apply. "Covered health services" means the health services reimbursed
327.2under chapter 256B, with the exception of inpatient hospital services, special education
327.3services, private duty nursing services, adult dental care services other than services
327.4covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
327.5medical transportation services, personal care assistant and case management services,
327.6nursing home or intermediate care facilities services, inpatient mental health services,
327.7and chemical dependency services. Outpatient mental health services covered under the
327.8MinnesotaCare program are limited to diagnostic assessments, psychological testing,
327.9explanation of findings, mental health telemedicine, psychiatric consultation, medication
327.10management by a physician, day treatment, partial hospitalization, and individual, family,
327.11and group psychotherapy.
327.12    No public funds shall be used for coverage of abortion under MinnesotaCare
327.13except where the life of the female would be endangered or substantial and irreversible
327.14impairment of a major bodily function would result if the fetus were carried to term; or
327.15where the pregnancy is the result of rape or incest.
327.16    Covered health services shall be expanded as provided in this section.
327.17EFFECTIVE DATE.This section is effective January 1, 2008, except coverage for
327.18mental health case management under subdivision 1 is effective January 1, 2009.

327.19    Sec. 30. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
327.20    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
327.21and (c), the MinnesotaCare benefit plan shall include the following co-payments and
327.22coinsurance requirements for all enrollees:
327.23    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
327.24subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
327.25$3,000 per family;
327.26    (2) $3 per prescription for adult enrollees;
327.27    (3) $25 for eyeglasses for adult enrollees;
327.28    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
327.29episode of service which is required because of a recipient's symptoms, diagnosis, or
327.30established illness, and which is delivered in an ambulatory setting by a physician or
327.31physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
327.32audiologist, optician, or optometrist; and
327.33    (5) $6 for nonemergency visits to a hospital-based emergency room.
327.34    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
327.35children under the age of 21 in households with family income equal to or less than 175
328.1percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
328.2parents and relative caretakers of children under the age of 21 in households with family
328.3income greater than 175 percent of the federal poverty guidelines for inpatient hospital
328.4admissions occurring on or after January 1, 2001.
328.5    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children
328.6under the age of 21.
328.7    (d) Paragraph (a), clause (4), does not apply to mental health services.
328.8    (e) Adult enrollees with family gross income that exceeds 175 percent of the
328.9federal poverty guidelines and who are not pregnant shall be financially responsible for
328.10the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
328.11hospital benefit limit.
328.12    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
328.13or changes from one prepaid health plan to another during a calendar year, any charges
328.14submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
328.15expenses incurred by the enrollee for inpatient services, that were submitted or incurred
328.16prior to enrollment, or prior to the change in health plans, shall be disregarded.

328.17    Sec. 31. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:
328.18    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after
328.19October 1, 2003, the total payment made to managed care plans under the MinnesotaCare
328.20program is reduced 1.0 percent. This provision excludes payments for mental health
328.21services added as covered benefits after December 31, 2007.

328.22    Sec. 32. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:
328.23    Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted
328.24of theft under section 609.52, embezzlement of public funds under section 609.54, or
328.25forgery under section 609.625, 609.63, or 609.631, the probation officer shall determine in
328.26the report prepared under subdivision 1 whether or not compulsive gambling contributed
328.27to the commission of the offense. If so, the report shall contain the results of a compulsive
328.28gambling assessment conducted in accordance with this subdivision. The probation officer
328.29shall make an appointment for the offender to undergo the assessment if so indicated.
328.30    (b) The compulsive gambling assessment report must include a recommended level
328.31of treatment for the offender if the assessor concludes that the offender is in need of
328.32compulsive gambling treatment. The assessment must be conducted by an assessor
328.33qualified either under section 245.98, subdivision 2a Minnesota Rules, part 9585.0040,
328.34subpart 1, item C, or qualifications determined to be equivalent by the commissioner, to
329.1perform these assessments or to provide compulsive gambling treatment. An assessor
329.2providing a compulsive gambling assessment may not have any direct or shared financial
329.3interest or referral relationship resulting in shared financial gain with a treatment provider.
329.4If an independent assessor is not available, the probation officer may use the services of an
329.5assessor with a financial interest or referral relationship as authorized under rules adopted
329.6by the commissioner of human services under section 245.98, subdivision 2a.
329.7    (c) The commissioner of human services shall reimburse the assessor for the
329.8costs associated with a each compulsive gambling assessment at a rate established
329.9by the commissioner up to a maximum of $100 for each assessment. To the extent
329.10practicable, the commissioner shall standardize reimbursement rates for assessments. The
329.11commissioner shall reimburse these costs the assessor after receiving written verification
329.12from the probation officer that the assessment was performed and found acceptable.

329.13    Sec. 33. REPORT.
329.14    The commissioner shall make a report to the legislature by January 15, 2008,
329.15regarding the transfer of funds to counties for state registered nurses employed in
329.16community mental health pilot projects as part of the assertive community treatment
329.17teams under Minnesota Statutes, section 245.4661. The report shall address the impact
329.18of the nursing shortage on replacing these positions, continuity of patient care if these
329.19positions cannot be filled, and ways to maintain state registered nurses in these positions
329.20until the nurse retires or leaves employment. No funds for state registered nurse positions
329.21referenced in this section may be transferred before the report date. This section does not
329.22apply to positions vacated by routine attrition.

329.23    Sec. 34. CASE MANAGEMENT; BEST PRACTICES.
329.24    The commissioner of human services, in consultation with consumers, families,
329.25counties, and other interested stakeholders, will develop recommendations for changes in
329.26the adult mental health act related to case management, consistent with evidence-based
329.27and best practices.

329.28    Sec. 35. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.
329.29    Subdivision 1. Pilot project authorized; purpose. A two-year Regional Children's
329.30Mental Health Initiative pilot project is established to improve children's mental health
329.31service coordination, communication, and processes in Blue Earth, Brown, Faribault,
329.32Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The
330.1purpose of the Regional Children's Mental Health Initiative will be to plan and develop
330.2new programs and services related to children's mental health in south central Minnesota.
330.3    Subd. 2. Goals. To accomplish its purpose, the Regional Children's Mental Health
330.4Initiative shall have the following goals:
330.5    (1) work to streamline delivery and regional access to services;
330.6    (2) share strategies and resources for the management of out-of-home placements;
330.7    (3) establish standard protocols and operating procedures for functions that are
330.8performed across all counties;
330.9    (4) share information to improve resource allocation and service delivery across
330.10counties;
330.11    (5) evaluate outcomes of various treatment alternatives;
330.12    (6) create a network for and provide support to service delivery groups;
330.13    (7) establish a regional process to match children in need of out-of-home placement
330.14with foster homes that can meet their needs; and
330.15    (8) recruit and retain foster homes.
330.16    Subd. 3. Director's Council. The Director's Council shall govern the operations of
330.17the Regional Children's Mental Health Initiative. Members of the Director's Council shall
330.18represent each of the 11 counties participating in the pilot project.
330.19    Subd. 4. Regional Children's Mental Health Initiative Team. The members
330.20of the Regional Children's Mental Health Initiative Team shall conduct planning and
330.21development of new and modified children's mental health programs and services in the
330.22region. Members of the team shall reflect the cultural, demographic, and geographic
330.23diversity of the region and shall be composed of representatives from each of the
330.24following:
330.25    (1) the medical community;
330.26    (2) human services;
330.27    (3) corrections;
330.28    (4) education;
330.29    (5) mental health providers and vendors;
330.30    (6) advocacy organizations;
330.31    (7) parents; and
330.32    (8) children and youth.
330.33    Subd. 5. Authority. The regional children's mental health initiative shall have the
330.34authority to develop and implement the following programs:
331.1    (1) Flexible funding payments. This program will make funds available to respond to
331.2the unique and unpredictable needs of children with mental health issues such as the need
331.3for prescription drugs, transportation, clothing, and assessments not otherwise available.
331.4    (2) Transition to self-sufficiency. This program will help youths between the ages of
331.514 and 21 establish professional relationships, find jobs, build financial foundations, and
331.6learn to fulfill their roles as productive citizens.
331.7    (3) Crisis response. This program will establish public and private partnerships
331.8to offer a range of options to meet the needs of children in crisis. Methods to meet
331.9these needs may include accessible local services, holistic assessments, urgent care and
331.10stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.
331.11    (4) Integrated services for complex conditions. This program will design, develop,
331.12and implement packages of integrated services to meet the needs of children with specific,
331.13complex conditions.
331.14    Subd. 6. Evaluation and report. The regional children's mental health initiative
331.15shall develop a method for evaluating the effectiveness of this pilot project focusing on
331.16identifiable goals and outcomes. An interim report on the pilot project's effectiveness
331.17shall be submitted to the house and senate finance committees having jurisdiction over
331.18mental health, the commissioner of human services, and the Minnesota Association of
331.19County Social Service Administrators no later than December 31, 2008. A final report
331.20is due no later than December 31, 2009.

331.21    Sec. 36. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S
331.22MENTAL HEALTH PILOT PROJECT.
331.23    Subdivision 1. Pilot project authorized. The commissioner of human services
331.24shall fund a three-year pilot project to measure the effect of children's identified mental
331.25health needs, including social and emotional needs, on Minnesota family investment
331.26program (MFIP) participants' ability to obtain and retain employment. The project shall
331.27also measure the effect on work activity of MFIP participants' needs to address their
331.28children's identified mental health needs.
331.29    Subd. 2. Provider and agency proposals. (a) Interested MFIP providers and
331.30agencies shall:
331.31    (1) submit proposals defining how they will identify participants whose children
331.32have mental health needs that hinder the employment process;
331.33    (2) connect families with appropriate developmental, social, and emotional
331.34screenings and services; and
331.35    (3) incorporate those services into the participant's employment plan.
332.1Each proposal under this paragraph must include an evaluation component.
332.2    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP
332.3participants of the following:
332.4    (1) the availability of developmental, social, and emotional screening tools for
332.5children and youth;
332.6    (2) the purpose of the screenings;
332.7    (3) how the information will be used to assist the participants in identifying and
332.8addressing potential barriers to employment; and
332.9    (4) that their employment plan may be modified based on the screening results.
332.10    Subd. 3. Program components. (a) MFIP providers shall obtain the participant's
332.11written consent for participation in the pilot project, including consent for developmental,
332.12social, and emotional screening.
332.13    (b) MFIP providers shall coordinate with county social service agencies and health
332.14plans to assist recipients in arranging referrals indicated by the screening results.
332.15    (c) Tools used for developmental, social, and emotional screenings shall be approved
332.16by the commissioner of human services.
332.17    Subd. 4. Program evaluation. The commissioner of human services shall conduct
332.18an evaluation of the pilot project to determine:
332.19    (1) the number of participants who took part in the screening;
332.20    (2) the number of children who were screened and what screening tools were used;
332.21    (3) the number of children who were identified in the screening who needed referral
332.22or follow-up services;
332.23    (4) the number of children who received services, what agency provided the services,
332.24and what type of services were provided;
332.25    (5) the number of employment plans that were adjusted to include the activities
332.26recommended in the screenings;
332.27    (6) the changes in work participation rates;
332.28    (7) the changes in earned income;
332.29    (8) the changes in sanction rates; and
332.30    (9) the participants' report of program effectiveness.
332.31    Subd. 5. Work activity. Participant involvement in screenings and subsequent
332.32referral and follow-up services shall count as work activity under Minnesota Statutes,
332.33section 256J.49, subdivision 13.
332.34    Subd. 6. Evaluation. Of the amounts appropriated, the commissioner may use up
332.35to $100,000 for evaluation of this pilot.

333.1    Sec. 37. SOCIAL AND ECONOMIC COSTS OF GAMBLING.
333.2    Subdivision 1. Report. The commissioner of human services, in consultation with
333.3the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed
333.4vendors, shall prepare a report that provides a process and funding mechanism to study the
333.5issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate
333.6of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall
333.7include in the report potential financial commitments made by stakeholders and others in
333.8order to fund the study. The report is due to the legislative committees having jurisdiction
333.9over compulsive gambling issues by December 1, 2007.
333.10    Subd. 2. Issues to be addressed. The study must address:
333.11    (1) state, local, and tribal government policies and practices in Minnesota to legalize
333.12or prohibit gambling;
333.13    (2) the relationship between gambling and crime in Minnesota, including: (i) the
333.14relationship between gambling and overall crime rates; (ii) the relationship between
333.15gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child
333.16neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement
333.17and regulation practices that are intended to address the relationship between gambling
333.18and levels of crime;
333.19    (3) the relationship between expanded gambling and increased rates of problem
333.20gambling in Minnesota, including the impact of pathological or problem gambling on
333.21individuals, families, businesses, social institutions, and the economy;
333.22    (4) the social impact of gambling on individuals, families, businesses, and social
333.23institutions in Minnesota, including an analysis of the relationship between gambling and
333.24depression, abuse, divorce, homelessness, suicide, and bankruptcy;
333.25    (5) the economic impact of gambling on state, local, and tribal economies in
333.26Minnesota; and
333.27    (6) any other issues deemed necessary in assessing the social and economic impact
333.28of gambling in Minnesota.
333.29    Subd. 3. Quantification of social and economic impact. The study shall quantify
333.30the social and economic impact on both (1) state, local, and tribal governments in
333.31Minnesota, and (2) Minnesota's communities and social institutions, including individuals,
333.32families, and businesses within those communities and institutions.

333.33    Sec. 38. REVISOR'S INSTRUCTION.
333.34    (a) The revisor of statutes shall change the references to sections "245.487 to
333.35245.4887" wherever it appears in statutes or rules to sections "245.487 to 245.4889."
334.1    (b) The revisor of statutes shall correct all internal references that are necessary
334.2from the relettering in section 20.

334.3    Sec. 39. REPEALER.
334.4Minnesota Rules, part 9585.0030, is repealed.

334.5ARTICLE 9

334.6DEPARTMENT OF HEALTH POLICY

334.7    Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:
334.8    Subd. 2. Definitions. For purposes of this section, the terms defined in this
334.9subdivision have the meanings given.
334.10    (a) "Access" means the financial, temporal, and geographic availability of health
334.11care to individuals who need it.
334.12    (b) (a) "Capital expenditure" means an expenditure which, under generally accepted
334.13accounting principles, is not properly chargeable as an expense of operation and
334.14maintenance.
334.15    (c) "Cost" means the amount paid by consumers or third party payers for health
334.16care services or products.
334.17    (d) "Date of the major spending commitment" means the date the provider formally
334.18obligated itself to the major spending commitment. The obligation may be incurred
334.19by entering into a contract, making a down payment, issuing bonds or entering a loan
334.20agreement to provide financing for the major spending commitment, or taking some other
334.21formal, tangible action evidencing the provider's intention to make the major spending
334.22commitment.
334.23    (e) (b) "Health care service" means:
334.24    (1) a service or item that would be covered by the medical assistance program
334.25under chapter 256B if provided in accordance with medical assistance requirements to an
334.26eligible medical assistance recipient; and
334.27    (2) a service or item that would be covered by medical assistance except that it is
334.28characterized as experimental, cosmetic, or voluntary.
334.29    "Health care service" does not include retail, over-the-counter sales of
334.30nonprescription drugs and other retail sales of health-related products that are not generally
334.31paid for by medical assistance and other third-party coverage.
334.32    (f) (c) "Major spending commitment" means an expenditure in excess of $1,000,000
334.33for:
334.34    (1) acquisition of a unit of medical equipment;
335.1    (2) a capital expenditure for a single project for the purposes of providing health
335.2care services, other than for the acquisition of medical equipment;
335.3    (3) offering a new specialized service not offered before;
335.4    (4) planning for an activity that would qualify as a major spending commitment
335.5under this paragraph; or
335.6    (5) a project involving a combination of two or more of the activities in clauses
335.7(1) to (4).
335.8    The cost of acquisition of medical equipment, and the amount of a capital
335.9expenditure, is the total cost to the provider regardless of whether the cost is distributed
335.10over time through a lease arrangement or other financing or payment mechanism.
335.11    (g) (d) "Medical equipment" means fixed and movable equipment that is used by
335.12a provider in the provision of a health care service. "Medical equipment" includes, but
335.13is not limited to, the following:
335.14    (1) an extracorporeal shock wave lithotripter;
335.15    (2) a computerized axial tomography (CAT) scanner;
335.16    (3) a magnetic resonance imaging (MRI) unit;
335.17    (4) a positron emission tomography (PET) scanner; and
335.18    (5) emergency and nonemergency medical transportation equipment and vehicles.
335.19    (h) (e) "New specialized service" means a specialized health care procedure or
335.20treatment regimen offered by a provider that was not previously offered by the provider,
335.21including, but not limited to:
335.22    (1) cardiac catheterization services involving high-risk patients as defined in the
335.23Guidelines for Coronary Angiography established by the American Heart Association
335.24and the American College of Cardiology;
335.25    (2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or
335.26any other service for transplantation of any other organ;
335.27    (3) megavoltage radiation therapy;
335.28    (4) open heart surgery;
335.29    (5) neonatal intensive care services; and
335.30    (6) any new medical technology for which premarket approval has been granted by
335.31the United States Food and Drug Administration, excluding implantable and wearable
335.32devices.
335.33    (f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic,
335.34obstetrics, mental health, chemical dependency, and emergency services.

335.35    Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:
336.1    Subd. 4a. Expenditure reporting. (a) A provider making a major spending
336.2commitment after April 1, 1992, shall submit notification of the expenditure to the
336.3commissioner and provide the commissioner with any relevant background information.
336.4    (b) Notification must include a report, submitted within 60 days after the date of the
336.5major spending commitment, using terms conforming to the definitions in section 62J.03
336.6and this section. Each report is subject to retrospective review and must contain:
336.7    (1) a detailed description of the major spending commitment, including the specific
336.8dollar amount of each expenditure, and its purpose;
336.9    (2) the date of the major spending commitment;
336.10    (3) a statement of the expected impact that the major spending commitment will
336.11have on charges by the provider to patients and third party payers;
336.12    (4) a statement of the expected impact on the clinical effectiveness or quality of care
336.13received by the patients that the provider expects to serve;
336.14    (5) a statement of the extent to which equivalent services or technology are already
336.15available to the provider's actual and potential patient population;
336.16    (6) a statement of the distance from which the nearest equivalent services or
336.17technology are already available to the provider's actual and potential population;
336.18    (7) a statement describing the pursuit of any lawful collaborative arrangements; and
336.19    (8) a statement of assurance that the provider will not use, purchase, or perform
336.20health care technologies and procedures that are not clinically effective and cost-effective,
336.21unless the technology is used for experimental or research purposes to determine whether
336.22a technology or procedure is clinically effective and cost-effective.
336.23    The provider may submit any additional information that it deems relevant.
336.24    (c) The commissioner may request additional information from a provider for the
336.25purpose of review of a report submitted by that provider, and may consider relevant
336.26information from other sources. A provider shall provide any information requested by
336.27the commissioner within the time period stated in the request, or within 30 days after the
336.28date of the request if the request does not state a time.
336.29    (d) If the provider fails to submit a complete and timely expenditure report, including
336.30any additional information requested by the commissioner, the commissioner may make
336.31the provider's subsequent major spending commitments subject to the procedures of
336.32prospective review and approval under subdivision 6a.
336.33    Each hospital, outpatient surgical center, diagnostic imaging center, and physician
336.34clinic shall report annually to the commissioner on all major spending commitments,
336.35in the form and manner specified by the commissioner. The report shall include the
336.36following information:
337.1    (a) a description of major spending commitments made during the previous year,
337.2including the total dollar amount of major spending commitments and purpose of the
337.3expenditures;
337.4    (b) the cost of land acquisition, construction of new facilities, and renovation of
337.5existing facilities;
337.6    (c) the cost of purchased or leased medical equipment, by type of equipment;
337.7    (d) expenditures by type for specialty care and new specialized services;
337.8    (e) information on the amount and types of added capacity for diagnostic imaging
337.9services, outpatient surgical services, and new specialized services; and
337.10    (f) information on investments in electronic medical records systems.
337.11For hospitals and outpatient surgical centers, this information shall be included in reports
337.12to the commissioner that are required under section 144.698. For diagnostic imaging
337.13centers, this information shall be included in reports to the commissioner that are required
337.14under section 144.565. For physician clinics, this information shall be included in reports
337.15to the commissioner that are required under section 62J.41. For all other health care
337.16providers that are subject to this reporting requirement, reports must be submitted to the
337.17commissioner by March 1 each year for the preceding calendar year.

337.18    Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 6a, is amended to read:
337.19    Subd. 6a. Prospective review and approval. (a) No health care provider subject
337.20to prospective review under this subdivision shall make a major spending commitment
337.21unless:
337.22    (1) the provider has filed an application with the commissioner to proceed with the
337.23major spending commitment and has provided all supporting documentation and evidence
337.24requested by the commissioner; and
337.25    (2) the commissioner determines, based upon this documentation and evidence, that
337.26the major spending commitment is appropriate under the criteria provided in subdivision
337.275a in light of the alternatives available to the provider.
337.28    (b) A provider subject to prospective review and approval shall submit an
337.29application to the commissioner before proceeding with any major spending commitment.
337.30The application must address each item listed in subdivision 4a, paragraph (a), and must
337.31also include documentation to support the response to each item. The provider may
337.32submit information, with supporting documentation, regarding why the major spending
337.33commitment should be excepted from prospective review under subdivision 7. The
337.34submission may be made either in addition to or instead of the submission of information
337.35relating to the items listed in subdivision 4a, paragraph (a).
338.1    (c) The commissioner shall determine, based upon the information submitted,
338.2whether the major spending commitment is appropriate under the criteria provided
338.3in subdivision 5a, or whether it should be excepted from prospective review under
338.4subdivision 7. In making this determination, the commissioner may also consider relevant
338.5information from other sources. At the request of the commissioner, the health technology
338.6advisory committee shall convene an expert review panel made up of persons with
338.7knowledge and expertise regarding medical equipment, specialized services, health care
338.8expenditures, and capital expenditures to review applications and make recommendations
338.9to the commissioner. The commissioner shall make a decision on the application within
338.1060 days after an application is received.
338.11    (d) The commissioner of health has the authority to issue fines, seek injunctions, and
338.12pursue other remedies as provided by law.

338.13    Sec. 4. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:
338.14    Subd. 7. Exceptions. (a) The retrospective review process as described in
338.15subdivision 5a and the prospective review and approval process as described in subdivision
338.166a reporting requirement in subdivision 4a do does not apply to:
338.17    (1) a major spending commitment to replace existing equipment with comparable
338.18equipment used for direct patient care, upgrades of equipment beyond the current model,
338.19or comparable model must be reported;
338.20    (2) (1) a major spending commitment made by a research and teaching institution
338.21for purposes of conducting medical education, medical research supported or sponsored
338.22by a medical school, or by a federal or foundation grant or clinical trials;
338.23    (3) a major spending commitment to repair, remodel, or replace existing buildings or
338.24fixtures if, in the judgment of the commissioner, the project does not involve a substantial
338.25expansion of service capacity or a substantial change in the nature of health care services
338.26provided;
338.27    (4) (2) a major spending commitment for building maintenance including heating,
338.28water, electricity, and other maintenance-related expenditures; and
338.29    (5) (3) a major spending commitment for activities, not directly related to the
338.30delivery of patient care services, including food service, laundry, housekeeping, and
338.31other service-related activities; and.
338.32    (6) a major spending commitment for computer equipment or data systems not
338.33directly related to the delivery of patient care services, including computer equipment or
338.34data systems related to medical record automation.
339.1    (b) In addition to the exceptions listed in paragraph (a), the prospective review and
339.2approval process described in subdivision 6a reporting requirement in subdivision 4a does
339.3not apply to mergers, acquisitions, and other changes in ownership or control that, in the
339.4judgment of the commissioner, do not involve a substantial expansion of service capacity
339.5or a substantial change in the nature of health care services provided.

339.6    Sec. 5. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:
339.7    Subdivision 1. Cost containment data to be collected from providers. The
339.8commissioner shall require health care providers to collect and provide both patient
339.9specific information and descriptive and financial aggregate data on:
339.10    (1) the total number of patients served;
339.11    (2) the total number of patients served by state of residence and Minnesota county;
339.12    (3) the site or sites where the health care provider provides services;
339.13    (4) the number of individuals employed, by type of employee, by the health care
339.14provider;
339.15    (5) the services and their costs for which no payment was received;
339.16    (6) total revenue by type of payer or by groups of payers, including but not limited
339.17to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service
339.18plan corporations, commercial insurers, health maintenance organizations, and individual
339.19patients;
339.20    (7) revenue from research activities;
339.21    (8) revenue from educational activities;
339.22    (9) revenue from out-of-pocket payments by patients;
339.23    (10) revenue from donations; and
339.24    (11) a report on health care capital expenditures during the previous year, as required
339.25by section 62J.17; and
339.26    (11) (12) any other data required by the commissioner, including data in
339.27unaggregated form, for the purposes of developing spending estimates, setting spending
339.28limits, monitoring actual spending, and monitoring costs.
339.29The commissioner may, by rule, modify the data submission categories listed above if the
339.30commissioner determines that this will reduce the reporting burden on providers without
339.31having a significant negative effect on necessary data collection efforts.

339.32    Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:
339.33    Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1,
339.341996, all institutional inpatient hospital services, ancillary services, institutionally owned
340.1or operated outpatient services rendered by providers in Minnesota, and institutional
340.2or noninstitutional home health services that are not being billed using an equivalent
340.3electronic billing format, must be billed using the uniform billing form CMS 1450, except
340.4as provided in subdivision 5.
340.5    (b) The instructions and definitions for the use of the uniform billing form CMS
340.61450 shall be in accordance with the uniform billing form manual specified by the
340.7commissioner. In promulgating these instructions, the commissioner may utilize the
340.8manual developed by the National Uniform Billing Committee, as adopted and finalized
340.9by the Minnesota Uniform Billing Committee.
340.10    (c) Services to be billed using the uniform billing form CMS 1450 include:
340.11institutional inpatient hospital services and distinct units in the hospital such as psychiatric
340.12unit services, physical therapy unit services, swing bed (SNF) services, inpatient state
340.13psychiatric hospital services, inpatient skilled nursing facility services, home health
340.14services (Medicare part A), and hospice services; ancillary services, where benefits are
340.15exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals,
340.16skilled nursing facilities, and home health (Medicare part B); institutional owned or
340.17operated outpatient services such as waivered services, hospital outpatient services,
340.18including ambulatory surgical center services, hospital referred laboratory services,
340.19hospital-based ambulance services, and other hospital outpatient services, skilled nursing
340.20facilities, home health, freestanding renal dialysis centers, comprehensive outpatient
340.21rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health
340.22clinics, and community mental health centers; home health services such as home health
340.23intravenous therapy providers, waivered services, personal care attendants, and hospice;
340.24and any other health care provider certified by the Medicare program to use this form.
340.25    (d) On and after January 1, 1996, a mother and newborn child must be billed
340.26separately, and must not be combined on one claim form.
340.27    (e) Services provided by Medicare Critical Access Hospitals electing Method
340.28II billing will be allowed an exception to this provision to allow the inclusion of the
340.29professional fees on the CMS 1450.

340.30    Sec. 7. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:
340.31    Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all
340.32noninstitutional health care services rendered by providers in Minnesota except dental
340.33or pharmacy providers, that are not currently being billed using an equivalent electronic
340.34billing format, must be billed using the health insurance claim form CMS 1500, except as
340.35provided in subdivision 5.
341.1    (b) The instructions and definitions for the use of the uniform billing form CMS
341.21500 shall be in accordance with the manual developed by the Administrative Uniformity
341.3Committee entitled standards for the use of the CMS 1500 form, dated February 1994,
341.4as further defined by the commissioner.
341.5    (c) Services to be billed using the uniform billing form CMS 1500 include physician
341.6services and supplies, durable medical equipment, noninstitutional ambulance services,
341.7independent ancillary services including occupational therapy, physical therapy, speech
341.8therapy and audiology, home infusion therapy, podiatry services, optometry services,
341.9mental health licensed professional services, substance abuse licensed professional
341.10services, nursing practitioner professional services, certified registered nurse anesthetists,
341.11chiropractors, physician assistants, laboratories, medical suppliers, and other health care
341.12providers such as day activity centers and freestanding ambulatory surgical centers.
341.13    (d) Services provided by Medicare Critical Access Hospitals electing Method
341.14II billing will be allowed an exception to this provision to allow the inclusion of the
341.15professional fees on the CMS 1450.

341.16    Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:
341.17    Subd. 2. General characteristics. (a) The Minnesota uniform health care
341.18identification card must be a preprinted card constructed of plastic, paper, or any other
341.19medium that conforms with ANSI and ISO 7810 physical characteristics standards. The
341.20card dimensions must also conform to ANSI and ISO 7810 physical characteristics
341.21standard. The use of a signature panel is optional. The uniform prescription drug
341.22information contained on the card must conform with the format adopted by the NCPDP
341.23and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of
341.24the fields required to submit a claim in conformance with the most recent pharmacy
341.25identification card implementation guide produced by the NCPDP. All information
341.26required to submit a prescription drug claim, exclusive of information provided on a
341.27prescription that is required by law, must be included on the card in a clear, readable, and
341.28understandable manner. If a health benefit plan requires a conditional or situational field,
341.29as defined by the NCPDP, the conditional or situational field must conform to the most
341.30recent pharmacy information card implementation guide produced by the NCPDP.
341.31    (b) The Minnesota uniform health care identification card must have an essential
341.32information window on the front side with the following data elements: card issuer name,
341.33electronic transaction routing information, card issuer identification number, cardholder
341.34(insured) identification number, and cardholder (insured) identification name. No optional
341.35data may be interspersed between these data elements.
342.1    (c) Standardized labels are required next to human readable data elements and
342.2must come before the human data elements.

342.3    Sec. 9. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:
342.4    Subd. 3. Human readable data elements. (a) The following are the minimum
342.5human readable data elements that must be present on the front side of the Minnesota
342.6uniform health care identification card:
342.7    (1) card issuer name or logo, which is the name or logo that identifies the card issuer.
342.8The card issuer name or logo may be located at the top of the card. No standard label
342.9is required for this data element;
342.10    (2) complete electronic transaction routing information including, at a minimum,
342.11the international identification number. The standardized label of this data element
342.12is "RxBIN." Processor control numbers and group numbers are required if needed to
342.13electronically process a prescription drug claim. The standardized label for the process
342.14control numbers data element is "RxPCN" and the standardized label for the group
342.15numbers data element is "RxGrp," except that if the group number data element is a
342.16universal element to be used by all health care providers, the standardized label may be
342.17"Grp." To conserve vertical space on the card, the international identification number and
342.18the processor control number may be printed on the same line;
342.19     (3) cardholder (insured) identification number, which is the unique identification
342.20number of the individual card holder established and defined under this section. The
342.21standardized label for the data element is "ID";
342.22    (4) cardholder (insured) identification name, which is the name of the individual
342.23card holder. The identification name must be formatted as follows: first name, space,
342.24optional middle initial, space, last name, optional space and name suffix. The standardized
342.25label for this data element is "Name";
342.26    (5) care type, which is the description of the group purchaser's plan product under
342.27which the beneficiary is covered. The description shall include the health plan company
342.28name and the plan or product name. The standardized label for this data element is
342.29"Care Type";
342.30    (6) service type, which is the description of coverage provided such as hospital,
342.31dental, vision, prescription, or mental health. The standard label for this data element
342.32is "Svc Type"; and
342.33    (7) provider/clinic name, which is the name of the primary care clinic the card
342.34holder is assigned to by the health plan company. The standard label for this field is
343.1"PCP." This information is mandatory only if the health plan company assigns a specific
343.2primary care provider to the card holder.
343.3    (b) The following human readable data elements shall be present on the back side
343.4of the Minnesota uniform health care identification card. These elements must be left
343.5justified, and no optional data elements may be interspersed between them:
343.6    (1) claims submission names and addresses, which are the names and addresses of
343.7the entity or entities to which claims should be submitted. If different destinations are
343.8required for different types of claims, this must be labeled;
343.9    (2) telephone numbers and names that pharmacies and other health care providers
343.10may call for assistance. These telephone numbers and names are required on the back
343.11side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies
343.12or other providers with assistance or with the telephone numbers and names of contacts
343.13for assistance; and
343.14    (3) telephone numbers and names; which are the telephone numbers and names of the
343.15following contacts with a standardized label describing the service function as applicable:
343.16    (i) eligibility and benefit information;
343.17    (ii) utilization review;
343.18    (iii) precertification; or
343.19    (iv) customer services.
343.20    (c) The following human readable data elements are mandatory on the back
343.21side of the Minnesota uniform health care identification card for health maintenance
343.22organizations:
343.23    (1) emergency care authorization telephone number or instruction on how to receive
343.24authorization for emergency care. There is no standard label required for this information;
343.25and
343.26    (2) one of the following:
343.27    (i) telephone number to call to appeal to or file a complaint with the commissioner of
343.28health; or
343.29    (ii) for persons enrolled under section 256B.69, 256D.03, or 256L.12, the telephone
343.30number to call to file a complaint with the ombudsperson designated by the commissioner
343.31of human services under section 256B.69 and the address to appeal to the commissioner of
343.32human services. There is no standard label required for this information.
343.33    (d) All human readable data elements not required under paragraphs (a) to (c) are
343.34optional and may be used at the issuer's discretion.

343.35    Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:
344.1    Subd. 3. Approval. (a) Prior to the operation of a community-based health care
344.2coverage program, a community-based health initiative shall submit to the commissioner
344.3of health for approval the community-based health care coverage program developed by
344.4the initiative. The commissioner shall only approve a program that has been awarded
344.5a community access program grant from the United States Department of Health and
344.6Human Services. The commissioner shall ensure that the program meets the federal grant
344.7requirements and any requirements described in this section and is actuarially sound based
344.8on a review of appropriate records and methods utilized by the community-based health
344.9initiative in establishing premium rates for the community-based health care coverage
344.10program.
344.11    (b) Prior to approval, the commissioner shall also ensure that:
344.12    (1) the benefits offered comply with subdivision 8 and that there are adequate
344.13numbers of health care providers participating in the community-based health network to
344.14deliver the benefits offered under the program;
344.15    (2) the activities of the program are limited to activities that are exempt under this
344.16section or otherwise from regulation by the commissioner of commerce;
344.17    (3) the complaint resolution process meets the requirements of subdivision 10; and
344.18    (4) the data privacy policies and procedures comply with state and federal law.

344.19    Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:
344.20    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval
344.21by the commissioner of health a community-based health care coverage program. The
344.22operational structure established by the initiative shall include, but is not limited to:
344.23    (1) establishing a process for enrolling eligible individuals and their dependents;
344.24    (2) collecting and coordinating premiums from enrollees and employers of enrollees;
344.25    (3) providing payment to participating providers;
344.26    (4) establishing a benefit set according to subdivision 8 and establishing premium
344.27rates and cost-sharing requirements;
344.28    (5) creating incentives to encourage primary care and wellness services; and
344.29    (6) initiating disease management services, as appropriate.
344.30    (b) The payments collected under paragraph (a), clause (2), may be used to capture
344.31available federal funds.

344.32    Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:
345.1    Subd. 13. Report. (a) The initiative shall submit quarterly status reports to the
345.2commissioner of health on January 15, April 15, July 15, and October 15 of each year,
345.3with the first report due January 15, 2007 2008. The status report shall include:
345.4    (1) the financial status of the program, including the premium rates, cost per member
345.5per month, claims paid out, premiums received, and administrative expenses;
345.6    (2) a description of the health care benefits offered and the services utilized;
345.7    (3) the number of employers participating, the number of employees and dependents
345.8covered under the program, and the number of health care providers participating;
345.9    (4) a description of the health outcomes to be achieved by the program and a status
345.10report on the performance measurements to be used and collected; and
345.11    (5) any other information requested by the commissioner of health or commerce or
345.12the legislature.
345.13    (b) The initiative shall contract with an independent entity to conduct an evaluation
345.14of the program to be submitted to the commissioners of health and commerce and the
345.15legislature by January 15, 2009 2010. The evaluation shall include:
345.16    (1) an analysis of the health outcomes established by the initiative and the
345.17performance measurements to determine whether the outcomes are being achieved;
345.18    (2) an analysis of the financial status of the program, including the claims to
345.19premiums loss ratio and utilization and cost experience;
345.20    (3) the demographics of the enrollees, including their age, gender, family income,
345.21and the number of dependents;
345.22    (4) the number of employers and employees who have been denied access to the
345.23program and the basis for the denial;
345.24    (5) specific analysis on enrollees who have aggregate medical claims totaling over
345.25$5,000 per year, including data on the enrollee's main diagnosis and whether all the
345.26medical claims were covered by the program;
345.27    (6) number of enrollees referred to state public assistance programs;
345.28    (7) a comparison of employer-subsidized health coverage provided in a comparable
345.29geographic area to the designated community-based geographic area served by the
345.30program, including, to the extent available:
345.31    (i) the difference in the number of employers with 50 or fewer employees offering
345.32employer-subsidized health coverage;
345.33    (ii) the difference in uncompensated care being provided in each area; and
345.34    (iii) a comparison of health care outcomes and measurements established by the
345.35initiative; and
345.36    (8) any other information requested by the commissioner of health or commerce.

346.1    Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:
346.2    Subd. 14. Sunset. This section expires December 31, 2011 2012.

346.3    Sec. 14. Minnesota Statutes 2006, section 144.552, is amended to read:
346.4144.552 PUBLIC INTEREST REVIEW.
346.5    (a) The following entities must submit a plan to the commissioner:
346.6    (1) a hospital seeking to increase its number of licensed beds; or
346.7    (2) an organization seeking to obtain a hospital license and notified by the
346.8commissioner under section 144.553, subdivision 1, paragraph (c), that it is subject
346.9to this section.
346.10The plan must include information that includes an explanation of how the expansion will
346.11meet the public's interest. When submitting a plan to the commissioner, an applicant
346.12shall pay the commissioner for the commissioner's cost of reviewing and monitoring the
346.13plan, as determined by the commissioner and notwithstanding section 16A.1283. Money
346.14received by the commissioner under this section is appropriated to the commissioner for
346.15the purpose of administering this section.
346.16    (b) Plans submitted under this section shall include detailed information necessary
346.17for the commissioner to review the plan and reach a finding. The commissioner may
346.18request additional information from the hospital submitting a plan under this section and
346.19from others affected by the plan that the commissioner deems necessary to review the
346.20plan and make a finding.
346.21    (c) The commissioner shall review the plan and, within 90 days, but no more than
346.22six months if extenuating circumstances apply, issue a finding on whether the plan is in
346.23the public interest. In making the recommendation, the commissioner shall consider
346.24issues including but not limited to:
346.25    (1) whether the new hospital or hospital beds are needed to provide timely access to
346.26care or access to new or improved services;
346.27    (2) the financial impact of the new hospital or hospital beds on existing acute-care
346.28hospitals that have emergency departments in the region;
346.29    (3) how the new hospital or hospital beds will affect the ability of existing hospitals
346.30in the region to maintain existing staff;
346.31    (4) the extent to which the new hospital or hospital beds will provide services to
346.32nonpaying or low-income patients relative to the level of services provided to these groups
346.33by existing hospitals in the region; and
346.34    (5) the views of affected parties.
347.1    (d) If the plan is being submitted by an existing hospital seeking authority to
347.2construct a new hospital, the commissioner shall also consider:
347.3    (1) the ability of the applicant to maintain the applicant's current level of community
347.4benefit as defined in section 144.699, subdivision 5, at the existing facility; and
347.5    (2) the impact on the workforce at the existing facility including the applicant's
347.6plan for:
347.7    (i) transitioning current workers to the new facility;
347.8    (ii) retraining and employment security for current workers; and
347.9    (iii) addressing the impact of layoffs at the existing facility on affected workers.
347.10    (e) Prior to making a recommendation, the commissioner shall conduct a public
347.11hearing in the affected hospital service area to take testimony from interested persons.
347.12    (d) (f) Upon making a recommendation under paragraph (c), the commissioner shall
347.13provide a copy of the recommendation to the chairs of the house and senate committees
347.14having jurisdiction over health and human services policy and finance.
347.15    (g) If an exception to the moratorium is approved under section 144.551 after a
347.16review under this section, the commissioner shall monitor the implementation of the
347.17exception up to completion of the construction project. Thirty days after completion of
347.18the construction project, the hospital shall submit to the commissioner a report on how
347.19the construction has met the provisions of the plan originally submitted under the public
347.20interest review process or a plan submitted pursuant to section 144.551, subdivision 1,
347.21paragraph (b), clause (20).

347.22    Sec. 15. Minnesota Statutes 2006, section 144.553, subdivision 3, is amended to read:
347.23    Subd. 3. Process when hospital need is determined. (a) If the commissioner
347.24determines that a new hospital is needed in the proposed service area, the commissioner
347.25shall notify the applicants of that finding and shall select the applicant determined under
347.26the process established in this subdivision to be best able to provide services consistent
347.27with the review criteria established in this subdivision.
347.28    (b) The commissioner shall:
347.29    (1) determine market-specific criteria that shall be used to evaluate all proposals.
347.30The criteria must include standards regarding:
347.31    (i) access to care;
347.32    (ii) quality of care;
347.33    (iii) cost of care; and
347.34    (iv) overall project feasibility;
348.1    (2) establish additional criteria at the commissioner's discretion. In establishing the
348.2criteria, the commissioner shall consider the need for:
348.3    (i) mental health services in the service area, including both inpatient and outpatient
348.4services for adults, adolescents, and children;
348.5    (ii) a significant commitment to providing uncompensated care, including discounts
348.6for uninsured patients and coordination with other providers of care to low-income
348.7uninsured persons; and
348.8    (iii) coordination with other hospitals so that specialized services are not
348.9unnecessarily duplicated and are provided in sufficient volume to ensure the maintenance
348.10of high-quality care; and
348.11    (3) define a service area for the proposed hospital. The service area shall consist of:
348.12    (i) in the 11-county metropolitan area, in St. Cloud, and in Duluth, the zip codes
348.13located within a 20-mile radius of the proposed new hospital location; and
348.14    (ii) in the remainder of the state, the zip codes within a 30-mile radius of the
348.15proposed new hospital location.
348.16    (c) If the plan is being submitted by an existing hospital, the commissioner shall
348.17also consider:
348.18    (1) the ability of the applicant to maintain the applicant's current level of community
348.19benefit as defined in section 144.699, subdivision 5, at the existing facility; and
348.20    (2) the impact on the workforce at the existing facility including the applicant's
348.21plan for:
348.22    (i) transitioning current workers to the new facility;
348.23    (ii) retraining and employment security for current workers; and
348.24    (iii) addressing the impact of layoffs at the existing facility on affected workers.
348.25    (d) The commissioner shall publish the criteria determined under paragraph
348.26paragraphs (b) and (c) in the State Register within 60 days of the determination under
348.27subdivision 2. Once published, the criteria shall not be modified with respect to the
348.28particular project and applicants to which they apply. The commissioner shall publish with
348.29the criteria guidelines for a proposal and submission review process.
348.30    (d) (e) For 60 days after the publication under paragraph (c) (d), the commissioner
348.31shall accept proposals to construct a hospital from organizations that have submitted a
348.32letter of intent under subdivision 1, paragraph (a), or have notified the commissioner under
348.33subdivision 1, paragraph (b). The proposal must include a plan for the new hospital and
348.34evidence of compliance with the criteria specified under paragraph paragraphs (b) and (c).
348.35Once submitted, the proposal may not be revised except:
348.36    (1) to submit corrections of material facts; or
349.1    (2) in response to a request from the commissioner to provide clarification or
349.2further information.
349.3    (e) (f) The commissioner shall determine within 90 days of the deadline for
349.4applications under paragraph (d) (e), which applicant has demonstrated that it is best able
349.5to provide services consistent with the published criteria. The commissioner shall make
349.6this determination by order following a hearing according to this paragraph. The hearing
349.7shall not constitute or be considered to be a contested case hearing under chapter 14 and
349.8shall be conducted solely under the procedures specified in this paragraph. The hearing
349.9shall commence upon at least 30 days' notice to the applicants by the commissioner.
349.10The hearing may be conducted by the commissioner or by a person designated by the
349.11commissioner. The designee may be an administrative law judge. The purpose of the
349.12hearing shall be to receive evidence to assist the commissioner in determining which
349.13applicant has demonstrated that it best meets the published criteria.
349.14    The parties to the hearing shall consist only of those applicants who have submitted
349.15a completed application. Each applicant shall have the right to be represented by
349.16counsel, to present evidence deemed relevant by the commissioner, and to examine and
349.17cross-examine witnesses. Persons who are not parties to the proceeding but who wish to
349.18present comments or submit information may do so in the manner determined by the
349.19commissioner or the commissioner's designee. Any person who is not a party shall have
349.20no right to examine or cross-examine witnesses. The commissioner may participate as an
349.21active finder of fact in the hearing and may ask questions to elicit information or clarify
349.22answers or responses.
349.23    (f) (g) Prior to making a determination selecting an application, the commissioner
349.24shall hold a public hearing in the proposed hospital service area to accept comments from
349.25members of the public. The commissioner shall take this information into consideration in
349.26making the determination. The commissioner may shall appoint an advisory committee,
349.27including legislators and local elected officials who represent the service area and outside
349.28experts to assist in the recommendation process. The legislative appointees shall include,
349.29at a minimum, the chairs of the senate and house of representatives committees with
349.30jurisdiction over health care policy. The commissioner shall issue an order selecting an
349.31application following the closing of the record of the hearing as determined by the hearing
349.32officer. The commissioner's order shall include a statement of the reasons the selected
349.33application best meets the published criteria.
349.34    (g) (h) Within 30 days following the determination under paragraph (e) (f), the
349.35commissioner shall recommend the selected proposal to the legislature.
350.1    (i) If an exception to the moratorium is approved under section 144.551 after a
350.2review under this section, the commissioner shall monitor the implementation of the
350.3exception up to completion of the construction project. Thirty days after completion of
350.4the construction project, the hospital shall submit to the commissioner a report on how
350.5the construction has met the provisions of the plan originally submitted under the public
350.6interest review process or a plan submitted pursuant to section 144.551, subdivision 1,
350.7paragraph (b), clause (20).

350.8    Sec. 16. Minnesota Statutes 2006, section 144.565, is amended to read:
350.9144.565 DIAGNOSTIC IMAGING FACILITIES.
350.10    Subdivision 1. Utilization and services data; economic and financial interests.
350.11    The commissioner shall require diagnostic imaging facilities and providers of diagnostic
350.12imaging services in Minnesota to annually report by March 1 each year for the preceding
350.13fiscal year to the commissioner, in the form and manner specified by the commissioner:
350.14    (1) utilization data for each health plan company and each public program,
350.15including workers' compensation, as follows: of diagnostic imaging services as defined
350.16in subdivision 4, paragraph (b);
350.17    (i) the number of computerized tomography (CT) procedures performed;
350.18    (ii) the number of magnetic resonance imaging (MRI) procedures performed; and
350.19    (iii) the number of positron emission tomography (PET) procedures performed; and
350.20    (2) the names of all physicians with any financial or economic interest excluding
350.21salaried physicians, unless the physicians' salary is adjusted for volume of service, and all
350.22other individuals with a ten percent or greater financial or economic interest in the facility.;
350.23    (3) the location where procedures were performed;
350.24    (4) the number of units of each type of fixed, portable, and mobile scanner used at
350.25each location;
350.26    (5) the average number of hours per month each mobile scanner was operated at
350.27each location;
350.28    (6) the number of hours per month each scanner was leased, if applicable;
350.29    (7) the total number of diagnostic imaging procedures billed for by the provider at
350.30each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph
350.31(b); and
350.32    (8) a report on major health care capital expenditures during the previous year, as
350.33required by section 62J.17.
350.34    Subd. 2. Commissioner's right to inspect records. If the report is not filed or
350.35the commissioner of health has reason to believe the report is incomplete or false, the
351.1commissioner shall have the right to inspect diagnostic imaging facility books, audits,
351.2and records.
351.3    Subd. 3. Separate reports. For a diagnostic imaging facility that is not attached
351.4or not contiguous to a hospital or a hospital affiliate, the commissioner shall require
351.5the information in subdivision 1 be reported separately for each detached diagnostic
351.6imaging facility as part of the report required under section 144.702. If any entity owns
351.7more than one diagnostic imaging facility, that entity must report by individual facility.
351.8Reports must include only services that were billed by the provider of diagnostic imaging
351.9services submitting the report. If a diagnostic imaging facility leases capacity, technical
351.10services, or professional services to one or more other providers of diagnostic imaging
351.11services, each provider must submit a separate annual report to the commissioner for all
351.12diagnostic imaging services that it provided and billed. The owner of the leased capacity
351.13must provide a report listing the names and addresses of providers to whom the diagnostic
351.14imaging services and equipment were leased.
351.15    Subd. 4. Definitions. For purposes of this section, the following terms have the
351.16meanings given:
351.17    (a) "Diagnostic imaging facility" means a health care facility that provides is not
351.18a hospital or location licensed as a hospital which offers diagnostic imaging services
351.19through the use of ionizing radiation or other imaging technique including, but not limited
351.20to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a
351.21freestanding or mobile basis in Minnesota, regardless of whether the equipment used
351.22to provide the service is owned or leased. For the purposes of this section, diagnostic
351.23imaging facility includes, but is not limited to, facilities such as a physician's office, clinic,
351.24mobile transport vehicle, outpatient imaging center, or surgical center.
351.25    (b) "Diagnostic imaging service" means the use of ionizing radiation or other
351.26imaging technique on a human patient including, but not limited to, magnetic resonance
351.27imaging (MRI) or computerized tomography (CT), positron emission tomography (PET),
351.28or single photon emission computerized tomography (SPECT) scans using fixed, portable,
351.29or mobile equipment.
351.30    (b) (c) "Financial or economic interest" means a direct or indirect:
351.31    (1) equity or debt security issued by an entity, including, but not limited to, shares of
351.32stock in a corporation, membership in a limited liability company, beneficial interest in
351.33a trust, units or other interests in a partnership, bonds, debentures, notes or other equity
351.34interests or debt instruments, or any contractual arrangements;
351.35    (2) membership, proprietary interest, or co-ownership with an individual, group, or
351.36organization to which patients, clients, or customers are referred to; or
352.1    (3) employer-employee or independent contractor relationship, including, but not
352.2limited to, those that may occur in a limited partnership, profit-sharing arrangement, or
352.3other similar arrangement with any facility to which patients are referred, including any
352.4compensation between a facility and a health care provider, the group practice of which
352.5the provider is a member or employee or a related party with respect to any of them.
352.6    (c) (d) "Freestanding Fixed equipment" means a stationary diagnostic imaging
352.7facility that is not located within a: machine installed in a permanent location.
352.8    (1) hospital;
352.9    (2) location licensed as a hospital; or
352.10    (3) physician's office or clinic where the professional practice of medicine by
352.11licensed physicians is the primary purpose and not the provision of ancillary services
352.12such as diagnostic imaging.
352.13    (d) (e) "Mobile equipment" means a diagnostic imaging facility that is transported to
352.14various sites not including movement within a hospital or a physician's office or clinic
352.15machine in a self-contained transport vehicle designed to be brought to a temporary offsite
352.16location to perform diagnostic imaging services.
352.17    (f) "Portable equipment" means a diagnostic imaging machine designed to be
352.18temporarily transported within a permanent location to perform diagnostic imaging
352.19services.
352.20    (g) "Provider of diagnostic imaging services" means a diagnostic imaging facility
352.21or an entity that offers and bills for diagnostic imaging services at a facility owned or
352.22leased by the entity.
352.23    Subd. 5. Reports open to public inspection. All reports filed pursuant to this
352.24section shall be open to public inspection.

352.25    Sec. 17. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS
352.26CONTROL PROGRAMS.
352.27    In order to improve the prevention of hospital-associated infections due
352.28to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall
352.29establish an MRSA control program that meets Minnesota Department of Health
352.30MRSA recommendations as published January 15, 2008. In developing the MRSA
352.31recommendations, the Department of Health shall consider the following infection control
352.32practices:
352.33    (1) identification of MRSA-colonized patients in all intensive care units, or other
352.34at-risk patients identified by the hospital;
353.1    (2) isolation of identified MRSA-colonized or MRSA-infected patients in an
353.2appropriate manner;
353.3    (3) adherence to hand hygiene requirements; and
353.4    (4) monitor trends in the incidence of MRSA in the hospital over time and modify
353.5interventions if MRSA infection rates do not decrease.
353.6The Department of Health shall review the MRSA recommendations on an annual basis
353.7and revise the recommendations as necessary, in accordance with available scientific data.

353.8    Sec. 18. Minnesota Statutes 2006, section 144.651, subdivision 9, is amended to read:
353.9    Subd. 9. Information about treatment. Patients and residents shall be given by
353.10their physicians complete and current information concerning their diagnosis, treatment,
353.11alternatives, risks, and prognosis as required by the physician's legal duty to disclose. This
353.12information shall be in terms and language the patients or residents can reasonably be
353.13expected to understand. Patients and residents may be accompanied by a family member
353.14or other chosen representative, or both. This information shall include the likely medical
353.15or major psychological results of the treatment and its alternatives. In cases where it is
353.16medically inadvisable, as documented by the attending physician in a patient's or resident's
353.17medical record, the information shall be given to the patient's or resident's guardian or
353.18other person designated by the patient or resident as a representative. Individuals have the
353.19right to refuse this information.
353.20    Every patient or resident suffering from any form of breast cancer shall be fully
353.21informed, prior to or at the time of admission and during her stay, of all alternative
353.22effective methods of treatment of which the treating physician is knowledgeable, including
353.23surgical, radiological, or chemotherapeutic treatments or combinations of treatments and
353.24the risks associated with each of those methods.

353.25    Sec. 19. Minnesota Statutes 2006, section 144.651, subdivision 10, is amended to read:
353.26    Subd. 10. Participation in planning treatment; notification of family members.
353.27    (a) Patients and residents shall have the right to participate in the planning of their
353.28health care. This right includes the opportunity to discuss treatment and alternatives
353.29with individual caregivers, the opportunity to request and participate in formal care
353.30conferences, and the right to include a family member or other chosen representative, or
353.31both. In the event that the patient or resident cannot be present, a family member or other
353.32representative chosen by the patient or resident may be included in such conferences. A
353.33chosen representative may include a doula of the patient's choice.
354.1    (b) If a patient or resident who enters a facility is unconscious or comatose or is
354.2unable to communicate, the facility shall make reasonable efforts as required under
354.3paragraph (c) to notify either a family member or a person designated in writing by the
354.4patient as the person to contact in an emergency that the patient or resident has been
354.5admitted to the facility. The facility shall allow the family member to participate in
354.6treatment planning, unless the facility knows or has reason to believe the patient or
354.7resident has an effective advance directive to the contrary or knows the patient or resident
354.8has specified in writing that they do not want a family member included in treatment
354.9planning. After notifying a family member but prior to allowing a family member to
354.10participate in treatment planning, the facility must make reasonable efforts, consistent
354.11with reasonable medical practice, to determine if the patient or resident has executed an
354.12advance directive relative to the patient or resident's health care decisions. For purposes of
354.13this paragraph, "reasonable efforts" include:
354.14    (1) examining the personal effects of the patient or resident;
354.15    (2) examining the medical records of the patient or resident in the possession
354.16of the facility;
354.17    (3) inquiring of any emergency contact or family member contacted under this
354.18section whether the patient or resident has executed an advance directive and whether the
354.19patient or resident has a physician to whom the patient or resident normally goes for
354.20care; and
354.21    (4) inquiring of the physician to whom the patient or resident normally goes for care,
354.22if known, whether the patient or resident has executed an advance directive. If a facility
354.23notifies a family member or designated emergency contact or allows a family member
354.24to participate in treatment planning in accordance with this paragraph, the facility is not
354.25liable to the patient or resident for damages on the grounds that the notification of the
354.26family member or emergency contact or the participation of the family member was
354.27improper or violated the patient's privacy rights.
354.28    (c) In making reasonable efforts to notify a family member or designated emergency
354.29contact, the facility shall attempt to identify family members or a designated emergency
354.30contact by examining the personal effects of the patient or resident and the medical records
354.31of the patient or resident in the possession of the facility. If the facility is unable to notify
354.32a family member or designated emergency contact within 24 hours after the admission,
354.33the facility shall notify the county social service agency or local law enforcement agency
354.34that the patient or resident has been admitted and the facility has been unable to notify a
354.35family member or designated emergency contact. The county social service agency and
354.36local law enforcement agency shall assist the facility in identifying and notifying a family
355.1member or designated emergency contact. A county social service agency or local law
355.2enforcement agency that assists a facility in implementing this subdivision is not liable
355.3to the patient or resident for damages on the grounds that the notification of the family
355.4member or emergency contact or the participation of the family member was improper or
355.5violated the patient's privacy rights.

355.6    Sec. 20. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:
355.7    Subd. 26. Right to associate. (a) Residents may meet with and receive visitors
355.8and participate in activities of commercial, religious, political, as defined in section
355.9203B.11 and community groups without interference at their discretion if the activities
355.10do not infringe on the right to privacy of other residents or are not programmatically
355.11contraindicated. This includes:
355.12    (1) the right to join with other individuals within and outside the facility to work for
355.13improvements in long-term care;
355.14    (2) the right to visitation by an individual the patient has appointed as the patient's
355.15health care agent under chapter 145C;
355.16    (3) the right to visitation and health care decision making by an individual designated
355.17by the patient under paragraph (c).
355.18    (b) Upon admission to a facility where federal law prohibits unauthorized disclosure
355.19of patient or resident identifying information to callers and visitors, the patient or
355.20resident, or the legal guardian or conservator of the patient or resident, shall be given the
355.21opportunity to authorize disclosure of the patient's or resident's presence in the facility
355.22to callers and visitors who may seek to communicate with the patient or resident. To the
355.23extent possible, the legal guardian or conservator of a patient or resident shall consider the
355.24opinions of the patient or resident regarding the disclosure of the patient's or resident's
355.25presence in the facility.
355.26    (c) Upon admission to a facility, the patient or resident, or the legal guardian
355.27or conservator of the patient or resident, must be given the opportunity to designate
355.28a person who is not related who will have the status of the patient's next of kin with
355.29respect to visitation and making a health care decision. A designation must be included
355.30in the patient's health record. With respect to making a health care decision, a health
355.31care directive or appointment of a health care agent under chapter 145C prevails over a
355.32designation made under this paragraph. The unrelated person may also be identified as
355.33such by the patient or by the patient's family.

356.1    Sec. 21. Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision
356.2to read:
356.3    Subd. 5. Annual reports on community benefit, community care amounts, and
356.4state program underfunding. (a) For each hospital reporting health care cost information
356.5under section 144.698 or 144.702, the commissioner shall report annually on the
356.6hospital's community benefit and community care, including detailed information on each
356.7component of those costs as defined in this subdivision. The information shall be reported
356.8in terms of total dollars and as a percentage of total operating costs for each hospital.
356.9    (b) For purposes of this subdivision, "community benefit" means the costs of
356.10community care, underpayment for services provided under state health care programs,
356.11research costs, community health services costs, financial and in-kind contributions, costs
356.12of community building activities, costs of community benefit operations, education costs,
356.13and the cost of operating subsidized services. The cost of bad debts and underpayment for
356.14Medicare services are not included in the calculation of community benefit.
356.15    (c) For purposes of this subdivision, "community care" means the costs for medical
356.16care that a hospital has determined is charity care as defined under Minnesota Rules, part
356.174650.0115, or for which the hospital determines after billing for the services that there is a
356.18demonstrated inability to pay. Any costs forgiven under a hospital's community care plan
356.19or under section 62J.83 may be counted in the hospital's calculation of community care.
356.20Bad debt expenses and discounted charges available to the uninsured shall not be included
356.21in the calculation of community care. The amount of community care is the value of costs
356.22incurred and not the charges made for services.
356.23    (d) For purposes of this subdivision, "underpayment for services provided under
356.24state health care programs" means the difference between hospital costs and public
356.25program payments.

356.26    Sec. 22. Minnesota Statutes 2006, section 145C.05, is amended to read:
356.27145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.
356.28    Subdivision 1. Content. A health care directive executed pursuant to this chapter
356.29may, but need not, be in the form contained in section 145C.16.
356.30    Subd. 2. Provisions that may be included. (a) A health care directive may include
356.31provisions consistent with this chapter, including, but not limited to:
356.32    (1) the designation of one or more alternate health care agents to act if the named
356.33health care agent is not reasonably available to serve;
357.1    (2) directions to joint health care agents regarding the process or standards by which
357.2the health care agents are to reach a health care decision for the principal, and a statement
357.3whether joint health care agents may act independently of one another;
357.4    (3) limitations, if any, on the right of the health care agent or any alternate health
357.5care agents to receive, review, obtain copies of, and consent to the disclosure of the
357.6principal's medical records or to visit the principal when the principal is a patient in a
357.7health care facility;
357.8    (4) limitations, if any, on the nomination of the health care agent as guardian for
357.9purposes of sections 524.5-202, 524.5-211, 524.5-302, and 524.5-303;
357.10    (5) a document of gift for the purpose of making an anatomical gift, as set forth in
357.11sections 525.921 to 525.9224, or an amendment to, revocation of, or refusal to make
357.12an anatomical gift;
357.13    (6) a declaration regarding intrusive mental health treatment under section 253B.03,
357.14subdivision 6d , or a statement that the health care agent is authorized to give consent for
357.15the principal under section 253B.04, subdivision 1a;
357.16    (7) a funeral directive as provided in section 149A.80, subdivision 2;
357.17    (8) limitations, if any, to the effect of dissolution or annulment of marriage or
357.18termination of domestic partnership on the appointment of a health care agent under
357.19section 145C.09, subdivision 2;
357.20    (9) specific reasons why a principal wants a health care provider or an employee
357.21of a health care provider attending the principal to be eligible to act as the principal's
357.22health care agent;
357.23    (10) health care instructions by a woman of child bearing age regarding how she
357.24would like her pregnancy, if any, to affect health care decisions made on her behalf; and
357.25    (11) health care instructions regarding artificially administered nutrition or hydration.
357.26    (b) A health care directive may include a statement of the circumstances under
357.27which the directive becomes effective other than upon the judgment of the principal's
357.28attending physician in the following situations:
357.29    (1) a principal who in good faith generally selects and depends upon spiritual means
357.30or prayer for the treatment or care of disease or remedial care and does not have an
357.31attending physician, may include a statement appointing an individual who may determine
357.32the principal's decision-making capacity; and
357.33    (2) a principal who in good faith does not generally select a physician or a health
357.34care facility for the principal's health care needs may include a statement appointing an
357.35individual who may determine the principal's decision-making capacity, provided that if
357.36the need to determine the principal's capacity arises when the principal is receiving care
358.1under the direction of an attending physician in a health care facility, the determination
358.2must be made by an attending physician after consultation with the appointed individual.
358.3    If a person appointed under clause (1) or (2) is not reasonably available and the
358.4principal is receiving care under the direction of an attending physician in a health care
358.5facility, an attending physician shall determine the principal's decision-making capacity.
358.6    (c) A health care directive may authorize a health care agent to make health care
358.7decisions for a principal even though the principal retains decision-making capacity.

358.8    Sec. 23. Minnesota Statutes 2006, section 145C.07, is amended by adding a
358.9subdivision to read:
358.10    Subd. 5. Visitation. A health care agent may visit the principal when the
358.11principal is a patient in a health care facility regardless of whether the principal retains
358.12decision-making capacity, unless:
358.13    (1) the principal has otherwise specified in the health care directive;
358.14    (2) a principal who retains decision-making capacity indicates otherwise; or
358.15    (3) a health care provider reasonably determines that the principal must be isolated
358.16from all visitors or that the presence of the health care agent would endanger the health or
358.17safety of the principal, other patients, or the facility in which the care is being provided.

358.18    Sec. 24. Minnesota Statutes 2006, section 148.6445, subdivision 1, is amended to read:
358.19    Subdivision 1. Initial licensure fee. The initial licensure fee for occupational
358.20therapists is $180 $145. The initial licensure fee for occupational therapy assistants is
358.21$100 $80. The commissioner shall prorate fees based on the number of quarters remaining
358.22in the biennial licensure period.

358.23    Sec. 25. Minnesota Statutes 2006, section 148.6445, subdivision 2, is amended to read:
358.24    Subd. 2. Licensure renewal fee. The biennial licensure renewal fee for
358.25occupational therapists is $180 $145. The biennial licensure renewal fee for occupational
358.26therapy assistants is $100 $80.

358.27    Sec. 26. [148.785] FEES.
358.28    The fees charged by the board are fixed at the following rates:
358.29    (1) application fee for physical therapists and physical therapist assistants, $100;
358.30    (2) annual licensure for physical therapists and physical therapist assistants, $60;
358.31    (3) licensure renewal late fee, $20;
358.32    (4) temporary permit, $25;
359.1    (5) duplicate license or registration, $20;
359.2    (6) certification letter, $25;
359.3    (7) education or training program approval, $100;
359.4    (8) report creation and generation, $60 per hour billed in quarter-hour increments
359.5with a quarter-hour minimum; and
359.6    (9) examination administration:
359.7    (i) half day, $50; and
359.8    (ii) full day, $80.

359.9    Sec. 27. [148.995] DEFINITIONS.
359.10    Subdivision 1. Applicability. The definitions in this section apply to sections
359.11148.995 to 148.997.
359.12    Subd. 2. Certified doula. "Certified doula" means an individual who has received
359.13a certification to perform doula services from the International Childbirth Education
359.14Association, the Doulas of North America (DONA), the Association of Labor Assistants
359.15and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional
359.16Association (CAPPA), or Childbirth International.
359.17    Subd. 3. Commissioner. "Commissioner" means the commissioner of health.
359.18    Subd. 4. Doula services. "Doula services" means emotional and physical support
359.19during pregnancy, labor, birth, and postpartum.
359.20EFFECTIVE DATE.This section is effective July 1, 2007.

359.21    Sec. 28. [148.996] REGISTRY.
359.22    Subdivision 1. Establishment. The commissioner of health shall maintain a registry
359.23of certified doulas who have met the requirements listed in subdivision 2.
359.24    Subd. 2. Qualifications. The commissioner shall include on the registry any
359.25individual who:
359.26    (1) submits an application on a form provided by the commissioner. The form must
359.27include the applicant's name, address, and contact information;
359.28    (2) maintains a current certification from one of the organizations listed in section
359.29146B.01, subdivision 2; and
359.30    (3) pays the fees required under section 148.997.
359.31    Subd. 3. Criminal background check. The commissioner shall conduct a
359.32criminal background check by reviewing the Bureau of Criminal Apprehension's Web
359.33site. If the review indicates that an applicant has been engaged in criminal behavior,
360.1the commissioner shall indicate this on the registry and provide a link to the Bureau of
360.2Criminal Apprehension's Web site.
360.3    Subd. 4. Renewal. Inclusion on the registry maintained by the commissioner is
360.4valid for three years. At the end of the three-year period, the certified doula may submit a
360.5new application to remain on the doula registry by meeting the requirements described in
360.6subdivision 2.
360.7    Subd. 5. Public access. The commissioner shall provide a link to the registry
360.8on the Department of Health's Web site.
360.9EFFECTIVE DATE.This section is effective July 1, 2007.

360.10    Sec. 29. [148.997] FEES.
360.11    Subdivision 1. Fees. (a) The application fee is $130.
360.12    (b) The criminal background check fee is $6.
360.13    Subd. 2. Nonrefundable fees. The fees in this section are nonrefundable.
360.14EFFECTIVE DATE.This section is effective July 1, 2007.

360.15    Sec. 30. Minnesota Statutes 2006, section 148B.53, subdivision 3, is amended to read:
360.16    Subd. 3. Fee. Nonrefundable fees are as follows:
360.17    (1) initial license application fee for licensed professional counseling (LPC) - $250
360.18$150;
360.19    (2) initial license fee for LPC - $250;
360.20    (3) annual active license renewal fee for LPC - $200 $250 or equivalent;
360.21    (3) (4) annual inactive license renewal fee for LPC - $100 $125;
360.22    (5) initial license application fee for licensed professional clinical counseling
360.23(LPCC) - $150;
360.24    (6) initial license fee for LPCC - $250;
360.25    (7) annual active license renewal fee for LPCC - $250 or equivalent;
360.26    (8) annual inactive license renewal fee for LPCC - $125;
360.27    (4) (9) license renewal late fee - $100 per month or portion thereof;
360.28    (5) (10) copy of board order or stipulation - $10;
360.29    (6) (11) certificate of good standing or license verification - $10 $25;
360.30    (7) (12) duplicate certificate fee - $10 $25;
360.31    (8) (13) professional firm renewal fee - $25;
360.32    (9) (14) sponsor application for approval of a continuing education course - $60;
360.33    (15) initial registration fee - $50; and
361.1    (10) (16) annual registration renewal fee - $25; and
361.2    (17) approved supervisor application processing fee - $30.

361.3    Sec. 31. Minnesota Statutes 2006, section 149A.52, subdivision 3, is amended to read:
361.4    Subd. 3. Application procedure; documentation; initial inspection. An applicant
361.5for a license to operate a crematory shall submit to the commissioner a completed
361.6application. A completed application includes:
361.7    (1) a completed application form, as provided by the commissioner;
361.8    (2) proof of business form and ownership; and
361.9    (3) proof of liability insurance coverage or other financial documentation, as
361.10determined by the commissioner, that demonstrates the applicant's ability to respond in
361.11damages for liability arising from the ownership, maintenance, management, or operation
361.12of a crematory.
361.13    Upon receipt of the application and appropriate fee, the commissioner shall review
361.14and verify all information. Upon completion of the verification process and resolution
361.15of any deficiencies in the application information, the commissioner shall conduct an
361.16initial inspection of the premises to be licensed. After the inspection and resolution of
361.17any deficiencies found and any reinspections as may be necessary, the commissioner shall
361.18make a determination, based on all the information available, to grant or deny licensure. If
361.19the commissioner's determination is to grant the license, the applicant shall be notified and
361.20the license shall issue and remain valid for a period prescribed on the license, but not to
361.21exceed one calendar year from the date of issuance of the license. If the commissioner's
361.22determination is to deny the license, the commissioner must notify the applicant, in
361.23writing, of the denial and provide the specific reason for denial.

361.24    Sec. 32. [149A.65] FEES.
361.25    Subdivision 1. Generally. This section establishes the fees for registrations,
361.26examinations, initial and renewal licenses, and late fees authorized under the provisions
361.27of this chapter.
361.28    Subd. 2. Mortuary science fees. Fees for mortuary science are:
361.29    (1) $50 for the initial and renewal registration of a mortuary science intern;
361.30    (2) $100 for the mortuary science examination;
361.31    (3) $125 for issuance of initial and renewal mortuary science licenses;
361.32    (4) $25 late fee charge for a license renewal; and
361.33    (5) $200 for issuing a mortuary science license by endorsement.
362.1    Subd. 3. Funeral directors. The license renewal fee for funeral directors is $125.
362.2The late fee charge for a license renewal is $25.
362.3    Subd. 4. Funeral establishments. The initial and renewal fee for funeral
362.4establishments is $300. The late fee charge for a license renewal is $25.
362.5    Subd. 5. Crematories. The initial and renewal fee for a crematory is $300. The
362.6late fee charge for a license renewal is $25.

362.7    Sec. 33. Minnesota Statutes 2006, section 149A.97, subdivision 7, is amended to read:
362.8    Subd. 7. Reports to commissioner. Every funeral provider lawfully doing business
362.9in Minnesota that accepts funds under subdivision 2 must make a complete annual report
362.10to the commissioner. The reports may be on forms provided by the commissioner or
362.11substantially similar forms containing, at least, identification and the state of each trust
362.12account, including all transactions involving principal and accrued interest, and must be
362.13filed by March 31 of the calendar year following the reporting year along with a filing
362.14fee of $15 $25 for each report. Fees shall be paid to the commissioner of finance, state of
362.15Minnesota, for deposit in the state government special revenue fund in the state treasury.
362.16Reports must be signed by an authorized representative of the funeral provider and
362.17notarized under oath. All reports to the commissioner shall be reviewed for account
362.18inaccuracies or possible violations of this section. If the commissioner has a reasonable
362.19belief to suspect that there are account irregularities or possible violations of this section,
362.20the commissioner shall report that belief, in a timely manner, to the state auditor. The
362.21commissioner shall also file an annual letter with the state auditor disclosing whether or
362.22not any irregularities or possible violations were detected in review of the annual trust
362.23fund reports filed by the funeral providers. This letter shall be filed with the state auditor
362.24by May 31 of the calendar year following the reporting year.

362.25    Sec. 34. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:
362.26    Subdivision 1. License required annually. A license is required annually for every
362.27person, firm, or corporation engaged in the business of conducting a food and beverage
362.28service establishment, hotel, motel, lodging establishment, or resort. Any person wishing
362.29to operate a place of business licensed in this section shall first make application, pay the
362.30required fee specified in this section, and receive approval for operation, including plan
362.31review approval. Seasonal and temporary food stands and special event food stands are
362.32not required to submit plans. Nonprofit organizations operating a special event food
362.33stand with multiple locations at an annual one-day event shall be issued only one license.
362.34Application shall be made on forms provided by the commissioner and shall require
363.1the applicant to state the full name and address of the owner of the building, structure,
363.2or enclosure, the lessee and manager of the food and beverage service establishment,
363.3hotel, motel, lodging establishment, or resort; the name under which the business is to
363.4be conducted; and any other information as may be required by the commissioner to
363.5complete the application for license.

363.6    Sec. 35. INJUNCTIVE RELIEF REPORT.
363.7    The commissioner of health shall present to the 2008 legislature, by December 15,
363.82007, recommendations to fund the cost of bringing actions for injunctive relief under
363.9Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).

363.10    Sec. 36. HEARING AID DISPENSER FEES.
363.11    Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section
363.12153A.17, may not be increased until after the Department of Health provides a report to
363.13the legislature regarding the need and reasons for fee increases.

363.14    Sec. 37. REPEALER.
363.15Minnesota Rules, part 4610.2800, is repealed.

363.16ARTICLE 10

363.17DEPARTMENT OF HEALTH

363.18    Section 1. Minnesota Statutes 2006, section 62Q.80, is amended by adding a
363.19subdivision to read:
363.20    Subd. 1a. Demonstration project. The commissioner of health shall award a
363.21demonstration project grant to a community-based health care initiative to develop and
363.22operate a community-based health care coverage program to operate within Carlton, Cook,
363.23Lake, and St. Louis County. The demonstration project shall extend for five years and
363.24must comply with the requirements of this section.

363.25    Sec. 2. [144.291] MINNESOTA HEALTH RECORDS ACT.
363.26    Subdivision 1. Short title. Sections 144.291 to 144.298 may be cited as the
363.27Minnesota Health Records Act.
363.28    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following
363.29terms have the meanings given.
363.30    (a) Group purchaser. "Group purchaser" has the meaning given in section 62J.03,
363.31subdivision 6.
364.1    (b) Health information exchange. "Health information exchange" means a legal
364.2arrangement between health care providers and group purchasers to enable and oversee the
364.3business and legal issues involved in the electronic exchange of health records between
364.4the entities for the delivery of patient care.
364.5    (c) Health record. "Health record" means any information, whether oral or recorded
364.6in any form or medium, that relates to the past, present, or future physical or mental health
364.7or condition of a patient; the provision of health care to a patient; or the past, present, or
364.8future payment for the provision of health care to a patient.
364.9    (d) Identifying information. "Identifying information" means the patient's name,
364.10address, date of birth, gender, parent's or guardian's name regardless of the age of the
364.11patient, and other nonclinical data which can be used to uniquely identify a patient.
364.12    (e) Individually identifiable form. "Individually identifiable form" means a form in
364.13which the patient is or can be identified as the subject of the health records.
364.14    (f) Medical emergency. "Medical emergency" means medically necessary care
364.15which is immediately needed to preserve life, prevent serious impairment to bodily
364.16functions, organs, or parts, or prevent placing the physical or mental health of the patient
364.17in serious jeopardy.
364.18    (g) Patient. "Patient" means a natural person who has received health care services
364.19from a provider for treatment or examination of a medical, psychiatric, or mental
364.20condition, the surviving spouse and parents of a deceased patient, or a person the patient
364.21appoints in writing as a representative, including a health care agent acting according to
364.22chapter 145C, unless the authority of the agent has been limited by the principal in the
364.23principal's health care directive. Except for minors who have received health care services
364.24under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or
364.25guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.
364.26    (h) Provider. "Provider" means:
364.27    (1) any person who furnishes health care services and is regulated to furnish the
364.28services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
364.29151, 153, or 153A;
364.30    (2) a home care provider licensed under section 144A.46;
364.31    (3) a health care facility licensed under this chapter or chapter 144A;
364.32    (4) a physician assistant registered under chapter 147A; and
364.33    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to
364.34148B.71.
365.1    (i) Record locator service. "Record locator service" means an electronic index of
365.2patient identifying information that directs providers in a health information exchange to
365.3the location of patient health records held by providers and group purchasers.
365.4    (j) Related health care entity. "Related health care entity" means an affiliate, as
365.5defined in section 144.6521, subdivision 3, paragraph (b), of the provider releasing the
365.6health records.

365.7    Sec. 3. [144.292] PATIENT RIGHTS.
365.8    Subdivision 1. Scope. Patients have the rights specified in this section regarding the
365.9treatment the patient receives and the patient's health record.
365.10    Subd. 2. Patient access. Upon request, a provider shall supply to a patient complete
365.11and current information possessed by that provider concerning any diagnosis, treatment,
365.12and prognosis of the patient in terms and language the patient can reasonably be expected
365.13to understand.
365.14    Subd. 3. Additional patient rights. A patient's right specified in this section and
365.15sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and
365.16144.652 and any other provision of law relating to the access of a patient to the patient's
365.17health records.
365.18    Subd. 4. Notice of rights; information on release. A provider shall provide to
365.19patients, in a clear and conspicuous manner, a written notice concerning practices and
365.20rights with respect to access to health records. The notice must include an explanation of:
365.21    (1) disclosures of health records that may be made without the written consent of the
365.22patient, including the type of records and to whom the records may be disclosed; and
365.23    (2) the right of the patient to have access to and obtain copies of the patient's health
365.24records and other information about the patient that is maintained by the provider.
365.25    The notice requirements of this subdivision are satisfied if the notice is included with
365.26the notice and copy of the patient and resident bill of rights under section 144.652 or if it
365.27is displayed prominently in the provider's place of business. The commissioner of health
365.28shall develop the notice required in this subdivision and publish it in the State Register.
365.29    Subd. 5. Copies of health records to patients. Except as provided in section
365.30144.296, upon a patient's written request, a provider, at a reasonable cost to the patient,
365.31shall promptly furnish to the patient:
365.32    (1) copies of the patient's health record, including but not limited to laboratory
365.33reports, x-rays, prescriptions, and other technical information used in assessing the
365.34patient's health conditions; or
365.35    (2) the pertinent portion of the record relating to a condition specified by the patient.
366.1    With the consent of the patient, the provider may instead furnish only a summary
366.2of the record. The provider may exclude from the health record written speculations
366.3about the patient's health condition, except that all information necessary for the patient's
366.4informed consent must be provided.
366.5    Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for
366.6purposes of reviewing current medical care, the provider must not charge a fee.
366.7    (b) When a provider or its representative makes copies of patient records upon a
366.8patient's request under this section, the provider or its representative may charge the
366.9patient or the patient's representative no more than 75 cents per page, plus $10 for time
366.10spent retrieving and copying the records, unless other law or a rule or contract provide for
366.11a lower maximum charge. This limitation does not apply to x-rays. The provider may
366.12charge a patient no more than the actual cost of reproducing x-rays, plus no more than
366.13$10 for the time spent retrieving and copying the x-rays.
366.14    (c) The respective maximum charges of 75 cents per page and $10 for time provided
366.15in this subdivision are in effect for calendar year 1992 and may be adjusted annually each
366.16calendar year as provided in this subdivision. The permissible maximum charges shall
366.17change each year by an amount that reflects the change, as compared to the previous year,
366.18in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
366.19published by the Department of Labor.
366.20    (d) A provider or its representative must not charge a fee to provide copies of records
366.21requested by a patient or the patient's authorized representative if the request for copies
366.22of records is for purposes of appealing a denial of Social Security disability income or
366.23Social Security disability benefits under title II or title XVI of the Social Security Act. For
366.24the purpose of further appeals, a patient may receive no more than two medical record
366.25updates without charge, but only for medical record information previously not provided.
366.26For purposes of this paragraph, a patient's authorized representative does not include units
366.27of state government engaged in the adjudication of Social Security disability claims.
366.28    Subd. 7. Withholding health records from patient. (a) If a provider, as defined in
366.29section 144.291, subdivision 2, paragraph (h), clause (1), reasonably determines that the
366.30information is detrimental to the physical or mental health of the patient, or is likely to
366.31cause the patient to inflict self harm, or to harm another, the provider may withhold the
366.32information from the patient and may supply the information to an appropriate third party
366.33or to another provider, as defined in section 144.291, subdivision 2, paragraph (h), clause
366.34(1). The other provider or third party may release the information to the patient.
366.35    (b) A provider, as defined in section 144.291, subdivision 2, paragraph (h), clause
366.36(3), shall release information upon written request unless, prior to the request, a provider,
367.1as defined in section 144.291, subdivision 2, paragraph (h), clause (1), has designated and
367.2described a specific basis for withholding the information as authorized by paragraph (a).
367.3    Subd. 8. Form. By January 1, 2008, the Department of Health must develop a form
367.4that may be used by a patient to request access to health records under this section. A form
367.5developed by the commissioner must be accepted by a provider as a legally enforceable
367.6request under this section.

367.7    Sec. 4. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.
367.8    Subdivision 1. Release or disclosure of health records. Health records can be
367.9released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.
367.10    Subd. 2. Patient consent to release of records. A provider, or a person who
367.11receives health records from a provider, may not release a patient's health records to a
367.12person without:
367.13    (1) a signed and dated consent from the patient or the patient's legally authorized
367.14representative authorizing the release;
367.15    (2) specific authorization in law; or
367.16    (3) a representation from a provider that holds a signed and dated consent from the
367.17patient authorizing the release.
367.18    Subd. 3. Release from one provider to another. A patient's health record,
367.19including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical
367.20information used in assessing the patient's condition, or the pertinent portion of the record
367.21relating to a specific condition, or a summary of the record, shall promptly be furnished to
367.22another provider upon the written request of the patient. The written request shall specify
367.23the name of the provider to whom the health record is to be furnished. The provider who
367.24furnishes the health record or summary may retain a copy of the materials furnished. The
367.25patient shall be responsible for the reasonable costs of furnishing the information.
367.26    Subd. 4. Duration of consent. Except as provided in this section, a consent is
367.27valid for one year or for a lesser period specified in the consent or for a different period
367.28provided by law.
367.29    Subd. 5. Exceptions to consent requirement. This section does not prohibit the
367.30release of health records:
367.31    (1) for a medical emergency when the provider is unable to obtain the patient's
367.32consent due to the patient's condition or the nature of the medical emergency;
367.33    (2) to other providers within related health care entities when necessary for the
367.34current treatment of the patient; or
368.1    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same
368.2types of health care facilities licensed by this chapter and chapter 144A that are licensed
368.3in another state when a patient:
368.4    (i) is returning to the health care facility and unable to provide consent; or
368.5    (ii) who resides in the health care facility, has services provided by an outside
368.6resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
368.7to provide consent.
368.8    Subd. 6. Consent does not expire. Notwithstanding subdivision 4, if a patient
368.9explicitly gives informed consent to the release of health records for the purposes and
368.10restrictions in clauses (1) and (2), the consent does not expire after one year for:
368.11    (1) the release of health records to a provider who is being advised or consulted with
368.12in connection with the releasing provider's current treatment of the patient;
368.13    (2) the release of health records to an accident and health insurer, health service plan
368.14corporation, health maintenance organization, or third-party administrator for purposes of
368.15payment of claims, fraud investigation, or quality of care review and studies, provided that:
368.16    (i) the use or release of the records complies with sections 72A.49 to 72A.505;
368.17    (ii) further use or release of the records in individually identifiable form to a person
368.18other than the patient without the patient's consent is prohibited; and
368.19    (iii) the recipient establishes adequate safeguards to protect the records from
368.20unauthorized disclosure, including a procedure for removal or destruction of information
368.21that identifies the patient.
368.22    Subd. 7. Exception to consent. Subdivision 2 does not apply to the release of health
368.23records to the commissioner of health or the Health Data Institute under chapter 62J,
368.24provided that the commissioner encrypts the patient identifier upon receipt of the data.
368.25    Subd. 8. Record locator service. (a) A provider or group purchaser may release
368.26patient identifying information and information about the location of the patient's health
368.27records to a record locator service without consent from the patient, unless the patient
368.28has elected to be excluded from the service under paragraph (d). The Department of
368.29Health may not access the record locator service or receive data from the record locator
368.30service. Only a provider may have access to patient identifying information in a record
368.31locator service. Except in the case of a medical emergency, a provider participating in a
368.32health information exchange using a record locator service does not have access to patient
368.33identifying information and information about the location of the patient's health records
368.34unless the patient specifically consents to the access. A consent does not expire but may
368.35be revoked by the patient at any time by providing written notice of the revocation to the
368.36provider.
369.1    (b) A health information exchange maintaining a record locator service must
369.2maintain an audit log of providers accessing information in a record locator service that
369.3at least contains information on:
369.4    (1) the identity of the provider accessing the information;
369.5    (2) the identity of the patient whose information was accessed by the provider; and
369.6    (3) the date the information was accessed.
369.7    (c) No group purchaser may in any way require a provider to participate in a record
369.8locator service as a condition of payment or participation.
369.9    (d) A provider or an entity operating a record locator service must provide
369.10a mechanism under which patients may exclude their identifying information and
369.11information about the location of their health records from a record locator service. At
369.12a minimum, a consent form that permits a provider to access a record locator service
369.13must include a conspicuous check-box option that allows a patient to exclude all of the
369.14patient's information from the record locator service. A provider participating in a health
369.15information exchange with a record locator service who receives a patient's request to
369.16exclude all of the patient's information from the record locator service or to have a specific
369.17provider contact excluded from the record locator service is responsible for removing that
369.18information from the record locator service.
369.19    Subd. 9. Documentation of release. (a) In cases where a provider releases health
369.20records without patient consent as authorized by law, the release must be documented in
369.21the patient's health record. In the case of a release under section 144.294, subdivision 2, the
369.22documentation must include the date and circumstances under which the release was made,
369.23the person or agency to whom the release was made, and the records that were released.
369.24    (b) When a health record is released using a representation from a provider that
369.25holds a consent from the patient, the releasing provider shall document:
369.26    (1) the provider requesting the health records;
369.27    (2) the identity of the patient;
369.28    (3) the health records requested; and
369.29    (4) the date the health records were requested.
369.30    Subd. 10. Warranties regarding consents, requests, and disclosures. (a) When
369.31requesting health records using consent, a person warrants that the consent:
369.32    (1) contains no information known to the person to be false; and
369.33    (2) accurately states the patient's desire to have health records disclosed or that there
369.34is specific authorization in law.
369.35    (b) When requesting health records using consent, or a representation of holding a
369.36consent, a provider warrants that the request:
370.1    (1) contains no information known to the provider to be false;
370.2    (2) accurately states the patient's desire to have health records disclosed or that
370.3there is specific authorization in law; and
370.4    (3) does not exceed any limits imposed by the patient in the consent.
370.5    (c) When disclosing health records, a person releasing health records warrants that
370.6the person:
370.7    (1) has complied with the requirements of this section regarding disclosure of
370.8health records;
370.9    (2) knows of no information related to the request that is false; and
370.10    (3) has complied with the limits set by the patient in the consent.

370.11    Sec. 5. [144.294] RECORDS RELATING TO MENTAL HEALTH.
370.12    Subdivision 1. Provider inquiry. Upon the written request of a spouse, parent,
370.13child, or sibling of a patient being evaluated for or diagnosed with mental illness, a
370.14provider shall inquire of a patient whether the patient wishes to authorize a specific
370.15individual to receive information regarding the patient's current and proposed course of
370.16treatment. If the patient so authorizes, the provider shall communicate to the designated
370.17individual the patient's current and proposed course of treatment. Section 144.293,
370.18subdivisions 2 and 4, apply to consents given under this subdivision.
370.19    Subd. 2. Disclosure to law enforcement agency. Notwithstanding section 144.293,
370.20subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental
370.21health to a law enforcement agency if the law enforcement agency provides the name
370.22of the patient and communicates that the:
370.23    (1) patient is currently involved in an emergency interaction with the law
370.24enforcement agency; and
370.25    (2) disclosure of the records is necessary to protect the health or safety of the patient
370.26or of another person.
370.27    The scope of disclosure under this subdivision is limited to the minimum necessary
370.28for law enforcement to respond to the emergency. A law enforcement agency that obtains
370.29health records under this subdivision shall maintain a record of the requestor, the provider
370.30of the information, and the patient's name. Health records obtained by a law enforcement
370.31agency under this subdivision are private data on individuals as defined in section 13.02,
370.32subdivision 12, and must not be used by law enforcement for any other purpose.
370.33    Subd. 3. Records release for family and caretaker; mental health care. (a)
370.34Notwithstanding section 144.293, a provider providing mental health care and treatment
371.1may disclose health record information described in paragraph (b) about a patient to a
371.2family member of the patient or other person who requests the information if:
371.3    (1) the request for information is in writing;
371.4    (2) the family member or other person lives with, provides care for, or is directly
371.5involved in monitoring the treatment of the patient;
371.6    (3) the involvement under clause (2) is verified by the patient's mental health care
371.7provider, the patient's attending physician, or a person other than the person requesting the
371.8information, and is documented in the patient's medical record;
371.9    (4) before the disclosure, the patient is informed in writing of the request, the name
371.10of the person requesting the information, the reason for the request, and the specific
371.11information being requested;
371.12    (5) the patient agrees to the disclosure, does not object to the disclosure, or is
371.13unable to consent or object, and the patient's decision or inability to make a decision is
371.14documented in the patient's medical record; and
371.15    (6) the disclosure is necessary to assist in the provision of care or monitoring of the
371.16patient's treatment.
371.17    (b) The information disclosed under this paragraph is limited to diagnosis, admission
371.18to or discharge from treatment, the name and dosage of the medications prescribed, side
371.19effects of the medication, consequences of failure of the patient to take the prescribed
371.20medication, and a summary of the discharge plan.
371.21    (c) If a provider reasonably determines that providing information under this
371.22subdivision would be detrimental to the physical or mental health of the patient or is
371.23likely to cause the patient to inflict self harm or to harm another, the provider must not
371.24disclose the information.
371.25    (d) This subdivision does not apply to disclosures for a medical emergency or
371.26to family members as authorized or required under subdivision 1 or section 144.293,
371.27subdivision 5, clause (1).

371.28    Sec. 6. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL
371.29RESEARCH.
371.30    Subdivision 1. Methods of release. (a) Notwithstanding section 144.293,
371.31subdivisions 2 and 4, health records may be released to an external researcher solely for
371.32purposes of medical or scientific research only as follows:
371.33    (1) health records generated before January 1, 1997, may be released if the patient
371.34has not objected or does not elect to object after that date;
371.35    (2) for health records generated on or after January 1, 1997, the provider must:
372.1    (i) disclose in writing to patients currently being treated by the provider that health
372.2records, regardless of when generated, may be released and that the patient may object, in
372.3which case the records will not be released; and
372.4    (ii) use reasonable efforts to obtain the patient's written general authorization that
372.5describes the release of records in item (i), which does not expire but may be revoked or
372.6limited in writing at any time by the patient or the patient's authorized representative;
372.7    (3) the provider must advise the patient of the rights specified in clause (4); and
372.8    (4) the provider must, at the request of the patient, provide information on how the
372.9patient may contact an external researcher to whom the health record was released and
372.10the date it was released.
372.11    (b) Authorization may be established if an authorization is mailed at least two
372.12times to the patient's last known address with a postage prepaid return envelope and a
372.13conspicuous notice that the patient's medical records may be released if the patient does
372.14not object, and at least 60 days have expired since the second notice was sent.
372.15    Subd. 2. Duties of researcher. In making a release for research purposes, the
372.16provider shall make a reasonable effort to determine that:
372.17    (1) the use or disclosure does not violate any limitations under which the record
372.18was collected;
372.19    (2) the use or disclosure in individually identifiable form is necessary to accomplish
372.20the research or statistical purpose for which the use or disclosure is to be made;
372.21    (3) the recipient has established and maintains adequate safeguards to protect the
372.22records from unauthorized disclosure, including a procedure for removal or destruction of
372.23information that identifies the patient; and
372.24    (4) further use or release of the records in individually identifiable form to a person
372.25other than the patient without the patient's consent is prohibited.

372.26    Sec. 7. [144.296] COPIES OF VIDEOTAPES.
372.27    A provider may not release a copy of a videotape of a child victim or alleged victim
372.28of physical or sexual abuse without a court order under section 13.03, subdivision 6, or
372.29as provided in section 611A.90. This section does not limit the right of a patient to view
372.30the videotape.

372.31    Sec. 8. [144.297] INDEPENDENT MEDICAL EXAMINATION.
372.32    Sections 144.291 to 144.298 apply to the subject and provider of an independent
372.33medical examination requested by or paid for by a third party. Notwithstanding section
373.1144.293, a provider may release health records created as part of an independent medical
373.2examination to the third party who requested or paid for the examination.

373.3    Sec. 9. [144.298] PENALTIES.
373.4    Subdivision 1. Licensing action. A violation of sections 144.291 to 144.298 may
373.5be grounds for disciplinary action against a provider by the appropriate licensing board
373.6or agency.
373.7    Subd. 2. Liability of provider or other person. A person who does any of the
373.8following is liable to the patient for compensatory damages caused by an unauthorized
373.9release, plus costs and reasonable attorney fees:
373.10    (1) negligently or intentionally requests or releases a health record in violation
373.11of sections 144.291 to 144.297;
373.12    (2) forges a signature on a consent form or materially alters the consent form of
373.13another person without the person's consent; or
373.14    (3) obtains a consent form or the health records of another person under false
373.15pretenses.
373.16    Subd. 3. Liability for record locator service. A patient is entitled to receive
373.17compensatory damages plus costs and reasonable attorney fees if a health information
373.18exchange maintaining a record locator service, or an entity maintaining a record locator
373.19service for a health information exchange, negligently or intentionally violates the
373.20provisions of section 144.293, subdivision 8.

373.21    Sec. 10. Minnesota Statutes 2006, section 144.3345, is amended to read:
373.22144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD
373.23GRANTS.
373.24    Subdivision 1. Definitions. The following definitions are used for the purposes
373.25of this section.
373.26    (a) "Eligible community e-health collaborative" means an existing or newly
373.27established collaborative to support the adoption and use of interoperable electronic
373.28health records. A collaborative must consist of at least three two or more eligible health
373.29care entities in at least two of the categories listed in paragraph (b) and have a focus on
373.30interconnecting the members of the collaborative for secure and interoperable exchange of
373.31health care information.
373.32    (b) "Eligible health care entity" means one of the following:
373.33    (1) community clinics, as defined under section 145.9268;
374.1    (2) hospitals eligible for rural hospital capital improvement grants, as defined
374.2in section 144.148;
374.3    (3) physician clinics located in a community with a population of less than 50,000
374.4according to United States Census Bureau statistics and outside the seven-county
374.5metropolitan area;
374.6    (4) nursing facilities licensed under sections 144A.01 to 144A.27;
374.7    (5) community health boards or boards of health as established under chapter 145A;
374.8    (6) nonprofit entities with a purpose to provide health information exchange
374.9coordination governed by a representative, multi-stakeholder board of directors; and
374.10    (7) other providers of health or health care services approved by the commissioner
374.11for which interoperable electronic health record capability would improve quality of
374.12care, patient safety, or community health.
374.13    Subd. 2. Grants authorized. The commissioner of health shall award grants to:
374.14    (a) eligible community e-health collaborative projects to improve the implementation
374.15and use of interoperable electronic health records including but not limited to the
374.16following projects:
374.17    (1) collaborative efforts to host and support fully functional interoperable electronic
374.18health records in multiple care settings;
374.19    (2) electronic medication history and electronic patient registration medical history
374.20information;
374.21    (3) electronic personal health records for persons with chronic diseases and for
374.22prevention services;
374.23    (4) rural and underserved community models for electronic prescribing; and
374.24    (5) enabling modernize local public health information systems to rapidly and
374.25electronically exchange information needed to participate in community e-health
374.26collaboratives or for public health emergency preparedness and response.; and
374.27    (6) implement regional or community-based health information exchange
374.28organizations;
374.29    (b) community clinics, as defined under section 145.9268, to implement and use
374.30interoperable electronic health records, including but not limited to the following projects:
374.31    (1) efforts to plan for and implement fully functional, standards-based interoperable
374.32electronic health records; and
374.33    (2) purchases and implementation of computer hardware, software, and technology
374.34to fully implement interoperable electronic health records;
375.1    (c) regional or community-based health information exchange organizations to
375.2connect and facilitate the exchange of health information between eligible health care
375.3entities, including but not limited to the development, testing, and implementation of:
375.4    (1) data exchange standards, including data, vocabulary, and messaging standards,
375.5for the exchange of health information, provided that such standards are consistent with
375.6state and national standards;
375.7    (2) security standards necessary to ensure the confidentiality and integrity of health
375.8records;
375.9    (3) computer interfaces and mechanisms for standardizing health information
375.10exchanged between eligible health care entities;
375.11    (4) a record locator service for identifying the location of patient health records; or
375.12    (5) interfaces and mechanisms for implementing patient consent requirements; and
375.13    (d) community health boards and boards of health as established under chapter
375.14145A to modernize local public health information systems to be standards-based and
375.15interoperable with other electronic health records and information systems, or for
375.16enhanced public health emergency preparedness and response.
375.17    Grant funds may not be used for construction of health care or other buildings or
375.18facilities.
375.19    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible
375.20community e-health collaborative, community clinic, regional or community-based health
375.21information exchange, or community health boards and boards of health must submit an
375.22application to the commissioner of health by the deadline established by the commissioner.
375.23A grant may be awarded upon the signing of a grant contract. In awarding grants, the
375.24commissioner shall give preference to projects benefiting providers located in rural and
375.25underserved areas of Minnesota which the commissioner has determined have an unmet
375.26need for the development and funding of electronic health records. Applicants may apply
375.27for and the commissioner may award grants for one-year, two-year, or three-year periods.
375.28    (b) An application must be on a form and contain information as specified by the
375.29commissioner but at a minimum must contain:
375.30    (1) a description of the purpose or project for which grant funds will be used;
375.31    (2) a description of the problem or problems the grant funds will be used to address,
375.32including an assessment of the likelihood of the project occurring absent grant funding;
375.33    (3) a description of achievable objectives, a workplan, budget, budget narrative, a
375.34project communications plan, a timeline for implementation and completion of processes
375.35or projects enabled by the grant, and an assessment of privacy and security issues and a
375.36proposed approach to address these issues;
376.1    (4) a description of the health care entities and other groups participating in the
376.2project, including identification of the lead entity responsible for applying for and
376.3receiving grant funds;
376.4    (5) a plan for how patients and consumers will be involved in development of
376.5policies and procedures related to the access to and interchange of information;
376.6    (6) evidence of consensus and commitment among the health care entities and others
376.7who developed the proposal and are responsible for its implementation; and
376.8    (7) a plan for documenting and evaluating results of the grant. ; and
376.9    (8) a plan for use of data exchange standards, including data and vocabulary.
376.10    (c) The commissioner shall review each application to determine whether the
376.11application is complete and whether the applicant and the project are eligible for a
376.12grant. In evaluating applications, the commissioner shall take into consideration factors,
376.13including but not limited to, the following:
376.14    (1) the degree to which the proposal interconnects the various providers of care with
376.15other health care entities in the applicant's geographic community;
376.16    (2) the degree to which the project provides for the interoperability of electronic
376.17health records or related health information technology between the members of the
376.18collaborative, and presence and scope of a description of how the project intends to
376.19interconnect with other providers not part of the project into the future;
376.20    (3) the degree to which the project addresses current unmet needs pertaining
376.21to interoperable electronic health records in a geographic area of Minnesota and the
376.22likelihood that the needs would not be met absent grant funds;
376.23    (4) the applicant's thoroughness and clarity in describing the project, how the project
376.24will improve patient safety, quality of care, and consumer empowerment, and the role of
376.25the various collaborative members;
376.26    (5) the recommendations of the Health Information and Technology Infrastructure
376.27Advisory Committee; and
376.28    (6) other factors that the commissioner deems relevant.
376.29    (d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall
376.30be required to provide $1 in the form of cash or in-kind staff or services for each $3
376.31provided under the grant program.
376.32    (e) Grants shall not exceed $900,000 per grant. The commissioner has discretion
376.33over the size and number of grants awarded.
376.34    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the
376.35overall effectiveness of the grant program. The commissioner shall collect progress
377.1and expenditure reports to evaluate the grant program from the eligible community
377.2collaboratives receiving grants.

377.3    Sec. 11. Minnesota Statutes 2006, section 144D.03, subdivision 1, is amended to read:
377.4    Subdivision 1. Registration procedures. The commissioner shall establish forms
377.5and procedures for annual registration of housing with services establishments. The
377.6commissioner shall charge an annual registration fee of $35 $155. No fee shall be
377.7refunded. A registered establishment shall notify the commissioner within 30 days of the
377.8date it is no longer required to be registered under this chapter or of any change in the
377.9business name or address of the establishment, the name or mailing address of the owner
377.10or owners, or the name or mailing address of the managing agent. There shall be no
377.11fee for submission of the notice.

377.12    Sec. 12. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
377.13    Subdivision 1. Definitions. For purposes of this section, "federally qualified health
377.14center" means an entity that is receiving a grant under United States Code, title 42,
377.15section 254b, or, based on the recommendation of the Health Resources and Services
377.16Administration within the Public Health Service, is determined by the secretary to meet
377.17the requirements for receiving such a grant.
377.18    Subd. 2. Allocation of subsidies. The commissioner of health shall distribute
377.19subsidies to federally qualified health centers operating in Minnesota to continue, expand,
377.20and improve federally qualified health center services to low-income populations. The
377.21commissioner shall distribute the funds appropriated under this section to federally
377.22qualified health centers operating in Minnesota as of January 1, 2007. The amount of
377.23each subsidy shall be in proportion to each federally qualified health center's amount of
377.24discounts granted to patients during calendar year 2006 as reported on the federal Uniform
377.25Data System report in conformance with the Bureau of Primary Health Care Program
377.26Expectations Policy Information Notice 98-23, except that each eligible federally qualified
377.27health center shall receive at least two percent but no more than 30 percent of the total
377.28amount of money available under this section.

377.29    Sec. 13. HEALTH PROMOTION PROGRAM.
377.30    The commissioner of health, in consultation with the State Community Health
377.31Services Advisory Committee established in Minnesota Statutes, section 145A.10,
377.32subdivision 10, shall develop a plan to fund and implement an ongoing comprehensive
377.33health promotion program that can effect change more effectively and at lower cost at
378.1a community level rather than through individual counseling and change promotion.
378.2The program shall use proven public health strategies to promote healthy lifestyles and
378.3behaviors in order to establish a sustainable, long-term approach to reducing preventable
378.4disability, chronic health conditions, and disease. The focus shall be on community
378.5based initiatives that address childhood and adult obesity, tobacco and substance abuse,
378.6improved activity levels among senior citizens, and other lifestyle issues that impact
378.7health and healthcare costs. Because of its population health focus, funding shall be
378.8related to the size of the population to be served. The plan shall be completed by October
378.91, 2007, and shared with the Legislative Health Care Access Commission.

378.10    Sec. 14. CERVICAL CANCER PREVENTION AND HUMAN PAPILLOMA
378.11VIRUS VACCINE STUDY.
378.12    The commissioner of health shall reconvene the cervical cancer elimination study
378.13required under Laws 2005, First Special Session chapter 4, article 6, section 52, to conduct
378.14a study, in collaboration with the Minnesota Immunization Practices Advisory Committee,
378.15on the human papilloma virus vaccine, including, but not limited to, the following:
378.16    (1) the risks and benefits of the human papilloma virus vaccine;
378.17    (2) the availability and effectiveness of the vaccine;
378.18    (3) the extent to which health plan companies cover the cost of this vaccination; and
378.19    (4) ways to cover the cost of vaccination for persons without coverage.
378.20    The commissioner shall submit a report to the legislature by February 1, 2008, on
378.21the findings of the study and recommendations as to whether the human papilloma virus
378.22vaccine should be made mandatory statewide.

378.23    Sec. 15. REVISOR'S INSTRUCTION.
378.24    In Minnesota Statutes and Minnesota Rules, the revisor shall change the references
378.25in column A with the references in column B.

378.26	Column A	Column B
378.27	section 144.335	sections 144.291 to 144.298
378.28	section 144.335, subdivision 1	section 144.291, subdivision 2
378.29 378.30	section 144.335, subdivision 1, paragraph (b)	section 144.291, subdivision 2, paragraph (h)
378.31 378.32	section 144.335, subdivision 2, paragraphs (a) and (b)	section 144.292, subdivisions 2 and 5
378.33	section 144.335, subdivision 2	section 144.292
378.34	section 144.335, subdivision 3a	section 144.294, subdivision 2
378.35 378.36	section 144.335, subdivision 3a, paragraph (d)	section 144.295
379.1 379.2	section 144.335, subdivision 3a, paragraph (f)	section 144.294
379.3	section 144.335, subdivision 3b	section 144.293, subdivision 7

379.4    Sec. 16. REPEALER.
379.5Minnesota Statutes 2006, section 144.335, and Laws 2006, chapter 249, section
379.66, are repealed.

379.7ARTICLE 11

379.8MISCELLANEOUS POLICY

379.9    Section 1. Minnesota Statutes 2006, section 13.381, is amended by adding a
379.10subdivision to read:
379.11    Subd. 16a. Prescription electronic reporting system. Access to data in the
379.12prescription electronic reporting system is governed by section 152.126.

379.13    Sec. 2. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision
379.14to read:
379.15    Subd. 11. Dispensing by protocol. A registered nurse in a family planning agency
379.16as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives
379.17prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant
379.18to a dispensing protocol established by the agency's medical director or under the direction
379.19of a physician. The dispensing protocol must address the requirements of sections 151.01,
379.20subdivision 30, and 151.212, subdivision 1.

379.21    Sec. 3. Minnesota Statutes 2006, section 151.19, subdivision 2, is amended to read:
379.22    Subd. 2. Nonresident pharmacies. The board shall require and provide for an
379.23annual nonresident special pharmacy registration for all pharmacies located outside of this
379.24state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
379.25prescription medications into this state. Nonresident special pharmacy registration shall
379.26be granted by the board upon the disclosure and certification by a pharmacy:
379.27    (1) that it is licensed in the state in which the dispensing facility is located and from
379.28which the drugs are dispensed;
379.29    (2) the location, names, and titles of all principal corporate officers and all
379.30pharmacists who are dispensing drugs to residents of this state;
379.31    (3) that it complies with all lawful directions and requests for information from
379.32the Board of Pharmacy of all states in which it is licensed or registered, except that it
380.1shall respond directly to all communications from the board concerning emergency
380.2circumstances arising from the dispensing of drugs to residents of this state;
380.3    (4) that it maintains its records of drugs dispensed to residents of this state so that the
380.4records are readily retrievable from the records of other drugs dispensed;
380.5    (5) that it cooperates with the board in providing information to the Board of
380.6Pharmacy of the state in which it is licensed concerning matters related to the dispensing
380.7of drugs to residents of this state; and
380.8    (6) that during its regular hours of operation, but not less than six days per week, for
380.9a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
380.10communication between patients in this state and a pharmacist at the pharmacy who has
380.11access to the patients' records; the toll-free number must be disclosed on the label affixed
380.12to each container of drugs dispensed to residents of this state.; and
380.13    (7) that, upon request of a resident of a long-term care facility located within the
380.14state of Minnesota, the resident's authorized representative, or a contract pharmacy or
380.15licensed health care facility acting on behalf of the resident, the pharmacy will dispense
380.16medications prescribed for the resident in unit-dose packaging or, alternatively, comply
380.17with the provisions of section 151.415, subdivision 5.

380.18    Sec. 4. [151.415] LONG-TERM CARE RESIDENT ACCESS TO
380.19PHARMACEUTICALS ACT.
380.20    Subdivision 1. Title; citation. This section may be cited as the "Long-Term Care
380.21Resident Access to Pharmaceuticals Act."
380.22    Subd. 2. Definitions. For the purposes of this section, the following terms have the
380.23meanings given them unless otherwise provided by text:
380.24    (a) "Board" means the Board of Pharmacy.
380.25    (b) "Contract pharmacy" means a pharmacy, licensed under this chapter, which is
380.26under contract to a long-term care facility.
380.27    (c) "Long-term care facility" means a nursing home licensed under sections 144A.02
380.28to 144A.10, or a boarding care home licensed under sections 144.50 to 144.56. Facilities
380.29not certified under title XIX of the federal Social Security Act are not included in this
380.30definition.
380.31    (d) "Original dispensing pharmacy" shall mean a pharmacy, licensed in any state in
380.32the United States, which dispenses drugs in bulk prescription containers to a person who
380.33is a resident in a long-term care facility.
380.34    Subd. 3. Authorization to administer and repackage drugs. (a) A contract
380.35pharmacist or pharmacy may repackage a resident's prescription drugs, which have been
381.1lawfully dispensed from bulk prescription containers by an original dispensing pharmacy,
381.2into a unit-dose system compatible with the system used by the long-term care facility.
381.3    (b) A long-term care facility may administer drugs to residents of the facility that
381.4have been repackaged according to this subdivision. The contract pharmacy shall notify
381.5the long-term care facility whenever medications have been dispensed according to
381.6this subdivision and must certify that the repackaging and dispensing has been done in
381.7accordance with this subdivision.
381.8    (c) Drugs may be dispensed for a resident of a long-term care facility according to
381.9this subdivision, provided that:
381.10    (1) the drug is dispensed by the original dispensing pharmacy according to a current,
381.11valid prescription;
381.12    (2) the original bulk prescription container for the resident is delivered by the
381.13original dispensing pharmacy directly to the contract pharmacist or pharmacy;
381.14    (3) the contract pharmacist or pharmacy verifies the name and strength of the drug,
381.15the name of the manufacturer of the drug, the manufacturer's lot or control number, the
381.16manufacturer's expiration date for the drug, and the date the drug was dispensed by the
381.17original dispensing pharmacy;
381.18    (4) the contract pharmacist or pharmacy verifies the validity and accuracy of the
381.19current prescription order;
381.20    (5) the contract pharmacist or pharmacy repackages the drug in board-approved
381.21unit-dose packaging, with labeling that complies with Minnesota Rules, part 6800.6300,
381.22and that identifies that the drug has been repackaged according to this section;
381.23    (6) the resident for whom the medication is repackaged obtains medications from or
381.24receives medications at a discounted rate from the original dispensing pharmacy under the
381.25resident's state or federal health assistance program or a private health insurance plan; and
381.26    (7) the resident for whom the medication is to be repackaged, or the resident's
381.27authorized representative, has signed an informed consent form provided by the facility
381.28which includes an explanation of the repackaging process and which notifies the resident
381.29of the immunities from liability provided in this section.
381.30    Subd. 4. Maintenance of records. For each drug repackaged by a contract
381.31pharmacy under this section, the contract pharmacy shall maintain a record for at least
381.32two years of the following information:
381.33    (1) the name, manufacturer, manufacturer's lot number, manufacturer's expiration
381.34date, and quantity of the drug prescribed;
381.35    (2) the name and address of the resident for whom the drug was repackaged;
381.36    (3) the name and address or other identifier of the prescriber;
382.1    (4) the date the prescription was issued and the date the drug was repackaged;
382.2    (5) the date the repackaged drug was delivered to the long-term care facility;
382.3    (6) the directions for use;
382.4    (7) a copy of the label that was affixed to the repackaged drug;
382.5    (8) the initials of the packager;
382.6    (9) the initials of the supervising pharmacist; and
382.7    (10) the name and business address of the original dispensing pharmacy.
382.8    Subd. 5. Duties of the original dispensing pharmacy. Upon request of the
382.9resident, the resident's authorized representative, or a contract pharmacy or licensed
382.10health care facility acting on behalf of the resident, the original dispensing pharmacy
382.11is required to deliver medications dispensed for the resident directly to the contract
382.12pharmacist or pharmacy. The original dispensing pharmacy is further required to provide
382.13the contract pharmacist or pharmacy with the name and strength of the drug, the name of
382.14the manufacturer of the drug, the manufacturer's lot or control number, the manufacturer's
382.15expiration date for the drug, and the date the drug was dispensed.
382.16    Subd. 6. Redispensing of returned drugs prohibited. Unused drugs repackaged
382.17according to this section that are returned to any pharmacy shall not be redispensed.
382.18    Subd. 7. Immunity from civil liability. (a) A contract pharmacist or pharmacy
382.19and its employees or agents repackaging a drug acquired from an original dispensing
382.20pharmacy shall be immune from civil liability arising from harm caused by the drug due
382.21to acts or omissions of other persons outside of the contract pharmacist or pharmacy if the
382.22contract pharmacist or pharmacy properly repackages the drug according to this section.
382.23    (b) A long-term care facility and the facility's employees or agents who properly
382.24administer a drug repackaged by a contract pharmacist or pharmacy under this section
382.25shall be immune from civil liability arising from harm caused by the drug due to acts or
382.26omissions of other persons outside the long-term care facility.
382.27    Subd. 8. Handling fee. A contract pharmacist or pharmacy may charge a monthly
382.28fee of no more than 250 percent of the medical assistance program dispensing fee for
382.29each drug repackaged according to this section, but no more than $100 per month for
382.30each individual resident.

382.31    Sec. 5. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to
382.32read:
382.33    Subd. 2d. Identification requirement for schedule II or III controlled substance.
382.34    No person may dispense a controlled substance included in schedule II or III without
382.35requiring the person purchasing the controlled substance, who need not be the person for
383.1whom the controlled substance prescription is written, to present valid photographic
383.2identification, unless the person purchasing the controlled substance, or if applicable the
383.3person for whom the controlled substance prescription is written, is known to the dispenser.

383.4    Sec. 6. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES
383.5PRESCRIPTION ELECTRONIC REPORTING SYSTEM.
383.6    Subdivision 1. Definitions. For purposes of this section, the terms defined in this
383.7subdivision have the meanings given.
383.8    (a) "Board" means the Minnesota State Board of Pharmacy established under
383.9chapter 151.
383.10    (b) "Controlled substances" means those substances listed in section 152.02,
383.11subdivisions 3 and 4, and those substances defined by the board pursuant to section
383.12152.02, subdivisions 7, 8, and 12.
383.13    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
383.1430. Dispensing does not include the direct administering of a controlled substance to a
383.15patient by a licensed health care professional.
383.16    (d) "Dispenser" means a person authorized by law to dispense a controlled substance,
383.17pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy
383.18that distributes controlled substances for inpatient hospital care.
383.19    (e) "Prescriber" means a licensed health care professional who is authorized to
383.20prescribe a controlled substance under section 152.12, subdivision 1.
383.21    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.
383.22    Subd. 2. Prescription electronic reporting system. (a) The board shall establish
383.23by January 1, 2009, an electronic system for reporting the information required under
383.24subdivision 4 for all controlled substances dispensed within the state. Data for controlled
383.25substance prescriptions that are dispensed in a quantity small enough to provide treatment
383.26to a patient for a period of 48 hours or less need not be reported.
383.27    (b) The board may contract with a vendor for the purpose of obtaining technical
383.28assistance in the design, implementation, and maintenance of the electronic reporting
383.29system. The vendor's role shall be limited to providing technical support to the board
383.30concerning the software, databases, and computer systems required to interface with the
383.31existing systems currently used by pharmacies to dispense prescriptions and transmit
383.32prescription data to other third parties.
383.33    Subd. 3. Prescription Electronic Reporting Advisory Committee. (a) The
383.34board shall convene an advisory committee. The committee must include at least one
383.35representative of:
384.1    (1) the Department of Health;
384.2    (2) the Department of Human Services;
384.3    (3) each health-related licensing board that licenses prescribers;
384.4    (4) a professional medical association, which may include an association of pain
384.5management and chemical dependency specialists;
384.6    (5) a professional pharmacy association;
384.7    (6) a consumer privacy or security advocate; and
384.8    (7) a consumer or patient rights organization.
384.9    (b) The advisory committee shall advise the board on the development and operation
384.10of the electronic reporting system, including, but not limited to:
384.11    (1) technical standards for electronic prescription drug reporting;
384.12    (2) proper analysis and interpretation of prescription monitoring data; and
384.13    (3) an evaluation process for the program.
384.14    (c) The Board of Pharmacy, after consultation with the advisory committee, shall
384.15present recommendations and draft legislation on the issues addressed by the advisory
384.16committee under paragraph (b), to the legislature by December 15, 2007.
384.17    Subd. 4. Reporting requirements; notice. (a) Each dispenser must submit the
384.18following data to the board or its designated vendor, subject to the notice required under
384.19paragraph (d):
384.20    (1) name of the prescriber;
384.21    (2) national provider identifier of the prescriber;
384.22    (3) name of the dispenser;
384.23    (4) national provider identifier of the dispenser;
384.24    (5) name of the patient for whom the prescription was written;
384.25    (6) date of birth of the patient for whom the prescription was written;
384.26    (7) date the prescription was written;
384.27    (8) date the prescription was filled;
384.28    (9) name and strength of the controlled substance;
384.29    (10) quantity of controlled substance prescribed; and
384.30    (11) quantity of controlled substance dispensed.
384.31    (b) The dispenser must submit the required information by a procedure and in a
384.32format established by the board.
384.33    (c) A dispenser is not required to submit this data for those controlled substance
384.34prescriptions dispensed for:
384.35    (1) individuals residing in licensed skilled nursing or intermediate care facilities;
385.1    (2) individuals receiving assisted living services under chapter 144G or through a
385.2medical assistance home and community-based waiver;
385.3    (3) individuals receiving medication intravenously;
385.4    (4) individuals receiving hospice and other palliative or end-of-life care; and
385.5    (5) individuals receiving services from a home care provider regulated under chapter
385.6144A.
385.7    (d) A dispenser must not submit data under this subdivision unless a conspicuous
385.8notice of the reporting requirements of this section is given to the patient for whom the
385.9prescription was written.
385.10    Subd. 5. Use of data by board. (a) The board shall develop and maintain a database
385.11of the data reported under subdivision 4. The board shall maintain data that could identify
385.12an individual prescriber or dispenser in encrypted form. The database may be used by
385.13permissible users identified under subdivision 6 for the identification of:
385.14    (1) individuals receiving prescriptions for controlled substances from prescribers
385.15who subsequently obtain controlled substances from dispensers in quantities or with
385.16a frequency inconsistent with standards accepted by national and international pain
385.17management associations of dosage for those controlled substances; and
385.18    (2) individuals presenting forged or otherwise false or altered prescriptions for
385.19controlled substances to dispensers.
385.20    (b) No permissible user identified under subdivision 6 may access the database
385.21for the sole purpose of identifying prescribers of controlled substances for unusual or
385.22excessive prescribing patterns without a valid search warrant or court order.
385.23    (c) No personnel of a state or federal occupational licensing board or agency may
385.24access the database for the purpose of obtaining information to be used to initiate or
385.25substantiate a disciplinary action against a prescriber.
385.26    (d) Data reported under subdivision 4 shall be retained by the board in the database
385.27for a 12-month period, and shall be removed from the database 12 months from the date
385.28the data was received.
385.29    Subd. 6. Access to reporting system data. (a) Except as indicated in this
385.30subdivision, the data submitted to the board under subdivision 4 is private data on
385.31individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
385.32    (b) Except as specified in subdivision 5, the following persons shall be considered
385.33permissible users and may access the data submitted under subdivision 4 in the same or
385.34similar manner, and for the same or similar purposes, as those persons who are authorized
385.35to access similar private data on individuals under federal and state law:
386.1    (1) a prescriber, to the extent the information relates specifically to a current patient
386.2of the prescriber, to whom the practitioner is prescribing or considering prescribing any
386.3controlled substance;
386.4    (2) a dispenser, to the extent the information relates specifically to a current patient
386.5to whom that dispenser is dispensing or considering dispensing any controlled substance;
386.6    (3) an individual who is the recipient of a controlled substance prescription for
386.7which data was submitted under subdivision 4, or a guardian of the individual, parent or
386.8guardian of a minor, or health care agent of the individual acting under a health care
386.9directive under chapter 145C;
386.10    (4) personnel of the board specifically assigned to conduct a bona fide investigation
386.11of a specific licensee;
386.12    (5) personnel of the board engaged in the collection of controlled substance
386.13prescription information as part of the assigned duties and responsibilities under this
386.14section;
386.15    (6) authorized personnel of a vendor under contract with the board who are engaged
386.16in the design, implementation, and maintenance of the electronic reporting system as part
386.17of the assigned duties and responsibilities of their employment, provided that access to data
386.18is limited to the minimum amount necessary to test and maintain the system databases;
386.19    (7) federal, state, and local law enforcement authorities acting pursuant to a valid
386.20search warrant; and
386.21    (8) personnel of the medical assistance program assigned to use the data collected
386.22under this section to identify recipients whose usage of controlled substances may warrant
386.23restriction to a single primary care physician, a single outpatient pharmacy, or a single
386.24hospital.
386.25    For purposes of clause (3), access by an individual includes persons in the definition
386.26of an individual under section 13.02.
386.27    (c) Any permissible user identified in paragraph (b), who directly accesses
386.28the data electronically, shall implement and maintain a comprehensive information
386.29security program that contains administrative, technical, and physical safeguards that
386.30are appropriate to the user's size and complexity, and the sensitivity of the personal
386.31information obtained. The permissible user shall identify reasonably foreseeable internal
386.32and external risks to the security, confidentiality, and integrity of personal information
386.33that could result in the unauthorized disclosure, misuse, or other compromise of the
386.34information and assess the sufficiency of any safeguards in place to control the risks.
387.1    (d) The board shall not release data submitted under this section unless it is provided
387.2with evidence, satisfactory to the board, that the person requesting the information is
387.3entitled to receive the data.
387.4    (e) The board shall not release the name of a prescriber without the written consent
387.5of the prescriber or a valid search warrant or court order. The board shall provide a
387.6mechanism for a prescriber to submit to the board a signed consent authorizing the release
387.7of the prescriber's name when data containing the prescriber's name is requested.
387.8    (f) The board shall maintain a log of all persons who access the data and shall ensure
387.9that any permissible user complies with paragraph (c) prior to attaining direct access to
387.10the data.
387.11    Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to
387.12the board as required under this section is subject to disciplinary action by the appropriate
387.13health-related licensing board.
387.14    (b) A prescriber or dispenser authorized to access the data who knowingly discloses
387.15the data in violation of state or federal laws relating to the privacy of health care data
387.16shall be subject to disciplinary action by the appropriate health-related licensing board,
387.17and appropriate civil penalties.
387.18    Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription
387.19electronic reporting system to determine if the system is cost-effective and whether it is
387.20negatively impacting appropriate prescribing practices of controlled substances. The
387.21board may contract with a vendor to design and conduct the evaluation.
387.22    (b) The board shall submit the evaluation of the system to the legislature by January
387.2315, 2010.
387.24    Subd. 9. Immunity from liability; no requirement to obtain information. (a) A
387.25pharmacist, prescriber, or other dispenser making a report to the program in good faith
387.26under this section is immune from any civil, criminal, or administrative liability, which
387.27might otherwise be incurred or imposed as a result of the report, or on the basis that the
387.28pharmacist or prescriber did or did not seek or obtain or use information from the program.
387.29    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
387.30to obtain information about a patient from the program, and the pharmacist, prescriber,
387.31or other dispenser, if acting in good faith, is immune from any civil, criminal, or
387.32administrative liability that might otherwise be incurred or imposed for requesting,
387.33receiving, or using information from the program.
387.34EFFECTIVE DATE.This section is effective July 1, 2007, or upon receiving
387.35sufficient nonstate funds to implement the prescription electronic reporting program,
387.36whichever is later. In the event that nonstate funds are not secured by the Board of
388.1Pharmacy to adequately fund the implementation of the prescription electronic reporting
388.2program, the board is not required to implement this section without a subsequent
388.3appropriation from the legislature.

388.4    Sec. 7. Minnesota Statutes 2006, section 245.4874, is amended to read:
388.5245.4874 DUTIES OF COUNTY BOARD.
388.6    (a) The county board must:
388.7    (1) develop a system of affordable and locally available children's mental health
388.8services according to sections 245.487 to 245.4887;
388.9    (2) establish a mechanism providing for interagency coordination as specified in
388.10section 245.4875, subdivision 6;
388.11    (3) consider the assessment of unmet needs in the county as reported by the local
388.12children's mental health advisory council under section 245.4875, subdivision 5, paragraph
388.13(b), clause (3). The county shall provide, upon request of the local children's mental health
388.14advisory council, readily available data to assist in the determination of unmet needs;
388.15    (4) assure that parents and providers in the county receive information about how to
388.16gain access to services provided according to sections 245.487 to 245.4887;
388.17    (5) coordinate the delivery of children's mental health services with services
388.18provided by social services, education, corrections, health, and vocational agencies to
388.19improve the availability of mental health services to children and the cost-effectiveness of
388.20their delivery;
388.21    (6) assure that mental health services delivered according to sections 245.487
388.22to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
388.23assessment and individual treatment plan;
388.24    (7) provide the community with information about predictors and symptoms of
388.25emotional disturbances and how to access children's mental health services according to
388.26sections 245.4877 and 245.4878;
388.27    (8) provide for case management services to each child with severe emotional
388.28disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
388.29subdivisions 1, 3, and 5 ;
388.30    (9) provide for screening of each child under section 245.4885 upon admission
388.31to a residential treatment facility, acute care hospital inpatient treatment, or informal
388.32admission to a regional treatment center;
388.33    (10) prudently administer grants and purchase-of-service contracts that the county
388.34board determines are necessary to fulfill its responsibilities under sections 245.487 to
388.35245.4887 ;
389.1    (11) assure that mental health professionals, mental health practitioners, and case
389.2managers employed by or under contract to the county to provide mental health services
389.3are qualified under section 245.4871;
389.4    (12) assure that children's mental health services are coordinated with adult mental
389.5health services specified in sections 245.461 to 245.486 so that a continuum of mental
389.6health services is available to serve persons with mental illness, regardless of the person's
389.7age;
389.8    (13) assure that culturally informed mental health consultants are used as necessary
389.9to assist the county board in assessing and providing appropriate treatment for children of
389.10cultural or racial minority heritage; and
389.11    (14) consistent with section 245.486, arrange for or provide a children's mental
389.12health screening to a child receiving child protective services or a child in out-of-home
389.13placement, a child for whom parental rights have been terminated, a child found to be
389.14delinquent, and a child found to have committed a juvenile petty offense for the third
389.15or subsequent time, unless a screening or diagnostic assessment has been performed
389.16within the previous 180 days, or the child is currently under the care of a mental health
389.17professional. The court or county agency must notify a parent or guardian whose
389.18parental rights have not been terminated of the potential mental health screening and the
389.19option to prevent the screening by notifying the court or county agency in writing. The
389.20screening shall be conducted with a screening instrument approved by the commissioner
389.21of human services according to criteria that are updated and issued annually to ensure
389.22that approved screening instruments are valid and useful for child welfare and juvenile
389.23justice populations, and shall be conducted by a mental health practitioner as defined in
389.24section 245.4871, subdivision 26, or a probation officer or local social services agency
389.25staff person who is trained in the use of the screening instrument. Training in the use of the
389.26instrument shall include training in the administration of the instrument, the interpretation
389.27of its validity given the child's current circumstances, the state and federal data practices
389.28laws and confidentiality standards, the parental consent requirement, and providing respect
389.29for families and cultural values. If the screen indicates a need for assessment, the child's
389.30family, or if the family lacks mental health insurance, the local social services agency,
389.31in consultation with the child's family, shall have conducted a diagnostic assessment,
389.32including a functional assessment, as defined in section 245.4871. The administration of
389.33the screening shall safeguard the privacy of children receiving the screening and their
389.34families and shall comply with the Minnesota Government Data Practices Act, chapter
389.3513, and the federal Health Insurance Portability and Accountability Act of 1996, Public
390.1Law 104-191. Screening results shall be considered private data and the commissioner
390.2shall not collect individual screening results.
390.3    (b) When the county board refers clients to providers of children's therapeutic
390.4services and supports under section 256B.0943, the county board must clearly identify
390.5the desired services components not covered under section 256B.0943 and identify the
390.6reimbursement source for those requested services, the method of payment, and the
390.7payment rate to the provider.

390.8    Sec. 8. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:
390.9    Subd. 2. Transfer to correctional facility. (a) If a person has been committed
390.10under this section and later is committed to the custody of the commissioner of corrections
390.11for any reason, including but not limited to, being sentenced for a crime or revocation of
390.12the person's supervised release or conditional release under section 244.05, 609.108,
390.13subdivision 6 , or 609.109, subdivision 7, the person shall be transferred to a facility
390.14designated by the commissioner of corrections without regard to the procedures provided
390.15in section 253B.18.
390.16    (b) If a person is committed under this section after a commitment to the
390.17commissioner of corrections, the person shall first serve the sentence in a facility
390.18designated by the commissioner of corrections. After the person has served the sentence,
390.19the person shall be transferred to a treatment program designated by the commissioner
390.20of human services.

390.21    Sec. 9. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:
390.22    Subd. 3. Rules for chemical dependency care. The commissioner of human
390.23services shall establish by rule criteria to be used in determining the appropriate level
390.24of chemical dependency care, whether outpatient, inpatient or short-term treatment
390.25programs, for each recipient of public assistance seeking treatment for alcohol or other
390.26drug dependency and abuse problems. The criteria shall address, at least, the family
390.27relationship, past treatment history, medical or physical problems, arrest record, and
390.28employment situation.

390.29    Sec. 10. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:
390.30    Subd. 2. Program and service guidelines. (a) The commissioner shall provide
390.31program and service guidelines and technical assistance to the county boards in carrying
390.32out services authorized under sections section 254A.08, 254A.12, 254A.14, and their
390.33responsibilities under chapter 256E.
391.1    (b) The commissioner shall recommend to the governor means of improving
391.2the efficiency and effectiveness of comprehensive program services in the state and
391.3maximizing the use of nongovernmental funds for providing comprehensive programs.

391.4    Sec. 11. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:
391.5    Subdivision 1. Chemical dependency treatment allocation. The chemical
391.6dependency funds appropriated for allocation shall be placed in a special revenue account.
391.7The commissioner shall annually transfer funds from the chemical dependency fund to pay
391.8for operation of the drug and alcohol abuse normative evaluation system and to pay for all
391.9costs incurred by adding two positions for licensing of chemical dependency treatment
391.10and rehabilitation programs located in hospitals for which funds are not otherwise
391.11appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall
391.12allocate funds to the American Indian chemical dependency tribal account for treatment
391.13of American Indians by eligible vendors under section 254B.05, equal to the amount
391.14allocated in fiscal year 1997. Six percent of the remaining money must be reserved for
391.15tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall
391.16annually divide the money available in the chemical dependency fund that is not held
391.17in reserve by counties from a previous allocation, or allocated to the American Indian
391.18chemical dependency tribal account. Six percent of the remaining money must be
391.19reserved for the nonreservation American Indian chemical dependency allocation for
391.20treatment of American Indians by eligible vendors under section 254B.05, subdivision
391.211 . The remainder of the money must be allocated among the counties according to the
391.22following formula, using state demographer data and other data sources determined by
391.23the commissioner:
391.24    (a) For purposes of this formula, American Indians and children under age 14 are
391.25subtracted from the population of each county to determine the restricted population.
391.26    (b) The amount of chemical dependency fund expenditures for entitled persons for
391.27services not covered by prepaid plans governed by section 256B.69 in the previous year is
391.28divided by the amount of chemical dependency fund expenditures for entitled persons for
391.29all services to determine the proportion of exempt service expenditures for each county.
391.30    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt
391.31service expenditures to determine the adjusted prepaid plan months of eligibility for
391.32each county.
391.33    (d) The adjusted prepaid plan months of eligibility is added to the number of
391.34restricted population fee for service months of eligibility for the Minnesota family
392.1investment program, general assistance, and medical assistance and divided by the county
392.2restricted population to determine county per capita months of covered service eligibility.
392.3    (e) The number of adjusted prepaid plan months of eligibility for the state is added
392.4to the number of fee for service months of eligibility for the Minnesota family investment
392.5program, general assistance, and medical assistance for the state restricted population and
392.6divided by the state restricted population to determine state per capita months of covered
392.7service eligibility.
392.8    (f) The county per capita months of covered service eligibility is divided by the
392.9state per capita months of covered service eligibility to determine the county welfare
392.10caseload factor.
392.11    (g) The median married couple income for the most recent three-year period
392.12available for the state is divided by the median married couple income for the same period
392.13for each county to determine the income factor for each county.
392.14    (h) The county restricted population is multiplied by the sum of the county welfare
392.15caseload factor and the county income factor to determine the adjusted population.
392.16    (i) $15,000 shall be allocated to each county.
392.17    (j) The remaining funds shall be allocated proportional to the county adjusted
392.18population.

392.19    Sec. 12. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:
392.20    Subd. 5. Administrative adjustment. The commissioner may make payments to
392.21local agencies from money allocated under this section to support administrative activities
392.22under sections 254B.03 and 254B.04. The administrative payment must not exceed
392.23five percent of the first $50,000, four percent of the next $50,000, and three percent of
392.24the remaining payments for services from the allocation. Twenty-five percent of the
392.25administrative allowance shall be advanced at the beginning of each quarter, based on
392.26the payments for services made in the most recent quarter for which data is available.
392.27Adjustment of any overestimate or underestimate based on actual expenditures shall be
392.28made by the state agency by adjusting the administrative allowance for any succeeding
392.29quarter.

392.30    Sec. 13. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:
392.31    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical
392.32dependency services to persons residing within its jurisdiction who meet criteria
392.33established by the commissioner for placement in a chemical dependency residential or
392.34nonresidential treatment service. Chemical dependency money must be administered
393.1by the local agencies according to law and rules adopted by the commissioner under
393.2sections 14.001 to 14.69.
393.3    (b) In order to contain costs, the county board shall, with the approval of the
393.4commissioner of human services, select eligible vendors of chemical dependency services
393.5who can provide economical and appropriate treatment. Unless the local agency is a social
393.6services department directly administered by a county or human services board, the local
393.7agency shall not be an eligible vendor under section 254B.05. The commissioner may
393.8approve proposals from county boards to provide services in an economical manner or to
393.9control utilization, with safeguards to ensure that necessary services are provided. If a
393.10county implements a demonstration or experimental medical services funding plan, the
393.11commissioner shall transfer the money as appropriate. If a county selects a vendor located
393.12in another state, the county shall ensure that the vendor is in compliance with the rules
393.13governing licensure of programs located in the state.
393.14    (c) The calendar year 2002 rate for vendors may not increase more than three
393.15percent above the rate approved in effect on January 1, 2001. The calendar year 2003
393.16rate for vendors may not increase more than three percent above the rate in effect on
393.17January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in
393.18effect on January 1, 2003.
393.19    (d) (c) A culturally specific vendor that provides assessments under a variance under
393.20Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
393.21persons not covered by the variance.

393.22    Sec. 14. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:
393.23    Subd. 3. Local agencies to pay state for county share. Local agencies shall submit
393.24invoices to the state on forms supplied by the commissioner and according to procedures
393.25established by the commissioner. Local agencies shall pay the state for the county share
393.26of the invoiced services authorized by the local agency. Payments shall be made at the
393.27beginning of each month for services provided in the previous month. The commissioner
393.28shall bill the county monthly for services, based on the most recent month for which
393.29expenditure information is available. Adjustment of any overestimate or underestimate
393.30based on actual expenditures shall be made by the state agency by adjusting the estimate
393.31for any succeeding month.

393.32    Sec. 15. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:
393.33    Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for
393.34placements made by local agencies under section 254B.03, subdivision 1, and placements
394.1by tribal designated agencies according to section 254B.09. The commissioner may
394.2reduce or deny payment of the state share when services are not provided according to the
394.3placement criteria established by the commissioner. The commissioner may pay for all or
394.4a portion of improper county chemical dependency placements and bill the county for the
394.5entire payment made when the placement did not comply with criteria established by the
394.6commissioner. The commissioner may make payments to vendors and charge the county
394.7100 percent of the payments if documentation of a county approved placement is received
394.8more than 30 working days, exclusive of weekends and holidays, after the date services
394.9began; or if the county approved invoice is received by the commissioner more than 120
394.10days after the last date of service provided. The commissioner shall not pay vendors until
394.11private insurance company claims have been settled.

394.12    Sec. 16. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to
394.13read:
394.14    Subd. 23. Day treatment services. Medical assistance covers day treatment
394.15services as specified in sections 245.462, subdivision 8, and 245.4871, subdivision 10, that
394.16are provided under contract with the county board. Notwithstanding Minnesota Rules,
394.17part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day
394.18treatment for adults according to section 256B.0625, subdivision 25. Notwithstanding
394.19Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance
394.20covers day treatment services for children as specified under section 256B.0943.

394.21    Sec. 17. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to
394.22read:
394.23    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be
394.24an eligible provider entity under this section, a provider entity must have a clinical
394.25infrastructure that utilizes diagnostic assessment, an individualized treatment plan,
394.26service delivery, and individual treatment plan review that are culturally competent,
394.27child-centered, and family-driven to achieve maximum benefit for the client. The provider
394.28entity must review and update the clinical policies and procedures every three years and
394.29must distribute the policies and procedures to staff initially and upon each subsequent
394.30update.
394.31    (b) The clinical infrastructure written policies and procedures must include policies
394.32and procedures for:
394.33    (1) providing or obtaining a client's diagnostic assessment that identifies acute and
394.34chronic clinical disorders, co-occurring medical conditions, sources of psychological and
395.1environmental problems, and a functional assessment. The functional assessment must
395.2clearly summarize the client's individual strengths and needs;
395.3    (2) developing an individual treatment plan that is:
395.4    (i) based on the information in the client's diagnostic assessment;
395.5    (ii) developed no later than the end of the first psychotherapy session after the
395.6completion of the client's diagnostic assessment by the mental health professional who
395.7provides the client's psychotherapy;
395.8    (iii) developed through a child-centered, family-driven planning process that
395.9identifies service needs and individualized, planned, and culturally appropriate
395.10interventions that contain specific treatment goals and objectives for the client and the
395.11client's family or foster family;
395.12    (iv) reviewed at least once every 90 days and revised, if necessary; and
395.13    (v) signed by the client or, if appropriate, by the client's parent or other person
395.14authorized by statute to consent to mental health services for the client;
395.15    (3) developing an individual behavior plan that documents services to be provided
395.16by the mental health behavioral aide. The individual behavior plan must include:
395.17    (i) detailed instructions on the service to be provided;
395.18    (ii) time allocated to each service;
395.19    (iii) methods of documenting the child's behavior;
395.20    (iv) methods of monitoring the child's progress in reaching objectives; and
395.21    (v) goals to increase or decrease targeted behavior as identified in the individual
395.22treatment plan;
395.23    (4) clinical supervision of the mental health practitioner and mental health behavioral
395.24aide. A mental health professional must document the clinical supervision the professional
395.25provides by cosigning individual treatment plans and making entries in the client's record
395.26on supervisory activities. Clinical supervision does not include the authority to make or
395.27terminate court-ordered placements of the child. A clinical supervisor must be available
395.28for urgent consultation as required by the individual client's needs or the situation. Clinical
395.29supervision may occur individually or in a small group to discuss treatment and review
395.30progress toward goals. The focus of clinical supervision must be the client's treatment
395.31needs and progress and the mental health practitioner's or behavioral aide's ability to
395.32provide services;
395.33    (4a) CTSS certified provider entities providing day treatment programs must meet
395.34the conditions in items (i) to (iii):
396.1    (i) the provider supervisor must be present and available on the premises more
396.2than 50 percent of the time in a five-working-day period during which the supervisee is
396.3providing a mental health service;
396.4    (ii) the diagnosis and the client's individual treatment plan or a change in the
396.5diagnosis or individual treatment plan must be made by or reviewed, approved, and signed
396.6by the provider supervisor; and
396.7    (iii) every 30 days, the supervisor must review and sign the record of the client's care
396.8for all activities in the preceding 30-day period;
396.9    (4b) for all other services provided under CTSS, clinical supervision standards
396.10provided in items (i) to (iii) must be used:
396.11    (i) medical assistance shall reimburse a mental health practitioner who maintains a
396.12consulting relationship with a mental health professional who accepts full professional
396.13responsibility and is present on site for at least one observation during the first 12 hours
396.14in which the mental health practitioner provides the individual, family, or group skills
396.15training to the child or the child's family;
396.16    (ii) thereafter, the mental health professional is required to be present on site for
396.17observation as clinically appropriate when the mental health practitioner is providing
396.18individual, family, or group skills training to the child or the child's family; and
396.19    (iii) the observation must be a minimum of one clinical unit. The on-site presence of
396.20the mental health professional must be documented in the child's record and signed by the
396.21mental health professional who accepts full professional responsibility;
396.22    (5) providing direction to a mental health behavioral aide. For entities that employ
396.23mental health behavioral aides, the clinical supervisor must be employed by the provider
396.24entity or other certified children's therapeutic supports and services provider entity to
396.25ensure necessary and appropriate oversight for the client's treatment and continuity
396.26of care. The mental health professional or mental health practitioner giving direction
396.27must begin with the goals on the individualized treatment plan, and instruct the mental
396.28health behavioral aide on how to construct therapeutic activities and interventions that
396.29will lead to goal attainment. The professional or practitioner giving direction must also
396.30instruct the mental health behavioral aide about the client's diagnosis, functional status,
396.31and other characteristics that are likely to affect service delivery. Direction must also
396.32include determining that the mental health behavioral aide has the skills to interact with
396.33the client and the client's family in ways that convey personal and cultural respect and
396.34that the aide actively solicits information relevant to treatment from the family. The aide
396.35must be able to clearly explain the activities the aide is doing with the client and the
396.36activities' relationship to treatment goals. Direction is more didactic than is supervision
397.1and requires the professional or practitioner providing it to continuously evaluate the
397.2mental health behavioral aide's ability to carry out the activities of the individualized
397.3treatment plan and the individualized behavior plan. When providing direction, the
397.4professional or practitioner must:
397.5    (i) review progress notes prepared by the mental health behavioral aide for accuracy
397.6and consistency with diagnostic assessment, treatment plan, and behavior goals and the
397.7professional or practitioner must approve and sign the progress notes;
397.8    (ii) identify changes in treatment strategies, revise the individual behavior plan,
397.9and communicate treatment instructions and methodologies as appropriate to ensure
397.10that treatment is implemented correctly;
397.11    (iii) demonstrate family-friendly behaviors that support healthy collaboration among
397.12the child, the child's family, and providers as treatment is planned and implemented;
397.13    (iv) ensure that the mental health behavioral aide is able to effectively communicate
397.14with the child, the child's family, and the provider; and
397.15    (v) record the results of any evaluation and corrective actions taken to modify the
397.16work of the mental health behavioral aide;
397.17    (6) providing service delivery that implements the individual treatment plan and
397.18meets the requirements under subdivision 9; and
397.19    (7) individual treatment plan review. The review must determine the extent to which
397.20the services have met the goals and objectives in the previous treatment plan. The review
397.21must assess the client's progress and ensure that services and treatment goals continue to
397.22be necessary and appropriate to the client and the client's family or foster family. Revision
397.23of the individual treatment plan does not require a new diagnostic assessment unless the
397.24client's mental health status has changed markedly. The updated treatment plan must be
397.25signed by the client, if appropriate, and by the client's parent or other person authorized by
397.26statute to give consent to the mental health services for the child.

397.27    Sec. 18. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to
397.28read:
397.29    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a
397.30certified provider entity must ensure that:
397.31    (1) each individual provider's caseload size permits the provider to deliver services
397.32to both clients with severe, complex needs and clients with less intensive needs. The
397.33provider's caseload size should reasonably enable the provider to play an active role in
397.34service planning, monitoring, and delivering services to meet the client's and client's
397.35family's needs, as specified in each client's individual treatment plan;
398.1    (2) site-based programs, including day treatment and preschool programs, provide
398.2staffing and facilities to ensure the client's health, safety, and protection of rights, and that
398.3the programs are able to implement each client's individual treatment plan;
398.4    (3) a day treatment program is provided to a group of clients by a multidisciplinary
398.5team under the clinical supervision of a mental health professional. The day treatment
398.6program must be provided in and by: (i) an outpatient hospital accredited by the Joint
398.7Commission on Accreditation of Health Organizations and licensed under sections
398.8144.50 to 144.55; (ii) a community mental health center under section 245.62; and (iii)
398.9an entity that is under contract with the county board to operate a program that meets
398.10the requirements of sections 245.4712, subdivision 2, and 245.4884, subdivision 2,
398.11and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must
398.12stabilize the client's mental health status while developing and improving the client's
398.13independent living and socialization skills. The goal of the day treatment program must be
398.14to reduce or relieve the effects of mental illness and provide training to enable the client
398.15to live in the community. The program must be available at least one day a week for a
398.16minimum three-hour time block. The three-hour time block must include at least one
398.17hour, but no more than two hours, of individual or group psychotherapy. The remainder
398.18of the three-hour time block may include recreation therapy, socialization therapy, or
398.19independent living skills therapy, but only if the therapies are included in the client's
398.20individual treatment plan. Day treatment programs are not part of inpatient or residential
398.21treatment services; and
398.22    (4) a preschool program is a structured treatment program offered to a child who
398.23is at least 33 months old, but who has not yet reached the first day of kindergarten, by a
398.24preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts
398.259503.0005 to 9503.0175. The program must be available at least one day a week for a
398.26minimum two-hour time block. The structured treatment program may include individual
398.27or group psychotherapy and recreation therapy, socialization therapy, or independent
398.28living skills therapy, if included in the client's individual treatment plan.
398.29    (b) A provider entity must deliver the service components of children's therapeutic
398.30services and supports in compliance with the following requirements:
398.31    (1) individual, family, and group psychotherapy must be delivered as specified in
398.32Minnesota Rules, part 9505.0323;
398.33    (2) individual, family, or group skills training must be provided by a mental health
398.34professional or a mental health practitioner who has a consulting relationship with a
398.35mental health professional who accepts full professional responsibility for the training;
399.1    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
399.2through arrangements for direct intervention and support services to the child and the
399.3child's family. Crisis assistance must utilize resources designed to address abrupt or
399.4substantial changes in the functioning of the child or the child's family as evidenced by
399.5a sudden change in behavior with negative consequences for well being, a loss of usual
399.6coping mechanisms, or the presentation of danger to self or others;
399.7    (4) medically necessary services that are provided by a mental health behavioral
399.8aide must be designed to improve the functioning of the child and support the family in
399.9activities of daily and community living. A mental health behavioral aide must document
399.10the delivery of services in written progress notes. The mental health behavioral aide
399.11must implement goals in the treatment plan for the child's emotional disturbance that
399.12allow the child to acquire developmentally and therapeutically appropriate daily living
399.13skills, social skills, and leisure and recreational skills through targeted activities. These
399.14activities may include:
399.15    (i) assisting a child as needed with skills development in dressing, eating, and
399.16toileting;
399.17    (ii) assisting, monitoring, and guiding the child to complete tasks, including
399.18facilitating the child's participation in medical appointments;
399.19    (iii) observing the child and intervening to redirect the child's inappropriate behavior;
399.20    (iv) assisting the child in using age-appropriate self-management skills as related
399.21to the child's emotional disorder or mental illness, including problem solving, decision
399.22making, communication, conflict resolution, anger management, social skills, and
399.23recreational skills;
399.24    (v) implementing deescalation techniques as recommended by the mental health
399.25professional;
399.26    (vi) implementing any other mental health service that the mental health professional
399.27has approved as being within the scope of the behavioral aide's duties; or
399.28    (vii) assisting the parents to develop and use parenting skills that help the child
399.29achieve the goals outlined in the child's individual treatment plan or individual behavioral
399.30plan. Parenting skills must be directed exclusively to the child's treatment; and
399.31    (5) direction of a mental health behavioral aide must include the following:
399.32    (i) a total of one hour of on-site observation by a mental health professional during
399.33the first 12 hours of service provided to a child;
399.34    (ii) ongoing on-site observation by a mental health professional or mental health
399.35practitioner for at least a total of one hour during every 40 hours of service provided
399.36to a child; and
400.1    (iii) immediate accessibility of the mental health professional or mental health
400.2practitioner to the mental health behavioral aide during service provision.

400.3    Sec. 19. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to
400.4read:
400.5    Subd. 11. Documentation and billing. (a) A provider entity must document the
400.6services it provides under this section. The provider entity must ensure that the entity's
400.7documentation standards meet the requirements of federal and state laws. Services billed
400.8under this section that are not documented according to this subdivision shall be subject to
400.9monetary recovery by the commissioner. The provider entity may not bill for anything
400.10other than direct service time.
400.11    (b) An individual mental health provider must promptly document the following
400.12in a client's record after providing services to the client:
400.13    (1) each occurrence of the client's mental health service, including the date, type,
400.14length, and scope of the service;
400.15    (2) the name of the person who gave the service;
400.16    (3) contact made with other persons interested in the client, including representatives
400.17of the courts, corrections systems, or schools. The provider must document the name
400.18and date of each contact;
400.19    (4) any contact made with the client's other mental health providers, case manager,
400.20family members, primary caregiver, legal representative, or the reason the provider did
400.21not contact the client's family members, primary caregiver, or legal representative, if
400.22applicable; and
400.23    (5) required clinical supervision, as appropriate.

400.24    Sec. 20. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to
400.25read:
400.26    Subd. 12. Excluded services. The following services are not eligible for medical
400.27assistance payment as children's therapeutic services and supports:
400.28    (1) service components of children's therapeutic services and supports
400.29simultaneously provided by more than one provider entity unless prior authorization is
400.30obtained;
400.31    (2) children's therapeutic services and supports provided in violation of medical
400.32assistance policy in Minnesota Rules, part 9505.0220;
401.1    (3) mental health behavioral aide services provided by a personal care assistant who
401.2is not qualified as a mental health behavioral aide and employed by a certified children's
401.3therapeutic services and supports provider entity;
401.4    (4) service components of CTSS that are the responsibility of a residential or
401.5program license holder, including foster care providers under the terms of a service
401.6agreement or administrative rules governing licensure; and
401.7    (5) adjunctive activities that may be offered by a provider entity but are not
401.8otherwise covered by medical assistance, including:
401.9    (i) a service that is primarily recreation oriented or that is provided in a setting that
401.10is not medically supervised. This includes sports activities, exercise groups, activities
401.11such as craft hours, leisure time, social hours, meal or snack time, trips to community
401.12activities, and tours;
401.13    (ii) a social or educational service that does not have or cannot reasonably be
401.14expected to have a therapeutic outcome related to the client's emotional disturbance;
401.15    (iii) consultation with other providers or service agency staff about the care or
401.16progress of a client;
401.17    (iv) prevention or education programs provided to the community; and
401.18    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and
401.19    (6) activities that are not direct service time.

401.20    Sec. 21. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:
401.21    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.
401.22    (b) "Family asset account" means a savings account opened by a household
401.23participating in the Minnesota family assets for independence initiative.
401.24    (c) "Fiduciary organization" means:
401.25    (1) a community action agency that has obtained recognition under section 268.53
401.26256E.31 ;
401.27    (2) a federal community development credit union serving the seven-county
401.28metropolitan area; or
401.29    (3) a women-oriented economic development agency serving the seven-county
401.30metropolitan area.
401.31    (d) "Financial institution" means a bank, bank and trust, savings bank, savings
401.32association, or credit union, the deposits of which are insured by the Federal Deposit
401.33Insurance Corporation or the National Credit Union Administration.
401.34    (e) "Permissible use" means:
402.1    (1) postsecondary educational expenses at an accredited public postsecondary
402.2institution including books, supplies, and equipment required for courses of instruction;
402.3    (2) acquisition costs of acquiring, constructing, or reconstructing a residence,
402.4including any usual or reasonable settlement, financing, or other closing costs;
402.5    (3) business capitalization expenses for expenditures on capital, plant, equipment,
402.6working capital, and inventory expenses of a legitimate business pursuant to a business
402.7plan approved by the fiduciary organization; and
402.8    (4) acquisition costs of a principal residence within the meaning of section 1034 of
402.9the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area
402.10purchase price applicable to the residence determined according to section 143(e)(2) and
402.11(3) of the Internal Revenue Code of 1986.
402.12    (f) "Household" means all individuals who share use of a dwelling unit as primary
402.13quarters for living and eating separate from other individuals.

402.14    Sec. 22. Minnesota Statutes 2006, section 518A.32, subdivision 3, is amended to read:
402.15    Subd. 3. Parent not considered voluntarily unemployed or underemployed.
402.16    A parent is not considered voluntarily unemployed or underemployed upon a showing
402.17by the parent that:
402.18    (1) unemployment or underemployment is temporary and will ultimately lead to
402.19an increase in income; or
402.20    (2) the unemployment or underemployment represents a bona fide career change that
402.21outweighs the adverse effect of that parent's diminished income on the child; or
402.22    (3) the unemployment or underemployment is because a parent is physically or
402.23mentally incapacitated.
402.24EFFECTIVE DATE.This section is effective retroactively from January 1, 2007.

402.25    Sec. 23. Laws 2005, chapter 98, article 3, section 25, is amended to read:
402.26    Sec. 25. REPEALER.
402.27    Minnesota Statutes 2004, sections 245.713, subdivisions 2 and subdivision 4;
402.28245.716 ; and 626.5551, subdivision 4, are repealed.
402.29EFFECTIVE DATE.This section is effective retroactively from August 1, 2005.

402.30    Sec. 24. FEDERAL GRANTS.
402.31    The Board of Pharmacy shall apply for any applicable federal grants or other nonstate
402.32funds to establish and fully implement the prescription electronic reporting system.
403.1EFFECTIVE DATE.This section is effective the day following final enactment.

403.2    Sec. 25. BOARD OF PHARMACY.
403.3    The Board of Pharmacy shall not increase the license fees of pharmacists or
403.4pharmacies in order to adequately fund the prescription electronic reporting system under
403.5Minnesota Statutes, section 152.126, without specific authority from the legislature.
403.6EFFECTIVE DATE.This section is effective the day following final enactment.

403.7    Sec. 26. BOARD OF MEDICAL PRACTICE.
403.8    The Board of Medical Practice shall convene a work group to discuss the appropriate
403.9prescribing of controlled substances listed in Minnesota Statutes, section 152.02,
403.10subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under
403.11Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and
403.12shall report to the legislature by December 15, 2007.

403.13    Sec. 27. REPEALER.
403.14(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16;
403.15254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175;
403.16254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.
403.17(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.

403.18ARTICLE 12

403.19MISCELLANEOUS

403.20    Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a
403.21subdivision to read:
403.22    Subd. 2a. Base budget detail. Within one week of the release of the budget forecasts
403.23required in section 16A.102 in November of an even-numbered year and February of an
403.24odd-numbered year, the commissioner, after consulting with the commissioners of human
403.25services and health, must provide to the legislature information at the program, budget
403.26activity and management activity level for the base level budget of the Department of
403.27Human Services and the Department of Health for the next biennium. The information
403.28must be organized in a manner that explains how base level budget appropriations are
403.29projected to be spent. Within one week of the release of the budget forecasts required in
403.30section 16A.102 in November of an even-numbered year, the commissioner must also
404.1provide the legislature with the information submitted by the commissioners of human
404.2services and health under subdivision 2, clauses (3) and (4).

404.3    Sec. 2. Minnesota Statutes 2006, section 62E.02, subdivision 7, is amended to read:
404.4    Subd. 7. Dependent. "Dependent" means a spouse or unmarried child under the
404.5age of 19 years, a dependent child who is a student under the age of 25, or a dependent
404.6child of any age who is disabled.
404.7EFFECTIVE DATE.This section is effective January 1, 2008, and applies to
404.8coverage offered, sold, issued, or renewed on or after that date.

404.9    Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:
404.1062H.02 REQUIRED PROVISIONS.
404.11    (a) A joint self-insurance plan must include aggregate excess stop-loss coverage and
404.12individual excess stop-loss coverage provided by an insurance company licensed by the
404.13state of Minnesota.
404.14    (b) Aggregate excess stop-loss coverage must include provisions to cover incurred,
404.15unpaid claim liability in the event of plan termination. In addition,
404.16    (c) The plan of self-insurance must have participating employers fund an amount at
404.17least equal to the point at which the excess or stop-loss insurer has contracted to assume
404.18100 percent of additional liability.
404.19    (d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance
404.20contract to the commissioner of commerce at least 30 days prior to the proposed plan's
404.21effective date and at least 30 days subsequent to any renewal date. The commissioner shall
404.22review the contract to determine if they meet the standards established by sections 62H.01
404.23to 62H.08 and respond within a 30-day period.
404.24    (e) Any excess or stop-loss insurance plan must contain a provision that the excess
404.25or stop-loss insurer will give the plan and the commissioner of commerce a minimum of
404.26180 days' notice of termination or nonrenewal. If the plan fails to secure replacement
404.27coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the
404.28commissioner shall issue an order providing for the orderly termination of the plan.
404.29    (f) The commissioner may waive the requirements of this section and of any rule
404.30relating to the requirements of this section, if the commissioner determines that a joint
404.31self-insurance plan has established alternative arrangements that fully fund the plan's
404.32liability or incurred but unpaid claims. The commissioner may not waive the requirement
404.33that a joint self-insurance plan have excess stop-loss coverage.
405.1EFFECTIVE DATE.This section is effective the day following final enactment.

405.2    Sec. 4. Minnesota Statutes 2006, section 62J.07, subdivision 1, is amended to read:
405.3    Subdivision 1. Legislative oversight. The Legislative Commission on Health
405.4Care Access reviews the activities of the commissioner of health, the Health Technology
405.5Advisory Committee, and all other state agencies involved in the implementation and
405.6administration of this chapter, including efforts to obtain federal approval through waivers
405.7and other means shall make recommendations to the legislature on how to achieve the
405.8goal of universal health coverage as described in section 62Q.165. The recommendations
405.9shall include a timetable in which measurable progress must be achieved toward this goal.
405.10The commission shall submit to the legislature by January 15, 2008, the recommendations
405.11and corresponding timetable.

405.12    Sec. 5. Minnesota Statutes 2006, section 62J.07, subdivision 3, is amended to read:
405.13    Subd. 3. Reports to the commission. The commissioner commissioners of
405.14health, human services, commerce, and the Health Technology Advisory Committee shall
405.15report on their activities annually and at other times at the request of the Legislative
405.16Commission on Health Care Access. The commissioners of health, commerce, and human
405.17services shall provide periodic reports to the legislative commission on the progress of
405.18rulemaking that is authorized or required under this chapter and shall notify members
405.19of the commission when a draft of a proposed rule has been completed and scheduled
405.20for publication in the State Register. At the request of a member of the commission,
405.21a commissioner shall provide a description and a copy of a proposed rule other state
405.22agencies shall provide assistance and technical support to the commission at the request
405.23of the commission. The commission may convene subcommittees to provide additional
405.24assistance and advice to the commission.

405.25    Sec. 6. Minnesota Statutes 2006, section 62L.02, subdivision 11, is amended to read:
405.26    Subd. 11. Dependent. "Dependent" means an eligible employee's spouse,
405.27unmarried child who is under the age of 19 years, unmarried child under the age of 25
405.28years who is a full-time student as defined in section 62A.301, dependent child of any age
405.29who is disabled and who meets the eligibility criteria in section 62A.14, subdivision 2,
405.30or any other person whom state or federal law requires to be treated as a dependent for
405.31purposes of health plans. For the purpose of this definition, a child includes a child for
405.32whom the employee or the employee's spouse has been appointed legal guardian and an
405.33adoptive child as provided in section 62A.27.
406.1EFFECTIVE DATE.This section is effective January 1, 2008, and applies to
406.2coverage offered, sold, issued, and renewed on or after that date.

406.3    Sec. 7. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision
406.4to read:
406.5    Subd. 5. Base budget detail. The commissioner shall provide the commissioner
406.6of finance with the information necessary to provide base budget detail to the legislature
406.7under section 16A.10, subdivision 2a.

406.8    Sec. 8. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:
406.9    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of
406.10professional practice only, may prescribe, administer, and dispense a legend drug, and may
406.11cause the same to be administered by a nurse, a physician assistant, or medical student or
406.12resident under the practitioner's direction and supervision, and may cause a person who
406.13is an appropriately certified, registered, or licensed health care professional to prescribe,
406.14dispense, and administer the same within the expressed legal scope of the person's practice
406.15as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug,
406.16without reference to a specific patient, by directing a nurse, pursuant to section 148.235,
406.17subdivisions 8 and 9 , physician assistant, or medical student or resident to adhere to
406.18a particular practice guideline or protocol when treating patients whose condition falls
406.19within such guideline or protocol, and when such guideline or protocol specifies the
406.20circumstances under which the legend drug is to be prescribed and administered. An
406.21individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
406.22order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
406.23This paragraph applies to a physician assistant only if the physician assistant meets the
406.24requirements of section 147A.18.
406.25    (b) A licensed practitioner that dispenses for profit a legend drug that is to be
406.26administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must
406.27file with the practitioner's licensing board a statement indicating that the practitioner
406.28dispenses legend drugs for profit, the general circumstances under which the practitioner
406.29dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to
406.30dispense legend drugs for profit after July 31, 1990, unless the statement has been filed
406.31with the appropriate licensing board. For purposes of this paragraph, "profit" means (1)
406.32any amount received by the practitioner in excess of the acquisition cost of a legend drug
406.33for legend drugs that are purchased in prepackaged form, or (2) any amount received
406.34by the practitioner in excess of the acquisition cost of a legend drug plus the cost of
407.1making the drug available if the legend drug requires compounding, packaging, or other
407.2treatment. The statement filed under this paragraph is public data under section 13.03.
407.3This paragraph does not apply to a licensed doctor of veterinary medicine or a registered
407.4pharmacist. Any person other than a licensed practitioner with the authority to prescribe,
407.5dispense, and administer a legend drug under paragraph (a) shall not dispense for profit.
407.6To dispense for profit does not include dispensing by a community health clinic when the
407.7profit from dispensing is used to meet operating expenses.
407.8    (c) A prescription or drug order for a legend drug is not valid if it is based solely
407.9on an online questionnaire, unless it can be established that the prescription or order was
407.10based on a documented patient evaluation adequate to establish a diagnosis and identify
407.11underlying conditions and contraindications to treatment.

407.12    Sec. 9. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to
407.13read:
407.14    Subd. 2d. Identification requirement for schedule II or III controlled substance.
407.15    (a) No person may dispense a controlled substance included in schedule II or III without
407.16requiring the person purchasing the controlled substance, who need not be the person for
407.17whom the controlled substance prescription is written, to present valid photographic
407.18identification, unless the person purchasing the controlled substance, or if applicable the
407.19person for whom the controlled substance prescription is written, is known to the dispenser.
407.20    (b) This subdivision applies only to purchases of controlled substances that are not
407.21covered, in whole or in part, by a health plan company or other third-party payor. The
407.22Board of Pharmacy shall report to the legislature by July 1, 2009, on the effect of this
407.23subdivision. The board shall include in the report the incidence of complaints, if any,
407.24generated by the requirements of this subdivision and whether this subdivision is creating
407.25barriers to pharmaceutical access.

407.26    Sec. 10. Minnesota Statutes 2006, section 169A.70, subdivision 4, is amended to read:
407.27    Subd. 4. Assessor standards; rules; assessment time limits. A chemical use
407.28assessment required by this section must be conducted by an assessor appointed by the
407.29court. The assessor must meet the training and qualification requirements of rules adopted
407.30by the commissioner of human services under section 254A.03, subdivision 3 (chemical
407.31dependency treatment rules). Notwithstanding section 13.82 (law enforcement data), the
407.32assessor shall have access to any police reports, laboratory test results, and other law
407.33enforcement data relating to the current offense or previous offenses that are necessary
407.34to complete the evaluation. An assessor providing an assessment under this section may
408.1not have any direct or shared financial interest or referral relationship resulting in shared
408.2financial gain with a treatment provider, except as authorized under section 254A.20,
408.3subdivision 3. If an independent assessor is not available, the court may use the services
408.4of an assessor authorized to perform assessments for the county social services agency
408.5under a variance granted under rules adopted by the commissioner of human services
408.6under section 254A.03, subdivision 3. An appointment for the defendant to undergo the
408.7assessment must be made by the court, a court services probation officer, or the court
408.8administrator as soon as possible but in no case more than one week after the defendant's
408.9court appearance. The assessment must be completed no later than three weeks after the
408.10defendant's court appearance. If the assessment is not performed within this time limit, the
408.11county where the defendant is to be sentenced shall perform the assessment. The county
408.12of financial responsibility must be determined under chapter 256G.
408.13EFFECTIVE DATE.This section is effective the day following final enactment.

408.14    Sec. 11. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:
408.15    Subd. 7. Essential employee. "Essential employee" means firefighters, peace
408.16officers subject to licensure under sections 626.84 to 626.863, 911 system and police and
408.17fire department public safety dispatchers, guards at correctional facilities, confidential
408.18employees, supervisory employees, assistant county attorneys, assistant city attorneys,
408.19principals, and assistant principals. However, for state employees, "essential employee"
408.20means all employees, except for nonprofessional employees employed by the Department
408.21of Human Services in mental health facilities for the treatment of psychopathic
408.22personalities, sexual predators, and the criminally insane, in law enforcement, public
408.23safety radio communications operators, health care professionals, correctional guards,
408.24professional engineering, and supervisory collective bargaining units, irrespective of
408.25severance, and no other employees. For University of Minnesota employees, "essential
408.26employee" means all employees in law enforcement, nursing professional and supervisory
408.27units, irrespective of severance, and no other employees. "Firefighters" means salaried
408.28employees of a fire department whose duties include, directly or indirectly, controlling,
408.29extinguishing, preventing, detecting, or investigating fires. Employees for whom the state
408.30court administrator is the negotiating employer are not essential employees. For Hennepin
408.31Healthcare System, Inc. employees, "essential employees" means all employees.
408.32EFFECTIVE DATE.This section is effective the day following final enactment.

408.33    Sec. 12. [254A.20] CHEMICAL USE ASSESSMENTS.
409.1    Subdivision 1. Persons arrested outside of home county. When a chemical use
409.2assessment is required under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person
409.3who is arrested and taken into custody by a peace officer outside of the person's county
409.4of residence, the assessment must be completed by the person's county of residence no
409.5later than three weeks after the assessment is initially requested. If the assessment is
409.6not performed within this time limit, the county where the person is to be sentenced
409.7shall perform the assessment. The county of financial responsibility is determined under
409.8chapter 256G.
409.9    Subd. 2. Probation officer as contact. When a chemical use assessment is required
409.10under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person who is on probation
409.11or under other correctional supervision, the assessor, either orally or in writing, shall
409.12contact the person's probation officer to verify or supplement the information provided
409.13by the person.
409.14    Subd. 3. Financial conflicts of interest. (a) Except as provided in paragraph (b), an
409.15assessor conducting a chemical use assessment under Minnesota Rules, parts 9530.6600
409.16to 9530.6655, may not have any direct or shared financial interest or referral relationship
409.17resulting in shared financial gain with a treatment provider.
409.18    (b) A county may contract with an assessor having a conflict described in paragraph
409.19(a) if the county documents that:
409.20    (1) the assessor is employed by a culturally specific service provider or a service
409.21provider with a program designed to treat individuals of a specific age, sex, or sexual
409.22preference;
409.23    (2) the county does not employ a sufficient number of qualified assessors and the
409.24only qualified assessors available in the county have a direct or shared financial interest or
409.25a referral relationship resulting in shared financial gain with a treatment provider; or
409.26    (3) the county social service agency has an existing relationship with an assessor
409.27or service provider and elects to enter into a contract with that assessor to provide both
409.28assessment and treatment under circumstances specified in the county's contract, provided
409.29the county retains responsibility for making placement decisions.
409.30    An assessor under this paragraph may not place clients in treatment. The assessor
409.31shall gather required information and provide it to the county along with any required
409.32documentation. The county shall make all placement decisions for clients assessed by
409.33assessors under this paragraph.
409.34EFFECTIVE DATE.This section is effective July 1, 2007, except for subdivision
409.353, which is effective the day following final enactment.

410.1    Sec. 13. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
410.2to read:
410.3    Subd. 25. Base budget detail. The commissioner shall provide the commissioner
410.4of finance with the information necessary to provide base budget detail to the legislature
410.5under section 16A.10, subdivision 2a.

410.6    Sec. 14. [256B.0636] CONTROLLED SUBSTANCE PRESCRIPTIONS; ABUSE
410.7PREVENTION.
410.8    The commissioner of human services shall develop and implement a plan to:
410.9    (1) review utilization patterns of Minnesota health care program enrollees for
410.10controlled substances listed in section 152.02, subdivisions 3 and 4, and those substances
410.11defined by the Board of Pharmacy under section 152.02, subdivisions 8 and 12;
410.12    (2) develop a mechanism to address abuses both for fee-for-service Minnesota health
410.13care program enrollees and those enrolled in managed care plans; and
410.14    (3) provide education to Minnesota health care program enrollees on the proper use
410.15of controlled substances.
410.16    For purposes of this section, "Minnesota health care program" means medical
410.17assistance, MinnesotaCare, or general assistance medical care.

410.18    Sec. 15. Minnesota Statutes 2006, section 609.115, subdivision 8, is amended to read:
410.19    Subd. 8. Chemical use assessment required. (a) If a person is convicted of a
410.20felony, the probation officer shall determine in the report prepared under subdivision 1
410.21whether or not alcohol or drug use was a contributing factor to the commission of the
410.22offense. If so, the report shall contain the results of a chemical use assessment conducted
410.23in accordance with this subdivision. The probation officer shall make an appointment for
410.24the defendant to undergo the chemical use assessment if so indicated.
410.25    (b) The chemical use assessment report must include a recommended level of
410.26care for the defendant in accordance with the criteria contained in rules adopted by the
410.27commissioner of human services under section 254A.03, subdivision 3. The assessment
410.28must be conducted by an assessor qualified under rules adopted by the commissioner of
410.29human services under section 254A.03, subdivision 3. An assessor providing a chemical
410.30use assessment may not have any direct or shared financial interest or referral relationship
410.31resulting in shared financial gain with a treatment provider, except as authorized under
410.32section 254A.20, subdivision 3. If an independent assessor is not available, the probation
410.33officer may use the services of an assessor authorized to perform assessments for the
411.1county social services agency under a variance granted under rules adopted by the
411.2commissioner of human services under section 254A.03, subdivision 3.
411.3EFFECTIVE DATE.This section is effective the day following final enactment.

411.4    Sec. 16. INTERPRETER SERVICES WORK GROUP.
411.5    (a) The commissioner of health shall convene a work group of interested parties to
411.6discuss the provision of interpreter services to patients in medical and dental care settings.
411.7    (b) The work group shall develop findings and recommendations on the following:
411.8    (1) ensuring access to interpreter services;
411.9    (2) compliance with requirements of federal law and guidance;
411.10    (3) developing a quality assurance program to ensure the quality of health care
411.11interpreting services, including requirements for training and establishing a certification
411.12process; and
411.13    (4) identifying broad-based funding mechanisms for interpreter services.
411.14    (c) The work group shall report findings and recommendations to the commissioner
411.15of health and to the chairs of the health policy and finance committees in the house and
411.16senate by January 15, 2008.
411.17    (d) The work group expires the day following the submission of the report required
411.18by paragraph (c).
411.19EFFECTIVE DATE.This section is effective the day following final enactment.

411.20    Sec. 17. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.
411.21    Subdivision 1. Pilot project requirements. Notwithstanding contrary provisions of
411.22Minnesota Statutes, chapter 62H, the following apply to a joint self-insurance pilot project
411.23administered by a trust sponsored by one or more agricultural cooperatives organized
411.24under Minnesota Statutes, chapter 308A, or under a federal charter for the purpose of
411.25offering health coverage to members of the cooperatives and their families, provided the
411.26project satisfies the other requirements of Minnesota Statutes, chapter 62H:
411.27    (1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;
411.28    (2) the notice period required under Minnesota Statutes, section 62H.02, paragraph
411.29(e), is 90 days;
411.30    (3) a joint self-insurance plan may elect to treat the sale of a health plan to or for
411.31an employer that has only one eligible employee who has not waived coverage as the
411.32sale of an individual health plan as allowed under Minnesota Statutes, section 62L.02,
411.33subdivision 26;
412.1    (4) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), applies; and
412.2    (5) the trust must pay the assessment for the Minnesota Comprehensive Health
412.3Association as provided under Minnesota Statutes, section 62E.11.
412.4    Subd. 2. Evaluation and renewal. The pilot project authorized under this section
412.5is for a period of four years from the date of initial enrollment. The commissioner of
412.6commerce shall grant an extension of four additional years if the trust provides evidence
412.7that it remains in compliance with the requirements of this section and other applicable
412.8laws and rules. If the commissioner determines that the operation of the trust has not
412.9improved access, expanded health plan choices, or improved the affordability of health
412.10coverage for farm families, or that it has significantly damaged access, choice, or
412.11affordability for other consumers not enrolled in the trust, the commissioner shall provide
412.12at least 180 days' advance written notice to the trust and to the chairs of the senate and
412.13house finance and policy committees with jurisdiction over health and insurance of the
412.14commissioner's intention not to renew the pilot project at the expiration of a four-year
412.15period.
412.16EFFECTIVE DATE.This section is effective the day following final enactment.

412.17    Sec. 18. HEALTH PLAN PURCHASING POOL STUDY GROUP.
412.18    Subdivision 1. Creation; membership. (a) A health plan purchasing pool study
412.19group is created to study and make recommendations regarding the creation of a voluntary,
412.20statewide health plan purchasing pool that would contract directly with providers to
412.21provide affordable health coverage to eligible Minnesota residents. The study group is
412.22composed of:
412.23    (1) three members of the senate appointed by the Subcommittee on Committees of
412.24the Committee on Rules and Administration, including one member of the minority;
412.25    (2) three members of the house of representatives, two from the majority party
412.26appointed by the speaker of the house of representatives, and one from the minority party
412.27appointed by the minority leader of the house of representatives;
412.28    (3) the attorney general or the attorney general's designated representative;
412.29    (4) three representatives of health care providers appointed as follows:
412.30    (i) one member appointed by the governor;
412.31    (ii) one member appointed by the speaker of the house; and
412.32    (iii) one member appointed by the Subcommittee on Committees of the senate
412.33Committee on Rules and Administration;
412.34    (5) one member selected by the American Federation of State, County, and
412.35Municipal employees;
413.1    (6) one member selected by the Minnesota Association of Professional Employees;
413.2    (7) one member selected by Education Minnesota;
413.3    (8) one member selected by the Minnesota Business Partnership; and
413.4    (9) one member selected by the Metropolitan Interdependent Business Organization.
413.5All appointments made under this subdivision must be made within 30 days of the
413.6effective date of this act.
413.7    (b) The attorney general or the attorney general's designee shall convene the first
413.8meeting of the study group. The study group shall select its chair at the first meeting.
413.9    Subd. 2. Study; report. The study group shall study and make recommendations
413.10on the following issues related to the creation, maintenance, and funding of a voluntary,
413.11statewide health plan purchasing pool to provide comprehensive, cost-effective, and
413.12medically appropriate health coverage to all public and private employees in Minnesota
413.13and all Minnesota residents:
413.14    (1) the creation of an independent public entity to administer the pool;
413.15    (2) eligibility and participation requirements for existing public and private health
413.16care purchasing pools, public and private employers, and residents of this state;
413.17    (3) how to contract directly with providers to provide comprehensive coverage for
413.18preventive, mental health, dental and other medical services, and comprehensive drug
413.19benefits to enrollees and maximize the cost savings and other efficiencies that a large
413.20purchasing pool would be expected to generate without the need for a public subsidy;
413.21    (4) provisions that allow the pool to contract directly with health care providers
413.22to provide coverage to enrollees;
413.23    (5) incentives designed to attract and retain the maximum number of enrollees;
413.24    (6) recommendations for the administration of the pool and the plans that will be
413.25available to enrollees including, but not limited to, recommendations to keep the pool
413.26solvent and profitable so that public subsidies are not necessary; and
413.27    (7) other elements the study group concludes are necessary or desirable for the
413.28pool to possess.
413.29    The study group shall submit its report and the draft legislation necessary to
413.30implement its recommendations to the chairs of the legislative committees and divisions
413.31with jurisdiction over health care policy and finance, the Health Care Access Commission,
413.32and the governor by February 1, 2008.
413.33    Subd. 3. Staffing. State agencies shall assist the study group with any requests for
413.34information the study group considers necessary to complete the study and report under
413.35subdivision 2.
414.1    Subd. 4. Removal; vacancies; expenses. Removal of members, vacancies, and
414.2expenses for members shall be as provided in Minnesota Statutes, section 15.059.
414.3    Subd. 5. Expiration. This section expires after the submission of the report as
414.4required in subdivision 2.

414.5    Sec. 19. PREMIUM INCREASE REQUEST.
414.6    If the cost of providing dependent coverage under the state employee group
414.7insurance program increases as a direct result of the change to dependent coverage made
414.8in Minnesota Statutes, section 62L.02, the commissioner of employee relations may
414.9request an appropriation from the health care access fund for the next fiscal year to cover
414.10the cost of the increase. The request must include documentation substantiating the cost
414.11increase and the amount incurred by each state agency.

414.12    Sec. 20. REPEALER.
414.13Minnesota Statutes 2006, section 62A.301, is repealed, effective January 1, 2008.

414.14ARTICLE 13

414.15CHILDREN'S HEALTH PROGRAMS; MINNESOTACARE

414.16    Section 1. Minnesota Statutes 2006, section 256B.057, is amended by adding a
414.17subdivision to read:
414.18    Subd. 2c. Extended coverage for children. A child receiving medical assistance
414.19under subdivision 2, who becomes ineligible due to excess income, is eligible for two
414.20additional months of medical assistance. Eligibility under this section is effective
414.21following any coverage available under section 256B.0625.
414.22    A child eligible for extended coverage under this section is deemed automatically
414.23eligible for MinnesotaCare until renewal. MinnesotaCare coverage begins in accordance
414.24with section 256L.05, subdivision 3.
414.25EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
414.26approval, whichever is later.

414.27    Sec. 2. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:
414.28    Subdivision 1. Families with children. (a) Families with children with family
414.29income equal to or less than 275 percent of the federal poverty guidelines for the
414.30applicable family size shall be eligible for MinnesotaCare according to this section. All
415.1other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
415.2to enrollment under section 256L.07, shall apply unless otherwise specified.
415.3    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
415.4if the children are eligible. Children may be enrolled separately without enrollment by
415.5parents. However, if one parent in the household enrolls, both parents must enroll, unless
415.6other insurance is available. If one child from a family is enrolled, all children must
415.7be enrolled, unless other insurance is available. If one spouse in a household enrolls,
415.8the other spouse in the household must also enroll, unless other insurance is available.
415.9Families cannot choose to enroll only certain uninsured members.
415.10    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
415.11to the MinnesotaCare program. These persons are no longer counted in the parental
415.12household and may apply as a separate household.
415.13    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are
415.14not eligible for MinnesotaCare if their gross income exceeds $50,000.
415.15    (e) Children formerly enrolled in medical assistance and automatically deemed
415.16eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
415.17from the requirements of this section until renewal.
415.18EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
415.19approval, whichever is later.

415.20    Sec. 3. Minnesota Statutes 2006, section 256L.07, is amended by adding a subdivision
415.21to read:
415.22    Subd. 7. Exception for certain children. Children formerly enrolled in medical
415.23assistance and automatically deemed eligible for MinnesotaCare according to section
415.24256B.057, subdivision 2c, are exempt from the requirements of this section until renewal.
415.25EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
415.26approval, whichever is later.

415.27    Sec. 4. [256L.22] DEFINITION; CHILDREN'S HEALTH PROGRAM.
415.28    For purposes of sections 256L.22 to 256L.28, "children's health program" means
415.29the medical assistance and MinnesotaCare programs to the extent medical assistance and
415.30MinnesotaCare provide health coverage to children.
415.31EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
415.32approval, whichever is later.

416.1    Sec. 5. [256L.24] HEALTH CARE ELIGIBILITY FOR CHILDREN.
416.2    Subdivision 1. Applicability. This section applies to children who are enrolled in a
416.3children's health program.
416.4    Subd. 2. Application procedure. The commissioner shall develop an application
416.5form for children's health programs for children that is easily understandable and does not
416.6exceed four pages in length. The provisions of section 256L.05, subdivision 1, apply.
416.7    Subd. 3. Premiums. Children enrolled in MinnesotaCare shall pay premiums as
416.8provided in section 256L.15, except that notwithstanding section 256L.15, subdivision 3,
416.9children in families with incomes at or below 200 percent of the federal poverty guidelines
416.10shall pay a monthly premium of $4.
416.11    Subd. 4. Eligibility renewal. The commissioner shall require children enrolled in
416.12MinnesotaCare to renew eligibility every 12 months.
416.13    Subd. 5. Employer-subsidized coverage. Section 256L.07, subdivision 2, does
416.14not apply to children.
416.15EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
416.16approval, whichever is later.

416.17    Sec. 6. [256L.26] ASSISTANCE TO APPLICANTS.
416.18    The commissioner shall assist children in choosing a managed care organization
416.19to receive services under a children's health program, by:
416.20    (1) establishing a Web site to provide information about managed care organizations
416.21and to allow online enrollment;
416.22    (2) making applications and information on managed care organizations available
416.23to applicants and enrollees according to Title VI of the Civil Rights Act and federal
416.24regulations adopted under that law or any guidance from the United States Department of
416.25Health and Human Services; and
416.26    (3) making benefit educators available to assist applicants in choosing a managed
416.27care organization.
416.28EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
416.29approval, whichever is later.

416.30    Sec. 7. [256L.28] FEDERAL APPROVAL.
416.31    The commissioner shall seek all federal waivers and approvals necessary to
416.32implement sections 256L.22 to 256L.28, including, but not limited to, waivers and
416.33approvals necessary to:
417.1    (1) coordinate medical assistance and MinnesotaCare coverage for children; and
417.2    (2) maximize receipt of the federal medical assistance match for covered children,
417.3by increasing income standards through the use of more liberal income methodologies as
417.4provided under United States Code, title 42, sections 1396a and 1396u-1.
417.5EFFECTIVE DATE.This section is effective October 1, 2008, or upon federal
417.6approval, whichever is later.

417.7ARTICLE 14

417.8HEALTH CARE REFORM POLICY

417.9    Section 1. Minnesota Statutes 2006, section 62J.82, is amended to read:
417.1062J.82 HOSPITAL CHARGE INFORMATION REPORTING DISCLOSURE.
417.11    Subdivision 1. Required information. The Minnesota Hospital Association shall
417.12develop a Web-based system, available to the public free of charge, for reporting charge
417.13information the following, for Minnesota residents,:
417.14    (1) hospital-specific performance on the measures of care developed under section
417.15256B.072 for acute myocardial infarction, heart failure, and pneumonia;
417.16    (2) by January 1, 2009, hospital-specific performance on the public reporting
417.17measures for hospital-acquired infections as published by the National Quality Forum
417.18and collected by the Minnesota Hospital Association and Stratis Health in collaboration
417.19with infection control practitioners; and
417.20    (3) charge information, including, but not limited to, number of discharges, average
417.21length of stay, average charge, average charge per day, and median charge, for each of the
417.2250 most common inpatient diagnosis-related groups and the 25 most common outpatient
417.23surgical procedures as specified by the Minnesota Hospital Association.
417.24    Subd. 2. Web site. The Web site must provide information that compares
417.25hospital-specific data to hospital statewide data. The Web site must be established by
417.26October 1, 2006, and must be updated annually. The commissioner shall provide a link to
417.27this reporting information on the department's Web site.
417.28    Subd. 3. Enforcement. The commissioner shall provide a link to this information
417.29on the department's Web site. If a hospital does not provide this information to the
417.30Minnesota Hospital Association, the commissioner of health may require the hospital to
417.31do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a
417.32link to this information on the department's Web site.

418.1ARTICLE 15

418.2HEALTH CARE REFORM

418.3    Section 1. [62J.431] EVIDENCE-BASED HEALTH CARE GUIDELINES.
418.4    Evidence-based guidelines must meet the following criteria:
418.5    (1) the scope and application are clear;
418.6    (2) authorship is stated and any conflicts of interest disclosed;
418.7    (3) authors represent all pertinent clinical fields or other means of input have been
418.8used;
418.9    (4) the development process is explicitly stated;
418.10    (5) the guideline is grounded in evidence;
418.11    (6) the evidence is cited and grated;
418.12    (7) the document itself is clear and practical;
418.13    (8) the document is flexible in use, with exceptions noted or provided for with
418.14general statements;
418.15    (9) measures are included for use in systems improvement; and
418.16    (10) the guideline has scheduled reviews and updating.

418.17    Sec. 2. Minnesota Statutes 2006, section 62J.495, is amended to read:
418.1862J.495 HEALTH INFORMATION TECHNOLOGY AND
418.19INFRASTRUCTURE ADVISORY COMMITTEE.
418.20    Subdivision 1. Establishment; members; duties Implementation. By January
418.211, 2015, all hospitals and health care providers must have in place an interoperable
418.22electronic health records system within their hospital system or clinical practice setting.
418.23The commissioner of health, in consultation with the Health Information Technology and
418.24Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal,
418.25including uniform standards to be used for the interoperable system for sharing and
418.26synchronizing patient data across systems. The standards must be compatible with federal
418.27efforts. The uniform standards must be developed by January 1, 2009, with a status report
418.28on the development of these standards submitted to the legislature by January 15, 2008.
418.29    Subd. 2. Health Information Technology and Infrastructure Advisory
418.30Committee. (a) The commissioner shall establish a Health Information Technology
418.31and Infrastructure Advisory Committee governed by section 15.059 to advise the
418.32commissioner on the following matters:
418.33    (1) assessment of the use of health information technology by the state, licensed
418.34health care providers and facilities, and local public health agencies;
419.1    (2) recommendations for implementing a statewide interoperable health information
419.2infrastructure, to include estimates of necessary resources, and for determining standards
419.3for administrative data exchange, clinical support programs, patient privacy requirements,
419.4and maintenance of the security and confidentiality of individual patient data; and
419.5    (3) recommendations for encouraging use of innovative health care applications
419.6using information technology and systems to improve patient care and reduce the cost
419.7of care, including applications relating to disease management and personal health
419.8management that enable remote monitoring of patients' conditions, especially those with
419.9chronic conditions; and
419.10    (4) other related issues as requested by the commissioner.
419.11    (b) The members of the Health Information Technology and Infrastructure Advisory
419.12Committee shall include the commissioners, or commissioners' designees, of health,
419.13human services, administration, and commerce and additional members to be appointed
419.14by the commissioner to include persons representing Minnesota's local public health
419.15agencies, licensed hospitals and other licensed facilities and providers, private purchasers,
419.16the medical and nursing professions, health insurers and health plans, the state quality
419.17improvement organization, academic and research institutions, consumer advisory
419.18organizations with an interest and expertise in health information technology, and other
419.19stakeholders as identified by the Health Information Technology and Infrastructure
419.20Advisory Committee.
419.21    Subd. 2. Annual report. (c) The commissioner shall prepare and issue an annual
419.22report not later than January 30 of each year outlining progress to date in implementing a
419.23statewide health information infrastructure and recommending future projects.
419.24    Subd. 3. Expiration. (d) Notwithstanding section 15.059, this section subdivision
419.25expires June 30, 2009 2015.

419.26    Sec. 3. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
419.27ACCOUNT AND LOAN PROGRAM.
419.28    Subdivision 1. Account establishment. An account is established to provide loans
419.29to eligible borrowers to assist in financing the installation or support of an interoperable
419.30health record system. The system must provide for the interoperable exchange of health
419.31care information between the applicant and, at a minimum, a hospital system, pharmacy,
419.32and a health care clinic or other physician group.
419.33    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
419.34    (1) community clinics, as defined under section 145.9268;
420.1    (2) hospitals eligible for rural hospital capital improvement grants, as defined
420.2in section 144.148;
420.3    (3) physician clinics located in a community with a population of less than 50,000
420.4according to United States Census Bureau statistics and outside the seven-county
420.5metropolitan area;
420.6    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and
420.7    (5) other providers of health or health care services approved by the commissioner
420.8for which interoperable electronic health record capability would improve quality of
420.9care, patient safety, or community health.
420.10    (b) To be eligible for a loan under this section, the applicant must submit a loan
420.11application to the commissioner of health on forms prescribed by the commissioner. The
420.12application must include, at a minimum:
420.13    (1) the amount of the loan requested and a description of the purpose or project
420.14for which the loan proceeds will be used;
420.15    (2) a quote from a vendor;
420.16    (3) a description of the health care entities and other groups participating in the
420.17project;
420.18    (4) evidence of financial stability and a demonstrated ability to repay the loan; and
420.19    (5) a description of how the system to be financed interconnects or plans in the
420.20future to interconnect with other health care entities and provider groups located in the
420.21same geographical area.
420.22    Subd. 3. Loans. (a) The commissioner of health may make a no interest loan
420.23to a provider or provider group who is eligible under subdivision 2 on a first-come,
420.24first-served basis provided that the applicant is able to comply with this section. The total
420.25accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of
420.26health has discretion over the size and number of loans made.
420.27    (b) The commissioner of health may prescribe forms and establish an application
420.28process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable
420.29application fee to cover the cost of administering the loan program. Any application
420.30fees imposed and collected under the electronic health records system revolving account
420.31and loan program in this section are appropriated to the commissioner of health for the
420.32duration of the loan program.
420.33    (c) The borrower must begin repaying the principal no later than two years from the
420.34date of the loan. Loans must be amortized no later than six years from the date of the loan.
420.35    (d) Repayments must be credited to the account.
421.1    Subd. 4. Data classification. Data collected by the commissioner of health on the
421.2application to determine eligibility under subdivision 2 and to monitor borrowers' default
421.3risk or collect payments owed under subdivision 3 are (1) private data on individuals as
421.4defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section
421.513.02, subdivision 9. The names of borrowers and the amounts of the loans granted are
421.6public data.

421.7    Sec. 4. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND
421.8IMPLEMENTATION GUIDE STANDARDS.
421.9    Subdivision 1. Electronic claims and eligibility transactions required. (a)
421.10Beginning January 15, 2009, all group purchasers must accept from health care providers
421.11the eligibility for a health plan transaction described under Code of Federal Regulations,
421.12title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept
421.13from health care providers the health care claims or equivalent encounter information
421.14transaction described under Code of Federal Regulations, title 45, part 162, subpart K.
421.15    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the
421.16eligibility for a health plan transaction described under Code of Federal Regulations, title
421.1745, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit
421.18to providers the health care payment and remittance advice transaction described under
421.19Code of Federal Regulations, title 45, part 162, subpart P.
421.20    (c) Beginning January 15, 2009, all health care providers must submit to group
421.21purchasers the eligibility for a health plan transaction described under Code of Federal
421.22Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care
421.23providers must submit to group purchasers the health care claims or equivalent encounter
421.24information transaction described under Code of Federal Regulations, title 45, part 162,
421.25subpart K.
421.26    (d) Beginning January 15, 2009, all health care providers must accept from group
421.27purchasers the eligibility for a health plan transaction described under Code of Federal
421.28Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care
421.29providers must accept from group purchasers the health care payment and remittance
421.30advice transaction described under Code of Federal Regulations, title 45, part 162, subpart
421.31P.
421.32    (e) Each of the transactions described in paragraphs (a) to (d) shall require the use
421.33of a single, uniform companion guide to the implementation guides described under
421.34Code of Federal Regulations, title 45, part 162. The companion guides will be developed
421.35pursuant to subdivision 2.
422.1    (f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group
422.2purchasers and health care providers must exchange claims and eligibility information
422.3electronically using the transactions, companion guides, implementation guides, and
422.4timelines required under this subdivision. Group purchasers may not impose any fee on
422.5providers for the use of the transactions prescribed in this subdivision.
422.6    (g) Nothing in this subdivision shall prohibit group purchasers and health care
422.7providers from using a direct data entry, Web-based methodology for complying with
422.8the requirements of this subdivision. Any direct data entry method for conducting
422.9the transactions specified in this subdivision must be consistent with the data content
422.10component of the single, uniform companion guides required in paragraph (e) and the
422.11implementation guides described under Code of Federal Regulations, title 45, part 162.
422.12    Subd. 2. Establishing uniform, standard companion guides. (a) At least 12
422.13months prior to the timelines required in subdivision 1, the commissioner of health shall
422.14promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers
422.15and health care providers to use the transactions and the uniform, standard companion
422.16guides required under subdivision 1, paragraph (e).
422.17    (b) The commissioner of health must consult with the Minnesota Administrative
422.18Uniformity Committee on the development of the single, uniform companion guides
422.19required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1.
422.20The single uniform companion guides required under subdivision 1, paragraph (e), must
422.21specify uniform billing and coding standards. The commissioner of health shall base the
422.22companion guides required under subdivision 1, paragraph (e), billing and coding rules,
422.23and standards on the Medicare program, with modifications that the commissioner deems
422.24appropriate after consulting the Minnesota Administrative Uniformity Committee.
422.25    (c) No group purchaser or health care provider may add to or modify the single,
422.26uniform companion guides defined in subdivision 1, paragraph (e), through additional
422.27companion guides or other requirements.
422.28    (d) In promulgating the rules in paragraph (a), the commissioner shall not require
422.29data content that is not essential to accomplish the purpose of the transactions in
422.30subdivision 1.
422.31    Subd. 3. Definition. Notwithstanding section 62J.03, subdivision 8, for purposes of
422.32this section, "health care provider" includes licensed nursing homes, licensed boarding
422.33care homes, and licensed home care providers.

422.34    Sec. 5. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:
423.1    Subdivision 1. Definitions. For purposes of this section, the following definitions
423.2apply:
423.3    (a) "Accredited clinical training" means the clinical training provided by a
423.4medical education program that is accredited through an organization recognized by the
423.5Department of Education, the Centers for Medicare and Medicaid Services, or another
423.6national body who reviews the accrediting organizations for multiple disciplines and
423.7whose standards for recognizing accrediting organizations are reviewed and approved by
423.8the commissioner of health in consultation with the Medical Education and Research
423.9Advisory Committee.
423.10    (b) "Commissioner" means the commissioner of health.
423.11    (c) "Clinical medical education program" means the accredited clinical training of
423.12physicians (medical students and residents), doctor of pharmacy practitioners, doctors
423.13of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
423.14registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
423.15physician assistants.
423.16    (d) "Sponsoring institution" means a hospital, school, or consortium located in
423.17Minnesota that sponsors and maintains primary organizational and financial responsibility
423.18for a clinical medical education program in Minnesota and which is accountable to the
423.19accrediting body.
423.20    (e) "Teaching institution" means a hospital, medical center, clinic, or other
423.21organization that conducts a clinical medical education program in Minnesota.
423.22    (f) "Trainee" means a student or resident involved in a clinical medical education
423.23program.
423.24    (g) "Eligible trainee FTEs FTE's" means the number of trainees, as measured by
423.25full-time equivalent counts, that are at training sites located in Minnesota with a currently
423.26active medical assistance provider number enrollment status and a National Provider
423.27Identification (NPI) number where training occurs in either an inpatient or ambulatory
423.28patient care setting and where the training is funded, in part, by patient care revenues.
423.29Training that occurs in nursing facility settings is not eligible for funding under this section.
423.30EFFECTIVE DATE.This section is effective January 1, 2008.

423.31    Sec. 6. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:
423.32    Subd. 4. Distribution of funds. (a) Following the distribution described under
423.33paragraph (b), the commissioner shall annually distribute 90 percent of the available
423.34medical education funds to all qualifying applicants based on a distribution formula that
423.35reflects a summation of two factors:
424.1    (1) an education factor, which is determined by the total number of eligible trainee
424.2FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical
424.3medical education program; and
424.4    (2) a public program volume factor, which is determined by the total volume of
424.5public program revenue received by each training site as a percentage of all public
424.6program revenue received by all training sites in the fund pool; and
424.7    (2) a supplemental public program volume factor, which is determined by providing
424.8a supplemental payment of 20 percent of each training site's grant to training sites whose
424.9public program revenue accounted for at least 0.98 percent of the total public program
424.10revenue received by all eligible training sites. Grants to training sites whose public
424.11program revenue accounted for less than 0.98 percent of the total public program revenue
424.12received by all eligible training sites shall be reduced by an amount equal to the total
424.13value of the supplemental payment.
424.14    In this formula, the education factor is weighted at 67 percent and the public program
424.15volume factor is weighted at 33 percent.
424.16    Public program revenue for the distribution formula includes revenue from medical
424.17assistance, prepaid medical assistance, general assistance medical care, and prepaid
424.18general assistance medical care. Training sites that receive no public program revenue
424.19are ineligible for funds available under this paragraph subdivision. For purposes of
424.20determining training-site level grants to be distributed under paragraph (a), total statewide
424.21average costs per trainee for medical residents is based on audited clinical training costs
424.22per trainee in primary care clinical medical education programs for medical residents.
424.23Total statewide average costs per trainee for dental residents is based on audited clinical
424.24training costs per trainee in clinical medical education programs for dental students. Total
424.25statewide average costs per trainee for pharmacy residents is based on audited clinical
424.26training costs per trainee in clinical medical education programs for pharmacy students.
424.27    (b) The commissioner shall annually distribute ten percent of total available medical
424.28education funds to all qualifying applicants based on the percentage received by each
424.29applicant under paragraph (a). These funds are to be used to offset clinical education
424.30costs at eligible clinical training sites based on criteria developed by the clinical medical
424.31education program. Applicants may choose to distribute funds allocated under this
424.32paragraph based on the distribution formula described in paragraph (a). $5,350,000 of the
424.33available medical education funds shall be distributed as follows:
424.34    (1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
424.35    (2) $2,075,000 to the University of Minnesota School of Dentistry; and
424.36    (3) $1,800,000 to the Academic Health Center.
425.1    (c) Funds distributed shall not be used to displace current funding appropriations
425.2from federal or state sources.
425.3    (d) Funds shall be distributed to the sponsoring institutions indicating the amount
425.4to be distributed to each of the sponsor's clinical medical education programs based on
425.5the criteria in this subdivision and in accordance with the commissioner's approval letter.
425.6Each clinical medical education program must distribute funds allocated under paragraph
425.7(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
425.8institutions, which are accredited through an organization recognized by the Department
425.9of Education or the Centers for Medicare and Medicaid Services, may contract directly
425.10with training sites to provide clinical training. To ensure the quality of clinical training,
425.11those accredited sponsoring institutions must:
425.12    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
425.13training conducted at sites; and
425.14    (2) take necessary action if the contract requirements are not met. Action may
425.15include the withholding of payments under this section or the removal of students from
425.16the site.
425.17    (e) Any funds not distributed in accordance with the commissioner's approval letter
425.18must be returned to the medical education and research fund within 30 days of receiving
425.19notice from the commissioner. The commissioner shall distribute returned funds to the
425.20appropriate training sites in accordance with the commissioner's approval letter.
425.21    (f) The commissioner shall distribute by June 30 of each year an amount equal to
425.22the funds transferred under subdivision 10, plus five percent interest to the University of
425.23Minnesota Board of Regents for the instructional costs of health professional programs
425.24at the Academic Health Center and for interdisciplinary academic initiatives within the
425.25Academic Health Center.
425.26    (g) A maximum of $150,000 of the funds dedicated to the commissioner under
425.27section 297F.10, subdivision 1, paragraph (b), clause (2), may be used by the commissioner
425.28for administrative expenses associated with implementing this section.
425.29EFFECTIVE DATE.This section is effective January 1, 2008.

425.30    Sec. 7. Minnesota Statutes 2006, section 62J.692, subdivision 5, is amended to read:
425.31    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section
425.32must sign and submit a medical education grant verification report (GVR) to verify that
425.33the correct grant amount was forwarded to each eligible training site. If the sponsoring
425.34institution fails to submit the GVR by the stated deadline, or to request and meet
425.35the deadline for an extension, the sponsoring institution is required to return the full
426.1amount of funds received to the commissioner within 30 days of receiving notice from
426.2the commissioner. The commissioner shall distribute returned funds to the appropriate
426.3training sites in accordance with the commissioner's approval letter.
426.4    (b) The reports must provide verification of the distribution of the funds and must
426.5include:
426.6    (1) the total number of eligible trainee FTEs in each clinical medical education
426.7program;
426.8    (2) the name of each funded program and, for each program, the dollar amount
426.9distributed to each training site;
426.10    (3) documentation of any discrepancies between the initial grant distribution notice
426.11included in the commissioner's approval letter and the actual distribution;
426.12    (4) a statement by the sponsoring institution describing the distribution of funds
426.13allocated under subdivision 4, paragraph (b), including information on which clinical
426.14training sites received funding and the rationale used for determining funding priorities;
426.15    (5) a statement by the sponsoring institution stating that the completed grant
426.16verification report is valid and accurate; and
426.17    (6) (5) other information the commissioner, with advice from the advisory
426.18committee, deems appropriate to evaluate the effectiveness of the use of funds for medical
426.19education.
426.20    (c) By February 15 of each year, the commissioner, with advice from the
426.21advisory committee, shall provide an annual summary report to the legislature on the
426.22implementation of this section.
426.23EFFECTIVE DATE.This section is effective January 1, 2008.

426.24    Sec. 8. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:
426.25    Subd. 8. Federal financial participation. (a) The commissioner of human
426.26services shall seek to maximize federal financial participation in payments for medical
426.27education and research costs. If the commissioner of human services determines that
426.28federal financial participation is available for the medical education and research, the
426.29commissioner of health shall transfer to the commissioner of human services the amount
426.30of state funds necessary to maximize the federal funds available. The amount transferred
426.31to the commissioner of human services, plus the amount of federal financial participation,
426.32shall be distributed to medical assistance providers in accordance with the distribution
426.33methodology described in subdivision 4.
427.1    (b) For the purposes of paragraph (a), The commissioner shall use physician clinic
427.2rates where possible to maximize federal financial participation. Any additional funds that
427.3become available must be distributed under subdivision 4, paragraph (a).
427.4EFFECTIVE DATE.This section is effective January 1, 2008.

427.5    Sec. 9. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:
427.6    Subdivision 1. Required disclosure of estimated payment. (a) A health care
427.7provider, as defined in section 62J.03, subdivision 8, or the provider's designee as agreed
427.8to by that designee, shall, at the request of a consumer, and at no cost to the consumer
427.9or the consumer's employer, provide that consumer with a good faith estimate of the
427.10reimbursement allowable payment the provider expects to receive from the health plan
427.11company in which the consumer is enrolled has agreed to accept from the consumer's
427.12health plan company for the services specified by the consumer, specifying the amount of
427.13the allowable payment due from the health plan company. Health plan companies must
427.14allow contracted providers, or their designee, to release this information. A good faith
427.15estimate must also be made available at the request of a consumer who is not enrolled in
427.16a health plan company. If a consumer has no applicable public or private coverage, the
427.17health care provider must give the consumer, and at no cost to the consumer, a good faith
427.18estimate of the average allowable reimbursement the provider accepts as payment from
427.19private third-party payers for the services specified by the consumer and the estimated
427.20amount the noncovered consumer will be required to pay. Payment information provided
427.21by a provider, or by the provider's designee as agreed to by that designee, to a patient
427.22pursuant to this subdivision does not constitute a legally binding estimate of the allowable
427.23charge for or cost to the consumer of services.
427.24    (b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at
427.25the request of an enrollee or the enrollee's designee, provide that enrollee with a good
427.26faith estimate of the reimbursement allowable amount the health plan company would
427.27expect to pay to has contracted for with a specified provider within the network as total
427.28payment for a health care service specified by the enrollee and the portion of the allowable
427.29amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the
427.30enrollee, the health plan company shall also provide to the enrollee a good faith estimate
427.31of the enrollee's out-of-pocket cost for the health care service. An estimate provided to
427.32an enrollee under this paragraph is not a legally binding estimate of the reimbursement
427.33allowable amount or enrollee's out-of-pocket cost.
427.34EFFECTIVE DATE.This section is effective August 1, 2007.

428.1    Sec. 10. [62Q.101] EVALUATION OF PROVIDER PERFORMANCE.
428.2    A health plan company, or a vendor of risk management services as defined under
428.3section 60A.23, subdivision 8, shall, in evaluating the performance of a health care
428.4provider:
428.5    (1) conduct the evaluation using a bona fide baseline based upon practice experience
428.6of the provider group; and
428.7    (2) disclose the baseline to the health care provider in writing and prior to the
428.8beginning of the time period used for the evaluation.

428.9    Sec. 11. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:
428.10    Subdivision 1. Definition. It is the commitment of the state to achieve universal
428.11health coverage for all Minnesotans by the year 2011. Universal coverage is achieved
428.12when:
428.13    (1) every Minnesotan has access to a full range of quality health care services;
428.14    (2) every Minnesotan is able to obtain affordable health coverage which pays for the
428.15full range of services, including preventive and primary care; and
428.16    (3) every Minnesotan pays into the health care system according to that person's
428.17ability.
428.18EFFECTIVE DATE.This section is effective July 1, 2007.

428.19    Sec. 12. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:
428.20    Subd. 2. Goal. It is the goal of the state to make continuous progress toward
428.21reducing the number of Minnesotans who do not have health coverage so that by January
428.221, 2000, fewer than four percent of the state's population will be without health coverage
428.232011, all Minnesota residents have access to affordable health care. The goal will be
428.24achieved by improving access to private health coverage through insurance reforms and
428.25market reforms, by making health coverage more affordable for low-income Minnesotans
428.26through purchasing pools and state subsidies, and by reducing the cost of health coverage
428.27through cost containment programs and methods of ensuring that all Minnesotans are
428.28paying into the system according to their ability.
428.29EFFECTIVE DATE.This section is effective July 1, 2007.

428.30    Sec. 13. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:
428.31    Subdivision 1. Yearly reports. Each hospital and each outpatient surgical center,
428.32which has not filed the financial information required by this section with a voluntary,
429.1nonprofit reporting organization pursuant to section 144.702, shall file annually with the
429.2commissioner of health after the close of the fiscal year:
429.3    (1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or
429.4outpatient surgical center;
429.5    (2) a detailed statement of income and expenses;
429.6    (3) a copy of its most recent cost report, if any, filed pursuant to requirements of
429.7Title XVIII of the United States Social Security Act;
429.8    (4) a copy of all changes to articles of incorporation or bylaws;
429.9    (5) information on services provided to benefit the community, including services
429.10provided at no cost or for a reduced fee to patients unable to pay, teaching and research
429.11activities, or other community or charitable activities;
429.12    (6) information required on the revenue and expense report form set in effect on
429.13July 1, 1989, or as amended by the commissioner in rule;
429.14    (7) information on changes in ownership or control; and
429.15    (8) other information required by the commissioner in rule.;
429.16    (9) information on the number of available hospital beds that are dedicated to certain
429.17specialized services, as designated by the commissioner, and annual occupancy rates for
429.18those beds, separately for adult and pediatric care;
429.19    (10) from outpatient surgical centers, the total number of surgeries; and
429.20    (11) a report on health care capital expenditures during the previous year, as required
429.21by section 62J.17.

429.22    Sec. 14. [145.985] HEALTH PROMOTION AND WELLNESS.
429.23    Community health boards as defined in section 145A.02, subdivision 5, may work
429.24with schools, health care providers, and others to coordinate health and wellness programs
429.25in their communities. In order to meet the requirements of this section, community
429.26health boards may:
429.27    (1) provide instruction, technical assistance, and recommendations on how to
429.28evaluate project outcomes;
429.29    (2) assist with on-site health and wellness programs utilizing volunteers and others
429.30addressing health and wellness topics including smoking, nutrition, obesity, and others; and
429.31    (3) encourage health and wellness programs consistent with the Centers for Disease
429.32Control and Prevention's Community Guide and goals consistent with the Centers for
429.33Disease Control and Prevention's Healthy People 2010 initiative.

429.34    Sec. 15. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:
430.1    Subd. 2b. Performance payments. (a) The commissioner shall develop and
430.2implement a pay-for-performance system to provide performance payments to eligible
430.3medical groups and clinics that demonstrate optimum care in serving individuals
430.4with chronic diseases who are enrolled in health care programs administered by the
430.5commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any
430.6federal matching money that is made available through the medical assistance program
430.7for managed care oversight contracted through vendors, including consumer surveys,
430.8studies, and external quality reviews as required by the federal Balanced Budget Act of
430.91997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external
430.10quality review. Any federal money received for managed care oversight is appropriated
430.11to the commissioner for this purpose. The commissioner may expend the federal money
430.12received in either year of the biennium.
430.13    (b) Upon federal approval the commissioner shall develop and implement a patient
430.14incentive health program to provide incentives and rewards to patients who are enrolled in
430.15health care programs administered by the commissioner under chapters 256B, 256D, and
430.16256L, and who have agreed to and have met personal health goals established with the
430.17patients' primary care providers to manage a chronic disease or condition, including but
430.18not limited to diabetes, high blood pressure, and coronary artery disease.

430.19    Sec. 16. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
430.20subdivision to read:
430.21    Subd. 49. Provider-directed care coordination services. The commissioner
430.22shall develop and implement a provider-directed care coordination program for medical
430.23assistance recipients who are not enrolled in the prepaid medical assistance program and
430.24who are receiving services on a fee-for-service basis. This program provides payment
430.25to primary care clinics for care coordination for people who have complex and chronic
430.26medical conditions. Clinics must meet certain criteria such as the capacity to develop care
430.27plans; have a dedicated care coordinator; and have an adequate number of fee-for-service
430.28clients, evaluation mechanisms, and quality improvement processes to qualify for
430.29reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic
430.30designated as the patient's first point of contact for medical care, available 24 hours a
430.31day, seven days a week, that provides or arranges for the patient's comprehensive health
430.32care needs, and provides overall integration, coordination and continuity over time and
430.33referrals for specialty care.
430.34EFFECTIVE DATE.This section is effective January 1, 2008.

431.1    Sec. 17. HEALTH CARE PAYMENT SYSTEM REFORM.
431.2    Subdivision 1. Payment reform plan. The commissioners of employee relations,
431.3human services, commerce, and health shall develop a plan for promoting and facilitating
431.4changes in payment rates and methods for paying for health care services, drugs, devices,
431.5supplies, and equipment in order to:
431.6    (1) reward the provision of cost-effective primary and preventive care;
431.7    (2) reward the use of evidence-based care;
431.8    (3) discourage underutilization, overuse, and misuse;
431.9    (4) reward the use of the most cost-effective settings, drugs, devices, providers,
431.10and treatments; and
431.11    (5) encourage consumers to maintain good health and use the health care system
431.12appropriately.
431.13    In developing the plan, the commissioners shall analyze existing data to determine
431.14specific services and health conditions for which changes in payment rates and methods
431.15would lead to significant improvements in quality of care. The commissioners shall
431.16include a definition of the term "quality" for uniform understanding of the plan's impact.
431.17    Subd. 2. Report. The commissioners shall submit a report to the legislature by
431.18December 15, 2007, describing the payment reform plan. The report must include
431.19proposed legislation for implementing those components of the plan requiring legislative
431.20action or appropriations of money.
431.21EFFECTIVE DATE.This section is effective July 1, 2007.

431.22    Sec. 18. COMMUNITY INITIATIVES TO COVER UNINSURED AND
431.23UNDERINSURED.
431.24    Subdivision 1. Community partnerships. The commissioner of health shall
431.25provide planning grants to up to three community partnerships that satisfy the requirements
431.26in this section. A community partnership is eligible for a grant if the community
431.27partnership includes:
431.28    (1) at least one county;
431.29    (2) at least one local hospital;
431.30    (3) at least one local employer who collectively provides at least 300 jobs in the
431.31community;
431.32    (4) at least one school system;
431.33    (5) at least one of the following:
431.34    (i) one or more integrated health care clinics or physician groups. For purposes of
431.35this section, "integrated health care" means integrated mental health and primary care; or
432.1    (ii) one or more health care clinics or physician groups and one or more mental
432.2health clinics; and
432.3    (6) a third-party payer, which may include a county-based purchasing plan, an
432.4employer, or a health plan company.
432.5    Subd. 2 Proposal requirements. The planning grants shall be used by community
432.6partnerships to develop a comprehensive proposal to provide affordable health care
432.7services to uninsured and underinsured individuals with chronic health conditions through
432.8an integrated community partnership system. A community partnership requesting a
432.9planning grant must submit to the commissioner a planning proposal that includes:
432.10    (1) methods for identifying potential uninsured or underinsured individuals and
432.11patients who have or who are at risk of developing a chronic health condition;
432.12    (2) methods to integrate and coordinate medical, mental health, and chemical health
432.13services with services provided through county social services, corrections, public health,
432.14school districts, and health care providers;
432.15    (3) providing early intervention and prevention activities; and
432.16    (4) methods to identify and support accountability across public and private systems,
432.17including means to measure outcomes and economic savings from providing services
432.18through an integrated system.
432.19    Subd. 3. Planning grant criteria. (a) Proposals for planning grants shall be
432.20submitted to the commissioner. Preference shall be given to planning proposals that:
432.21    (1) have broad community support from local business, providers, counties, and
432.22other public and private organizations;
432.23    (2) propose to provide services to uninsured or underinsured individuals of every
432.24age who have or are at risk of developing multiple, co-occurring chronic conditions;
432.25    (3) integrate or coordinate resources from multiple sources; and
432.26    (4) demonstrate how administrative costs for health plan companies and providers
432.27can be reduced through greater simplification, coordination, consolidation, standardization,
432.28reducing billing errors, or other methods.
432.29    (b) Community partnerships receiving a planning grant under this section shall
432.30submit their proposed initiatives to the commissioner by December 15, 2007.
432.31    (c) The commissioner shall submit a report to the legislature by February 15, 2008,
432.32that:
432.33    (1) identifies the community partnerships that received a planning grant under this
432.34section; and
432.35    (2) summarizes the planned initiatives submitted to the commissioner based on
432.36the requirements in this section.

433.1    Sec. 19. CARE COORDINATION PILOT PROJECTS.
433.2    Subdivision 1. Pilot projects. (a) The commissioner of human services shall
433.3develop and administer up to four pilot projects for children and adults with complex
433.4health care needs who are enrolled in fee-for-service medical assistance, to the extent
433.5permitted by federal requirements. At least two of the grantees must focus on children
433.6with autism or children with complex/multi-diagnoses physical conditions. The purpose
433.7of the projects is to pilot primary care clinic models of care delivery focused on care
433.8coordination and family involvement in order to:
433.9    (1) incent and support the provision of cost-effective primary and preventive care;
433.10    (2) reward the use of evidence-based care;
433.11    (3) reward coordination of care for patients with chronic conditions;
433.12    (4) discourage overuse and misuse of high cost services;
433.13    (5) reward the use of the most cost-effective settings, drugs, devices, providers,
433.14and treatments; and
433.15    (6) encourage consumers to maintain good health and use the health care system
433.16appropriately.
433.17    (b) The pilot projects must involve the use of designated care professionals or
433.18clinics to serve as a patient's medical home and be responsible for coordinating health
433.19care services across the continuum of care.
433.20    Subd. 2. Requirements. In order to be designated a pilot project, health care
433.21professionals or clinics must demonstrate the ability to:
433.22    (1) be the patient's first point of contact by telephone or other means, 24 hours per
433.23day, seven days a week;
433.24    (2) provide or arrange for patients' comprehensive health care needs, including the
433.25ability to structure planned chronic disease visits and train and support the caregivers to
433.26effectively monitor and manage the person's health condition;
433.27    (3) coordinate patients' care when care must be provided outside the medical home;
433.28    (4) provide longitudinal care, not just episodic care, including meeting long-term
433.29and unique personal needs; and
433.30    (5) systematically improve quality of care using, among other inputs, patient
433.31feedback.
433.32    Subd. 3. Evaluation. Pilot projects must be evaluated based on patient satisfaction,
433.33provider satisfaction, clinical process and outcome measures, program costs and savings,
433.34and economic impact on health care providers. Pilot projects must be evaluated based
433.35on the extent to which the medical home:
434.1    (1) coordinated health care services across the continuum of care and thereby
434.2reduced duplication of services and enhanced communication across providers;
434.3    (2) provided safe and high-quality care by increasing utilization of effective
434.4treatments, reduced use of ineffective treatments, reduced barriers to essential care and
434.5services, and eliminated barriers to access;
434.6    (3) reduced unnecessary hospitalizations and emergency room visits and increased
434.7use of cost-effective care and settings;
434.8    (4) encouraged long-term patient and provider relationships by shifting from
434.9episodic care to consistent, coordinated communication and care with a specified team of
434.10providers or individual providers;
434.11    (5) engaged and educated consumers by encouraging shared patient and provider
434.12responsibility and accountability for disease prevention, health promotion, chronic
434.13disease management, acute care, and overall well-being, encouraging informed medical
434.14decision-making, ensuring the availability of accurate medical information, and facilitated
434.15the transfer of accurate medical information;
434.16    (6) fostered the expansion of a technology infrastructure that supports collaboration;
434.17and
434.18    (7) reduced overall health care costs as compared to conventional payment methods
434.19for similar patient populations.
434.20    Subd. 4. Rulemaking. The commissioner is exempt from administrative rulemaking
434.21under chapter 14 for purposes of developing, administering, contracting for, and evaluating
434.22pilot projects under this section. The commissioner shall publish a proposed request for
434.23proposals in the State Register and allow 30 days for comment before issuing the final
434.24request for proposals.
434.25    Subd. 5. Care coordination payments. Grantees under this section are not eligible
434.26for care coordination payments under Minnesota Statutes, section 256B.0625, subdivision
434.2749.

434.28    Sec. 20. MERC DISTRIBUTION FORMULA.
434.29    The commissioner of health shall evaluate the effect of the 2007 revisions to the
434.30medical education and research costs (MERC) distribution formula adopted in this act
434.31on sponsoring institutions and clinical training sites with low numbers of eligible trainee
434.32full-time equivalents. The commissioner shall present to the legislature, by January 15,
434.332009, any recommendations for changes in the MERC distribution formula necessary to
434.34ensure the financial viability of clinical medical education at these sponsoring institutions
434.35and clinical training sites.

435.1    Sec. 21. HEALTH CARE TRANSFORMATION TASK FORCE.
435.2    Subdivision 1. Task force. (a) The governor shall convene a health care
435.3transformation task force to advise and assist the governor and the Minnesota legislature
435.4regarding activities to transform the health care system, and to develop a statewide action
435.5plan as provided under subdivision 3. The task force shall consist of:
435.6    (1) two legislators from the house of representatives appointed by the speaker, and
435.7two legislators from the senate appointed by the Subcommittee on Committees of the
435.8Committee on Rules and Administration;
435.9    (2) four representatives of the governor and state agencies, appointed by the
435.10governor;
435.11    (3) four persons appointed by the governor who have demonstrated leadership in
435.12health care organizations, health improvement initiatives, health care trade or professional
435.13associations, or other collaborative health system improvement activities;
435.14    (4) four persons appointed by the governor who have demonstrated leadership in
435.15employer and group purchaser activities related to health system improvement, at least
435.16two of which must be from a labor organization; and
435.17    (5) one person appointed by the governor who has demonstrated public or private
435.18sector leadership and innovation.
435.19    The governor is exempt from the requirements of the open appointments process for
435.20purposes of appointing task force members.
435.21    (b) The Department of Health shall provide staff support to the task force. The task
435.22force may accept outside resources to help support its efforts.
435.23    Subd. 2. Public and stakeholder engagement. (a) The commissioner of health
435.24shall review available research, and conduct statewide, regional, and local surveys, focus
435.25groups, and other activities as needed to fill gaps in existing research, to determine
435.26Minnesotans' values, preferences, opinions, and perceptions related to health care and to
435.27the issues confronting the task force, and shall report the findings to the task force.
435.28    (b) The task force shall seek information, advice, and assistance from private-sector
435.29groups that are collaborating across health care industry sectors, business, labor, consumer,
435.30and stakeholder groups to assist the task force, legislature, and governor in planning and
435.31implementing health system changes to achieve the goals and timelines established by the
435.32task force as specified in subdivision 3.
435.33    Subd. 3. Duties. (a) The task force shall, by August 1, 2007, establish overall goals,
435.34timelines, and guiding principles for transforming the health care system to improve
435.35affordability, quality, access, and the health status of Minnesotans.
436.1    (b) By December 15, 2007, the task force shall develop and present to the legislature
436.2and the governor a statewide action plan for transforming the health care system to
436.3improve affordability, quality, access, and the health status of Minnesotans. The plan shall
436.4include draft legislation needed to implement the plan. The plan may consist of legislative
436.5actions, administrative actions of governmental entities, collaborative actions, and actions
436.6of individuals and individual organizations. Among other things, the action plan must
436.7include the following, with specific and measurable goals and deadlines for each:
436.8    (1) proposed action that will reduce the rate of growth in health care spending in
436.9Minnesota by ten percent per year for the next five years;
436.10    (2) actions that will increase the affordable health coverage options for uninsured
436.11and underinsured Minnesotans and other strategies that will ensure all Minnesotans will
436.12have health coverage by January 2011;
436.13    (3) actions to improve the quality and safety of health care and reduce racial and
436.14ethnic disparities in access and quality;
436.15    (4) actions that will improve the health status of Minnesotans and reduce the rate of
436.16preventable chronic illness through prevention, public health, and wellness initiatives;
436.17    (5) proposed changes to state health care purchasing and payment strategies used for
436.18state health care programs and state employees that will promote higher quality, lower
436.19cost health care through incentives that reward prevention and early intervention, use
436.20of cost-effective primary care, effective care coordination, and management of chronic
436.21disease;
436.22    (6) actions that will promote the appropriate and cost-effective investment in new
436.23facilities, technologies, and drugs;
436.24    (7) on options for serving small employers and their employees, and self-employed
436.25individuals; and
436.26    (8) actions to reduce administrative costs.

436.27    Sec. 22. REPEALER.
436.28(a) Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective
436.29August 1, 2007.
436.30(b) Minnesota Statutes 2006, section 62J.692, subdivision 10, is repealed effective
436.31January 1, 2008.

437.1ARTICLE 16

437.2PUBLIC HEALTH POLICY

437.3    Section 1. Minnesota Statutes 2006, section 16B.61, is amended by adding a
437.4subdivision to read:
437.5    Subd. 3b. Window fall prevention device code. The commissioner of labor and
437.6industry shall adopt rules for window fall prevention devices as part of the state Building
437.7Code. Window fall prevention devices include, but are not limited to, safety screens,
437.8hardware, guards, and other devices that comply with the standards established by the
437.9commissioner of labor and industry. The rules shall require compliance with standards
437.10for window fall prevention devices developed by ASTM International, contained in the
437.11International Building Code as the model language with amendments deemed necessary to
437.12coordinate with the other adopted building codes in Minnesota. The rules shall establish a
437.13scope that includes the applicable building occupancies, and the types, locations, and sizes
437.14of windows that will require the installation of fall devices. The rules will be effective July
437.151, 2009. The commissioner shall report to the legislature on the status of the rulemaking
437.16on or before February 15, 2008.

437.17    Sec. 2. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:
437.18    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable
437.19application fee of $175 $215 to cover the administrative cost of processing a request for a
437.20variance or modification of rules adopted by the commissioner under this chapter.
437.21EFFECTIVE DATE.This section is effective July 1, 2008.

437.22    Sec. 3. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:
437.23    Subdivision 1. Well notification fee. The well notification fee to be paid by a
437.24property owner is:
437.25    (1) for a new water supply well, $175 $215, which includes the state core function
437.26fee;
437.27    (2) for a well sealing, $35 $50 for each well, which includes the state core function
437.28fee, except that for monitoring wells constructed on a single property, having depths
437.29within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of
437.30$35 $50; and
437.31    (3) for construction of a dewatering well, $175 $215, which includes the state core
437.32function fee, for each dewatering well except a dewatering project comprising five or
438.1more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering
438.2wells recorded on the notification.
438.3EFFECTIVE DATE.This section is effective July 1, 2008.

438.4    Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:
438.5    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:
438.6    (1) for a water supply well that is not in use under a maintenance permit, $150 $175
438.7annually;
438.8    (2) for construction of a monitoring well, $175 $215, which includes the state
438.9core function fee;
438.10    (3) for a monitoring well that is unsealed under a maintenance permit, $150 $175
438.11annually;
438.12    (4) for monitoring wells used as a leak detection device at a single motor fuel retail
438.13outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
438.14chemical facility site, the construction permit fee is $175 $215, which includes the state
438.15core function fee, per site regardless of the number of wells constructed on the site, and
438.16the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per
438.17site regardless of the number of monitoring wells located on site;
438.18    (5) for a groundwater thermal exchange device, in addition to the notification fee for
438.19water supply wells, $175 $215, which includes the state core function fee;
438.20    (6) for a vertical heat exchanger, $175 $215;
438.21    (7) for a dewatering well that is unsealed under a maintenance permit, $150 $175
438.22annually for each dewatering well, except a dewatering project comprising more than five
438.23dewatering wells shall be issued a single permit for $750 $875 annually for dewatering
438.24wells recorded on the permit; and
438.25    (8) for an elevator boring, $175 $215 for each boring.
438.26EFFECTIVE DATE.This section is effective July 1, 2008.

438.27    Sec. 5. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:
438.28    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to
438.29sell or transfer real property, the seller must disclose in writing to the buyer information
438.30about the status and location of all known wells on the property, by delivering to the buyer
438.31either a statement by the seller that the seller does not know of any wells on the property,
438.32or a disclosure statement indicating the legal description and county, and a map drawn
438.33from available information showing the location of each well to the extent practicable.
439.1In the disclosure statement, the seller must indicate, for each well, whether the well is in
439.2use, not in use, or sealed.
439.3    (b) At the time of closing of the sale, the disclosure statement information, name and
439.4mailing address of the buyer, and the quartile, section, township, and range in which each
439.5well is located must be provided on a well disclosure certificate signed by the seller or a
439.6person authorized to act on behalf of the seller.
439.7    (c) A well disclosure certificate need not be provided if the seller does not know
439.8of any wells on the property and the deed or other instrument of conveyance contains
439.9the statement: "The Seller certifies that the Seller does not know of any wells on the
439.10described real property."
439.11    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
439.12required by this subdivision shall be signed by the buyer or a person authorized to act on
439.13behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
439.14certificate is not required if the following statement appears on the deed followed by the
439.15signature of the grantee or, if there is more than one grantee, the signature of at least one
439.16of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
439.17described real property." The statement and signature of the grantee may be on the front
439.18or back of the deed or on an attached sheet and an acknowledgment of the statement by
439.19the grantee is not required for the deed to be recordable.
439.20    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:
439.21    (1) that consists solely of a sale or transfer of severed mineral interests; or
439.22    (2) that consists of an individual condominium unit as described in chapters 515
439.23and 515B.
439.24    (f) For an area owned in common under chapter 515 or 515B the association or other
439.25responsible person must report to the commissioner by July 1, 1992, the location and
439.26status of all wells in the common area. The association or other responsible person must
439.27notify the commissioner within 30 days of any change in the reported status of wells.
439.28    (g) For real property sold by the state under section 92.67, the lessee at the time of
439.29the sale is responsible for compliance with this subdivision.
439.30    (h) If the seller fails to provide a required well disclosure certificate, the buyer, or
439.31a person authorized to act on behalf of the buyer, may sign a well disclosure certificate
439.32based on the information provided on the disclosure statement required by this section
439.33or based on other available information.
439.34    (i) A county recorder or registrar of titles may not record a deed or other instrument
439.35of conveyance dated after October 31, 1990, for which a certificate of value is required
439.36under section 272.115, or any deed or other instrument of conveyance dated after October
440.131, 1990, from a governmental body exempt from the payment of state deed tax, unless
440.2the deed or other instrument of conveyance contains the statement made in accordance
440.3with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all
440.4the information required by paragraph (b) or (d). The county recorder or registrar of titles
440.5must not accept a certificate unless it contains all the required information. The county
440.6recorder or registrar of titles shall note on each deed or other instrument of conveyance
440.7accompanied by a well disclosure certificate that the well disclosure certificate was
440.8received. The notation must include the statement "No wells on property" if the disclosure
440.9certificate states there are no wells on the property. The well disclosure certificate shall not
440.10be filed or recorded in the records maintained by the county recorder or registrar of titles.
440.11After noting "No wells on property" on the deed or other instrument of conveyance, the
440.12county recorder or registrar of titles shall destroy or return to the buyer the well disclosure
440.13certificate. The county recorder or registrar of titles shall collect from the buyer or the
440.14person seeking to record a deed or other instrument of conveyance, a fee of $40 $45
440.15for receipt of a completed well disclosure certificate. By the tenth day of each month,
440.16the county recorder or registrar of titles shall transmit the well disclosure certificates
440.17to the commissioner of health. By the tenth day after the end of each calendar quarter,
440.18the county recorder or registrar of titles shall transmit to the commissioner of health
440.19$32.50 $37.50 of the fee for each well disclosure certificate received during the quarter.
440.20The commissioner shall maintain the well disclosure certificate for at least six years. The
440.21commissioner may store the certificate as an electronic image. A copy of that image
440.22shall be as valid as the original.
440.23    (j) No new well disclosure certificate is required under this subdivision if the buyer
440.24or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed
440.25or other instrument of conveyance that the status and number of wells on the property
440.26have not changed since the last previously filed well disclosure certificate. The following
440.27statement, if followed by the signature of the person making the statement, is sufficient
440.28to comply with the certification requirement of this paragraph: "I am familiar with the
440.29property described in this instrument and I certify that the status and number of wells on
440.30the described real property have not changed since the last previously filed well disclosure
440.31certificate." The certification and signature may be on the front or back of the deed or on
440.32an attached sheet and an acknowledgment of the statement is not required for the deed or
440.33other instrument of conveyance to be recordable.
440.34    (k) The commissioner in consultation with county recorders shall prescribe the form
440.35for a well disclosure certificate and provide well disclosure certificate forms to county
440.36recorders and registrars of titles and other interested persons.
441.1    (l) Failure to comply with a requirement of this subdivision does not impair:
441.2    (1) the validity of a deed or other instrument of conveyance as between the parties
441.3to the deed or instrument or as to any other person who otherwise would be bound by
441.4the deed or instrument; or
441.5    (2) the record, as notice, of any deed or other instrument of conveyance accepted for
441.6filing or recording contrary to the provisions of this subdivision.
441.7EFFECTIVE DATE.This section is effective July 1, 2008.

441.8    Sec. 6. Minnesota Statutes 2006, section 144.123, is amended to read:
441.9144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES;
441.10EXCEPTIONS.
441.11    Subdivision 1. Who must pay. Except for the limitation contained in this section,
441.12the commissioner of health shall charge a handling fee for each specimen submitted to
441.13the Department of Health for analysis for diagnostic purposes by any hospital, private
441.14laboratory, private clinic, or physician. No fee shall be charged to any entity which
441.15receives direct or indirect financial assistance from state or federal funds administered by
441.16the Department of Health, including any public health department, nonprofit community
441.17clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar
441.18entity. No fee will be charged for any biological materials submitted to the Department
441.19of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
441.20materials requested by the department to gather information for disease prevention or
441.21control purposes. The commissioner of health may establish by rule other exceptions to
441.22the handling fee as may be necessary to gather information for epidemiologic purposes
441.23protect the public's health. All fees collected pursuant to this section shall be deposited in
441.24the state treasury and credited to the state government special revenue fund.
441.25    Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate
441.26rules, in accordance with chapter 14, which shall specify the amount of the charge a
441.27handling fee prescribed in subdivision 1. The fee shall approximate the costs to the
441.28department of handling specimens including reporting, postage, specimen kit preparation,
441.29and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen
441.30until the commissioner promulgates rules pursuant to this subdivision.

441.31    Sec. 7. Minnesota Statutes 2006, section 144.125, is amended to read:
441.32144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL
441.33DISORDERS.
442.1    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative
442.2officer or other person in charge of each institution caring for infants 28 days or less
442.3of age, (2) the person required in pursuance of the provisions of section 144.215, to
442.4register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
442.5birth, to arrange to have administered to every infant or child in its care tests for heritable
442.6and congenital disorders according to subdivision 2 and rules prescribed by the state
442.7commissioner of health. Testing and the recording and reporting of test results shall be
442.8performed at the times and in the manner prescribed by the commissioner of health. The
442.9commissioner shall charge laboratory service fees a fee so that the total of fees collected
442.10will approximate the costs of conducting the tests and implementing and maintaining a
442.11system to follow-up infants with heritable or congenital disorders, including hearing loss
442.12detected through the early hearing detection and intervention program under section
442.13144.966. The laboratory service fee is $61 $101 per specimen. Costs associated with
442.14capital expenditures and the development of new procedures may be prorated over a
442.15three-year period when calculating the amount of the fees.
442.16    Subd. 2. Determination of tests to be administered. The commissioner shall
442.17periodically revise the list of tests to be administered for determining the presence of a
442.18heritable or congenital disorder. Revisions to the list shall reflect advances in medical
442.19science, new and improved testing methods, or other factors that will improve the public
442.20health. In determining whether a test must be administered, the commissioner shall take
442.21into consideration the adequacy of laboratory analytical methods to detect the heritable
442.22or congenital disorder, the ability to treat or prevent medical conditions caused by the
442.23heritable or congenital disorder, and the severity of the medical conditions caused by the
442.24heritable or congenital disorder. The list of tests to be performed may be revised if the
442.25changes are recommended by the advisory committee established under section 144.1255,
442.26approved by the commissioner, and published in the State Register. The revision is
442.27exempt from the rulemaking requirements in chapter 14, and sections 14.385 and 14.386
442.28do not apply.
442.29    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under
442.30subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to
442.31perform testing thereunder as well as the results of such testing may be retained by the
442.32Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that
442.33the following options are available to them with respect to the testing: (i) to decline to
442.34have the tests, or (ii) to elect to have the tests but to require that all blood samples and
442.35records of test results be destroyed within 24 months of the testing. If the parents of
442.36an infant object in writing to testing for heritable and congenital disorders or elect to
443.1require that blood samples and test results be destroyed, the objection or election shall
443.2be recorded on a form that is signed by a parent or legal guardian and made part of the
443.3infant's medical record. A written objection exempts an infant from the requirements of
443.4this section and section 144.128.

443.5    Sec. 8. Minnesota Statutes 2006, section 144.9507, is amended by adding a subdivision
443.6to read:
443.7    Subd. 6. Medical assistance. Medical assistance reimbursement for lead risk
443.8assessment services under section 256B.0625, subdivision 49, shall not be used to replace
443.9or decrease existing state or local funding for lead services and lead-related activities.

443.10    Sec. 9. Minnesota Statutes 2006, section 144.9512, is amended to read:
443.11144.9512 LEAD ABATEMENT PROGRAM.
443.12    Subdivision 1. Definitions. (a) The definitions in section 144.9501 and in this
443.13subdivision apply to this section.
443.14    (b) "Eligible organization" means a lead contractor, city, board of health, community
443.15health department, community action agency as defined in section 256E.30, or community
443.16development corporation.
443.17    (c) "Commissioner" means the commissioner of health, or the commissioner of the
443.18Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.
443.19    Subd. 2. Grants; administration. Within the limits of the available appropriation,
443.20the commissioner must develop a swab team services program which may shall make
443.21demonstration and training grants to eligible organizations a nonprofit organization
443.22currently operating the CLEARCorps lead hazard reduction project to train workers to
443.23provide swab team services and swab team services for residential property. Grants may
443.24be awarded to nonprofit organizations to provide technical assistance and training to
443.25ensure quality and consistency within the statewide program. Grants must be awarded to
443.26help ensure full-time employment to workers providing swab team services and must be
443.27awarded for a two-year period.
443.28    Grants awarded under this section must be made in consultation with the
443.29commissioner of the Housing Finance Agency and representatives of neighborhood
443.30groups from areas at high risk for toxic lead exposure, a labor organization, the lead
443.31coalition, community action agencies, and the legal aid society. The consulting team must
443.32review grant applications and recommend awards to eligible organizations that meet
443.33requirements for receiving a grant under this section.
444.1    Subd. 3. Applicants. (a) Interested eligible organizations may apply to the
444.2commissioner for grants under this section. Two or more eligible organizations may
444.3jointly apply for a grant. Priority shall be given to community action agencies in greater
444.4Minnesota and to either community action agencies or neighborhood based nonprofit
444.5organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may
444.6be used for administrative purposes. The commissioner may deviate from this percentage
444.7if a grantee can justify the need for a larger administrative allowance. Of this amount,
444.8up to five percent may be used by the commissioner for state administrative purposes.
444.9Applications must provide information requested by the commissioner, including at least
444.10the information required to assess the factors listed in paragraph (d).
444.11    (b) The commissioner must consult with boards of health to provide swab team
444.12services for purposes of secondary prevention. The priority for swab teams created
444.13by grants to eligible organizations under this section must be work assigned by the
444.14commissioner of health, or by a board of health if so designated by the commissioner of
444.15health, to provide secondary prevention swab team services to fulfill the requirements
444.16of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned
444.17work under this section by the commissioner, that are not engaged daily in fulfilling the
444.18requirements of section 144.9504, subdivision 6, must deliver swab team services in
444.19response to elevated blood lead levels as defined in section 144.9501, subdivision 9,
444.20where lead orders were not issued, and for purposes of primary prevention in census
444.21tracts known to be in areas at high risk for toxic lead exposure as described in section
444.22144.9503, subdivision 2.
444.23    (c) Any additional money must be used for grants to establish swab teams for
444.24primary prevention under section 144.9503, in census tracts in areas at high risk for toxic
444.25lead exposure as determined under section 144.9503, subdivision 2.
444.26    (d) In evaluating grant applications, the commissioner must consider the following
444.27criteria:
444.28    (1) the use of lead contractors and lead workers for residential swab team services;
444.29    (2) the participation of neighborhood groups and individuals, as swab team workers,
444.30in areas at high risk for toxic lead exposure;
444.31    (3) plans for the provision of swab team services for primary and secondary
444.32prevention as required under subdivision 4;
444.33    (4) plans for supervision, training, career development, and postprogram placement
444.34of swab team members;
444.35    (5) plans for resident and property owner education on lead safety;
445.1    (6) plans for distributing cleaning supplies to area residents and educating residents
445.2and property owners on cleaning techniques;
445.3    (7) sources of other funding and cost estimates for training, lead inspections, swab
445.4team services, equipment, monitoring, testing, and administration;
445.5    (8) measures of program effectiveness;
445.6    (9) coordination of program activities with other federal, state, and local public
445.7health, job training, apprenticeship, and housing renovation programs including programs
445.8under sections 116L.86 to 116L.881; and
445.9    (10) prior experience in providing swab team services.
445.10    Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible
445.11organizations and lead supervisors or certified firms may participate in the swab team
445.12program. An eligible organization The nonprofit receiving a grant under this section
445.13must assure ensure that all participating lead supervisors or certified firms are licensed
445.14and that all swab team workers are certified by the Department of Health under section
445.15144.9505 . Eligible organizations and lead supervisors or certified firms may distinguish
445.16between interior and exterior services in assigning duties and The nonprofit organization
445.17may participate in the program by:
445.18    (1) providing on-the-job training for swab team workers;
445.19    (2) providing swab team services to meet the requirements of sections 144.9503,
445.20subdivision 4 , and 144.9504, subdivision 6;
445.21    (3) providing a removal and replacement component using skilled craft workers
445.22under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501,
445.23subdivision 17;
445.24    (4) providing lead testing according to subdivision 8;
445.25    (5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as
445.26described in section 144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or
445.27    (6) (5) having a swab team worker instruct residents and property owners on
445.28appropriate lead control techniques, including the lead-safe directives developed by the
445.29commissioner of health.;
445.30    (6) conducting blood lead testing events including screening children and pregnant
445.31women according to Department of Health screening guidelines;
445.32    (7) performing case management services according to Department of Health case
445.33management guidelines; or
445.34    (8) conducting mandated risk assessments under Minnesota Statutes, section
445.35144.9504, subdivision 2.
445.36    (b) Participating lead supervisors or certified firms must:
446.1    (1) demonstrate proof of workers' compensation and general liability insurance
446.2coverage;
446.3    (2) be knowledgeable about lead abatement requirements established by the
446.4Department of Housing and Urban Development and the Occupational Safety and Health
446.5Administration and lead hazard reduction requirements and lead-safe directives of the
446.6commissioner of health;
446.7    (3) demonstrate experience with on-the-job training programs;
446.8    (4) demonstrate an ability to recruit employees from areas at high risk for toxic
446.9lead exposure; and
446.10    (5) demonstrate experience in working with low-income clients.
446.11    Subd. 5. Swab team workers. Each worker engaged in swab team services
446.12established under this section must have blood lead concentrations below 15 micrograms
446.13of lead per deciliter of whole blood as determined by a baseline blood lead screening.
446.14Any The nonprofit organization receiving a grant under this section is responsible for lead
446.15screening and must assure ensure that all swab team workers meet the standards established
446.16in this subdivision. Grantees The nonprofit organization must use appropriate workplace
446.17procedures including following the lead-safe directives developed by the commissioner of
446.18health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization
446.19and participating contractors must report all employee blood lead levels that exceed 15
446.20micrograms of lead per deciliter of whole blood to the commissioner of health.
446.21    Subd. 6. On-the-job training component. (a) Programs established under this
446.22section must provide on-the-job training for swab team workers.
446.23    (b) Swab team workers must receive monetary compensation equal to the prevailing
446.24wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed
446.25contractor's principal business.
446.26    Subd. 7. Removal and replacement component. (a) Within the limits of the
446.27available appropriation and if a need is identified by a lead inspector, the commissioner
446.28may establish a component for removal and replacement of deteriorated paint in residential
446.29properties according to the following criteria:
446.30    (1) components within a residence must have both deteriorated lead-based paint and
446.31substrate damage beyond repair or rotting wooden framework to be eligible for removal
446.32and replacement;
446.33    (2) all removal and replacement must be done using least-cost methods and
446.34following lead-safe directives;
446.35    (3) whenever windows and doors or other components covered with deteriorated
446.36lead-based paint have sound substrate or are not rotting, those components should be
447.1repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or
447.2covered with protective guards instead of being replaced, provided that such an activity is
447.3the least-cost method of providing the swab team service;
447.4    (4) removal and replacement or repair must be done by lead contractors using skilled
447.5craft workers or trained swab team members; and
447.6    (5) all craft work that requires a state license must be supervised by a person with
447.7a state license in the craft work being supervised. The grant recipient may contract for
447.8this supervision.
447.9    (b) The program design must:
447.10    (1) identify the need for on-the-job training of swab team workers to be removal and
447.11replacement workers; and
447.12    (2) describe plans to involve appropriate groups in designing methods to meet the
447.13need for training swab team workers.
447.14    Subd. 8. Testing and evaluation. (a) Testing of the environment is not necessary
447.15by swab teams whose work is assigned by the commissioner of health or a designated
447.16board of health under section 144.9504. The commissioner of health or designated board
447.17of health must share the analytical testing data collected on each residence for purposes
447.18of secondary prevention under section 144.9504 with the swab team workers in order to
447.19provide constructive feedback on their work and to the commissioner for the purposes
447.20set forth in paragraph (c).
447.21    (b) For purposes of primary prevention evaluation, the following samples must be
447.22collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a
447.23notation of the extent and location of bare soil and of deteriorated lead-based paint. The
447.24analytical testing data collected on each residence for purposes of primary prevention
447.25under section 144.9503 must be shared with the swab team workers in order to provide
447.26constructive feedback on their work and to the commissioner for the purposes set forth in
447.27paragraph (c).
447.28    (c) The commissioner of health must establish a program to collect appropriate data
447.29as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of
447.30swab team services for primary and secondary prevention. Within the limits of available
447.31appropriations, the commissioner of health must conduct on up to 1,000 residences which
447.32have received primary or secondary prevention swab team services, a postremediation
447.33evaluation, on at least a quarterly basis for a period of at least two years for each residence.
447.34The evaluation must note the condition of the paint within the residence, the extent of bare
447.35soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample.
447.36The data collected must be evaluated to determine the efficacy of providing swab team
448.1services as a method of reducing lead exposure in young children. In evaluating this data,
448.2the commissioner of health must consider city size, community location, historic traffic
448.3flow, soil lead level of the property by area or census tract, distance to industrial point
448.4sources that emit lead, season of the year, age of the housing, age and number of children
448.5living at the residence, the presence of pets that move in and out of the residence, and
448.6other relevant factors as the commissioner of health may determine.
448.7    Subd. 9. Program benefits. As a condition of providing swab team services under
448.8this section, an the nonprofit organization may require a property owner to not increase
448.9rents on a property solely as a result of a substantial improvement made with public
448.10funds under the programs in this section.
448.11    Subd. 10. Requirements of organizations receiving grants the nonprofit
448.12organization. An eligible The nonprofit organization that is awarded a training and
448.13demonstration grant under this section must prepare and submit a quarterly progress report
448.14to the commissioner beginning three months after receipt of the grant.

448.15    Sec. 10. [144.966] EARLY HEARING DETECTION AND INTERVENTION
448.16PROGRAM.
448.17    Subdivision 1. Definitions. (a) "Child" means a person 18 years of age or younger.
448.18    (b) "False positive rate" means the proportion of infants identified as having a
448.19significant hearing loss by the screening process who are ultimately found to not have a
448.20significant hearing loss.
448.21    (c) "False negative rate" means the proportion of infants not identified as having
448.22a significant hearing loss by the screening process who are ultimately found to have a
448.23significant hearing loss.
448.24    (d) "Hearing screening test" means automated auditory brain stem response,
448.25otoacoustic emissions, or another appropriate screening test approved by the Department
448.26of Health.
448.27    (e) "Hospital" means a birthing health care facility or birthing center licensed in
448.28this state that provides obstetrical services.
448.29    (f) "Infant" means a child who is not a newborn and has not attained the age of
448.30one year.
448.31    (g) "Newborn" means an infant 28 days of age or younger.
448.32    (h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or
448.33custodian of a newborn or infant.
449.1    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
449.2commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
449.3to advise and assist the Department of Health and the Department of Education in:
449.4    (1) developing protocols and timelines for screening, rescreening, and diagnostic
449.5audiological assessment and early medical, audiological, and educational intervention
449.6services for children who are deaf or hard-of-hearing;
449.7    (2) designing protocols for tracking children from birth through age three that may
449.8have passed newborn screening but are at risk for delayed or late onset of permanent
449.9hearing loss;
449.10    (3) designing a technical assistance program to support facilities implementing the
449.11screening program and facilities conducting rescreening and diagnostic audiological
449.12assessment;
449.13    (4) designing implementation and evaluation of a system of follow-up and tracking;
449.14and
449.15    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
449.16culturally appropriate services for children with a confirmed hearing loss and their families.
449.17    (b) The commissioner of health shall appoint at least one member from each of the
449.18following groups with no less than two of the members being deaf or hard-of-hearing:
449.19    (1) a representative from a consumer organization representing culturally deaf
449.20persons;
449.21    (2) a parent with a child with hearing loss representing a parent organization;
449.22    (3) a consumer from an organization representing oral communication options;
449.23    (4) a consumer from an organization representing cued speech communication
449.24options;
449.25    (5) an audiologist who has experience in evaluation and intervention of infants
449.26and young children;
449.27    (6) a speech-language pathologist who has experience in evaluation and intervention
449.28of infants and young children;
449.29    (7) two primary care providers who have experience in the care of infants and young
449.30children, one of which shall be a pediatrician;
449.31    (8) a representative from the early hearing detection intervention teams;
449.32    (9) a representative from the Department of Education resource center for the deaf
449.33and hard-of-hearing or the representative's designee;
449.34    (10) a representative of the Minnesota Commission Serving Deaf and Hard of
449.35Hearing People;
450.1    (11) a representative from the Department of Human Services Deaf and Hard of
450.2Hearing Services Division;
450.3    (12) one or more of the Part C coordinators from the Department of Education,
450.4the Department of Health, or the Department of Human Services or the department's
450.5designees;
450.6    (13) the Department of Health early hearing detection and intervention coordinator;
450.7    (14) two birth hospital representatives from one rural and one urban hospital;
450.8    (15) a pediatric geneticist;
450.9    (16) an otolaryngologist;
450.10    (17) a representative from the Newborn Screening Advisory Committee under
450.11this subdivision; and
450.12    (18) a representative of the Department of Education regional low-incidence
450.13facilitators.
450.14The commissioner must complete the appointments required under this subdivision by
450.15September 1, 2007.
450.16    (c) The Department of Health member shall chair the first meeting of the committee.
450.17At the first meeting, the committee shall elect a chair from its membership. The committee
450.18shall meet at the call of the chair, at least four times a year. The committee shall adopt
450.19written bylaws to govern its activities. The Department of Health shall provide technical
450.20and administrative support services as required by the committee. These services shall
450.21include technical support from individuals qualified to administer infant hearing screening,
450.22rescreening, and diagnostic audiological assessments.
450.23    Members of the committee shall receive no compensation for their service, but
450.24shall be reimbursed as provided in section 15.059 for expenses incurred as a result of
450.25their duties as members of the committee.
450.26    (d) This subdivision expires June 30, 2013.
450.27    Subd. 3. Early hearing detection and intervention programs. All hospitals
450.28shall establish an early hearing detection and intervention (EHDI) program. Each EHDI
450.29program shall:
450.30    (1) in advance of any hearing screening testing, provide to the newborn's or infant's
450.31parents or parent information concerning the nature of the screening procedure, applicable
450.32costs of the screening procedure, the potential risks and effects of hearing loss, and the
450.33benefits of early detection and intervention;
450.34    (2) comply with parental consent under section 144.125, subdivision 3;
450.35    (3) develop policies and procedures for screening and rescreening based on
450.36Department of Health recommendations;
451.1    (4) provide appropriate training and monitoring of individuals responsible for
451.2performing hearing screening tests as recommended by the Department of Health;
451.3    (5) test the newborn's hearing prior to discharge, or, if the newborn is expected to
451.4remain in the hospital for a prolonged period, testing shall be performed prior to three
451.5months of age or when medically feasible;
451.6    (6) develop and implement procedures for documenting the results of all hearing
451.7screening tests;
451.8    (7) inform the newborn's or infant's parents or parent, primary care physician, and
451.9the Department of Health according to recommendations of the Department of Health of
451.10the results of the hearing screening test or rescreening if conducted, or if the newborn or
451.11infant was not successfully tested. The hospital that discharges the newborn or infant to
451.12home is responsible for the screening; and
451.13    (8) collect performance data specified by the Department of Health.
451.14    Subd. 4. Notification and information. (a) Notification to the parents or parent,
451.15primary care provider, and the Department of Health shall occur prior to discharge or no
451.16later than ten days following the date of testing. Notification shall include information
451.17recommended by the Department of Health.
451.18    (b) A physician, nurse, midwife, or other health professional attending a birth outside
451.19a hospital or institution shall provide information, orally and in writing, as established by
451.20the Department of Health, to parents regarding places where the parents may have their
451.21infant's hearing screened and the importance of the screening.
451.22    (c) The professional conducting the diagnostic procedure to confirm the hearing loss
451.23must report the results to the parents, primary care provider, and Department of Health
451.24according to the Department of Health recommendations.
451.25    Subd. 5. Oversight responsibility. The Department of Health shall exercise
451.26oversight responsibility for EHDI programs, including establishing a performance data set
451.27and reviewing performance data collected by each hospital.
451.28    Subd. 6. Civil and criminal immunity and penalties. (a) No physician or hospital
451.29shall be civilly or criminally liable for failure to conduct hearing screening testing.
451.30    (b) No physician, midwife, nurse, other health professional, or hospital acting in
451.31compliance with this section shall be civilly or criminally liable for any acts conforming
451.32with this section, including furnishing information required according to this section.
451.33    Subd. 7. Fees. The commissioner shall charge a fee so that the total of fees
451.34collected will approximate the costs of implementing and maintaining a system to follow
451.35up on infants and provide technical assistance, a tracking system, data management, and
451.36evaluation. The fee shall be incorporated in the fee charged under section 144.125.
452.1EFFECTIVE DATE.This section is effective the day following final enactment.

452.2    Sec. 11. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:
452.3    Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life
452.4support ambulance shall be staffed by at least two ambulance service personnel, at least
452.5one of which must be an EMT, who provide a level of care so as to ensure that:
452.6    (1) life-threatening situations and potentially serious injuries are recognized;
452.7    (2) patients are protected from additional hazards;
452.8    (3) basic treatment to reduce the seriousness of emergency situations is administered;
452.9and
452.10    (4) patients are transported to an appropriate medical facility for treatment.
452.11    (b) A basic life support service shall provide basic airway management.
452.12    (c) By January 1, 2001, a basic life support service shall provide automatic
452.13defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).
452.14    (d) A basic life support service licensee's medical director may authorize the
452.15ambulance service personnel to carry and to use medical antishock trousers and to perform
452.16intravenous infusion if the ambulance service personnel have been properly trained.
452.17    (e) Upon application from an ambulance service that includes evidence
452.18demonstrating hardship, the board may grant a temporary variance from the staff
452.19requirements in paragraph (a) and may authorize a basic life support ambulance to be
452.20staffed by one EMT and one first responder. The variance shall apply to basic life support
452.21ambulances operated by the ambulance service for up to one year from the date of the
452.22variance's issuance until the ambulance service renews its license. When a variance
452.23expires, an ambulance service may apply for a new variance under this paragraph. For
452.24purposes of this paragraph, "ambulance service" means either an ambulance service whose
452.25primary service area is located outside the metropolitan counties listed in section 473.121,
452.26subdivision 4 , and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
452.27Cloud; or an ambulance service based in a community with a population of less than 1,000.

452.28    Sec. 12. Minnesota Statutes 2006, section 144E.127, is amended to read:
452.29144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.
452.30    Subdivision 1. Interhospital transfers. When transporting a patient from one
452.31licensed hospital to another, a licensee may substitute for one of the required ambulance
452.32service personnel, a physician, a registered nurse, or physician's assistant who has been
452.33trained to use the equipment in the ambulance and is knowledgeable of the licensee's
452.34ambulance service protocols.
453.1    Subd. 2. Interfacility transfers. In an interfacility transport, a licensee whose
453.2primary service area is located outside the metropolitan counties listed in section 473.121,
453.3subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
453.4Cloud; or an ambulance service based in a community with a population of less than 1,000,
453.5may substitute one EMT with a registered first responder if an EMT or EMT-paramedic,
453.6physician, registered nurse, or physician's assistant is in the patient compartment. If using
453.7a physician, registered nurse, or physician's assistant as the sole provider in the patient
453.8compartment, the individual must be trained to use the equipment in the ambulance and be
453.9knowledgeable of the ambulance service protocols.

453.10    Sec. 13. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:
453.11    Subdivision 1. Repayment for volunteer training. Any political subdivision, or
453.12nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall
453.13be reimbursed by the board for the necessary expense of the initial training of a volunteer
453.14ambulance attendant upon successful completion by the attendant of a basic emergency
453.15care course, or a continuing education course for basic emergency care, or both, which has
453.16been approved by the board, pursuant to section 144E.285. Reimbursement may include
453.17tuition, transportation, food, lodging, hourly payment for the time spent in the training
453.18course, and other necessary expenditures, except that in no instance shall a volunteer
453.19ambulance attendant be reimbursed more than $450 $600 for successful completion of a
453.20basic course, and $225 $275 for successful completion of a continuing education course.

453.21    Sec. 14. [156.015] FEES.
453.22    Subdivision 1. Verification of licensure. The board may charge a fee of $25 per
453.23license verification to a licensee for verification of licensure status provided to other
453.24veterinary licensing boards.
453.25    Subd. 2. Continuing education review. The board may charge a fee of $50 per
453.26submission to a sponsor for review and approval of individual continuing education
453.27seminars, courses, wet labs, and lectures. This fee does not apply to continuing education
453.28sponsors that already meet the criteria for preapproval under Minnesota Rules, part
453.299100.1000, subpart 3, item A.

453.30    Sec. 15. Minnesota Statutes 2006, section 198.075, is amended to read:
453.31198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED
453.32FROM COMMISSARY PRIVILEGES.
454.1    Except as provided in this section, no commissary privileges including food, laundry
454.2service, janitorial service, and household supplies shall be furnished to any employee of
454.3the Minnesota veterans homes. An employee of the Minnesota veterans homes who works
454.4a second shift that is consecutive with a regularly scheduled shift may be allowed one free
454.5meal at the veterans home on the day of that extra shift.

454.6    Sec. 16. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
454.7subdivision to read:
454.8    Subd. 49. Lead risk assessments. (a) Effective October 1, 2007, or six months after
454.9federal approval, whichever is later, medical assistance covers lead risk assessments
454.10provided by a lead risk assessor who is licensed by the commissioner of health under
454.11section 144.9505 and employed by an assessing agency as defined in section 144.9501.
454.12Medical assistance covers a onetime on-site investigation of a recipient's home or primary
454.13residence to determine the existence of lead so long as the recipient is under the age
454.14of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2,
454.15paragraph (a).
454.16    (b) Medical assistance reimbursement covers the lead risk assessor's time to
454.17complete the following activities:
454.18    (1) gathering samples;
454.19    (2) interviewing family members;
454.20    (3) gathering data, including meter readings; and
454.21    (4) providing a report with the results of the investigation and options for reducing
454.22lead-based paint hazards.
454.23    Medical assistance coverage of lead risk assessment does not include testing of
454.24environmental substances such as water, paint, or soil or any other laboratory services.
454.25Medical assistance coverage of lead risk assessments is not included in the capitated
454.26services for children enrolled in health plans through the prepaid medical assistance
454.27program and the MinnesotaCare program.
454.28    (c) Payment for lead risk assessment must be cost-based and must meet the
454.29criteria for federal financial participation under the Medicaid program. The rate must
454.30be based on allowable expenditures from cost information gathered. Under section
454.31144.9507, subdivision 5, federal medical assistance funds may not replace existing
454.32funding for lead-related activities. The nonfederal share of costs for services provided
454.33under this subdivision must be from state or local funds and is the responsibility of the
454.34agency providing the risk assessment. When the risk assessment is conducted by the
454.35commissioner of health, the state share must be from appropriations to the commissioner
455.1of health for this purpose. Eligible expenditures for the nonfederal share of costs may not
455.2be made from federal funds or funds used to match other federal funds. Any federal
455.3disallowances are the responsibility of the agency providing risk assessment services.

455.4    Sec. 17. Minnesota Statutes 2006, section 471.59, subdivision 1, is amended to read:
455.5    Subdivision 1. Agreement. Two or more governmental units, by agreement entered
455.6into through action of their governing bodies, may jointly or cooperatively exercise any
455.7power common to the contracting parties or any similar powers, including those which
455.8are the same except for the territorial limits within which they may be exercised. The
455.9agreement may provide for the exercise of such powers by one or more of the participating
455.10governmental units on behalf of the other participating units. The term "governmental
455.11unit" as used in this section includes every city, county, town, school district, other
455.12political subdivision of this or another state, another state, the University of Minnesota,
455.13nonprofit hospitals licensed under sections 144.50 to 144.56, rehabilitation facilities and
455.14extended employment providers that are certified by the commissioner of employment
455.15and economic development, day training and habilitation services licensed under sections
455.16245B.01 to 245B.08, nonprofit community health clinics providing family planning
455.17services as defined in section 145.925, and any agency of the state of Minnesota or the
455.18United States, and includes any instrumentality of a governmental unit. For the purpose of
455.19this section, an instrumentality of a governmental unit means an instrumentality having
455.20independent policy making and appropriating authority.

455.21    Sec. 18. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2,
455.22is amended to read:

455.23 455.24

Subd. 2.Community and Family Health Improvement

455.25	Summary by Fund
455.26	General	40,413,000	40,382,000
455.27 455.28	State Government Special Revenue	141,000	128,000
455.29	Health Care Access	3,510,000	3,516,000
455.30	Federal TANF	6,000,000	6,000,000

455.31Family Planning Base Reduction. Base
455.32level funding for the family planning
455.33special projects grant program is reduced
455.34by $1,877,000 each year of the biennium
455.35beginning July 1, 2007, provided that
456.1this reduction shall only take place
456.2upon full implementation of the family
456.3planning project section of the 1115 waiver.
456.4Notwithstanding Minnesota Statutes, section
456.5145.925, the commissioner shall give priority
456.6to community health care clinics providing
456.7family planning services that either serve a
456.8high number of women who do not qualify
456.9for medical assistance or are unable to
456.10participate in the medical assistance program
456.11as a medical assistance provider when
456.12allocating the remaining appropriations.
456.13Notwithstanding section 15, this paragraph
456.14shall not expire.
456.15Shaken Baby Video. Of the state
456.16government special revenue fund
456.17appropriation, $13,000 in 2006 is
456.18appropriated to the commissioner of health
456.19to provide a video to hospitals on shaken
456.20baby syndrome. The commissioner of health
456.21shall assess a fee to hospitals to cover the
456.22cost of the approved shaken baby video and
456.23the revenue received is to be deposited in the
456.24state government special revenue fund.

456.25    Sec. 19. STUDY OF BLOOD LEAD TESTING METHODS.
456.26    (a) The commissioner of health, in consultation with the commissioner of human
456.27services, cities of the first class, health care providers, and other interested parties, shall
456.28conduct a study to evaluate blood lead testing methods used to confirm elevated blood
456.29lead status. The study shall examine:
456.30    (1) the false positive rate of capillary tests for children who are younger than 72
456.31months old;
456.32    (2) current protocols for conducting capillary testing, including filter paper
456.33methodology; and
456.34    (3) existing guidelines and regulations from other states and federal agencies
456.35regarding lead testing.
457.1    (b) The commissioner shall make recommendations on:
457.2    (1) the use of capillary tests to initiate environmental investigations and case
457.3management, including number and timing of tests and fiscal implications for state and
457.4local lead programs; and
457.5    (2) reducing the state mandatory intervention to ten micrograms of lead per deciliter
457.6of whole blood.
457.7    (c) The commissioner shall submit the results of the study and recommendations,
457.8including any necessary legislative changes, to the legislature by January 15, 2008.

457.9    Sec. 20. WINDOW SAFETY EDUCATION.
457.10    The commissioner of health shall create in the department's current educational
457.11safety program a component targeted at parents and caregivers of young children to
457.12provide awareness of the need to take precautions to prevent children from falling
457.13through open windows. The commissioner of health shall consult with representatives
457.14of the residential building industry, the window products industry, the child safety
457.15advocacy community, and the Department of Labor and Industry to create the window
457.16safety program component. The program must include the gathering of data about
457.17falls from windows that result in severe injury in order to measure the effectiveness of
457.18the safety program. The commissioner of health may consult with other child safety
457.19advocacy groups, experts, and interested parties in the development and implementation
457.20of the window safety program. The commissioner of health shall prepare and submit
457.21a final report on the window safety program to the legislature by March 1, 2011. The
457.22commissioner shall prepare and submit a yearly progress report to the legislature by
457.23March 1 of each year beginning in 2008 until the submission of the final report. The
457.24final report must include a summary of the safety program, the impact of the program on
457.25children falling from windows, and any recommendations for further study or action.

457.26    Sec. 21. REVISOR'S INSTRUCTION.
457.27    The revisor of statutes shall change the range reference "144.9501 to 144.9509"
457.28to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and
457.29Minnesota Rules.

457.30    Sec. 22. REPEALER.
457.31Laws 2004, chapter 288, article 6, section 27, is repealed.

458.1ARTICLE 17

458.2PUBLIC HEALTH

458.3    Section 1. Minnesota Statutes 2006, section 145A.17, is amended to read:
458.4145A.17 FAMILY HOME VISITING PROGRAMS.
458.5    Subdivision 1. Establishment; goals. The commissioner shall establish a program
458.6to fund family home visiting programs designed to foster a healthy beginning for children
458.7in families at or below 200 percent of the federal poverty guidelines beginnings, improve
458.8pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce
458.9juvenile delinquency, promote positive parenting and resiliency in children, and promote
458.10family health and economic self-sufficiency for children and families. The commissioner
458.11shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
458.12professionals and paraprofessionals from the fields of public health nursing, social work,
458.13and early childhood education. A program funded under this section must serve families
458.14at or below 200 percent of the federal poverty guidelines, and other families determined
458.15to be at risk, including but not limited to being at risk for child abuse, child neglect, or
458.16juvenile delinquency. Programs must give priority for services to families considered to
458.17be in need of services, including but not limited to begin prenatally whenever possible and
458.18must be targeted to families with:
458.19    (1) adolescent parents;
458.20    (2) a history of alcohol or other drug abuse;
458.21    (3) a history of child abuse, domestic abuse, or other types of violence;
458.22    (4) a history of domestic abuse, rape, or other forms of victimization;
458.23    (5) reduced cognitive functioning;
458.24    (6) a lack of knowledge of child growth and development stages;
458.25    (7) low resiliency to adversities and environmental stresses; or
458.26    (8) insufficient financial resources to meet family needs;
458.27    (9) a history of homelessness;
458.28    (10) a risk of long-term welfare dependence or family instability due to employment
458.29barriers; or
458.30    (11) other risk factors as determined by the commissioner.
458.31    Subd. 3. Requirements for programs; process. (a) Before a community health
458.32board or tribal government may receive an allocation under subdivision 2, a community
458.33health board or tribal government must submit a proposal to the commissioner that
458.34includes identification, based on a community assessment, of the populations at or below
458.35200 percent of the federal poverty guidelines that will be served and the other populations
459.1that will be served. Each program that receives funds must Community health boards
459.2and tribal governments that receive funding under this section must submit a plan to
459.3the commissioner describing a multidisciplinary approach to targeted home visiting for
459.4families. The plan must be submitted on forms provided by the commissioner. At a
459.5minimum, the plan must include the following:
459.6    (1) a description of outreach strategies to families prenatally or at birth;
459.7    (2) provisions for the seamless delivery of health, safety, and early learning services;
459.8    (3) methods to promote continuity of services when families move within the state;
459.9    (4) a description of the community demographics;
459.10    (5) a plan for meeting outcome measures; and
459.11    (6) a proposed work plan that includes:
459.12    (i) coordination to ensure nonduplication of services for children and families;
459.13    (ii) a description of the strategies to ensure that children and families at greatest risk
459.14receive appropriate services; and
459.15    (iii) collaboration with multidisciplinary partners including public health,
459.16ECFE, Head Start, community health workers, social workers, community home
459.17visiting programs, school districts, and other relevant partners. Letters of intent from
459.18multidisciplinary partners must be submitted with the plan.
459.19    (b) Each program that receives funds must accomplish the following program
459.20requirements:
459.21    (1) use either a broad community-based or selective community-based strategy to
459.22provide preventive and early intervention home visiting services;
459.23    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
459.24home visit must occur prenatally or as soon after birth as possible and must include a
459.25public health nursing assessment by a public health nurse;
459.26    (3) offer, at a minimum, information on infant care, child growth and development,
459.27positive parenting, preventing diseases, preventing exposure to environmental hazards,
459.28and support services available in the community;
459.29    (4) provide information on and referrals to health care services, if needed, including
459.30information on and assistance in applying for health care coverage for which the child or
459.31family may be eligible; and provide information on preventive services, developmental
459.32assessments, and the availability of public assistance programs as appropriate;
459.33    (5) provide youth development programs when appropriate;
459.34    (6) recruit home visitors who will represent, to the extent possible, the races,
459.35cultures, and languages spoken by families that may be served;
460.1    (7) train and supervise home visitors in accordance with the requirements established
460.2under subdivision 4;
460.3    (8) maximize resources and minimize duplication by coordinating activities or
460.4contracting with local social and human services organizations, education organizations,
460.5and other appropriate governmental entities and community-based organizations and
460.6agencies; and
460.7    (9) utilize appropriate racial and ethnic approaches to providing home visiting
460.8services; and
460.9    (10) connect eligible families, as needed, to additional resources available in the
460.10community, including, but not limited to, early care and education programs, health or
460.11mental health services, family literacy programs, employment agencies, social services,
460.12and child care resources and referral agencies.
460.13    (c) When available, programs that receive funds under this section must offer or
460.14provide the family with a referral to center-based or group meetings that meet at least
460.15once per month for those families identified with additional needs. The meetings must
460.16focus on further enhancing the information, activities, and skill-building addressed during
460.17home visitation; offering opportunities for parents to meet with and support each other;
460.18and offering infants and toddlers a safe, nurturing, and stimulating environment for
460.19socialization and supervised play with qualified teachers.
460.20    (b) (d) Funds available under this section shall not be used for medical services. The
460.21commissioner shall establish an administrative cost limit for recipients of funds. The
460.22outcome measures established under subdivision 6 must be specified to recipients of
460.23funds at the time the funds are distributed.
460.24    (c) (e) Data collected on individuals served by the home visiting programs must
460.25remain confidential and must not be disclosed by providers of home visiting services
460.26without a specific informed written consent that identifies disclosures to be made.
460.27Upon request, agencies providing home visiting services must provide recipients with
460.28information on disclosures, including the names of entities and individuals receiving the
460.29information and the general purpose of the disclosure. Prospective and current recipients
460.30of home visiting services must be told and informed in writing that written consent for
460.31disclosure of data is not required for access to home visiting services.
460.32    Subd. 4. Training. The commissioner shall establish training requirements for
460.33home visitors and minimum requirements for supervision by a public health nurse. The
460.34requirements for nurses must be consistent with chapter 148. The commissioner must
460.35provide training for home visitors. Training must include child development, positive
461.1parenting techniques, screening and referrals for child abuse and neglect, and diverse
461.2cultural practices in child rearing and family systems the following:
461.3    (1) effective relationships for engaging and retaining families and ensuring family
461.4health, safety, and early learning;
461.5    (2) effective methods of implementing parent education, conducting home visiting,
461.6and promoting quality early childhood development;
461.7    (3) early childhood development from birth to age five;
461.8    (4) diverse cultural practices in child rearing and family systems;
461.9    (5) recruiting, supervising, and retaining qualified staff;
461.10    (6) increasing services for underserved populations; and
461.11    (7) relevant issues related to child welfare and protective services, with information
461.12provided being consistent with state child welfare agency training.
461.13    Subd. 5. Technical assistance. The commissioner shall provide administrative
461.14and technical assistance to each program, including assistance in data collection and
461.15other activities related to conducting short- and long-term evaluations of the programs
461.16as required under subdivision 7. The commissioner may request research and evaluation
461.17support from the University of Minnesota.
461.18    Subd. 6. Outcome and performance measures. The commissioner shall establish
461.19outcomes measures to determine the impact of family home visiting programs funded
461.20under this section on the following areas:
461.21    (1) appropriate utilization of preventive health care;
461.22    (2) rates of substantiated child abuse and neglect;
461.23    (3) rates of unintentional child injuries;
461.24    (4) rates of children who are screened and who pass early childhood screening; and
461.25    (5) rates of children accessing early care and educational services;
461.26    (6) program retention rates;
461.27    (7) number of home visits provided compared to the number of home visits planned;
461.28    (8) participant satisfaction;
461.29    (9) rates of at-risk populations reached; and
461.30    (10) any additional qualitative goals and quantitative measures established by the
461.31commissioner.
461.32    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and
461.33performance measures established under subdivisions 1 and 6, the commissioner shall
461.34conduct ongoing evaluations of the programs funded under this section. Community
461.35health boards and tribal governments shall cooperate with the commissioner in the
461.36evaluations and shall provide the commissioner with the information necessary to conduct
462.1the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact
462.2of the programs on the outcome measures listed in subdivision 6, and shall periodically
462.3determine whether home visiting programs are the best way to achieve the qualitative
462.4goals established under subdivisions 1 and 6. If the commissioner determines that home
462.5visiting programs are not the best way to achieve these goals, the commissioner shall
462.6provide the legislature with alternative methods for achieving them.
462.7    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered
462.8year thereafter, the commissioner shall submit a report to the legislature on the family
462.9home visiting programs funded under this section and on the results of the evaluations
462.10conducted under subdivision 7.
462.11    Subd. 9. No supplanting of existing funds. Funding available under this section
462.12may be used only to supplement, not to replace, nonstate funds being used for home
462.13visiting services as of July 1, 2001.

462.14    Sec. 2. WATER LEVEL STANDARDS.
462.15    (a) Until the commissioner of health adopts rules setting the health risk limits
462.16required in paragraph (b), the health risk limit for all contaminants in private domestic
462.17wells must be the more stringent of the state standards or the federal standards determined
462.18by the United States Environmental Protection Agency.
462.19    (b) By March 1, 2008, the commissioner of health must publish in the State Register
462.20notice of intent to adopt rules relating to health risk limits for commonly detected
462.21contaminants. The commissioner of health shall review current scientific information to
462.22establish health risk limits for commonly detected contaminants in groundwater that
462.23provides a reasonable margin of safety to adequately protect the health of developing
462.24fetuses, infants, and children, in accordance with the requirements of Minnesota Statutes,
462.25section 144.0751. Nothing in paragraph (a) prohibits the commissioner from setting
462.26standards that are stricter than the federal standards.
462.27    (c) By March 1, 2009, the commissioner shall adopt rules relating to health risk
462.28limits for the ten most commonly detected contaminants.
462.29    (d) By February 1, 2008, the commissioner shall report to the legislature on the
462.30implications for public health and the costs to enforce the more stringent of health risk
462.31limits or maximum contaminant levels for public water systems.

462.32    Sec. 3. FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.
462.33    The commissioner of health, in conjunction with the commissioner of the Pollution
462.34Control Agency, shall apply for federal funding to renew and expand the state's
463.1environmental justice mapping capacity in order to promote public health tracking. If
463.2implemented, the commissioner of health shall coordinate the project with the Pollution
463.3Control Agency and the Department of Agriculture in order to explore possible links
463.4between environmental health and toxic exposures and to help create a system for
463.5environmental public health tracking and make recommendations to the legislature for
463.6additional sources of funding within the state.
463.7EFFECTIVE DATE.This section is effective the day following final enactment.

463.8    Sec. 4. FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.
463.9    Subdivision 1. Purpose. Recognizing that scented products may trigger asthma or
463.10chemical sensitivity reactions in students and school staff, which can contribute to learning
463.11and breathing problems, the commissioner of health shall develop a fragrance-free schools
463.12education pilot project.
463.13    Subd. 2. Education. The commissioner of health, in collaboration with the
463.14Minneapolis Board of Education, shall establish a working group composed of at least
463.15three students, two teachers, one school administrator, and one member of the Minneapolis
463.16Board of Education to recommend an education campaign in Minneapolis public schools
463.17to inform students and parents about the potentially harmful effects of the use of fragrance
463.18products on sensitive students and school personnel in Minneapolis schools. The
463.19commissioner shall report findings to the legislature by February 1, 2008.
463.20EFFECTIVE DATE.This section is effective the day following final enactment.

463.21    Sec. 5. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.
463.22    The commissioner of human services shall inform providers that testing for arsenic
463.23under Minnesota Statutes, section 144.967, is covered under medical assistance.

463.24ARTICLE 18

463.25HUMAN SERVICES FORECAST ADJUSTMENTS

463.26 463.27

Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

463.28    The dollar amounts shown are added to or, if shown in parentheses, are subtracted
463.29from the appropriations in Laws 2006, chapter 282, from the general fund, or any other
463.30fund named, to the Department of Human Services for the purposes specified in this
463.31article, to be available for the fiscal year indicated for each purpose. The figure "2007"
464.1used in this article means that the appropriation or appropriations listed are available
464.2for the fiscal year ending June 30, 2007.

464.3							2007
464.4	General Fund					$	(25,226,000)
464.5	Health Care Access					$	(53,980,000)
464.6	TANF					$	(24,805,000)
464.7	Total					$	(104,011,000)

464.8 464.9

Sec. 2. COMMISSIONER OF HUMAN SERVICES

464.10

Subdivision 1.Total Appropriation

$

(104,011,000)

464.11	Appropriations by Fund
464.12			2007
464.13	General		(25,226,000)
464.14	Health Care Access		(53,980,000)
464.15	TANF		(24,805,000)

464.16

Subd. 2.Revenue and Pass Through

464.17

TANF

(106,000)

464.18 464.19

Subd. 3.Children and Economic Assistance Grants

464.20	General						3,221,000
464.21	TANF						(24,699,000)

464.22The amounts that may be spent from this
464.23appropriation for each purpose are as follows:

464.24	(a) MFIP/DWP Grants
464.25	General						13,827,000
464.26	TANF						(24,699,000)

464.27	(b) MFIP Child Care Assistance Grants
464.28	General						(4,733,000)

464.29	(c) General Assistance Grants
464.30	General						1,081,000

464.31	(d) Minnesota Supplemental Aid Grants
464.32	General						(1,099,000)

464.33	(e) Group Residential Housing Grants
464.34	General						(5,855,000)

464.35

Subd. 4.Basic Health Care Grants

465.1	General						17,592,000
465.2	Health Care Access						(53,980,000)

465.3The amounts that may be spent from this
465.4appropriation for each purpose are as follows:

465.5

(a) MinnesotaCare Health Care Access

(53,980,000)

465.6	(b) MA Basic Health Care - Families and Children
465.7	General						15,729,000

465.8	(c) MA Basic Health Care - Elderly and Disabled
465.9	General						(4,540,000)

465.10	(d) General Assistance Medical Care
465.11	General						6,403,000

465.12

Subd. 5.Continuing Care Grants

465.13

General

(46,039,000)

465.14The amounts that may be spent from this
465.15appropriation for each purpose are as follows:

465.16	(a) MA Long-Term Care Facilities
465.17	General						(15,028,000)

465.18	(b) MA Long-Term Care Waivers
465.19	General						(20,677,000)

465.20	(c) Chemical Dependency Entitlement Grants
465.21	General						(10,334,000)

465.22    Sec. 3. EFFECTIVE DATE.
465.23    Sections 1 and 2 are effective the day following final enactment.

465.24ARTICLE 19

465.25HUMAN SERVICES APPROPRIATIONS

465.26

Section 1. SUMMARY OF APPROPRIATIONS.

465.27    The amounts shown in this section summarize direct appropriations, by fund, made
465.28in this article.

465.29			2008		2009		Total
465.30	General	$	4,767,301,000	$	5,109,906,000	$	9,877,206,000
465.31 465.32	State Government Special Revenue		59,686,000		58,595,000		118,281,000
466.1	Health Care Access		448,113,000		526,381,000		974,494,000
466.2	Federal TANF		265,813,000		278,334,000		544,147,000
466.3	Lottery Prize Fund		2,185,000		1,790,000		3,975,000
466.4	Total	$	5,543,098,000	$	5,975,006,000	$	11,518,104,000

466.5

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

466.6    The sums shown in the columns marked "Appropriations" are appropriated to the
466.7agencies and for the purposes specified in this article. The appropriations are from the
466.8general fund, or another named fund, and are available for the fiscal years indicated
466.9for each purpose. The figures "2008" and "2009" used in this article mean that the
466.10appropriations listed under them are available for the fiscal year ending June 30, 2008, or
466.11June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal
466.12year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal
466.13year ending June 30, 2007, are effective the day following final enactment.

466.14				APPROPRIATIONS
466.15				Available for the Year
466.16				Ending June 30
466.17					2008		2009

466.18

Sec. 3. HUMAN SERVICES

466.19

Subdivision 1.Total Appropriation

$

5,316,163,000

$

5,752,672,000

466.20	Appropriations by Fund
466.21		2008	2009
466.22	General	4,631,549,000	4,977,470,000
466.23 466.24	State Government Special Revenue	549,000	565,000
466.25	Health Care Access	427,485,000	506,246,000
466.26	Federal TANF	254,395,000	266,601,000
466.27	Lottery Prize Fund	2,185,000	1,790,000

466.28The amounts that may be spent for each
466.29purpose are specified in the following
466.30subdivisions.
467.1Receipts for Systems Projects.
467.2Appropriations and federal receipts for
467.3information system projects for MAXIS,
467.4PRISM, MMIS, and SSIS must be deposited
467.5in the state system account authorized in
467.6Minnesota Statutes, section 256.014. Money
467.7appropriated for computer projects approved
467.8by the Minnesota Office of Enterprise
467.9Technology, funded by the legislature, and
467.10approved by the commissioner of finance,
467.11may be transferred from one project to
467.12another and from development to operations
467.13as the commissioner of human services
467.14considers necessary. Any unexpended
467.15balance in the appropriation for these
467.16projects does not cancel but is available for
467.17ongoing development and operations.
467.18Pay for Performance. (a) Of the general
467.19fund appropriation, $272,000 each year
467.20is available to the commissioner of
467.21human services only under the following
467.22circumstances:
467.23(1) $272,000 shall be made available by the
467.24commissioner of finance on January 1, 2009,
467.25only after notification by the commissioner
467.26of human services to the commissioner of
467.27finance and to the chairs of the relevant house
467.28of representatives and senate finance and
467.29policy committees that the average number
467.30of days from the receipt of a MinnesotaCare
467.31application at the state processing unit until
467.32the initial eligibility determination of the
467.33application was 30 days or less during the
467.34period October 1, 2007, to September 30,
467.352008. Applications transferred from counties
468.1to the state processing unit are excluded from
468.2this calculation; and
468.3(2) $272,000 shall be made available by the
468.4commissioner of finance on January 1, 2009,
468.5only after notification by the commissioner
468.6of human services to the commissioner of
468.7finance and to the chairs of the relevant
468.8house of representatives and senate finance
468.9and policy committees that the commissioner
468.10initiated a separate treatment program for
468.11persons in the Minnesota sex offenders
468.12program who are between the ages of 18 and
468.1325 by January 1, 2008.
468.14(b) Regardless of whether these
468.15appropriations are made available to
468.16the commissioner of human services, they
468.17shall be part of base level funding for the
468.18biennium beginning July 1, 2009.
468.19Nonfederal Share Transfers. The
468.20nonfederal share of activities for which
468.21federal administrative reimbursement is
468.22appropriated to the commissioner may be
468.23transferred to the special revenue fund.
468.24TANF Maintenance of Effort. (a) In order
468.25to meet the basic MOE requirements of the
468.26TANF block grant specified under Code
468.27of Federal Regulations, title 45, section
468.28263.1, the commissioner may only report
468.29nonfederal money expended for allowable
468.30activities listed in the following clauses as
468.31TANF/MOE expenditures:
468.32(1) MFIP cash, diversionary work program,
468.33and food assistance benefits under Minnesota
468.34Statutes, chapter 256J;
469.1(2) the child care assistance programs
469.2under Minnesota Statutes, sections 119B.03
469.3and 119B.05, and county child care
469.4administrative costs under Minnesota
469.5Statutes, section 119B.15;
469.6(3) state and county MFIP administrative
469.7costs under Minnesota Statutes, chapters
469.8256J and 256K;
469.9(4) state, county, and tribal MFIP
469.10employment services under Minnesota
469.11Statutes, chapters 256J and 256K;
469.12(5) expenditures made on behalf of
469.13noncitizen MFIP recipients who qualify
469.14for the medical assistance without federal
469.15financial participation program under
469.16Minnesota Statutes, section 256B.06,
469.17subdivision 4, paragraphs (d), (e), and (j);
469.18and
469.19(6) qualifying working family credit
469.20expenditures under Minnesota Statutes,
469.21section 290.0671.
469.22(b) The commissioner shall ensure that
469.23sufficient qualified nonfederal expenditures
469.24are made each year to meet the state's
469.25TANF/MOE requirements. For the activities
469.26listed in paragraph (a), clauses (2) to
469.27(6), the commissioner may only report
469.28expenditures that are excluded from the
469.29definition of assistance under Code of
469.30Federal Regulations, title 45, section 260.31.
469.31(c) The commissioner shall ensure that the
469.32MOE used by the commissioner of finance
469.33for the February and November forecasts
469.34required under Minnesota Statutes, section
469.3516A.103, contains expenditures under
470.1paragraph (a), clause (1), equal to at least 16
470.2percent of the total required under Code of
470.3Federal Regulations, title 45, section 263.1.
470.4(d) Minnesota Statutes, section 256.011,
470.5subdivision 3, which requires that federal
470.6grants or aids secured or obtained under that
470.7subdivision be used to reduce any direct
470.8appropriations provided by law, does not
470.9apply if the grants or aids are federal TANF
470.10funds.
470.11(e) Notwithstanding any contrary provision
470.12in this article, this rider expires June 30,
470.132011.
470.14Working Family Credit Expenditures as
470.15TANF/MOE. The commissioner may claim
470.16as TANF/MOE up to $6,707,000 per year
470.17for fiscal year 2008 through fiscal year 2011.
470.18Notwithstanding any contrary provision in
470.19this article, this rider expires June 30, 2011.
470.20Additional Working Family Credit
470.21Expenditures to be Claimed for
470.22TANF/MOE. In addition to the amounts
470.23provided in this section, the commissioner
470.24may count the following amounts of working
470.25family credit expenditure as TANF/MOE:
470.26(1) fiscal year 2008, $11,126,000;
470.27(2) fiscal year 2009, $25,788,000;
470.28(3) fiscal year 2010, $13,113,000; and
470.29(4) fiscal year 2011, $11,414,000.
470.30Notwithstanding any contrary provision in
470.31this article, this rider expires June 30, 2011.
470.32Capitation Rate Increase. Of the health care
470.33access fund appropriations to the University
470.34of Minnesota in the higher education
471.1omnibus appropriation bill, $2,157,000 in
471.2fiscal year 2008 and $2,157,000 in fiscal year
471.32009 are to be used to increase the capitation
471.4payments under Minnesota Statutes, section
471.5256B.69.

471.6

Subd. 2.Agency Management

471.7The amounts that may be spent from the
471.8appropriation for each purpose are as follows:

471.9

(a) Financial Operations

471.10	Appropriations by Fund
471.11	General	7,165,000	7,652,000
471.12	Health Care Access	799,000	804,000
471.13	Federal TANF	122,000	122,000

471.14

(b) Legal and Regulation Operations

471.15	Appropriations by Fund
471.16	General	12,352,000	12,439,000
471.17 471.18	State Government Special Revenue	427,000	440,000
471.19	Health Care Access	900,000	926,000
471.20	Federal TANF	100,000	100,000

471.21Base Adjustment. The general fund base
471.22is $12,376,000 for each of fiscal years 2010
471.23and 2011.

471.24

(c) Management Operations

471.25	Appropriations by Fund
471.26	General	4,332,000	4,419,000
471.27	Health Care Access	236,000	243,000

471.28

(d) Information Technology Operations

471.29	Appropriations by Fund
471.30	General	23,949,000	23,922,000
471.31	Health Care Access	6,015,000	5,972,000

471.32 471.33

Subd. 3.Revenue and Pass-Through Expenditures

471.34

Federal TANF

59,246,000

61,680,000

472.1TANF Transfer to Federal Child Care
472.2and Development Fund. The following
472.3TANF fund amounts are appropriated to the
472.4commissioner for the purposes of MFIP and
472.5transition year child care under Minnesota
472.6Statutes, section 119B.05:
472.7(1) fiscal year 2008, $2,737,000;
472.8(2) fiscal year 2009, $4,783,000;
472.9(3) fiscal year 2010, $4,789,000; and
472.10(4) fiscal year 2011, $4,821,000.
472.11The commissioner shall authorize transfer
472.12of sufficient TANF funds to the federal
472.13child care and development fund to meet
472.14this appropriation and shall ensure that all
472.15transferred funds are expended according
472.16the federal child care and development fund
472.17regulations.

472.18 472.19

Subd. 4.Children and Economic Assistance Grants

472.20The amounts that may be spent from this
472.21appropriation for each purpose are as follows:

472.22

(a) MFIP/DWP Grants

472.23	Appropriations by Fund
472.24	General	62,069,000	62,514,000
472.25	Federal TANF	78,402,000	85,221,000

472.26

(b) Support Services Grants

472.27	Appropriations by Fund
472.28	General	8,715,000	8,715,000
472.29	Federal TANF	113,429,000	115,902,000

472.30TANF Prior Appropriation Cancellation.
472.31Notwithstanding Laws 2001, First Special
472.32Session chapter 9, article 17, section
472.332, subdivision 11, paragraph (b), any
472.34unexpended TANF funds appropriated to the
473.1commissioner to contract with the Board of
473.2Trustees of Minnesota State Colleges and
473.3Universities, to provide tuition waivers to
473.4employees of health care and human service
473.5providers that are members of qualifying
473.6consortia operating under Minnesota
473.7Statutes, sections 116L.10 to 116L.15, must
473.8cancel at the end of fiscal year 2007.
473.9MFIP Pilot Program. Of the TANF
473.10appropriation, $100,000 in fiscal year 2008
473.11and $750,000 in fiscal year 2009 are for a
473.12grant to the Stearns-Benton Employment and
473.13Training Council for the Workforce U pilot
473.14program. Base level funding for this program
473.15shall be $750,000 in 2010 and $0 in 2011.
473.16Supported Work. (1) Of the TANF
473.17appropriation, $5,468,000 in fiscal year
473.182008 and $7,291,000 in fiscal year
473.192009 are for supported work for MFIP
473.20participants, to be allocated to counties
473.21and tribes based on the criteria under
473.22clauses (2) and (3). Paid transitional work
473.23experience and other supported employment
473.24under this rider provides a continuum of
473.25employment assistance, including outreach
473.26and recruitment, program orientation
473.27and intake, testing and assessment, job
473.28development and marketing, preworksite
473.29training, supported worksite experience, job
473.30coaching, and postplacement follow-up, in
473.31addition to extensive case management and
473.32referral services.
473.33(2) A county or tribe is eligible to receive an
473.34allocation under this rider if:
474.1(i) the county or tribe is not meeting the
474.2federal work participation rate;
474.3(ii) the county or tribe has participants who
474.4are required to perform work activities under
474.5Minnesota Statutes, chapter 256J, but are not
474.6meeting hourly work requirements; and
474.7(iii) the county or tribe has assessed
474.8participants who have completed six weeks
474.9of job search or are required to perform
474.10work activities and are not meeting the
474.11hourly requirements, and the county or tribe
474.12has determined that the participant would
474.13benefit from working in a supported work
474.14environment.
474.15(3) A county or tribe may also be eligible for
474.16funds in order to contract for supplemental
474.17hours of paid work at the participant's child's
474.18place of education, child care location, or the
474.19child's physical or mental health treatment
474.20facility or office. This grant to counties and
474.21tribes is specifically for MFIP participants
474.22who need to work up to five hours more
474.23per week in order to meet the hourly work
474.24requirement, and the participant's employer
474.25cannot or will not offer more hours to the
474.26participant.
474.27Work Study. Of the TANF appropriation,
474.28$750,000 each year are to the commissioner
474.29to contract with the Minnesota Office of
474.30Higher Education for the biennium beginning
474.31July 1, 2007, for work study grants under
474.32Minnesota Statutes, section 136A.233,
474.33specifically for low-income individuals who
474.34receive assistance under Minnesota Statutes,
475.1chapter 256J, and for grants to opportunities
475.2industrialization centers.
475.3Integrated Service Projects. $2,500,000 in
475.4fiscal year 2008 and $2,500,000 in fiscal year
475.52009 are appropriated from the TANF fund
475.6to the commissioner to fund the integrated
475.7services project for MFIP families.
475.8Base Adjustment. The TANF base for fiscal
475.9year 2010 is $115,902,000 and for fiscal year
475.102011 is $115,152,000.

475.11

(c) MFIP Child Care Assistance Grants

475.12

General

74,672,000

72,173,000

475.13 475.14

(d) Basic Sliding Fee Child Care Assistance Grants

475.15

General

43,398,000

45,548,000

475.16Base Adjustment. The general fund base
475.17is $45,557,000 for fiscal year 2010 and
475.18$45,535,000 for fiscal year 2011.
475.19At-Home Infant Care Program. No
475.20funding shall be allocated to or spent on
475.21the at-home infant care program under
475.22Minnesota Statutes, section 119B.035.

475.23

(e) Child Care Development Grants

475.24

General

4,365,000

4,365,000

475.25Child Care Services Grants. Of this
475.26appropriation, $1,000,000 each year are for
475.27the purpose of providing child care services
475.28grants under Minnesota Statutes, section
475.29119B.21, subdivision 5. This appropriation
475.30is for the 2008-2009 biennium only, and does
475.31not increase the base funding.
475.32Early Childhood Professional
475.33Development System. Of this appropriation,
476.1$1,000,000 each year are for purposes of the
476.2early childhood professional development
476.3system, which increases the quality and
476.4continuum of professional development
476.5opportunities for child care practitioners.
476.6This appropriation is for the 2008-2009
476.7biennium only, and does not increase the
476.8base funding.
476.9Family, Friend, and Neighbor Grant
476.10Program. Of this appropriation, $750,000
476.11each year are for the family, friend, and
476.12neighbor grant program in article 1, section
476.1394. Any balance in the first year does not
476.14cancel but is available in the second year.
476.15This appropriation is for the 2008-2009
476.16biennium only, and does not increase the
476.17base funding.
476.18Increased Child Care Provider
476.19Connections. (1) Of the general fund
476.20appropriation, $100,000 each year are for the
476.21following purposes: $50,000 each year is
476.22for a grant to Hennepin County, and $50,000
476.23each year is for a grant to Ramsey County.
476.24The two counties shall each contract with
476.25a nonprofit organization to work with the
476.26contracting county and county-based licensed
476.27family child care providers to facilitate
476.28county-based information regarding family
476.29and children's resources and to make training
476.30and peer support available to licensed family
476.31child care providers consistent with clause
476.32(2). These appropriations are available
476.33until June 30, 2009, and shall not become
476.34part of base level funding for the biennium
476.35beginning July 1, 2009.
477.1(2) Programs to improve child care provider
477.2connections to county services shall be
477.3established in Hennepin and Ramsey
477.4counties to:
477.5(i) improve county contact activities
477.6with county-licensed family child care
477.7providers that facilitate utilization of county
477.8educational, social service, public health,
477.9and economic assistance services by eligible
477.10families, parents, and children using licensed
477.11family child care; and
477.12(ii) support licensed family child care
477.13providers to qualify as quality-rated child
477.14care providers through peer support and
477.15coaching networks.
477.16Hennepin and Ramsey Counties shall
477.17contract with a nonprofit organization under
477.18clause (1) that utilizes licensed family child
477.19care providers as contacts for families using
477.20licensed family child care and to provide
477.21peer support to licensed family child care
477.22providers.
477.23(3) Hennepin and Ramsey Counties
477.24must evaluate (i) successful strategies
477.25for increasing contact with county-based
477.26licensed family child care providers and (ii)
477.27the effect of that increased contact and report
477.28their findings to the appropriate legislative
477.29committees by February 15, 2010.
477.30Base Adjustment. The general fund base
477.31is $1,515,000 for each of fiscal years 2010
477.32and 2011.

477.33

(f) Child Support Enforcement Grants

477.34

General

11,038,000

3,705,000

478.1Child Support Enforcement. $7,333,000
478.2for fiscal year 2008 is to make grants to
478.3counties for child support enforcement
478.4programs to make up for the loss under the
478.52005 federal Deficit Reduction Act of federal
478.6matching funds for federal incentive funds
478.7passed on to the counties by the state.
478.8This appropriation is available until June 30,
478.92009.

478.10

(g) Children's Services Grants

478.11	Appropriations by Fund
478.12	General	61,293,000	73,281,000
478.13	Health Care Access	250,000	-0-
478.14	TANF	250,000	730,000

478.15Child Welfare Project. Of this
478.16appropriation, $10,000 in fiscal year
478.172008 and $390,000 in fiscal year 2009 from
478.18the TANF fund and $720,000 in fiscal year
478.192009 from the general fund are for expanding
478.20the American Indian child welfare project
478.21under Minnesota Statutes, section 256.01,
478.22subdivision 14b, to include the Red Lake
478.23Band of Chippewa Indians Tribe, provided
478.24the tribe meets the criteria in Minnesota
478.25Statutes, section 256.01, subdivision 14b.
478.26Grants for Programs Serving Young
478.27Parents. Of the TANF fund appropriation,
478.28$140,000 each year is for a grant to a program
478.29or programs that provide comprehensive
478.30services through a private, nonprofit agency
478.31to young parents in Hennepin County who
478.32have dropped out of school and are receiving
478.33public assistance. The program administrator
478.34shall report annually to the commissioner on
478.35skills development, education, job training,
479.1and job placement outcomes for program
479.2participants.
479.3County Allocations for Rate Increases.
479.4County Children and Community Services
479.5Act allocations shall be increased by
479.6$321,000 effective October 1, 2007, and
479.7$980,000 effective October 1, 2008, to help
479.8counties pay for the rate adjustments to
479.9day training and habilitation providers for
479.10participants paid by county social service
479.11funds. Notwithstanding the provisions of
479.12Minnesota Statutes, section 256M.40, the
479.13allocation to a county shall be based on
479.14the county's proportion of social services
479.15spending for day training and habilitation
479.16services as determined in the most recent
479.17social services expenditure and grant
479.18reconciliation report.
479.19Privatized Adoption Grants. Federal
479.20reimbursement for privatized adoption grant
479.21and foster care recruitment grant expenditures
479.22is appropriated to the commissioner for
479.23adoption grants and foster care and adoption
479.24administrative purposes.
479.25Adoption Assistance Incentive Grants.
479.26Federal funds available during fiscal year
479.272008 and fiscal year 2009 for the adoption
479.28incentive grants are appropriated to the
479.29commissioner for these purposes.
479.30Adoption Assistance and Relative Custody
479.31Assistance. The commissioner may transfer
479.32unencumbered appropriation balances for
479.33adoption assistance and relative custody
479.34assistance between fiscal years and between
479.35programs.
480.1Crisis Nurseries. Of the general fund
480.2appropriation, $1,100,000 each year are for
480.3the crisis nurseries program. Of this amount,
480.4$100,000 each year are to be made available
480.5for capacity development and technical
480.6support for crisis nurseries.
480.7Children's Mental Health Grants. Of the
480.8general fund appropriation, $3,413,000 in
480.9fiscal year 2008 and $6,825,000 in fiscal year
480.102009 are for children's mental health grants.
480.11The purpose of these grants is to increase and
480.12maintain the state's children's mental health
480.13service capacity, especially for school-based
480.14mental health services. The commissioner
480.15shall require grantees to utilize all available
480.16third party reimbursement sources as a
480.17condition of using state grant funds. At
480.18least 15 percent of these funds shall be
480.19used to encourage efficiencies through early
480.20intervention services. At least another 15
480.21percent shall be used to provide respite care
480.22services for children with severe emotional
480.23disturbance at risk of out-of-home placement.
480.24Mental Health Crisis Services. Of the
480.25general fund appropriation, $1,278,000 in
480.26fiscal year 2008 and $2,850,000 in fiscal year
480.272009 are for statewide funding of children's
480.28mental health crisis services. Providers must
480.29utilize all available funding streams.
480.30Children's Mental Health Evidence-Based
480.31and Best Practices. Of the general fund
480.32appropriation, $375,000 in fiscal year 2008
480.33and $750,000 in fiscal year 2009 are for
480.34children's mental health evidence-based and
480.35best practices including, but not limited
481.1to: Adolescent Integrated Dual Diagnosis
481.2Treatment services; school-based mental
481.3health services; co-location of mental
481.4health and physical health care, and; the
481.5use of technological resources to better
481.6inform diagnosis and development of
481.7treatment plan development by mental
481.8health professionals. The commissioner
481.9shall require grantees to utilize all available
481.10third-party reimbursement sources as a
481.11condition of using state grant funds.
481.12Culturally Specific Mental Health
481.13Treatment Grants. Of the general fund
481.14appropriation, $75,000 in fiscal year 2008
481.15and $300,000 in fiscal year 2009 are for
481.16children's mental health grants to support
481.17increased availability of mental health
481.18services for persons from cultural and
481.19ethnic minorities within the state. The
481.20commissioner shall use at least 20 percent
481.21of these funds to help members of cultural
481.22and ethnic minority communities to become
481.23qualified mental health professionals and
481.24practitioners. The commissioner shall assist
481.25grantees to meet third-party credentialing
481.26requirements and require them to utilize all
481.27available third-party reimbursement sources
481.28as a condition of using state grant funds.
481.29Mental Health Services for Children with
481.30Special Treatment Needs. Of the general
481.31fund appropriation, $50,000 in fiscal year
481.322008 and $200,000 in fiscal year 2009 are
481.33for children's mental health grants to support
481.34increased availability of mental health
481.35services for children with special treatment
481.36needs. These shall include, but not be limited
482.1to: victims of trauma, including children
482.2subjected to abuse or neglect, veterans and
482.3their families, and refugee populations;
482.4persons with complex treatment needs,
482.5such as eating disorders; and those with
482.6low incidence disorders. Of this amount,
482.7$150,000 in fiscal year 2008 and $250,000 in
482.8fiscal year 2009 must be directed to programs
482.9serving victims of trauma.
482.10MFIP and Children's Mental Health
482.11Pilot Project. Of the TANF appropriation,
482.12$100,000 in fiscal year 2008 and $200,000
482.13in fiscal year 2009 are to fund the MFIP
482.14and children's mental health pilot project.
482.15Of these amounts, up to $100,000 may be
482.16expended on evaluation of this pilot.
482.17Regional Children's Mental Health
482.18Initiative. Of the general fund appropriation,
482.19$700,000 each year are to fund the Regional
482.20Children's Mental Health Initiative pilot
482.21project. This is a onetime appropriation.
482.22Fetal Alcohol Syndrome. Of the general
482.23fund appropriation, $75,000 each year is
482.24to the commissioner to transfer as grants
482.25to three programs that provide services
482.26to reduce fetal alcohol syndrome under
482.27Minnesota Statutes, section 254A.171. The
482.28three program grantees are the University
482.29of Minnesota, the Meeker-McLeod-Sibley
482.30Community, and the American Indian Family
482.31Center. This appropriation shall become part
482.32of the base appropriation.
482.33Prenatal Alcohol or Drug Use. Of the
482.34general fund appropriation, $75,000 each
482.35year is to award grants beginning July 1,
483.12007, to programs that provide services
483.2under Minnesota Statutes, section 254A.171,
483.3in Pine, Kanabec, and Carlton Counties. This
483.4appropriation shall become part of the base
483.5appropriation.
483.6Base Adjustment. The general fund base
483.7is $71,399,000 in fiscal year 2010 and
483.8$71,402,000 in fiscal year 2011.
483.9The TANF fund base is $722,000 in each
483.10year of the 2010-2011 biennium.

483.11

(h) Children and Community Services Grants

483.12

General

104,911,000

69,371,000

483.13Base Adjustment. The general fund base
483.14is $69,616,000 in each of fiscal years 2010
483.15and 2011.
483.16Targeted Case Management Temporary
483.17Funding. Of the general fund appropriation,
483.18$36,134,000 in fiscal year 2008 is allocated to
483.19counties and tribes affected by reductions in
483.20targeted case management federal Medicaid
483.21revenue as a result of the provisions in
483.22the federal Deficit Reduction Act of 2005,
483.23Public Law 109-171. The commissioner
483.24shall distribute the funds proportionate
483.25to each affected county or tribe's targeted
483.26case management federal earnings for
483.27calendar year 2005. Prior to distribution
483.28of funds, the commissioner shall estimate
483.29and certify the amount by which the federal
483.30regulations will reduce case management
483.31revenue over the 2008-2009 biennium. The
483.32commissioner may provide grants up to the
483.33amount of the estimated reduction, not to
483.34exceed $36,134,000 for the biennium. The
483.35commissioner may determine the timing and
484.1frequency of payments to counties. These
484.2funds are available in either year of the
484.3biennium. Counties shall use these funds to
484.4pay for social service-related costs, but the
484.5funds are not subject to provisions of the
484.6Children and Community Services Act grant
484.7under Minnesota Statutes, chapter 256M.

484.8

(i) General Assistance Grants

484.9

General

37,876,000

38,253,000

484.10General Assistance Standard. The
484.11commissioner shall set the monthly standard
484.12of assistance for general assistance units
484.13consisting of an adult recipient who is
484.14childless and unmarried or living apart
484.15from parents or a legal guardian at $203.
484.16The commissioner may reduce this amount
484.17according to Laws 1997, chapter 85, article
484.183, section 54.
484.19Emergency General Assistance. The
484.20amount appropriated for emergency general
484.21assistance funds is limited to no more
484.22than $7,889,812 in fiscal year 2008 and
484.23$7,889,812 in fiscal year 2009. Funds
484.24to counties must be allocated by the
484.25commissioner using the allocation method
484.26specified in Minnesota Statutes, section
484.27256D.06.

484.28

(j) Minnesota Supplemental Aid Grants

484.29

General

30,505,000

30,812,000

484.30Emergency Minnesota Supplemental
484.31Aid Funds. The amount appropriated for
484.32emergency Minnesota supplemental aid
484.33funds is limited to no more than $1,100,000
484.34in fiscal year 2008 and $1,100,000 in fiscal
485.1year 2009. Funds to counties must be
485.2allocated by the commissioner using the
485.3allocation method specified in Minnesota
485.4Statutes, section 256D.46.

485.5

(k) Group Residential Housing Grants

485.6

General

91,181,000

98,879,000

485.7People Incorporated. Of the general fund
485.8appropriation, $460,000 each year is to
485.9augment community support and mental
485.10health services provided to individuals
485.11residing in facilities under Minnesota
485.12Statutes, section 256I.05, subdivision 1m.

485.13 485.14

(l) Other Children and Economic Assistance Grants

485.15	General	21,547,000	19,433,000
485.16	Federal TANF	1,500,000	1,500,000

485.17Base Adjustment. The general fund base
485.18shall be $19,708,000 in fiscal year 2010 and
485.19$19,208,000 in fiscal year 2011.
485.20Homeless and Runaway Youth.Of the
485.21general fund appropriation, $1,639,000 the
485.22first year and $1,375,000 the second year are
485.23for the Runaway and Homeless Youth Act
485.24under Minnesota Statutes, section 256K.45.
485.25Funds shall be spent in each area of the
485.26continuum of care to ensure that programs
485.27are meeting the greatest need. The base is
485.28decreased by $425,000 each year in fiscal
485.29year 2010 and fiscal year 2011.
485.30Transitional Housing and Emergency
485.31Services.
485.32(1) Of the general fund appropriation,
485.33$750,000 the first year is for transitional
485.34housing programs under Minnesota Statutes,
486.1section 256E.33. Up to ten percent of this
486.2appropriation may be used for housing and
486.3services which extend beyond 24 months;
486.4and
486.5(2) $600,000 the first year is added to the
486.6base for emergency services grants under
486.7Laws 1997, chapter 162, article 3, section 7.
486.8Foodshelf Programs. Of the general
486.9fund appropriation, $325,000 each year is
486.10for foodshelf programs under Minnesota
486.11Statutes, section 256E.34.
486.12Minnesota Community Action Grants. (a)
486.13Of the general fund appropriation, $250,000
486.14each year is for the purposes of Minnesota
486.15community action grants under Minnesota
486.16Statutes, sections 256E.30 to 256E.32. Base
486.17level funding for this appropriation for the
486.18biennium beginning July 1, 2009, shall be
486.19$500,000 each year.
486.20(b) Of the TANF appropriation, $1,500,000
486.21each year is for community action agencies
486.22for auto repairs, auto loans, and auto purchase
486.23grants to individuals who are eligible to
486.24receive benefits under Minnesota Statutes,
486.25chapter 256J, or who have lost eligibility for
486.26benefits under Minnesota Statutes, chapter
486.27256J, due to earnings in the prior 12 months.
486.28(c) Money appropriated under paragraphs (a)
486.29and (b) that is not spent in the first year does
486.30not cancel but is available for the second
486.31year.
486.32Tenant Hotline Services Program.Of the
486.33general fund appropriation, $50,000 each
486.34year is for a grant to HOME Line for the
487.1tenant hotline services program. This is a
487.2onetime appropriation.

487.3 487.4

Subd. 5.Children and Economic Assistance Management

487.5The amounts that may be spent from the
487.6appropriation for each purpose are as follows:

487.7 487.8

(a) Children and Economic Assistance Administration

487.9	Appropriations by Fund
487.10	General	9,888,000	9,956,000
487.11	Federal TANF	1,196,000	1,196,000

487.12Child Care Licensing. Of the general fund
487.13appropriation, $116,000 in fiscal year 2008
487.14and $223,000 in fiscal year 2009 are for
487.15purposes of completing background studies
487.16for family and group family child care
487.17providers under Minnesota Statutes, chapter
487.18245C.
487.19Base Adjustment. The general fund
487.20base is $9,829,000 in fiscal year 2010 and
487.21$9,741,000 in fiscal year 2011.

487.22 487.23

(b) Children and Economic Assistance Operations

487.24	Appropriations by Fund
487.25	General	35,667,000	36,023,000
487.26	Health Care Access	350,000	361,000

487.27Financial Institution Data Match and
487.28Payment of Fees. The commissioner is
487.29authorized to allocate up to $310,000 each
487.30year in fiscal years 2008 and 2009 from the
487.31PRISM special revenue account to make
487.32payments to financial institutions in exchange
487.33for performing data matches between account
487.34information held by financial institutions
487.35and the public authority's database of child
488.1support obligors as authorized by Minnesota
488.2Statutes, section 13B.06, subdivision 7.
488.3Base Adjustment. The general fund base
488.4is $35,967,000 in each of fiscal years 2010
488.5and 2011.

488.6

Subd. 6.Basic Health Care Grants

488.7The amounts that may be spent from the
488.8appropriation for each purpose are as follows:

488.9

(a) MinnesotaCare Grants

488.10

Health Care Access

391,818,000

470,951,000

488.11HealthMatch Delay. Of this appropriation,
488.12$2,560,000 the first year and $21,735,000
488.13the second year are for the MinnesotaCare
488.14program costs related to a six-month delay in
488.15implementation of the HealthMatch program.

488.16 488.17

(b) MA Basic Health Care - Families and Children

488.18	Appropriations by Fund
488.19	General	740,771,000	843,211,000
488.20	Health Care Access	1,672,000	-0-

488.21 488.22

(c) MA Basic Health Care - Elderly and Disabled

488.23

General

997,868,000

1,106,356,000

488.24Provider-Directed Care Coordination. In
488.25addition to medical assistance reimbursement
488.26under Minnesota Statutes, sections
488.27256B.0625 and 256B.76, clinics participating
488.28in provider-directed care coordination under
488.29Minnesota Statutes, section 256B.0625, also
488.30receive a monthly payment per client when
488.31the clinic serves an eligible client. The
488.32payments across the program must average
488.33$50 per month per client.
489.1MR/RC Waiver. The commissioner must
489.2serve: an additional 50 persons in the
489.3MR/RC waiver program beginning in fiscal
489.4year 2008.

489.5

(d) General Assistance Medical Care Grants

489.6

General

239,215,000

251,729,000

489.7

(e) Other Health Care Grants

489.8	General	1,621,000	1,671,000
489.9	Health Care Access	150,000	150,000

489.10Community-Based Health Care
489.11Demonstration Project. Of the general
489.12fund appropriation, $212,000 each year is
489.13to be transferred to the commissioner of
489.14health for the demonstration project grant
489.15described in Minnesota Statutes, section
489.1662Q.80, subdivision 1a. This appropriation
489.17shall remain part of base level funding until
489.18June 30, 2012. Notwithstanding any contrary
489.19provision in this article, this rider expires
489.20July 1, 2012.
489.21 Care Coordination Pilot Projects. Of the
489.22general fund appropriation, $750,000 in
489.23fiscal year 2009 is for the health care pilot
489.24projects for children and adults with complex
489.25health care needs. Base level funding for this
489.26program is $750,000 in 2010 and $0 in 2011.
489.27Patient Incentive Programs. Of the general
489.28fund appropriation, $500,000 in fiscal year
489.292008 and $500,000 in fiscal year 2009 are
489.30for patient incentive programs.
489.31Base Adjustment. The general fund base is
489.32$1,671,000 in fiscal year 2010 and $921,000
489.33in fiscal year 2011.
490.1Oral Health Care Innovations Grants. (a)
490.2Of the general fund appropriation, $400,000
490.3for the fiscal year beginning July 1, 2007,
490.4is to award competitive oral health care
490.5innovations grants to organizations described
490.6in Minnesota Statutes, section 256B.76,
490.7paragraph (b), clause (4), or coalitions of
490.8such organizations, providing access to oral
490.9health services for low-income and uninsured
490.10persons. The commissioner shall award one
490.11grant for a project to develop a nonprofit
490.12dental clinic serving public program
490.13recipients and uninsured persons in Beltrami
490.14County; one grant for the maintenance of
490.15nonprofit dental clinics providing oral health
490.16care services to children ages birth to 18 in
490.17St. Louis County; and one grant for the bright
490.18smiles program to increase access to oral
490.19health care for low-income and immigrant
490.20children, ages birth to five years, and their
490.21families in underserved areas in Minneapolis.
490.22(b) This grant shall not become part of base
490.23level funding.
490.24State Health Policies Grant. Of the
490.25general fund appropriation, $300,000 in
490.26fiscal year 2008 is to provide a grant to a
490.27research center associated with a safety net
490.28hospital and county-affiliated health system
490.29to develop the capabilities necessary for
490.30evaluating the effects of changes in state
490.31health policies on low-income and uninsured
490.32individuals, including the impact on state
490.33health care program costs, health outcomes,
490.34cost-shifting to different units and levels
490.35of government, and utilization patterns
490.36including use of emergency room care and
491.1hospitalization rates. The center shall report
491.2on the use of this money by December 1,
491.32008, to the chairs of the senate and house
491.4of representatives committees with relevant
491.5jurisdiction.

491.6

Subd. 7.Health Care Management

491.7The amounts that may be spent from the
491.8appropriation for each purpose are as follows:

491.9

(a) Health Care Policy Administration

491.10	Appropriations by Fund
491.11	General	10,993,000	11,370,000
491.12	Health Care Access	1,897,000	3,082,000

491.13Minnesota Senior Health Options
491.14Reimbursement. Federal administrative
491.15reimbursement resulting from the Minnesota
491.16senior health options project is appropriated
491.17to the commissioner for this activity.
491.18Disproportionate Share Hospital Payment
491.19Formulas. The commissioner is prohibited
491.20from altering formulas for disbursement of
491.21disproportionate share hospital funds under
491.22the disproportionate share hospital program
491.23by rule, bulletin, or any other administrative
491.24method without explicit legislative authority.
491.25Utilization Review. Federal administrative
491.26reimbursement resulting from prior
491.27authorization and inpatient admission
491.28certification by a professional review
491.29organization is dedicated to the commissioner
491.30for these purposes. A portion of these funds
491.31must be used for activities to decrease
491.32unnecessary pharmaceutical costs in medical
491.33assistance.
492.1Base Adjustment. The health care access
492.2fund base is $4,049,000 in fiscal year 2010
492.3and $4,065,000 in fiscal year 2011, for health
492.4care administration.
492.5Base Adjustment. The general fund base
492.6is $11,164,000 in fiscal year 2010 and
492.7$10,770,000 in fiscal year 2011.

492.8

(b) Health Care Operations

492.9	Appropriations by Fund
492.10	General	21,941,000	21,874,000
492.11	Health Care Access	22,355,000	23,007,000

492.12Base Adjustment. The general fund base
492.13is $21,839,000 in each of fiscal years 2010
492.14and 2011. The health care access fund
492.15base is $24,024,000 in fiscal year 2010 and
492.16$23,627,000 in fiscal year 2011.
492.17Outreach Funding. Of these appropriations,
492.18the following amounts are to the
492.19commissioner for the Minnesota health care
492.20outreach program under Minnesota Statutes,
492.21section 256.962:
492.22(1) $950,000 the first year and $1,000,000
492.23the second year from the health care access
492.24fund for a statewide outreach campaign
492.25under Minnesota Statutes, section 256.962,
492.26subdivision 1;
492.27(2) $700,000 each year from the general
492.28fund and $300,000 each year from the health
492.29care access fund for the incentive program
492.30under Minnesota Statutes, section 256.962,
492.31subdivision 5; and
492.32(3) $150,000 each year from the health
492.33care access fund appropriation for other
492.34health care grants for a grant to a nonprofit
493.1organization to provide a statewide toll-free
493.2number under Minnesota Statutes, section
493.3256.962, subdivision 4.

493.4

Subd. 8.Continuing Care Grants

493.5The amounts that may be spent from the
493.6appropriation for each purpose are as follows:

493.7

(a) Aging and Adult Services Grants

493.8

General

14,957,000

15,390,000

493.9Information and Assistance
493.10Reimbursement. Federal administrative
493.11reimbursement obtained from information
493.12and assistance services provided by the
493.13Senior LinkAge Line to people who are
493.14identified as eligible for medical assistance
493.15is appropriated to the commissioner for this
493.16activity.
493.17Senior Companion Program. Of this
493.18appropriation, $83,000 each year is for the
493.19senior companion program under Minnesota
493.20Statutes, section 256.977.
493.21Volunteer Senior Citizens. Of this
493.22appropriation, $84,000 each year is for the
493.23volunteer programs for retired senior citizens
493.24under Minnesota Statutes, section 256.9753.
493.25Foster Grandparent Program. Of this
493.26appropriation, $83,000 each year is for the
493.27foster grandparent program in Minnesota
493.28Statutes, section 256.976.
493.29Senior Nutrition. Of this appropriation,
493.30$250,000 each year is for the senior nutrition
493.31programs under Minnesota Statutes, section
493.32256.9752. The commissioner shall give
493.33priority to increase services to: (1) persons
493.34facing language or cultural barriers, (2)
494.1persons with special diets, (3) persons
494.2living in isolated rural areas, and (4) other
494.3hard-to-serve populations.
494.4Kinship Navigator Program. Of the
494.5general fund appropriation, $175,000 in
494.6fiscal year 2008 and $175,000 in fiscal year
494.72009 is to the commissioner for a two-year
494.8demonstration grant, to be transferred to a
494.9nonprofit statewide organization advocating
494.10for, supporting, and providing information
494.11and resources to individuals raising their
494.12grandchildren, other related children, or
494.13children of friends for purposes of providing
494.14support to grandparents or relatives who are
494.15raising kinship children. The demonstration
494.16grant sites must include a central site in the
494.17metropolitan area and another site in the
494.18Bemidji region. The support must provide a
494.19one-stop services program. The services that
494.20may be provided include, but are not limited
494.21to, legal services, education, information,
494.22family activities, support groups, mental
494.23health access, advocacy, mentors, and
494.24information related to foster care licensing.
494.25The funds may also be used for a media
494.26campaign to inform kinship families about
494.27available information and services, support
494.28sites, and other program development.
494.29For the biennium beginning July 1, 2009,
494.30base level funding for these grants shall be
494.31$160,000 each year.
494.32Reverse Mortgage Incentive Program.
494.33Of the general fund appropriation for the
494.34biennium beginning July 1, 2007, the
494.35following amounts are for the purposes
494.36listed:
495.1(1) $120,000 the first year and $120,000 the
495.2second year are for costs associated with the
495.3reverse mortgage incentive program; and
495.4(2) $39,000 each year is to be transferred
495.5to the commissioner of the Minnesota
495.6Housing Finance Agency for the purposes of
495.7Minnesota Statutes, section 462A.05.
495.8Base Adjustment. The general fund base
495.9is $15,554,000 in each of fiscal years 2010
495.10and 2011.

495.11

(b) Alternative Care Grants

495.12

General

50,012,000

52,099,000

495.13Alternative Care Transfer. Any money
495.14allocated to the alternative care program that
495.15is not spent for the purposes indicated does
495.16not cancel but is transferred to the medical
495.17assistance account.
495.18Base Adjustment. The general fund
495.19base is $52,940,000 in fiscal year 2010
495.20and $53,167,000 in fiscal year 2011 for
495.21alternative care grants.

495.22 495.23

(c) Medical Assistance Grants - Long-Term Care Facilities

495.24

General

499,615,000

506,667,000

495.25Long-Term Care Consultation Funding
495.26Increase. For the rate year beginning
495.27October 1, 2008, the county long-term
495.28care consultation allocations in Minnesota
495.29Statutes, section 256B.0911, subdivision
495.306, must be increased based on the number
495.31of transitional long-term care consultation
495.32visits projected by the commissioner in
495.33each county. For the rate year beginning
495.34October 1, 2009, final allocations must be
496.1determined based on the average between
496.2the actual number of transitional long-term
496.3care visits that were conducted in the prior
496.412-month period and the projected number
496.5of consultations that will be provided in
496.6the rate year beginning October 1, 2009.
496.7Notwithstanding any contrary provision in
496.8this article, this paragraph expires June 30,
496.92010.
496.10Nursing Facility Sprinkler Systems. Of
496.11the general fund appropriation, $2,500,000
496.12the first year is to reimburse the costs of
496.13nursing facility sprinkler systems under
496.14Minnesota Statutes, section 256B.434,
496.15subdivision 4, paragraph (e). Any portion of
496.16this appropriation not spent in the first year
496.17shall not cancel but shall be available for the
496.18second year.
496.19Nursing Home Moratorium Exceptions.
496.20During fiscal year 2008, the commissioner of
496.21health may approve moratorium exception
496.22projects under Minnesota Statutes, section
496.23144A.073, for which the full annualized
496.24state share of medical assistance costs does
496.25not exceed $3,000,000. During fiscal year
496.262009, the commissioner of health may
496.27approve moratorium exception projects
496.28under Minnesota Statutes, section 144A.073,
496.29for which the full annualized state share of
496.30medical assistance costs does not exceed
496.31$3,000,000 less the amount approved during
496.32the first year. Priority shall be given to
496.33proposals that entail:
496.34(1) complete building replacement in
496.35conjunction with reductions in the number of
497.1beds in a county, with greater weight given
497.2to projects in counties with a greater than
497.3average number of beds per 1,000 elderly;
497.4(2) technology improvements;
497.5(3) improvements in life safety;
497.6(4) construction of nursing facilities that are
497.7part of senior services campuses; and
497.8(5) improvements in the work environment.

497.9 497.10

(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

497.11

General

961,966,000

1,085,510,000

497.12

(e) Mental Health Grants

497.13	Appropriations by Fund
497.14	General	57,609,000	62,656,000
497.15	Health Care Access	750,000	750,000
497.16	Lottery Prize	1,933,000	1,633,000

497.17County CADI allocation adjustment.
497.18(1) The commissioner shall adjust 2007
497.19home and community-based allocations
497.20under Minnesota Statutes, section 256B.49,
497.21to qualifying counties that transferred
497.22persons to the community alternatives for
497.23disabled individuals (CADI) waiver program
497.24under Laws 2006, chapter 282, article 20,
497.25section 35. The adjustment shall reflect
497.26the amount that county-authorized funding
497.27for CADI waiver services exceeded the
497.28allowable amount as shown in the Medicaid
497.29Management Information System (MMIS)
497.30on March 1, 2007.
497.31(2) A county that may qualify under
497.32paragraph (1) shall apply to the commissioner
497.33by June 10, 2007. Following a review of the
497.34county request and the MMIS documentation,
498.1the commissioner shall adjust the county
498.2allocation, as appropriate, by June 25, 2007.
498.3(3) The amounts provided to a county under
498.4this section shall become part of the county's
498.5base level state allocation for the CADI
498.6waiver for the biennium beginning July 1,
498.72007.
498.8(4) This rider is effective the day following
498.9final enactment.
498.10Mental Health Crisis Services. Of the
498.11general fund appropriation, $1,278,000 in
498.12fiscal year 2008 and $3,278,000 in fiscal
498.13year 2009 are for statewide funding of adult
498.14mental health crisis services. Providers must
498.15utilize all available funding streams.
498.16Adult Mental Health Evidence-Based
498.17and Best Practices. Of the general fund
498.18appropriation, $375,000 in fiscal year 2008
498.19and $750,000 in fiscal year 2009 are for
498.20adult mental health evidence-based and
498.21best practices including, but not limited
498.22to, Assertive Community Treatment and
498.23Integrated Dual Diagnosis Treatment
498.24services. The commissioner shall require
498.25grantees to utilize all available third-party
498.26reimbursement sources as a condition of
498.27using state grant funds.
498.28Culturally Specific Mental Health
498.29Treatment Grants. Of the general fund
498.30appropriation, $75,000 in fiscal year 2008
498.31and $300,000 in fiscal year 2009 are for adult
498.32mental health grants to support increased
498.33availability of mental health services for
498.34persons from cultural and ethnic minorities
498.35within the state. The commissioner shall use
499.1at least 20 percent of these funds to help
499.2members of cultural and ethnic minority
499.3communities to become qualified mental
499.4health professionals and practitioners. The
499.5commissioner shall assist grantees to meet
499.6third-party credentialing requirements
499.7and require them to utilize all available
499.8third-party reimbursement sources as a
499.9condition of using state grant funds.
499.10Mental Health Services for Adults with
499.11Special Treatment Needs. Of the general
499.12fund appropriation, $50,000 in fiscal year
499.132008 and $200,000 in fiscal year 2009 are
499.14for adult mental health grants to support
499.15increased availability of mental health
499.16services for adults with special treatment
499.17needs. These adults shall include, but not
499.18be limited to: victims of trauma, including
499.19persons subjected to abuse or neglect,
499.20veterans and their families, and refugee
499.21populations; person's with complex treatment
499.22needs, such as eating disorders; and those
499.23with low incidence disorders.
499.24Supportive Housing Services for Adults
499.25with Mental Illness. Of the general fund
499.26appropriation, $750,000 in fiscal year 2008
499.27and $1,500,000 in fiscal year 2009 are
499.28for adult mental health grants to support
499.29increased availability of a range of housing
499.30options with supports for persons with
499.31serious mental illness.
499.32National Council on Problem Gambling.
499.33(1) Of the appropriation from the lottery prize
499.34fund, $225,000 each year is for a grant to
499.35the state affiliate recognized by the National
500.1Council on Problem Gambling. The affiliate
500.2must provide services to increase public
500.3awareness of problem gambling, education,
500.4and training for individuals and organizations
500.5providing effective treatment services to
500.6problem gamblers and their families, and
500.7research relating to problem gambling. These
500.8services must be complementary to and not
500.9duplicative of the services provided through
500.10the problem gambling program administered
500.11by the commissioner of human services. This
500.12grant does not prevent the commissioner
500.13from regular monitoring and oversight of the
500.14grant or the ability to reallocate the funds to
500.15other services within the problem gambling
500.16program for nonperformance of duties by
500.17the grantee.
500.18(2) Of this appropriation, $100,000 in
500.19fiscal year 2008 and $100,000 in fiscal year
500.202009 are contingent on the contribution
500.21of nonstate matching funds. Matching
500.22funds may be either cash or qualifying
500.23in-kind contributions. The commissioner of
500.24finance may disburse the state portion of the
500.25matching funds in increments of $25,000
500.26upon receipt of a commitment for an equal
500.27amount of matching nonstate funds. The
500.28general fund base shall be $100,000 in fiscal
500.29year 2010 and $100,000 in fiscal year 2011.
500.30(3) Of the lottery prize fund appropriation,
500.31$100,000 in fiscal year 2008 is for a grant
500.32or grants to be awarded competitively
500.33to develop programs and services for
500.34problem gambling treatment, prevention,
500.35and education in immigrant communities.
500.36This appropriation is available until June
501.130, 2009, at which time the project must
501.2be completed and final products delivered,
501.3unless an earlier completion date is specified
501.4in the work program.
501.5Compulsive Gambling. Of the lottery prize
501.6fund appropriation, $300,000 in fiscal year
501.72008 and $100,000 in fiscal year 2009 are for
501.8purposes of compulsive gambling education,
501.9assessment, and treatment under Minnesota
501.10Statutes, section 245.98.
501.11Compulsive Gambling Study. Of the lottery
501.12prize fund appropriation, $100,000 in fiscal
501.13year 2008 is to continue the study currently
501.14being done on compulsive gambling
501.15treatment effectiveness and long-term effects
501.16of gambling.
501.17Base Adjustment. The general fund base
501.18is $62,940,000 in each of fiscal years 2010
501.19and 2011.
501.20Base Adjustment. The lottery prize fund
501.21base is $1,508,000 in each of fiscal years
501.222010 and 2011.

501.23

(f) Deaf and Hard-of-Hearing Grants

501.24

General

1,932,000

2,368,000

501.25Hearing Loss Mentors. Of the general
501.26fund appropriation, $40,000 each year is to
501.27provide mentors who have a hearing loss
501.28to parents of newly identified infants and
501.29children with hearing loss.
501.30Base Adjustment. The general fund base is
501.31$2,387,000 in each of fiscal years 2010 and
501.322011.

501.33

(g) Chemical Dependency Entitlement Grants

502.1

General

78,618,000

88,957,000

502.2 502.3

(h) Chemical Dependency Nonentitlement Grants

502.4	General	1,605,000	1,805,000
502.5	TANF	150,000	150,000

502.6Alcohol and Drug Intervention. Of this
502.7appropriation, $300,000 each year from the
502.8general fund and $150,000 each year from
502.9the TANF fund are to the commissioner for
502.10the purposes of a program in Ramsey County
502.11that provides early intervention efforts
502.12designed to discourage pregnant women
502.13from using alcohol and illegal drugs. The
502.14appropriation shall not become part of base
502.15level funding and is available until spent.
502.16Long-Term Homelessness. Of the general
502.17fund appropriation, $1,900,000 each year is
502.18for implementation of programs to address
502.19long-term homelessness.
502.20Methamphetamine Abuse Grants. Of the
502.21general fund appropriation, $175,000 in the
502.22first year and $375,000 in the second year
502.23are for grants to existing programs that treat
502.24methamphetamine abuse, and the abuse
502.25of other substances in Carlton, Faribault,
502.26Martin, Olmsted, and Anoka Counties, that
502.27received grant funds under Laws 2005,
502.28chapter 136, article 1, section 9, subdivision
502.296. The commissioner shall administer the
502.30grants to programs that the commissioner
502.31deems successful, and may discontinue
502.32grants to programs after an evaluation of
502.33the program and a determination by the
502.34commissioner that the program should no
503.1longer receive funds. This appropriation
503.2shall not become part of base level funding.
503.3Base Adjustment. The general fund base is
503.4$1,055,000 in each of fiscal years 2010 and
503.52011.

503.6

(i) Other Continuing Care Grants

503.7

General

21,889,000

17,856,000

503.8Family Support Program; SILS. The
503.9commissioner must serve an additional 100
503.10persons in fiscal year 2008 and 200 persons
503.11in fiscal year 2009 in the family support grant
503.12program under Minnesota Statutes, section
503.13252.32, and an additional 100 persons in
503.14fiscal year 2008 and 200 persons in fiscal
503.15year 2009 in the semi-independent living
503.16services program under Minnesota Statutes,
503.17section 252.275.
503.18Native American Juvenile Treatment
503.19Center. Of the general fund appropriation,
503.20$50,000 is to conduct a feasibility study
503.21of and to predesign a Native American
503.22juvenile treatment center on or near the
503.23White Earth Reservation. The facility must
503.24house and treat Native American juveniles
503.25and provide culturally specific programming
503.26to juveniles placed in the treatment center.
503.27The commissioner of human services may
503.28contract with parties who have experience
503.29in the design and construction of juvenile
503.30treatment centers to assist in the feasibility
503.31study and predesign. On or before January
503.3215, 2008, the commissioner shall present
503.33the results of the feasibility study and the
503.34predesign of the facility to the chairs of house
503.35of representatives and senate committees
504.1having jurisdiction over human services
504.2finance, public safety finance, and capital
504.3investment.
504.4Leech Lake Youth Treatment Center. Of
504.5the general fund appropriation, $75,000 each
504.6year are for a grant to the Leech Lake Youth
504.7Treatment Center project partners, in order
504.8to pay the salaries and other directly related
504.9costs associated with the development of this
504.10project. This is a onetime appropriation.
504.11Repayment. Of the general fund
504.12appropriation, $4,302,000 the first year
504.13is to repay the amount of overspending
504.14in the waiver program for persons with
504.15developmental disabilities incurred by
504.16Fillmore, Steele, and St. Louis Counties in
504.17calendar years 2004 and 2005.
504.18Department of Employment and Economic
504.19Development Transfer. For fiscal year 2008,
504.20the commissioner of finance shall transfer
504.21$200,000 from the methamphetamine
504.22abatement loan fund to the commissioner
504.23of human services for methamphetamine
504.24treatment programs.
504.25Base Adjustment. The general fund base
504.26is $18,228,000 in fiscal year 2010 and
504.27$18,282,000 in fiscal year 2011 for other
504.28continuing care grants.

504.29

Subd. 9.Continuing Care Management

504.30	General	19,722,000	19,914,000
504.31 504.32	State Government Special Revenue	122,000	125,000
504.33	Health Care Access	293,000	-0-
504.34	Lottery Prize	252,000	157,000

505.1Quality Assurance System Expansion. Of
505.2the general fund appropriation, $200,000
505.3in fiscal year 2008 and $200,000 in fiscal
505.4year 2009 are to develop a statewide quality
505.5assurance and improvement system under
505.6Minnesota Statutes, section 256B.096, for
505.7persons receiving disability services. Any
505.8unspent portion of the appropriation for
505.9the first year shall not cancel but shall be
505.10available for the second year. These are
505.11onetime appropriations.
505.12Base Adjustment. The general fund base
505.13is $19,745,000 in fiscal year 2010 and
505.14$19,835,000 in fiscal year 2011.
505.15Disability Linkage Line. Of the general
505.16fund appropriation, $469,000 in fiscal year
505.172008 and $626,000 in fiscal year 2009 are to
505.18establish and maintain the disability linkage
505.19line.
505.20Home Health Reimbursement Study. (1)
505.21Of the general fund appropriation, $100,000
505.22in fiscal year 2008 is to the commissioner to
505.23contract with a Minnesota-based, nonprofit
505.24quality improvement organization that
505.25collaborates with providers and consumers
505.26in health improvement activities, for the
505.27purpose of conducting an independent
505.28analysis of the reimbursement methodologies
505.29for home health services provided to
505.30enrollees in the Minnesota senior health
505.31options and Minnesota disability health
505.32options programs.
505.33(2) The analysis of reimbursement
505.34methodologies shall include, at a minimum,
505.35a review of:
506.1(i) any limitations on flexibility in services or
506.2technology for the home health provider;
506.3(ii) the Medicare program reimbursement
506.4methodologies, including possible
506.5alternatives, and Medicare benefits;
506.6(iii) potential access issues raised by current
506.7reimbursement methodologies; and
506.8(iv) incentives, including episodic care
506.9reimbursement methodologies, to promote
506.10best practices and achieve identified clinical
506.11outcomes.
506.12(3) The analysis and any supporting
506.13recommendations shall be presented to the
506.14commissioner by December 1, 2007, and
506.15to the chairs of the appropriate legislative
506.16committees by December 15, 2007. In no
506.17event shall the study disclose any specific
506.18reimbursement amount or methodologies
506.19attributable to an individual health carrier.
506.20(4) In conducting its analysis, the
506.21organization described in paragraph (a)
506.22shall consult with the commissioner, the
506.23Minnesota Home Care Association, managed
506.24care organizations, and other interested
506.25home health entities and advocates, and
506.26shall convene the parties to discuss pertinent
506.27issues.

506.28

Subd. 10.State-Operated Services

506.29Transfer Authority Related to
506.30State-Operated Services. Money
506.31appropriated to finance state-operated
506.32services programs and administrative
506.33services may be transferred between fiscal
507.1years of the biennium with the approval of
507.2the commissioner of finance.

507.3

(a) Mental Health Services

507.4

General

116,185,000

119,507,000

507.5Appropriation Limitation. No part of
507.6the appropriation in this article to the
507.7commissioner for mental health treatment
507.8services at the regional treatment centers
507.9shall be used for the Minnesota sex offender
507.10program.
507.11Remembering With Dignity Project. (1)
507.12Of the general fund appropriation, $200,000
507.13is to the commissioner to be available until
507.14June 30, 2009, to make a grant to Advocating
507.15Change Together for the purposes of the
507.16Remembering With Dignity project in
507.17paragraph (2).
507.18(2) As part of the Remembering With Dignity
507.19project, the grant recipient shall:
507.20(i) conduct necessary research on persons
507.21buried in state cemeteries who were residents
507.22of state hospitals or regional treatment
507.23centers and buried in numbered or unmarked
507.24graves;
507.25(ii) purchase and install headstones that are
507.26properly inscribed with their names on the
507.27graves of those persons; and
507.28(iii) collaborate with community groups
507.29and state and local government agencies to
507.30build community involvement and public
507.31awareness, ensure public access to the
507.32graves, and ensure appropriate perpetual
507.33maintenance of state cemeteries.
508.1Community Behavioral Health Hospitals.
508.2Notwithstanding Minnesota Statutes, section
508.3246.51, subdivision 1, a determination order
508.4for clients in a community behavioral health
508.5hospital operated by the commissioner is
508.6only required when a client's third-party
508.7coverage has been exhausted.

508.8

(b) Minnesota Sex Offender Services

508.9

General

67,614,000

62,569,000

508.10 508.11

(c) Minnesota Security Hospital and METO Services

508.12

General

82,495,000

84,505,000

508.13Minnesota Security Hospital. For the
508.14purposes of enhancing the safety of
508.15the public, improving supervision, and
508.16enhancing community-based mental health
508.17treatment, state-operated services may
508.18establish additional community capacity
508.19for providing treatment and supervision
508.20of clients who have been ordered into
508.21less restrictive alternative care from the
508.22state-operated services transitional services
508.23program consistent with Minnesota Statutes,
508.24section 246.014.

508.25

Sec. 4. COMMISSIONER OF HEALTH

508.26

Subdivision 1.Total Appropriation

$

161,774,000

$

155,440,000

508.27	Appropriations by Fund
508.28		2008	2009
508.29	General	85,932,000	80,773,000
508.30 508.31	State Government Special Revenue	43,796,000	42,799,000
508.32	Health Care Access	20,628,000	20,135,000
508.33	Federal TANF	11,418,000	11,733,000

508.34Pay for Performance. (a) For the biennium
508.35beginning July 1, 2009, of the general fund
509.1appropriation, $91,000 each year shall
509.2be made available to the commissioner
509.3of health on January 1, 2011, only after
509.4notification by the commissioner of health to
509.5the commissioner of finance and to the chairs
509.6of the relevant house of representatives and
509.7senate finance and policy committees that the
509.8state has met by that date the health disparity
509.9elimination goals established in Minnesota
509.10Statutes, section 145.928, subdivision 1.
509.11(b) Regardless of whether these
509.12appropriations are made available to
509.13the commissioner of health, they shall be
509.14part of base level funding for the biennium
509.15beginning July 1, 2011.
509.16(c) Notwithstanding any contrary provision
509.17of this article, this rider shall not expire.
509.18Transfer from the State Government
509.19Special Revenue Fund. During the
509.20fiscal year beginning July 1, 2007, the
509.21commissioner of finance shall transfer
509.22$7,200,000 from the state government
509.23special revenue fund to the general fund.

509.24 509.25

Subd. 2.Community and Family Health Promotion

509.26	Appropriations by Fund
509.27	General	44,672,000	44,436,000
509.28 509.29	State Government Special Revenue	870,000	875,000
509.30	Health Care Access	3,550,000	3,586,000
509.31	Federal TANF	8,735,000	8,735,000

509.32TANF Appropriations. (a) $3,579,000 of
509.33the TANF funds is appropriated in each year
509.34of the biennium to the commissioner for
509.35home visiting and nutritional services listed
509.36under Minnesota Statutes, section 145.882,
510.1subdivision 7, clauses (6) and (7). Funding
510.2shall be distributed to community health
510.3boards based on Minnesota Statutes, section
510.4145A.131, subdivision 1.
510.5(b) $4,000,000 in the first year and $4,000,000
510.6in the second year are appropriated to the
510.7commissioner of health for the family
510.8home visiting grant program according to
510.9Minnesota Statutes, section 145A.17. The
510.10commissioner may use five percent of the
510.11funds appropriated in each fiscal year to
510.12conduct the ongoing evaluations required
510.13under Minnesota Statutes, section 145A.17,
510.14subdivision 7, and may use ten percent of
510.15the funds appropriated each fiscal year to
510.16provide training and technical assistance as
510.17required under Minnesota Statutes, section
510.18145A.17, subdivisions 4 and 5.
510.19TANF Carryforward. Any unexpended
510.20balance of the TANF appropriation in the
510.21first year of the biennium does not cancel but
510.22is available for the second year.
510.23Loan Forgiveness. $400,000 in fiscal
510.24year 2010 and $400,000 in fiscal year
510.252011 from the state government special
510.26revenue fund are to the commissioner
510.27for the loan forgiveness program under
510.28Minnesota Statutes, section 144.1501. This
510.29appropriation shall not become part of base
510.30level funding for the biennium beginning
510.31July 1, 2011. Notwithstanding any contrary
510.32provision in this article, this rider expires
510.33December 31, 2011.
510.34MN ENABL. Base level funding for the MN
510.35ENABL program, under Minnesota Statutes,
511.1section 145.9255, is reduced by $220,000
511.2each year of the biennium beginning July 1,
511.32007.
511.4Fetal Alcohol Spectrum Disorder.
511.5$500,000 each year is added to the base for
511.6fetal alcohol spectrum disorder.
511.7(1) On July 1 of each fiscal year, the
511.8portion of the general fund appropriation
511.9to the commissioner of health for fetal
511.10alcohol spectrum disorder administration
511.11and grants shall be transferred to a
511.12statewide organization that focuses solely
511.13on prevention of and intervention with fetal
511.14alcohol spectrum disorder as follows:
511.15(i) on July 1, 2007, $2,090,000; and
511.16(ii) on July 1, 2008, $2,090,000.
511.17(2) The money shall be used for prevention
511.18and intervention services and programs,
511.19including, but not limited to, community
511.20grants, professional education, public
511.21awareness, and diagnosis. The organization
511.22may retain $60,000 of the transferred money
511.23for administrative costs. The organization
511.24shall report to the commissioner annually
511.25by January 15 on the services and programs
511.26funded by the appropriation.
511.27(3) Notwithstanding any contrary provision
511.28in this article, this rider shall not expire.
511.29Deaf or Hearing Loss Support. $100,000
511.30for the first year and $100,000 for the second
511.31year is for the purpose of providing family
511.32support and assistance to families with
511.33children who are deaf or have a hearing
511.34loss. The family support provided must
512.1include direct parent-to-parent assistance and
512.2information on communication, educational,
512.3and medical options. The commissioner
512.4may contract with a nonprofit organization
512.5that has the ability to provide these services
512.6throughout the state.
512.7Heart Disease and Stroke Prevention. Of
512.8the general fund appropriation, $200,000 the
512.9first year is for the heart disease and stroke
512.10prevention unit to fund data collection and
512.11other activities to improve cardiovascular
512.12health and reduce the burden of heart disease
512.13and stroke in Minnesota. This is a onetime
512.14appropriation.
512.15Family Planning Grants. Of the TANF
512.16appropriation, $1,156,000 each year is for
512.17family planning grants under Minnesota
512.18Statutes, section 145.925.
512.19Suicide prevention programs. $355,000
512.20in fiscal year 2008 and $145,000 in fiscal
512.21year 2009 are to fund the suicide prevention
512.22program.
512.23Hearing Aid and Instrument Loan Bank.
512.24Of the general fund appropriation, $70,000
512.25each year is to the commissioner for the
512.26purpose of providing a grant to cover
512.27administrative costs for a statewide hearing
512.28aid and instrument loan bank to families with
512.29children newly diagnosed with hearing loss
512.30from birth to the age of ten.
512.31Medical Home Learning Collaborative.
512.32Of the general fund appropriation, $500,000
512.33in fiscal year 2008 and $500,000 in fiscal
512.34year 2009 are to expand the medical
512.35home learning collaborative initiative in
513.1collaboration with the commissioner of
513.2human services. Services provided under this
513.3funding must support a medical home model
513.4for children with special health care needs.
513.5The collaborative shall report back to the
513.6legislature on use of the funds by January 15,
513.72010. This appropriation shall not become
513.8part of the base funding for the 2010-2011
513.9biennium.
513.10Community Collaboratives. Of the general
513.11fund appropriation, $300,000 in fiscal
513.12year 2008 is to provide planning grants
513.13to community collaboratives to cover the
513.14uninsured. This is a onetime appropriation.
513.15Base Adjustment. General fund base is
513.16$43,936,000 in each of fiscal years 2010 and
513.172011. State government special revenue base
513.18is $1,275,000 in each fiscal years 2010 and
513.192011.

513.20

Subd. 3.Policy, Quality, and Compliance

513.21	Appropriations by Fund
513.22	General	12,402,000	11,950,000
513.23 513.24	State Government Special Revenue	13,451,000	13,597,000
513.25	Health Care Access	17,078,000	16,549,000

513.26Transformation Task Force. Of the general
513.27fund appropriation, $170,000 the first year
513.28is for the health care Transformation Task
513.29Force.
513.30Health Care Access Survey. Of the
513.31health care access fund appropriation,
513.32$600,000 in fiscal year 2008 is appropriated
513.33to the commissioner to conduct a health
513.34insurance survey of Minnesota households,
513.35in partnership with the State Health Access
514.1Data Assistance Center at the University
514.2of Minnesota. The commissioner shall
514.3contract with the State Health Access Data
514.4Assistance Center to conduct a survey that
514.5provides information on the characteristics
514.6of the uninsured in Minnesota and the
514.7reasons for changing patterns of insurance
514.8coverage and access to health care services.
514.9This appropriation shall become part of the
514.10agency's base budget for even-numbered
514.11fiscal years.
514.12MERC Federal Compliance. Of the general
514.13fund appropriation, $6,750,000 each year is
514.14to the commissioner to distribute to the Mayo
514.15Clinic for the purpose of providing transition
514.16funding while federal compliance changes
514.17are made to the medical education and
514.18research cost funding distribution formula in
514.19Minnesota Statutes, section 62J.692.
514.20The base level funding for 2010 and 2011 is
514.21$2,500,000 each year.
514.22Notwithstanding any contrary provision of
514.23this article, this rider expires June 30, 2012.
514.24Health Information Technology. Of
514.25the health care access fund appropriation,
514.26$6,750,000 each fiscal year is to implement
514.27Minnesota Statutes, section 144.3345. Up
514.28to $350,000 each fiscal year is available for
514.29grant administration and health information
514.30technology technical assistance and
514.31$6,400,000 each year is to establish a
514.32revolving loan account under Minnesota
514.33Statutes, section 62J.496. This appropriation
514.34shall not be included in the agency's base
515.1budget for the fiscal year beginning July 1,
515.22009.
515.3Uniform Electronic Transactions. Of the
515.4general fund appropriation, $146,000 in fiscal
515.5year 2008 is for development of uniform
515.6electronic transactions and implementation
515.7guide standards under Minnesota Statutes,
515.8section 62J.536.
515.9Federally Qualified Health Centers. Of the
515.10general fund appropriation, $1,500,000 in
515.11each fiscal year is for subsidies to federally
515.12qualified health centers under Minnesota
515.13Statutes, section 145.9269.
515.14Base Adjustment. The general fund base
515.15is $7,846,000 in each of fiscal years 2010
515.16and 2011. The health care access fund
515.17base is $3,503,000 in fiscal year 2010 and
515.18$2,903,000 in fiscal year 2011.

515.19

Subd. 4.Health Protection

515.20	Appropriations by Fund
515.21	General	15,314,000	10,851,000
515.22 515.23	State Government Special Revenue	27,475,000	28,327,000

515.24Pandemic Influenza Preparedness. Of the
515.25general fund appropriation $115,000 in fiscal
515.26year 2008 is for department activities of
515.27epidemiology, laboratory services, exercises,
515.28and planning. This appropriation shall not
515.29become part of base level funding for the
515.30biennium beginning July 1, 2009.
515.31Pandemic Influenza Preparedness.
515.32$3,970,000 is to prepare for and respond
515.33to a pandemic influenza outbreak. Of this
515.34appropriation, $1,985,000 is to purchase
515.35antiviral medications and $1,985,000 is to
516.1prepare and manage a stockpile of health
516.2care supplies.
516.3AIDS Prevention Initiative Focusing on
516.4Foreign-born Residents. $250,000 in 2008
516.5is for an AIDS prevention initiative focusing
516.6on foreign-born residents. This appropriation
516.7is a onetime appropriation and shall not
516.8become part of the base level funding for the
516.92010-2011 biennium.
516.10The commissioner of health shall award
516.11grants in accordance with Minnesota Statutes,
516.12section 145.924, paragraph (b), for a public
516.13education and awareness campaign targeting
516.14communities of foreign-born Minnesota
516.15residents. The grants shall be designed to
516.16promote knowledge and understanding about
516.17HIV and to increase knowledge in order
516.18to eliminate and reduce the risk for HIV
516.19infection; to encourage screening and testing
516.20for HIV; and to link individuals to public
516.21health and health care resources. The grants
516.22must be awarded to collaborative efforts that
516.23bring together nonprofit community-based
516.24groups with demonstrated experience in
516.25addressing the public health, health care,
516.26and social service needs of foreign-born
516.27communities.
516.28Lead Abatement. $550,000 in each fiscal
516.29year is for the lead abatement program in
516.30Minnesota Statutes, section 144.9512.
516.31Water Treatment. $40,000 in fiscal year
516.322008 is to augment any appropriation from the
516.33remediation fund to conduct an evaluation of
516.34point of use water treatment units at removing
516.35perfluorooctanoic acid, perfluorooctane
517.1sulfonate, and perfluorobutanoic acid from
517.2known concentrations of these compounds
517.3in drinking water. The evaluation shall be
517.4completed by December 31, 2007, and the
517.5commissioner may contract for services to
517.6complete the evaluation. This is a onetime
517.7appropriation.
517.8HIV Information. $80,000 each year
517.9is to fund a community-based nonprofit
517.10organization with demonstrated capacity to
517.11operate a statewide HIV information and
517.12referral service using telephone, Internet,
517.13and other appropriate technologies. This
517.14appropriation shall become part of base level
517.15funding for the biennium beginning July 1,
517.162009.
517.17Base Adjustment. The general fund base is
517.18$10,751,000 in each of the fiscal years 2010
517.19and 2011.

517.20

Subd. 5.Minority and Multicultural Health

517.21	Appropriations by Fund
517.22	General	5,047,000	5,012,000
517.23	Federal TANF	2,683,000	2,998,000

517.24TANF Appropriations. (a) $2,000,000
517.25of the TANF funds is appropriated in each
517.26year of the biennium to the commissioner
517.27for decreasing racial and ethnic disparities
517.28in infant mortality rates under Minnesota
517.29Statutes, section 145.928, subdivision 7.
517.30(b) $503,000 the first year and $818,000
517.31the second year of the TANF funds are
517.32appropriated to the commissioner for the
517.33family home visiting and grant program
517.34under Minnesota Statutes, section 145A.17.
517.35Funding shall be distributed to tribal
518.1governments based on Minnesota Statutes,
518.2section 145A.14, subdivision 2a, paragraph
518.3(b). The commissioner may use five percent
518.4of the funds appropriated in each fiscal year
518.5to conduct the ongoing evaluations required
518.6under Minnesota Statutes, section 145A.17,
518.7subdivision 7, and may use ten percent of
518.8the funds appropriated each fiscal year to
518.9provide training and technical assistance as
518.10required under Minnesota Statutes, section
518.11145A.17, subdivisions 4 and 5.
518.12TANF Carryforward. Any unexpended
518.13balance of the TANF appropriation in the
518.14first year of the biennium does not cancel but
518.15is available for the second year.

518.16

Subd. 6.Administrative Support Services

518.17	Appropriations by Fund
518.18	General	8,497,000	8,524,000
518.19 518.20	State Government Special Revenue	2,000,000	-0-

518.21Disease Surveillance. Of the state
518.22government special revenue fund
518.23appropriation, $2,000,000 the first year is for
518.24redesigning and implementing coordinated
518.25and modern disease surveillance systems
518.26for the department, and for modifying the
518.27Minnesota Cancer Surveillance database and
518.28communicating with providers to include
518.29occupational and residential histories. This
518.30is a onetime appropriation.

518.31 518.32

Sec. 5. VETERANS NURSING HOMES BOARD

$

43,434,000

$

45,456,000

518.33Veterans Homes Special Revenue Account.
518.34The general fund appropriations made to
518.35the board may be transferred to a veterans
519.1homes special revenue account in the
519.2special revenue fund in the same manner
519.3as other receipts are deposited according to
519.4Minnesota Statutes, section 198.34, and are
519.5appropriated to the board for the operation of
519.6board facilities and programs.
519.7Repair and Betterment. Of this
519.8appropriation, $3,500,000 in fiscal year 2008
519.9and $3,500,000 in fiscal year 2009 are to be
519.10used for repair, maintenance, rehabilitation,
519.11and betterment activities at facilities
519.12statewide. This is a onetime appropriation.
519.13Base Adjustment. The general fund base is
519.14$41,956,000 in each year of the fiscal 2010
519.15and 2011 biennium.
519.16Pay for Performance. (a) For fiscal year
519.172008, $50,000 shall be made available to
519.18the board on January 1, 2009, only after
519.19notification by the board to the commissioner
519.20of finance and to the chairs of the relevant
519.21house of representatives and senate finance
519.22and policy committees that during the period
519.23October 1, 2007, to September 30, 2008, the
519.24Department of Health has not issued any
519.25penalty assessments under the provisions
519.26of Minnesota Statutes, section 144.653 or
519.27144A.10, or any correction orders under the
519.28provisions of Minnesota Statutes, section
519.29144.653 or 144A.10, that the Department
519.30of Health deems equivalent to findings of
519.31either immediate jeopardy or substandard
519.32quality of care, as defined in Code of Federal
519.33Regulations, title 42, section 488.301.
519.34(b) Regardless of whether this appropriation
519.35is made available to the board, it shall be
520.1part of base level funding for the biennium
520.2beginning July 1, 2009.

520.3

Sec. 6. HEALTH-RELATED BOARDS

520.4 520.5

Subdivision 1.Total Appropriation; State Government Special Revenue Fund

$

14,654,000

$

14,527,000

520.6The amounts that may be spent for each
520.7purpose are specified in the following
520.8subdivisions.

520.9

Subd. 2.Board of Chiropractic Examiners

450,000

447,000

520.10

Subd. 3.Board of Dentistry

987,000

1,009,000

520.11 520.12

Subd. 4.Board of Dietetic and Nutrition Practice

103,000

119,000

520.13Base Adjustment. Of this appropriation in
520.14fiscal year 2009, $14,000 is onetime.

520.15 520.16

Subd. 5.Board of Marriage and Family Therapy

134,000

154,000

520.17Base Adjustment. Of this appropriation in
520.18fiscal year 2009, $17,000 is onetime.

520.19

Subd. 6.Board of Medical Practice

4,120,000

3,674,000

520.20

Subd. 7.Board of Nursing

3,985,000

4,146,000

520.21 520.22

Subd. 8.Board of Nursing Home Administrators

633,000

647,000

520.23Administrative Services Unit. Of this
520.24appropriation, $430,000 in fiscal year
520.252008 and $439,000 in fiscal year 2009 are
520.26for the administrative services unit. The
520.27administrative services unit may receive
520.28and expend reimbursements for services
520.29performed by other agencies.

520.30

Subd. 9.Board of Optometry

98,000

114,000

520.31Base Adjustment. Of this appropriation in
520.32fiscal year 2009, $13,000 is onetime.

520.33

Subd. 10.Board of Pharmacy

1,375,000

1,442,000

521.1Base Adjustment. Of this appropriation in
521.2fiscal year 2009, $29,000 is onetime.

521.3

Subd. 11.Board of Physical Therapy

306,000

295,000

521.4

Subd. 12.Board of Podiatry

54,000

63,000

521.5Base Adjustment. Of this appropriation in
521.6fiscal year 2009, $7,000 is onetime.

521.7

Subd. 13.Board of Psychology

788,000

806,000

521.8

Subd. 14.Board of Social Work

997,000

1,022,000

521.9

Subd. 15.Board of Veterinary Medicine

230,000

195,000

521.10 521.11

Subd. 16.Board of Behavioral Health and Therapy

394,000

394,000

521.12 521.13

Sec. 7. EMERGENCY MEDICAL SERVICES BOARD

$

4,421,000

$

4,467,000

521.14	Appropriations by Fund
521.15		2008	2009
521.16	General	3,734,000	3,763,000
521.17 521.18	State Government Special Revenue	687,000	704,000

521.19Regional Grants. Of the general fund
521.20appropriation, $400,000 in fiscal year 2008
521.21and $400,000 in fiscal year 2009 are to
521.22the board for regional emergency medical
521.23services programs, to be distributed equally
521.24to the eight emergency medical service
521.25regions. This amount shall not become part
521.26of base level funding. Notwithstanding
521.27Minnesota Statutes, section 144E.50, 100
521.28percent of the appropriation shall be passed
521.29on to the emergency medical service regions.
521.30Longevity Award and Incentive Program.
521.31(a) Of the general fund appropriation,
521.32$700,000 in fiscal year 2008 and $700,000
521.33in fiscal year 2009 are to the board for the
521.34ambulance service personnel longevity award
522.1and incentive program, under Minnesota
522.2Statutes, section 144E.40.
522.3(b) In fiscal year 2008, $800,000 shall be
522.4transferred from the ambulance service
522.5personnel longevity award and incentive
522.6trust to the general fund.
522.7Health Professional Services Program.
522.8$687,000 in fiscal year 2008 and $704,000 in
522.9fiscal year 2009 from the state government
522.10special revenue fund are for the health
522.11professional services program.
522.12Base Adjustment. The general fund base is
522.13$3,363,000 in each year of the fiscal 2010
522.14and 2011 biennium.

522.15

Sec. 8. COUNCIL ON DISABILITY

$

812,000

$

524,000

522.16Assistive Technology. Of the general
522.17fund appropriation to the Council on
522.18Disability in fiscal year 2008, $100,000
522.19is to provide financial support to the
522.20Minnesota Regional Assistive Technology
522.21Collaborative, and $200,000 is for a transfer
522.22to the commissioner of administration
522.23for the purposes of completing the state's
522.24remaining share of the local match required
522.25to access the federal Technology Related
522.26Assistance Act for Persons with Disabilities,
522.27Title III, Alternative Financing Project 2003
522.28grant award, which provides microloans
522.29to individuals for the purpose of acquiring
522.30assistive technology devices and services.

522.31 522.32 522.33

Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,584,000

$

1,655,000

522.34

Sec. 10. OMBUDSMAN FOR FAMILIES

$

255,000

$

265,000

523.1    Sec. 11. Minnesota Statutes 2006, section 16A.724, is amended by adding a
523.2subdivision to read:
523.3    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
523.4participation pertaining to administrative costs of the Minnesota health care reform waiver
523.5shall be deposited as nondedicated revenue in the health care access fund. Receipts
523.6received as a result of federal participation pertaining to grants shall be deposited in the
523.7federal fund and shall offset health care access funds for payments to providers.

523.8    Sec. 12. Minnesota Statutes 2006, section 16A.724, is amended by adding a
523.9subdivision to read:
523.10    Subd. 4. MinnesotaCare funding. The commissioner of human services may
523.11expend money appropriated from the health care access fund for MinnesotaCare in either
523.12year of the biennium.

523.13    Sec. 13. Minnesota Statutes 2006, section 69.021, subdivision 11, is amended to read:
523.14    Subd. 11. Excess police state-aid holding account. (a) The excess police state-aid
523.15holding account is established in the general fund. The excess police state-aid holding
523.16account must be administered by the commissioner.
523.17    (b) Excess police state aid determined according to subdivision 10, must be
523.18deposited in the excess police state-aid holding account.
523.19    (c) From the balance in the excess police state-aid holding account, $900,000
523.20is appropriated to and must be transferred canceled annually to the ambulance service
523.21personnel longevity award and incentive suspense account established by section 144E.42,
523.22subdivision 2 to the general fund.
523.23    (d) If a police officer stress reduction program is created by law and money is
523.24appropriated for that program, an amount equal to that appropriation must be transferred
523.25to the administrator of that program from the balance in the excess police state-aid holding
523.26account.
523.27    (e) On October 1 of each year, one-half of the balance of the excess police
523.28state-aid holding account remaining after the deductions under paragraphs (c) and (d) is
523.29appropriated for additional amortization aid under section 423A.02, subdivision 1b.
523.30    (f) Annually, the remaining balance in the excess police state-aid holding account,
523.31after the deductions under paragraphs (c), (d), and (e), cancels to the general fund.

523.32    Sec. 14. Minnesota Statutes 2006, section 245.771, is amended by adding a subdivision
523.33to read:
524.1    Subd. 4. Food stamp bonus awards. In the event that Minnesota qualifies for
524.2the United States Department of Agriculture Food and Nutrition Services Food Stamp
524.3Program performance bonus awards, the funding is appropriated to the commissioner. The
524.4commissioner shall retain 25 percent of the funding and distribute the other 75 percent
524.5among the counties according to a formula that takes into account each county's impact
524.6on state performance in the applicable bonus categories.

524.7    Sec. 15. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
524.8to read:
524.9    Subd. 23. Nonstate funding for program costs. Notwithstanding sections 16A.013
524.10to 16A.016, the commissioner may accept, on behalf of the state, additional funding
524.11from sources other than state funds for the purpose of financing the cost of assistance
524.12program grants or nongrant administration. All additional funding is appropriated to the
524.13commissioner for use as designated by the grantor of funding.

524.14    Sec. 16. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
524.15to read:
524.16    Subd. 24. Systems continuity. In the event of disruption of technical systems or
524.17computer operations, the commissioner may use available grant appropriations to ensure
524.18continuity of payments for maintaining the health, safety, and well-being of clients served
524.19by programs administered by the Department of Human Services. Grant funds must be
524.20used in a manner consistent with the original intent of the appropriation.

524.21    Sec. 17. Minnesota Statutes 2006, section 256J.02, is amended by adding a subdivision
524.22to read:
524.23    Subd. 6. TANF funds appropriated to other entities. Any expenditures from
524.24the TANF block grant shall be expended in accordance with the requirements and
524.25limitations of part A of Title IV of the Social Security Act, as amended, and any other
524.26applicable federal requirement or limitation. Prior to any expenditure of these funds, the
524.27commissioner shall ensure that funds are expended in compliance with the requirements
524.28and limitations of federal law and that any reporting requirements of federal law are
524.29met. It shall be the responsibility of any entity to which these funds are appropriated to
524.30implement a memorandum of understanding with the commissioner that provides the
524.31necessary assurance of compliance prior to any expenditure of funds. The commissioner
524.32shall receipt TANF funds appropriated to other state agencies and coordinate all related
524.33interagency accounting transactions necessary to implement these appropriations.
525.1Unexpended TANF funds appropriated to any state, local, or nonprofit entity cancel at the
525.2end of the state fiscal year unless appropriating or statutory language permits otherwise.

525.3    Sec. 18. Minnesota Statutes 2006, section 256J.77, is amended to read:
525.4256J.77 AGING OF CASH BENEFITS.
525.5    Cash benefits under chapters 256D, 256J, and 256K, except food stamp benefits
525.6under chapter 256D, by warrants or electronic benefit transfer that have not been accessed
525.7within 90 days of issuance shall be canceled. Cash benefits may be replaced after they are
525.8canceled, for up to one year after the date of issuance, if failure to do so would place the
525.9client or family at risk. For purposes of this section, "accessed" means cashing a warrant
525.10or making at least one withdrawal from benefits deposited in an electronic benefit account.

525.11    Sec. 19. Minnesota Statutes 2006, section 518A.56, is amended by adding a
525.12subdivision to read:
525.13    Subd. 13. Child support payment center. Payments to the commissioner from
525.14other governmental units, private enterprises, and individuals for services performed by
525.15the child support payment center must be deposited in the state systems account authorized
525.16under section 256.014. These payments are appropriated to the commissioner for the
525.17operation of the child support payment center or system, according to section 256.014.

525.18    Sec. 20. NONGRANT OPERATING CARRYFORWARD.
525.19    For the biennium ending June 30, 2007, any remaining nongrant operating balances
525.20in the Department of Human Services, Minnesota Department of Health, veterans homes,
525.21health-related boards, emergency medical services boards, Council on Disability, the
525.22ombudsman for mental health and developmental disabilities, and the ombudsman
525.23for families direct appropriated accounts may be transferred, with the approval of the
525.24commissioner of finance, to a special revenue account. Funds in those accounts are
525.25appropriated for costs associated with onetime technology, infrastructure, and systems
525.26development projects. Remaining nongrant operating balances in fiscal year 2007 in
525.27the Minnesota sex offender program and the Minnesota security hospital shall not be
525.28transferred.
525.29    (a) Transfers to a special revenue account shall be reported to the chairs and the
525.30ranking members of the senate Health and Human Services Budget Division and the house
525.31of representatives Health Care and Human Services Finance Division.
526.1    (b) When these balances originate in nongeneral funds, the transfers shall be made
526.2to separate accounts within the same funds and may only be used to support projects
526.3relevant to the original funding source.
526.4    (c) Uses of these special revenue account funds shall be reported annually by each
526.5agency to the commissioner of finance, and to the chairs and ranking members of the
526.6senate Health and Human Services Budget Division and the house of representatives
526.7Health Care and Human Services Finance Division.
526.8EFFECTIVE DATE.This section is effective the day following final enactment.

526.9    Sec. 21. TRANSFERS.
526.10    Subdivision 1. Grants. The commissioner of human services, with the approval
526.11of the commissioner of finance and after notifying the chairs of the senate and house
526.12committees with jurisdiction, may transfer unencumbered appropriation balances for the
526.13biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance;
526.14general assistance medical care; medical assistance; MFIP child care assistance under
526.15Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential
526.16housing programs; and the entitlement portion of the chemical dependency consolidated
526.17treatment fund and between fiscal years of the biennium.
526.18    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
526.19money may be transferred within the Departments of Human Services and Health and
526.20within the programs operated by the Veterans Nursing Homes Board as the commissioners
526.21and the board consider necessary, with the advance approval of the commissioner of
526.22finance. The commissioner or the board shall inform the chairs of the house and senate
526.23committees with jurisdiction quarterly about transfers made under this provision.

526.24    Sec. 22. INDIRECT COSTS NOT TO FUND PROGRAMS.
526.25    The commissioners of health and of human services shall not use indirect cost
526.26allocations to pay for the operational costs of any program for which they are responsible.

526.27    Sec. 23. SUNSET OF UNCODIFIED LANGUAGE.
526.28    All uncodified language contained in this article expires on June 30, 2009, unless a
526.29different expiration date is explicit.

526.30    Sec. 24. EFFECTIVE DATE.
526.31    The provisions in this article are effective July 1, 2007, unless a different effective
526.32date is specified.