HF 1220

as introduced - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to long-term care; expanding the availability 
  1.3             of information for consumers; expanding the capacity 
  1.4             of the community-based system; establishing a process 
  1.5             for voluntary nursing facility closure; expanding 
  1.6             respite care options; providing a wage increase for 
  1.7             employees; modifying workforce provisions; proposing a 
  1.8             health insurance subsidy; regulating nursing pools; 
  1.9             appropriating money; amending Minnesota Statutes 2000, 
  1.10            sections 116L.11, subdivision 4; 116L.12, subdivisions 
  1.11            4 and 5; 116L.13, subdivision 1; 144.057; 144.1464; 
  1.12            144.1496, subdivision 3; 245A.04, subdivisions 3, 3a, 
  1.13            3b, and 3d; 256.975, by adding subdivisions; 
  1.14            256B.0911, subdivisions 1, 3, 5, 6, 7, and by adding 
  1.15            subdivisions; 256B.0913, subdivision 14; 256B.0915, 
  1.16            subdivision 3; 256B.431, by adding a subdivision; 
  1.17            256B.434, subdivision 4; and 256B.5012, by adding a 
  1.18            subdivision; proposing coding for new law in Minnesota 
  1.19            Statutes, chapters 116L; 144; 144A; and 256B; 
  1.20            repealing Minnesota Statutes 2000, sections 116L.10; 
  1.21            116L.12, subdivisions 2 and 7; 256B.0911, subdivisions 
  1.22            2, 2a, 4, 8, and 9; 256B.0913, subdivisions 15a, 15b, 
  1.23            and 15c; and 256B.0915, subdivisions 3a, 3b, and 3c. 
  1.24  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.25                             ARTICLE 1
  1.26                CONSUMER INFORMATION AND ASSISTANCE
  1.27                      AND COMMUNITY-BASED CARE
  1.28     Section 1.  Minnesota Statutes 2000, section 256.975, is 
  1.29  amended by adding a subdivision to read: 
  1.30     Subd. 7.  [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 
  1.31  LINKAGE.] (a) The Minnesota board on aging shall operate a 
  1.32  statewide information and assistance service to aid older 
  1.33  Minnesotans and their families in making informed choices about 
  1.34  long-term care options and health care benefits.  Language 
  2.1   services to persons with limited English language skills must be 
  2.2   made available.  The service, known as Senior LinkAGE Line, must 
  2.3   be available during business hours through a statewide toll-free 
  2.4   number and must also be available through the Internet. 
  2.5      (b) The service must assist older adults, caregivers, and 
  2.6   providers in accessing information about choices in long-term 
  2.7   care services that are purchased through private providers or 
  2.8   available through public options.  The service must: 
  2.9      (1) develop a comprehensive database that includes detailed 
  2.10  listings in both consumer- and provider-oriented formats; 
  2.11     (2) make the database accessible on the Internet and 
  2.12  through other telecommunication and media-related tools; 
  2.13     (3) link callers to interactive long-term care screening 
  2.14  tools and making these tools available through the Internet by 
  2.15  integrating the tools with the database; 
  2.16     (4) develop community education materials with a focus on 
  2.17  planning for long-term care and evaluating independent living, 
  2.18  housing, and service options; 
  2.19     (5) conduct an outreach campaign to assist older adults and 
  2.20  their caregivers in finding information on the Internet and 
  2.21  through other means of communication; 
  2.22     (6) implement a messaging system for overflow callers and 
  2.23  respond to these callers by the next business day; and 
  2.24     (7) link callers with county human services and other 
  2.25  providers to receive more in-depth assistance and consultation 
  2.26  related to long-term care options. 
  2.27     Sec. 2.  Minnesota Statutes 2000, section 256B.0911, 
  2.28  subdivision 1, is amended to read: 
  2.29     Subdivision 1.  [PURPOSE AND GOAL.] (a) The purpose of the 
  2.30  preadmission screening program long-term care consultation 
  2.31  services is to assist persons with long-term or chronic care 
  2.32  needs in making long-term care decisions and selecting options 
  2.33  that meet their needs and reflect their preferences.  The 
  2.34  availability of, and access to, information and other types of 
  2.35  assistance is also intended to prevent or delay certified 
  2.36  nursing facility placements by assessing applicants and 
  3.1   residents and offering cost-effective alternatives appropriate 
  3.2   for the person's needs and to provide transition assistance 
  3.3   after admission.  Further, the goal of the program these 
  3.4   services is to contain costs associated with unnecessary 
  3.5   certified nursing facility admissions.  The commissioners of 
  3.6   human services and health shall seek to maximize use of 
  3.7   available federal and state funds and establish the broadest 
  3.8   program possible within the funding available. 
  3.9      (b) These services must be coordinated with services 
  3.10  provided under sections 256.975, subdivision 7, and 256.9772, 
  3.11  and with services provided by other public and private agencies 
  3.12  in the community to offer a variety of cost-effective 
  3.13  alternatives to persons with disabilities and elderly persons.  
  3.14  The county agency providing long-term care consultation services 
  3.15  shall encourage the use of volunteers from families, religious 
  3.16  organizations, social clubs, and similar civic and service 
  3.17  organizations to provide community-based services. 
  3.18     Sec. 3.  Minnesota Statutes 2000, section 256B.0911, is 
  3.19  amended by adding a subdivision to read: 
  3.20     Subd. 1a.  [DEFINITIONS.] For purposes of this section, the 
  3.21  following definitions apply: 
  3.22     (a) "Long-term care consultation services" means: 
  3.23     (1) providing information and education to the general 
  3.24  public regarding availability of the services authorized under 
  3.25  this section; 
  3.26     (2) an intake process that provides access to the services 
  3.27  described in this section; 
  3.28     (3) assessment of the health, psychological, and social 
  3.29  needs of referred individuals; 
  3.30     (4) assistance in identifying services needed to maintain 
  3.31  an individual in the least restrictive environment; 
  3.32     (5) providing recommendations on cost-effective community 
  3.33  services that are available to the individual; 
  3.34     (6) development of an individual's community support plan; 
  3.35     (7) providing information regarding eligibility for 
  3.36  Minnesota health care programs; 
  4.1      (8) preadmission screening to determine the need for a 
  4.2   nursing facility level of care; 
  4.3      (9) preliminary determination of Minnesota health care 
  4.4   programs eligibility for individuals who need a nursing facility 
  4.5   level of care, with appropriate referrals for final 
  4.6   determination; 
  4.7      (10) providing recommendations for nursing facility 
  4.8   placement when there are no cost-effective community services 
  4.9   available; and 
  4.10     (11) assistance to transition people back to community 
  4.11  settings after facility admission. 
  4.12     (b) "Minnesota health care programs" means the medical 
  4.13  assistance program under chapter 256B, the alternative care 
  4.14  program under section 256B.0913, and the prescription drug 
  4.15  program under section 256.955. 
  4.16     Sec. 4.  Minnesota Statutes 2000, section 256B.0911, 
  4.17  subdivision 3, is amended to read: 
  4.18     Subd. 3.  [PERSONS RESPONSIBLE FOR CONDUCTING THE 
  4.19  PREADMISSION SCREENING LONG-TERM CARE CONSULTATION TEAM.] (a) A 
  4.20  local screening long-term care consultation team shall be 
  4.21  established by the county board of commissioners.  Each local 
  4.22  screening consultation team shall consist of screeners who are a 
  4.23  at least one social worker and a at least one public health 
  4.24  nurse from their respective county agencies.  The board may 
  4.25  designate public health or social services as the lead agency 
  4.26  for long-term care consultation services.  If a county does not 
  4.27  have a public health nurse available, it may request approval 
  4.28  from the commissioner to assign a county registered nurse with 
  4.29  at least one year experience in home care to participate on the 
  4.30  team.  The screening team members must confer regarding the most 
  4.31  appropriate care for each individual screened.  Two or more 
  4.32  counties may collaborate to establish a joint local screening 
  4.33  consultation team or teams. 
  4.34     (b) In assessing a person's needs, screeners shall have a 
  4.35  physician available for consultation and shall consider the 
  4.36  assessment of the individual's attending physician, if any.  The 
  5.1   individual's physician shall be included if the physician 
  5.2   chooses to participate.  Other personnel may be included on the 
  5.3   team as deemed appropriate by the county agencies.  The team is 
  5.4   responsible for providing long-term care consultation services 
  5.5   to all persons located in the county who request the services, 
  5.6   regardless of eligibility for Minnesota health care programs. 
  5.7      Sec. 5.  Minnesota Statutes 2000, section 256B.0911, is 
  5.8   amended by adding a subdivision to read: 
  5.9      Subd. 3a.  [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 
  5.10  requesting assessment, services planning, or other assistance 
  5.11  intended to support community-based living must be visited by a 
  5.12  long-term care consultation team within ten working days after 
  5.13  the date on which an assessment was requested or recommended.  
  5.14  Assessments must be conducted according to paragraphs (b) to (g).
  5.15     (b) The county may utilize a team of either the social 
  5.16  worker or public health nurse, or both, to conduct the 
  5.17  assessment in a face-to-face interview.  The screening 
  5.18  consultation team members must confer regarding the most 
  5.19  appropriate care for each individual screened or assessed. 
  5.20     (c) The long-term care consultation team must assess the 
  5.21  health and social needs of the person, using an assessment form 
  5.22  provided by the commissioner of human services. 
  5.23     (d) The team must conduct the assessment in a face-to-face 
  5.24  interview with the person being assessed and the person's legal 
  5.25  representative, if applicable. 
  5.26     (e) The team must provide the person, or the person's legal 
  5.27  representative, with written recommendations for facility- or 
  5.28  community-based services.  The team must document that the most 
  5.29  cost-effective alternatives available were offered to the 
  5.30  individual.  For purposes of this requirement, "cost-effective 
  5.31  alternatives" means community services and living arrangements 
  5.32  that cost the same as or less than nursing facility care. 
  5.33     (f) If the person chooses to use community-based services, 
  5.34  the team must provide the person or the person's legal 
  5.35  representative with a written community support plan, regardless 
  5.36  of whether the individual is eligible for Minnesota health care 
  6.1   programs.  The person may request assistance in developing a 
  6.2   community support plan without participating in a complete 
  6.3   assessment. 
  6.4      (g) The team must give the person receiving assessment or 
  6.5   support planning, or the person's legal representative, 
  6.6   materials supplied by the commissioner of human services 
  6.7   containing the following information: 
  6.8      (1) the purpose of preadmission screening and assessment; 
  6.9      (2) information about Minnesota health care programs; 
  6.10     (3) the person's freedom to accept or reject the 
  6.11  recommendations of the team; 
  6.12     (4) the person's right to confidentiality under the 
  6.13  Minnesota government data practices act, chapter 13; and 
  6.14     (5) the person's right to appeal the decision regarding the 
  6.15  need for nursing facility level of care or the county's final 
  6.16  decisions regarding public programs eligibility according to 
  6.17  section 256.045, subdivision 3. 
  6.18     Sec. 6.  Minnesota Statutes 2000, section 256B.0911, is 
  6.19  amended by adding a subdivision to read: 
  6.20     Subd. 3b.  [TRANSITION ASSISTANCE.] (a) A long-term care 
  6.21  consultation team shall provide assistance to persons residing 
  6.22  in a nursing facility, hospital, regional treatment center, or 
  6.23  intermediate care facility for persons with mental retardation 
  6.24  who request or are referred for such assistance.  Transition 
  6.25  assistance must include assessment, community support plan 
  6.26  development, referrals to Minnesota health care programs, and 
  6.27  referrals to programs that provide assistance with housing. 
  6.28     (b) The county shall develop transition processes with 
  6.29  institutional social workers and discharge planners to ensure 
  6.30  that: 
  6.31     (1) persons admitted to facilities receive information 
  6.32  about transition assistance that is available; 
  6.33     (2) the assessment is completed for persons within ten 
  6.34  working days of the date of referral; and 
  6.35     (3) there is a plan for transition and follow-up for the 
  6.36  individual's return to the community.  The plan must require 
  7.1   notification of other local agencies when a person who may 
  7.2   require assistance is screened by one county for admission to a 
  7.3   facility located in another county. 
  7.4      (c) If a person who is eligible for a Minnesota health care 
  7.5   program is admitted to a nursing facility and has been 
  7.6   determined to have discharge potential by a long-term care 
  7.7   consultation team, the nursing facility must include a 
  7.8   consultation team member or the case manager in the discharge 
  7.9   planning process. 
  7.10     Sec. 7.  Minnesota Statutes 2000, section 256B.0911, is 
  7.11  amended by adding a subdivision to read: 
  7.12     Subd. 4a.  [PREADMISSION SCREENING ACTIVITIES RELATED TO 
  7.13  NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 
  7.14  certified nursing facilities, including certified boarding care 
  7.15  facilities, must be screened prior to admission regardless of 
  7.16  income, assets, or funding sources for nursing facility care, 
  7.17  except as described in subdivision 4b.  The purpose of the 
  7.18  screening is to determine the need for nursing facility level of 
  7.19  care as described in paragraph (d) and to complete activities 
  7.20  required under federal law related to mental illness and mental 
  7.21  retardation as outlined in paragraph (b). 
  7.22     (b) A person who has a diagnosis or possible diagnosis of 
  7.23  mental illness, mental retardation, or a related condition must 
  7.24  receive a preadmission screening before admission regardless of 
  7.25  the exemptions outlined in subdivision 4b, paragraph (b), to 
  7.26  identify the need for further evaluation and specialized 
  7.27  services, unless the admission prior to screening is authorized 
  7.28  by the local mental health authority or the local developmental 
  7.29  disabilities case manager, or unless authorized by the county 
  7.30  agency according to Public Law Number 100-508.  
  7.31     The following criteria apply to the preadmission screening: 
  7.32     (1) the county must use forms and criteria developed by the 
  7.33  commissioner of human services to identify persons who require 
  7.34  referral for further evaluation and determination of the need 
  7.35  for specialized services; and 
  7.36     (2) the evaluation and determination of the need for 
  8.1   specialized services must be done by: 
  8.2      (i) a qualified independent mental health professional, for 
  8.3   persons with a primary or secondary diagnosis of a serious 
  8.4   mental illness; or 
  8.5      (ii) a qualified mental retardation professional, for 
  8.6   persons with a primary or secondary diagnosis of mental 
  8.7   retardation or related conditions.  For purposes of this 
  8.8   requirement, a qualified mental retardation professional must 
  8.9   meet the standards for a qualified mental retardation 
  8.10  professional under Code of Federal Regulations, title 42, 
  8.11  section 483.430. 
  8.12     (c) The local county mental health authority or the state 
  8.13  mental retardation authority under Public Laws Numbers 100-203 
  8.14  and 101-508 may prohibit admission to a nursing facility if the 
  8.15  individual does not meet the nursing facility level of care 
  8.16  criteria or needs specialized services as defined in Public Laws 
  8.17  Numbers 100-203 and 101-508.  For purposes of this section, 
  8.18  "specialized services" for a person with mental retardation or a 
  8.19  related condition means active treatment as that term is defined 
  8.20  under Code of Federal Regulations, title 42, section 483.440, 
  8.21  paragraph (a), clause (1). 
  8.22     (d) The determination of the need for nursing facility 
  8.23  level of care must be made according to criteria developed by 
  8.24  the commissioner of human services.  In assessing a person's 
  8.25  needs, consultation team members shall have a physician 
  8.26  available for consultation and shall consider the assessment of 
  8.27  the individual's attending physician, if any.  The individual's 
  8.28  physician must be included if the physician chooses to 
  8.29  participate.  Other personnel may be included on the team as 
  8.30  deemed appropriate by the county. 
  8.31     Sec. 8.  Minnesota Statutes 2000, section 256B.0911, is 
  8.32  amended by adding a subdivision to read: 
  8.33     Subd. 4b.  [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 
  8.34  Exemptions from the federal screening requirements outlined in 
  8.35  subdivision 4a, paragraphs (b) and (c), are limited to: 
  8.36     (1) a person who, having entered an acute care facility 
  9.1   from a certified nursing facility, is returning to a certified 
  9.2   nursing facility; and 
  9.3      (2) a person transferring from one certified nursing 
  9.4   facility in Minnesota to another certified nursing facility in 
  9.5   Minnesota. 
  9.6      (b) Persons who are exempt from preadmission screening for 
  9.7   purposes of level of care determination include: 
  9.8      (1) persons described in paragraph (a); 
  9.9      (2) an individual who has a contractual right to have 
  9.10  nursing facility care paid for indefinitely by the veterans' 
  9.11  administration; 
  9.12     (3) an individual enrolled in a demonstration project under 
  9.13  section 256B.69, subdivision 8, at the time of application to a 
  9.14  nursing facility; 
  9.15     (4) an individual currently being served under the 
  9.16  alternative care program or under a home and community-based 
  9.17  services waiver authorized under section 1915(c) of the federal 
  9.18  Social Security Act; and 
  9.19     (5) individuals admitted to a certified nursing facility 
  9.20  for a short-term stay, which is expected to be 14 days or less 
  9.21  in duration based upon a physician's certification, and who have 
  9.22  been assessed and approved for nursing facility admission within 
  9.23  the previous six months.  This exemption applies only if the 
  9.24  consultation team member determines at the time of the initial 
  9.25  assessment of the six-month period that it is appropriate to use 
  9.26  the nursing facility for short-term stays and that there is an 
  9.27  adequate plan of care for return to the home or community-based 
  9.28  setting.  If a stay exceeds 14 days, the individual must be 
  9.29  referred no later than the first county working day following 
  9.30  the 14th resident day for a screening, which must be completed 
  9.31  within five working days of the referral.  The payment 
  9.32  limitations in subdivision 7 apply to an individual found at 
  9.33  screening to not meet the level of care criteria for admission 
  9.34  to a certified nursing facility. 
  9.35     (c) Persons admitted to a Medicaid-certified nursing 
  9.36  facility from the community on an emergency basis as described 
 10.1   in paragraph (d) or from an acute care facility on a nonworking 
 10.2   day must be screened the first working day after admission. 
 10.3      (d) Emergency admission to a nursing facility prior to 
 10.4   screening is permitted when all of the following conditions are 
 10.5   met: 
 10.6      (1) a person is admitted from the community to a certified 
 10.7   nursing or certified boarding care facility during county 
 10.8   nonworking hours; 
 10.9      (2) a physician has determined that delaying admission 
 10.10  until preadmission screening is completed would adversely affect 
 10.11  the person's health and safety; 
 10.12     (3) there is a recent precipitating event that precludes 
 10.13  the client from living safely in the community, such as 
 10.14  sustaining an injury, sudden onset of acute illness, or a 
 10.15  caregiver's inability to continue to provide care; 
 10.16     (4) the attending physician has authorized the emergency 
 10.17  placement and has documented the reason that the emergency 
 10.18  placement is recommended; and 
 10.19     (5) the county is contacted on the first working day 
 10.20  following the emergency admission. 
 10.21  Transfer of a patient from an acute care hospital to a nursing 
 10.22  facility is not considered an emergency except for a person who 
 10.23  has received hospital services in the following situations: 
 10.24  hospital admission for observation, care in an emergency room 
 10.25  without hospital admission, or following hospital 24-hour bed 
 10.26  care. 
 10.27     Sec. 9.  Minnesota Statutes 2000, section 256B.0911, is 
 10.28  amended by adding a subdivision to read: 
 10.29     Subd. 4c.  [SCREENING REQUIREMENTS.] (a) A person may be 
 10.30  screened for nursing facility admission by telephone or in a 
 10.31  face-to-face screening interview.  Consultation team members 
 10.32  shall identify each individual's needs using the following 
 10.33  categories: 
 10.34     (1) the person needs no face-to-face screening interview to 
 10.35  determine the need for nursing facility level of care based on 
 10.36  information obtained from other health care professionals; 
 11.1      (2) the person needs an immediate face-to-face screening 
 11.2   interview to determine the need for nursing facility level of 
 11.3   care and complete activities required under subdivision 4a; or 
 11.4      (3) the person may be exempt from screening requirements as 
 11.5   outlined in subdivision 4b, but will need transitional 
 11.6   assistance after admission or in-person follow-along after a 
 11.7   return home. 
 11.8      (b) Persons admitted on a nonemergency basis to a 
 11.9   Medicaid-certified nursing facility must be screened prior to 
 11.10  admission. 
 11.11     (c) The long-term care consultation team shall recommend a 
 11.12  case mix classification for persons admitted to a certified 
 11.13  nursing facility when sufficient information is received to make 
 11.14  that classification.  The nursing facility is authorized to 
 11.15  conduct all case mix assessments for persons who have been 
 11.16  screened prior to admission for whom the county did not 
 11.17  recommend a case mix classification.  The nursing facility is 
 11.18  authorized to conduct all case mix assessments for persons 
 11.19  admitted to the facility prior to a preadmission screening.  The 
 11.20  county retains the responsibility of distributing appropriate 
 11.21  case mix forms to the nursing facility. 
 11.22     (d) The county screening or intake activity must include 
 11.23  processes to identify persons who may require transition 
 11.24  assistance as described in subdivision 3b. 
 11.25     Sec. 10.  Minnesota Statutes 2000, section 256B.0911, 
 11.26  subdivision 5, is amended to read: 
 11.27     Subd. 5.  [SIMPLIFICATION OF FORMS ADMINISTRATIVE 
 11.28  ACTIVITY.] The commissioner shall minimize the number of forms 
 11.29  required in the preadmission screening process provision of 
 11.30  long-term care consultation services and shall limit the 
 11.31  screening document to items necessary for care community support 
 11.32  plan approval, reimbursement, program planning, evaluation, and 
 11.33  policy development. 
 11.34     Sec. 11.  Minnesota Statutes 2000, section 256B.0911, 
 11.35  subdivision 6, is amended to read: 
 11.36     Subd. 6.  [PAYMENT FOR PREADMISSION SCREENING LONG-TERM 
 12.1   CARE CONSULTATION SERVICES.] (a) The total screening payment for 
 12.2   each county must be paid monthly by certified nursing facilities 
 12.3   in the county.  The monthly amount to be paid by each nursing 
 12.4   facility for each fiscal year must be determined by dividing the 
 12.5   county's annual allocation for screenings long-term care 
 12.6   consultation services by 12 to determine the monthly payment and 
 12.7   allocating the monthly payment to each nursing facility based on 
 12.8   the number of licensed beds in the nursing facility.  Payments 
 12.9   to counties in which there is no certified nursing facility must 
 12.10  be made by increasing the payment rate of the two facilities 
 12.11  located nearest to the county agency. 
 12.12     (b) The commissioner shall include the total annual payment 
 12.13  for screening determined under paragraph (a) for each nursing 
 12.14  facility according to section 256B.431, subdivision 2b, 
 12.15  paragraph (g), or 256B.435. 
 12.16     (c) Payments for screening activities long-term care 
 12.17  consultation services are available to the county or counties to 
 12.18  cover staff salaries and expenses to provide the screening 
 12.19  function services described in subdivision 1a.  The lead agency 
 12.20  shall employ, or contract with other agencies to employ, within 
 12.21  the limits of available funding, sufficient personnel to conduct 
 12.22  the preadmission screening activity provide long-term care 
 12.23  consultation services while meeting the state's long-term care 
 12.24  outcomes and objectives as defined in section 256B.0917, 
 12.25  subdivision 1.  The local agency county shall be accountable for 
 12.26  meeting local objectives as approved by the commissioner in the 
 12.27  CSSA biennial plan. 
 12.28     (d) Notwithstanding section 256B.0641, overpayments 
 12.29  attributable to payment of the screening costs under the medical 
 12.30  assistance program may not be recovered from a facility.  
 12.31     (e) The commissioner of human services shall amend the 
 12.32  Minnesota medical assistance plan to include reimbursement for 
 12.33  the local screening consultation teams. 
 12.34     (f) The county may bill, as case management services, 
 12.35  assessments, support planning, and follow-along provided to 
 12.36  persons determined to be eligible for case management under 
 13.1   Minnesota health care programs.  No individual or family member 
 13.2   shall be charged for an initial assessment or initial support 
 13.3   plan development provided under subdivision 3a or 3b. 
 13.4      Sec. 12.  Minnesota Statutes 2000, section 256B.0911, 
 13.5   subdivision 7, is amended to read: 
 13.6      Subd. 7.  [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 
 13.7   (a) Medical assistance reimbursement for nursing facilities 
 13.8   shall be authorized for a medical assistance recipient only if a 
 13.9   preadmission screening has been conducted prior to admission or 
 13.10  the local county agency has authorized an exemption.  Medical 
 13.11  assistance reimbursement for nursing facilities shall not be 
 13.12  provided for any recipient who the local screener has determined 
 13.13  does not meet the level of care criteria for nursing facility 
 13.14  placement or, if indicated, has not had a level II PASARR OBRA 
 13.15  evaluation as required under the federal Omnibus Reconciliation 
 13.16  Act of 1987 completed unless an admission for a recipient with 
 13.17  mental illness is approved by the local mental health authority 
 13.18  or an admission for a recipient with mental retardation or 
 13.19  related condition is approved by the state mental retardation 
 13.20  authority. 
 13.21     (b) The nursing facility must not bill a person who is not 
 13.22  a medical assistance recipient for resident days that preceded 
 13.23  the date of completion of screening activities as required under 
 13.24  subdivisions 4a, 4b, and 4c.  The nursing facility must include 
 13.25  unreimbursed resident days in the nursing facility resident day 
 13.26  totals reported to the commissioner. 
 13.27     (c) The commissioner shall make a request to the health 
 13.28  care financing administration for a waiver allowing screening 
 13.29  team approval of Medicaid payments for certified nursing 
 13.30  facility care.  An individual has a choice and makes the final 
 13.31  decision between nursing facility placement and community 
 13.32  placement after the screening team's recommendation, except as 
 13.33  provided in paragraphs (b) and (c) subdivision 4a, paragraph (d).
 13.34     (c) The local county mental health authority or the state 
 13.35  mental retardation authority under Public Law Numbers 100-203 
 13.36  and 101-508 may prohibit admission to a nursing facility, if the 
 14.1   individual does not meet the nursing facility level of care 
 14.2   criteria or needs specialized services as defined in Public Law 
 14.3   Numbers 100-203 and 101-508.  For purposes of this section, 
 14.4   "specialized services" for a person with mental retardation or a 
 14.5   related condition means "active treatment" as that term is 
 14.6   defined in Code of Federal Regulations, title 42, section 
 14.7   483.440(a)(1). 
 14.8      (e) Appeals from the screening team's recommendation or the 
 14.9   county agency's final decision shall be made according to 
 14.10  section 256.045, subdivision 3. 
 14.11     Sec. 13.  Minnesota Statutes 2000, section 256B.0913, 
 14.12  subdivision 14, is amended to read: 
 14.13     Subd. 14.  [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 
 14.14  Reimbursement for expenditures for the alternative care services 
 14.15  as approved by the client's case manager shall be through the 
 14.16  invoice processing procedures of the department's Medicaid 
 14.17  Management Information System (MMIS).  To receive reimbursement, 
 14.18  the county or vendor must submit invoices within 12 months 
 14.19  following the date of service.  The county agency and its 
 14.20  vendors under contract shall not be reimbursed for services 
 14.21  which exceed the county allocation. 
 14.22     (b) If a county collects less than 50 percent of the client 
 14.23  premiums due under subdivision 12, the commissioner may withhold 
 14.24  up to three percent of the county's final alternative care 
 14.25  program allocation determined under subdivisions 10 and 11. 
 14.26     (c) The county shall negotiate individual rates with 
 14.27  vendors and may be reimbursed for actual costs up to the greater 
 14.28  of the county's current approved rate or 60 percent of the 
 14.29  maximum rate in fiscal year 1994 and 65 percent of the maximum 
 14.30  rate in fiscal year 1995 for each alternative care service.  
 14.31  Notwithstanding any other rule or statutory provision to the 
 14.32  contrary, the commissioner shall not be authorized to increase 
 14.33  rates by an annual inflation factor, unless so authorized by the 
 14.34  legislature.  To improve access to community services and 
 14.35  eliminate payment disparities between the alternative care 
 14.36  program and the elderly waiver, the commissioner shall establish 
 15.1   statewide maximum service rate limits and eliminate 
 15.2   county-specific service rate limits.  Effective July 1, 2001, 
 15.3   for service rate limits, except those in subdivision 5, 
 15.4   paragraphs (d) and (j), the rate limit for each service is the 
 15.5   greater of the alternative care statewide maximum rate or the 
 15.6   elderly waiver statewide maximum rate.  Counties may negotiate 
 15.7   individual service rates with vendors for actual costs up to the 
 15.8   statewide maximum service rate limit. 
 15.9      (d) On July 1, 1993, the commissioner shall increase the 
 15.10  maximum rate for home delivered meals to $4.50 per meal. 
 15.11     Sec. 14.  Minnesota Statutes 2000, section 256B.0915, 
 15.12  subdivision 3, is amended to read: 
 15.13     Subd. 3.  [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 
 15.14  FORECASTING.] (a) The number of medical assistance waiver 
 15.15  recipients that a county may serve must be allocated according 
 15.16  to the number of medical assistance waiver cases open on July 1 
 15.17  of each fiscal year.  Additional recipients may be served with 
 15.18  the approval of the commissioner. 
 15.19     (b) The monthly limit for the cost of waivered services to 
 15.20  an individual waiver client shall be the statewide average 
 15.21  payment rate of the case mix resident class to which the waiver 
 15.22  client would be assigned under the medical assistance case mix 
 15.23  reimbursement system.  If medical supplies and equipment or 
 15.24  adaptations are or will be purchased for an elderly waiver 
 15.25  services recipient, the costs may be prorated on a monthly basis 
 15.26  throughout the year in which they are purchased.  If the monthly 
 15.27  cost of a recipient's other waivered services exceeds the 
 15.28  monthly limit established in this paragraph, the annual cost of 
 15.29  the waivered services shall be determined.  In this event, the 
 15.30  annual cost of waivered services shall not exceed 12 times the 
 15.31  monthly limit calculated in this paragraph.  The statewide 
 15.32  average payment rate is calculated by determining the statewide 
 15.33  average monthly nursing home rate, effective July 1 of the 
 15.34  fiscal year in which the cost is incurred, less the statewide 
 15.35  average monthly income of nursing home residents who are age 65 
 15.36  or older, and who are medical assistance recipients in the month 
 16.1   of March of the previous state fiscal year.  The annual cost 
 16.2   divided by 12 of elderly or disabled waivered services for a 
 16.3   person who is a nursing facility resident at the time of 
 16.4   requesting a determination of eligibility for elderly or 
 16.5   disabled waivered services shall be the greater of the monthly 
 16.6   payment for:  (i) the resident class assigned under Minnesota 
 16.7   Rules, parts 9549.0050 to 9549.0059, for that resident in the 
 16.8   nursing facility where the resident currently resides; or (ii) 
 16.9   the statewide average payment of the case mix resident class to 
 16.10  which the resident would be assigned under the medical 
 16.11  assistance case mix reimbursement system, provided that the 
 16.12  limit under this clause only applies to persons discharged from 
 16.13  a nursing facility and found eligible for waivered services on 
 16.14  or after July 1, 1997.  The following costs must be included in 
 16.15  determining the total monthly costs for the waiver client: 
 16.16     (1) cost of all waivered services, including extended 
 16.17  medical supplies and equipment; and 
 16.18     (2) cost of skilled nursing, home health aide, and personal 
 16.19  care services reimbursable by medical assistance.  
 16.20     (c) Medical assistance funding for skilled nursing 
 16.21  services, private duty nursing, home health aide, and personal 
 16.22  care services for waiver recipients must be approved by the case 
 16.23  manager and included in the individual care plan. 
 16.24     (d) For both the elderly waiver and the nursing facility 
 16.25  disabled waiver, a county may purchase extended supplies and 
 16.26  equipment without prior approval from the commissioner when 
 16.27  there is no other funding source and the supplies and equipment 
 16.28  are specified in the individual's care plan as medically 
 16.29  necessary to enable the individual to remain in the community 
 16.30  according to the criteria in Minnesota Rules, part 9505.0210, 
 16.31  items A and B.  A county is not required to contract with a 
 16.32  provider of supplies and equipment if the monthly cost of the 
 16.33  supplies and equipment is less than $250.  
 16.34     (e) The adult foster care daily rate for the elderly and 
 16.35  disabled waivers shall be negotiated between the county agency 
 16.36  and the foster care provider.  The rate established under this 
 17.1   section shall not exceed the state average monthly nursing home 
 17.2   payment for the case mix classification to which the individual 
 17.3   receiving foster care is assigned; the rate must allow for other 
 17.4   waiver and medical assistance home care services to be 
 17.5   authorized by the case manager. 
 17.6      (f) The assisted living and residential care service rates 
 17.7   for elderly and community alternatives for disabled individuals 
 17.8   (CADI) waivers shall be made to the vendor as a monthly rate 
 17.9   negotiated with the county agency based on an individualized 
 17.10  service plan for each resident.  The rate shall not exceed the 
 17.11  nonfederal share of the greater of either the statewide or any 
 17.12  of the geographic groups' weighted average monthly medical 
 17.13  assistance nursing facility payment rate of the case mix 
 17.14  resident class to which the elderly or disabled client would be 
 17.15  assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
 17.16  unless the services are provided by a home care provider 
 17.17  licensed by the department of health and are provided in a 
 17.18  building that is registered as a housing with services 
 17.19  establishment under chapter 144D and that provides 24-hour 
 17.20  supervision.  For alternative care assisted living projects 
 17.21  established under Laws 1988, chapter 689, article 2, section 
 17.22  256, monthly rates may not exceed 65 percent of the greater of 
 17.23  either the statewide or any of the geographic groups' weighted 
 17.24  average monthly medical assistance nursing facility payment rate 
 17.25  for the case mix resident class to which the elderly or disabled 
 17.26  client would be assigned under Minnesota Rules, parts 9549.0050 
 17.27  to 9549.0059.  The rate may not cover direct rent or food costs. 
 17.28     (g) The county shall negotiate individual rates with 
 17.29  vendors and may be reimbursed for actual costs up to the greater 
 17.30  of the county's current approved rate or 60 percent of the 
 17.31  maximum rate in fiscal year 1994 and 65 percent of the maximum 
 17.32  rate in fiscal year 1995 for each service within each program. 
 17.33  To improve access to community services and eliminate payment 
 17.34  disparities between the alternative care program and the elderly 
 17.35  waiver, the commissioner shall establish statewide maximum 
 17.36  service rate limits and eliminate county-specific service rate 
 18.1   limits.  Effective July 1, 2001, for service rate limits, except 
 18.2   those in paragraphs (e) and (f), the rate limit for each service 
 18.3   is the greater of the alternative care statewide maximum rate or 
 18.4   the elderly waiver statewide maximum rate.  Counties may 
 18.5   negotiate individual service rates with vendors for actual costs 
 18.6   up to the statewide maximum service rate limit. 
 18.7      (h) On July 1, 1993, the commissioner shall increase the 
 18.8   maximum rate for home-delivered meals to $4.50 per meal. 
 18.9      (i) Reimbursement for the medical assistance recipients 
 18.10  under the approved waiver shall be made from the medical 
 18.11  assistance account through the invoice processing procedures of 
 18.12  the department's Medicaid Management Information System (MMIS), 
 18.13  only with the approval of the client's case manager.  The budget 
 18.14  for the state share of the Medicaid expenditures shall be 
 18.15  forecasted with the medical assistance budget, and shall be 
 18.16  consistent with the approved waiver.  
 18.17     (j) Beginning July 1, 1991, the state shall reimburse 
 18.18  counties according to the payment schedule in section 256.025 
 18.19  for the county share of costs incurred under this subdivision on 
 18.20  or after January 1, 1991, for individuals who are receiving 
 18.21  medical assistance. 
 18.22     (k) For the community alternatives for disabled individuals 
 18.23  waiver, and nursing facility disabled waivers, county may use 
 18.24  waiver funds for the cost of minor adaptations to a client's 
 18.25  residence or vehicle without prior approval from the 
 18.26  commissioner if there is no other source of funding and the 
 18.27  adaptation: 
 18.28     (1) is necessary to avoid institutionalization; 
 18.29     (2) has no utility apart from the needs of the client; and 
 18.30     (3) meets the criteria in Minnesota Rules, part 9505.0210, 
 18.31  items A and B.  
 18.32  For purposes of this subdivision, "residence" means the client's 
 18.33  own home, the client's family residence, or a family foster 
 18.34  home.  For purposes of this subdivision, "vehicle" means the 
 18.35  client's vehicle, the client's family vehicle, or the client's 
 18.36  family foster home vehicle. 
 19.1      (l) The commissioner shall establish a maximum rate unit 
 19.2   for baths provided by an adult day care provider that are not 
 19.3   included in the provider's contractual daily or hourly rate. 
 19.4   This maximum rate must equal the home health aide extended rate 
 19.5   and shall be paid for baths provided to clients served under the 
 19.6   elderly and disabled waivers. 
 19.7      Sec. 15.  [INTEGRATED SERVICE ACCESS STUDY.] 
 19.8      By February 15, 2002, the commissioner of human services 
 19.9   shall submit to the legislature recommendations for creating 
 19.10  integrated service access at the county agency level for both 
 19.11  publicly subsidized and nonsubsidized long-term care services 
 19.12  and housing options.  The report must: 
 19.13     (1) include a plan to integrate public funding streams to 
 19.14  allow low-income, privately paying consumers to purchase 
 19.15  services through a sliding fee scale; and 
 19.16     (2) evaluate the feasibility of statewide implementation, 
 19.17  based upon an evaluation of public cost, consumer preferences 
 19.18  and satisfaction, and other relevant factors. 
 19.19     Sec. 16.  [RESPITE CARE.] 
 19.20     The Minnesota board on aging shall present recommendations 
 19.21  to the legislature by February 1, 2002, on the provision of 
 19.22  in-home and out-of-home respite care services on a sliding scale 
 19.23  basis under the federal Older Americans Act. 
 19.24     Sec. 17.  [APPROPRIATION.] 
 19.25     Subdivision 1.  [SENIOR LINKAGE.] $....... is appropriated 
 19.26  from the general fund to the commissioner of human services for 
 19.27  the biennium ending June 30, 2003, for the board on aging to 
 19.28  expand services provided through Senior LinkAGE. 
 19.29     Subd. 2.  [LONG-TERM CARE CONSULTATION SERVICES.] $....... 
 19.30  is appropriated from the general fund to the commissioner of 
 19.31  human services for the biennium ending June 30, 2003, to 
 19.32  increase county allocations for long-term care consultation 
 19.33  services. 
 19.34     Subd. 3.  [ALTERNATIVE CARE AND ELDERLY WAIVER 
 19.35  PROGRAMS.] $....... is appropriated from the general fund to the 
 19.36  commissioner of human services for the biennium ending June 30, 
 20.1   2003, to eliminate county-specific rates and serve additional 
 20.2   individuals under the alternative care and elderly waiver 
 20.3   programs.  
 20.4      Sec. 18.  [REPEALER.] 
 20.5      Minnesota Statutes 2000, sections 256B.0911, subdivisions 
 20.6   2, 2a, 4, 8, and 9; 256B.0913, subdivisions 15a, 15b, and 15c; 
 20.7   and 256B.0915, subdivisions 3a, 3b, and 3c, are repealed. 
 20.8                              ARTICLE 2
 20.9            LONG-TERM CARE SYSTEM REFORM AND REIMBURSEMENT
 20.10     Section 1.  Minnesota Statutes 2000, section 256B.431, is 
 20.11  amended by adding a subdivision to read: 
 20.12     Subd. 31.  [NURSING FACILITY RATE INCREASES BEGINNING JULY 
 20.13  1, 2001, AND JULY 1, 2002.] (a) For the rate years beginning 
 20.14  July 1, 2001, and July 1, 2002, the commissioner shall make 
 20.15  available to each nursing facility reimbursed under this section 
 20.16  or section 256B.434 an adjustment to the total operating payment 
 20.17  rates in effect on June 30, 2001, and June 30, 2002, 
 20.18  respectively.  The operating payment rate in effect on June 30, 
 20.19  2001, must include the adjustment in subdivision 2i, paragraph 
 20.20  (c).  The adjustment is comprised of a one-percent increase in 
 20.21  the total operating payment rate, to be used for operating 
 20.22  costs, and an adjustment determined under paragraph (b). 
 20.23     (b) The adjustment under this paragraph must be used to 
 20.24  increase the per-hour pay rate of all employees except 
 20.25  management fees, the administrator, and central office staff by 
 20.26  an equal dollar amount and to pay associated costs for FICA, the 
 20.27  Medicare tax, workers' compensation premiums, and federal and 
 20.28  state unemployment insurance.  The adjustment is calculated 
 20.29  according to clauses (1) to (3): 
 20.30     (1) the commissioner shall calculate the arithmetic mean of 
 20.31  all June 30, 2001, and June 30, 2002, operating rates for each 
 20.32  facility; 
 20.33     (2) the commissioner shall construct an array of nursing 
 20.34  facilities from highest to lowest according to the arithmetic 
 20.35  mean calculated in clause (1).  A numerical rank must be 
 20.36  assigned to each facility in the array.  The facility with the 
 21.1   highest mean must be assigned a numerical rank of one.  The 
 21.2   facility with the lowest mean must be assigned a numerical rank 
 21.3   equal to the total number of nursing facilities in the array.  
 21.4   All other facilities must be assigned a numerical rank in 
 21.5   accordance with their position in the array; and 
 21.6      (3) the amount of this rate increase is $1 plus an amount 
 21.7   equal to $3.72 multiplied by the ratio of the facility's numeric 
 21.8   rank divided by the number of facilities in the array. 
 21.9      Money received by a facility as a result of the additional 
 21.10  rate increase provided under this paragraph must be used only 
 21.11  for wage increases implemented on or after July 1, 2001, or July 
 21.12  1, 2002, respectively, and must not be used for wage increases 
 21.13  implemented prior to those dates. 
 21.14     (c) Nursing facilities may apply for the payment rate 
 21.15  adjustment calculated under paragraph (b).  The application must 
 21.16  be made to the commissioner and contain a computation of the 
 21.17  equal per-hour pay rate increase by which the nursing facility 
 21.18  will distribute the payment rate adjustment to employees of the 
 21.19  nursing facility.  For nursing facilities in which the employees 
 21.20  are represented by an exclusive bargaining representative, an 
 21.21  agreement negotiated and agreed to by the employer and the 
 21.22  exclusive bargaining representative constitutes the plan.  A 
 21.23  negotiated agreement may constitute the plan only if the 
 21.24  agreement is finalized after the date of enactment of all 
 21.25  increases for the rate year.  The commissioner shall review the 
 21.26  plan to ensure that the payment rate adjustment per diem is used 
 21.27  as provided in paragraph (b).  To be eligible, a facility must 
 21.28  submit its plan for the compensation distribution by December 31 
 21.29  each year.  If a facility's plan for compensation distribution 
 21.30  is effective for its employees after July 1 of the year that the 
 21.31  funds are available, the payment rate adjustment per diem is 
 21.32  effective the same date as its plan. 
 21.33     (d) A copy of the approved distribution plan must be made 
 21.34  available to all employees by giving each employee a copy or by 
 21.35  posting it in an area of the nursing facility to which all 
 21.36  employees have access.  If an employee does not receive the 
 22.1   compensation adjustment described in the facility's approved 
 22.2   plan and is unable to resolve the problem with the facility's 
 22.3   management or through the employee's union representative, the 
 22.4   employee may contact the commissioner at an address or telephone 
 22.5   number provided by the commissioner and included in the approved 
 22.6   plan.  
 22.7      Sec. 2.  Minnesota Statutes 2000, section 256B.434, 
 22.8   subdivision 4, is amended to read: 
 22.9      Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
 22.10  nursing facilities which have their payment rates determined 
 22.11  under this section rather than section 256B.431, the 
 22.12  commissioner shall establish a rate under this subdivision.  The 
 22.13  nursing facility must enter into a written contract with the 
 22.14  commissioner. 
 22.15     (b) A nursing facility's case mix payment rate for the 
 22.16  first rate year of a facility's contract under this section is 
 22.17  the payment rate the facility would have received under section 
 22.18  256B.431. 
 22.19     (c) A nursing facility's case mix payment rates for the 
 22.20  second and subsequent years of a facility's contract under this 
 22.21  section are the previous rate year's contract payment rates plus 
 22.22  an inflation adjustment.  The index for the inflation adjustment 
 22.23  must be based on the change in the Consumer Price Index-All 
 22.24  Items (United States City average) (CPI-U) forecasted by Data 
 22.25  Resources, Inc., as forecasted in the fourth quarter of the 
 22.26  calendar year preceding the rate year.  The inflation adjustment 
 22.27  must be based on the 12-month period from the midpoint of the 
 22.28  previous rate year to the midpoint of the rate year for which 
 22.29  the rate is being determined.  For the rate years beginning on 
 22.30  July 1, 1999, and July 1, 2000, July 1, 2001, and July 1, 2002, 
 22.31  this paragraph shall apply only to the property-related payment 
 22.32  rate.  In determining the amount of the property-related payment 
 22.33  rate adjustment under this paragraph, the commissioner shall 
 22.34  determine the proportion of the facility's rates that are 
 22.35  property-related based on the facility's most recent cost report.
 22.36     (d) The commissioner shall develop additional 
 23.1   incentive-based payments of up to five percent above the 
 23.2   standard contract rate for achieving outcomes specified in each 
 23.3   contract.  The specified facility-specific outcomes must be 
 23.4   measurable and approved by the commissioner.  The commissioner 
 23.5   may establish, for each contract, various levels of achievement 
 23.6   within an outcome.  After the outcomes have been specified the 
 23.7   commissioner shall assign various levels of payment associated 
 23.8   with achieving the outcome.  Any incentive-based payment cancels 
 23.9   if there is a termination of the contract.  In establishing the 
 23.10  specified outcomes and related criteria the commissioner shall 
 23.11  consider the following state policy objectives: 
 23.12     (1) improved cost effectiveness and quality of life as 
 23.13  measured by improved clinical outcomes; 
 23.14     (2) successful diversion or discharge to community 
 23.15  alternatives; 
 23.16     (3) decreased acute care costs; 
 23.17     (4) improved consumer satisfaction; 
 23.18     (5) the achievement of quality; or 
 23.19     (6) any additional outcomes proposed by a nursing facility 
 23.20  that the commissioner finds desirable. 
 23.21     Sec. 3.  [256B.437] [NURSING FACILITY VOLUNTARY CLOSURES 
 23.22  AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 
 23.23     Subdivision 1.  [DEFINITIONS.] (a) The definitions in this 
 23.24  subdivision apply to subdivisions 2 to 9. 
 23.25     (b) "Closure" means the cessation of operations of a 
 23.26  nursing facility and delicensure and decertification of all beds 
 23.27  within the facility. 
 23.28     (c) "Commencement of closure" means the date on which the 
 23.29  commissioner of health is notified of a planned closure in 
 23.30  accordance with section 144A.16 as part of an approved closure 
 23.31  plan. 
 23.32     (d) "Completion of closure" means the date on which the 
 23.33  final resident of the nursing facility or nursing facilities 
 23.34  designated for closure in an approved closure plan is discharged 
 23.35  from the facility or facilities. 
 23.36     (e) "Closure plan" means a plan to close one or more 
 24.1   nursing facilities and reallocate the resulting savings to 
 24.2   provide special rate adjustments at other facilities. 
 24.3      (f) "Partial closure" means the delicensure and 
 24.4   decertification of a portion of the beds within the facility. 
 24.5      (g)  "Planned closure rate adjustment" means an increase in 
 24.6   a nursing facility's operating rates under this section. 
 24.7      Subd. 2.  [REGIONAL LONG-TERM CARE PLANNING AND 
 24.8   DEVELOPMENT.] (a) The commissioner of human services shall 
 24.9   establish a process to adjust the capacity and distribution of 
 24.10  long-term care services to equalize the supply and demand for 
 24.11  different types of services.  The process must include community 
 24.12  and regional planning, expansion or establishment of needed 
 24.13  services, and voluntary nursing facility closures. 
 24.14     (b) The commissioner shall issue a request for proposals to 
 24.15  contract with regional long-term care planning groups.  Each 
 24.16  group must: 
 24.17     (1) consist of county health and social services agencies, 
 24.18  consumers, housing agencies, a representative of nursing 
 24.19  facilities, a representative of home and community-based 
 24.20  services providers, and area agencies on aging in the geographic 
 24.21  area; and 
 24.22     (2) serve an area that has at least 2,000 people who are 85 
 24.23  years of age or older. 
 24.24  In awarding contracts, the commissioner shall give preference to 
 24.25  groups that represent an entire area agency on aging region 
 24.26  where there is not already a planning and development group 
 24.27  established under section 256B.0917.  An area not included in a 
 24.28  proposal must be included in a group convened by the area agency 
 24.29  on aging of that planning and service area through a contract 
 24.30  negotiated by the commissioner. 
 24.31     (c) Each regional long-term care planning group shall: 
 24.32     (1) conduct a detailed assessment of the region's long-term 
 24.33  care services system.  This assessment must be completed within 
 24.34  90 days of the contract award and must evaluate the adequacy of 
 24.35  nursing facility beds and the impact of potential nursing 
 24.36  facility closures.  The commissioner of health and the 
 25.1   commissioner of human services, as appropriate, shall provide 
 25.2   data to the group on nursing facility bed distribution, 
 25.3   housing-with-service options, the closure of nursing facilities 
 25.4   in the planning area that occur outside of the planned closure 
 25.5   process, the approval of planned closures in the planning area, 
 25.6   the addition of new community long-term care services in the 
 25.7   area, the closure of existing community long-term care services 
 25.8   in the area, and other available data; 
 25.9      (2) plan options for increasing community capacity to 
 25.10  provide more home and community-based services to reduce 
 25.11  reliance on nursing facility services; 
 25.12     (3) respond to a notice from a nursing facility of its 
 25.13  intent to propose voluntary bed closures under this section.  
 25.14  This response must consist of reviewing, assessing, and 
 25.15  providing recommendations to the commissioner of human services, 
 25.16  to the interagency long-term care planning committee, and to the 
 25.17  nursing facility about the impact of a nursing facility closure; 
 25.18  and 
 25.19     (4) develop community services alternatives to ensure that 
 25.20  sufficient community-based services are available to meet demand.
 25.21     Subd. 3.  [REQUEST FOR APPLICATIONS FOR PLANNED CLOSURE OF 
 25.22  NURSING FACILITIES.] (a) By July 15, 2001, the commissioner of 
 25.23  human services shall publish a request for applications for 
 25.24  closure or partial closure of nursing facilities.  The request 
 25.25  for applications must specify: 
 25.26     (1) the criteria that will be used by the interagency 
 25.27  long-term care planning committee established under section 
 25.28  144A.31 and the commissioner to approve or reject applications; 
 25.29     (2) a requirement for the submission of a letter of intent 
 25.30  before the submission of an application; 
 25.31     (3) the information that must accompany an application; 
 25.32     (4) a schedule for letters of intent, applications, and 
 25.33  consideration of applications for a minimum of four review 
 25.34  processes to be conducted before June 30, 2003; and 
 25.35     (5) that applications may combine planned closure rate 
 25.36  adjustments with moratorium exception funding, in which case a 
 26.1   single application may serve both purposes. 
 26.2   Between October 1, 2001, and June 30, 2003, the commissioner may 
 26.3   approve planned closures of up to 4,000 nursing facility beds, 
 26.4   with no more than 2,000 approved for closure prior to July 1, 
 26.5   2002. 
 26.6      (b) A facility or facilities reimbursed under section 
 26.7   256B.431, 256B.434, or 256B.435 with a closure plan approved by 
 26.8   the commissioner under subdivision 6 may assign a planned 
 26.9   closure rate adjustment to another facility that is not 
 26.10  closing.  The planned closure rate adjustment must be calculated 
 26.11  under subdivision 7.  A planned closure rate adjustment under 
 26.12  this section is effective on the first day of the month 
 26.13  following completion of closure of all facilities designated for 
 26.14  closure in the application and becomes part of the nursing 
 26.15  facility's total operating payment rate. 
 26.16     Applicants may use the planned closure rate adjustment to 
 26.17  allow for a property payment for a new nursing facility or an 
 26.18  addition to an existing nursing facility.  Applications approved 
 26.19  under this clause are exempt from other requirements for 
 26.20  moratorium exceptions under sections 144A.071 to 144A.073. 
 26.21     (c) To be considered for approval, an application must 
 26.22  include: 
 26.23     (1) a description of the proposed closure plan, which must 
 26.24  include identification of the facility or facilities to receive 
 26.25  a planned closure rate adjustment and the amount and timing of a 
 26.26  planned closure rate adjustment proposed for each facility; 
 26.27     (2) the proposed timetable for any proposed closure, 
 26.28  including the proposed dates for announcement to residents, 
 26.29  commencement of closure, and completion of closure; 
 26.30     (3) the proposed relocation plan for current residents of 
 26.31  any facility designated for closure.  The proposed relocation 
 26.32  plan must be designed to comply with all applicable state and 
 26.33  federal statutes and regulations, including, but not limited to, 
 26.34  section 144A.16; and Minnesota Rules, parts 4655.6810 to 
 26.35  4655.6830; 4658.1600 to 4658.1690; and 9546.0010 to 9546.0060; 
 26.36     (4) a description of the relationship between the nursing 
 27.1   facility that is proposed for closure and the nursing facility 
 27.2   or facilities proposed to receive the planned closure rate 
 27.3   adjustment.  If these facilities are not under common ownership, 
 27.4   copies of any contracts, purchase agreements, or other documents 
 27.5   establishing a relationship or proposed relationship must be 
 27.6   provided; 
 27.7      (5) documentation, in a format approved by the 
 27.8   commissioner, that all the nursing facilities receiving a 
 27.9   planned closure rate adjustment under the plan have accepted 
 27.10  joint and several liability for recovery of overpayments under 
 27.11  section 256B.0641, subdivision 2, for the facilities designated 
 27.12  for closure under the plan; and 
 27.13     (6) a detailed plan developed by the facility submitting 
 27.14  the application and by: 
 27.15     (i) a regional long-term care planning group established 
 27.16  under subdivision 2; 
 27.17     (ii) a seniors' agenda for independent living (SAIL) 
 27.18  project under section 256B.0917; or 
 27.19     (iii) if a grantee under items (i) or (ii) has not been 
 27.20  established, a group similar to the group described in 
 27.21  subdivision 2 that is coordinated by the area agency on aging 
 27.22  and is engaged in regional planning. 
 27.23  The plan must address how services will be established or 
 27.24  expanded in the community to meet the needs of people who 
 27.25  require long-term care or demonstrate that adequate services are 
 27.26  already available in the community. 
 27.27     (d) The application must address the criteria listed in 
 27.28  subdivision 4. 
 27.29     Subd. 4.  [CRITERIA FOR REVIEW OF APPLICATION.] In 
 27.30  reviewing and approving closure proposals, the commissioner of 
 27.31  human services shall consider, but not be limited to, the 
 27.32  following criteria: 
 27.33     (1) improved quality of care and quality of life for 
 27.34  consumers; 
 27.35     (2) closure of a nursing facility that has a poor physical 
 27.36  plant; 
 28.1      (3) the existence of excess nursing facility beds, measured 
 28.2   in terms of beds per thousand persons aged 85 or older.  The 
 28.3   excess must be measured in reference to: 
 28.4      (i) the county in which the facility is located; 
 28.5      (ii) the county and all contiguous counties; 
 28.6      (iii) the region in which the facility is located; or 
 28.7      (iv) the facility's service area. 
 28.8   The facility shall indicate in its proposal the area it believes 
 28.9   is appropriate for this measurement.  A facility in a county 
 28.10  that is in the lowest quartile of counties with reference to 
 28.11  beds per thousand persons aged 85 or older is not in an area of 
 28.12  excess capacity; 
 28.13     (4) low-occupancy rates, provided that the unoccupied beds 
 28.14  are not the result of a personnel shortage.  In analyzing 
 28.15  occupancy rates, the commissioner shall examine waiting lists in 
 28.16  the applicant facility and at facilities in the surrounding 
 28.17  area, as determined under clause (3); 
 28.18     (5) evidence of a community planning process to determine 
 28.19  what services will be needed and ensure that needed services 
 28.20  will be established; 
 28.21     (6) innovative use of reinvestment funds; 
 28.22     (7) innovative use planned for the closed facility's 
 28.23  physical plant; 
 28.24     (8) evidence that the proposal serves the interests of the 
 28.25  state; and 
 28.26     (9) evidence of other factors that affect the viability of 
 28.27  the facility, including excessive nursing pool costs. 
 28.28     Subd. 5.  [CERTIFICATION.] Upon receipt of an application 
 28.29  for planned closure, the commissioner of human services shall 
 28.30  provide a copy of the application to the commissioner of 
 28.31  health.  The commissioner of health shall certify to the 
 28.32  commissioner of human services within 30 days whether the 
 28.33  application, if implemented, will satisfy the requirements of 
 28.34  section 144A.16 and Minnesota Rules, parts 4655.6810 to 
 28.35  4655.6830 and 4658.1600 to 4658.1690.  The commissioner of human 
 28.36  services shall reject all applications for which the 
 29.1   commissioner of health does not make the certification required 
 29.2   under this subdivision. 
 29.3      Subd. 6.  [REVIEW AND APPROVAL OF PROPOSALS.] (a) The 
 29.4   interagency long-term care planning committee may recommend that 
 29.5   the commissioner of human services grant approval, within the 
 29.6   limits established in subdivision 3, paragraph (a), to 
 29.7   applications that satisfy the requirements of this section.  The 
 29.8   interagency committee may appoint an advisory review panel 
 29.9   composed of representatives of counties, SAIL projects, 
 29.10  consumers, and providers to review proposals and provide 
 29.11  comments and recommendations to the committee.  The 
 29.12  commissioners of human services and health shall provide staff 
 29.13  and technical assistance to the committee for the review and 
 29.14  analysis of proposals.  The commissioners of human services and 
 29.15  health shall jointly approve or disapprove an application within 
 29.16  30 days after receiving the committee's recommendations. 
 29.17     (b) Approval of a planned closure expires 18 months after 
 29.18  approval by the commissioner of human services, unless 
 29.19  commencement of closure has begun. 
 29.20     (c) The commissioner of human services may change any 
 29.21  provision of the application to which all parties agree. 
 29.22     Subd. 7.  [PLANNED CLOSURE RATE ADJUSTMENT.] The 
 29.23  commissioner of human services shall calculate the amount of the 
 29.24  planned closure rate adjustment available under subdivision 3, 
 29.25  paragraph (b), according to clauses (1) to (4): 
 29.26     (1) the amount available is the net reduction of nursing 
 29.27  facility beds multiplied by $2,080; 
 29.28     (2) the total number of beds in the nursing facility 
 29.29  receiving the planned closure rate adjustment must be 
 29.30  identified; 
 29.31     (3) capacity days are determined by multiplying the number 
 29.32  determined under clause (2) by 365; and 
 29.33     (4) the planned closure rate adjustment is the amount 
 29.34  available in clause (1), divided by capacity days determined 
 29.35  under clause (3). 
 29.36     Subd. 8.  [OTHER RATE ADJUSTMENTS.] Facilities subject to 
 30.1   this section remain eligible for any applicable rate adjustments 
 30.2   provided under section 256B.431, 256B.434, or any other section. 
 30.3      Subd. 9.  [COUNTY COSTS.] The commissioner of human 
 30.4   services may allocate up to $400 per nursing facility bed that 
 30.5   is closing, within the limits of the appropriation specified for 
 30.6   this purpose, to be used for relocation costs incurred by 
 30.7   counties for planned closures under this section and resident 
 30.8   relocation under section 144A.16.  To be eligible for this 
 30.9   allocation, a county in which a nursing facility closes must 
 30.10  provide to the commissioner a detailed statement in a form 
 30.11  provided by the commissioner of additional costs, not to exceed 
 30.12  $400 per bed closed, that are directly incurred related to the 
 30.13  county's required role in the relocation process.  Money 
 30.14  appropriated for county resident relocation costs is available 
 30.15  until expended. 
 30.16     Sec. 4.  [256B.438] [LONG-TERM CARE QUALITY PROFILES.] 
 30.17     Subdivision l.  [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 
 30.18  PROFILES.] (a) The commissioner of human services shall develop 
 30.19  and implement a quality profile system for nursing facilities 
 30.20  and, beginning not later than July 1, 2003, other providers of 
 30.21  long-term care services.  The system must be developed and 
 30.22  implemented to the extent possible without the collection of 
 30.23  significant amounts of new data.  The system must be designed to 
 30.24  provide information on quality: 
 30.25     (1) to consumers and their families to facilitate informed 
 30.26  choices of service providers; 
 30.27     (2) to providers to enable them to measure the results of 
 30.28  their quality improvement efforts and compare quality 
 30.29  achievements with other service providers; and 
 30.30     (3) to public and private purchasers of long-term care 
 30.31  services to enable them to purchase high-quality care. 
 30.32     (b) The system must be developed in consultation with the 
 30.33  long-term care task force and representatives of consumers, 
 30.34  providers, and labor unions.  Within the limits of available 
 30.35  appropriations, the commissioner may employ consultants to 
 30.36  assist with this project. 
 31.1      Subd. 2.  [QUALITY MEASUREMENT TOOLS.] The commissioner of 
 31.2   human services shall identify and apply existing quality 
 31.3   measurement tools to: 
 31.4      (1) emphasize quality of care and its relationship to 
 31.5   quality of life; and 
 31.6      (2) address the needs of various users of long-term care 
 31.7   services, including, but not limited to, short-stay residents, 
 31.8   persons with behavioral problems, persons with dementia, and 
 31.9   persons who are members of minority groups. 
 31.10  The tools must be identified and applied, to the extent 
 31.11  possible, without requiring providers to supply information 
 31.12  beyond current state and federal requirements. 
 31.13     Subd. 3.  [CONSUMER SURVEYS.] Following identification of 
 31.14  the quality measurement tool, the commissioner of human services 
 31.15  shall conduct surveys of long-term care service consumers to 
 31.16  develop quality profiles of providers.  To the extent possible, 
 31.17  surveys must be conducted face-to-face by state employees or 
 31.18  contractors.  At the discretion of the commissioner, surveys may 
 31.19  be conducted by telephone or by provider staff.  Surveys must be 
 31.20  conducted periodically to update quality profiles of individual 
 31.21  service providers. 
 31.22     Subd. 4.  [DISSEMINATION OF QUALITY PROFILES.] By July 1, 
 31.23  2002, the commissioner of human services shall implement a 
 31.24  system to disseminate the quality profiles developed from 
 31.25  consumer surveys using the quality measurement tool.  Profiles 
 31.26  must be disseminated to consumers, providers, and purchasers of 
 31.27  long-term care services through all feasible printed and 
 31.28  electronic outlets.  The commissioner shall conduct a public 
 31.29  awareness campaign to inform potential users regarding profile 
 31.30  contents and potential uses. 
 31.31     Sec. 5.  Minnesota Statutes 2000, section 256B.5012, is 
 31.32  amended by adding a subdivision to read: 
 31.33     Subd. 4.  [ICF/MR RATE INCREASES BEGINNING JANUARY 1, 2002, 
 31.34  AND JANUARY 1, 2003.] (a) For the rate years beginning January 
 31.35  1, 2002, and January 1, 2003, the commissioner of human services 
 31.36  shall make available to each facility reimbursed under this 
 32.1   section an adjustment to the total operating payment rate of 3.5 
 32.2   percent.  Of this adjustment, 2.5 percentage points must be used 
 32.3   to provide an employee pay rate increase as provided under 
 32.4   paragraph (b) and one percentage point must be used for 
 32.5   operating costs. 
 32.6      (b) The adjustment under this paragraph must be used to 
 32.7   increase the per-hour pay rate of all employees except 
 32.8   administrative and central office employees by an equal dollar 
 32.9   amount and to pay associated costs for FICA, the Medicare tax, 
 32.10  workers' compensation premiums, and federal and state 
 32.11  unemployment insurance, provided that this increase must be used 
 32.12  only for wage increases implemented on or after the first day of 
 32.13  the rate year and must not be used for wage increases 
 32.14  implemented prior to that date. 
 32.15     (c) For each facility, the commissioner shall determine the 
 32.16  payment rate adjustment using the percentage specified in 
 32.17  paragraph (a) multiplied by the total operating payment rate in 
 32.18  effect on the last day of the prior rate year.  The total 
 32.19  operating payment rate includes the adjustment provided in 
 32.20  section 256B.501, subdivision 12. 
 32.21     (d) A facility whose payment rates are governed by closure 
 32.22  agreements, receivership agreements, or Minnesota Rules, part 
 32.23  9553.0075, is not eligible for an adjustment otherwise granted 
 32.24  under this subdivision.  
 32.25     (e) A facility may apply for the compensation-related 
 32.26  payment rate adjustment provided under paragraph (b).  The 
 32.27  application must be made to the commissioner and contain a plan 
 32.28  by which the facility will distribute the compensation-related 
 32.29  portion of the payment rate adjustment to employees of the 
 32.30  facility.  For facilities in which the employees are represented 
 32.31  by an exclusive bargaining representative, an agreement 
 32.32  negotiated and agreed to by the employer and the exclusive 
 32.33  bargaining representative constitutes the plan.  A negotiated 
 32.34  agreement may constitute the plan only if the agreement is 
 32.35  finalized after the date of enactment of all rate increases for 
 32.36  the rate year.  The commissioner shall review the plan to ensure 
 33.1   that the payment rate adjustment per diem is used as provided in 
 33.2   this subdivision.  To be eligible, a facility must submit its 
 33.3   plan for the compensation distribution by March 31, 2002, and 
 33.4   March 31, 2003, respectively.  If a facility's plan for 
 33.5   compensation distribution is effective for its employees after 
 33.6   the first day of the applicable rate year that the funds are 
 33.7   available, the payment rate adjustment per diem is effective the 
 33.8   same date as its plan. 
 33.9      (f) A copy of the approved distribution plan must be made 
 33.10  available to all employees by giving each employee a copy or by 
 33.11  posting it in an area of the facility to which all employees 
 33.12  have access.  If an employee does not receive the compensation 
 33.13  adjustment described in the facility's approved plan and is 
 33.14  unable to resolve the problem with the facility's management or 
 33.15  through the employee's union representative, the employee may 
 33.16  contact the commissioner at an address or telephone number 
 33.17  provided by the commissioner and included in the approved plan. 
 33.18     Sec. 6.  [DEVELOPMENT OF NEW NURSING FACILITY REIMBURSEMENT 
 33.19  SYSTEM.] 
 33.20     (a) The commissioner of human services shall develop and 
 33.21  report to the legislature by January 15, 2003, a system to 
 33.22  replace the current nursing facility reimbursement system 
 33.23  established under Minnesota Statutes, sections 256B.431; 
 33.24  256B.434; and 256B.435. 
 33.25     (b) The system must be developed in consultation with the 
 33.26  long-term care task force and with representatives of consumers, 
 33.27  providers, and labor unions.  Within the limits of available 
 33.28  appropriations, the commissioner may employ consultants to 
 33.29  assist with this project. 
 33.30     (c) The new reimbursement system must: 
 33.31     (1) provide incentives to enhance quality of life and 
 33.32  quality of care; 
 33.33     (2) recognize cost differences in the care of different 
 33.34  types of populations, including subacute care and dementia care; 
 33.35     (3) establish rates that are sufficient without being 
 33.36  excessive; 
 34.1      (4) be affordable for the state and for private-pay 
 34.2   residents; 
 34.3      (5) be sensitive to changing conditions in the long-term 
 34.4   care environment; 
 34.5      (6) avoid creating access problems related to insufficient 
 34.6   funding; 
 34.7      (7) allow providers maximum flexibility in their business 
 34.8   operations; and 
 34.9      (8) recognize the need for capital investment to improve 
 34.10  physical plants. 
 34.11     (d) Notwithstanding Minnesota Statutes, section 256B.435, 
 34.12  the commissioner must not implement a performance-based 
 34.13  contracting system for nursing facilities prior to July 1, 2003. 
 34.14  The commissioner shall continue to reimburse nursing facilities 
 34.15  under Minnesota Statutes, section 256B.431 or 256B.434, until 
 34.16  otherwise directed by law. 
 34.17     Sec. 7.  [DEVELOPMENT OF STANDARDS FOR SUBACUTE CARE 
 34.18  FACILITY LICENSURE.] 
 34.19     (a) The commissioner of health, in consultation with the 
 34.20  commissioner of human services, representatives of the nursing 
 34.21  home industry, consumers, health care professionals, labor 
 34.22  unions, and nursing home advocates, shall develop standards for 
 34.23  the licensure of subacute care facilities.  For the purposes of 
 34.24  this section, "subacute care" has the meaning given in Minnesota 
 34.25  Statutes, section 144.6505, subdivision 2. 
 34.26     (b) By January 15, 2003, the commissioner of health shall 
 34.27  submit a report to the legislature that contains a proposal for 
 34.28  the implementation of the licensure program for subacute care 
 34.29  facilities.  This report must include: 
 34.30     (1) standards that govern the operation and design of 
 34.31  subacute care facilities; 
 34.32     (2) an analysis of the differences between subacute care 
 34.33  facilities and the current provisions relating to the licensure 
 34.34  of nursing homes; 
 34.35     (3) the development of a bill of rights for recipients of 
 34.36  services in subacute care facilities; and 
 35.1      (4) a recommendation on the applicability of the nursing 
 35.2   home moratorium law to the licensure of subacute care facilities.
 35.3   The commissioner of health shall describe the positive and 
 35.4   negative consequences that the implementation of these standards 
 35.5   will have on residents and providers. 
 35.6      (c) The commissioner of health shall take the following 
 35.7   factors into consideration during the development of the 
 35.8   standards for subacute care facilities: 
 35.9      (1) the nature of the medical and nursing services needed 
 35.10  by residents in these facilities; 
 35.11     (2) the types of personnel that need to be available; 
 35.12     (3) whether specific standards for levels of care need to 
 35.13  be included; 
 35.14     (4) the type of assessment forms and the frequency of 
 35.15  assessments that are appropriate to residents in these 
 35.16  facilities; and 
 35.17     (5) the types of supportive and other care-related services 
 35.18  that need to be provided. 
 35.19  The commissioner of health shall take into consideration any 
 35.20  federal regulations that would apply to the operation of a 
 35.21  subacute care facility.  The commissioner of health shall 
 35.22  identify any areas of conflict between the proposed standards 
 35.23  and any federal regulations and identify steps that have been or 
 35.24  will be taken to eliminate those conflicts.  The commissioner of 
 35.25  health shall identify, to the extent possible, the consequences 
 35.26  to the state if the licensure requirements are implemented 
 35.27  despite conflicts with federal law. 
 35.28     (d) By January 15, 2003, the commissioner of human services 
 35.29  shall submit a report to the legislature identifying the 
 35.30  availability of federal financial participation for services 
 35.31  provided in a subacute care facility.  This report must specify 
 35.32  whether Medicare funding would also be available to cover costs 
 35.33  of care provided in these facilities.  The commissioner of human 
 35.34  services shall identify any problems with reimbursement under 
 35.35  the Medicare or Medicaid programs.  If reimbursement under the 
 35.36  Medicare and Medicaid programs will not be available, the 
 36.1   commissioner shall identify steps that can be taken to provide 
 36.2   for reimbursement.  The commissioner of human services shall 
 36.3   also provide information on total costs of care in these 
 36.4   facilities and the impact on state funds.  The commissioner of 
 36.5   human services shall also submit to the legislature any changes 
 36.6   that will be required in the current nursing home reimbursement 
 36.7   system. 
 36.8      Sec. 8.  [PROVIDER RATE INCREASES.] 
 36.9      (a) The commissioner of human services shall increase 
 36.10  reimbursement rates by 3.5 percent each year of the biennium for 
 36.11  the providers listed in paragraph (b).  The increases are 
 36.12  effective for services rendered on or after July 1 of each year. 
 36.13     (b) The rate increases described in this section must be 
 36.14  provided to home and community-based waivered services for: 
 36.15     (1) persons with mental retardation or related conditions 
 36.16  under Minnesota Statutes, section 256B.501; 
 36.17     (2) home and community-based waivered services for the 
 36.18  elderly under Minnesota Statutes, section 256B.0915; 
 36.19     (3) waivered services under community alternatives for 
 36.20  disabled individuals under Minnesota Statutes, section 256B.49; 
 36.21     (4) community alternative care waivered services under 
 36.22  Minnesota Statutes, section 256B.49; 
 36.23     (5) traumatic brain injury waivered services under 
 36.24  Minnesota Statutes, section 256B.49; 
 36.25     (6) nursing services and home health services under 
 36.26  Minnesota Statutes, section 256B.0625, subdivision 6a; 
 36.27     (7) personal care services and nursing supervision of 
 36.28  personal care services under Minnesota Statutes, section 
 36.29  256B.0625, subdivision 19a; 
 36.30     (8) private-duty nursing services under Minnesota Statutes, 
 36.31  section 256B.0625, subdivision 7; 
 36.32     (9) day training and habilitation services for adults with 
 36.33  mental retardation or related conditions under Minnesota 
 36.34  Statutes, sections 252.40 to 252.46; 
 36.35     (10) alternative care services under Minnesota Statutes, 
 36.36  section 256B.0913; 
 37.1      (11) adult residential program grants under Minnesota 
 37.2   Rules, parts 9535.2000 to 9535.3000; 
 37.3      (12) adult and family community support grants under 
 37.4   Minnesota Rules, parts 9535.1700 to 9535.1760; 
 37.5      (13) adult mental health integrated fund grants under 
 37.6   Minnesota Statutes, section 245.4661; 
 37.7      (14) semi-independent living services under Minnesota 
 37.8   Statutes, section 252.275, including SILS funding under county 
 37.9   social services grants formerly funded under Minnesota Statutes, 
 37.10  chapter 256I; 
 37.11     (15) community support services for deaf and 
 37.12  hard-of-hearing adults with mental illness who use or wish to 
 37.13  use sign language as their primary means of communication; and 
 37.14     (16) living skills training programs for persons with 
 37.15  intractable epilepsy who need assistance in the transition to 
 37.16  independent living. 
 37.17     (c) Providers that receive a rate increase under this 
 37.18  section shall use one percentage point of the additional revenue 
 37.19  for operating cost increases and 2.5 percentage points of the 
 37.20  additional revenue to increase the per-hour pay rate of all 
 37.21  employees other than the administrator and central office staff 
 37.22  by an equal dollar amount and to pay associated costs for FICA, 
 37.23  the Medicare tax, workers' compensation premiums, and federal 
 37.24  and state unemployment insurance.  For public employees, the 
 37.25  portion of this increase reserved to increase the per-hour pay 
 37.26  rate for certain staff by an equal dollar amount is available 
 37.27  and pay rates shall be increased only to the extent that they 
 37.28  comply with laws governing public employees collective 
 37.29  bargaining.  Money received by a provider for pay increases 
 37.30  under this section must be used only for wage increases 
 37.31  implemented on or after the first day of the state fiscal year 
 37.32  in which the increase is available and must not be used for wage 
 37.33  increases implemented prior to that date. 
 37.34     (d) A copy of the provider's plan for complying with 
 37.35  paragraph (c) must be made available to all employees by giving 
 37.36  each employee a copy or by posting it in an area of the 
 38.1   provider's operation to which all employees have access.  If an 
 38.2   employee does not receive the salary adjustment described in the 
 38.3   plan and is unable to resolve the problem with the provider, the 
 38.4   employee may contact the employee's union representative.  If 
 38.5   the employee is not covered by a collective bargaining 
 38.6   agreement, the employee may contact the commissioner at a phone 
 38.7   number provided by the commissioner and included in the 
 38.8   provider's plan. 
 38.9      Sec. 9.  [REGULATORY FLEXIBILITY.] 
 38.10     (a) By July 1, 2001, the commissioners of health and human 
 38.11  services shall: 
 38.12     (1) develop a summary of federal nursing facility and 
 38.13  community long-term care regulations that hamper state 
 38.14  flexibility and place burdens on the goal of achieving 
 38.15  high-quality care and optimum outcomes for consumers of 
 38.16  services; and 
 38.17     (2) share this summary with the legislature, other states, 
 38.18  national groups that advocate for state interests with Congress, 
 38.19  and the Minnesota congressional delegation. 
 38.20     (b) The commissioners shall conduct ongoing follow-up with 
 38.21  the entities to which this summary is provided and with the 
 38.22  health care financing administration to achieve maximum 
 38.23  regulatory flexibility, including the possibility of pilot 
 38.24  projects to demonstrate regulatory flexibility on less than a 
 38.25  statewide basis. 
 38.26     Sec. 10.  [REPORT.] 
 38.27     By January 15, 2003, the commissioner of health and the 
 38.28  commissioner of human services shall report to the senate health 
 38.29  and family security committee and the house health and human 
 38.30  services policy committee on the number of closures that have 
 38.31  taken place under section 3, alternatives to nursing facility 
 38.32  care that have been developed, any problems with access to 
 38.33  long-term care services that have resulted, and any 
 38.34  recommendations for continuation of the regional long-term care 
 38.35  planning process and the closure process after June 30, 2003. 
 38.36     Sec. 11.  [APPROPRIATIONS.] 
 39.1      (a) The following amounts are appropriated from the general 
 39.2   fund to the commissioner of human services for the biennium 
 39.3   beginning July 1, 2001, for the purposes indicated: 
 39.4      (1) $....... for the following purposes related to the 
 39.5   nursing facility planned closure process: 
 39.6      (i) $....... for incentive payments to nursing facilities; 
 39.7      (ii) $....... for state and county administrative costs; 
 39.8   and 
 39.9      (iii) $....... for transition planning grants to nursing 
 39.10  facilities; 
 39.11     (2) $....... to develop and disseminate quality measures in 
 39.12  nursing facilities and other long-term care settings; and 
 39.13     (3) $....... to develop a new nursing facility 
 39.14  reimbursement system. 
 39.15     (b) $....... is appropriated from the general fund to the 
 39.16  commissioner of health for the biennium beginning July 1, 2001, 
 39.17  to develop different regulatory standards for the licensure of 
 39.18  subacute care facilities. 
 39.19     (c) $....... is appropriated from the general fund to the 
 39.20  commissioner of human services for the biennium beginning July 
 39.21  1, 2001, for a 2.5 percent rate increase each year of the 
 39.22  biennium for nursing facilities, intermediate care facilities 
 39.23  for persons with mental retardation or related conditions, and 
 39.24  other service providers. 
 39.25     Sec. 12.  [EFFECTIVE DATE.] 
 39.26     Sections 3 and 9 are effective the day following final 
 39.27  enactment. 
 39.28                             ARTICLE 3
 39.29                WORKFORCE RECRUITMENT AND RETENTION
 39.30     Section 1.  Minnesota Statutes 2000, section 116L.11, 
 39.31  subdivision 4, is amended to read: 
 39.32     Subd. 4.  [QUALIFYING CONSORTIUM.] "Qualifying consortium" 
 39.33  means an entity that may include includes a public or private 
 39.34  institution of higher education, work force center, county, and 
 39.35  one or more eligible employers, but must include a public or 
 39.36  private institution of higher education and one or more eligible 
 40.1   employers employer. 
 40.2      Sec. 2.  Minnesota Statutes 2000, section 116L.12, 
 40.3   subdivision 4, is amended to read: 
 40.4      Subd. 4.  [GRANTS.] Within the limits of available 
 40.5   appropriations, the board shall make grants not to exceed 
 40.6   $400,000 each to qualifying consortia to operate local, 
 40.7   regional, or statewide training and retention programs.  Grants 
 40.8   may be made from TANF funds, general fund appropriations, and 
 40.9   any other funding sources available to the board, provided the 
 40.10  requirements of those funding sources are satisfied.  Grant 
 40.11  awards must establish specific, measurable outcomes and 
 40.12  timelines for achieving those outcomes. 
 40.13     Sec. 3.  Minnesota Statutes 2000, section 116L.12, 
 40.14  subdivision 5, is amended to read: 
 40.15     Subd. 5.  [LOCAL MATCH REQUIREMENTS.] A consortium must 
 40.16  provide at least a 50 percent match from local resources for 
 40.17  money appropriated under this section.  The local match 
 40.18  requirement must be satisfied on an overall program basis but 
 40.19  need not be satisfied for each particular client.  The local 
 40.20  match requirement may be reduced for consortia that include a 
 40.21  relatively large number of small employers whose financial 
 40.22  contribution has been reduced in accordance with section 116L.15.
 40.23  In-kind services and expenditures under section 116L.13, 
 40.24  subdivision 2, may be used to meet this local match 
 40.25  requirement.  The grant application must specify the financial 
 40.26  contribution from each member of the consortium satisfy the 
 40.27  match requirements established in section 116L.02, paragraph (a).
 40.28     Sec. 4.  Minnesota Statutes 2000, section 116L.13, 
 40.29  subdivision 1, is amended to read: 
 40.30     Subdivision 1.  [MARKETING AND RECRUITMENT.] A qualifying 
 40.31  consortium must implement a marketing and outreach strategy to 
 40.32  recruit into the health care and human services fields persons 
 40.33  from one or more of the potential employee target groups.  
 40.34  Recruitment strategies must include: 
 40.35     (1) a screening process to evaluate whether potential 
 40.36  employees may be disqualified as the result of a required 
 41.1   background check or are otherwise unlikely to succeed in the 
 41.2   position for which they are being recruited; and 
 41.3      (2) a process for modifying course work to meet the 
 41.4   training needs of non-English-speaking persons, when appropriate.
 41.5      Sec. 5.  [116L.146] [EXPEDITED GRANT PROCESS.] 
 41.6      (a) The board may authorize grants not to exceed $50,000 
 41.7   each through an expedited grant approval process to: 
 41.8      (1) eligible employers to provide training programs for up 
 41.9   to 50 workers; or 
 41.10     (2) a public or private institution of higher education to: 
 41.11     (i) do predevelopment or curriculum development for 
 41.12  training programs prior to submission for program funding under 
 41.13  section 116L.12; 
 41.14     (ii) convert an existing curriculum for distance learning 
 41.15  through interactive television or other communication methods; 
 41.16  or 
 41.17     (iii) enable a training program to be offered when it would 
 41.18  otherwise be canceled due to an enrollment shortfall of one or 
 41.19  two students when the program is offered in a health-related 
 41.20  field with a documented worker shortage and is part of a 
 41.21  training program not exceeding two years in length. 
 41.22     (b) The board shall develop application procedures and 
 41.23  evaluation policies for grants made under this subdivision. 
 41.24     Sec. 6.  Minnesota Statutes 2000, section 144.1464, is 
 41.25  amended to read: 
 41.26     144.1464 [SUMMER HEALTH CARE INTERNS.] 
 41.27     Subdivision 1.  [SUMMER INTERNSHIPS.] The commissioner of 
 41.28  health, through a contract with a nonprofit organization as 
 41.29  required by subdivision 4, shall award grants to hospitals and, 
 41.30  clinics, nursing facilities, and home care providers to 
 41.31  establish a secondary and post-secondary summer health care 
 41.32  intern program.  The purpose of the program is to expose 
 41.33  interested secondary and post-secondary pupils to various 
 41.34  careers within the health care profession. 
 41.35     Subd. 2.  [CRITERIA.] (a) The commissioner, through the 
 41.36  organization under contract, shall award grants to 
 42.1   hospitals and, clinics, nursing facilities, and home care 
 42.2   providers that agree to:  
 42.3      (1) provide secondary and post-secondary summer health care 
 42.4   interns with formal exposure to the health care profession; 
 42.5      (2) provide an orientation for the secondary and 
 42.6   post-secondary summer health care interns; 
 42.7      (3) pay one-half the costs of employing the secondary and 
 42.8   post-secondary summer health care intern, based on an overall 
 42.9   hourly wage that is at least the minimum wage but does not 
 42.10  exceed $6 an hour; 
 42.11     (4) interview and hire secondary and post-secondary pupils 
 42.12  for a minimum of six weeks and a maximum of 12 weeks; and 
 42.13     (5) employ at least one secondary student for each 
 42.14  post-secondary student employed, to the extent that there are 
 42.15  sufficient qualifying secondary student applicants. 
 42.16     (b) In order to be eligible to be hired as a secondary 
 42.17  summer health intern by a hospital or, clinic, nursing facility, 
 42.18  or home care provider, a pupil must: 
 42.19     (1) intend to complete high school graduation requirements 
 42.20  and be between the junior and senior year of high school; and 
 42.21     (2) be from a school district in proximity to the facility; 
 42.22  and 
 42.23     (3) provide the facility with a letter of recommendation 
 42.24  from a health occupations or science educator. 
 42.25     (c) In order to be eligible to be hired as a post-secondary 
 42.26  summer health care intern by a hospital or clinic, a pupil must: 
 42.27     (1) intend to complete a health care training program or a 
 42.28  two-year or four-year degree program and be planning on 
 42.29  enrolling in or be enrolled in that training program or degree 
 42.30  program; and 
 42.31     (2) be enrolled in a Minnesota educational institution or 
 42.32  be a resident of the state of Minnesota; priority must be given 
 42.33  to applicants from a school district or an educational 
 42.34  institution in proximity to the facility; and 
 42.35     (3) provide the facility with a letter of recommendation 
 42.36  from a health occupations or science educator. 
 43.1      (d) Hospitals and, clinics, nursing facilities, and home 
 43.2   care providers awarded grants may employ pupils as secondary and 
 43.3   post-secondary summer health care interns beginning on or after 
 43.4   June 15, 1993, if they agree to pay the intern, during the 
 43.5   period before disbursement of state grant money, with money 
 43.6   designated as the facility's 50 percent contribution towards 
 43.7   internship costs.  
 43.8      Subd. 3.  [GRANTS.] The commissioner, through the 
 43.9   organization under contract, shall award separate grants to 
 43.10  hospitals and, clinics, nursing facilities, and home care 
 43.11  providers meeting the requirements of subdivision 2.  The grants 
 43.12  must be used to pay one-half of the costs of employing secondary 
 43.13  and post-secondary pupils in a hospital or, clinic, nursing 
 43.14  facility, or home care setting during the course of the 
 43.15  program.  No more than 50 percent of the participants may be 
 43.16  post-secondary students, unless the program does not receive 
 43.17  enough qualified secondary applicants per fiscal year.  No more 
 43.18  than five pupils may be selected from any secondary or 
 43.19  post-secondary institution to participate in the program and no 
 43.20  more than one-half of the number of pupils selected may be from 
 43.21  the seven-county metropolitan area. 
 43.22     Subd. 4.  [CONTRACT.] The commissioner shall contract with 
 43.23  a statewide, nonprofit organization representing facilities at 
 43.24  which secondary and post-secondary summer health care interns 
 43.25  will serve, to administer the grant program established by this 
 43.26  section.  Grant funds that are not used in one fiscal year may 
 43.27  be carried over to the next fiscal year.  The organization 
 43.28  awarded the grant shall provide the commissioner with any 
 43.29  information needed by the commissioner to evaluate the program, 
 43.30  in the form and at the times specified by the commissioner. 
 43.31     Sec. 7.  Minnesota Statutes 2000, section 144.1496, 
 43.32  subdivision 3, is amended to read: 
 43.33     Subd. 3.  [LOAN FORGIVENESS.] The commissioner may accept 
 43.34  up to ten 170 applicants a year.  Applicants are responsible for 
 43.35  securing their own loans.  For each year of nursing education, 
 43.36  for up to two years, applicants accepted into the loan 
 44.1   forgiveness program may designate an agreed amount, not to 
 44.2   exceed $3,000, as a qualified loan.  For each year that a 
 44.3   participant practices nursing in a nursing home or intermediate 
 44.4   care facility for persons with mental retardation or related 
 44.5   conditions, up to a maximum of two years, the commissioner shall 
 44.6   annually repay an amount equal to one year of qualified loans.  
 44.7   Participants who move from one nursing home or intermediate care 
 44.8   facility for persons with mental retardation or related 
 44.9   conditions to another remain eligible for loan repayment.  
 44.10     Sec. 8.  [144.1498] [HEALTH CAREERS SCHOLARSHIP PROGRAM.] 
 44.11     Subdivision 1.  [ESTABLISHMENT; DUTIES OF 
 44.12  COMMISSIONER.] (a) The commissioner of health shall establish 
 44.13  and administer a health careers scholarship program for students 
 44.14  in nursing; occupational, physical, and respiratory therapy; and 
 44.15  similar programs.  The commissioner shall: 
 44.16     (1) notify potentially eligible scholarship sites about the 
 44.17  program; 
 44.18     (2) develop and disseminate application materials to sites; 
 44.19     (3) review and rank applications and verify the eligibility 
 44.20  of program participants; 
 44.21     (4) require each participant to sign a contract that 
 44.22  specifies the obligations of the participant and the state; 
 44.23     (5) arrange for payment to qualifying educational programs 
 44.24  on behalf of program participants; and 
 44.25     (6) monitor compliance by program participants with the 
 44.26  nursing facility work requirement. 
 44.27     (b) The commissioner may award 125 scholarships in the 
 44.28  fiscal year ending June 30, 2002, and 250 scholarships each 
 44.29  fiscal year thereafter. 
 44.30     Subd. 2.  [ELIGIBILITY.] To be eligible to receive a 
 44.31  scholarship through the health careers scholarship program, an 
 44.32  applicant must: 
 44.33     (1) be a resident of Minnesota; 
 44.34     (2) be currently employed by a nursing facility and be 
 44.35  listed on the Minnesota state registry as a nursing assistant 
 44.36  without filed complaints; 
 45.1      (3) not be currently employed by a nursing pool; 
 45.2      (4) submit a work reference from a current employer 
 45.3   verifying dates of employment and that the total number of hours 
 45.4   worked as a nursing assistant was at least 800 hours within the 
 45.5   last two calendar years; and 
 45.6      (5) be admitted to or enrolled in, on a part-time or 
 45.7   full-time basis, a degree-granting program at a Minnesota 
 45.8   university or technical college leading to licensure or 
 45.9   certification as a licensed practical nurse; registered nurse; 
 45.10  occupational, physical, or respiratory therapist; or similar 
 45.11  professional. 
 45.12     Subd. 3.  [AMOUNT OF SCHOLARSHIP.] The amount of the 
 45.13  scholarship for students at public institutions is limited to 
 45.14  the cost of tuition and fees for 12 academic credits per year.  
 45.15  For students at private institutions, the amount of the 
 45.16  scholarship is limited to the lesser of the actual tuition and 
 45.17  fees charged by the institution or the tuition and fees for 12 
 45.18  academic credits per year at a comparable public institution. 
 45.19     Subd. 4.  [SCHOLARSHIP RENEWALS.] A scholarship may be 
 45.20  renewed annually, for up to two additional academic years, if 
 45.21  the student: 
 45.22     (1) is a resident of Minnesota; 
 45.23     (2) maintains employment with a nursing facility and is 
 45.24  listed on the Minnesota state registry as a nursing assistant 
 45.25  without filed complaints; 
 45.26     (3) is not currently employed by a nursing pool; 
 45.27     (4) submits a work reference from a current employer 
 45.28  verifying dates of employment and that the total number of hours 
 45.29  worked as a nursing assistant was at least 400 hours within the 
 45.30  last calendar year; and 
 45.31     (5) is making satisfactory progress in a degree-granting 
 45.32  program at a Minnesota university or technical college leading 
 45.33  to licensure or certification as a licensed practical nurse; 
 45.34  registered nurse; occupational, physical, or respiratory 
 45.35  therapist; or similar professional. 
 45.36     Sec. 9.  [144.1499] [PROMOTION OF HEALTH CARE AND LONG-TERM 
 46.1   CARE CAREERS.] 
 46.2      The commissioner of health, in consultation with an 
 46.3   organization representing health care employers, long-term care 
 46.4   employers, and educational institutions, may make grants to 
 46.5   qualifying consortia as defined in section 116L.11, subdivision 
 46.6   4, for intergenerational programs to encourage middle and high 
 46.7   school students to work and volunteer in health care and 
 46.8   long-term care settings.  To qualify for a grant under this 
 46.9   section, a consortium shall: 
 46.10     (1) develop a health and long-term care careers curriculum 
 46.11  that provides career exploration and training in national skill 
 46.12  standards for health care and long-term care and that is 
 46.13  consistent with Minnesota graduation standards and other related 
 46.14  requirements; 
 46.15     (2) offer programs for high school students that provide 
 46.16  training in health and long-term care careers with credits that 
 46.17  articulate into post-secondary programs; and 
 46.18     (3) provide technical support to the participating health 
 46.19  care and long-term care employer to enable the use of the 
 46.20  employer's facilities and programs for K-12 health and long-term 
 46.21  care careers education. 
 46.22     Sec. 10.  [EMPLOYER-SUBSIDIZED INSURANCE FOR LONG-TERM CARE 
 46.23  INDUSTRY WORKERS.] 
 46.24     The commissioner of health, in consultation with the 
 46.25  commissioner of human services, shall present to the legislature 
 46.26  by February 1, 2002, a plan and draft legislation for providing 
 46.27  employer-subsidized affordable health insurance to employees of 
 46.28  programs and facilities that serve the elderly and disabled.  
 46.29  The plan must provide for implementation by July 1, 2002.  In 
 46.30  developing the plan, the commissioner of health and the 
 46.31  commissioner of human services shall consider findings from the 
 46.32  study on employer-subsidized insurance required under Laws 2000, 
 46.33  chapter 460, section 64.  The commissioners shall also consider 
 46.34  initiatives that access enhanced federal funding through the 
 46.35  children's health insurance program (CHIP). 
 46.36     Sec. 11.  [APPROPRIATIONS.] 
 47.1      Subdivision 1.  [SUMMER HEALTH CARE INTERN 
 47.2   PROGRAM.] $....... is appropriated from the health care access 
 47.3   fund to the commissioner of health for the biennium ending June 
 47.4   30, 2003, to expand eligibility for the summer health care 
 47.5   intern program and to increase the number of internships funded. 
 47.6      Subd. 2.  [NURSE LOAN FORGIVENESS PROGRAM.] $....... is 
 47.7   appropriated from the health care access fund to the 
 47.8   commissioner of health for the biennium ending June 30, 2003, to 
 47.9   expand the nurse loan forgiveness program. 
 47.10     Subd. 3.  [HEALTH CAREERS SCHOLARSHIP PROGRAM.] $....... is 
 47.11  appropriated from the health care access fund to the 
 47.12  commissioner of health for the biennium ending June 30, 2003, to 
 47.13  implement and administer the health careers scholarship program. 
 47.14     Subd. 4.  [MINNESOTA JOB SKILLS.] $....... is appropriated 
 47.15  from the general fund to the Minnesota job skills partnership 
 47.16  board for the biennium ending June 30, 2003, to fund the health 
 47.17  care and human services worker training program. 
 47.18     Sec. 12.  [REPEALER.] 
 47.19     Minnesota Statutes 2000, sections 116L.10; and 116L.12, 
 47.20  subdivisions 2 and 7, are repealed. 
 47.21                             ARTICLE 4
 47.22                     REGULATION OF SUPPLEMENTAL
 47.23                     NURSING SERVICES AGENCIES
 47.24     Section 1.  Minnesota Statutes 2000, section 144.057, is 
 47.25  amended to read: 
 47.26     144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 
 47.27  NURSING SERVICES AGENCY PERSONNEL.] 
 47.28     Subdivision 1.  [BACKGROUND STUDIES REQUIRED.] The 
 47.29  commissioner of health shall contract with the commissioner of 
 47.30  human services to conduct background studies of: 
 47.31     (1) individuals providing services which have direct 
 47.32  contact, as defined under section 245A.04, subdivision 3, with 
 47.33  patients and residents in hospitals, boarding care homes, 
 47.34  outpatient surgical centers licensed under sections 144.50 to 
 47.35  144.58; nursing homes and home care agencies licensed under 
 47.36  chapter 144A; residential care homes licensed under chapter 
 48.1   144B, and board and lodging establishments that are registered 
 48.2   to provide supportive or health supervision services under 
 48.3   section 157.17; and 
 48.4      (2) beginning July 1, 1999, all other employees in nursing 
 48.5   homes licensed under chapter 144A, and boarding care homes 
 48.6   licensed under sections 144.50 to 144.58.  A disqualification of 
 48.7   an individual in this section shall disqualify the individual 
 48.8   from positions allowing direct contact or access to patients or 
 48.9   residents receiving services; 
 48.10     (3) individuals employed by a supplemental nursing services 
 48.11  agency, as defined under section 144A.70, who are providing 
 48.12  services in health care facilities; and 
 48.13     (4) controlling persons of a supplemental nursing services 
 48.14  agency, as defined under section 144A.70. 
 48.15     If a facility or program is licensed by the department of 
 48.16  human services and subject to the background study provisions of 
 48.17  chapter 245A and is also licensed by the department of health, 
 48.18  the department of human services is solely responsible for the 
 48.19  background studies of individuals in the jointly licensed 
 48.20  programs. 
 48.21     Subd. 2.  [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 
 48.22  SERVICES.] The department of human services shall conduct the 
 48.23  background studies required by subdivision 1 in compliance with 
 48.24  the provisions of chapter 245A and Minnesota Rules, parts 
 48.25  9543.3000 to 9543.3090.  For the purpose of this section, the 
 48.26  term "residential program" shall include all facilities 
 48.27  described in subdivision 1.  The department of human services 
 48.28  shall provide necessary forms and instructions, shall conduct 
 48.29  the necessary background studies of individuals, and shall 
 48.30  provide notification of the results of the studies to the 
 48.31  facilities, supplemental nursing services agencies, individuals, 
 48.32  and the commissioner of health.  Individuals shall be 
 48.33  disqualified under the provisions of chapter 245A and Minnesota 
 48.34  Rules, parts 9543.3000 to 9543.3090.  If an individual is 
 48.35  disqualified, the department of human services shall notify the 
 48.36  facility, the supplemental nursing services agency, and the 
 49.1   individual and shall inform the individual of the right to 
 49.2   request a reconsideration of the disqualification by submitting 
 49.3   the request to the department of health. 
 49.4      Subd. 3.  [RECONSIDERATIONS.] The commissioner of health 
 49.5   shall review and decide reconsideration requests, including the 
 49.6   granting of variances, in accordance with the procedures and 
 49.7   criteria contained in chapter 245A and Minnesota Rules, parts 
 49.8   9543.3000 to 9543.3090.  The commissioner's decision shall be 
 49.9   provided to the individual and to the department of human 
 49.10  services.  The commissioner's decision to grant or deny a 
 49.11  reconsideration of disqualification is the final administrative 
 49.12  agency action. 
 49.13     Subd. 4.  [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 
 49.14  Facilities and agencies described in subdivision 1 shall be 
 49.15  responsible for cooperating with the departments in implementing 
 49.16  the provisions of this section.  The responsibilities imposed on 
 49.17  applicants and licensees under chapter 245A and Minnesota Rules, 
 49.18  parts 9543.3000 to 9543.3090, shall apply to these 
 49.19  facilities and supplemental nursing services agencies.  The 
 49.20  provision of section 245A.04, subdivision 3, paragraph (e), 
 49.21  shall apply to applicants, licensees, registrants, or an 
 49.22  individual's refusal to cooperate with the completion of the 
 49.23  background studies.  Supplemental nursing services agencies 
 49.24  subject to the registration requirements in section 144A.71 must 
 49.25  maintain records verifying compliance with the background study 
 49.26  requirements under this section. 
 49.27     Sec. 2.  [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 
 49.28  SERVICES AGENCIES; DEFINITIONS.] 
 49.29     Subdivision 1.  [SCOPE.] As used in sections 144A.70 to 
 49.30  144A.74, the terms defined in this section have the meanings 
 49.31  given them. 
 49.32     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
 49.33  commissioner of health. 
 49.34     Subd. 3.  [CONTROLLING PERSON.] "Controlling person" means 
 49.35  a business entity, officer, program administrator, or director 
 49.36  whose responsibilities include the direction of the management 
 50.1   or policies of a supplemental nursing services agency.  
 50.2   Controlling person also means an individual who, directly or 
 50.3   indirectly, beneficially owns an interest in a corporation, 
 50.4   partnership, or other business association that is a controlling 
 50.5   person. 
 50.6      Subd. 4.  [HEALTH CARE FACILITY.] "Health care facility" 
 50.7   means a hospital, boarding care home, or outpatient surgical 
 50.8   center licensed under sections 144.50 to 144.58; a nursing home 
 50.9   or home care agency licensed under chapter 144A; a residential 
 50.10  care home licensed under chapter 144B; or a board and lodging 
 50.11  establishment that is registered to provide supportive or health 
 50.12  supervision services under section 157.17. 
 50.13     Subd. 5.  [PERSON.] "Person" includes an individual, firm, 
 50.14  corporation, partnership, or association. 
 50.15     Subd. 6.  [SUPPLEMENTAL NURSING SERVICES 
 50.16  AGENCY.] "Supplemental nursing services agency" means a person, 
 50.17  firm, corporation, partnership, or association engaged for hire 
 50.18  in the business of providing or procuring temporary employment 
 50.19  in health care facilities for nurses, nursing assistants, nurse 
 50.20  aides, and orderlies.  Supplemental nursing services agency does 
 50.21  not include an individual who only engages in providing the 
 50.22  individual's services on a temporary basis to health care 
 50.23  facilities.  Supplemental nursing services agency also does not 
 50.24  include any nursing service agency that is limited to providing 
 50.25  temporary nursing personnel solely to one or more health care 
 50.26  facilities owned or operated by the same person, firm, 
 50.27  corporation, or partnership. 
 50.28     Sec. 3.  [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 
 50.29  REGISTRATION.] 
 50.30     Subdivision 1.  [DUTY TO REGISTER.] A person who operates a 
 50.31  supplemental nursing services agency shall register the agency 
 50.32  with the commissioner.  Each separate location of the business 
 50.33  of a supplemental nursing services agency shall register the 
 50.34  agency with the commissioner.  Each separate location of the 
 50.35  business of a supplemental nursing services agency shall have a 
 50.36  separate registration. 
 51.1      Subd. 2.  [APPLICATION INFORMATION AND FEE.] The 
 51.2   commissioner shall establish forms and procedures for processing 
 51.3   each supplemental nursing services agency registration 
 51.4   application.  An application for a supplemental nursing services 
 51.5   agency registration must include at least the following: 
 51.6      (1) the names and addresses of the owner or owners of the 
 51.7   supplemental nursing services agency; 
 51.8      (2) if the owner is a corporation, copies of its articles 
 51.9   of incorporation and current bylaws, together with the names and 
 51.10  addresses of its officers and directors; 
 51.11     (3) any other relevant information that the commissioner 
 51.12  determines is necessary to properly evaluate an application for 
 51.13  registration; and 
 51.14     (4) the annual registration fee for a supplemental nursing 
 51.15  services agency, which is $........ 
 51.16     Subd. 3.  [REGISTRATION NOT TRANSFERABLE.] A registration 
 51.17  issued by the commissioner according to this section is 
 51.18  effective for a period of one year from the date of its issuance 
 51.19  unless the registration is revoked or suspended under section 
 51.20  144A.72, subdivision 2, or unless the supplemental nursing 
 51.21  services agency is sold or ownership or management is 
 51.22  transferred.  When a supplemental nursing services agency is 
 51.23  sold or ownership or management is transferred, the registration 
 51.24  of the agency must be voided and the new owner or operator may 
 51.25  apply for a new registration. 
 51.26     Sec. 4.  [144A.72] [REGISTRATION REQUIREMENTS; PENALTIES.] 
 51.27     Subdivision 1.  [MINIMUM CRITERIA.] The commissioner shall 
 51.28  require that, as a condition of registration: 
 51.29     (1) the supplemental nursing services agency shall document 
 51.30  that each temporary employee provided to health care facilities 
 51.31  currently meets the minimum licensing, training, and continuing 
 51.32  education standards for the position in which the employee will 
 51.33  be working; 
 51.34     (2) the supplemental nursing services agency shall comply 
 51.35  with all pertinent requirements relating to the health and other 
 51.36  qualifications of personnel employed in health care facilities; 
 52.1      (3) the supplemental nursing services agency must not 
 52.2   restrict in any manner the employment opportunities of its 
 52.3   employees; 
 52.4      (4) the supplemental nursing services agency, when 
 52.5   supplying temporary employees to a health care facility, and 
 52.6   when requested by the facility to do so, shall agree that at 
 52.7   least 30 percent of the total personnel hours supplied are 
 52.8   during night, holiday, or weekend shifts; 
 52.9      (5) the supplemental nursing services agency shall carry 
 52.10  medical malpractice insurance to insure against the loss, 
 52.11  damage, or expense incident to a claim arising out of the death 
 52.12  or injury of any person as the result of negligence or 
 52.13  malpractice in the provision of health care services by the 
 52.14  supplemental nursing services agency or by any employee of the 
 52.15  agency; and 
 52.16     (6) the supplemental nursing services agency must not, in 
 52.17  any contract with any employee or health care facility, require 
 52.18  the payment of liquidated damages, employment fees, or other 
 52.19  compensation should the employee be hired as a permanent 
 52.20  employee of a health care facility. 
 52.21     Subd. 2.  [PENALTIES.] The commissioner shall establish by 
 52.22  rule appropriate penalties for the violation of sections 144A.70 
 52.23  to 144A.74. 
 52.24     Sec. 5.  [144A.73] [COMPLAINT SYSTEM.] 
 52.25     The commissioner shall establish a system for reporting 
 52.26  complaints against a supplemental nursing services agency or its 
 52.27  employees.  Complaints may be made by any member of the public.  
 52.28  Written complaints must be forwarded to the employer of each 
 52.29  person against whom a complaint is made.  The employer shall 
 52.30  promptly report to the commissioner any corrective action taken. 
 52.31     Sec. 6.  [144A.74] [MAXIMUM CHARGES.] 
 52.32     A supplemental nursing services agency must not bill or 
 52.33  receive payments from a nursing home licensed under this chapter 
 52.34  at a rate higher than 150 percent of the weighted average wage 
 52.35  rate for the applicable employee classification for the 
 52.36  geographic group to which the nursing home is assigned under 
 53.1   chapter 256B.  The weighted average wage rates must be 
 53.2   determined by the commissioner of human services and reported to 
 53.3   the commissioner of health on an annual basis.  Facilities shall 
 53.4   provide information necessary to determine weighted average wage 
 53.5   rates to the commissioner of human services in a format 
 53.6   requested by the commissioner.  The maximum rate must include 
 53.7   all charges for administrative fees, contract fees, or other 
 53.8   special charges in addition to the hourly rates for the 
 53.9   temporary nursing pool personnel supplied to a nursing home. 
 53.10     Sec. 7.  Minnesota Statutes 2000, section 245A.04, 
 53.11  subdivision 3, is amended to read: 
 53.12     Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
 53.13  (a) Before the commissioner issues a license, the commissioner 
 53.14  shall conduct a study of the individuals specified in paragraph 
 53.15  (c) (d), clauses (1) to (5), according to rules of the 
 53.16  commissioner. 
 53.17     Beginning January 1, 1997, the commissioner shall also 
 53.18  conduct a study of employees providing direct contact services 
 53.19  for nonlicensed personal care provider organizations described 
 53.20  in paragraph (c) (d), clause (5). 
 53.21     The commissioner shall recover the cost of these background 
 53.22  studies through a fee of no more than $12 per study charged to 
 53.23  the personal care provider organization.  
 53.24     Beginning August 1, 1997, the commissioner shall conduct 
 53.25  all background studies required under this chapter for adult 
 53.26  foster care providers who are licensed by the commissioner of 
 53.27  human services and registered under chapter 144D.  The 
 53.28  commissioner shall conduct these background studies in 
 53.29  accordance with this chapter.  The commissioner shall initiate a 
 53.30  pilot project to conduct up to 5,000 background studies under 
 53.31  this chapter in programs with joint licensure as home and 
 53.32  community-based services and adult foster care for people with 
 53.33  developmental disabilities when the license holder does not 
 53.34  reside in the foster care residence. 
 53.35     (b) Beginning July 1, 1998, the commissioner shall conduct 
 53.36  a background study on individuals specified in 
 54.1   paragraph (c) (d), clauses (1) to (5), who perform direct 
 54.2   contact services in a nursing home or a home care agency 
 54.3   licensed under chapter 144A or a boarding care home licensed 
 54.4   under sections 144.50 to 144.58, when the subject of the study 
 54.5   resides outside Minnesota; the study must be at least as 
 54.6   comprehensive as that of a Minnesota resident and include a 
 54.7   search of information from the criminal justice data 
 54.8   communications network in the state where the subject of the 
 54.9   study resides. 
 54.10     (c) Beginning August 1, 2001, the commissioner shall 
 54.11  conduct all background studies required under this chapter and 
 54.12  initiated by supplemental nursing services agencies registered 
 54.13  under chapter 144A.  Studies for the agencies must be initiated 
 54.14  annually by each agency.  The commissioner shall conduct the 
 54.15  background studies according to this chapter.  The commissioner 
 54.16  shall recover the cost of the background studies through a fee 
 54.17  of no more than $....... per study, charged to the supplemental 
 54.18  nursing services agency. 
 54.19     (d) The applicant, license holder, the registrant, bureau 
 54.20  of criminal apprehension, the commissioner of health, and county 
 54.21  agencies, after written notice to the individual who is the 
 54.22  subject of the study, shall help with the study by giving the 
 54.23  commissioner criminal conviction data and reports about the 
 54.24  maltreatment of adults substantiated under section 626.557 and 
 54.25  the maltreatment of minors in licensed programs substantiated 
 54.26  under section 626.556.  The individuals to be studied shall 
 54.27  include: 
 54.28     (1) the applicant; 
 54.29     (2) persons over the age of 13 living in the household 
 54.30  where the licensed program will be provided; 
 54.31     (3) current employees or contractors of the applicant who 
 54.32  will have direct contact with persons served by the facility, 
 54.33  agency, or program; 
 54.34     (4) volunteers or student volunteers who have direct 
 54.35  contact with persons served by the program to provide program 
 54.36  services, if the contact is not directly supervised by the 
 55.1   individuals listed in clause (1) or (3); and 
 55.2      (5) any person who, as an individual or as a member of an 
 55.3   organization, exclusively offers, provides, or arranges for 
 55.4   personal care assistant services under the medical assistance 
 55.5   program as authorized under sections 256B.04, subdivision 16, 
 55.6   and 256B.0625, subdivision 19a. 
 55.7      The juvenile courts shall also help with the study by 
 55.8   giving the commissioner existing juvenile court records on 
 55.9   individuals described in clause (2) relating to delinquency 
 55.10  proceedings held within either the five years immediately 
 55.11  preceding the application or the five years immediately 
 55.12  preceding the individual's 18th birthday, whichever time period 
 55.13  is longer.  The commissioner shall destroy juvenile records 
 55.14  obtained pursuant to this subdivision when the subject of the 
 55.15  records reaches age 23.  
 55.16     For purposes of this section and Minnesota Rules, part 
 55.17  9543.3070, a finding that a delinquency petition is proven in 
 55.18  juvenile court shall be considered a conviction in state 
 55.19  district court. 
 55.20     For purposes of this subdivision, "direct contact" means 
 55.21  providing face-to-face care, training, supervision, counseling, 
 55.22  consultation, or medication assistance to persons served by a 
 55.23  program.  For purposes of this subdivision, "directly supervised"
 55.24  means an individual listed in clause (1), (3), or (5) is within 
 55.25  sight or hearing of a volunteer to the extent that the 
 55.26  individual listed in clause (1), (3), or (5) is capable at all 
 55.27  times of intervening to protect the health and safety of the 
 55.28  persons served by the program who have direct contact with the 
 55.29  volunteer. 
 55.30     A study of an individual in clauses (1) to (5) shall be 
 55.31  conducted at least upon application for initial license or 
 55.32  registration and reapplication for a license or registration.  
 55.33  The commissioner is not required to conduct a study of an 
 55.34  individual at the time of reapplication for a license or if the 
 55.35  individual has been continuously affiliated with a foster care 
 55.36  provider licensed by the commissioner of human services and 
 56.1   registered under chapter 144D, other than a family day care or 
 56.2   foster care license, if:  (i) a study of the individual was 
 56.3   conducted either at the time of initial licensure or when the 
 56.4   individual became affiliated with the license holder; (ii) the 
 56.5   individual has been continuously affiliated with the license 
 56.6   holder since the last study was conducted; and (iii) the 
 56.7   procedure described in paragraph (d) (e) has been implemented 
 56.8   and was in effect continuously since the last study was 
 56.9   conducted.  For the purposes of this section, a physician 
 56.10  licensed under chapter 147 is considered to be continuously 
 56.11  affiliated upon the license holder's receipt from the 
 56.12  commissioner of health or human services of the physician's 
 56.13  background study results.  For individuals who are required to 
 56.14  have background studies under clauses (1) to (5) and who have 
 56.15  been continuously affiliated with a foster care provider that is 
 56.16  licensed in more than one county, criminal conviction data may 
 56.17  be shared among those counties in which the foster care programs 
 56.18  are licensed.  A county agency's receipt of criminal conviction 
 56.19  data from another county agency shall meet the criminal data 
 56.20  background study requirements of this section. 
 56.21     The commissioner may also conduct studies on individuals 
 56.22  specified in clauses (3) and (4) when the studies are initiated 
 56.23  by: 
 56.24     (i) personnel pool agencies; 
 56.25     (ii) temporary personnel agencies; 
 56.26     (iii) educational programs that train persons by providing 
 56.27  direct contact services in licensed programs; and 
 56.28     (iv) professional services agencies that are not licensed 
 56.29  and which contract with licensed programs to provide direct 
 56.30  contact services or individuals who provide direct contact 
 56.31  services. 
 56.32     Studies on individuals in items (i) to (iv) must be 
 56.33  initiated annually by these agencies, programs, and 
 56.34  individuals.  Except for personal care provider 
 56.35  organizations and supplemental nursing services agencies, no 
 56.36  applicant, license holder, or individual who is the subject of 
 57.1   the study shall pay any fees required to conduct the study. 
 57.2      (1) At the option of the licensed facility, rather than 
 57.3   initiating another background study on an individual required to 
 57.4   be studied who has indicated to the licensed facility that a 
 57.5   background study by the commissioner was previously completed, 
 57.6   the facility may make a request to the commissioner for 
 57.7   documentation of the individual's background study status, 
 57.8   provided that: 
 57.9      (i) the facility makes this request using a form provided 
 57.10  by the commissioner; 
 57.11     (ii) in making the request the facility informs the 
 57.12  commissioner that either: 
 57.13     (A) the individual has been continuously affiliated with a 
 57.14  licensed facility since the individual's previous background 
 57.15  study was completed, or since October 1, 1995, whichever is 
 57.16  shorter; or 
 57.17     (B) the individual is affiliated only with a personnel pool 
 57.18  agency, a temporary personnel agency, an educational program 
 57.19  that trains persons by providing direct contact services in 
 57.20  licensed programs, or a professional services agency that is not 
 57.21  licensed and which contracts with licensed programs to provide 
 57.22  direct contact services or individuals who provide direct 
 57.23  contact services; and 
 57.24     (iii) the facility provides notices to the individual as 
 57.25  required in paragraphs (a) to (d) (e), and that the facility is 
 57.26  requesting written notification of the individual's background 
 57.27  study status from the commissioner.  
 57.28     (2) The commissioner shall respond to each request under 
 57.29  paragraph (1) with a written or electronic notice to the 
 57.30  facility and the study subject.  If the commissioner determines 
 57.31  that a background study is necessary, the study shall be 
 57.32  completed without further request from a licensed agency or 
 57.33  notifications to the study subject.  
 57.34     (3) When a background study is being initiated by a 
 57.35  licensed facility or a foster care provider that is also 
 57.36  registered under chapter 144D, a study subject affiliated with 
 58.1   multiple licensed facilities may attach to the background study 
 58.2   form a cover letter indicating the additional facilities' names, 
 58.3   addresses, and background study identification numbers.  When 
 58.4   the commissioner receives such notices, each facility identified 
 58.5   by the background study subject shall be notified of the study 
 58.6   results.  The background study notice sent to the subsequent 
 58.7   agencies shall satisfy those facilities' responsibilities for 
 58.8   initiating a background study on that individual. 
 58.9      (d) (e) If an individual who is affiliated with a program 
 58.10  or facility regulated by the department of human services or 
 58.11  department of health or who is affiliated with a nonlicensed 
 58.12  personal care provider organization, is convicted of a crime 
 58.13  constituting a disqualification under subdivision 3d, the 
 58.14  probation officer or corrections agent shall notify the 
 58.15  commissioner of the conviction.  The commissioner, in 
 58.16  consultation with the commissioner of corrections, shall develop 
 58.17  forms and information necessary to implement this paragraph and 
 58.18  shall provide the forms and information to the commissioner of 
 58.19  corrections for distribution to local probation officers and 
 58.20  corrections agents.  The commissioner shall inform individuals 
 58.21  subject to a background study that criminal convictions for 
 58.22  disqualifying crimes will be reported to the commissioner by the 
 58.23  corrections system.  A probation officer, corrections agent, or 
 58.24  corrections agency is not civilly or criminally liable for 
 58.25  disclosing or failing to disclose the information required by 
 58.26  this paragraph.  Upon receipt of disqualifying information, the 
 58.27  commissioner shall provide the notifications required in 
 58.28  subdivision 3a, as appropriate to agencies on record as having 
 58.29  initiated a background study or making a request for 
 58.30  documentation of the background study status of the individual.  
 58.31  This paragraph does not apply to family day care and child 
 58.32  foster care programs. 
 58.33     (e) (f) The individual who is the subject of the study must 
 58.34  provide the applicant or license holder with sufficient 
 58.35  information to ensure an accurate study including the 
 58.36  individual's first, middle, and last name; home address, city, 
 59.1   county, and state of residence for the past five years; zip 
 59.2   code; sex; date of birth; and driver's license number.  The 
 59.3   applicant or license holder shall provide this information about 
 59.4   an individual in paragraph (c) (d), clauses (1) to (5), on forms 
 59.5   prescribed by the commissioner.  By January 1, 2000, for 
 59.6   background studies conducted by the department of human 
 59.7   services, the commissioner shall implement a system for the 
 59.8   electronic transmission of:  (1) background study information to 
 59.9   the commissioner; and (2) background study results to the 
 59.10  license holder.  The commissioner may request additional 
 59.11  information of the individual, which shall be optional for the 
 59.12  individual to provide, such as the individual's social security 
 59.13  number or race. 
 59.14     (f) (g) Except for child foster care, adult foster care, 
 59.15  and family day care homes, a study must include information 
 59.16  related to names of substantiated perpetrators of maltreatment 
 59.17  of vulnerable adults that has been received by the commissioner 
 59.18  as required under section 626.557, subdivision 9c, paragraph 
 59.19  (i), and the commissioner's records relating to the maltreatment 
 59.20  of minors in licensed programs, information from juvenile courts 
 59.21  as required in paragraph (c) (d) for persons listed in paragraph 
 59.22  (c) (d), clause (2), and information from the bureau of criminal 
 59.23  apprehension.  For child foster care, adult foster care, and 
 59.24  family day care homes, the study must include information from 
 59.25  the county agency's record of substantiated maltreatment of 
 59.26  adults, and the maltreatment of minors, information from 
 59.27  juvenile courts as required in paragraph (c) (d) for persons 
 59.28  listed in paragraph (c) (d), clause (2), and information from 
 59.29  the bureau of criminal apprehension.  The commissioner may also 
 59.30  review arrest and investigative information from the bureau of 
 59.31  criminal apprehension, the commissioner of health, a county 
 59.32  attorney, county sheriff, county agency, local chief of police, 
 59.33  other states, the courts, or the Federal Bureau of Investigation 
 59.34  if the commissioner has reasonable cause to believe the 
 59.35  information is pertinent to the disqualification of an 
 59.36  individual listed in paragraph (c) (d), clauses (1) to (5).  The 
 60.1   commissioner is not required to conduct more than one review of 
 60.2   a subject's records from the Federal Bureau of Investigation if 
 60.3   a review of the subject's criminal history with the Federal 
 60.4   Bureau of Investigation has already been completed by the 
 60.5   commissioner and there has been no break in the subject's 
 60.6   affiliation with the license holder who initiated the background 
 60.7   studies. 
 60.8      When the commissioner has reasonable cause to believe that 
 60.9   further pertinent information may exist on the subject, the 
 60.10  subject shall provide a set of classifiable fingerprints 
 60.11  obtained from an authorized law enforcement agency.  For 
 60.12  purposes of requiring fingerprints, the commissioner shall be 
 60.13  considered to have reasonable cause under, but not limited to, 
 60.14  the following circumstances: 
 60.15     (1) information from the bureau of criminal apprehension 
 60.16  indicates that the subject is a multistate offender; 
 60.17     (2) information from the bureau of criminal apprehension 
 60.18  indicates that multistate offender status is undetermined; or 
 60.19     (3) the commissioner has received a report from the subject 
 60.20  or a third party indicating that the subject has a criminal 
 60.21  history in a jurisdiction other than Minnesota. 
 60.22     (g) (h) An applicant's or, license holder's, or 
 60.23  registrant's failure or refusal to cooperate with the 
 60.24  commissioner is reasonable cause to disqualify a subject, deny a 
 60.25  license application or immediately suspend, suspend, or revoke a 
 60.26  license or registration.  Failure or refusal of an individual to 
 60.27  cooperate with the study is just cause for denying or 
 60.28  terminating employment of the individual if the individual's 
 60.29  failure or refusal to cooperate could cause the applicant's 
 60.30  application to be denied or the license holder's license to be 
 60.31  immediately suspended, suspended, or revoked. 
 60.32     (h) (i) The commissioner shall not consider an application 
 60.33  to be complete until all of the information required to be 
 60.34  provided under this subdivision has been received.  
 60.35     (i) (j) No person in paragraph (c) (d), clause (1), (2), 
 60.36  (3), (4), or (5), who is disqualified as a result of this 
 61.1   section may be retained by the agency in a position involving 
 61.2   direct contact with persons served by the program. 
 61.3      (j) (k) Termination of persons in paragraph (c) (d), clause 
 61.4   (1), (2), (3), (4), or (5), made in good faith reliance on a 
 61.5   notice of disqualification provided by the commissioner shall 
 61.6   not subject the applicant or license holder to civil liability. 
 61.7      (k) (l) The commissioner may establish records to fulfill 
 61.8   the requirements of this section. 
 61.9      (l) (m) The commissioner may not disqualify an individual 
 61.10  subject to a study under this section because that person has, 
 61.11  or has had, a mental illness as defined in section 245.462, 
 61.12  subdivision 20. 
 61.13     (m) (n) An individual subject to disqualification under 
 61.14  this subdivision has the applicable rights in subdivision 3a, 
 61.15  3b, or 3c. 
 61.16     (n) (o) For the purposes of background studies completed by 
 61.17  tribal organizations performing licensing activities otherwise 
 61.18  required of the commissioner under this chapter, after obtaining 
 61.19  consent from the background study subject, tribal licensing 
 61.20  agencies shall have access to criminal history data in the same 
 61.21  manner as county licensing agencies and private licensing 
 61.22  agencies under this chapter. 
 61.23     Sec. 8.  Minnesota Statutes 2000, section 245A.04, 
 61.24  subdivision 3a, is amended to read: 
 61.25     Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
 61.26  STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 
 61.27  commissioner shall notify the applicant or, license holder, or 
 61.28  registrant and the individual who is the subject of the study, 
 61.29  in writing or by electronic transmission, of the results of the 
 61.30  study.  When the study is completed, a notice that the study was 
 61.31  undertaken and completed shall be maintained in the personnel 
 61.32  files of the program.  For studies on individuals pertaining to 
 61.33  a license to provide family day care or group family day care, 
 61.34  foster care for children in the provider's own home, or foster 
 61.35  care or day care services for adults in the provider's own home, 
 61.36  the commissioner is not required to provide a separate notice of 
 62.1   the background study results to the individual who is the 
 62.2   subject of the study unless the study results in a 
 62.3   disqualification of the individual. 
 62.4      The commissioner shall notify the individual studied if the 
 62.5   information in the study indicates the individual is 
 62.6   disqualified from direct contact with persons served by the 
 62.7   program.  The commissioner shall disclose the information 
 62.8   causing disqualification and instructions on how to request a 
 62.9   reconsideration of the disqualification to the individual 
 62.10  studied.  An applicant or license holder who is not the subject 
 62.11  of the study shall be informed that the commissioner has found 
 62.12  information that disqualifies the subject from direct contact 
 62.13  with persons served by the program.  However, only the 
 62.14  individual studied must be informed of the information contained 
 62.15  in the subject's background study unless the only basis for the 
 62.16  disqualification is failure to cooperate, the Data Practices Act 
 62.17  provides for release of the information, or the individual 
 62.18  studied authorizes the release of the information. 
 62.19     (b) If the commissioner determines that the individual 
 62.20  studied has a disqualifying characteristic, the commissioner 
 62.21  shall review the information immediately available and make a 
 62.22  determination as to the subject's immediate risk of harm to 
 62.23  persons served by the program where the individual studied will 
 62.24  have direct contact.  The commissioner shall consider all 
 62.25  relevant information available, including the following factors 
 62.26  in determining the immediate risk of harm:  the recency of the 
 62.27  disqualifying characteristic; the recency of discharge from 
 62.28  probation for the crimes; the number of disqualifying 
 62.29  characteristics; the intrusiveness or violence of the 
 62.30  disqualifying characteristic; the vulnerability of the victim 
 62.31  involved in the disqualifying characteristic; and the similarity 
 62.32  of the victim to the persons served by the program where the 
 62.33  individual studied will have direct contact.  The commissioner 
 62.34  may determine that the evaluation of the information immediately 
 62.35  available gives the commissioner reason to believe one of the 
 62.36  following: 
 63.1      (1) The individual poses an imminent risk of harm to 
 63.2   persons served by the program where the individual studied will 
 63.3   have direct contact.  If the commissioner determines that an 
 63.4   individual studied poses an imminent risk of harm to persons 
 63.5   served by the program where the individual studied will have 
 63.6   direct contact, the individual and the license holder must be 
 63.7   sent a notice of disqualification.  The commissioner shall order 
 63.8   the license holder to immediately remove the individual studied 
 63.9   from direct contact.  The notice to the individual studied must 
 63.10  include an explanation of the basis of this determination. 
 63.11     (2) The individual poses a risk of harm requiring 
 63.12  continuous supervision while providing direct contact services 
 63.13  during the period in which the subject may request a 
 63.14  reconsideration.  If the commissioner determines that an 
 63.15  individual studied poses a risk of harm that requires continuous 
 63.16  supervision, the individual and the license holder must be sent 
 63.17  a notice of disqualification.  The commissioner shall order the 
 63.18  license holder to immediately remove the individual studied from 
 63.19  direct contact services or assure that the individual studied is 
 63.20  within sight or hearing of another staff person when providing 
 63.21  direct contact services during the period in which the 
 63.22  individual may request a reconsideration of the 
 63.23  disqualification.  If the individual studied does not submit a 
 63.24  timely request for reconsideration, or the individual submits a 
 63.25  timely request for reconsideration, but the disqualification is 
 63.26  not set aside for that license holder, the license holder will 
 63.27  be notified of the disqualification and ordered to immediately 
 63.28  remove the individual from any position allowing direct contact 
 63.29  with persons receiving services from the license holder. 
 63.30     (3) The individual does not pose an imminent risk of harm 
 63.31  or a risk of harm requiring continuous supervision while 
 63.32  providing direct contact services during the period in which the 
 63.33  subject may request a reconsideration.  If the commissioner 
 63.34  determines that an individual studied does not pose a risk of 
 63.35  harm that requires continuous supervision, only the individual 
 63.36  must be sent a notice of disqualification.  The license holder 
 64.1   must be sent a notice that more time is needed to complete the 
 64.2   individual's background study.  If the individual studied 
 64.3   submits a timely request for reconsideration, and if the 
 64.4   disqualification is set aside for that license holder, the 
 64.5   license holder will receive the same notification received by 
 64.6   license holders in cases where the individual studied has no 
 64.7   disqualifying characteristic.  If the individual studied does 
 64.8   not submit a timely request for reconsideration, or the 
 64.9   individual submits a timely request for reconsideration, but the 
 64.10  disqualification is not set aside for that license holder, the 
 64.11  license holder will be notified of the disqualification and 
 64.12  ordered to immediately remove the individual from any position 
 64.13  allowing direct contact with persons receiving services from the 
 64.14  license holder.  
 64.15     (c) County licensing agencies performing duties under this 
 64.16  subdivision may develop an alternative system for determining 
 64.17  the subject's immediate risk of harm to persons served by the 
 64.18  program, providing the notices under paragraph (b), and 
 64.19  documenting the action taken by the county licensing agency.  
 64.20  Each county licensing agency's implementation of the alternative 
 64.21  system is subject to approval by the commissioner.  
 64.22  Notwithstanding this alternative system, county licensing 
 64.23  agencies shall complete the requirements of paragraph (a). 
 64.24     Sec. 9.  Minnesota Statutes 2000, section 245A.04, 
 64.25  subdivision 3b, is amended to read: 
 64.26     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
 64.27  individual who is the subject of the disqualification may 
 64.28  request a reconsideration of the disqualification.  
 64.29     The individual must submit the request for reconsideration 
 64.30  to the commissioner in writing.  A request for reconsideration 
 64.31  for an individual who has been sent a notice of disqualification 
 64.32  under subdivision 3a, paragraph (b), clause (1) or (2), must be 
 64.33  submitted within 30 calendar days of the disqualified 
 64.34  individual's receipt of the notice of disqualification.  A 
 64.35  request for reconsideration for an individual who has been sent 
 64.36  a notice of disqualification under subdivision 3a, paragraph 
 65.1   (b), clause (3), must be submitted within 15 calendar days of 
 65.2   the disqualified individual's receipt of the notice of 
 65.3   disqualification.  Removal of a disqualified individual from 
 65.4   direct contact shall be ordered if the individual does not 
 65.5   request reconsideration within the prescribed time, and for an 
 65.6   individual who submits a timely request for reconsideration, if 
 65.7   the disqualification is not set aside.  The individual must 
 65.8   present information showing that: 
 65.9      (1) the information the commissioner relied upon is 
 65.10  incorrect or inaccurate.  If the basis of a reconsideration 
 65.11  request is that a maltreatment determination or disposition 
 65.12  under section 626.556 or 626.557 is incorrect, and the 
 65.13  commissioner has issued a final order in an appeal of that 
 65.14  determination or disposition under section 256.045, the 
 65.15  commissioner's order is conclusive on the issue of maltreatment; 
 65.16  or 
 65.17     (2) the subject of the study does not pose a risk of harm 
 65.18  to any person served by the applicant or, license holder, or 
 65.19  registrant. 
 65.20     (b) The commissioner may set aside the disqualification 
 65.21  under this section if the commissioner finds that the 
 65.22  information the commissioner relied upon is incorrect or the 
 65.23  individual does not pose a risk of harm to any person served by 
 65.24  the applicant or, license holder, or registrant.  In determining 
 65.25  that an individual does not pose a risk of harm, the 
 65.26  commissioner shall consider the consequences of the event or 
 65.27  events that lead to disqualification, whether there is more than 
 65.28  one disqualifying event, the vulnerability of the victim at the 
 65.29  time of the event, the time elapsed without a repeat of the same 
 65.30  or similar event, documentation of successful completion by the 
 65.31  individual studied of training or rehabilitation pertinent to 
 65.32  the event, and any other information relevant to 
 65.33  reconsideration.  In reviewing a disqualification under this 
 65.34  section, the commissioner shall give preeminent weight to the 
 65.35  safety of each person to be served by the license holder or, 
 65.36  applicant, or registrant over the interests of the license 
 66.1   holder or, applicant, or registrant. 
 66.2      (c) Unless the information the commissioner relied on in 
 66.3   disqualifying an individual is incorrect, the commissioner may 
 66.4   not set aside the disqualification of an individual in 
 66.5   connection with a license to provide family day care for 
 66.6   children, foster care for children in the provider's own home, 
 66.7   or foster care or day care services for adults in the provider's 
 66.8   own home if: 
 66.9      (1) less than ten years have passed since the discharge of 
 66.10  the sentence imposed for the offense; and the individual has 
 66.11  been convicted of a violation of any offense listed in sections 
 66.12  609.20 (manslaughter in the first degree), 609.205 (manslaughter 
 66.13  in the second degree), criminal vehicular homicide under 609.21 
 66.14  (criminal vehicular homicide and injury), 609.215 (aiding 
 66.15  suicide or aiding attempted suicide), felony violations under 
 66.16  609.221 to 609.2231 (assault in the first, second, third, or 
 66.17  fourth degree), 609.713 (terroristic threats), 609.235 (use of 
 66.18  drugs to injure or to facilitate crime), 609.24 (simple 
 66.19  robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
 66.20  609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
 66.21  first or second degree), 609.71 (riot), burglary in the first or 
 66.22  second degree under 609.582 (burglary), 609.66 (dangerous 
 66.23  weapon), 609.665 (spring guns), 609.67 (machine guns and 
 66.24  short-barreled shotguns), 609.749 (harassment; stalking), 
 66.25  152.021 or 152.022 (controlled substance crime in the first or 
 66.26  second degree), 152.023, subdivision 1, clause (3) or (4), or 
 66.27  subdivision 2, clause (4) (controlled substance crime in the 
 66.28  third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
 66.29  (controlled substance crime in the fourth degree), 609.224, 
 66.30  subdivision 2, paragraph (c) (fifth-degree assault by a 
 66.31  caregiver against a vulnerable adult), 609.228 (great bodily 
 66.32  harm caused by distribution of drugs), 609.23 (mistreatment of 
 66.33  persons confined), 609.231 (mistreatment of residents or 
 66.34  patients), 609.2325 (criminal abuse of a vulnerable adult), 
 66.35  609.233 (criminal neglect of a vulnerable adult), 609.2335 
 66.36  (financial exploitation of a vulnerable adult), 609.234 (failure 
 67.1   to report), 609.265 (abduction), 609.2664 to 609.2665 
 67.2   (manslaughter of an unborn child in the first or second degree), 
 67.3   609.267 to 609.2672 (assault of an unborn child in the first, 
 67.4   second, or third degree), 609.268 (injury or death of an unborn 
 67.5   child in the commission of a crime), 617.293 (disseminating or 
 67.6   displaying harmful material to minors), a gross misdemeanor 
 67.7   offense under 609.324, subdivision 1 (other prohibited acts), a 
 67.8   gross misdemeanor offense under 609.378 (neglect or endangerment 
 67.9   of a child), a gross misdemeanor offense under 609.377 
 67.10  (malicious punishment of a child), 609.72, subdivision 3 
 67.11  (disorderly conduct against a vulnerable adult); or an attempt 
 67.12  or conspiracy to commit any of these offenses, as each of these 
 67.13  offenses is defined in Minnesota Statutes; or an offense in any 
 67.14  other state, the elements of which are substantially similar to 
 67.15  the elements of any of the foregoing offenses; 
 67.16     (2) regardless of how much time has passed since the 
 67.17  discharge of the sentence imposed for the offense, the 
 67.18  individual was convicted of a violation of any offense listed in 
 67.19  sections 609.185 to 609.195 (murder in the first, second, or 
 67.20  third degree), 609.2661 to 609.2663 (murder of an unborn child 
 67.21  in the first, second, or third degree), a felony offense under 
 67.22  609.377 (malicious punishment of a child), a felony offense 
 67.23  under 609.324, subdivision 1 (other prohibited acts), a felony 
 67.24  offense under 609.378 (neglect or endangerment of a child), 
 67.25  609.322 (solicitation, inducement, and promotion of 
 67.26  prostitution), 609.342 to 609.345 (criminal sexual conduct in 
 67.27  the first, second, third, or fourth degree), 609.352 
 67.28  (solicitation of children to engage in sexual conduct), 617.246 
 67.29  (use of minors in a sexual performance), 617.247 (possession of 
 67.30  pictorial representations of a minor), 609.365 (incest), a 
 67.31  felony offense under sections 609.2242 and 609.2243 (domestic 
 67.32  assault), a felony offense of spousal abuse, a felony offense of 
 67.33  child abuse or neglect, a felony offense of a crime against 
 67.34  children, or an attempt or conspiracy to commit any of these 
 67.35  offenses as defined in Minnesota Statutes, or an offense in any 
 67.36  other state, the elements of which are substantially similar to 
 68.1   any of the foregoing offenses; 
 68.2      (3) within the seven years preceding the study, the 
 68.3   individual committed an act that constitutes maltreatment of a 
 68.4   child under section 626.556, subdivision 10e, and that resulted 
 68.5   in substantial bodily harm as defined in section 609.02, 
 68.6   subdivision 7a, or substantial mental or emotional harm as 
 68.7   supported by competent psychological or psychiatric evidence; or 
 68.8      (4) within the seven years preceding the study, the 
 68.9   individual was determined under section 626.557 to be the 
 68.10  perpetrator of a substantiated incident of maltreatment of a 
 68.11  vulnerable adult that resulted in substantial bodily harm as 
 68.12  defined in section 609.02, subdivision 7a, or substantial mental 
 68.13  or emotional harm as supported by competent psychological or 
 68.14  psychiatric evidence. 
 68.15     In the case of any ground for disqualification under 
 68.16  clauses (1) to (4), if the act was committed by an individual 
 68.17  other than the applicant or, license holder, or registrant 
 68.18  residing in the applicant's or, license holder's, or 
 68.19  registrant's home, the applicant or, license holder, or 
 68.20  registrant may seek reconsideration when the individual who 
 68.21  committed the act no longer resides in the home.  
 68.22     The disqualification periods provided under clauses (1), 
 68.23  (3), and (4) are the minimum applicable disqualification 
 68.24  periods.  The commissioner may determine that an individual 
 68.25  should continue to be disqualified from licensure or 
 68.26  registration because the license holder or, registrant, or 
 68.27  applicant poses a risk of harm to a person served by that 
 68.28  individual after the minimum disqualification period has passed. 
 68.29     (d) The commissioner shall respond in writing or by 
 68.30  electronic transmission to all reconsideration requests for 
 68.31  which the basis for the request is that the information relied 
 68.32  upon by the commissioner to disqualify is incorrect or 
 68.33  inaccurate within 30 working days of receipt of a request and 
 68.34  all relevant information.  If the basis for the request is that 
 68.35  the individual does not pose a risk of harm, the commissioner 
 68.36  shall respond to the request within 15 working days after 
 69.1   receiving the request for reconsideration and all relevant 
 69.2   information.  If the disqualification is set aside, the 
 69.3   commissioner shall notify the applicant or license holder in 
 69.4   writing or by electronic transmission of the decision. 
 69.5      (e) Except as provided in subdivision 3c, the 
 69.6   commissioner's decision to disqualify an individual, including 
 69.7   the decision to grant or deny a rescission or set aside a 
 69.8   disqualification under this section, is the final administrative 
 69.9   agency action and shall not be subject to further review in a 
 69.10  contested case under chapter 14 involving a negative licensing 
 69.11  appeal taken in response to the disqualification or involving an 
 69.12  accuracy and completeness appeal under section 13.04. 
 69.13     Sec. 10.  Minnesota Statutes 2000, section 245A.04, 
 69.14  subdivision 3d, is amended to read: 
 69.15     Subd. 3d.  [DISQUALIFICATION.] (a) Except as provided in 
 69.16  paragraph (b), when a background study completed under 
 69.17  subdivision 3 shows any of the following:  a conviction of one 
 69.18  or more crimes listed in clauses (1) to (4); the individual has 
 69.19  admitted to or a preponderance of the evidence indicates the 
 69.20  individual has committed an act or acts that meet the definition 
 69.21  of any of the crimes listed in clauses (1) to (4); or an 
 69.22  administrative determination listed under clause (4), the 
 69.23  individual shall be disqualified from any position allowing 
 69.24  direct contact with persons receiving services from the license 
 69.25  holder or registrant: 
 69.26     (1) regardless of how much time has passed since the 
 69.27  discharge of the sentence imposed for the offense, and unless 
 69.28  otherwise specified, regardless of the level of the conviction, 
 69.29  the individual was convicted of any of the following offenses:  
 69.30  sections 609.185 (murder in the first degree); 609.19 (murder in 
 69.31  the second degree); 609.195 (murder in the third degree); 
 69.32  609.2661 (murder of an unborn child in the first degree); 
 69.33  609.2662 (murder of an unborn child in the second degree); 
 69.34  609.2663 (murder of an unborn child in the third degree); 
 69.35  609.322 (solicitation, inducement, and promotion of 
 69.36  prostitution); 609.342 (criminal sexual conduct in the first 
 70.1   degree); 609.343 (criminal sexual conduct in the second degree); 
 70.2   609.344 (criminal sexual conduct in the third degree); 609.345 
 70.3   (criminal sexual conduct in the fourth degree); 609.352 
 70.4   (solicitation of children to engage in sexual conduct); 609.365 
 70.5   (incest); felony offense under 609.377 (malicious punishment of 
 70.6   a child); a felony offense under 609.378 (neglect or 
 70.7   endangerment of a child); a felony offense under 609.324, 
 70.8   subdivision 1 (other prohibited acts); 617.246 (use of minors in 
 70.9   sexual performance prohibited); 617.247 (possession of pictorial 
 70.10  representations of minors); a felony offense under sections 
 70.11  609.2242 and 609.2243 (domestic assault), a felony offense of 
 70.12  spousal abuse, a felony offense of child abuse or neglect, a 
 70.13  felony offense of a crime against children; or attempt or 
 70.14  conspiracy to commit any of these offenses as defined in 
 70.15  Minnesota Statutes, or an offense in any other state or country, 
 70.16  where the elements are substantially similar to any of the 
 70.17  offenses listed in this clause; 
 70.18     (2) if less than 15 years have passed since the discharge 
 70.19  of the sentence imposed for the offense; and the individual has 
 70.20  received a felony conviction for a violation of any of these 
 70.21  offenses:  sections 609.20 (manslaughter in the first degree); 
 70.22  609.205 (manslaughter in the second degree); 609.21 (criminal 
 70.23  vehicular homicide and injury); 609.215 (suicide); 609.221 to 
 70.24  609.2231 (assault in the first, second, third, or fourth 
 70.25  degree); repeat offenses under 609.224 (assault in the fifth 
 70.26  degree); repeat offenses under 609.3451 (criminal sexual conduct 
 70.27  in the fifth degree); 609.713 (terroristic threats); 609.235 
 70.28  (use of drugs to injure or facilitate crime); 609.24 (simple 
 70.29  robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 
 70.30  609.255 (false imprisonment); 609.561 (arson in the first 
 70.31  degree); 609.562 (arson in the second degree); 609.563 (arson in 
 70.32  the third degree); repeat offenses under 617.23 (indecent 
 70.33  exposure; penalties); repeat offenses under 617.241 (obscene 
 70.34  materials and performances; distribution and exhibition 
 70.35  prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 
 70.36  609.67 (machine guns and short-barreled shotguns); 609.749 
 71.1   (harassment; stalking; penalties); 609.228 (great bodily harm 
 71.2   caused by distribution of drugs); 609.2325 (criminal abuse of a 
 71.3   vulnerable adult); 609.2664 (manslaughter of an unborn child in 
 71.4   the first degree); 609.2665 (manslaughter of an unborn child in 
 71.5   the second degree); 609.267 (assault of an unborn child in the 
 71.6   first degree); 609.2671 (assault of an unborn child in the 
 71.7   second degree); 609.268 (injury or death of an unborn child in 
 71.8   the commission of a crime); 609.52 (theft); 609.2335 (financial 
 71.9   exploitation of a vulnerable adult); 609.521 (possession of 
 71.10  shoplifting gear); 609.582 (burglary); 609.625 (aggravated 
 71.11  forgery); 609.63 (forgery); 609.631 (check forgery; offering a 
 71.12  forged check); 609.635 (obtaining signature by false pretense); 
 71.13  609.27 (coercion); 609.275 (attempt to coerce); 609.687 
 71.14  (adulteration); 260C.301 (grounds for termination of parental 
 71.15  rights); and chapter 152 (drugs; controlled substance).  An 
 71.16  attempt or conspiracy to commit any of these offenses, as each 
 71.17  of these offenses is defined in Minnesota Statutes; or an 
 71.18  offense in any other state or country, the elements of which are 
 71.19  substantially similar to the elements of the offenses in this 
 71.20  clause.  If the individual studied is convicted of one of the 
 71.21  felonies listed in this clause, but the sentence is a gross 
 71.22  misdemeanor or misdemeanor disposition, the lookback period for 
 71.23  the conviction is the period applicable to the disposition, that 
 71.24  is the period for gross misdemeanors or misdemeanors; 
 71.25     (3) if less than ten years have passed since the discharge 
 71.26  of the sentence imposed for the offense; and the individual has 
 71.27  received a gross misdemeanor conviction for a violation of any 
 71.28  of the following offenses:  sections 609.224 (assault in the 
 71.29  fifth degree); 609.2242 and 609.2243 (domestic assault); 
 71.30  violation of an order for protection under 518B.01, subdivision 
 71.31  14; 609.3451 (criminal sexual conduct in the fifth degree); 
 71.32  repeat offenses under 609.746 (interference with privacy); 
 71.33  repeat offenses under 617.23 (indecent exposure); 617.241 
 71.34  (obscene materials and performances); 617.243 (indecent 
 71.35  literature, distribution); 617.293 (harmful materials; 
 71.36  dissemination and display to minors prohibited); 609.71 (riot); 
 72.1   609.66 (dangerous weapons); 609.749 (harassment; stalking; 
 72.2   penalties); 609.224, subdivision 2, paragraph (c) (assault in 
 72.3   the fifth degree by a caregiver against a vulnerable adult); 
 72.4   609.23 (mistreatment of persons confined); 609.231 (mistreatment 
 72.5   of residents or patients); 609.2325 (criminal abuse of a 
 72.6   vulnerable adult); 609.233 (criminal neglect of a vulnerable 
 72.7   adult); 609.2335 (financial exploitation of a vulnerable adult); 
 72.8   609.234 (failure to report maltreatment of a vulnerable adult); 
 72.9   609.72, subdivision 3 (disorderly conduct against a vulnerable 
 72.10  adult); 609.265 (abduction); 609.378 (neglect or endangerment of 
 72.11  a child); 609.377 (malicious punishment of a child); 609.324, 
 72.12  subdivision 1a (other prohibited acts; minor engaged in 
 72.13  prostitution); 609.33 (disorderly house); 609.52 (theft); 
 72.14  609.582 (burglary); 609.631 (check forgery; offering a forged 
 72.15  check); 609.275 (attempt to coerce); or an attempt or conspiracy 
 72.16  to commit any of these offenses, as each of these offenses is 
 72.17  defined in Minnesota Statutes; or an offense in any other state 
 72.18  or country, the elements of which are substantially similar to 
 72.19  the elements of any of the offenses listed in this clause.  If 
 72.20  the defendant is convicted of one of the gross misdemeanors 
 72.21  listed in this clause, but the sentence is a misdemeanor 
 72.22  disposition, the lookback period for the conviction is the 
 72.23  period applicable to misdemeanors; or 
 72.24     (4) if less than seven years have passed since the 
 72.25  discharge of the sentence imposed for the offense; and the 
 72.26  individual has received a misdemeanor conviction for a violation 
 72.27  of any of the following offenses:  sections 609.224 (assault in 
 72.28  the fifth degree); 609.2242 (domestic assault); violation of an 
 72.29  order for protection under 518B.01 (Domestic Abuse Act); 
 72.30  violation of an order for protection under 609.3232 (protective 
 72.31  order authorized; procedures; penalties); 609.746 (interference 
 72.32  with privacy); 609.79 (obscene or harassing phone calls); 
 72.33  609.795 (letter, telegram, or package; opening; harassment); 
 72.34  617.23 (indecent exposure; penalties); 609.2672 (assault of an 
 72.35  unborn child in the third degree); 617.293 (harmful materials; 
 72.36  dissemination and display to minors prohibited); 609.66 
 73.1   (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 
 73.2   exploitation of a vulnerable adult); 609.234 (failure to report 
 73.3   maltreatment of a vulnerable adult); 609.52 (theft); 609.27 
 73.4   (coercion); or an attempt or conspiracy to commit any of these 
 73.5   offenses, as each of these offenses is defined in Minnesota 
 73.6   Statutes; or an offense in any other state or country, the 
 73.7   elements of which are substantially similar to the elements of 
 73.8   any of the offenses listed in this clause; failure to make 
 73.9   required reports under section 626.556, subdivision 3, or 
 73.10  626.557, subdivision 3, for incidents in which:  (i) the final 
 73.11  disposition under section 626.556 or 626.557 was substantiated 
 73.12  maltreatment, and (ii) the maltreatment was recurring or 
 73.13  serious; or substantiated serious or recurring maltreatment of a 
 73.14  minor under section 626.556 or of a vulnerable adult under 
 73.15  section 626.557 for which there is a preponderance of evidence 
 73.16  that the maltreatment occurred, and that the subject was 
 73.17  responsible for the maltreatment. 
 73.18     For the purposes of this section, "serious maltreatment" 
 73.19  means sexual abuse; maltreatment resulting in death; or 
 73.20  maltreatment resulting in serious injury which reasonably 
 73.21  requires the care of a physician whether or not the care of a 
 73.22  physician was sought; or abuse resulting in serious injury.  For 
 73.23  purposes of this section, "abuse resulting in serious injury" 
 73.24  means:  bruises, bites, skin laceration or tissue damage; 
 73.25  fractures; dislocations; evidence of internal injuries; head 
 73.26  injuries with loss of consciousness; extensive second-degree or 
 73.27  third-degree burns and other burns for which complications are 
 73.28  present; extensive second-degree or third-degree frostbite, and 
 73.29  others for which complications are present; irreversible 
 73.30  mobility or avulsion of teeth; injuries to the eyeball; 
 73.31  ingestion of foreign substances and objects that are harmful; 
 73.32  near drowning; and heat exhaustion or sunstroke.  For purposes 
 73.33  of this section, "care of a physician" is treatment received or 
 73.34  ordered by a physician, but does not include diagnostic testing, 
 73.35  assessment, or observation.  For the purposes of this section, 
 73.36  "recurring maltreatment" means more than one incident of 
 74.1   maltreatment for which there is a preponderance of evidence that 
 74.2   the maltreatment occurred, and that the subject was responsible 
 74.3   for the maltreatment. 
 74.4      (b) If the subject of a background study is licensed by a 
 74.5   health-related licensing board, the board shall make the 
 74.6   determination regarding a disqualification under this 
 74.7   subdivision based on a finding of substantiated maltreatment 
 74.8   under section 626.556 or 626.557.  The commissioner shall notify 
 74.9   the health-related licensing board if a background study shows 
 74.10  that a licensee would be disqualified because of substantiated 
 74.11  maltreatment and the board shall make a determination under 
 74.12  section 214.104. 
 74.13     Sec. 11.  [APPROPRIATION.] 
 74.14     $....... is appropriated from the general fund to the 
 74.15  commissioner of health for the biennium beginning July 1, 2001, 
 74.16  to regulate supplemental nursing services agencies. 
 74.17                             ARTICLE 5
 74.18                      LONG-TERM CARE INSURANCE
 74.19     Section 1.  Minnesota Statutes 2000, section 256.975, is 
 74.20  amended by adding a subdivision to read: 
 74.21     Subd. 8.  [PROMOTION OF LONG-TERM CARE INSURANCE.] The 
 74.22  Minnesota board on aging, either directly or through contract, 
 74.23  shall promote the provision of employer-sponsored long-term care 
 74.24  insurance.  The board shall encourage private- and public-sector 
 74.25  employers to make long-term care insurance available to 
 74.26  employees, provide interested employers with information on the 
 74.27  long-term care insurance product offered to state employees, and 
 74.28  provide technical assistance to employers in designing long-term 
 74.29  care insurance products and contacting health plan companies 
 74.30  offering long-term care insurance products. 
 74.31     Sec. 2.  [APPROPRIATION.] 
 74.32     $....... is appropriated from the general fund to the 
 74.33  commissioner of human services for the biennium ending June 30, 
 74.34  2003, for the board on aging to promote employer-sponsored 
 74.35  long-term care insurance as required under section 1.